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      A novel variant of SPAST in a pedigree with pure hereditary spastic paraplegia in Yunnan Province

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          Abstract

          Background

          Hereditary spastic paraplegia (HSP) is a rare group of genetically heterogeneous, neurodegenerative disorders. The aim of this study was to identify pathological candidate genes and variants in a large pedigree cohort of 11 purely HSP patients in Yunnan Province.

          Methods

          Whole-exome sequencing (WES) was applied to 2 HSP patients and 1 control patient to screen out the candidate gene variants. Then, filtration and verification of these pathological variants were performed by Sanger sequencing.

          Results

          After the raw data were filtered, two genes with novel variations ( SPAST: c.1510 C>T, p.Gln504X, RefSeq.NM_199436; DNAJC16: c.718 C>T, p.Q240X, Ref Seq NM_015291) were identified. The accession numbers of the genes in the ClinVar database were SCV001573094 and SCV001573804, respectively. One gene with a reported single nucleotide polymorphism ( CPT1C: rs150853576) was filtered as a candidate variant. Using Sanger sequencing, the novel SPAST gene (protein: Spastin) variant leading to a predicted premature termination and an 18% deletion of the SPAST/spastic paraplegia type 4 (SPG4) protein was confirmed to exist only in affected individuals. The candidate CPT1C and DNAJC16 variants were verified in almost all HSP patients, with one exception.

          Conclusions

          Considering that the clinical symptoms and time of onset of HSP are highly heterogeneous, the SPAST as a genotype-phenotype cosegregated variant might be the causative gene of this pedigree, and the other two variants might present cumulative risks to the occurrence and progression of HSP. These three candidate genes with or without novel variants may be potential contributors to disease onset, and therefore useful diagnostic and therapeutic biomarkers. Further research is required to confirm the functions of these genes.

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          Most cited references36

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          Hereditary spastic paraplegia: clinical-genetic characteristics and evolving molecular mechanisms.

          Hereditary spastic paraplegia (HSP) is a group of clinically and genetically heterogeneous neurological disorders characterized by pathophysiologic hallmark of length-dependent distal axonal degeneration of the corticospinal tracts. The prominent features of this pathological condition are progressive spasticity and weakness of the lower limbs. To date, 72 spastic gait disease-loci and 55 spastic paraplegia genes (SPGs) have been identified. All modes of inheritance (autosomal dominant, autosomal recessive, and X-linked) have been described. Recently, a late onset spastic gait disorder with maternal trait of inheritance has been reported, as well as mutations in genes not yet classified as spastic gait disease. Several cellular processes are involved in its pathogenesis, such as membrane and axonal transport, endoplasmic reticulum membrane modeling and shaping, mitochondrial function, DNA repair, autophagy, and abnormalities in lipid metabolism and myelination processes. Moreover, recent evidences have been found about the impairment of endosome membrane trafficking in vesicle formation and about the involvement of oxidative stress and mtDNA polymorphisms in the onset of the disease. Interactome networks have been postulated by bioinformatics and biological analyses of spastic paraplegia genes, which would contribute to the development of new therapeutic approaches. Copyright © 2014. Published by Elsevier Inc.
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            Hereditary Spastic Paraplegia: Clinical and Genetic Hallmarks.

            Hereditary spastic paraplegia comprises a wide and heterogeneous group of inherited neurodegenerative and neurodevelopmental disorders resulting from primary retrograde dysfunction of the long descending fibers of the corticospinal tract. Although spastic paraparesis and urinary dysfunction represent the most common clinical presentation, a complex group of different neurological and systemic compromise has been recognized recently and a growing number of new genetic subtypes were described in the last decade. Clinical characterization of individual and familial history represents the main step during diagnostic workup; however, frequently, few and unspecific data allows a low rate of definite diagnosis based solely in clinical and neuroimaging basis. Likewise, a wide group of neurological acquired and inherited disorders should be included in the differential diagnosis and properly excluded after a complete laboratorial, neuroimaging, and genetic evaluation. The aim of this review article is to provide an extensive overview regarding the main clinical and genetic features of the classical and recently described subtypes of hereditary spastic paraplegia (HSP).
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              CLASSIFICATION OF THE HEREDITARY ATAXIAS AND PARAPLEGIAS

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                Author and article information

                Journal
                Ann Transl Med
                Ann Transl Med
                ATM
                Annals of Translational Medicine
                AME Publishing Company
                2305-5839
                2305-5847
                January 2022
                January 2022
                : 10
                : 2
                : 67
                Affiliations
                [1 ]deptInstitute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology , The First People’s Hospital of Yunnan Province , Kunming, China;
                [2 ]deptDepartment of Pulmonary and Critical Care Medicine , The First People’s Hospital of Yunnan Province , Kunming, China;
                [3 ]deptDepartment of Digestive System , The First People’s Hospital of Yunnan Province , Kunming, China;
                [4 ]deptDepartment of Neurology , The First People’s Hospital of Yunnan Province , Kunming, China
                Author notes

                Contributions: (I) Conception and design: T Shen, KW Zheng; (II) Administrative support: The First People’s Hospital of Yunnan Province; (III) Provision of study materials or patients: T Shen, KW Zheng; (IV) Collection and assembly of data: L Li, RX Zuo, ZJ Wang, T Xiao; (V) Data analysis and interpretation: T Shen, W Zhang, KW Zheng; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Kun-Wen Zheng. Department of Neurology, The First People’s Hospital of Yunnan Province, No. 157 of Jinbi Street, Kunming 650032, China. Email: cchhww0629@ 123456sina.com ; Tao Shen. Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology, Department of Pulmonary and Critical Care Medicine, The First People’s Hospital of Yunnan Province, No. 157 of Jinbi Street, Kunming 650032, China. Email: ts902@ 123456hotmail.com .
                Article
                atm-10-02-67
                10.21037/atm-21-6698
                8848415
                35282124
                6e60056f-ab4b-4ffb-9ba5-5be8607b9433
                2022 Annals of Translational Medicine. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 23 November 2021
                : 05 January 2022
                Categories
                Original Article

                pure hereditary spastic paraplegia,pedigree,sequencing,pathological variants

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