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Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic
INTRODUCTION: Retinal degenerative or inflammatory changes may occur with hereditary immunological disorders (HID) due to variants in approximately 20 genes. This study aimed to investigate if such retinopathy may present as an initial sign of immunological disorders in eye clinic. METHODS: The vari...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498122/ https://www.ncbi.nlm.nih.gov/pubmed/37711606 http://dx.doi.org/10.3389/fimmu.2023.1239886 |
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author | Wang, Yingwei Jiang, Yi Wang, Junwen Li, Shiqiang Jia, Xiaoyun Xiao, Xueshan Sun, Wenmin Wang, Panfeng Zhang, Qingjiong |
author_facet | Wang, Yingwei Jiang, Yi Wang, Junwen Li, Shiqiang Jia, Xiaoyun Xiao, Xueshan Sun, Wenmin Wang, Panfeng Zhang, Qingjiong |
author_sort | Wang, Yingwei |
collection | PubMed |
description | INTRODUCTION: Retinal degenerative or inflammatory changes may occur with hereditary immunological disorders (HID) due to variants in approximately 20 genes. This study aimed to investigate if such retinopathy may present as an initial sign of immunological disorders in eye clinic. METHODS: The variants in the 20 genes were selected from in-house exome sequencing data from 10,530 individuals with different eye conditions. Potential pathogenic variants were assessed by multistep bioinformatic analysis. Pathogenic variants were defined according to the ACMG/AMP criteria and confirmed by Sanger sequencing, co-segregation analysis, and consistency with related phenotypes. Ocular clinical data were thoroughly reviewed, especially fundus changes. RESULTS: A total of seven pathogenic variants in four of the 20 genes were detected in six probands from six families, including three with hemizygous nonsense variants p.(Q308*), p.(Q416*), and p.(R550*) in MSN, one with homozygous nonsense variants p.(R257*) in AIRE, one with compound heterozygous nonsense variants p.(R176*) and p.(T902*) in LAMB2, and one with a known c.1222T>C (p.W408R) heterozygous variant in CBL. Ocular presentation, as the initial signs of the diseases, was mainly retinopathy mimicking other forms of hereditary retinal degeneration, including exudative vitreoretinopathy in the three patients with MSN variants or tapetoretinal degeneration in the other three patients. Neither extraocular symptoms nor extraocular manifestations were recorded at the time of visit to our eye clinic. However, of the 19 families in the literature with retinopathy caused by variants in these four genes, only one family with an AIRE homozygous variant had retinopathy as an initial symptom, while the other 18 families had systemic abnormalities that preceded retinopathy. DISCUSSION: This study, for the first time, identified six unrelated patients with retinopathy as their initial and only presenting sign of HID, contrary to the previous reports where retinopathy was the accompanying sign of systemic HID. Recognizing such phenotype of HID may facilitate the clinical care of these patients. Follow-up visits to such patients and additional studies are expected to validate and confirm our findings. |
format | Online Article Text |
id | pubmed-10498122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104981222023-09-14 Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic Wang, Yingwei Jiang, Yi Wang, Junwen Li, Shiqiang Jia, Xiaoyun Xiao, Xueshan Sun, Wenmin Wang, Panfeng Zhang, Qingjiong Front Immunol Immunology INTRODUCTION: Retinal degenerative or inflammatory changes may occur with hereditary immunological disorders (HID) due to variants in approximately 20 genes. This study aimed to investigate if such retinopathy may present as an initial sign of immunological disorders in eye clinic. METHODS: The variants in the 20 genes were selected from in-house exome sequencing data from 10,530 individuals with different eye conditions. Potential pathogenic variants were assessed by multistep bioinformatic analysis. Pathogenic variants were defined according to the ACMG/AMP criteria and confirmed by Sanger sequencing, co-segregation analysis, and consistency with related phenotypes. Ocular clinical data were thoroughly reviewed, especially fundus changes. RESULTS: A total of seven pathogenic variants in four of the 20 genes were detected in six probands from six families, including three with hemizygous nonsense variants p.(Q308*), p.(Q416*), and p.(R550*) in MSN, one with homozygous nonsense variants p.(R257*) in AIRE, one with compound heterozygous nonsense variants p.(R176*) and p.(T902*) in LAMB2, and one with a known c.1222T>C (p.W408R) heterozygous variant in CBL. Ocular presentation, as the initial signs of the diseases, was mainly retinopathy mimicking other forms of hereditary retinal degeneration, including exudative vitreoretinopathy in the three patients with MSN variants or tapetoretinal degeneration in the other three patients. Neither extraocular symptoms nor extraocular manifestations were recorded at the time of visit to our eye clinic. However, of the 19 families in the literature with retinopathy caused by variants in these four genes, only one family with an AIRE homozygous variant had retinopathy as an initial symptom, while the other 18 families had systemic abnormalities that preceded retinopathy. DISCUSSION: This study, for the first time, identified six unrelated patients with retinopathy as their initial and only presenting sign of HID, contrary to the previous reports where retinopathy was the accompanying sign of systemic HID. Recognizing such phenotype of HID may facilitate the clinical care of these patients. Follow-up visits to such patients and additional studies are expected to validate and confirm our findings. Frontiers Media S.A. 2023-08-28 /pmc/articles/PMC10498122/ /pubmed/37711606 http://dx.doi.org/10.3389/fimmu.2023.1239886 Text en Copyright © 2023 Wang, Jiang, Wang, Li, Jia, Xiao, Sun, Wang and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Wang, Yingwei Jiang, Yi Wang, Junwen Li, Shiqiang Jia, Xiaoyun Xiao, Xueshan Sun, Wenmin Wang, Panfeng Zhang, Qingjiong Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title | Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title_full | Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title_fullStr | Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title_full_unstemmed | Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title_short | Retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
title_sort | retinopathy as an initial sign of hereditary immunological diseases: report of six families and challenges in eye clinic |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498122/ https://www.ncbi.nlm.nih.gov/pubmed/37711606 http://dx.doi.org/10.3389/fimmu.2023.1239886 |
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