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  Autosomal recessive mental retardation, deafness, ankylosis, and mild hypophosphatemia associated with a novel ANKH mutation in a consanguineous family

Morava, E., Kuhnisch, J., Drijvers, J. M., Robben, J. H., Cremers, C., van Setten, P., et al. (2011). Autosomal recessive mental retardation, deafness, ankylosis, and mild hypophosphatemia associated with a novel ANKH mutation in a consanguineous family. J Clin Endocrinol Metab, 96(1), E189-98. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20943778 http://jcem.endojournals.org/content/96/1/E189.full.pdf.

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Morava, E., Author
Kuhnisch, J., Author
Drijvers, J. M., Author
Robben, J. H., Author
Cremers, C., Author
van Setten, P., Author
Branten, A., Author
Stumpp, S., Author
de Jong, A., Author
Voesenek, K., Author
Vermeer, S., Author
Heister, A., Author
Claahsen-van der Grinten, H. L., Author
O'Neill, C. W., Author
Willemsen, M. A., Author
Lefeber, D., Author
Deen, P. M., Author
Kornak, U.1, Author           
Kremer, H., Author
Wevers, R. A., Author
1Research Group Development & Disease (Head: Stefan Mundlos), Max Planck Institute for Molecular Genetics, Max Planck Society, ou_1433557              


Free keywords: Ankylosis/*genetics; Bone Diseases, Metabolic/genetics; Calcinosis/genetics/pathology; Consanguinity; Deafness/*genetics; Humans; Hypophosphatemia/*genetics; Intellectual Disability/*genetics; Joints/pathology; Mutation; Pedigree; Phenotype; Phosphate Transport Proteins/*genetics
 Abstract: CONTEXT: Mutations in ANKH cause the highly divergent conditions familial chondrocalcinosis and craniometaphyseal dysplasia. The gene product ANK is supposed to regulate tissue mineralization by transporting pyrophosphate to the extracellular space. OBJECTIVE: We evaluated several family members of a large consanguineous family with mental retardation, deafness, and ankylosis. We compared their skeletal, metabolic, and serological parameters to that of the autosomal recessive progressive ankylosis (ank) mouse mutant, caused by a loss-of-function mutation in the murine ortholog Ank. PARTICIPANTS: The studied patients had painful small joint soft-tissue calcifications, progressive spondylarthropathy, osteopenia, mild hypophosphatemia, mixed hearing loss, and mental retardation. RESULTS: After mapping the disease gene to 5p15, we identified the novel homozygous ANK missense mutation L244S in all patients. Although L244 is a highly conserved amino acid, the mutated ANK protein was detected at normal levels at the plasma membrane in primary patient fibroblasts. The phenotype was highly congruent with the autosomal recessive progressive ankylosis (ank) mouse mutant. This indicates a loss-of-function effect of the L244S mutation despite normal ANK protein expression. Interestingly, our analyses revealed that the primary step of joint degeneration is fibrosis and mineralization of articular soft tissues. Moreover, heterozygous carriers of the L244S mutation showed mild osteoarthritis without metabolic alterations, pathological calcifications, or central nervous system involvement. CONCLUSION: Beyond the description of the first human progressive ankylosis phenotype, our results indicate that ANK influences articular soft tissues commonly involved in degenerative joint disorders. Furthermore, this human disorder provides the first direct evidence for a role of ANK in the central nervous system.


 Dates: 2011
 Publication Status: Published in print
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Title: J Clin Endocrinol Metab
Source Genre: Journal
Publ. Info: -
Pages: - Volume / Issue: 96 (1) Sequence Number: - Start / End Page: E189 - 98 Identifier: ISSN: 1945-7197 (Electronic) 0021-972X (Linking)