Evaluation of Genotypes and Epidemiology of Spinal Muscular Atrophy in Greece: A Nationwide Study Spanning 24 Years.


Journal

Journal of neuromuscular diseases
ISSN: 2214-3602
Titre abrégé: J Neuromuscul Dis
Pays: Netherlands
ID NLM: 101649948

Informations de publication

Date de publication:
2020
Historique:
pubmed: 18 5 2020
medline: 9 3 2021
entrez: 18 5 2020
Statut: ppublish

Résumé

Promising genetic treatments targeting the molecular defect of severe early-onset genetic conditions are expected to dramatically improve patients' quality of life and disease epidemiology. Spinal Muscular Atrophy (SMA), is one of these conditions and approved therapeutic approaches have recently become available to patients. Analysis of genetic and clinical data from SMA patients referred to the single public-sector provider of genetic services for the disease throughout Greece followed by a retrospective assessment in the context of epidemiology and genotype-phenotype associations. Molecular genetic analysis and retrospective evaluation of findings for 361 patients tested positive for SMA- and 862 apparently healthy subjects from the general population. Spearman rank test and generalized linear models were applied to evaluate secondary modifying factors with respect to their impact on clinical severity and age of onset. Causative variations- including 5 novel variants- were detected indicating a minimal incidence of about 1/12,000, and a prevalence of at least 1.5/100,000. For prognosis a minimal model pertaining disease onset before 18 months was proposed to include copy numbers of NAIP (OR = 9.9;95% CI, 4.7 to 21) and SMN2 (OR = 6.2;95% CI, 2.5-15.2) genes as well as gender (OR = 2.2;95% CI, 1.04 to 4.6). This long-term survey shares valuable information on the current status and practices for SMA diagnosis on a population basis and provides an important reference point for the future assessment of strategic advances towards disease prevention and health care planning.

Sections du résumé

BACKGROUND BACKGROUND
Promising genetic treatments targeting the molecular defect of severe early-onset genetic conditions are expected to dramatically improve patients' quality of life and disease epidemiology. Spinal Muscular Atrophy (SMA), is one of these conditions and approved therapeutic approaches have recently become available to patients.
OBJECTIVE OBJECTIVE
Analysis of genetic and clinical data from SMA patients referred to the single public-sector provider of genetic services for the disease throughout Greece followed by a retrospective assessment in the context of epidemiology and genotype-phenotype associations.
METHODS METHODS
Molecular genetic analysis and retrospective evaluation of findings for 361 patients tested positive for SMA- and 862 apparently healthy subjects from the general population. Spearman rank test and generalized linear models were applied to evaluate secondary modifying factors with respect to their impact on clinical severity and age of onset.
RESULTS RESULTS
Causative variations- including 5 novel variants- were detected indicating a minimal incidence of about 1/12,000, and a prevalence of at least 1.5/100,000. For prognosis a minimal model pertaining disease onset before 18 months was proposed to include copy numbers of NAIP (OR = 9.9;95% CI, 4.7 to 21) and SMN2 (OR = 6.2;95% CI, 2.5-15.2) genes as well as gender (OR = 2.2;95% CI, 1.04 to 4.6).
CONCLUSIONS CONCLUSIONS
This long-term survey shares valuable information on the current status and practices for SMA diagnosis on a population basis and provides an important reference point for the future assessment of strategic advances towards disease prevention and health care planning.

Identifiants

pubmed: 32417790
pii: JND190466
doi: 10.3233/JND-190466
pmc: PMC7836056
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

247-256

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Auteurs

Kyriaki Kekou (K)

Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Maria Svingou (M)

Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Christalena Sofocleous (C)

Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.
Research Institute for the Study of Genetic and Malignant Disorders in Childhood, "Aghia Sophia" Children's Hospital, Athens.

Niki Mourtzi (N)

First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Evangelia Nitsa (E)

Postgraduate Program in Biostatistics School Of Medicine, National and Kapodistrian University of Athens, Athens.

George Konstantinidis (G)

Laboratory of, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Sotiris Youroukos (S)

First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Konstantinos Skiadas (K)

Department of Neurology, "Aghia Sophia" Children's Hospital, Athens.

Marina Katsalouli (M)

Department of Neurology, "Aghia Sophia" Children's Hospital, Athens.

Roser Pons (R)

First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

Antigoni Papavasiliou (A)

Department of Pediatric Neurology, Penteli Children's Hospital, Athens.

Charalabos Kotsalis (C)

Department of Pediatric Neurology, Penteli Children's Hospital, Athens.

Evangelos Pavlou (E)

2nd Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, University General Hospital AHEPA, Thessaloniki.

Athanasios Evangeliou (A)

Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki.

Efstathia Katsarou (E)

Department of Neurology, 'P & A Kyriakou' Children's Hospital, Athens.

Konstantinos Voudris (K)

Department of Neurology, 'P & A Kyriakou' Children's Hospital, Athens.

Argirios Dinopoulos (A)

Third Department of Pediatrics, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens.

Pelagia Vorgia (P)

Pediatric Department, University Hospital of Heraklion, Crete.

George Niotakis (G)

Pediatric Neurology Clinics, Venizeleion General Hospital, Heraklion, Crete.

Nikolaos Diamantopoulos (N)

Department of Pediatric Neurology, Karamandanion Children's Hospital, Patras.

Iliada Nakou (I)

Department of Pediatrics, University of Ioannina, Stavros Niarchos Avenue, Ioannina.

Vasiliki Koute (V)

Pediatric Department, University Hospital of Larissa, University of Thessaly, Larissa.

George Vartzelis (G)

Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, "P. & A. Kyriakou" Children's Hospital, Athens, Greece.

George-Konstantinos Papadimas (GK)

Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens.

Constantinos Papadopoulos (C)

Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens.

Georgios Tsivgoulis (G)

Second Department of Neurology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens.

Joanne Traeger-Synodinos (J)

Laboratory of Medical Genetics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens.

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