Pathogenic G6PD variants: Different clinical pictures arise from different missense mutations in the same codon.

G6PD G6PD deficiency chronic haemolytic disorder class A variant molecular dynamics simulations

Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
18 Sep 2024
Historique:
received: 04 07 2024
accepted: 06 09 2024
medline: 19 9 2024
pubmed: 19 9 2024
entrez: 19 9 2024
Statut: aheadofprint

Résumé

G6PD deficiency results from mutations in the X-linked G6PD gene. More than 200 variants are associated with enzyme deficiency: each one of them may either cause predisposition to haemolytic anaemia triggered by exogenous agents (class B variants), or may cause a chronic haemolytic disorder (class A variants). Genotype-phenotype correlations are subtle. We report a rare G6PD variant, discovered in a baby presenting with severe jaundice and haemolytic anaemia since birth: the mutation of this class A variant was found to be p.(Arg454Pro). Two variants affecting the same codon were already known: G6PD Union, p.(Arg454Cys), and G6PD Andalus, p.(Arg454His). Both these class B variants and our class A variant exhibit severe G6PD deficiency. By molecular dynamics simulations, we performed a comparative analysis of the three mutants and of the wild-type G6PD. We found that the tetrameric structure of the enzyme is not perturbed in any of the variants; instead, loss of the positively charged Arg residue causes marked variant-specific rearrangement of hydrogen bonds, and it influences interactions with the substrates G6P and NADP. These findings explain severe deficiency of enzyme activity and may account for p.(Arg454Pro) expressing a more severe clinical phenotype.

Identifiants

pubmed: 39295190
doi: 10.1111/bjh.19775
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

Références

Minucci A, Moradkhani K, Hwang MJ, Zuppi C, Giardina B, Capoluongo E. Glucose‐6‐phosphate dehydrogenase (G6PD) mutations database: review of the ‘old’ and update of the new mutations. Blood Cells Mol Dis. 2012;48(3):154–165. https://doi.org/10.1016/j.bcmd.2012.01.001
Luzzatto L, Ally M, Notaro R. Glucose‐6‐phosphate dehydrogenase deficiency. Blood. 2020;136(11):1225–1240. https://doi.org/10.1182/blood.2019000944
Geck RC, Powell NR, Dunham MJ. Functional interpretation, cataloging, and analysis of 1,341 glucose‐6‐phosphate dehydrogenase variants. Am J Hum Genet. 2023;110(2):228–239. https://doi.org/10.1016/j.ajhg.2023.01.003
Luzzatto L, Nannelli C, Notaro R. Potentially pathogenic and pathogenic G6PD variants. Am J Hum Genet. 2023;110(11):1983–1985. https://doi.org/10.1016/j.ajhg.2023.10.003
Luzzatto L, Bancone G, Dugué PA, Jiang W, Minucci A, Nannelli C, et al. New WHO classification of genetic variants causing G6PD deficiency. Bull World Health Organ. 2024;102(8):615–617. https://doi.org/10.2471/BLT.23.291224
Minucci A, Giardina B, Zuppi C, Capoluongo E. Glucose‐6‐phosphate dehydrogenase laboratory assay: how, when, and why? IUBMB Life. 2009;61(1):27–34. https://doi.org/10.1002/iub.137
Mason PJ, Bautista JM, Gilsanz F. G6PD deficiency: the genotype‐phenotype association. Blood Rev. 2007;21(5):267–283. https://doi.org/10.1016/j.blre.2007.05.002
Rovira A, Vulliamy TJ, Pujades A, Luzzatto L, Corrons JL. The glucose‐6‐phosphate dehydrogenase (G6PD) deficient variant G6PD Union (454 Arg → Cys) has a worldwide distribution possibly due to recurrent mutation. Hum Mol Genet. 1994;3(5):833–835. https://doi.org/10.1093/hmg/3.5.833
Vives‐Corrons JL, Kuhl W, Pujades MA, Beutler E. Molecular genetics of the glucose‐6‐phosphate dehydrogenase (G6PD) Mediterranean variant and description of a new G6PD mutant, G6PD Andalus1361A. Am J Hum Genet. 1990;47(3):575–579.
Minucci A, Delibato E, Castagnola M, Concolino P, Ameglio F, Zuppi C, et al. Identification of RFLP G6PD mutations by using microcapillary electrophoretic chips (Experion). J Sep Sci. 2008;31(14):2694–2700. https://doi.org/10.1002/jssc.200800216
Minucci A, Concolino P, Vendittelli F, Giardina B, Zuppi C, Capoluongo E. Glucose‐6‐phosphate dehydrogenase Buenos Aires: a novel de novo missense mutation associated with severe enzyme deficiency. Clin Biochem. 2008;41(9):742–745. https://doi.org/10.1016/j.clinbiochem.2007.11.009
Minucci A, Ruggiero A, Canu G, Maurizi P, De Bonis M, Concolino P, et al. Co‐inheritance of G6PD and PK deficiencies in a neonate carrying a novel UGT1A1 genotype associated to Crigler‐Najjar type II syndrome. Pediatr Blood Cancer. 2015;62(9):1680–1681. https://doi.org/10.1002/pbc.25500
Wei X, Kixmoeller K, Baltrusaitis E, Yang X, Marmorstein R. Allosteric role of a structural NADP+ molecule in glucose‐6‐phosphate dehydrogenase activity. Proc Natl Acad Sci U S A. 2022;119(29):e2119695119. https://doi.org/10.1073/pnas.2119695119
Abraham MJ, Murtola T d, Schulz R, Páll S, Smith JC, Hess B, et al. GROMACS: high performance molecular simulations through multi‐level parallelism from laptops to supercomputers. Softwarex. 2015;1–2:19–25.
Huang J, MacKerell AD Jr. CHARMM36 all‐atom additive protein force field: validation based on comparison to NMR data. J Comput Chem. 2013;34(25):2135–2145. https://doi.org/10.1002/jcc.23354
Vanommeslaeghe K, Hatcher E, Acharya C, Kundu S, Zhong S, Shim J, et al. CHARMM general force field: a force field for drug‐like molecules compatible with the CHARMM all‐atom additive biological force fields. J Comput Chem. 2010;31(4):671–690. https://doi.org/10.1002/jcc.21367
Bernetti M, Bussi G. Pressure control using stochastic cell rescaling. J Chem Phys. 2020;153(11):114107. https://doi.org/10.1063/5.0020514
Powers JL, Best DH, Grenache DG. Genotype‐phenotype correlations of glucose‐6‐phosphate‐deficient variants throughout an activity distribution. J Appl Lab Med. 2018;2(6):841–850. https://doi.org/10.1373/jalm.2017.024935
Filosa S, Giacometti N, Wangwei C, De Mattia D, Pagnini D, Alfinito F, et al. Somatic‐cell selection is a major determinant of the blood‐cell phenotype in heterozygotes for glucose‐6‐phosphate dehydrogenase mutations causing severe enzyme deficiency. Am J Hum Genet. 1996;59(4):887–895.
Ben Fredj D, Barro C, Joly P, Thomassin N, Collardeau‐Frachon S, Plantaz D, et al. Transient liver injury and severe neonatal cholestasis in infant with glucose‐6‐phosphate dehydrogenase deficiency due to a new mutation. Arch Pediatr. 2019;26(6):370–373. https://doi.org/10.1016/j.arcped.2019.05.005
Keffler S, Kelly DA, Powell JE, Green A. Population screening for neonatal liver disease: a feasibility study. J Pediatr Gastroenterol Nutr. 1998;27(3):306–311. https://doi.org/10.1097/00005176‐199809000‐00007
Dellert SF, Balistreri WF. Neonatal cholestasis. In: Walker A, Durie P, Hamilton J, Walker Smith J, editors. Pediatric gastroenterology. 3rd ed. Lewiston, NY: B.C. Decker, Inc; 2000. p. 880–894.
Kordes U, Richter A, Santer R, Schäfer H, Singer D, Sonntag J, et al. Neonatal cholestasis and glucose‐6‐P‐dehydrogenase deficiency. Pediatr Blood Cancer. 2010;54(5):758–760. https://doi.org/10.1002/pbc.22390
Mizukawa B, George A, Pushkaran S, Weckbach L, Kalinyak K, Heubi JE, et al. Cooperating G6PD mutations associated with severe neonatal hyperbilirubinemia and cholestasis. Pediatr Blood Cancer. 2011;56(5):840–842. https://doi.org/10.1002/pbc.22744
Hirono A, Miwa S, Fujii H, Ishida F, Yamada K, Kubota K. Molecular study of eight Japanese cases of glucose‐6‐phosphate dehydrogenase deficiency by nonradioisotopic single‐strand conformation polymorphism analysis. Blood. 1994;83(11):3363–3368.
Ainoon O, Yu YH, Amir Muhriz AL, Boo NY, Cheong SK, Hamidah NH. Glucose‐6‐phosphate dehydrogenase (G6PD) variants in Malaysian Malays. Hum Mutat. 2003;21(1):101. https://doi.org/10.1002/humu.9103
Arunachalam AK, Sumithra S, Maddali M, Fouzia NA, Abraham A, George B, et al. Molecular characterization of G6PD deficiency: report of three novel G6PD variants. Indian J Hematol Blood Transfus. 2020;36(2):349–355. https://doi.org/10.1007/s12288‐019‐01205‐7
Horikoshi N, Hwang S, Gati C, Matsui T, Castillo‐Orellana C, Raub AG, et al. Long‐range structural defects by pathogenic mutations in most severe glucose‐6‐phosphate dehydrogenase deficiency. Proc Natl Acad Sci U S A. 2021;118(4):e2022790118. https://doi.org/10.1073/pnas.2022790118
Wang XT, Chan TF, Lam VM, Engel PC. What is the role of the second ‘structural’ NADP+‐binding site in human glucose 6‐phosphate dehydrogenase? Protein Sci. 2008;17(8):1403–1411. https://doi.org/10.1110/ps.035352.108
Rani S, Malik FP, Anwar J, Zafar PR. Investigating effect of mutation on structure and function of G6PD enzyme: a comparative molecular dynamics simulation study. PeerJ. 2022;10:e12984. Published 2022 Mar 29. https://doi.org/10.7717/peerj.12984
Alakbaree M, Abdulsalam AH, Ahmed HH, Ali FH, Al‐Hili A, Omar MSS, et al. A computational study of structural analysis of class I human glucose‐6‐phosphate dehydrogenase (G6PD) variants: elaborating the correlation to chronic non‐spherocytic hemolytic anemia (CNSHA). Comput Biol Chem. 2023;104:107873. https://doi.org/10.1016/j.compbiolchem.2023.107873
Sirdah M, Reading NS, Vankayalapati H, Prchal JT. A computational study of structural differences of binding of NADP+ and G6P substrates to G6PD Mediterraneanc.563T, G6PD A‐c.202A/c.376G, G6PD Cairoc.404C and G6PD Gazac.536A mutations. Blood Cells Mol Dis. 2021;89:102572. https://doi.org/10.1016/j.bcmd.2021.102572
Nannelli C, Bosman A, Cunningham J, Dugué PA, Luzzatto L. Genetic variants causing G6PD deficiency: clinical and biochemical data support new WHO classification. Br J Haematol. 2023;202(5):1024–1032. https://doi.org/10.1111/bjh.18943

Auteurs

Simonetta Costa (S)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

Angelo Minucci (A)

Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Amit Kumawat (A)

Department of Biosciences, University of Milano, Milan, Italy.

Maria De Bonis (M)

Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Giorgia Prontera (G)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Mariannita Gelsomino (M)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Milena Tana (M)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Eloisa Tiberi (E)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Alberto Romano (A)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Antonio Ruggiero (A)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

Stefano Mastrangelo (S)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

Giuseppe Palumbo (G)

Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Valentina Giorgio (V)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

Maria Elisabetta Onori (ME)

Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Martino Bolognesi (M)

Department of Biosciences, University of Milano, Milan, Italy.
Centro di Ricerca Pediatrica Romeo ed Enrica Invernizzi, Università degli Studi di Milano, Milan, Italy.

Carlo Camilloni (C)

Department of Biosciences, University of Milano, Milan, Italy.

Lucio Luzzatto (L)

Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania.
Department of Hematology, University of Florence, Firenze, Italy.

Giovanni Vento (G)

Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.

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