Continuing Medical Education

Advances in digenic Alport syndrome

  • Hongwen ZHANG
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  • Department of Paediatrics, Peking University First Hospital, Beijing 100034, China

Received date: 2023-11-21

  Online published: 2024-11-08

Abstract

Digenic Alport syndrome (AS) refers to two pathogenic variants in different genes of COL4A3, COL4A4 and COL4A5. This condition is categorized into two subtypes: one subtype results from a pathogenic variant in COL4A5 combined with another in either COL4A3 or COL4A4, while the other subtype arises from pathogenic variants in both COL4A3 and COL4A4. Although digenic AS is hypothesized to exhibit more pronounced clinical manifestations, particularly with respect to proteinuria and renal impairment, definitive evidence necessitates additional multicenter, large-sample studies for validation.

Cite this article

Hongwen ZHANG . Advances in digenic Alport syndrome[J]. Journal of Clinical Pediatrics, 2024 , 42(11) : 983 -986 . DOI: 10.12372/jcp.2024.23e1125

References

[1] Kashtan CE, Ding J, Garosi G, et al. Alport syndrome: a unified classification of genetic disorders of collagen IV alpha345: a position paper of the Alport Syndrome Classification Working Group[J]. Kidney Int, 2018, 93(5): 1045-1051.
[2] Reiterova J, Tesar V. Current and future therapeutical options in alport syndrome[J]. Int J Mol Sci, 2023, 24(6): 1-11.
[3] Gibson JT, Huang M, Shenelli Croos Dabrera M, et al. Genotype-phenotype correlations for COL4A3-COL4A5 variants resulting in Gly substitutions in Alport syndrome[J]. Sci Rep, 2022, 12(1): 2722.
[4] Deltas C. Digenic inheritance and genetic modifiers[J]. Clin Genet, 2018, 93(3): 429-438.
[5] Savige J, Renieri A, Ars E, et al. Digenic Alport syndrome[J]. Clin J Am Soc Nephrol, 2022, 17(11): 1697-1706.
[6] Mencarelli MA, Heidet L, Storey H, et al. Evidence of digenic inheritance in Alport syndrome[J]. J Med Genet, 2015, 52(3): 163-174.
[7] Schaffer AA. Digenic inheritance in medical genetics[J]. J Med Genet, 2013, 50(10): 641-652.
[8] Gazzo A, Raimondi D, Daneels D, et al. Understanding mutational effects in digenic diseases[J]. Nucleic Acids Res, 2017, 45(15): e140.
[9] Daga S, Fallerini C, Furini S, et al. Non-collagen genes role in digenic Alport syndrome[J]. BMC Nephrol, 2019, 20(1): 70.
[10] Daga S, Ding J, Deltas C, et al. The 2019 and 2021 international workshops on Alport syndrome[J]. Eur J Hum Genet, 2022, 30(5): 507-516.
[11] 倪婕, 陈植, 凌晨, 等. 儿童Alport综合征的临床、病理及基因分析[J]. 罕见病研究, 2021, 1(3): 259-269.
[12] 胡宁宁, 戴选彤, 蒋更如, 等. 双基因突变型X连锁Alport综合征女性患者临床与遗传学特征分析[J]. 上海医学, 2021, 44(6): 434-442.
[13] Zhang Y, Ding J, Zhang H, et al. Effect of heterozygous pathogenic COL4A3 or COL4A4 variants on patients with X-linked Alport syndrome[J]. Mol Genet Genomic Med, 2019, 7(5): e647.
[14] Mastrangelo A, Giani M, Groppali E, et al. X-Linked Alport syndrome in women: genotype and clinical course in 24 cases[J]. Front Med (Lausanne), 2020, 11(7): 1-10.
[15] Furlano M, Martinez V, Pybus M, et al. Clinical and genetic features of autosomal dominant Alport syndrome: a cohort study[J]. Am J Kidney Dis, 2021, 78(4): 560-570.
[16] Fallerini C, Baldassarri M, Trevisson E, et al. Alport syndrome: impact of digenic inheritance in patients management[J]. Clinical genetics, 2017, 92(1): 34-44.
[17] 张宏文. 关于儿童肾脏疾病的某些思索[J]. 临床儿科杂志, 2018, 36(6): 401-404.
[18] 张宏文. 关于儿童肾小球疾病临床和病理诊断的个人建议[J]. 临床肾脏病杂志, 2023, 23(2): 89-92.
[19] Nozu K, Nakanishi K, Abe Y, et al. A review of clinical characteristics and genetic backgrounds in Alport syndrome[J]. Clin Exp Nephrol, 2019, 23(2): 158-168.
[20] Rosado C, Bueno E, Felipe C, et al. Study of the true clinical progression of autosomal dominant Alport syndrome in a European population[J]. Kidney Blood Press Res, 2015, 40(4): 435-442.
[21] van der Loop FT, Heidet L, Timmer ED, et al. Autosomal dominant Alport syndrome caused by a COL4A3 splice site mutation[J]. Kidney international, 2000, 58(5): 1870-1875.
[22] 王利霞, 樊畇秀, 杨武, 等. 早发肾衰竭的常染色体显性遗传性 Alport 综合征一家系报告并文献复习[J]. 临床肾脏病杂志, 2023, 23(12): 1044-1046.
[23] Savige J. Heterozygous pathogenic COL4A3 and COL4A4 variants (autosomal dominant Alport syndrome) are common, and not typically associated with end-stage kidney failure, hearing loss, or ocular abnormalities[J]. Kidney Int Rep, 2022, 7(9): 1933-1938.
[24] Savige J. Should we diagnose autosomal dominant Alport syndrome when there is a pathogenic heterozygous COL4A3 or COL4A4 variant?[J]. Kidney Int Rep, 2018, 3(6): 1239-1241.
[25] Kamiyoshi N, Nozu K, Fu XJ, et al. Genetic, clinical, and pathologic backgrounds of patients with autosomal dominant Alport syndrome[J]. Clin J Am Soc Nephrol, 2016, 11(8): 1441-1449.
[26] Izumi Y, Hamaguchi A, Miura R, et al. Autosomal dominant Alport syndrome due to a COL4A4 mutation with an additional ESPN variant detected by whole-exome analysis[J]. CEN Case Rep, 2020, 9(1): 59-64.
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