transforming-growth-factor-beta and Eye-Diseases--Hereditary

Over the past decade, the pace of gene identification of the causes of inherited eye diseases has increased dramatically as the complete human genome information becoming available. Molecular genetic analysis establishes reliable clinical diagnostic criteria and improves the accuracy of diagnosis. We encountered two atypical cases, a patient who had only bilateral band-shaped opacities without any gelatinous prominences, and a patient who had diffuse central corneal stromal opacity without any lattice lines. The diagnosis of gelatinous drop-like dystrophy and lattice corneal dystrophy I was confirmed by molecular genetic analysis of TACSTD2 and TGFBI, respectively. We confirmed the existence of a predominantly ocular type of stickler syndrome by identifying the mutation involving exon 2 of the COL2A1 gene in a Japanese patient who had received a diagnosis of rhegmatogenous retinal detachment. We surmise that in Japan in the past, this diagnosis may have been overlooked or misdiagnosed as Wagner disease. Molecular genetic analysis is also useful for gaining a better understanding of diseases. We detected a novel FZD4 mutation in a patient with familial exudative vitreoretinopathy who exhibited peripheral avascular areas bilaterally, a dragged disk, and retinal holes unilaterally, suggesting that FZD4 may be involved in the angiogenesis of the human peripheral retina. Molecular genetic analysis of a Japanese patient with pseudoxanthoma elasticum with choroidal neovascularization revealed a homozygous nonsense mutation in the ABCC6, a member of the ABC transporter family, indicating that angioid streaks may be caused by a primary metabolic disorder. The development of rapid and comprehensive genotyping systems using state-of-the-art technology such as genotyping microarray may eventually offer unique and reliable diagnostic tools. This should then accelerate our understanding of the basic mechanisms underlying inherited eye diseases and their phenotypic variability, thus facilitating prospective diagnosis.

Topics: Antigens, Neoplasm; Cell Adhesion Molecules; Collagen Type II; Extracellular Matrix Proteins; Eye Diseases, Hereditary; Frizzled Receptors; Genome, Human; Genotype; Humans; Microarray Analysis; Molecular Diagnostic Techniques; Multidrug Resistance-Associated Proteins; Mutation; Receptors, G-Protein-Coupled; Signal Transduction; Transforming Growth Factor beta; Wnt Proteins

Topics: Corneal Dystrophies, Hereditary; Diagnosis, Differential; Eye Diseases, Hereditary; Genetic Testing; Humans; Molecular Diagnostic Techniques; Transforming Growth Factor beta

Recessive variants in LTBP2 are associated with eye-restricted phenotypes including (a) primary congenital glaucoma and (b) microspherophakia/megalocornea and ectopia lentis with/without secondary glaucoma. Nosology of LTBP2 pathology in humans is apparently in contrast with the consolidated evidence of a wide expression of this gene in the developing embryo. Accordingly, in previously published patients with LTBP2-related eye disease, additional extraocular findings have been occasionally reported and include, among others, high-arched palate, tall stature, and variable cardiac involvement. Anyway, no emphasis was put on such systemic manifestations. Here, we report two unrelated Roma/Gypsy patients first ascertained for a multisystem disorder mainly characterized by primary congenital glaucoma, complex congenital heart defect, tall stature, long fingers, skin striae and dystrophic scarring, and resembling Marfan syndrome. Heart involvement was severe with polyvalvular heart dysplasia in one, and transposition of great arteries, thoracic arterial tortuosity, polyvalvular heart dysplasia, and neo-aortic root dilatation in the other. Both patients were homozygous for the recurrent c.895C>T[p.(R299X)] variant, typically found in individuals of Roma/Gypsy descent with an eye-restricted phenotype. Our findings point out LTBP2 as responsible of a systemic phenotype coherent with the community of syndromes related to anomalies in genes involved in the TGFβ-pathway. Among these disorders, LTBP2-related systemic disease emerges as a distinct condition with expanding prognostic implications and autosomal recessive inheritance.

Topics: Adolescent; Child; Corneal Diseases; Ectopia Lentis; Eye Diseases, Hereditary; Female; Genetic Diseases, X-Linked; Glaucoma; Heart; Heart Defects, Congenital; Homozygote; Humans; Iris; Latent TGF-beta Binding Proteins; Male; Marfan Syndrome; Phenotype; Roma; Transforming Growth Factor beta

To determine whether the capacity to induce ACAID by antigen injection into the anterior chamber is altered in animals with genetically determined retinal degeneration and increased age.. Anterior chamber-associated immune deviation (ACAID) induced by injection of ovalbumin into the anterior chamber of the eye was studied in three rodent strains with different forms of hereditary retinal degeneration (Royal College of Surgeon [RCS] rats, retinal degeneration [rd] mice, and Norrie-Disease [ND] mice) and in different age groups (age range, 1-23 months). The data were compared with those of age-matched controls. Aqueous humors of rd mice, RCS rats, and age-matched congenic controls were investigated for concentrations of transforming growth factor-beta2 (TGF-beta2) using enzyme-linked immunosorbent assay.. ACAID was readily induced in RCS rats and ND mice irrespective of amount of retinal degeneration or aging. In rd mice ACAID could be induced in young animals but not in animals more than 12 months of age. In old rd mice, loss of ACAID was accompanied by a marked reduction in total TGF-beta2 levels in aqueous humor.. Rd mice more than 1 year of age lose the capacity of the anterior chamber to support the induction of ACAID by intracameral injection of soluble protein antigen. Because loss of ACAID correlated with a decrease in TGF-beta2 concentration in aqueous humor, it is proposed that eyes of rd mice are unable to maintain an immunosuppressive microenvironment necessary for ACAID.

Topics: Aging; Animals; Anterior Chamber; Aqueous Humor; Enzyme-Linked Immunosorbent Assay; Eye Diseases, Hereditary; Mice; Mice, Inbred C57BL; Mice, Mutant Strains; Ovalbumin; Rats; Rats, Mutant Strains; Retinal Degeneration; Transforming Growth Factor beta