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Missense variants in the TRPM7 α-kinase domain are associated with recurrent pediatric acute liver failure

Background: - Pediatric acute liver failure (PALF) is a rare and life-threatening condition. In up to 50% of PALF cases, the underlying etiology remains unknown during routine clinical testing. This lack of knowledge complicates clinical management and liver transplantation decisions. Rec...

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Main Authors: Schlieben, Lea D. (Author) , Achleitner, Melanie T. (Author) , Bourke, Billy (Author) , Diesner, Max (Author) , Feichtinger, René G. (Author) , Fichtner, Alexander (Author) , Flechtenmacher, Christa (Author) , Hadzic, Nedim (Author) , Hegarty, Robert (Author) , Heilos, Andreas (Author) , Janecke, Andreas (Author) , Konstantopoulou, Vassiliki (Author) , Lenz, Dominic (Author) , Mayr, Johannes A. (Author) , Müller, Thomas (Author) , Prokisch, Holger (Author) , Vogel, Georg (Author)
Format: Article (Journal)
Language:English
Published: December 2024
In: Hepatology communications
Year: 2024, Volume: 8, Issue: 12, Pages: 1-11
ISSN:2471-254X
DOI:10.1097/HC9.0000000000000598
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1097/HC9.0000000000000598
Verlag, kostenfrei, Volltext: https://journals.lww.com/hepcomm/fulltext/2024/12010/missense_variants_in_the_trpm7___kinase_domain_are.18.aspx
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Author Notes:Lea D. Schlieben, Melanie T. Achleitner, Billy Bourke, Max Diesner, René G. Feichtinger, Alexander Fichtner, Christa Flechtenmacher, Nedim Hadzic, Robert Hegarty, Andreas Heilos, Andreas Janecke, Vassiliki Konstantopoulou, Dominic Lenz, Johannes A. Mayr, Thomas Müller, Holger Prokisch, Georg F. Vogel
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Summary:Background: - Pediatric acute liver failure (PALF) is a rare and life-threatening condition. In up to 50% of PALF cases, the underlying etiology remains unknown during routine clinical testing. This lack of knowledge complicates clinical management and liver transplantation decisions. Recently, whole-exome sequencing has identified genetic disorders in a large number of cases without specific laboratory biomarkers or metabolic fingerprints. - Methods: - We describe how further analysis of whole-exome sequencing data combined with proteomic analyses in 5 previously unsolved PALF patients, where no pathogenic variants in genes previously associated with acute liver failure were identified, revealed rare biallelic variants in transient receptor potential cation channel subfamily M member 7 (TRPM7). - Results: - We establishe TRPM7 as a novel disease gene for PALF. Yet, the cation channel kinase TRPM7 has not been associated with any Mendelian disorder. No homozygous loss-of-function variants were found in in-house exomes or publicly available databases. Rare biallelic TRPM7-variants were significantly enriched in the PALF cohort compared with a pediatric control cohort. Viral infections preceded the majority of PALF episodes. Recurrent PALF episodes characterized the disease course with rapid progression, leading to early death in 3 cases. Proteomic analyses of patient fibroblasts unveiled significantly reduced TRPM7 protein levels, indicative of functional impairment. Severely reduced Mg2+ levels in one individual with a mutation in the channel domain suggests a potential interaction between disturbed Mg2+ homeostasis and PALF. The consistent presence of mutations in the TRPM7 protein-kinase-domain across all patients suggests its specific relevance in PALF. - Conclusions: - Our data extend the genetic spectrum of recurrent PALF and prompt consideration of TRPM7 in children with unexplained liver failure.
Item Description:Gesehen am 25.07.2025
Physical Description:Online Resource
ISSN:2471-254X
DOI:10.1097/HC9.0000000000000598

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