Quantitative natural history modeling of HPDL-related disease based on cross-sectional data reveals genotype-phenotype correlations

Purpose - Biallelic HPDL variants have been identified as the cause of a progressive childhood-onset movement disorder, with a broad clinical spectrum from severe neurodevelopmental disorder to juvenile-onset pure hereditary spastic paraplegia type 83. This study aims at delineating the geno- and ph...

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Hauptverfasser: Alecu, Julian (VerfasserIn) , Tam, Amy (VerfasserIn) , Richter, Silja (VerfasserIn) , Quiroz, Vicente (VerfasserIn) , Schierbaum, Luca (VerfasserIn) , Saffari, Afshin (VerfasserIn) , Ebrahimi-Fakhari, Darius (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 25 December 2024
In: Genetics in medicine
Year: 2025, Jahrgang: 27, Heft: 3, Pages: 1-12
ISSN:1530-0366
DOI:10.1016/j.gim.2024.101349
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.gim.2024.101349
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1098360024002831
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Verfasserangaben:Julian E. Alecu, Amy Tam, Silja Richter, Vicente Quiroz, Luca Schierbaum, Afshin Saffari, Darius Ebrahimi-Fakhari

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520 |a Purpose - Biallelic HPDL variants have been identified as the cause of a progressive childhood-onset movement disorder, with a broad clinical spectrum from severe neurodevelopmental disorder to juvenile-onset pure hereditary spastic paraplegia type 83. This study aims at delineating the geno- and phenotypic spectra of patients with HPDL-related disease, quantitatively modeling the natural history, and uncovering genotype-phenotype associations. - Methods - A cross-sectional analysis of 90 published and 1 novel case was performed, using a Human-Phenotype-Ontology-based approach. Unsupervised phenotypic clustering was used alongside in silico analyses to identify distinct patient subgroups. - Results - The study models the natural history of the HPDL-related disease in a global cohort, clarifying the molecular and phenotypic spectrum and identifying 3 distinct subgroups characterized by differences in onset, clinical trajectories, and survival. It establishes genotype-phenotype associations, showing that the presence of moderately pathogenic missense variants in 1 allele leads to a milder, spastic paraplegic phenotype with later disease onset, whereas biallelic, highly pathogenic missense or truncating variants are associated with a more severe phenotype and reduced life span. - Conclusion - Quantitative and unbiased natural history modeling in HPDL-related disease reveals significant genotype-phenotype associations, providing a foundation for variant interpretation, anticipatory guidance, and choice of outcome measures in future prospective and functional studies. 
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