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Screening of SHOX gene sequence variants in Saudi Arabian children with idiopathic short stature

  • Alharthi, Abdulla A. (Deanship of Scientific Research, Taif University) ;
  • El-Hallous, Ehab I. (Deanship of Scientific Research, Taif University) ;
  • Talaat, Iman M. (Pediatrics Department, Faculty of Medicine, Ain Shams University) ;
  • Alghamdi, Hamed A. (Pediatrics Department, Alhada Armed Forces Hospital) ;
  • Almalki, Matar I. (Children Hospital) ;
  • Gaber, Ahmed (Deanship of Scientific Research, Taif University)
  • Received : 2016.07.18
  • Accepted : 2017.01.26
  • Published : 2017.10.15

Abstract

Purpose: Short stature affects approximately 2%-3% of children, representing one of the most frequent disorders for which clinical attention is sought during childhood. Despite assumed genetic heterogeneity, mutations or deletions in the short stature homeobox-containing gene (SHOX ) are frequently detected in subjects with short stature. Idiopathic short stature (ISS) refers to patients with short stature for various unknown reasons. The goal of this study was to screen all the exons of SHOX to identify related mutations. Methods: We screened all the exons of SHOX for mutations analysis in 105 ISS children patients (57 girls and 48 boys) living in Taif governorate, KSA using a direct DNA sequencing method. Height, arm span, and sitting height were recorded, and subischial leg length was calculated. Results: A total of 30 of 105 ISS patients (28%) contained six polymorphic variants in exons 1, 2, 4, and 6. One mutation was found in the DNA domain binding region of exon 4. Three of these polymorphic variants were novel, while the others were reported previously. There were no significant differences in anthropometric measures in ISS patients with and without identifiable polymorphic variants in SHOX. Conclusion: In Saudi Arabia ISS patients, rather than SHOX, it is possible that new genes are involved in longitudinal growth. Additional molecular analysis is required to diagnose and understand the etiology of this disease.

Keywords

References

  1. Funari MF, Jorge AA, Souza SC, Billerbeck AE, Arnhold IJ, Mendonca BB, et al. Usefulness of MLPA in the detection of SHOX deletions. Eur J Med Genet 2010;53:234-8. https://doi.org/10.1016/j.ejmg.2010.06.001
  2. Wit JM, Clayton PE, Rogol AD, Savage MO, Saenger PH, Cohen P. Idiopathic short stature: definition, epidemiology, and diagnostic evaluation. Growth Horm IGF Res 2008;18:89-110. https://doi.org/10.1016/j.ghir.2007.11.004
  3. Chen J, Wildhardt G, Zhong Z, Roth R, Weiss B, Steinberger D, et al. Enhancer deletions of the SHOX gene as a frequent cause of short stature: the essential role of a 250 kb downstream regulatory domain. J Med Genet 2009;46:834-9. https://doi.org/10.1136/jmg.2009.067785
  4. Rao E, Weiss B, Fukami M, Rump A, Niesler B, Mertz A, et al. Pseudoautosomal deletions encompassing a novel homeobox gene cause growth failure in idiopathic short stature and Turner syndrome. Nat Genet 1997;16:54-63. https://doi.org/10.1038/ng0597-54
  5. Flanagan SF, Munns CF, Hayes M, Williams B, Berry M, Vickers D, et al. Prevalence of mutations in the short stature homeobox containing gene (SHOX) in Madelung deformity of childhood. J Med Genet 2002;39:758-63. https://doi.org/10.1136/jmg.39.10.758
  6. Huber C, Rosilio M, Munnich A, Cormier-Daire V; French SHOX GeNeSIS Module. High incidence of SHOX anomalies in individuals with short stature. J Med Genet 2006;43:735-9. https://doi.org/10.1136/jmg.2006.040998
  7. Jorge AA, Souza SC, Nishi MY, Billerbeck AE, Liborio DC, Kim CA, et al. SHOX mutations in idiopathic short stature and Leri-Weill dyschondrosteosis: frequency and phenotypic variability. Clin Endocrinol (Oxf) 2007;66:130-5.
  8. Sabherwal N, Bangs F, Roth R, Weiss B, Jantz K, Tiecke E, et al. Longrange conserved non-coding SHOX sequences regulate expression in developing chicken limb and are associated with short stature phenotypes in human patients. Hum Mol Genet 2007;16:210-22.
  9. Al-Jurayyan N NA, Mohamed SH, Al Otaibi HM, Al Issa ST, Omer HG. Short stature in children: Pattern and frequency in a pediatric clinic, Riyadh, Saudi Arabia. Sudan J Paediatr 2012;12:79-83.
  10. El Mouzan MI, Al Herbish AS, Al Salloum AA, Foster PJ, Al Omer AA, Qurachi MM. Prevalence of short stature in Saudi children and adolescents. Ann Saudi Med 2011;31:498-501. https://doi.org/10.4103/0256-4947.84628
  11. Al-Ruhaily AD, Malabu UH. Short stature in Saudi Arabia: etiologic profile in adult endocrine clinic. Niger J Med 2009;18:268-71.
  12. Growth Hormone Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society. J Clin Endocrinol Metab 2000;85:3990-3.
  13. Bogin B, Varela-Silva MI. Leg length, body proportion, and health: a review with a note on beauty. Int J Environ Res Public Health 2010;7:1047-75. https://doi.org/10.3390/ijerph7031047
  14. Solc R, Hirschfeldova K, Kebrdlova V, Baxova A. Analysis of common SHOX gene sequence variants and -4.9-kb PAR1 deletion in ISS patients. J Genet 2014;93:505-8. https://doi.org/10.1007/s12041-014-0375-y
  15. Iughetti L, Capone L, Elsedfy H, Bertorelli R, Predieri B, Bruzzi P, et al. Unexpected phenotype in a boy with trisomy of the SHOX gene. J Pediatr Endocrinol Metab 2010;23:159-69.
  16. Clement-Jones M, Schiller S, Rao E, Blaschke RJ, Zuniga A, Zeller R, et al. The short stature homeobox gene SHOX is involved in skeletal abnormalities in Turner syndrome. Hum Mol Genet 2000;9:695-702. https://doi.org/10.1093/hmg/9.5.695
  17. Schneider KU, Sabherwal N, Jantz K, Roth R, Muncke N, Blum WF, et al. Identification of a major recombination hotspot in patients with short stature and SHOX deficiency. Am J Hum Genet 2005;77:89-96. https://doi.org/10.1086/431655
  18. Shapiro S, Klein GW, Klein ML, Wallach EJ, Fen Y, Godbold JH, et al. SHOX gene variants: growth hormone/insulin-like growth factor-1 status and response to growth hormone treatment. Horm Res Paediatr 2015;83:26-35. https://doi.org/10.1159/000365507
  19. Nicolosi A, Caruso-Nicoletti M. Epidemiology of SHOX deficiency. J Endocrinol Invest 2010;33(6 Suppl):7-10. https://doi.org/10.1007/BF03346543
  20. El-Hazmi MA, Al-Swailem AR, Warsy AS, Al-Swailem AM, Sulaimani R, Al-Meshari AA. Consanguinity among the Saudi Arabian population. J Med Genet 1995;32:623-6. https://doi.org/10.1136/jmg.32.8.623
  21. Rappold GA, Fukami M, Niesler B, Schiller S, Zumkeller W, Bettendorf M, et al. Deletions of the homeobox gene SHOX (short stature homeobox) are an important cause of growth failure in children with short stature. J Clin Endocrinol Metab 2002;87:1402-6. https://doi.org/10.1210/jcem.87.3.8328
  22. Sandoval GT, Jaimes GC, Barrios MC, Cespedes C, Velasco HM. SHOX gene and conserved noncoding element deletions/duplications in Colombian patients with idiopathic short stature. Mol Genet Genomic Med 2014;2:95-102. https://doi.org/10.1002/mgg3.39
  23. Binder G. Short stature due to SHOX deficiency: genotype, phenotype, and therapy. Horm Res Paediatr 2011;75:81-9. https://doi.org/10.1159/000324105
  24. Ogata T, Matsuo N, Nishimura G. SHOX haploinsufficiency and overdosage: impact of gonadal function status. J Med Genet 2001;38:1-6. https://doi.org/10.1136/jmg.38.1.1
  25. Kant SG, Broekman SJ, de Wit CC, Bos M, Scheltinga SA, Bakker E, et al. Phenotypic characterization of patients with deletions in the 3'-flanking SHOX region. PeerJ 2013;1:e35. https://doi.org/10.7717/peerj.35
  26. Benito-Sanz S, Thomas NS, Huber C, Gorbenko del Blanco D, Aza- Carmona M, Crolla JA, et al. A novel class of Pseudoautosomal region 1 deletions downstream of SHOX is associated with Leri-Weill dyschondrosteosis. Am J Hum Genet 2005;77:533-44. https://doi.org/10.1086/449313
  27. Blaschke RJ, Topfer C, Marchini A, Steinbeisser H, Janssen JW, Rappold GA. Transcriptional and translational regulation of the Leri-Weill and Turner syndrome homeobox gene SHOX. J Biol Chem 2003;278:47820-6. https://doi.org/10.1074/jbc.M306685200
  28. Marchini A, Marttila T, Winter A, Caldeira S, Malanchi I, Blaschke RJ, et al. The short stature homeodomain protein SHOX induces cellular growth arrest and apoptosis and is expressed in human growth plate chondrocytes. J Biol Chem 2004;279:37103-14. https://doi.org/10.1074/jbc.M307006200
  29. Schneider KU, Marchini A, Sabherwal N, Roth R, Niesler B, Marttila T, et al. Alteration of DNA binding, dimerization, and nuclear translocation of SHOX homeodomain mutations identified in idiopathic short stature and Leri-Weill dyschondrosteosis. Hum Mutat 2005;26:44-52. https://doi.org/10.1002/humu.20187
  30. Rappold G, Blum WF, Shavrikova EP, Crowe BJ, Roeth R, Quigley CA, et al. Genotypes and phenotypes in children with short stature: clinical indicators of SHOX haploinsufficiency. J Med Genet 2007;44:306-13. https://doi.org/10.1136/jmg.2006.046581
  31. Thomas NS, Harvey JF, Bunyan DJ, Rankin J, Grigelioniene G, Bruno DL, et al. Clinical and molecular characterization of duplications encompassing the human SHOX gene reveal a variable effect on stature. Am J Med Genet A 2009;149A:1407-14. https://doi.org/10.1002/ajmg.a.32914
  32. Fukami M, Kato F, Tajima T, Yokoya S, Ogata T. Transactivation function of an approximately 800-bp evolutionarily conserved sequence at the SHOX 3' region: implication for the downstream enhancer. Am J Hum Genet 2006;78:167-70. https://doi.org/10.1086/499254
  33. Stuppia L, Gatta V, Antonucci I, Giuliani R, Palka G. Different approaches in the molecular analysis of the SHOX gene dysfunctions. J Endocrinol Invest 2010;33(6 Suppl):30-3.
  34. Binder G, Ranke MB, Martin DD. Auxology is a valuable instrument for the clinical diagnosis of SHOX haploinsufficiency in school-age children with unexplained short stature. J Clin Endocrinol Metab 2003;88:4891-6. https://doi.org/10.1210/jc.2003-030136
  35. Rosilio M, Huber-Lequesne C, Sapin H, Carel JC, Blum WF, Cormier-Daire V. Genotypes and phenotypes of children with SHOX deficiency in France. J Clin Endocrinol Metab 2012;97:E1257-65. https://doi.org/10.1210/jc.2011-3460