Title : Opening a window on lysosomal acid lipase deficiency: Biochemical, molecular, and epidemiological insights - Cappuccio_2019_J.Inherit.Metab.Dis_42_509 |
Author(s) : Cappuccio G , Donti TR , Hubert L , Sun Q , Elsea SH |
Ref : J Inherit Metab Dis , 42 :509 , 2019 |
Abstract :
Lysosomal acid lipase deficiency (LAL-D) is a multi-organ autosomal recessive disease caused by mutations in LIPA. We reviewed data from 681 samples (white blood cells [WBC] n = 625, fibroblasts = 30, liver = 4, amniocytes = 13, chorionic villus = 9) received for analysis of lysosomal acid lipase (LAL) activity over a 15-year period. LIPA sequencing was performed in 49 patients with reduced (n = 26) or deficient (n = 23) LAL activity. The Exome Aggregation Consortium and Genome Aggregation Database dataset were used for LAL-D prevalence calculations. LAL WBC activity was reduced in 67 patients (10.72%) and deficient in 37 (5.92%). The average of LAL activity +/- margin of error (CI 95%) was 19.32 +/- 0.86 pmol/min/mg for reduced activity patients and 5.90 +/- 1.42 pmol/min/mg for deficient patients. The average age at diagnosis for LAL-D was 23.6 years with several patients older than age 30. The correlation between the age at diagnosis and LAL activity showed a significant moderate direct correlation (Pearson's r = 0.46, P < 0.005). Homozygous or compound heterozygous mutations were identified in 9 out of 23 patients with deficient results (detection rate 39.1%). The average LAL activity in molecularly confirmed patients was 4.02 +/- 2.02 pmol/min/mg protein, while in molecularly negative patients was 13.886 +/- 1.49 pmol/min/mg (P < 0.0001). Twenty-two different mutations were identified including two novel variants (c.309C>A and c.856G>C). A carrier frequency of approximately 1 in 350 was inferred. LAL activity in WBC is a validated tool for LAL-D diagnosis. Higher residual enzymatic activity might result in a milder phenotype leading to diagnosis delay. A cut-off below 12 pmol/min/mg protein might be useful to discriminate patients with LIPA mutations. |
PubMedSearch : Cappuccio_2019_J.Inherit.Metab.Dis_42_509 |
PubMedID: 30684275 |
Gene_locus related to this paper: human-LIPA |
Gene_locus | human-LIPA |
Disease | Wolman disease WD, Cholesterol Ester Storage Disease, CESD |
Cappuccio G, Donti TR, Hubert L, Sun Q, Elsea SH (2019)
Opening a window on lysosomal acid lipase deficiency: Biochemical, molecular, and epidemiological insights
J Inherit Metab Dis
42 :509
Cappuccio G, Donti TR, Hubert L, Sun Q, Elsea SH (2019)
J Inherit Metab Dis
42 :509