The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation

This work was supported by ARETHA grant PID2021122436OB-I00 funded by MCIN/AEI/https://doi.org/10.13039/501100011033 to M.S, by grant PLEC2021-007727/AEI /https://doi.org/10.13039/501100011033/Union Europea NextGenerationEU/PRTR from MCIN to M.S. and by Deutsche Josep Carreras Leukämie-Stiftung gran...

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Autores: Jové Solavera, Daniel, Rámila, Marta, Ferrer, Xènia, Olivella, Mireia, Venturi, Veronica, Morado, Marta, Hernández-Rodríguez, Ines, Khan, Aneal, Pérez-Montero, Santiago, Tornador, Cristian, Germing, Ulrich, Gattermann, Norbert, Sanchez-Fernandez, Mayka
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.12328/5055
Acceso en línea:http://hdl.handle.net/20.500.12328/5055
https://dx.doi.org/10.1038/s41598-025-95590-x
Access Level:acceso abierto
Palabra clave:ALAS2
Anèmia sideroblàstica lligada al cromosoma X
Anèmia sideroblàstica congènita
Anèmia hereditària
Sideroblasts en anell
Mutació stop-loss
Anemia sideroblástica ligada al cromosoma X
Anemia sideroblástica congénita
Anemia hereditaria
Sideroblastos en anillo
Mutación stop-loss
X-linked sideroblastic anemia
Congenital sideroblastic anemia
Hereditary anemia
Ring sideroblasts
Stop-loss mutation
61
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oai_identifier_str oai:recercat.cat:20.500.12328/5055
network_acronym_str ES
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dc.title.none.fl_str_mv The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
title The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
spellingShingle The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
Jové Solavera, Daniel
ALAS2
Anèmia sideroblàstica lligada al cromosoma X
Anèmia sideroblàstica congènita
Anèmia hereditària
Sideroblasts en anell
Mutació stop-loss
ALAS2
Anemia sideroblástica ligada al cromosoma X
Anemia sideroblástica congénita
Anemia hereditaria
Sideroblastos en anillo
Mutación stop-loss
ALAS2
X-linked sideroblastic anemia
Congenital sideroblastic anemia
Hereditary anemia
Ring sideroblasts
Stop-loss mutation
61
title_short The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
title_full The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
title_fullStr The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
title_full_unstemmed The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
title_sort The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivation
dc.creator.none.fl_str_mv Jové Solavera, Daniel
Rámila, Marta
Ferrer, Xènia
Olivella, Mireia
Venturi, Veronica
Morado, Marta
Hernández-Rodríguez, Ines
Khan, Aneal
Pérez-Montero, Santiago
Tornador, Cristian
Germing, Ulrich
Gattermann, Norbert
Sanchez-Fernandez, Mayka
author Jové Solavera, Daniel
author_facet Jové Solavera, Daniel
Rámila, Marta
Ferrer, Xènia
Olivella, Mireia
Venturi, Veronica
Morado, Marta
Hernández-Rodríguez, Ines
Khan, Aneal
Pérez-Montero, Santiago
Tornador, Cristian
Germing, Ulrich
Gattermann, Norbert
Sanchez-Fernandez, Mayka
author_role author
author2 Rámila, Marta
Ferrer, Xènia
Olivella, Mireia
Venturi, Veronica
Morado, Marta
Hernández-Rodríguez, Ines
Khan, Aneal
Pérez-Montero, Santiago
Tornador, Cristian
Germing, Ulrich
Gattermann, Norbert
Sanchez-Fernandez, Mayka
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ALAS2
Anèmia sideroblàstica lligada al cromosoma X
Anèmia sideroblàstica congènita
Anèmia hereditària
Sideroblasts en anell
Mutació stop-loss
ALAS2
Anemia sideroblástica ligada al cromosoma X
Anemia sideroblástica congénita
Anemia hereditaria
Sideroblastos en anillo
Mutación stop-loss
ALAS2
X-linked sideroblastic anemia
Congenital sideroblastic anemia
Hereditary anemia
Ring sideroblasts
Stop-loss mutation
61
topic ALAS2
Anèmia sideroblàstica lligada al cromosoma X
Anèmia sideroblàstica congènita
Anèmia hereditària
Sideroblasts en anell
Mutació stop-loss
ALAS2
Anemia sideroblástica ligada al cromosoma X
Anemia sideroblástica congénita
Anemia hereditaria
Sideroblastos en anillo
Mutación stop-loss
ALAS2
X-linked sideroblastic anemia
Congenital sideroblastic anemia
Hereditary anemia
Ring sideroblasts
Stop-loss mutation
61
description This work was supported by ARETHA grant PID2021122436OB-I00 funded by MCIN/AEI/https://doi.org/10.13039/501100011033 to M.S, by grant PLEC2021-007727/AEI /https://doi.org/10.13039/501100011033/Union Europea NextGenerationEU/PRTR from MCIN to M.S. and by Deutsche Josep Carreras Leukämie-Stiftung grant DJCLS R 14/04 to N.G. and M.S. D.J-S. hold a UIC predoctoral fellowship. X.F.-C. was partially supported by funds provided by the grant PID2021122436OB-I00 funded by MCIN/AEI/https://doi.org/10.13039/501100011033. V.V. was supported by funds provided by APU and ADISCON patient associations, UIC postdoctoral scholarship and by funds provided by RETOS COLABORACION grant RTC2019-007074-1 from MCIN/AEI/https://doi.org/10.13039/501100011033 from Spanish Ministry of Science and Innovation (MICINN).
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12328/5055
https://dx.doi.org/10.1038/s41598-025-95590-x
url http://hdl.handle.net/20.500.12328/5055
https://dx.doi.org/10.1038/s41598-025-95590-x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Scientific Reports
15
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 14
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling The role of genetic testing in accurate diagnosis of X-linked sideroblastic anemia: novel ALAS2 mutations and the impact of X-chromosome inactivationJové Solavera, DanielRámila, MartaFerrer, XèniaOlivella, MireiaVenturi, VeronicaMorado, MartaHernández-Rodríguez, InesKhan, AnealPérez-Montero, SantiagoTornador, CristianGerming, UlrichGattermann, NorbertSanchez-Fernandez, MaykaALAS2Anèmia sideroblàstica lligada al cromosoma XAnèmia sideroblàstica congènitaAnèmia hereditàriaSideroblasts en anellMutació stop-lossALAS2Anemia sideroblástica ligada al cromosoma XAnemia sideroblástica congénitaAnemia hereditariaSideroblastos en anilloMutación stop-lossALAS2X-linked sideroblastic anemiaCongenital sideroblastic anemiaHereditary anemiaRing sideroblastsStop-loss mutation61This work was supported by ARETHA grant PID2021122436OB-I00 funded by MCIN/AEI/https://doi.org/10.13039/501100011033 to M.S, by grant PLEC2021-007727/AEI /https://doi.org/10.13039/501100011033/Union Europea NextGenerationEU/PRTR from MCIN to M.S. and by Deutsche Josep Carreras Leukämie-Stiftung grant DJCLS R 14/04 to N.G. and M.S. D.J-S. hold a UIC predoctoral fellowship. X.F.-C. was partially supported by funds provided by the grant PID2021122436OB-I00 funded by MCIN/AEI/https://doi.org/10.13039/501100011033. V.V. was supported by funds provided by APU and ADISCON patient associations, UIC postdoctoral scholarship and by funds provided by RETOS COLABORACION grant RTC2019-007074-1 from MCIN/AEI/https://doi.org/10.13039/501100011033 from Spanish Ministry of Science and Innovation (MICINN).X-linked sideroblastic anemia (XLSA) is a hereditary disorder affecting heme biosynthesis, caused by mutations in the ALAS2 gene, which encodes the erythroid-specific enzyme 5-aminolevulinate synthase. This enzyme, which requires pyridoxal 5’-phosphate (PLP) as a cofactor, catalyzes the first and rate-limiting step of heme synthesis in erythroid cells. XLSA is characterized by hypochromic microcytic anemia and ring sideroblasts in bone marrow, with most patients showing variable degrees of response to pyridoxine supplementation; however, female carriers of ALAS2 mutations often present a distinct clinical phenotype. A comprehensive review of the literature reveals over 100 distinct ALAS2 mutations linked to XLSA in more than 240 families. Here, we report seven new patients (four female cases) initially diagnosed with various conditions, later confirmed to have X-linked Sideroblastic Anemia due to ALAS2 mutations through genetic analysis. Among these, five represent novel ALAS2 mutations, including the first ever reported stop-loss mutation in ALAS2 associated with XLSA rather than X-linked dominant protoporphyria (XLDPP). Computational modelling of six reported cases revealed that four mutations significantly impact protein structure, conformation and cofactor interaction, consistent with our enzymatic assays demonstrating reduced ALAS2 activity. Furthermore, X-chromosome studies in female probands revealed a pronounced skewing of X-chromosome, which may provide an explanation for their distinct clinical manifestations in females.info:eu-repo/semantics/publishedVersionSpringer Nature2025info:eu-repo/semantics/article14http://hdl.handle.net/20.500.12328/5055https://dx.doi.org/10.1038/s41598-025-95590-xreponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésScientific Reports15This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:20.500.12328/50552026-05-29T05:05:01Z
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