Annual Report
2008/2009 |
The
Hess B. and Diane Finestone Laboratory in Memory of
Jacob and Jenny Finestone was established in 1988 to honour the memory of Jacob and Jenny Finestone
and the 80th birthday of Mr. Hess B. Finestone by
providing a permanent endowment at McGill University devoted to the advancement
of medical genetics. The specific objectives of the endowment are to a) fund
research projects related to the field of medical genetics; b) fund trainees in
the field of medical genetics; and c) publicize the field of medical genetics
through the support of special lectures, visiting professorships and other
appropriate means.
Dr.
David S. Rosenblatt has been Director of the laboratory since its inception. In
past years, this report has served as the Annual Report of the Division of
Medical Genetics of the Department of Medicine. With the creation of
free-standing Departments of Medical Genetics at both the McGill University
Health Centre and the Jewish General Hospital, a longstanding goal of Dr.
Rosenblatt, this and future Finestone reports will
restrict themselves to the activities of the Director. Material previously
found in this report should be sought in the respective university or hospital
annual reports.
Our
laboratory, located at the Montreal General Hospital Site of the McGill
University Health Centre, is one of two major international referral
laboratories for the diagnosis of patients with inherited disorders of folate and vitamin B12 transport and metabolism. It is
involved in studying the biochemical and molecular bases of these diseases.
Since Dr. Rosenblatt directs a certified molecular diagnostic laboratory
adjacent to the research laboratory, advances in knowledge from research can be
immediate translated to clinical diagnosis.
2008-2009
has been another very productive year:
1.
Along with collaborators in Germany and Switzerland, we described the LMBRD1
gene responsible for the cblF inborn
error of vitamin B12 metabolism. This work marked the successful completion of
a research goal going back to 1985, when Dr. Rosenblatt and colleagues
described the biochemical defect in the first patient with this disease in the
journal Science. This patient had been discovered following newborn urine
screening in Quebec. The defect is caused because of a defect in a protein that
is required to export vitamin B12 from the lysosome.
Because of this, the vitamin levels increase inside the lysosome
and the vitamin cannot get into the cell in order to be converted to its active
forms. This work was published in Nature Genetics and will comprise a portion
of the Ph.D. thesis of Isabelle R. Miousse.
2.
We have shown that transcobalamin (TC) is an
intracellular binder of vitamin B12 and that its level varies in cells lines
from patients with different inherited disorders of vitamin B12 metabolism-in
particular the mut and cblB complementation classes. This work
formed the basis of the M.Sc. thesis of Lama Yamani and was published in
Molecular Genetics and Metabolism.
3.
Transcobalamin deficiency can come to medical
attention with findings similar to those of leukemia. We described such an
infant in whom bone marrow transplantation was even being considered until the
correct diagnosis was made. The work was published in the Journal of Inherited
Metabolic Diseases.
4.
Last year, with colleagues in Switzerland, we identified MMADHC as the
gene responsible for the cblD form of
combined homocystinuria and methylmalonic
aciduria. In the initial report in the New England
Journal of Medicine, seven patients were studied and mutations in different
parts of the gene were shown to be responsible for either homocystinuria
alone (variant 1), methylmalonic aciduria
alone (variant 2) or combined homocystinuria and methylmalonic aciduria, the
classic form of cblD. This year, study of an
additional three patients' added support to the hypothesis, that mutations
affecting the N terminus of the MMACHC protein are associated with methylmalonic aciduria, whereas
mutations affecting the C terminus are associated with homocystinuria.
This work, published in the Journal of Pediatrics, increases the total number
published cases of this disease to ten.
5.
A number of years ago, using combined haplotype
analysis and homozygosity mapping followed by
sequencing of candidate genes, we identified MMACHC as the gene
responsible for the cblC disorder, which
is associated with combined homocystinuria and methylmalonic aciduria. We
discovered 42 different mutations in 204 individuals; many mutations were
consistent with loss of function of the gene product. The c.271dupA mutation
accounted for 40% of all disease-causing alleles, and almost always was found
on a single haplotype. Patients homozygous for this
mutation always had early-onset disease. Patients homozygous for another
mutation, c394 C>T (R132X) always had late-onset disease. We also showed
that a number of mutations had ethnic specificity; in particular c.331C>T
(R111X) was found in patients of French Canadian or Acadian ancestry.
Transduction of wild-type MMACHC into immortalized cblC
fibroblasts corrected the cellular defects in Cbl
metabolism. The function of the gene product is not well understood. It
contains a cobalamin-binding motif and a domain with
homology to the bacterial protein TonB, which is
involved in energy transduction for the transport of cobalamin
and other molecules. Molecular modeling predicted that the domain in MMACHC folds
similarly to TonB.
This
year, sequencing of 118 additional patients from a mainly European cohort
identified 11 novel mutations, as well as 21 that had been observed previously.
Allelic expression analysis carried out on cell lines derived from patients who
were compound heterozygotes for different
combinations of mutations indicated that the early-onset c.271dupA and
c.331C>T mutations were under-expressed when compared to the late onset
c.394C>T mutation. This work is published in Human Mutation and will form
part of the M.Sc. thesis of Natascia Anastasio.
6.
We have shown that a human melanoma-derived cell line, which is a phenocopy for cblC, shows methionine dependence due to aberrant methylation
of the MMACHC promoter. This shows that a cancer cell line can mimic an
inborn error of metabolism due to an epigenetic effect. This work is published
in Molecular Genetics and Metabolism and is the basis of the M.Sc. thesis of
Amanda Loewy.
Biology 575
Department:
Biology/Human Genetics
Format:
Lecture
Title: Inborn Errors of Folate and Cobalamin Transport
and Metabolism
Role:
Lecturer and Course Coordinator
Level:
Undergraduate/Graduate
Time:
6 hours
Unit 8
Department:
Human Genetics
Format:
Lecture and Small Group Teaching
Role:
Lecturer-2 sessions; Small Group Leader
Title: Introduction to
Medical Genetics
Huntington Disease
Level:
Medical Students
Time:
2 lectures plus 5 2-hour sessions, twelve hours in total
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