Abstract
Multicentric osteolysis with nodulosis and arthropathy (MONA, NAO (OMIM no. 605156)) is an autosomal recessive member of the ‘vanishing bone’ syndromes and is notable for the extent of carpal and tarsal osteolysis and interphalangeal joint erosions, facial dysmorphia, and the presence of fibrocollagenous nodules. This rare disorder has been described previously in Saudi Arabian and Indian families. We now report on the first Turkish family with MONA, further confirming the panethnic nature of this disease. Strikingly, and in addition to the previously noted skeletal and joint features, affected members of this family also had congenital heart defects. Molecular analysis identified a novel MMP2 inactivating mutation that deletes the terminal hemopexin domains and thus confirmed the diagnosis of MONA. On the basis of these findings, we suggest that cardiac defects may also represent a component of this syndrome and thus a physiologically relevant target of MMP-2 activity.
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References
Hardegger F, Simpson LA, Segmueller G : The syndrome of idiopathic osteolysis. classification, review, and case report. J Bone Joint Surg Br 1985; 67: 88–93.
Petit P, Fryns JP : Distal osteolysis, short stature, mental retardation, and characteristic facial appearance: delineation of an autosomal recessive subtype of essential osteolysis. Am J Med Genet 1986; 25: 537–541.
Al Aqeel A, Al Sewairi W, Edress B, Gorlin RJ, Desnick RJ, Martignetti JA : Inherited multicentric osteolysis with arthritis: a variant resembling torg syndrome in a saudi family. Am J Med Genet 2000; 93: 11–18.
Al-Mayouf SM, Majeed M, Hugosson C, Bahabri S : New form of idiopathic osteolysis: nodulosis, arthropathy and osteolysis (NAO) syndrome. Am J Med Genet 2000; 93: 5–10.
Hall CM : International nosology and classification of constitutional disorders of bone (2001). Am J Med Genet 2002; 113: 65–77.
Martignetti JA, Aqeel AA, Sewairi WA et al: Mutation of the matrix metalloproteinase 2 gene (MMP2) causes a multicentric osteolysis and arthritis syndrome. Nat Genet 2001; 28: 261–265.
Phadke SR, Ramirez M, Difeo A, Martignetti JA, Girisha KM : Torg-winchester syndrome: lack of efficacy of pamidronate therapy. Clin Dysmorphol 2007; 16: 95–100.
Rouzier C, Vanatka R, Bannwarth S et al: A novel homozygous MMP2 mutation in a family with winchester syndrome. Clin Genet 2006; 69: 271–276.
Zankl A, Pachman L, Poznanski A et al: Torg syndrome is caused by inactivating mutations in MMP2 and is allelic to NAO and winchester syndrome. J Bone Miner Res 2007; 22: 329–333.
Zankl A, Bonafe L, Calcaterra V, Di Rocco M, Superti-Furga A : Winchester syndrome caused by a homozygous mutation affecting the active site of matrix metalloproteinase 2. Clin Genet 2005; 67: 261–266.
Inoue K, Mikuni-Takagaki Y, Oikawa K et al: A crucial role for MMP-2 in osteocytic canalicular formation and bone metabolism. J Biol Chem 2006; 281: 33814–33824.
Mosig RA, Dowling O, Difeo A et al: Loss of MMP-2 disrupts skeletal and craniofacial development and results in decreased bone mineralization, joint erosion and defects in osteoblast and osteoclast growth. Hum Mol Genet 2007; 16: 1113–1123.
Morgunova E, Tuuttila A, Bergmann U et al: Structure of human pro-matrix metalloproteinase-2: activation mechanism revealed. Science 1999; 284: 1667–1670.
Bruneau BG : The developmental genetics of congenital heart disease. Nature 2008; 451: 943–948.
Basson CT, Huang T, Lin RC et al: Different TBX5 interactions in heart and limb defined by holt-oram syndrome mutations. Proc Natl Acad Sci USA 1999; 96: 2919–2924.
Schott JJ, Benson DW, Basson CT et al: Congenital heart disease caused by mutations in the transcription factor NKX2-5. Science 1998; 281: 108–111.
Garg V, Kathiriya IS, Barnes R et al: GATA4 mutations cause human congenital heart defects and reveal an interaction with TBX5. Nature 2003; 424: 443–447.
McElhinney DB, Geiger E, Blinder J, Benson DW, Goldmuntz E : NKX2.5 mutations in patients with congenital heart disease. J Am Coll Cardiol 2003; 42: 1650–1655.
Engin F, Yao Z, Yang T et al: Dimorphic effects of notch signaling in bone homeostasis. Nat Med 2008; 14: 299–305.
Garg V, Muth AN, Ransom JF et al: Mutations in NOTCH1 cause aortic valve disease. Nature 2005; 437: 270–274.
Gelb BD, Tartaglia M : Noonan syndrome and related disorders: dysregulated RAS-mitogen activated protein kinase signal transduction. Hum Mol Genet 2006; 15 (Spec No 2): R220–R226.
Abilleira S, Bevan S, Markus HS : The role of genetic variants of matrix metalloproteinases in coronary and carotid atherosclerosis. J Med Genet 2006; 43: 897–901.
Linask KK, Han M, Cai DH, Brauer PR, Maisastry SM : Cardiac morphogenesis: matrix metalloproteinase coordination of cellular mechanisms underlying heart tube formation and directionality of looping. Dev Dyn 2005; 233: 739–753.
Enciso JM, Gratzinger D, Camenisch TD, Canosa S, Pinter E, Madri JA : Elevated glucose inhibits VEGF-A-mediated endocardial cushion formation: modulation by PECAM-1 and MMP-2. J Cell Biol 2003; 160: 605–615.
Piccard H, Van den Steen PE, Opdenakker G : Hemopexin domains as multifunctional liganding modules in matrix metalloproteinases and other proteins. J Leukoc Biol 2007; 81: 870–892.
Overall CM, King AE, Sam DK et al: Identification of the tissue inhibitor of metalloproteinases-2 (TIMP-2) binding site on the hemopexin carboxyl domain of human gelatinase A by site-directed mutagenesis. the hierarchical role in binding TIMP-2 of the unique cationic clusters of hemopexin modules III and IV. J Biol Chem 1999; 274: 4421–4429.
Patterson ML, Atkinson SJ, Knauper V, Murphy G : Specific collagenolysis by gelatinase A, MMP-2, is determined by the hemopexin domain and not the fibronectin-like domain. FEBS Lett 2001; 503: 158–162.
Tam EM, Moore TR, Butler GS, Overall CM : Characterization of the distinct collagen binding, helicase and cleavage mechanisms of matrix metalloproteinase 2 and 14 (gelatinase A and MT1-MMP): The differential roles of the MMP hemopexin c domains and the MMP-2 fibronectin type II modules in collagen triple helicase activities. J Biol Chem 2004; 279: 43336–43344.
McQuibban GA, Butler GS, Gong JH et al: Matrix metalloproteinase activity inactivates the CXC chemokine stromal cell-derived factor-1. J Biol Chem 2001; 276: 43503–43508.
McQuibban GA, Gong JH, Tam EM, McCulloch CA, Clark-Lewis I, Overall CM : Inflammation dampened by gelatinase A cleavage of monocyte chemoattractant protein-3. Science 2000; 289: 1202–1206.
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Tuysuz, B., Mosig, R., Altun, G. et al. A novel matrix metalloproteinase 2 (MMP2) terminal hemopexin domain mutation in a family with multicentric osteolysis with nodulosis and arthritis with cardiac defects. Eur J Hum Genet 17, 565–572 (2009). https://doi.org/10.1038/ejhg.2008.204
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DOI: https://doi.org/10.1038/ejhg.2008.204
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