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A comprehensive molecular analysis and genotype–phenotype correlation in patients with familial mediterranean fever

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Abstract

Familial Mediterranean fever is an auto inflammatory genetic disease involving especially Turks, Armenians, Arabs and non-Ashkenazi Jews and caused by variants in the MEFV gene. In this study, we aimed to evaluate the distribution and frequency of clinical, MEFV gene variants in FMF patients and the relationship between mutations in different exons and phenotype-genotype and clinical findings. 1028 patients diagnosed as FMF were included. The most common genotypes were M694V / R202Q heterozygous (10.4%), M694V homozygous (7.5%), M694V / E148Q / R202Q heterozygous (4.6%), V726A heterozygous (4.5%), M680I heterozygous (4.2%). c.1611–1 G > C, G152R, S104C, R116S, E336K, R461Q mutations were detected in the literature for the first time in FMF patients. We also divided the patients into 4 groups according to whether the MEFV mutations were exon 10 or non-exon 10. The first group consisted of non-exon 10 homozygous or compound heterozygous (n = 180) patients, Group 2 consisted of exon 10- non-exon 10 compound heterozygous (n = 318) patients, Group 3 consisted of exon 10 homozygous or compound heterozygous (n = 256) patients, while Group 4 consisted of heterozygous (n = 227) patients at any exon. There was no significant difference between the groups in terms of abdominal pain, arthritis, arthralgia, vomiting diarrhea, erysipelas like rash, amyloidosis, renal failure family history. There was no difference in fever between Group 1 (55.6%) and 2 (62.3%); however, these two groups were different from Group 3 (75.8%) and 4 (76.7%). Group 3 (18.8%) had the highest rate of appendectomy. In addition, allele frequencies of all mutations detected in the analyses were compared with allele frequencies of healthy people in the gnomad database. It is useful to analyse all exons in the MEFV gene with the next generation sequence analysis in the detection of FMF disease. S104C, R116S, G152R, E336K, R461Q, L508Q and c.1611–1 G > C mutations are also new variants in literature. c.1611–1 G > C is a possible pathogenic variant.

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References

  1. Touitou I (2001) The spectrum of Familial Mediterranean Fever (FMF) mutations. Eur J Hum Genet 9(7):473–483. https://doi.org/10.1038/sj.ejhg.5200658

    Article  CAS  PubMed  Google Scholar 

  2. Booth DR, Gillmore JD, Lachmann HJ, Booth SE, Bybee A, Soyturk M, Akar S, Pepys MB, Tunca M, Hawkins PN (2000) The genetic basis of autosomal dominant familial Mediterranean fever. QJM 93(4):217–221

    Article  CAS  Google Scholar 

  3. Moradian MM, Sarkisian T, Ajrapetyan H, Avanesian N (2010) Genotype-phenotype studies in a large cohort of Armenian patients with familial Mediterranean fever suggest clinical disease with heterozygous MEFV mutations. J Hum Genet 55(6):389–393. https://doi.org/10.1038/jhg.2010.52

    Article  CAS  PubMed  Google Scholar 

  4. Tunca M, Akar S, Onen F, Ozdogan H, Kasapcopur O, Yalcinkaya F, Tutar E, Ozen S, Topaloglu R, Yilmaz E, Arici M, Bakkaloglu A, Besbas N, Akpolat T, Dinc A, Erken E, Turkish FMFSG (2005) Familial Mediterranean fever (FMF) in Turkey: results of a nationwide multicenter study. Medicine (Baltimore) 84(1):1–11

    Article  Google Scholar 

  5. French FMFC (1997) A candidate gene for familial Mediterranean fever. Nat Genet 17(1):25–31. https://doi.org/10.1038/ng0997-25

    Article  Google Scholar 

  6. Dogan HO, Omma A, Turhan T, Bogdaycioglu N, Karaaslan Y, Yavuz H, Demirpence O, Aydin H, Bakir S (2016) Decreased chitotriosidase activity and levels in Familial Mediterranean Fever. J Korean Med Sci 31(12):1902–1906. https://doi.org/10.3346/jkms.2016.31.12.1902

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Stella A, Cortellessa F, Scaccianoce G, Pivetta B, Settimo E, Portincasa P (2018) Familial Mediterranean fever: breaking all the (genetic) rules. Rheumatology (Oxford). https://doi.org/10.1093/rheumatology/key328

    Article  Google Scholar 

  8. Dundar M, Kiraz A, Emirogullari EF, Saatci CE, Taheri S, Baskol M, Polat S, Ozkul Y (2012) A molecular analysis of familial Mediterranean fever disease in a cohort of Turkish patients. Ann Saudi Med 32(4):343–348

    Article  Google Scholar 

  9. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40(10):1879–1885. https://doi.org/10.1002/art.1780401023

    Article  CAS  Google Scholar 

  10. Coskun S, Kurtgoz S, Keskin E, Sonmez F, Bozkurt G (2015) Frequency of mutations in Mediterranean fever gene, with gender and genotype-phenotype correlations in a Turkish population. J Genet 94(4):629–635

    Article  Google Scholar 

  11. Dusunsel R, Dursun I, Gunduz Z, Poyrazoglu MH, Gurgoze MK, Dundar M (2008) Genotype-phenotype correlation in children with familial Mediterranean fever in a Turkish population. Pediatr Int 50(2):208–212. https://doi.org/10.1111/j.1442-200X.2008.02554.x

    Article  CAS  PubMed  Google Scholar 

  12. Giancane G, Ter Haar NM, Wulffraat N, Vastert SJ, Barron K, Hentgen V, Kallinich T, Ozdogan H, Anton J, Brogan P, Cantarini L, Frenkel J, Galeotti C, Gattorno M, Grateau G, Hofer M, Kone-Paut I, Kuemmerle-Deschner J, Lachmann HJ, Simon A, Demirkaya E, Feldman B, Uziel Y, Ozen S (2015) Evidence-based recommendations for genetic diagnosis of familial Mediterranean fever. Ann Rheum Dis 74(4):635–641. https://doi.org/10.1136/annrheumdis-2014-206844

    Article  CAS  PubMed  Google Scholar 

  13. Ece A, Cakmak E, Uluca U, Kelekci S, Yolbas I, Gunes A, Yel S, Tan I, Sen V (2014) The MEFV mutations and their clinical correlations in children with familial Mediterranean fever in southeast Turkey. Rheumatol Int 34(2):207–212. https://doi.org/10.1007/s00296-013-2858-1

    Article  CAS  PubMed  Google Scholar 

  14. Ben-Chetrit E (2003) Familial Mediterranean fever (FMF) and renal AA amyloidosis–phenotype-genotype correlation, treatment and prognosis. J Nephrol 16(3):431–434

    CAS  PubMed  Google Scholar 

  15. Ben-Chetrit E, Backenroth R (2001) Amyloidosis induced, end stage renal disease in patients with familial Mediterranean fever is highly associated with point mutations in the MEFV gene. Ann Rheum Dis 60(2):146–149. https://doi.org/10.1136/ard.60.2.146

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Dundar M, Emirogullari EF, Kiraz A, Taheri S, Baskol M (2011) Common Familial Mediterranean Fever gene mutations in a Turkish cohort. Mol Biol Rep 38(8):5065–5069. https://doi.org/10.1007/s11033-010-0652-7

    Article  CAS  PubMed  Google Scholar 

  17. Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Aydin AK, Dasdemir S, Turanli ET, Buyru N, Kasapcopur O (2018) Familial Mediterranean fever in childhood: a single-center experience. Rheumatol Int 38(1):67–74. https://doi.org/10.1007/s00296-017-3796-0

    Article  CAS  PubMed  Google Scholar 

  18. Lachmann HJ, Sengul B, Yavuzsen TU, Booth DR, Booth SE, Bybee A, Gallimore JR, Soyturk M, Akar S, Tunca M, Hawkins PN (2006) Clinical and subclinical inflammation in patients with familial Mediterranean fever and in heterozygous carriers of MEFV mutations. Rheumatology (Oxford) 45(6):746–750. https://doi.org/10.1093/rheumatology/kei279

    Article  CAS  Google Scholar 

  19. Balta B, Erdogan M, Alisik M, Kiraz A, Akalin T, Bastug F, Erel O (2018) Does thiol-disulphide balance show oxidative stress in different MEFV mutations? Rheumatol Int 38(1):97–104. https://doi.org/10.1007/s00296-017-3914-z

    Article  CAS  PubMed  Google Scholar 

  20. Kilinc M, Ganiyusufoglu E, Sager H, Celik A, Olgar S, Cetin GY, Davutoglu M, Altunoren O (2016) The report of sequence analysis on familial Mediterranean fever gene (MEFV) in South-eastern Mediterranean region (Kahramanmaras) of Turkey. Rheumatol Int 36(1):25–31. https://doi.org/10.1007/s00296-015-3329-7

    Article  CAS  PubMed  Google Scholar 

  21. Sayin Kocakap DB, Gunel-Ozcan A, Cabuk F, Ensari C (2014) The frequency of Familial Mediterranean fever gene mutations and genotypes at Kirikkale and comparison with the mean of regional MEFV mutation frequency of Turkey. Mol Biol Rep 41(3):1419–1426. https://doi.org/10.1007/s11033-013-2986-4

    Article  CAS  PubMed  Google Scholar 

  22. Comak E, Akman S, Koyun M, Dogan CS, Gokceoglu AU, Arikan Y, Keser I (2014) Clinical evaluation of R202Q alteration of MEFV genes in Turkish children. Clin Rheumatol 33(12):1765–1771. https://doi.org/10.1007/s10067-014-2602-6

    Article  PubMed  Google Scholar 

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Balta, B., Erdogan, M., Kiraz, A. et al. A comprehensive molecular analysis and genotype–phenotype correlation in patients with familial mediterranean fever. Mol Biol Rep 47, 1835–1843 (2020). https://doi.org/10.1007/s11033-020-05277-x

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