Hereditary interstitial lung diseases manifesting in early childhood in Japan
Takuma Akimoto1, Kazutoshi Cho1, Itaru Hayasaka1
1Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan.
Insights
Genetic variations in Japanese infants with interstitial lung diseases (ILD) were investigated. Surfactant protein-C gene (SFTPC) abnormalities were most common, while surfactant protein-B (SP-B) deficiency was rare in these hereditary ILD cases.
Area of Science:
- Pediatric Pulmonology
- Medical Genetics
- Neonatology
Background:
- Interstitial lung diseases (ILD) in infants are challenging to diagnose.
- Genetic factors contributing to ILD in Japanese infants remain understudied.
- Unexplained lung dysfunction in infants necessitates etiological investigation.
Purpose of the Study:
- To identify genetic variations associated with ILD in Japanese infants.
- To determine the prevalence of specific gene mutations in different ILD subtypes.
- To elucidate the role of surfactant protein genes in infantile ILD.
Main Methods:
- Genetic analysis of SFTPC, ABCA3, SFTPB, and FOXF1 genes in 43 infants with unexplained lung dysfunction.
- Western blotting for surfactant protein-B (SP-B).
- Assessment of pSTAT-5 signaling pathway.
Main Results:
- Nine infants were diagnosed with ILD (interstitial pneumonitis, hereditary pulmonary alveolar proteinosis (hPAP), alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV)).
- Genetic variations were found in 67% of infants with ILD, predominantly involving SFTPC and ABCA3 genes in hPAP and interstitial pneumonitis.
- No SFTPB mutations or pSTAT-5 defects were observed; adequate SP-B protein levels were detected.
Conclusions:
- SFTPC gene abnormalities are the most prevalent genetic cause of hereditary ILD in Japanese infants.
- SP-B deficiency is uncommon in this population.
- Genetic testing is crucial for diagnosing hereditary ILD in infants with unexplained lung dysfunction.
Background:
Genetic variations associated with interstitial lung diseases (ILD) have not been extensively studied in Japanese infants.
Methods:
Forty-three infants with unexplained lung dysfunction were studied. All 43, 22, and 17 infants underwent analyses of surfactant protein (SP)-C gene (SFTPC) and ATP-binding cassette A3 gene (ABCA3), SP-B gene (SFTPB), and SP-B western blotting, respectively. Two and four underwent assessment of granulocyte macrophage colony-stimulating factor-stimulating phosphorylation of signal transducer and activator of transcription-5 (pSTAT-5) and analyses of FOXF1 gene (FOXF1), respectively.
Results:
ILD were diagnosed clinically in nine infants: four, three, and two had interstitial pneumonitis, hereditary pulmonary alveolar proteinosis (hPAP), and alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV), respectively. Genetic variations considered responsible were detected in six (67%) of the nine infants with ILD: three with hPAP (SFTPC p.Leu45Arg and p.Gln145fs, and ABCA3 p.Arg1583Trp/p.Val1495CysfsX21), two with interstitial pneumonitis (SFTPC p.Lys63Glu and p.Ser72Asn/p.Gly100Ala), and one with ACD/MPV (FOXF1 p.Leu300ArgfsX79). None showed SFTPB mutations or defects in pSTAT-5. The 17 bronchoalveolar lavage or tracheal aspirates contained enough SP-B protein.
Conclusion:
The SP-C abnormality was most prevalent, and SP-B deficiency was rare in Japanese infants with hereditary ILD.
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