RT Journal Article T1 Characterization of Genetic Variants of Uncertain Significance for the ALPL Gene in Patients With Adult Hypophosphatasia. A1 Sanabria-de la Torre, Raquel A1 Martinez-Heredia, Luis A1 Gonzalez-Salvatierra, Sheila A1 Andujar-Vera, Francisco A1 Iglesias-Baena, Ivan A1 Villa-Suarez, Juan Miguel A1 Contreras-Bolivar, Victoria A1 Corbacho-Soto, Mario A1 Martinez-Navajas, Gonzalo A1 Real, Pedro J A1 Garcia-Fontana, Cristina A1 Muñoz-Torres, Manuel A1 Garcia-Fontana, Beatriz K1 alkaline phosphatase K1 bone K1 enzymatic activity K1 genetic variant K1 hypophosphatasia K1 mineralization K1 pyridoxal 5´ phosphate AB Hypophosphatasia (HPP) a rare disease caused by mutations in the ALPL gene encoding for the tissue-nonspecific alkaline phosphatase protein (TNSALP), has been identified as a potentially under-diagnosed condition worldwide which may have higher prevalence than currently established. This is largely due to the overlapping of its symptomatology with that of other more frequent pathologies. Although HPP is usually associated with deficient bone mineralization, the high genetic variability of ALPL results in high clinical heterogeneity, which makes it difficult to establish a specific HPP symptomatology. In the present study, three variants of ALPL gene with uncertain significance and no previously described (p.Del Glu23_Lys24, p.Pro292Leu and p.His379Asn) were identified in heterozygosis in patients diagnosed with HPP. These variants were characterized at phenotypic, functional and structural levels. All genetic variants showed significantly lower in vitro ALP activity than the wild-type (WT) genotype (p-value PB Frontiers Research Foundation SN 1664-2392 YR 2022 FD 2022-03-14 LK http://hdl.handle.net/10668/20562 UL http://hdl.handle.net/10668/20562 LA en NO Sanabria-de la Torre R, Martínez-Heredia L, González-Salvatierra S, Andújar-Vera F, Iglesias-Baena I, Villa-Suárez JM, et al. Characterization of Genetic Variants of Uncertain Significance for the ALPL Gene in Patients With Adult Hypophosphatasia. Front Endocrinol (Lausanne). 2022 Apr 14;13:863940. NO This research was funded by the Instituto de Salud Carlos III grants (PI18-00803, PI21/01069 and PI18-01235), co-funded by the European Regional Development Fund (FEDER) and by Junta de Andalucía grant (PI-0268-2019). In addition, VC-B is supported by postdoctoral fellowship from Junta de Andalucía (RH-0141-2020) and JMV-S and SG-S are funded by predoctoral fellowships from Instituto de Salud Carlos III (CM19/00188 and FI19/00118 respectively). CG-F and RS-dT are funded by postdoctoral Sara Borrell fellowship and Research investigator grant in the framework of the youth guarantee Program from the Instituto de Salud Carlos III and the University of Granada with co-funding by FEDER respectively (CD20/00022 and 8110 grant number). GM-N is supported by the predoctoral program from Instituto de Salud Carlos III (FI17/00178) and PR is a Ramon y Cajal Researcher from the MINECO (RYC-2015-18383) at GENyO and University of Granada. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. DS RISalud RD Apr 10, 2025