%0 Journal Article
%A Aldámiz-Echevarría, Luis
%A Llarena, Marta
%A Bueno, María A
%A Dalmau, Jaime
%A Vitoria, Isidro
%A Fernández-Marmiesse, Ana
%A Andrade, Fernando
%A Blasco, Javier
%A Alcalde, Carlos
%A Gil, David
%A García, María C
%A González-Lamuño, Domingo
%A Ruiz, Mónica
%A Ruiz, María A
%A Peña-Quintana, Luis
%A González, David
%A Sánchez-Valverde, Felix
%A Desviat, Lourdes R
%A Pérez, Belen
%A Couce, María L
%T Molecular epidemiology, genotype-phenotype correlation and BH4 responsiveness in Spanish patients with phenylketonuria.
%D 2016
%U http://hdl.handle.net/10668/10033
%X Phenylketonuria (PKU), the most common inborn error of amino acid metabolism, is caused by mutations in the phenylalanine-4-hydroxylase (PAH) gene. This study aimed to assess the genotype-phenotype correlation in the PKU Spanish population and the usefulness in establishing genotype-based predictions of BH4 responsiveness in our population. It involved the molecular characterization of 411 Spanish PKU patients: mild hyperphenylalaninemia non-treated (mild HPA-NT) (34%), mild HPA (8.8%), mild-moderate (20.7%) and classic (36.5%) PKU. BH4 responsiveness was evaluated using a 6R-BH4 loading test. We assessed genotype-phenotype associations and genotype-BH4 responsiveness in our population according to literature and classification of the mutations. The mutational spectrum analysis showed 116 distinct mutations, most missense (70.7%) and located in the catalytic domain (62.9%). The most prevalent mutations were c.1066-11G>A (9.7%), p.Val388Met (6.6%) and p.Arg261Gln (6.3%). Three novel mutations (c.61-13del9, p.Ile283Val and p.Gly148Val) were reported. Although good genotype-phenotype correlation was observed, there was no exact correlation for some genotypes. Among the patients monitored for the 6R-BH4 loading test: 102 were responders (87, carried either one or two BH4-responsive alleles) and 194 non-responders (50, had two non-responsive mutations). More discrepancies were observed in non-responders. Our data reveal a great genetic heterogeneity in our population. Genotype is quite a good predictor of phenotype and BH4 responsiveness, which is relevant for patient management, treatment and follow-up.
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