Incidence and carrier frequency of Sandhoff disease in Saskatchewan determined using a novel substrate with detection by tandem mass spectrometry and molecular genetic analysis.

Sandhoff disease is a rare progressive neurodegenerative genetic disorder with a high incidence among certain isolated communities and ethnic groups around the world. Previous reports have shown a high occurrence of Sandhoff disease in northern Saskatchewan. Newborn screening cards from northern Saskatchewan were retrospectively screened in order to investigate the incidence and determine the carrier frequency of Sandhoff disease in these communities. PCR-based screening was conducted for the c.115delG (p.(Val39fs)) variant in the HEXB gene that was previously found in 4 Sandhoff disease patients from this area. The carrier frequency for this allele was estimated to be ~1:27. MS/MS-based screening of hexosaminidase activity along with genetic sequencing allowed for the identification of additional variants based on low total hexosaminidase activity and high % hexosaminidase A activity relative to c.115delG carriers. In total 4 pathogenic variants were discovered in the population (c.115delG, c.619A>G, c.1601G>T, and c.1652G>A) of which two are previously unreported (c.1601G>T and c.1652G>A). The combined carrier frequency of these alleles in the study area was estimated at ~1:15. Based on the number of cases of Sandhoff disease from this area we estimate the incidence to be ~1:390 corresponding to a child being born with the disease every 1-2 years on average. The results from our study were then compared with variants in the HEXB gene from the genomes available from the 1000 Genomes project. A total of 19 HEXB variants were found in the 1092 genomes of which 5 are suspected of having a deleterious effect on hexosaminidase activity. The estimated carrier frequency of Sandhoff disease in Saskatchewan at 1:15 is more than 3 times higher than the carrier frequency in the global sample provided by the 1000 Genomes project at 1:57.

Real-time PCR genotyping assay for GM2 gangliosidosis variant 0 in toy poodles and the mutant allele frequency in Japan.

GM2 gangliosidosis variant 0 (Sandhoff disease, SD) is a fatal, progressive neurodegenerative lysosomal storage disease caused by mutations of the HEXB gene. In canine SD, a pathogenic mutation (c.283delG) of the canine HEXB gene has been identified in toy poodles. In the present study, a TaqMan probe-based real-time PCR genotyping assay was developed and evaluated for rapid and large-scale genotyping and screening for this mutation. Furthermore, a genotyping survey was carried out in a population of toy poodles in Japan to determine the current mutant allele frequency. The real-time PCR assay clearly showed all genotypes of canine SD. The assay was suitable for large-scale survey as well as diagnosis, because of its high throughput and rapidity. The genotyping survey demonstrated a carrier frequency of 0.2%, suggesting that the current mutant allele frequency is low in Japan. However, there may be population stratification in different places, because of the founder effect by some carriers. Therefore, this new assay will be useful for the prevention and control of SD in toy poodles.

Sandhoff disease in Argentina: high frequency of a splice site mutation in the HEXB gene and correlation between enzyme and DNA-based tests for heterozygote detection.

The level of beta-hexosaminidase activity in plasma and leukocytes and the frequency of three known HEXB mutations were studied in an Argentinean deme with high incidence of infantile Sandhoff disease. Two mutations were previously identified in one of two Sandhoff patients from the region, a splice mutation, IVS-2 + 1 G-->A, and a 4-bp deletion, delta CTTT782-785. These mutations, and a 16-kb deletion from the 5' end of the HEXB gene common in non-Argentineans, were screened in 9 Sandhoff patients (all unrelated), 24 obligate heterozygotes, 33 additional individuals belonging to families with affected members, and 64 randomly ascertained individuals from the high risk region. Of 31 independent alleles examined, including those of the two patients previously reported, 30 had the IVS-2 splice mutation and only the originally reported patient had the delta CTTT deletion. The 16-kb deletion was not observed. Further, among the 57 unaffected members of families with a previous history of Sandhoff disease, and absolute correlation was found between carrier diagnosis by enzyme assay of leukocytes and the DNA-based tests for mutation. One of the 64 controls was classified as a carrier by enzyme assay but did not have one of the three mutations screened. We conclude that a single mutation predominates in this Argentinean population and that the DNA-based test can be an effective supplement or alternative to enzyme-based testing.

Estimación de la frecuencia de heterocigotes de la enfermedad de Sandhoff en una población Argentina de alto riesgo: asignación predictiva del genotipo mediante un análisis estadístico / Estimation of the frecuency of heterozygotes in Sandhoff disease in an Argentine population of high risk: predictive assignment of the genotype through a statistical analysis

En trabajos preliminares hemos evidenciado una alta frecuencia de la Enfermedad de Sandhoff (ES), deficiencia génica de la actividad hidrolítica de la hexosaminidasa (Hex) en sus dos mayores isoenzimas Hex A y Hex B, en niños criollos de un semi-aislado geográfico de la Argentina. La presente comunicación se refiere a la estimación de la proporción de portadores del gen anormal entre 1400 escolares de la zona mediante la determinación con sustratos artificiales de la Hex Total y Hex B Sérica. Los valores de las actividades enzimáticas de 32 heterocigotos testigos, 15 de ellos obligados (padres), sirvieron de patrón de referencia autóctono para la detección de 71 heterocigotos de la muestra problema (4,93%). Los límites de confidencia del 99% determinaron que la proporción de los heterocigotos en la población estaba en el intervalo 0,0346-0,0636 o sea 1 portador por cada 16 a 29 habitantes de la región, resultado similar a la heterocigosis calculada según la ley de Hardy-Weinberg (1:14 a 1:26). El análisis estadístico de las dos variables empleadas (Hex Total y Hex B) de los subgrupos referenciales homocigotos normales y heterocigotos testigos, permitió la elaboración de una función discriminante cuadrática (FDC) capaz de discernir, con alta probabilidad, entre un genotipo mutado y otro normal. Los datos obtenidos indican una heterocigosis de ES exepcionalmente alta en la población de riesgo y coherente con la frecuencia de homocigotos enfermos reconocidos, otorgándose fundamento a un programa preventivo a nivel regional. Entre tanto, la FDC elaborada provee un recurso eficaz y práctivo de asesoramiento individual, sobre todo en el ámbito clínico vinculado al problema