Clinical Trial: Genetics of Ehlers-Danlos Syndrome

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Observational [Patient Registry]

Official Title: Determine the Causative Genetic Variations in Patients With Ehlers-Danlos Syndrome

Brief Summary:

We are planning to collected blood and saliva for DNA extraction to use for genetic testing of children and adults with EDS and their relatives. Medical records from other institutions and clinical notes for visits in Dr. Holick's clinic will be reviewed to obtain the following information: previous diagnosis at other institutions, age, clinical signs and symptoms of EDS, Joints Hypermobility Syndrome (JHS), , and other metabolic or genetic disorders and laboratory results, radiology reports and images, and genetic testing that supports these diagnoses. Subjects' peripheral vein blood and saliva will be taken. No clinical intervention/randomizations will be performed. No patients' identifiers will be reported.

In this pilot study genomic DNA will be extracted and will be used for genotyping as sequencing in 30 EDS patients and their 30 relatives with or without EDS to compare genetic variations between them. After validation by Sanger sequencing for these variations, we plan to prepare a genetic panel for EDS. After all validation testing, we plan to evaluate the saliva DNA in a similar manner and compare the results with those obtained from the DNA from the blood sample. The purpose is that if they are comparable, we will be able to use saliva in place of blood as it easier method for accessing a person's DNA. This will be especially helpful for evaluating infants or those patients who prefer not to have a blood sample drawn.

Detailed Summary:

Ehlers-Danlos Syndrome (EDS) is a genetic disease that affects collagen synthesis and structure resulting in multisystem connective tissue involvement with twelve different subtypes. The clinical manifestations of EDS include skin hyperextensibility, skin fragility, joint hypermobility, muscle hypotonia, easy bruising, and mast cell hypersensitivity. We recently reported a cases series of EDS patients with different signs and symptoms. Most were evaluated along with their parents for evidence of acquired or inherited bone diseases. What is remarkable is that 93% of our cases at least one parent had clinically documented evidence for EDS a genetic disorder that compromises the structural integrity of the collagen/elastin matrix. Most of the parents were unaware they had this genetic disorder and the diagnosis was made for the first time in our clinic. Our previous study for reviewing patient's medical records was approved by the Boston University Medical Center's IRB. We have access to EDS patients from referrals and from Dr Holick's clinic. We plan to collect the blood and saliva samples from EDS patients and their relatives for this genetic study.

Genetic evaluation in limited number of our patients showed some causative variations. For example, one of our cases the patient was evaluated at an outside hospital for a causative variant in the COL5A1, COL5A2, FKBP14, and TNXB genes, which were negative, but she was found later to have a causative variant in serpin peptidase inhibitor, clade F, member 1 (SERPINF1) gene. A causative variation in SERPINF1 gene has been associated with osteogenesis imperfecta (OI) /EDS overlap syndrome and the mutation in this gene causes type VI OI.

The highly variable clinical presentation of patients with the hypermobility and clinical signs for EDS prompted an effort to classify patients wit
Sponsor: Boston University

Current Primary Outcome: Causative genetic variations relation to EDS [ Time Frame: one year ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: Boston University

Dates:
Date Received: March 22, 2017
Date Started: July 2017
Date Completion: December 2018
Last Updated: May 9, 2017
Last Verified: May 2017