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Lookup NU author(s): Dr Mario Abinun
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© 2022. Discovery that mutations in TCIRG1 (also known as Atp6i) gene are responsible for most instances of autosomal recessive osteopetrosis (ARO) heralded a new era for comprehension and treatment of this phenotypically heterogeneous rare bone disease. TCIRG1 encodes the a3 subunit, an essential isoform of the vacuolar ATPase proton pump involved in acidification of the osteoclast resorption lacuna and in secretory lysosome trafficking. TCIRG1 defects lead to inefficient bone resorption by nonfunctional osteoclasts seen in abundance on bone marrow biopsy, delineating this ARO as ‘osteoclast-rich’. Presentation is usually in early childhood and features of extramedullary haematopoiesis (hepatosplenomegaly, anaemia, thrombocytopenia) due to bone marrow fibrosis, and cranial nerve impingement (blindness in particular). Impaired dietary calcium uptake due to high pH causes the co-occurrence of rickets, described as “osteopetrorickets”. Osteoclast dysfunction leads to early death if untreated, and allogeneic haematopoietic stem cell transplantation is currently the treatment of choice. Studies of patients as well as of mouse models carrying spontaneous (the oc/oc mouse) or targeted disruption of Atp6i (TCIRG1) gene have been instrumental providing insight into disease pathogenesis and development of novel cellular therapies that exploit gene correction.
Author(s): Capo V, Abinun M, Villa A
Publication type: Article
Publication status: Published
Journal: Bone
Year: 2022
Volume: 165
Print publication date: 01/12/2022
Online publication date: 15/08/2022
Acceptance date: 11/08/2022
ISSN (print): 8756-3282
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.bone.2022.116519
DOI: 10.1016/j.bone.2022.116519
PubMed id: 35981697
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