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Research

Congenital sucrase–isomaltase deficiency: identification of a common Inuit founder mutation

Julien L. Marcadier, Margaret Boland, C. Ronald Scott, Kheirie Issa, Zaining Wu, Adam D. McIntyre, Robert A. Hegele, Michael T. Geraghty and Matthew A. Lines
CMAJ February 03, 2015 187 (2) 102-107; DOI: https://doi.org/10.1503/cmaj.140657
Julien L. Marcadier
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Margaret Boland
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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C. Ronald Scott
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Kheirie Issa
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Zaining Wu
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Adam D. McIntyre
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Robert A. Hegele
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Michael T. Geraghty
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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Matthew A. Lines
Department of Genetics (Marcadier), Children’s Hospital of Eastern Ontario; Division of Gastroenterology, Hepatology and Nutrition (Boland), Children’s Hospital of Eastern Ontario; Department of Pediatrics (Boland, Issa, Geraghty, Lines), University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; Department of Pediatrics (Scott, Wu), University of Washington, Seattle, Wash.; Robarts Research Institute (McIntyre, Hegele), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Metabolics (Geraghty, Lines), Children’s Hospital of Eastern Ontario, Ottawa, Ont.
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  • For correspondence: mlines@cheo.on.ca
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Abstract

Background: Congenital sucrase–isomaltase deficiency is a rare hereditary cause of chronic diarrhea in children. People with this condition lack the intestinal brush-border enzyme required for digestion of di- and oligosaccharides, including sucrose and isomaltose, leading to malabsorption. Although the condition is known to be highly prevalent (about 5%–10%) in several Inuit populations, the genetic basis for this has not been described. We sought to identify a common mutation for congenital sucrase–isomaltase deficiency in the Inuit population.

Methods: We sequenced the sucrase–isomaltase gene, SI, in a single Inuit proband with congenital sucrase–isomaltase deficiency who had severe fermentative diarrhea and failure to thrive. We then genotyped a further 128 anonymized Inuit controls from a variety of locales in the Canadian Arctic to assess for a possible founder effect.

Results: In the proband, we identified a novel, homozygous frameshift mutation, c.273_274delAG (p.Gly92Leufs*8), predicted to result in complete absence of a functional protein product. This change was very common among the Inuit controls, with an observed allele frequency of 17.2% (95% confidence interval [CI] 12.6%–21.8%). The predicted Hardy–Weinberg prevalence of congenital sucrase–isomaltase deficiency in Inuit people, based on this single founder allele, is 3.0% (95% CI 1.4%–4.5%), which is comparable with previous estimates.

Interpretation: We found a common mutation, SI c.273_274delAG, to be responsible for the high prevalence of congenital sucrase–isomaltase deficiency among Inuit people. Targeted mutation testing for this allele should afford a simple and minimally invasive means of diagnosing this condition in Inuit patients with chronic diarrhea.

See also research article on page E68 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.140840 and commentary on page 93 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.141509

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Canadian Medical Association Journal: 187 (2)
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Vol. 187, Issue 2
3 Feb 2015
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Congenital sucrase–isomaltase deficiency: identification of a common Inuit founder mutation
Julien L. Marcadier, Margaret Boland, C. Ronald Scott, Kheirie Issa, Zaining Wu, Adam D. McIntyre, Robert A. Hegele, Michael T. Geraghty, Matthew A. Lines
CMAJ Feb 2015, 187 (2) 102-107; DOI: 10.1503/cmaj.140657

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Congenital sucrase–isomaltase deficiency: identification of a common Inuit founder mutation
Julien L. Marcadier, Margaret Boland, C. Ronald Scott, Kheirie Issa, Zaining Wu, Adam D. McIntyre, Robert A. Hegele, Michael T. Geraghty, Matthew A. Lines
CMAJ Feb 2015, 187 (2) 102-107; DOI: 10.1503/cmaj.140657
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