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2
Inheritance
5
Pathophys.
1
Histopath.
25
Phenotypes
19
Pathograph
3
Genes
5
Treatments
3
Subtypes
10
References
1
Deep Research
👪

Inheritance

2
Autosomal dominant HP:0000006
FBN1- and LTBP3-related geleophysic dysplasia are autosomal dominant. Reported probands with parental molecular testing have had de novo pathogenic variants.
Autosomal dominant inheritance
Show evidence (3 references)
ORPHA:2623 SUPPORT Other
"Autosomal dominant"
Orphanet lists autosomal dominant inheritance for a subset of geleophysic dysplasia.
PMID:20301776 SUPPORT Human Clinical
"Geleophysic dysplasia caused by a heterozygous pathogenic variant in either FBN1 or LTBP3 is inherited in an autosomal dominant manner."
GeneReviews directly states the dominant inheritance pattern for FBN1 and LTBP3 subtypes.
PMID:20301776 SUPPORT Human Clinical
"Autosomal dominant inheritance: All probands reported to date with FBN1- or LTBP3-related geleophysic dysplasia whose parents have undergone molecular genetic testing have had the disorder as the result of a de novo pathogenic variant."
GeneReviews supports the de novo statement for tested FBN1- and LTBP3-related probands.
Autosomal recessive HP:0000007
ADAMTSL2-related geleophysic dysplasia is autosomal recessive and results from biallelic pathogenic variants.
Autosomal recessive inheritance
Show evidence (2 references)
ORPHA:2623 SUPPORT Other
"Autosomal recessive"
Orphanet lists autosomal recessive inheritance for a subset of geleophysic dysplasia.
PMID:20301776 SUPPORT Human Clinical
"Geleophysic dysplasia caused by biallelic pathogenic variants in ADAMTSL2 is inherited in an autosomal recessive manner."
GeneReviews directly states the recessive inheritance pattern for ADAMTSL2-related disease.

Subtypes

3
Geleophysic dysplasia 1 (ADAMTSL2-related) MONDO:0009269
Autosomal recessive ADAMTSL2-related geleophysic dysplasia. Functional studies show impaired secretion of mutant ADAMTSL2, with severity tracking the degree of ADAMTSL2 secretion impairment.
Show evidence (2 references)
PMID:31516831 SUPPORT Human Clinical
"Geleophysic dysplasia (GPHYSD1, MIM231050; GPHYSD2, MIM614185; GPHYSD3, MIM617809) is an autosomal disorder characterized by short-limb dwarfism, brachydactyly, cardiac valvular disease, and laryngotracheal stenosis."
The paper explicitly identifies the GPHYSD1 subtype and the core clinical phenotype.
PMID:38300707 SUPPORT Model Organism
"Geleophysic dysplasia-1 (GD1) is an autosomal recessive disorder caused by ADAMTS-like 2 (ADAMTSL2) variants."
This directly supports the GD1 ADAMTSL2-related subtype.
Geleophysic dysplasia 2 (FBN1-related) MONDO:0013612
Autosomal dominant FBN1-related geleophysic dysplasia. Domain-specific FBN1 variants produce a geleophysic phenotype rather than classic Marfan syndrome, consistent with a microfibril/TGF-beta signaling mechanism.
Show evidence (2 references)
PMID:31516831 SUPPORT Human Clinical
"Mutations in ADAMTSL2, FBN1, and LTBP3 genes are responsible for this condition."
The abstract identifies FBN1 among the causal genes for geleophysic dysplasia.
PMID:25762570 SUPPORT Model Organism
"domain-specific FBN1 mutations result in dominant GD."
This supports FBN1-related dominant geleophysic dysplasia.
Geleophysic dysplasia 3 (LTBP3-related) MONDO:0054722
Autosomal dominant LTBP3-related geleophysic dysplasia, reported in de novo heterozygous cases with early severe respiratory involvement and linked to the microfibrillar network.
Show evidence (2 references)
PMID:27068007 SUPPORT Human Clinical
"Two distinct de novo heterozygous LTPB3 mutations were also identified in two unrelated GD individuals who had died in early childhood from respiratory failure-a donor splice site mutation (exon 12 c.1846+5G>A) and a stop-loss mutation (exon 28: c.3912A>T: p.1304*Cysext*12)."
This identifies de novo heterozygous LTBP3 mutations in individuals with geleophysic dysplasia.
PMID:39705488 SUPPORT Human Clinical
"And the whole exome sequencing results indicated that the family carried a de novo mutation c.852_853insAGG (p.L284_P285insR) in the LTBP3 gene (NM_001130144.3) inherited from the mother."
This case report provides additional human evidence for LTBP3-related GD3.

Pathophysiology

5
ADAMTSL2 secretion and trafficking defect
ADAMTSL2 missense variants can disrupt Golgi trafficking and secretion of the extracellular ADAMTSL2 glycoprotein. In patient fibroblasts and transfected cells, mutant ADAMTSL2 mislocalizes, is poorly secreted, and is associated with increased SMAD2 phosphorylation, placing ADAMTSL2 secretion upstream of extracellular matrix and TGF-beta signaling abnormalities.
fibroblast link
intracellular protein transport link ⚠ ABNORMAL
Show evidence (2 references)
PMID:31516831 SUPPORT In Vitro
"We also showed that ADAMTSL2 with the missense variant p.Gly296Arg fails to localize in the Golgi and its secretion is impaired in contrast to wild-type ADAMTSL2 that traffics trough the Golgi complex and is efficiently secreted."
Cell-based localization and secretion assays show mutant ADAMTSL2 trafficking and secretion defects.
PMID:38300707 SUPPORT In Vitro
"The impairment of ADAMTSL2 secretion was observed in both variants, but p.A165T exhibited a more severe impact."
This mixed cellular/mouse-model study links ADAMTSL2 secretion impairment to variant severity.
Fibrillin microfibril matrix dysregulation
ADAMTSL2, FBN1, and LTBP3 converge on the fibrillin-containing extracellular microfibril network. Fibrillin microfibrils bind latent TGF-beta complexes, and acromelic dysplasia proteins interact with this matrix scaffold; variants in these genes therefore disturb matrix assembly and growth-factor bioavailability in connective tissues.
connective tissue cell link
extracellular matrix organization link ⚠ ABNORMAL
Show evidence (2 references)
PMID:32880985 SUPPORT Other
"most of the affected proteins directly interact with fibrillin microfibrils in the extracellular matrix and have been linked to the regulation of TGF-β signaling."
Review-level synthesis links acromelic dysplasia proteins to fibrillin microfibrils and TGF-beta regulation.
PMID:25762570 SUPPORT Model Organism
"ADAMTSL2 has been previously shown to bind FBN1 and latent TGFβ-binding protein-1 (LTBP1)."
The Adamtsl2 model paper grounds ADAMTSL2 in microfibril-associated protein interactions.
TGF-beta and SMAD signaling dysregulation
Geleophysic dysplasia genes affect latent TGF-beta handling and downstream SMAD signaling. Mutant ADAMTSL2 increases phosphorylated SMAD2 in cell assays, FBN1-related patient fibroblasts show defects in TGF-beta-linked matrix deposition, and LTBP3 variants are predicted or reported to alter TGF-beta signaling.
transforming growth factor beta receptor signaling pathway link ↕ DYSREGULATED
Show evidence (3 references)
PMID:31516831 SUPPORT In Vitro
"Moreover, lysates of HEK293 cells transfected with mutated ADAMTSL2 showed increased phosphorylated SMAD2 (pSMAD2) compared to cells transfected with wild-type ADAMTSL2 (Fig. 4B)."
Phosphorylated SMAD2 is a direct readout of increased TGF-beta pathway signaling in this cell assay.
PMID:31350823 SUPPORT In Vitro
"Geleophysic dysplasia (GPHYSD) is a disorder characterized by dysmorphic features, stiff joints and cardiac involvement due to defects of TGF-β signaling."
The FBN1 fibroblast study frames the disease mechanism as TGF-beta signaling defects.
PMID:39705488 SUPPORT Computational
"The results of bioinformatics prediction demonstrated the mutation influenced the stability of the LTBP3 gene, thereby enhanced the transforming growth factor β signaling pathways."
Bioinformatic prediction in a GD3 case report supports an LTBP3-specific effect on TGF-beta signaling.
Bronchial microfibril accumulation and epithelial dysplasia
Adamtsl2 loss in mice causes abnormal bronchial microfibril accumulation, bronchial epithelial dysplasia, glycogen-rich epithelial inclusions, and increased bronchial epithelial TGF-beta signaling. This provides organism-level evidence for the airway component of human geleophysic dysplasia.
epithelial cell of tracheobronchial tree link
extracellular matrix organization link ⚠ ABNORMAL transforming growth factor beta receptor signaling pathway link ↑ INCREASED
Show evidence (3 references)
PMID:25762570 SUPPORT Model Organism
"Adamtsl2(-/-) mice, which died at birth, had severe bronchial epithelial dysplasia with abnormal glycogen-rich inclusions in bronchial epithelium resembling the cellular anomalies described previously in GD."
Adamtsl2 knockout mice reproduce bronchial epithelial pathology relevant to GD airway disease.
PMID:25762570 SUPPORT Model Organism
"An increase in microfibrils in the bronchial wall was associated with increased FBN2 and microfibril-associated glycoprotein-1 (MAGP1) staining, whereas LTBP1 staining was increased in bronchial epithelium."
The model provides direct support for the bronchial microfibril accumulation claim.
PMID:25762570 SUPPORT Model Organism
"The observed extracellular matrix (ECM) alterations were associated with increased bronchial epithelial TGFβ signaling at 17.5 days of gestation; however, treatment with TGFβ-neutralizing antibody did not correct the epithelial dysplasia."
The model links airway ECM abnormalities with increased TGF-beta signaling, while showing epithelial dysplasia is not fully rescued by TGF-beta neutralization.
Fibroblast ECM secretion and MMP-mediated migration dysregulation
Patient-derived dermal fibroblasts with ADAMTSL2 or FBN1 variants show impaired secretion of ECM proteins, increased migration, and increased MMP-1 and MMP-14 expression. These findings expand the matrix pathomechanism from static microfibril defects to abnormal fibroblast matrix remodeling.
fibroblast link
cell migration link ↑ INCREASED extracellular matrix organization link ⚠ ABNORMAL
Show evidence (2 references)
PMID:40481143 SUPPORT In Vitro
"We found that the secretion of ECM proteins including ADAMTSL2, FBN1, and Fibronectin were impaired in GD fibroblasts."
Patient-derived fibroblast experiments show impaired ECM protein secretion.
PMID:40481143 SUPPORT In Vitro
"Increased cell migration was observed in GD fibroblasts carrying ADAMTSL2 or FBN1 variants, which was associated with up-regulation of MMP-1 and MMP-14, two proteases related to cell mobility."
This directly supports increased fibroblast migration and MMP dysregulation in GD cells.

Histopathology

1
Lysosomal-like intracellular inclusions in fibroblasts and airway epithelium
Geleophysic dysplasia cells can contain lysosomal-like vesicles with lamellar or electron-dense storage material. These inclusions are seen in patient fibroblasts with ADAMTSL2 or FBN1 variants and in Adamtsl2-null bronchial epithelium, supporting the historical lysosomal-storage-like appearance of the disease without making it a primary lysosomal enzyme deficiency.
Show evidence (2 references)
PMID:31516831 SUPPORT In Vitro
"Primary fibroblasts from skin biopsy available only for subject 3 were analyzed by EM and showed lysosomal-like vesicles with lamellar structure appearance and electron-dense storage material (Fig. 2) suggesting that inclusions are a feature of GPHYSD cells either carrying ADAMTSL2 or FBN1..."
Electron microscopy in patient-derived fibroblasts shows lysosomal-like inclusions.
PMID:31350823 SUPPORT In Vitro
"Moreover, we found that the storage material is enclosed within lysosomes and is associated with the upregulation of several lysosomal genes."
FBN1-related patient fibroblasts show storage material enclosed within lysosomes.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Geleophysic Dysplasia Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

25
Cardiovascular 1
Elevated pulmonary artery pressure FREQUENT Elevated pulmonary artery pressure (HP:0004890)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0004890 | Elevated pulmonary artery pressure | Frequent (79-30%)"
Orphanet reports elevated pulmonary artery pressure as frequent.
Ear 1
Conductive hearing impairment FREQUENT Conductive hearing impairment (HP:0000405)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0000405 | Conductive hearing impairment | Frequent (79-30%)"
Orphanet reports conductive hearing impairment as frequent.
Head and Neck 3
Long philtrum FREQUENT Long philtrum (HP:0000343)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0000343 | Long philtrum | Frequent (79-30%)"
Orphanet reports long philtrum as frequent.
Anteverted nares FREQUENT Anteverted nares (HP:0000463)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0000463 | Anteverted nares | Frequent (79-30%)"
Orphanet reports anteverted nares as frequent.
Short nose FREQUENT Short nose (HP:0003196)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0003196 | Short nose | Frequent (79-30%)"
Orphanet reports short nose as frequent.
Integument 1
Thickened skin FREQUENT Thickened skin (HP:0001072)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001072 | Thickened skin | Frequent (79-30%)"
Orphanet reports thickened skin as frequent in geleophysic dysplasia.
Limbs 2
Brachydactyly FREQUENT Brachydactyly (HP:0001156)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001156 | Brachydactyly | Frequent (79-30%)"
Orphanet reports brachydactyly as frequent in geleophysic dysplasia.
Short foot FREQUENT Short foot (HP:0001773)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001773 | Short foot | Frequent (79-30%)"
Orphanet reports short feet as frequent.
Musculoskeletal 3
Limitation of joint mobility FREQUENT Limitation of joint mobility (HP:0001376)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001376 | Limitation of joint mobility | Frequent (79-30%)"
Orphanet reports limitation of joint mobility as frequent in geleophysic dysplasia.
Joint contracture FREQUENT Joint contracture (HP:0034392)
Course: PROGRESSIVE
Show evidence (2 references)
ORPHA:2623 SUPPORT Other
"HP:0034392 | Joint contracture | Frequent (79-30%)"
Orphanet reports joint contracture as frequent in geleophysic dysplasia.
PMID:20301776 SUPPORT Human Clinical
"short hands and feet, progressive joint limitation and contractures, distinctive facial features"
GeneReviews supports progressive joint contractures as part of the clinical phenotype.
Delayed skeletal maturation FREQUENT Delayed skeletal maturation (HP:0002750)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0002750 | Delayed skeletal maturation | Frequent (79-30%)"
Orphanet reports delayed skeletal maturation as frequent.
Prenatal and Birth 1
Polyhydramnios FREQUENT Polyhydramnios (HP:0001561)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001561 | Polyhydramnios | Frequent (79-30%)"
Orphanet reports polyhydramnios as frequent.
Growth 2
Short stature VERY_FREQUENT Short stature (HP:0004322)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0004322 | Short stature | Very frequent (99-80%)"
Orphanet reports short stature as very frequent in geleophysic dysplasia.
Intrauterine growth retardation FREQUENT Intrauterine growth retardation (HP:0001511)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0001511 | Intrauterine growth retardation | Frequent (79-30%)"
Orphanet reports intrauterine growth retardation as frequent.
Other 11
Short fetal femur length FREQUENT Short fetal femur length (HP:0011428)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0011428 | Short fetal femur length | Frequent (79-30%)"
Orphanet reports short fetal femur length as frequent.
Short long bone FREQUENT Short long bone (HP:0003026)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0003026 | Short long bone | Frequent (79-30%)"
Orphanet reports short long bones as frequent.
Short palm FREQUENT Short palm (HP:0004279)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0004279 | Short palm | Frequent (79-30%)"
Orphanet reports short palms as frequent.
Phalangeal cone-shaped epiphyses FREQUENT Phalangeal cone-shaped epiphyses (HP:0034281)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0034281 | Phalangeal cone-shaped epiphyses | Frequent (79-30%)"
Orphanet reports cone-shaped phalangeal epiphyses as frequent.
Thin upper lip vermilion FREQUENT Thin upper lip vermilion (HP:0000219)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0000219 | Thin upper lip vermilion | Frequent (79-30%)"
Orphanet reports thin upper lip vermilion as frequent.
Round face FREQUENT Round face (HP:0000311)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0000311 | Round face | Frequent (79-30%)"
Orphanet reports round face as frequent.
Recurrent ear infections FREQUENT Recurrent ear infections (HP:0410018)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0410018 | Recurrent ear infections | Frequent (79-30%)"
Orphanet reports recurrent ear infections as frequent.
Increased size of nasopharyngeal adenoids FREQUENT Increased size of nasopharyngeal adenoids (HP:0040261)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0040261 | Increased size of nasopharyngeal adenoids | Frequent (79-30%)"
Orphanet reports enlarged nasopharyngeal adenoids as frequent.
Airway obstruction FREQUENT Airway obstruction (HP:0006536)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0006536 | Airway obstruction | Frequent (79-30%)"
Orphanet reports airway obstruction as frequent.
Asthma FREQUENT Asthma (HP:0002099)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0002099 | Asthma | Frequent (79-30%)"
Orphanet reports asthma as frequent.
Valvular pulmonary stenosis FREQUENT Valvular pulmonary stenosis (HP:0034350)
Show evidence (1 reference)
ORPHA:2623 SUPPORT Other
"HP:0034350 | Valvular pulmonary stenosis | Frequent (79-30%)"
Orphanet reports valvular pulmonary stenosis as frequent.
🧬

Genetic Associations

3
ADAMTSL2 disease-causing variants (Causative)
Autosomal recessive
Show evidence (2 references)
ORPHA:2623 SUPPORT Other
"ADAMTSL2 | ADAMTS like 2 | hgnc:14631 | Disease-causing germline mutation(s) in"
Orphanet lists ADAMTSL2 as a disease-causing gene for geleophysic dysplasia.
PMID:31516831 SUPPORT Human Clinical
"Mutations in ADAMTSL2, FBN1, and LTBP3 genes are responsible for this condition."
The paper identifies ADAMTSL2 as one of the causal genes.
FBN1 disease-causing variants (Causative)
Autosomal dominant
Show evidence (2 references)
ORPHA:2623 SUPPORT Other
"FBN1 | fibrillin 1 | hgnc:3603 | Disease-causing germline mutation(s) in"
Orphanet lists FBN1 as a disease-causing gene for geleophysic dysplasia.
PMID:31350823 SUPPORT Human Clinical
"GPHYSD can be caused by mutations in FBN1, ADAMTLS2, and LTBP3 genes."
The FBN1 fibroblast study identifies FBN1 as a causal gene for GPHYSD.
LTBP3 disease-causing variants (Causative)
Autosomal dominant
Show evidence (2 references)
ORPHA:2623 SUPPORT Other
"LTBP3 | latent transforming growth factor beta binding protein 3 | hgnc:6716 | Disease-causing germline mutation(s) in"
Orphanet lists LTBP3 as a disease-causing gene for geleophysic dysplasia.
PMID:27068007 SUPPORT Human Clinical
"We conclude that LTBP3 is a novel component of the microfibrillar network involved in the acromelic dysplasia spectrum."
The human genetic study identifies LTBP3 as an acromelic dysplasia gene.
💊

Treatments

5
Physiotherapy for joint limitation
Action: physical therapy MAXO:0000011
Ongoing physiotherapy is recommended to help prevent or reduce progression of joint limitation and contractures.
Target Phenotypes: Limitation of joint mobility Joint contracture
Show evidence (1 reference)
PMID:20301776 SUPPORT Human Clinical
"Ongoing physiotherapy to prevent joint limitation"
GeneReviews lists ongoing physiotherapy as treatment of manifestations.
Cardiac valve replacement for severe valvular disease
Action: cardiac valve replacement Ontology label: surgical procedure MAXO:0000004
Severe valvular stenosis or insufficiency may require cardiac valve replacement as a manifestation-directed surgical intervention.
Target Phenotypes: Valvular pulmonary stenosis
Show evidence (1 reference)
PMID:20301776 SUPPORT Human Clinical
"cardiac valve replacement in those with severe stenosis or insufficiency"
GeneReviews lists cardiac valve replacement for severe valvular disease.
Tracheostomy for severe tracheal stenosis
Action: tracheostomy MAXO:0000504
Tracheostomy is used when severe tracheal stenosis creates critical airway obstruction.
Target Phenotypes: Airway obstruction
Show evidence (1 reference)
PMID:20301776 SUPPORT Human Clinical
"tracheostomy as needed for severe tracheal stenosis"
GeneReviews lists tracheostomy for severe tracheal stenosis.
Pulmonary and supportive respiratory management
Action: supportive respiratory care Ontology label: supportive care MAXO:0000950
Restrictive lung disease, obstructive sleep apnea, asthma, and respiratory compromise are managed by pulmonology-directed supportive care.
Target Phenotypes: Airway obstruction Asthma
Show evidence (1 reference)
PMID:20301776 SUPPORT Human Clinical
"treatment of restrictive lung disease, obstructive sleep apnea, and/or asthma per pulmonologist"
GeneReviews lists pulmonology-directed care for respiratory manifestations.
Losartan for FBN1-related microfibril deposition defect
Action: Pharmacotherapy NCIT:C15986
Agent: losartan
Losartan is an investigational, mechanism-directed candidate for FBN1-related geleophysic dysplasia. In patient fibroblasts it did not reduce lysosomal storage material but improved extracellular deposition of fibrillin-1 microfibrils; this is cell-model evidence, not established clinical treatment evidence.
Mechanism Target:
MODULATES Fibrillin microfibril matrix dysregulation — Losartan improved fibrillin-1 microfibril deposition in FBN1-related GD fibroblasts.
Show evidence (1 reference)
PMID:31350823 PARTIAL In Vitro
"Treatment of GPHYSD fibroblasts carrying FBN1 mutations with the angiotensin II receptor type 1 inhibitor losartan that inhibits TGF-β signaling did not reduce the storage but improved the extracellular deposition of fibrillin-1 microfibrils."
This supports losartan as a candidate mechanism-directed therapy in fibroblasts but not as proven patient treatment.
{ }

Source YAML

click to show
name: Geleophysic Dysplasia
creation_date: "2026-05-10T04:22:24Z"
updated_date: "2026-05-10T04:22:24Z"
category: Mendelian
description: >-
  Geleophysic dysplasia is a rare acromelic skeletal dysplasia with severe
  short stature, short hands and feet, progressive joint limitation and
  contractures, thickened skin, distinctive facial features, and potentially
  lethal cardiac, airway, and pulmonary involvement. The disease is genetically
  heterogeneous: biallelic ADAMTSL2 variants cause the autosomal recessive
  subtype, while heterozygous FBN1 or LTBP3 variants cause autosomal dominant
  subtypes. These genes encode extracellular-matrix and microfibril-associated
  proteins, linking the clinical phenotype to abnormal fibrillin microfibrils,
  TGF-beta signaling dysregulation, and tissue-specific extracellular matrix
  defects.
disease_term:
  preferred_term: geleophysic dysplasia
  term:
    id: MONDO:0000127
    label: geleophysic dysplasia
parents:
- Skeletal dysplasia
- Acromelic dysplasia
synonyms:
- Geleophysic dwarfism
has_subtypes:
- name: GD1
  display_name: Geleophysic dysplasia 1 (ADAMTSL2-related)
  subtype_term:
    preferred_term: geleophysic dysplasia 1
    term:
      id: MONDO:0009269
      label: geleophysic dysplasia 1
  description: >
    Autosomal recessive ADAMTSL2-related geleophysic dysplasia. Functional
    studies show impaired secretion of mutant ADAMTSL2, with severity tracking
    the degree of ADAMTSL2 secretion impairment.
  evidence:
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Geleophysic dysplasia (GPHYSD1, MIM231050; GPHYSD2, MIM614185; GPHYSD3, MIM617809) is an autosomal disorder characterized by short-limb dwarfism, brachydactyly, cardiac valvular disease, and laryngotracheal stenosis."
    explanation: The paper explicitly identifies the GPHYSD1 subtype and the core clinical phenotype.
  - reference: PMID:38300707
    reference_title: "ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Geleophysic dysplasia-1 (GD1) is an autosomal recessive disorder caused by ADAMTS-like 2 (ADAMTSL2) variants."
    explanation: This directly supports the GD1 ADAMTSL2-related subtype.
- name: GD2
  display_name: Geleophysic dysplasia 2 (FBN1-related)
  subtype_term:
    preferred_term: geleophysic dysplasia 2
    term:
      id: MONDO:0013612
      label: geleophysic dysplasia 2
  description: >
    Autosomal dominant FBN1-related geleophysic dysplasia. Domain-specific FBN1
    variants produce a geleophysic phenotype rather than classic Marfan
    syndrome, consistent with a microfibril/TGF-beta signaling mechanism.
  evidence:
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Mutations in ADAMTSL2, FBN1, and LTBP3 genes are responsible for this condition."
    explanation: The abstract identifies FBN1 among the causal genes for geleophysic dysplasia.
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "domain-specific FBN1 mutations result in dominant GD."
    explanation: This supports FBN1-related dominant geleophysic dysplasia.
- name: GD3
  display_name: Geleophysic dysplasia 3 (LTBP3-related)
  subtype_term:
    preferred_term: geleophysic dysplasia 3
    term:
      id: MONDO:0054722
      label: geleophysic dysplasia 3
  description: >
    Autosomal dominant LTBP3-related geleophysic dysplasia, reported in de novo
    heterozygous cases with early severe respiratory involvement and linked to
    the microfibrillar network.
  evidence:
  - reference: PMID:27068007
    reference_title: "Mutations in LTBP3 cause acromicric dysplasia and geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Two distinct de novo heterozygous LTPB3 mutations were also identified in two unrelated GD individuals who had died in early childhood from respiratory failure-a donor splice site mutation (exon 12 c.1846+5G>A) and a stop-loss mutation (exon 28: c.3912A>T: p.1304*Cysext*12)."
    explanation: This identifies de novo heterozygous LTBP3 mutations in individuals with geleophysic dysplasia.
  - reference: PMID:39705488
    reference_title: "Expanded phenotypes and pathogenesis of geleophysic dysplasia 3 resulted from a de novo LTBP3 mutation: A case report."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "And the whole exome sequencing results indicated that the family carried a de novo mutation c.852_853insAGG (p.L284_P285insR) in the LTBP3 gene (NM_001130144.3) inherited from the mother."
    explanation: This case report provides additional human evidence for LTBP3-related GD3.
inheritance:
- name: Autosomal dominant
  inheritance_term:
    preferred_term: Autosomal dominant inheritance
    term:
      id: HP:0000006
      label: Autosomal dominant inheritance
  description: >
    FBN1- and LTBP3-related geleophysic dysplasia are autosomal dominant.
    Reported probands with parental molecular testing have had de novo
    pathogenic variants.
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "Autosomal dominant"
    explanation: Orphanet lists autosomal dominant inheritance for a subset of geleophysic dysplasia.
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Geleophysic dysplasia caused by a heterozygous pathogenic variant in either FBN1 or LTBP3 is inherited in an autosomal dominant manner."
    explanation: GeneReviews directly states the dominant inheritance pattern for FBN1 and LTBP3 subtypes.
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Autosomal dominant inheritance: All probands reported to date with FBN1- or LTBP3-related geleophysic dysplasia whose parents have undergone molecular genetic testing have had the disorder as the result of a de novo pathogenic variant."
    explanation: GeneReviews supports the de novo statement for tested FBN1- and LTBP3-related probands.
- name: Autosomal recessive
  inheritance_term:
    preferred_term: Autosomal recessive inheritance
    term:
      id: HP:0000007
      label: Autosomal recessive inheritance
  description: >
    ADAMTSL2-related geleophysic dysplasia is autosomal recessive and results
    from biallelic pathogenic variants.
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "Autosomal recessive"
    explanation: Orphanet lists autosomal recessive inheritance for a subset of geleophysic dysplasia.
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Geleophysic dysplasia caused by biallelic pathogenic variants in ADAMTSL2 is inherited in an autosomal recessive manner."
    explanation: GeneReviews directly states the recessive inheritance pattern for ADAMTSL2-related disease.
pathophysiology:
- name: ADAMTSL2 secretion and trafficking defect
  description: >
    ADAMTSL2 missense variants can disrupt Golgi trafficking and secretion of
    the extracellular ADAMTSL2 glycoprotein. In patient fibroblasts and
    transfected cells, mutant ADAMTSL2 mislocalizes, is poorly secreted, and is
    associated with increased SMAD2 phosphorylation, placing ADAMTSL2 secretion
    upstream of extracellular matrix and TGF-beta signaling abnormalities.
  cell_types:
  - preferred_term: fibroblast
    term:
      id: CL:0000057
      label: fibroblast
  biological_processes:
  - preferred_term: intracellular protein transport
    term:
      id: GO:0006886
      label: intracellular protein transport
    modifier: ABNORMAL
  evidence:
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "We also showed that ADAMTSL2 with the missense variant p.Gly296Arg fails to localize in the Golgi and its secretion is impaired in contrast to wild-type ADAMTSL2 that traffics trough the Golgi complex and is efficiently secreted."
    explanation: Cell-based localization and secretion assays show mutant ADAMTSL2 trafficking and secretion defects.
  - reference: PMID:38300707
    reference_title: "ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "The impairment of ADAMTSL2 secretion was observed in both variants, but p.A165T exhibited a more severe impact."
    explanation: This mixed cellular/mouse-model study links ADAMTSL2 secretion impairment to variant severity.
  downstream:
  - target: Fibrillin microfibril matrix dysregulation
    causal_link_type: DIRECT
    description: ADAMTSL2 binds fibrillin microfibrils, so impaired ADAMTSL2 secretion disrupts extracellular microfibril organization.
  - target: TGF-beta and SMAD signaling dysregulation
    causal_link_type: DIRECT
    description: Mutant ADAMTSL2 increases SMAD2 phosphorylation in cell assays.
- name: Fibrillin microfibril matrix dysregulation
  description: >
    ADAMTSL2, FBN1, and LTBP3 converge on the fibrillin-containing extracellular
    microfibril network. Fibrillin microfibrils bind latent TGF-beta complexes,
    and acromelic dysplasia proteins interact with this matrix scaffold; variants
    in these genes therefore disturb matrix assembly and growth-factor
    bioavailability in connective tissues.
  cell_types:
  - preferred_term: connective tissue cell
    term:
      id: CL:0002320
      label: connective tissue cell
  biological_processes:
  - preferred_term: extracellular matrix organization
    term:
      id: GO:0030198
      label: extracellular matrix organization
    modifier: ABNORMAL
  evidence:
  - reference: PMID:32880985
    reference_title: "Acromelic dysplasias: how rare musculoskeletal disorders reveal biological functions of extracellular matrix proteins."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "most of the affected proteins directly interact with fibrillin microfibrils in the extracellular matrix and have been linked to the regulation of TGF-β signaling."
    explanation: Review-level synthesis links acromelic dysplasia proteins to fibrillin microfibrils and TGF-beta regulation.
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "ADAMTSL2 has been previously shown to bind FBN1 and latent TGFβ-binding protein-1 (LTBP1)."
    explanation: The Adamtsl2 model paper grounds ADAMTSL2 in microfibril-associated protein interactions.
  downstream:
  - target: TGF-beta and SMAD signaling dysregulation
    causal_link_type: DIRECT
    description: Fibrillin microfibrils regulate latent TGF-beta bioavailability, so microfibril disruption alters TGF-beta signaling.
  - target: Short stature
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - impaired extracellular matrix assembly in cartilage, skin, and periarticular connective tissue
    - altered TGF-beta bioavailability
    description: Matrix disorganization affects skeletal growth through extracellular-matrix and signaling intermediates.
  - target: Thickened skin
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - abnormal dermal extracellular matrix assembly
    description: Matrix disorganization affects dermal connective tissue.
- name: TGF-beta and SMAD signaling dysregulation
  description: >
    Geleophysic dysplasia genes affect latent TGF-beta handling and downstream
    SMAD signaling. Mutant ADAMTSL2 increases phosphorylated SMAD2 in cell
    assays, FBN1-related patient fibroblasts show defects in TGF-beta-linked
    matrix deposition, and LTBP3 variants are predicted or reported to alter
    TGF-beta signaling.
  biological_processes:
  - preferred_term: transforming growth factor beta receptor signaling pathway
    term:
      id: GO:0007179
      label: transforming growth factor beta receptor signaling pathway
    modifier: DYSREGULATED
  evidence:
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Moreover, lysates of HEK293 cells transfected with mutated ADAMTSL2 showed increased phosphorylated SMAD2 (pSMAD2) compared to cells transfected with wild-type ADAMTSL2 (Fig. 4B)."
    explanation: Phosphorylated SMAD2 is a direct readout of increased TGF-beta pathway signaling in this cell assay.
  - reference: PMID:31350823
    reference_title: "Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Geleophysic dysplasia (GPHYSD) is a disorder characterized by dysmorphic features, stiff joints and cardiac involvement due to defects of TGF-β signaling."
    explanation: The FBN1 fibroblast study frames the disease mechanism as TGF-beta signaling defects.
  - reference: PMID:39705488
    reference_title: "Expanded phenotypes and pathogenesis of geleophysic dysplasia 3 resulted from a de novo LTBP3 mutation: A case report."
    supports: SUPPORT
    evidence_source: COMPUTATIONAL
    snippet: "The results of bioinformatics prediction demonstrated the mutation influenced the stability of the LTBP3 gene, thereby enhanced the transforming growth factor β signaling pathways."
    explanation: Bioinformatic prediction in a GD3 case report supports an LTBP3-specific effect on TGF-beta signaling.
  downstream:
  - target: Brachydactyly
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - altered extracellular-matrix signaling in skeletal and periarticular tissues
    description: TGF-beta dysregulation perturbs skeletal patterning and growth.
  - target: Valvular pulmonary stenosis
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - abnormal cardiac valve extracellular-matrix remodeling
    description: TGF-beta-linked matrix abnormalities contribute to valvular disease.
  - target: Elevated pulmonary artery pressure
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - abnormal pulmonary vascular extracellular-matrix remodeling
    description: TGF-beta-linked matrix abnormalities contribute to pulmonary vascular involvement.
- name: Bronchial microfibril accumulation and epithelial dysplasia
  description: >
    Adamtsl2 loss in mice causes abnormal bronchial microfibril accumulation,
    bronchial epithelial dysplasia, glycogen-rich epithelial inclusions, and
    increased bronchial epithelial TGF-beta signaling. This provides
    organism-level evidence for the airway component of human geleophysic
    dysplasia.
  cell_types:
  - preferred_term: epithelial cell of tracheobronchial tree
    term:
      id: CL:0002202
      label: epithelial cell of tracheobronchial tree
  biological_processes:
  - preferred_term: extracellular matrix organization
    term:
      id: GO:0030198
      label: extracellular matrix organization
    modifier: ABNORMAL
  - preferred_term: transforming growth factor beta receptor signaling pathway
    term:
      id: GO:0007179
      label: transforming growth factor beta receptor signaling pathway
    modifier: INCREASED
  evidence:
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Adamtsl2(-/-) mice, which died at birth, had severe bronchial epithelial dysplasia with abnormal glycogen-rich inclusions in bronchial epithelium resembling the cellular anomalies described previously in GD."
    explanation: Adamtsl2 knockout mice reproduce bronchial epithelial pathology relevant to GD airway disease.
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "An increase in microfibrils in the bronchial wall was associated with increased FBN2 and microfibril-associated glycoprotein-1 (MAGP1) staining, whereas LTBP1 staining was increased in bronchial epithelium."
    explanation: The model provides direct support for the bronchial microfibril accumulation claim.
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "The observed extracellular matrix (ECM) alterations were associated with increased bronchial epithelial TGFβ signaling at 17.5 days of gestation; however, treatment with TGFβ-neutralizing antibody did not correct the epithelial dysplasia."
    explanation: The model links airway ECM abnormalities with increased TGF-beta signaling, while showing epithelial dysplasia is not fully rescued by TGF-beta neutralization.
  downstream:
  - target: Airway obstruction
    causal_link_type: DIRECT
    description: Bronchial epithelial dysplasia and airway matrix abnormalities provide a direct tissue mechanism for airway obstruction and respiratory compromise.
- name: Fibroblast ECM secretion and MMP-mediated migration dysregulation
  description: >
    Patient-derived dermal fibroblasts with ADAMTSL2 or FBN1 variants show
    impaired secretion of ECM proteins, increased migration, and increased MMP-1
    and MMP-14 expression. These findings expand the matrix pathomechanism from
    static microfibril defects to abnormal fibroblast matrix remodeling.
  cell_types:
  - preferred_term: fibroblast
    term:
      id: CL:0000057
      label: fibroblast
  biological_processes:
  - preferred_term: cell migration
    term:
      id: GO:0016477
      label: cell migration
    modifier: INCREASED
  - preferred_term: extracellular matrix organization
    term:
      id: GO:0030198
      label: extracellular matrix organization
    modifier: ABNORMAL
  evidence:
  - reference: PMID:40481143
    reference_title: "Dysregulation of cell migration by matrix metalloproteinases in geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "We found that the secretion of ECM proteins including ADAMTSL2, FBN1, and Fibronectin were impaired in GD fibroblasts."
    explanation: Patient-derived fibroblast experiments show impaired ECM protein secretion.
  - reference: PMID:40481143
    reference_title: "Dysregulation of cell migration by matrix metalloproteinases in geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Increased cell migration was observed in GD fibroblasts carrying ADAMTSL2 or FBN1 variants, which was associated with up-regulation of MMP-1 and MMP-14, two proteases related to cell mobility."
    explanation: This directly supports increased fibroblast migration and MMP dysregulation in GD cells.
  downstream:
  - target: Thickened skin
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - abnormal dermal and periarticular extracellular-matrix remodeling
    description: Fibroblast matrix-remodeling defects plausibly contribute to dermal thickening.
  - target: Limitation of joint mobility
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - abnormal periarticular extracellular-matrix remodeling
    description: Fibroblast matrix-remodeling defects plausibly contribute to joint mobility limitation.
histopathology:
- name: Lysosomal-like intracellular inclusions in fibroblasts and airway epithelium
  description: >
    Geleophysic dysplasia cells can contain lysosomal-like vesicles with
    lamellar or electron-dense storage material. These inclusions are seen in
    patient fibroblasts with ADAMTSL2 or FBN1 variants and in Adamtsl2-null
    bronchial epithelium, supporting the historical lysosomal-storage-like
    appearance of the disease without making it a primary lysosomal enzyme
    deficiency.
  evidence:
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Primary fibroblasts from skin biopsy available only for subject 3 were analyzed by EM and showed lysosomal-like vesicles with lamellar structure appearance and electron-dense storage material (Fig. 2) suggesting that inclusions are a feature of GPHYSD cells either carrying ADAMTSL2 or FBN1 mutations [26]."
    explanation: Electron microscopy in patient-derived fibroblasts shows lysosomal-like inclusions.
  - reference: PMID:31350823
    reference_title: "Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect."
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Moreover, we found that the storage material is enclosed within lysosomes and is associated with the upregulation of several lysosomal genes."
    explanation: FBN1-related patient fibroblasts show storage material enclosed within lysosomes.
genetic:
- name: ADAMTSL2 disease-causing variants
  gene_term:
    preferred_term: ADAMTSL2
    term:
      id: hgnc:14631
      label: ADAMTSL2
  association: Causative
  relationship_type: CAUSATIVE
  subtype: GD1
  inheritance:
  - name: Autosomal recessive
  features: >
    Biallelic ADAMTSL2 variants cause GD1 and impair secretion of the ADAMTSL2
    extracellular matrix glycoprotein.
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "ADAMTSL2 | ADAMTS like 2 | hgnc:14631 | Disease-causing germline mutation(s) in"
    explanation: Orphanet lists ADAMTSL2 as a disease-causing gene for geleophysic dysplasia.
  - reference: PMID:31516831
    reference_title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Mutations in ADAMTSL2, FBN1, and LTBP3 genes are responsible for this condition."
    explanation: The paper identifies ADAMTSL2 as one of the causal genes.
- name: FBN1 disease-causing variants
  gene_term:
    preferred_term: FBN1
    term:
      id: hgnc:3603
      label: FBN1
  association: Causative
  relationship_type: CAUSATIVE
  subtype: GD2
  inheritance:
  - name: Autosomal dominant
  features: >
    Heterozygous domain-specific FBN1 variants cause GD2 and affect fibrillin
    microfibril deposition and TGF-beta-linked extracellular matrix biology.
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "FBN1 | fibrillin 1 | hgnc:3603 | Disease-causing germline mutation(s) in"
    explanation: Orphanet lists FBN1 as a disease-causing gene for geleophysic dysplasia.
  - reference: PMID:31350823
    reference_title: "Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "GPHYSD can be caused by mutations in FBN1, ADAMTLS2, and LTBP3 genes."
    explanation: The FBN1 fibroblast study identifies FBN1 as a causal gene for GPHYSD.
- name: LTBP3 disease-causing variants
  gene_term:
    preferred_term: LTBP3
    term:
      id: hgnc:6716
      label: LTBP3
  association: Causative
  relationship_type: CAUSATIVE
  subtype: GD3
  inheritance:
  - name: Autosomal dominant
  features: >
    Heterozygous LTBP3 variants cause GD3, consistent with LTBP3 acting as a
    microfibrillar-network component in the acromelic dysplasia spectrum.
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "LTBP3 | latent transforming growth factor beta binding protein 3 | hgnc:6716 | Disease-causing germline mutation(s) in"
    explanation: Orphanet lists LTBP3 as a disease-causing gene for geleophysic dysplasia.
  - reference: PMID:27068007
    reference_title: "Mutations in LTBP3 cause acromicric dysplasia and geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "We conclude that LTBP3 is a novel component of the microfibrillar network involved in the acromelic dysplasia spectrum."
    explanation: The human genetic study identifies LTBP3 as an acromelic dysplasia gene.
phenotypes:
- name: Short stature
  category: Growth
  frequency: VERY_FREQUENT
  diagnostic: true
  phenotype_term:
    preferred_term: Short stature
    term:
      id: HP:0004322
      label: Short stature
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0004322 | Short stature | Very frequent (99-80%)"
    explanation: Orphanet reports short stature as very frequent in geleophysic dysplasia.
- name: Brachydactyly
  category: Skeletal
  frequency: FREQUENT
  diagnostic: true
  phenotype_term:
    preferred_term: Brachydactyly
    term:
      id: HP:0001156
      label: Brachydactyly
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001156 | Brachydactyly | Frequent (79-30%)"
    explanation: Orphanet reports brachydactyly as frequent in geleophysic dysplasia.
- name: Limitation of joint mobility
  category: Musculoskeletal
  frequency: FREQUENT
  diagnostic: true
  phenotype_term:
    preferred_term: Limitation of joint mobility
    term:
      id: HP:0001376
      label: Limitation of joint mobility
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001376 | Limitation of joint mobility | Frequent (79-30%)"
    explanation: Orphanet reports limitation of joint mobility as frequent in geleophysic dysplasia.
- name: Joint contracture
  category: Musculoskeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Joint contracture
    term:
      id: HP:0034392
      label: Joint contracture
    clinical_course: PROGRESSIVE
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0034392 | Joint contracture | Frequent (79-30%)"
    explanation: Orphanet reports joint contracture as frequent in geleophysic dysplasia.
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "short hands and feet, progressive joint limitation and contractures, distinctive facial features"
    explanation: GeneReviews supports progressive joint contractures as part of the clinical phenotype.
- name: Thickened skin
  category: Dermatologic
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Thickened skin
    term:
      id: HP:0001072
      label: Thickened skin
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001072 | Thickened skin | Frequent (79-30%)"
    explanation: Orphanet reports thickened skin as frequent in geleophysic dysplasia.
- name: Intrauterine growth retardation
  category: Growth
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Intrauterine growth retardation
    term:
      id: HP:0001511
      label: Intrauterine growth retardation
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001511 | Intrauterine growth retardation | Frequent (79-30%)"
    explanation: Orphanet reports intrauterine growth retardation as frequent.
- name: Polyhydramnios
  category: Prenatal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Polyhydramnios
    term:
      id: HP:0001561
      label: Polyhydramnios
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001561 | Polyhydramnios | Frequent (79-30%)"
    explanation: Orphanet reports polyhydramnios as frequent.
- name: Short fetal femur length
  category: Prenatal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Short fetal femur length
    term:
      id: HP:0011428
      label: Short fetal femur length
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0011428 | Short fetal femur length | Frequent (79-30%)"
    explanation: Orphanet reports short fetal femur length as frequent.
- name: Short long bone
  category: Skeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Short long bone
    term:
      id: HP:0003026
      label: Short long bone
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0003026 | Short long bone | Frequent (79-30%)"
    explanation: Orphanet reports short long bones as frequent.
- name: Short foot
  category: Skeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Short foot
    term:
      id: HP:0001773
      label: Short foot
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0001773 | Short foot | Frequent (79-30%)"
    explanation: Orphanet reports short feet as frequent.
- name: Short palm
  category: Skeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Short palm
    term:
      id: HP:0004279
      label: Short palm
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0004279 | Short palm | Frequent (79-30%)"
    explanation: Orphanet reports short palms as frequent.
- name: Delayed skeletal maturation
  category: Skeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Delayed skeletal maturation
    term:
      id: HP:0002750
      label: Delayed skeletal maturation
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0002750 | Delayed skeletal maturation | Frequent (79-30%)"
    explanation: Orphanet reports delayed skeletal maturation as frequent.
- name: Phalangeal cone-shaped epiphyses
  category: Skeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Phalangeal cone-shaped epiphyses
    term:
      id: HP:0034281
      label: Phalangeal cone-shaped epiphyses
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0034281 | Phalangeal cone-shaped epiphyses | Frequent (79-30%)"
    explanation: Orphanet reports cone-shaped phalangeal epiphyses as frequent.
- name: Thin upper lip vermilion
  category: Craniofacial
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Thin upper lip vermilion
    term:
      id: HP:0000219
      label: Thin upper lip vermilion
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0000219 | Thin upper lip vermilion | Frequent (79-30%)"
    explanation: Orphanet reports thin upper lip vermilion as frequent.
- name: Round face
  category: Craniofacial
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Round face
    term:
      id: HP:0000311
      label: Round face
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0000311 | Round face | Frequent (79-30%)"
    explanation: Orphanet reports round face as frequent.
- name: Long philtrum
  category: Craniofacial
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Long philtrum
    term:
      id: HP:0000343
      label: Long philtrum
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0000343 | Long philtrum | Frequent (79-30%)"
    explanation: Orphanet reports long philtrum as frequent.
- name: Anteverted nares
  category: Craniofacial
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Anteverted nares
    term:
      id: HP:0000463
      label: Anteverted nares
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0000463 | Anteverted nares | Frequent (79-30%)"
    explanation: Orphanet reports anteverted nares as frequent.
- name: Short nose
  category: Craniofacial
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Short nose
    term:
      id: HP:0003196
      label: Short nose
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0003196 | Short nose | Frequent (79-30%)"
    explanation: Orphanet reports short nose as frequent.
- name: Conductive hearing impairment
  category: Audiologic
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Conductive hearing impairment
    term:
      id: HP:0000405
      label: Conductive hearing impairment
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0000405 | Conductive hearing impairment | Frequent (79-30%)"
    explanation: Orphanet reports conductive hearing impairment as frequent.
- name: Recurrent ear infections
  category: Audiologic
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Recurrent ear infections
    term:
      id: HP:0410018
      label: Recurrent ear infections
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0410018 | Recurrent ear infections | Frequent (79-30%)"
    explanation: Orphanet reports recurrent ear infections as frequent.
- name: Increased size of nasopharyngeal adenoids
  category: Respiratory
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Increased size of nasopharyngeal adenoids
    term:
      id: HP:0040261
      label: Increased size of nasopharyngeal adenoids
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0040261 | Increased size of nasopharyngeal adenoids | Frequent (79-30%)"
    explanation: Orphanet reports enlarged nasopharyngeal adenoids as frequent.
- name: Airway obstruction
  category: Respiratory
  frequency: FREQUENT
  diagnostic: true
  phenotype_term:
    preferred_term: Airway obstruction
    term:
      id: HP:0006536
      label: Airway obstruction
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0006536 | Airway obstruction | Frequent (79-30%)"
    explanation: Orphanet reports airway obstruction as frequent.
- name: Asthma
  category: Respiratory
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Asthma
    term:
      id: HP:0002099
      label: Asthma
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0002099 | Asthma | Frequent (79-30%)"
    explanation: Orphanet reports asthma as frequent.
- name: Elevated pulmonary artery pressure
  category: Cardiopulmonary
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Elevated pulmonary artery pressure
    term:
      id: HP:0004890
      label: Elevated pulmonary artery pressure
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0004890 | Elevated pulmonary artery pressure | Frequent (79-30%)"
    explanation: Orphanet reports elevated pulmonary artery pressure as frequent.
- name: Valvular pulmonary stenosis
  category: Cardiovascular
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Valvular pulmonary stenosis
    term:
      id: HP:0034350
      label: Valvular pulmonary stenosis
  evidence:
  - reference: ORPHA:2623
    reference_title: "Geleophysic dysplasia (Orphanet structured-database record)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "HP:0034350 | Valvular pulmonary stenosis | Frequent (79-30%)"
    explanation: Orphanet reports valvular pulmonary stenosis as frequent.
diagnosis:
- name: Clinical and radiographic diagnosis
  description: >
    Diagnosis can be established clinically when the characteristic clinical and
    radiographic phenotype is present, especially short stature, short hands and
    feet, progressive joint limitation, skin thickening, and cardiac or airway
    involvement.
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "The clinical diagnosis of geleophysic dysplasia can be established in a proband with characteristic clinical and radiographic findings"
    explanation: GeneReviews supports clinical/radiographic diagnosis.
- name: Molecular genetic testing
  description: >
    Molecular confirmation requires biallelic ADAMTSL2 pathogenic variants or a
    heterozygous pathogenic variant in FBN1 or LTBP3.
  diagnosis_term:
    preferred_term: molecular genetic testing
    term:
      id: MAXO:0000533
      label: molecular genetic testing
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "the molecular diagnosis of geleophysic dysplasia is established in a proband with characteristic clinical and radiographic findings and one of the following on molecular genetic testing: biallelic pathogenic variants in ADAMTSL2 or a heterozygous pathogenic variant in either FBN1 or LTBP3."
    explanation: GeneReviews specifies the gene and zygosity patterns for molecular diagnosis.
- name: Echocardiography for cardiac surveillance
  description: >
    Echocardiography is part of the recommended surveillance strategy because
    progressive cardiac valve disease and other cardiac complications can be
    life-threatening.
  diagnosis_term:
    preferred_term: echocardiography
    term:
      id: MAXO:0010203
      label: echocardiography
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Evaluation with cardiologist (including EKG and echocardiogram), pulmonologist, ENT specialist, and audiologist annually from birth until age three years, then at specific intervals."
    explanation: GeneReviews recommends echocardiography-containing cardiac surveillance.
treatments:
- name: Physiotherapy for joint limitation
  description: >
    Ongoing physiotherapy is recommended to help prevent or reduce progression
    of joint limitation and contractures.
  treatment_term:
    preferred_term: physical therapy
    term:
      id: MAXO:0000011
      label: physical therapy
  target_phenotypes:
  - preferred_term: Limitation of joint mobility
    term:
      id: HP:0001376
      label: Limitation of joint mobility
  - preferred_term: Joint contracture
    term:
      id: HP:0034392
      label: Joint contracture
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Ongoing physiotherapy to prevent joint limitation"
    explanation: GeneReviews lists ongoing physiotherapy as treatment of manifestations.
- name: Cardiac valve replacement for severe valvular disease
  description: >
    Severe valvular stenosis or insufficiency may require cardiac valve
    replacement as a manifestation-directed surgical intervention.
  treatment_term:
    preferred_term: cardiac valve replacement
    term:
      id: MAXO:0000004
      label: surgical procedure
  target_phenotypes:
  - preferred_term: Valvular pulmonary stenosis
    term:
      id: HP:0034350
      label: Valvular pulmonary stenosis
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "cardiac valve replacement in those with severe stenosis or insufficiency"
    explanation: GeneReviews lists cardiac valve replacement for severe valvular disease.
- name: Tracheostomy for severe tracheal stenosis
  description: >
    Tracheostomy is used when severe tracheal stenosis creates critical airway
    obstruction.
  treatment_term:
    preferred_term: tracheostomy
    term:
      id: MAXO:0000504
      label: tracheostomy
  target_phenotypes:
  - preferred_term: Airway obstruction
    term:
      id: HP:0006536
      label: Airway obstruction
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "tracheostomy as needed for severe tracheal stenosis"
    explanation: GeneReviews lists tracheostomy for severe tracheal stenosis.
- name: Pulmonary and supportive respiratory management
  description: >
    Restrictive lung disease, obstructive sleep apnea, asthma, and respiratory
    compromise are managed by pulmonology-directed supportive care.
  treatment_term:
    preferred_term: supportive respiratory care
    term:
      id: MAXO:0000950
      label: supportive care
  target_phenotypes:
  - preferred_term: Airway obstruction
    term:
      id: HP:0006536
      label: Airway obstruction
  - preferred_term: Asthma
    term:
      id: HP:0002099
      label: Asthma
  evidence:
  - reference: PMID:20301776
    reference_title: Geleophysic Dysplasia.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "treatment of restrictive lung disease, obstructive sleep apnea, and/or asthma per pulmonologist"
    explanation: GeneReviews lists pulmonology-directed care for respiratory manifestations.
- name: Losartan for FBN1-related microfibril deposition defect
  description: >
    Losartan is an investigational, mechanism-directed candidate for
    FBN1-related geleophysic dysplasia. In patient fibroblasts it did not reduce
    lysosomal storage material but improved extracellular deposition of
    fibrillin-1 microfibrils; this is cell-model evidence, not established
    clinical treatment evidence.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: losartan
      term:
        id: CHEBI:6541
        label: losartan
  target_mechanisms:
  - target: Fibrillin microfibril matrix dysregulation
    treatment_effect: MODULATES
    description: Losartan improved fibrillin-1 microfibril deposition in FBN1-related GD fibroblasts.
  evidence:
  - reference: PMID:31350823
    reference_title: "Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect."
    supports: PARTIAL
    evidence_source: IN_VITRO
    snippet: "Treatment of GPHYSD fibroblasts carrying FBN1 mutations with the angiotensin II receptor type 1 inhibitor losartan that inhibits TGF-β signaling did not reduce the storage but improved the extracellular deposition of fibrillin-1 microfibrils."
    explanation: This supports losartan as a candidate mechanism-directed therapy in fibroblasts but not as proven patient treatment.
animal_models:
- species: Mouse
  genotype: Adamtsl2 knockout
  description: >
    Adamtsl2-null mice are a model of ADAMTSL2-related geleophysic dysplasia.
    They die at birth and show bronchial epithelial dysplasia, abnormal
    glycogen-rich inclusions, bronchial microfibril changes, and increased
    bronchial epithelial TGF-beta signaling.
  genes:
  - preferred_term: Adamtsl2
    term:
      id: hgnc:14631
      label: ADAMTSL2
  associated_phenotypes:
  - Airway obstruction
  evidence:
  - reference: PMID:25762570
    reference_title: "Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia."
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Here, we investigated mice with targeted Adamtsl2 inactivation as a new model for GD (Adamtsl2(-/-) mice)."
    explanation: The paper explicitly introduces targeted Adamtsl2 inactivation mice as a GD model.
references:
- reference: ORPHA:2623
  title: Geleophysic dysplasia
  findings: []
- reference: PMID:20301776
  title: Geleophysic Dysplasia.
  findings: []
- reference: PMID:25762570
  title: Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia.
  findings: []
- reference: PMID:27068007
  title: Mutations in LTBP3 cause acromicric dysplasia and geleophysic dysplasia.
  findings: []
- reference: PMID:31350823
  title: Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect.
  findings: []
- reference: PMID:31516831
  title: "Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking."
  findings: []
- reference: PMID:32880985
  title: "Acromelic dysplasias: how rare musculoskeletal disorders reveal biological functions of extracellular matrix proteins."
  findings: []
- reference: PMID:38300707
  title: ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia.
  findings: []
- reference: PMID:39705488
  title: "Expanded phenotypes and pathogenesis of geleophysic dysplasia 3 resulted from a de novo LTBP3 mutation: A case report."
  findings: []
- reference: PMID:40481143
  title: Dysregulation of cell migration by matrix metalloproteinases in geleophysic dysplasia.
  findings: []
📚

References & Deep Research

References

10
Geleophysic dysplasia
No top-level findings curated for this source.
Geleophysic Dysplasia.
No top-level findings curated for this source.
Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia--a novel mouse model providing insights into geleophysic dysplasia.
No top-level findings curated for this source.
Mutations in LTBP3 cause acromicric dysplasia and geleophysic dysplasia.
No top-level findings curated for this source.
Skin fibroblasts of patients with geleophysic dysplasia due to FBN1 mutations have lysosomal inclusions and losartan improves their microfibril deposition defect.
No top-level findings curated for this source.
Geleophysic dysplasia: novel missense variants and insights into ADAMTSL2 intracellular trafficking.
No top-level findings curated for this source.
Acromelic dysplasias: how rare musculoskeletal disorders reveal biological functions of extracellular matrix proteins.
No top-level findings curated for this source.
ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia.
No top-level findings curated for this source.
Expanded phenotypes and pathogenesis of geleophysic dysplasia 3 resulted from a de novo LTBP3 mutation: A case report.
No top-level findings curated for this source.
Dysregulation of cell migration by matrix metalloproteinases in geleophysic dysplasia.
No top-level findings curated for this source.

Deep Research

1
Asta
Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Geleophysic Dysplasia. Core disease mechanisms, molecular and cellular pat...
Asta Scientific Corpus Retrieval 19 citations 2026-05-09T21:44:59.514126

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Geleophysic Dysplasia. Core disease mechanisms, molecular and cellular pat...

This report is retrieval-only and is generated directly from Asta results.

  • Papers retrieved: 19
  • Snippets retrieved: 20

Relevant Papers

[1] EndoCompass Project: Research Roadmap for Calcium and Bone Endocrinology

  • Authors: K. Jähn-Rickert, K. Z. Tomsic, A. Anastasilakis, Jean-Philippe Bertocchio, M. L. Brandi et al.
  • Year: 2025
  • Venue: Hormone Research in Pædiatrics
  • URL: https://www.semanticscholar.org/paper/fccbdcae3a86c448632e05f9c38ad2563c14284d
  • DOI: 10.1159/000549160
  • PMID: 41296665
  • PMCID: 12698132
  • Citations: 1
  • Summary: This framework identifies crucial investigation areas into metabolic bone disease pathophysiology, prevention, and treatment strategies, ultimately aimed at reducing the burden of these disorders on individuals and society.
  • Evidence snippets:
  • Snippet 1 (score: 0.452) > Skeletal dysplasias encompass a large spectrum of genetic disorders of the skeleton with abnormal bone growth, structure, or strength [85]. Individually, they are rare but, collectively, due to the large number of skeletal dysplasias (>700), they result in significant morbidity. The underlying pathology remains inadequately understood and the optimal therapy is often undefined, with precision drug treatment targeting the underlying molecular mechanism not available for most skeletal dysplasias. Gene discoveries have increased exponentially, demonstrating the value of advanced genetic tools and motivating further research into the complex pathogenesis of skeletal dysplasias. > However, further basic research is required to uncover the cellular pathology and implicated molecular pathways in various forms of skeletal dysplasia. Understanding the pathophysiology of skeletal dysplasias may also benefit a larger patient population. This is evidenced by anti-sclerostin treatment for osteoporosis [86] which, at present, is in clinical trials for osteogenesis imperfecta. Preclinical data show positive effects on bone mass and strength [87]. > The spectrum of disease manifestations of various skeletal dysplasias in different phases of life and health projections across the life course remain inadequately studied. Research on therapeutic approaches needs to focus not only on correcting the pathophysiology but also, more broadly, on surgical approaches, rehabilitation, functional/environmental adaptations, preventative measures, pain management, psychological support, and quality of life. Patient groups must be involved in identifying these research goals. International registries should be utilized to collect and analyse such data. > A multidisciplinary approach is of particular importance in genetic skeletal disorders, to enable cohesive care throughout the life course. The patients have a range of physical impairments due to their skeletal disorder, but also a disease-specific spectrum of extraskeletal manifestations requiring medical attention. These may include, for example, dental and oral health problems, immune deficiency, impaired hearing, and neurological or ophthalmologic manifestations.

[2] New therapeutic targets in rare genetic skeletal diseases

  • Authors: M. Briggs, Peter A. Bell, M. Wright, K. A. Pirog
  • Year: 2015
  • Venue: Expert Opinion on Orphan Drugs
  • URL: https://www.semanticscholar.org/paper/1363107f71ae6d2d60abca471cddf3da5d13644b
  • DOI: 10.1517/21678707.2015.1083853
  • PMID: 26635999
  • PMCID: 4643203
  • Citations: 38
  • Influential citations: 1
  • Summary: An overview of disease mechanisms that are shared amongst groups of different GSDs and potential therapeutic approaches that are under investigation are described to generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.442) > proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e. chondrocyte) to the abnormal extracellular environment is also important for disease progression as illustrated by several GSDs discussed in this review. > It is important that 'omics'-based approaches and technologies are systematically applied to the study of rare GSDs so that definitive reference profiles and disease signatures are generated for each phenotype. These can then be used in a Systems Biology approach to identify both common and dissimilar pathological signatures and disease mechanisms. This approach is entirely dependent upon relevant in vitro and in vivo models (and also novel 'disease-mechanism phenocopies' [107]) for testing new diagnostic and prognostic tools and for determining the molecular mechanisms that underpin the pathophysiology so that effective therapeutic treatments can be developed and validated. This approach will eventually lead to personalized treatments and care strategies centred on shared disease mechanisms with the use of relevant biomarkers to monitor the efficacy of treatment and disease progression. > It is vital that all relevant stakeholders are involved from the outset in defining the appropriate outcomes of any potential therapeutic regime. The perceptions of a successful therapy can differ widely between the clinical academic community and the relevant patient-support groups and it is vital that there is engagement on all these issues. > In summary, the identification of causative genes and mutations for GSDs over the last 20 years, coupled with the generation and in-depth analysis of a plethora of relevant cell and mouse models, has derived new knowledge on disease mechanisms and suggested potential therapeutic targets. The fast-evolving hypothesis that clinically disparate diseases can share common disease mechanisms is a powerful concept that will generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Snippet 2 (score: 0.436) > The extensive clinical variability and genetic heterogeneity of GSDs, coupled with complex disease mechanisms, renders this extensive group of rare diseases a bench to bedside challenge. Indeed, this large number of different and highly complex phenotypes makes the identification, validation and development of potential therapies almost impossible for anything other than the most common GSDs. As an alternative approach, we might consider identifying genotype-and/or phenotype-independent 'core disease mechanisms' that are shared amongst families of clinically unrelated GSDs. This approach would allow the focusing of resources into several areas of concerted investigation that have the potential to identify and validate therapeutic targets with a broad application to GSDs, inherited connective tissues as a whole and rare genetic disease in general. Indeed, Jürgen Spranger first suggested the idea of 'bone dysplasia families' in 1985 [124] and proposed that phenotypes with a similar clinical and radiographic phenotype would likely have a similar disease mechanism. Thirty years later, we can now expand upon this pioneering concept and propose that common disease mechanisms can also be shared amongst clinically different phenotypes ('common amongst the rare'). > In this context, ER stress has been associated with a diverse range of genetic diseases and chronic conditions such as skeletal dysplasia (as discussed in this review), myopathy [125], cerebro-vascular [42], kidney [126], ischaemia and cardiovascular diseases [127]. Moreover, ER stress is emerging as a very attractive target that is being successfully exploited in a broad range of diseases including neuropathy, juvenile-onset openangle glaucoma, obesity, diabetes, asthma and epidermolysis bullosa, to name but a few. Historically many GSDs were considered diseases of the ECM and proposed therapeutic interventions involved the removal and/or correction of the relevant mutated gene or abnormal gene product. This was particularly the case with dominant-negative mutations in the large structural proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e.

[3] Human Dermal Fibroblast: A Promising Cellular Model to Study Biological Mechanisms of Major Depression and Antidepressant Drug Response

  • Authors: P. Mesdom, R. Colle, É. Lebigot, S. Trabado, Eric Deflesselle et al.
  • Year: 2020
  • Venue: Current Neuropharmacology
  • URL: https://www.semanticscholar.org/paper/79368e365458486de96794333613c12a6063bf54
  • DOI: 10.2174/1570159X17666191021141057
  • PMID: 31631822
  • PMCID: 7327943
  • Citations: 14
  • Summary: This review highlights the great and still underused potential of HDF, which stands out as a very promising tool in the understanding of MDD and AD mechanisms of action.
  • Evidence snippets:
  • Snippet 1 (score: 0.415) > Background: Human dermal fibroblasts (HDF) can be used as a cellular model relatively easily and without genetic engineering. Therefore, HDF represent an interesting tool to study several human diseases including psychiatric disorders. Despite major depressive disorder (MDD) being the second cause of disability in the world, the efficacy of antidepressant drug (AD) treatment is not sufficient and the underlying mechanisms of MDD and the mechanisms of action of AD are poorly understood. Objective The aim of this review is to highlight the potential of HDF in the study of cellular mechanisms involved in MDD pathophysiology and in the action of AD response. Methods The first part is a systematic review following PRISMA guidelines on the use of HDF in MDD research. The second part reports the mechanisms and molecules both present in HDF and relevant regarding MDD pathophysiology and AD mechanisms of action. Results HDFs from MDD patients have been investigated in a relatively small number of works and most of them focused on the adrenergic pathway and metabolism-related gene expression as compared to HDF from healthy controls. The second part listed an important number of papers demonstrating the presence of many molecular processes in HDF, involved in MDD and AD mechanisms of action. Conclusion The imbalance in the number of papers between the two parts highlights the great and still underused potential of HDF, which stands out as a very promising tool in our understanding of MDD and AD mechanisms of action

[4] Changes in Serum Proteomic Profiles at Different Stages of Pregnancy Toxemia in Goats

  • Authors: M. Uzti̇mür, C. N. Ünal, Gurler Akpinar
  • Year: 2025
  • Venue: Journal of Veterinary Internal Medicine
  • URL: https://www.semanticscholar.org/paper/4b9c488b5dbd65d7b26fd2ad9aed70e8c4b59942
  • DOI: 10.1111/jvim.70139
  • PMID: 40492724
  • PMCID: 12150350
  • Summary: Understanding the serum proteome profiles of goats with pregnancy toxemia might help identify the proteomes and pathways responsible for the development of this disease and improve diagnosis and treatment.
  • Evidence snippets:
  • Snippet 1 (score: 0.404) > The pathophysiology and progression of this disease are not fully understood. > Traditional biomedical research has focused on the analysis of single genes, proteins, metabolites, or metabolic pathways in diseases. This molecular reductionist approach is based on the assumption that identifying genetic variations and molecular components will lead to new treatments for diseases [13][14][15][16]. However, many diseases are complex and multifactorial, and in order to determine the phenotype of such diseases, it is necessary to understand the changes that occur in more than one gene, pathway, protein, or metabolite at the cellular, tissue, and organismal levels [17][18][19]. Therefore, in recent years, proteomics, as one field of multi-omics technologies, has helped in evaluating the complex pathogenetic mechanisms of different diseases from a broad perspective and has made substantial contributions [20,21]. In veterinary medicine, proteomic analysis of metabolic diseases such as ketosis [16], hypocalcemia [22], and fatty liver [23] in dairy cows has contributed valuable insights for the definition of new pathophysiological pathways and new diagnosis and treatment protocols for these diseases. The proteomic approach can contribute importantly to a broad and detailed understanding of the changes that occur at the organismal level associated with the increase in BHBA concentration in goats with pregnancy toxemia. Our aim was to evaluate the serum protein profiles of goats with SPT or CPT using proteomic techniques to determine the proteomic profiles of these animals and to identify the relevant pathophysiological mechanisms.

[5] Skeletal Dysplasias Caused by Sulfation Defects

  • Authors: Chiara Paganini, Chiara Gramegna Tota, A. Superti-Furga, A. Rossi
  • Year: 2020
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/e455f358a08f6e9fc09ef5f2d3751d11e9145e92
  • DOI: 10.3390/ijms21082710
  • PMID: 32295296
  • PMCID: 7216085
  • Citations: 26
  • Influential citations: 1
  • Summary: A panoramic view of skeletal dysplasias caused by mutations in genes encoding for transporters or enzymes involved in macromolecular sulfation is presented, allowing the development of targeted therapies aimed at alleviating, preventing, or modifying the disease progression.
  • Evidence snippets:
  • Snippet 1 (score: 0.403) > Over the last few years, there have been significant advances in the skeletal dysplasia field leading to the identification of the underlying genetic defects in more than 400 different skeletal disorders [15]. The above synopsis highlights the complexity of skeletal defects caused by mutations in genes encoding for enzymes and transporters involved in sulfate metabolism. Progress in this field has been allowed by next-generation genomic technologies, that are a first-line diagnostic resource. In this complex scenario, patient derived biopsies, cell cultures, and animal models are fundamental to investigate the pathogenesis and to analyze new aspects of the role of GAG in connective tissue biology. > Despite the great step forward in the identification of causative genes, genotype-phenotype correlations are lacking and we are still far from a comprehensive view of the disease molecular mechanisms. First, it is unclear how the tissue specificity and the redundancy of genes can determine the phenotype. Defects in PG sulfation mainly affect cartilage and bone, but other tissues can be involved as cardiac tissue in SEDCJD [82,84] or lymphoid tissue leading to tumour progression in OCBMD [91]. The involvement of different tissues and its implications on the disease phenotype should be carefully studied in the future. Moreover, mutations in different genes cause skeletal dysplasias with overlapping features that may be wrongly diagnosed as occurs in condrodysplasia with joint dislocation, gPAPP type, Catel-Manzke syndrome and Desbuquois dysplasia type 1. Nowadays we cannot provide a full explanation why some classes of sulfated PGs are more affected by enzyme deficiency than others. Even if the GAGs role depends on their physicochemical properties, it is difficult to molecularly dissect the function of sulfated GAGs when they interact in the complex ECM network. Lastly, the variability in the clinical phenotypes caused by mutations in the same gene suggests that also environmental and epigenetic factors might play a role. > A deep understanding of the molecular mechanisms of these disorders is crucial to ultimately pave the way for innovative therapies.

[6] Mitochondrial Dysfunction in Diabetes: Shedding Light on a Widespread Oversight

  • Authors: F. Iheagwam, A. J. Joseph, E. D. Adedoyin, Olawumi Toyin Iheagwam, Samuel Akpoyowvare Ejoh
  • Year: 2025
  • Venue: Pathophysiology
  • URL: https://www.semanticscholar.org/paper/dbf8042761c1a5fc50f8cd894cc498505abac7cb
  • DOI: 10.3390/pathophysiology32010009
  • PMID: 39982365
  • PMCID: 12077258
  • Citations: 30
  • Summary: This review aims to elucidate the complex link between mitochondrial dysfunction and diabetes, covering the spectrum of diabetes types, the role of mitochondria in insulin resistance, highlighting pathophysiological mechanisms, mitochondrial DNA damage, and altered mitochondrial biogenesis and dynamics.
  • Evidence snippets:
  • Snippet 1 (score: 0.396) > The landscape of DM research is continuously evolving, with emerging technologies and approaches offering new insights into the pathophysiology of the disease and potential therapeutic targets. Advancements in omics technologies, encompassing genomes, transcriptomics, proteomics, and metabolomics, have transformed the molecular mechanisms underlying DM [134]. High-throughput sequencing techniques enable comprehensive analysis of genetic variants, gene expression profiles, protein abundance, and metabolite levels associated with DM and its complications [135]. Single-cell omics approaches provide unprecedented resolution and granularity, allowing researchers to dissect cellular heterogeneity and identify novel cell types, subpopulations, and signalling pathways involved in DM pathogenesis. Integrating multi-omics data sets offers a systems-level perspective of DM, unravelling complex networks of molecular interactions and regulatory circuits underlying disease progression [136]. > In addition to omics technologies, advances in imaging modalities, such as MRI, PET, and optical imaging, enable non-invasive visualisation and quantification of metabolic, functional, and structural changes. Molecular imaging probes targeting specific biomarkers and metabolic pathways provide valuable insights into disease mechanisms and treatment responses in preclinical and clinical settings [85]. Despite significant progress in DM research, numerous unanswered questions and knowledge gaps persist, hindering the ability to develop effective prevention and treatment strategies. Key areas requiring further investigation include the role of epigenetics, environmental factors, and the microbiome in DM susceptibility and progression. Moreover, the interaction between environmental cues and genetic predisposition remains incompletely understood, highlighting the need for comprehensive multi-omics studies and large-scale epidemiological analyses to identify gene-environment interactions and modifiable risk factors for DM [137]. Furthermore, the heterogeneity of DM phenotypes and clinical outcomes poses a challenge for personalised medicine approaches, necessitating robust biomarkers and predictive models to stratify patients based on disease subtypes, prognosis, and treatment response [138].

[7] Transcriptional profiling of Hutchinson-Gilford progeria patients identifies primary target pathways of progerin

  • Authors: Sandra Vidak, Sohyoung Kim, Tom Misteli
  • Year: 2026
  • Venue: Nucleus
  • URL: https://www.semanticscholar.org/paper/4bd99b0875508364d8672b6da5a50d024d485a53
  • DOI: 10.1080/19491034.2025.2611484
  • PMID: 41489464
  • PMCID: 12773485
  • Summary: To probe the clinical relevance of previously implicated cellular pathways and to address the extent of gene expression heterogeneity between patients, transcriptomic analysis of a comprehensive set of HGPS patients finds misexpression of several cellular pathways, including multiple signaling pathways, the UPR and mesodermal cell fate specification.
  • Evidence snippets:
  • Snippet 1 (score: 0.393) > Oxidative stress represents another key pathogenic mechanism in HGPS, as impaired NRF2 activity or increased reactive oxygen species (ROS) levels are sufficient to recapitulate HGPSassociated phenotypes [17,32,60]. Collectively, these findings underscore the multifactorial nature of HGPS pathogenesis, implicating interconnected signaling cascades involved in inflammation, oxidative stress, proteostasis, and vascular remodeling. Reassuringly, our findings indicate that many of the major pathways that have been described to contribute to HGPS phenotypes in mouse and cellular disease models are also misregulated in progeria patients, and targeting these pathways may provide therapeutic avenues to mitigate disease severity and improve outcomes in HGPS. > Although individuals with HGPS typically exhibit a characteristic set of clinical features, such as craniofacial abnormalities, growth retardation, and cardiovascular complications, there is notable variability in the age of onset, severity, and progression of symptoms between patients [7,9]. At the cellular level, HGPS is associated with several hallmark abnormalities, including nuclear envelope defects, decreased expression of several nuclear proteins and epigenetic marks, mitochondrial dysfunction, and increased cellular senescence [1,11,30,31,61]. These cellular phenotypes also exhibit considerable variation between patients, possibly contributing to differences in clinical outcomes. Our results indicate that even though some degree of transcriptional heterogeneity between the individual patients exists, the majority of patients exhibit misregulation of a set of shared pathways, suggesting that these pathways are universal driver mechanisms in HGPS. Further work is needed to understand the molecular and genetic factors that underlie inter-individual variability in disease expression and progression. > A limitation of pathway analysis of HGPS patient samples is to distinguish the pathways which are directly targeted by the disease-causing progerin protein and the emergence of adaptive secondary response pathways during progression of the disease in patients during their lifetime. The same caveat applies to the use of cell-based models used in the study of HGPS disease mechanisms.

[8] The ties that bind: functional clusters in limb-girdle muscular dystrophy

  • Authors: E. Barton, C. A. Pacak, Whitney L. Stoppel, P. Kang
  • Year: 2020
  • Venue: Skeletal Muscle
  • URL: https://www.semanticscholar.org/paper/653422e1a9dc9cc7f16758b10f3f203155bc68c9
  • DOI: 10.1186/s13395-020-00240-7
  • PMID: 32727611
  • PMCID: 7389686
  • Citations: 24
  • Summary: A deeper understanding of these disease pathways could yield a new generation of precision therapies that would each be expected to treat a broader range of LGMD patients than a single subtype, thus expanding the scope of the molecular medicines that may be developed for this complex array of muscular dystrophies.
  • Evidence snippets:
  • Snippet 1 (score: 0.390) > Pyridine nucleotide-disulfide reductase [55] Many of the protein functions listed require further confirmation or are disputed these methodologies. Those patients with moderate disease phenotypes regardless of the underlying causative gene mutation would likely fall into a category where there may be interest in testing a pharmacological treatment (that could be halted) but reduced interest in a more permanent experimental strategy. For all of the above-mentioned reasons, the identification of unifying therapeutic targets applicable to multiple subtypes of > LGMDs is highly desirable. > To identify such targets, we should first consider the question: What binds all of these LGMDs together? The two core phenotypic features are progressive proximal muscle weakness, along with characteristic signs of muscle fiber destruction on biopsy, referred to as "dystrophic" features. Nuances in clinical presentation have helped to distinguish some of the LGMDs, such as the frequent occurrence of difficulty walking on tiptoes in LGMD R2 (LGMD2B), caused by dysferlin deficiency. However, heterogeneity associated with variable ages of onset and ranges of severity makes it generally difficult to distinguish and diagnose LGMD subtypes based on clinical presentation alone. A change in perspective is in order to aid in understanding disease pathways responsible for clinical features even when the genetic mutation is unknown. Further, given the large number of genespecific LGMD subtypes, it could very well be that several major disease mechanisms may be shared across the family of diseases. Yet despite careful studies that have collectively determined the cellular localization of most proteins associated with LGMD (Fig. 1), there is limited knowledge of potentially unifying molecular disease mechanisms. We assert that the identification of functional clusters of these proteins, grouped by such common mechanisms, will streamline our understanding of the disease processes and identify therapeutic targets relevant to individuals in multiple disease subgroups, including individuals whose pathogenic mutations have not been found. By extension, this approach may serve as a tool to not only find common mechanisms, but may also help to distinguish LGMD subtypes that do not share similar functional patterns, and afford further refinement of potential treatments.

[9] The ties that bind: functional clusters in limb-girdle muscular dystrophy

  • Authors: E. Barton, C. A. Pacak, Whitney L. Stoppel, Peter B. Kang
  • Year: 2020
  • Venue: Skeletal Muscle
  • URL: https://www.semanticscholar.org/paper/3493c658bb8716d789a05ddf292162832e064e47
  • DOI: 10.1186/s13395-020-00240-7
  • Summary: A deeper understanding of these disease pathways could yield a new generation of precision therapies that would each be expected to treat a broader range of LGMD patients than a single subtype, thus expanding the scope of the molecular medicines that may be developed for this complex array of muscular dystrophies.
  • Evidence snippets:
  • Snippet 1 (score: 0.390) > Pyridine nucleotide-disulfide reductase [55] Many of the protein functions listed require further confirmation or are disputed these methodologies. Those patients with moderate disease phenotypes regardless of the underlying causative gene mutation would likely fall into a category where there may be interest in testing a pharmacological treatment (that could be halted) but reduced interest in a more permanent experimental strategy. For all of the above-mentioned reasons, the identification of unifying therapeutic targets applicable to multiple subtypes of > LGMDs is highly desirable. > To identify such targets, we should first consider the question: What binds all of these LGMDs together? The two core phenotypic features are progressive proximal muscle weakness, along with characteristic signs of muscle fiber destruction on biopsy, referred to as "dystrophic" features. Nuances in clinical presentation have helped to distinguish some of the LGMDs, such as the frequent occurrence of difficulty walking on tiptoes in LGMD R2 (LGMD2B), caused by dysferlin deficiency. However, heterogeneity associated with variable ages of onset and ranges of severity makes it generally difficult to distinguish and diagnose LGMD subtypes based on clinical presentation alone. A change in perspective is in order to aid in understanding disease pathways responsible for clinical features even when the genetic mutation is unknown. Further, given the large number of genespecific LGMD subtypes, it could very well be that several major disease mechanisms may be shared across the family of diseases. Yet despite careful studies that have collectively determined the cellular localization of most proteins associated with LGMD (Fig. 1), there is limited knowledge of potentially unifying molecular disease mechanisms. We assert that the identification of functional clusters of these proteins, grouped by such common mechanisms, will streamline our understanding of the disease processes and identify therapeutic targets relevant to individuals in multiple disease subgroups, including individuals whose pathogenic mutations have not been found. By extension, this approach may serve as a tool to not only find common mechanisms, but may also help to distinguish LGMD subtypes that do not share similar functional patterns, and afford further refinement of potential treatments.

[10] Nuclear damages and oxidative stress: new perspectives for laminopathies

  • Authors: G. Lattanzi, S. Marmiroli, Andrea Facchini, N. Maraldi
  • Year: 2012
  • Venue: European Journal of Histochemistry : EJH
  • URL: https://www.semanticscholar.org/paper/8611d2c59658a5c3139c153051a0a4d8881c55ea
  • DOI: 10.4081/ejh.2012.e45
  • PMID: 23361241
  • PMCID: 3567764
  • Citations: 49
  • Influential citations: 3
  • Summary: The identification of a mechanism that accounts for accumulation of unrepairable DNA damage due to reactive oxygen species (ROS) generation in laminopathic cells, similar to that found in other muscular dystrophies (MDs) caused by altered expression of extracellular matrix (ECM) components, suggests that anti-oxidant therapeutic strategies might prove beneficial to laminopathies patients.
  • Evidence snippets:
  • Snippet 1 (score: 0.388) > Mutations in genes encoding nuclear envelope proteins, particularly LMNA encoding the A-type lamins, cause a broad range of diverse diseases, referred to as laminopathies. The astonishing variety of diseased phenotypes suggests that different mechanisms could be involved in the pathogenesis of laminopathies. In this review we will focus mainly on two of these pathogenic mechanisms: the nuclear damages affecting the chromatin organization, and the oxidative stress causing un-repairable DNA damages. Alteration in the nuclear profile and in chromatin organization, which are particularly impressive in systemic laminopathies whose cells undergo premature senescence, are mainly due to accumulation of unprocessed prelamin A. The toxic effect of these molecular species, which interfere with chromatin-associated proteins, transcription factors, and signaling pathways, could be reduced by drugs which reduce their farnesylation and/or stability. In particular, inhibitors of farnesyl transferase (FTIs), have been proved to be active in rescuing the altered cellular phenotype, and statins, also in association with other drugs, have been included into pilot clinical trials. The identification of a mechanism that accounts for accumulation of unrepairable DNA damage due to reactive oxygen species (ROS) generation in laminopathic cells, similar to that found in other muscular dystrophies (MDs) caused by altered expression of extracellular matrix (ECM) components, suggests that anti-oxidant therapeutic strategies might prove beneficial to laminopathic patients.

[11] Renal ciliopathies: promising drug targets and prospects for clinical trials

  • Authors: L. Devlin, Praveen Dhondurao Sudhindar, J. Sayer
  • Year: 2023
  • Venue: Expert Opinion on Therapeutic Targets
  • URL: https://www.semanticscholar.org/paper/ab2155b6e12caba53d57ac0e8ce28860d69ec9fd
  • DOI: 10.1080/14728222.2023.2218616
  • PMID: 37243567
  • Citations: 10
  • Summary: The advances in basic science and clinical research into renal ciliopathies which have yielded promising small compounds and drug targets are reviewed, within both preclinical studies and clinical trials.
  • Evidence snippets:
  • Snippet 1 (score: 0.387) > Although renal ciliopathies can be classified into distinct syndromes, causative mutations in genes encoding proteins involved in the primary cilium or centrosome mean they may share overlapping mechanisms of disease, which may be amenable for therapeutic intervention (Figure 2). Abnormal functioning of proteins involved in ciliogenesis, such as CEP164, can prevent proper cilia formation, which will effect a myriad of downstream ciliary signaling pathways. Additionally, mutations in genes encoding for proteins involved in cargo trafficking or regulation, such as CEP290, will have implications for signal pathway transduction, as well as mutations in components of signaling pathways themselves, such as PKD1. In regard to renal ciliopathies, abnormalities in signaling pathways such as cAMP, Shh, Wnt, mTOR, and AMPK, likely cause misoriented cellular divisions, increased proliferation, increased fluid secretion and subsequent cystogenesis, consequently leading to further kidney damage. Ciliary and centriolar proteins which have roles in DDR and cell cycle regulation may also be driving a renal cystogenesis phenotype alongside increased fibrosis and apoptosis. Increased inflammation and dysfunctional mitochondria are also byproducts of dysregulated signaling pathways have been shown to contribute to the progression of renal ciliopathies. Extensive reviews of mechanisms of renal ciliopathy diseases have recently been performed [23,24]. Importantly, due to the wide range of cellular processes that primary cilia regulate, it is likely that in each syndrome there are multiple pathogenic drivers of disease. In some ways, this is advantageous as it offers many points for potential therapeutic targets. However, the cross talk between pathways and feedback loops introduces complications of changing one pathway without negatively affecting another. Further challenges arise with core biological pathways, such as Shh signaling, in which modification in vitro may be beneficial, but systemic treatment is unrealistic due to the expected severe side effects [18,24,116].

[12] Geleophysic dysplasia.

  • Authors: J. E. Wraith, A. Bankier, C. W. Chow, D. Danks, I. Sardharwalla
  • Year: 2020
  • Venue: American journal of medical genetics
  • URL: https://www.semanticscholar.org/paper/0c69b6958651c9c9c550e91f725c1ec945e752e2
  • DOI: 10.1007/978-1-4020-6754-9_6502
  • PMID: 2090119
  • Citations: 39
  • Influential citations: 6
  • Summary: Histological and ultrastructural changes suggest that a disturbance in the relations between cell membrane and extracellular matrix may be involved in the pathogenesis of geleophasic dysplasia.
  • Evidence snippets:
  • Snippet 1 (score: 0.387) > Geleophysic dysplasia.

[13] Therapies for Mitochondrial Disease: Past, Present, and Future

  • Authors: Megan Ball, Nicole J. Van Bergen, A. Compton, David R. Thorburn, S. Rahman et al.
  • Year: 2025
  • Venue: Journal of Inherited Metabolic Disease
  • URL: https://www.semanticscholar.org/paper/196ee50a950f29bc4134cfb8fe6bdfa9a3a1468b
  • DOI: 10.1002/jimd.70065
  • PMID: 40714961
  • PMCID: 12301291
  • Citations: 4
  • Summary: The latest developments in the pursuit to identify effective treatments for mitochondrial disease are examined and the barriers impeding their success in translation to clinical practice are discussed.
  • Evidence snippets:
  • Snippet 1 (score: 0.384) > Mitochondrial disease is a diverse group of clinically and genetically complex disorders caused by pathogenic variants in nuclear or mitochondrial DNA‐encoded genes that disrupt mitochondrial energy production or other important mitochondrial pathways. Mitochondrial disease can present with a wide spectrum of clinical features and can often be difficult to recognize. These conditions can be devastating; however, for the majority, there is no targeted treatment. In the last 60 years, mitochondrial medicine has experienced significant evolution, moving from the pre‐molecular era to the Age of Genomics in which considerable gene discovery and advancement in our understanding of the pathophysiology of mitochondrial disease have been made. In the last decade, in response to the urgent need for effective treatments, a wide range of emerging therapies have been developed, driven by innovative approaches addressing both the genetic and cellular mechanisms underpinning the diseases. Emerging therapies include dietary intervention, small molecule therapies aimed to restore mitochondrial function, stem cell or liver transplantation, and gene or RNA‐based therapies. However, despite these advances, translation to clinical practice is complicated by the sheer genetic and clinical complexity of mitochondrial disease, difficulty in efficient and precise delivery of therapies to affected tissues, rarity of individual genetic conditions, lack of reliable biomarkers and clinically relevant outcome measures, and the dearth of natural history data. This review examines the latest developments in the pursuit to identify effective treatments for mitochondrial disease and discusses the barriers impeding their success in translation to clinical practice. While treatment for mitochondrial disease may be on the horizon, many challenges must be addressed before it can become a reality.

[14] Targeting Hepatic Stellate Cells for the Prevention and Treatment of Liver Cirrhosis and Hepatocellular Carcinoma: Strategies and Clinical Translation

  • Authors: Hao Xiong, Jinsheng Guo
  • Year: 2025
  • Venue: Pharmaceuticals
  • URL: https://www.semanticscholar.org/paper/76e92127053136900f7e3f10e2c9278251ced5d2
  • DOI: 10.3390/ph18040507
  • PMID: 40283943
  • PMCID: 12030350
  • Citations: 10
  • Summary: HSC-targeted approaches using specific surface markers and receptors may enable the selective delivery of drugs, oligonucleotides, and therapeutic peptides that exert optimized anti-fibrotic and anti-HCC effects.
  • Evidence snippets:
  • Snippet 1 (score: 0.379) > Significant progress has been made in elucidating the cellular and molecular mechanisms of liver fibrosis; however, only a few findings have been successfully translated into clinical applications. Firstly, the high cost of drug development and target validation necessitates prolonged timelines and substantial financial investment. Secondly, as regulatory requirements become more stringent, there is an increasing demand for drugs with well-defined clinical efficacy and safety profiles. Moreover, the efficacy observed in animal models often fails to fully translate to clinical settings due to differences in pharmacokinetics, extracellular matrix (ECM) cross-linking, and disease pathophysiology. Despite advancements in anti-fibrotic drug development, accurately identifying ideal noninvasive biomarkers for fibrotic activity and establishing consensus on optimal clinical endpoints remain significant challenges [113,114]. > Currently, addressing the underlying cause remains the only proven strategy to halt or reverse liver fibrosis progression, while the development of effective anti-fibrotic therapies continues to pose a major challenge in liver disease management. Over the past few decades, substantial progress has been made in elucidating the cellular and molecular mechanisms underlying liver fibrosis. Liver fibrosis is a complex pathological change involving multiple cells, factors, and pathways, and the study of the cellular and molecular mechanisms of its occurrence and development provides an important theoretical basis and therapeutic target for clinical drug development. It is anticipated that improved animal models and well-designed clinical trials will facilitate the successful translation of anti-fibrotic research into effective clinical treatments in the near future.

[15] 18O-assisted dynamic metabolomics for individualized diagnostics and treatment of human diseases

  • Authors: E. Nemutlu, Song Zhang, N. Juranic, A. Terzic, S. Macura et al.
  • Year: 2012
  • Venue: Croatian Medical Journal
  • URL: https://www.semanticscholar.org/paper/880f053c7f060db4b990e447d0a22c4b69372ddb
  • DOI: 10.3325/cmj.2012.53.529
  • PMID: 23275318
  • PMCID: 3541579
  • Citations: 28
  • Summary: The potential use of dynamic phosphometabolomic platform for disease diagnostics currently under development at Mayo Clinic is described and discussed briefly.
  • Evidence snippets:
  • Snippet 1 (score: 0.378) > Living cells represent an integrated and interacting network of genes, transcripts, proteins, small signaling molecules, and metabolites that define cellular phenotype and function. Traditionally the focus of biomedical research was on individual genes, single protein targets, single metabolites, and metabolic or signaling pathways. This "molecular reductionist" paradigm was based on the assumption that identifying genetic variations and molecular components would lead to discovery of cures for human diseases. However, most of diseases are complex and multi-factorial and the disease phenotype is determined by the alterations of multiple genes, pathways, proteins and metabolites (at cellular, tissue, and organismal levels). Therefore, an integrated "omics" approach is more viable direction for uncovering alterations in metabolic networks, disease mechanisms, and mechanisms of drug effects. > Recent advent of large-scale metabolomics and fluxomic (metabolite dynamics and metabolic flux analysis) completed the "omics revolution" (Figure 1), where genomics, transcriptomics, proteomics, metabolomics, and fluxomics all together complement phenotype determination of living organism. Such integrated "omics" cascades provide a framework for advances in system and network biology, integrative physiology, and system medicine as well as system pharmacology and regenerative medicine. Noteworthy is the "reverse omic" approach or "metabolomicsinformed pharmacogenomics, " where discovery of specific metabolite changes have led to discovery of genetic alterations (2). Therefore, bringing new "omics" technologies to clinical practice will improve disease diagnostics and treatment by targeting drugs and procedures for each unique transcriptomic and metabolomic profiles.

[16] Autophagy Dysregulation in Diabetic Kidney Disease: From Pathophysiology to Pharmacological Interventions

  • Authors: Claudio D. Gonzalez, María Paula Carro Negueruela, Catalina Nicora Santamarina, R. Resnik, M. Vaccaro
  • Year: 2021
  • Venue: Cells
  • URL: https://www.semanticscholar.org/paper/7947636a7b11fdbf5fe9717b179f065548444576
  • DOI: 10.3390/cells10092497
  • PMID: 34572148
  • PMCID: 8469825
  • Citations: 46
  • Influential citations: 1
  • Summary: The relationship between autophagy and Diabetic kidney disease and the potential value of Autophagy modulation as a target for pharmacological intervention are discussed.
  • Evidence snippets:
  • Snippet 1 (score: 0.376) > Diabetic kidney disease (DKD) is a frequent, potentially devastating complication of diabetes mellitus. Several factors are involved in its pathophysiology. At a cellular level, diabetic kidney disease is associated with many structural and functional alterations. Autophagy is a cellular mechanism that transports intracytoplasmic components to lysosomes to preserve cellular function and homeostasis. Autophagy integrity is essential for cell homeostasis, its alteration can drive to cell damage or death. Diabetic kidney disease is associated with profound autophagy dysregulation. Autophagy rate and flux alterations were described in several models of diabetic kidney disease. Some of them are closely linked with disease progression and severity. Some antidiabetic agents have shown significant effects on autophagy. A few of them have also demonstrated to modify disease progression and improved outcomes in affected patients. Other drugs also target autophagy and are being explored for clinical use in patients with diabetic kidney disease. The modulation of autophagy could be relevant for the pharmacological treatment and prevention of this disease in the future. Therefore, this is an evolving area that requires further experimental and clinical research. Here we discuss the relationship between autophagy and Diabetic kidney disease and the potential value of autophagy modulation as a target for pharmacological intervention.

[17] A review of recent studies on the pathogenesis of Systemic Sclerosis: focus on fibrosis pathways

  • Authors: S.A. Jimenez, F. Mendoza, S. Piera-velázquez
  • Year: 2025
  • Venue: Frontiers in Immunology
  • URL: https://www.semanticscholar.org/paper/885a4a3f2202767da19370ad8e55f8fa85d9a135
  • DOI: 10.3389/fimmu.2025.1551911
  • PMID: 40308583
  • PMCID: 12040652
  • Citations: 18
  • Influential citations: 2
  • Summary: Systemic Sclerosis is a systemic autoimmune disease of unknown etiology characterized by the development of frequently progressive cutaneous and internal organ fibrosis accompanied by severe vascular alterations, resulting in a wide heterogeneity in the extent and severity of clinical manifestations.
  • Evidence snippets:
  • Snippet 1 (score: 0.374) > Systemic Sclerosis (SSc) is a clinically heterogeneous systemic autoimmune disease of unknown etiology characterized by a frequently progressive fibrotic process affecting the skin and various internal organs. The fibrotic process in SSc is usually accompanied by vasculopathy of small arteries and arterioles, the presence of a chronic inflammatory process in the affected tissues, and the occurrence of humoral and cellular immune abnormalities resulting in the production of multiple autoantibodies, some with high specificity for the disease and the SSc clinical phenotype (1)(2)(3)(4). > The molecular mechanisms involved in the clinical and pathologic manifestations of the disease are highly complex, and although numerous studies have provided substantial information about its intricate picture and clarified some of its early events, the precise altered regulatory pathways involved have not been completely elucidated. However, it has been well recognized that SSc involves multiple alterations in various molecular pathways (5)(6)(7)(8)(9) that may occur simultaneously or may develop sequentially. These events include: 1) Fibroproliferative lesions of small arteries and arterioles accompanied by severe structural and functional endothelial cell alterations; 2) Severe oxidative and high reactive oxygen species; 3) Excessive and often progressive deposition of collagen and other extracellular matrix (ECM) macromolecules in skin and various internal organs; 4) Alterations of cellular and humoral immunity with the production of numerous autoantibodies, some with high disease and clinical phenotype specificity; 5) Establishment of a chronic inflammatory process in affected tissues; 6) Cellular transdifferentation resulting in the phenotypic conversion of various cell types including resting fibroblasts, endothelial cells, epithelial cells, adipocytes, and other cells into activated myofibroblasts, the cellular elements ultimately involved in the exaggerated and excessive production and accumulation of fibrotic tissue; 7) Production and release of increased levels of various cytokines and growth factors causing profibrotic and inflammatory effects; and 8) Epigenetic alterations including numerous changes mediated by non-coding RNAs.

[18] Molecular insights into the premature aging disease progeria

  • Authors: Sandra Vidak, R. Foisner
  • Year: 2016
  • Venue: Histochemistry and Cell Biology
  • URL: https://www.semanticscholar.org/paper/60fb3b46bb7e42d5d08cc3b7cbc783b118300c31
  • DOI: 10.1007/s00418-016-1411-1
  • PMID: 26847180
  • PMCID: 4796323
  • Citations: 105
  • Influential citations: 3
  • Summary: Changes in mechanosignaling, altered chromatin organization and impaired genome stability, and changes in signaling pathways, leading to impaired regulation of adult stem cells, defective extracellular matrix production and premature cell senescence are discussed.
  • Evidence snippets:
  • Snippet 1 (score: 0.374) > The number of molecular biological studies aiming at the identification of lamin-mediated molecular disease mechanisms involved in HGPS increased tremendously following the surprising discovery that LMNA is causally linked to the premature aging disease HGPS in 2003. Despite numerous cellular pathways that were identified to be affected by the expression of the mutant lamin A protein (Fig. 2), the mechanistic details behind these effects are still unclear in most cases. Knowledge based on what was already known on lamin biology before the protein was linked to HGPS and findings on novel roles of lamins in diverse pathways in recent years allowed the launch of translational studies and the efficient search for drug targets and therapeutic approaches within a short time period. The results of the first clinical trials taught us that some improvements of the disease phenotypes can be achieved by FTI treatment, but they also made clear that we need a much better understanding of the underlying disease mechanisms to be able to tackle specific aspects of the disease in a more focused approach. It will also be important to elucidate which of the numerous pathways found to be impaired in HGPS are most relevant for and causally involved in the pathologies, and which ones are just bystanders.

[19] A Roadmap to Gene Discoveries and Novel Therapies in Monogenic Low and High Bone Mass Disorders

  • Authors: M. Formosa, D. Bergen, C. Gregson, A. Maurizi, A. Kämpe et al.
  • Year: 2021
  • Venue: Frontiers in Endocrinology
  • URL: https://www.semanticscholar.org/paper/be13ff3ea01dc5719f2c63b2cbf5d9f77bafd659
  • DOI: 10.3389/fendo.2021.709711
  • PMID: 34539568
  • PMCID: 8444146
  • Citations: 22
  • Summary: The monogenic forms of rare low and high rare bone Mass disorders known to date are described, a roadmap to unravel the genetic determinants of monogenic rare bone mass disorders is provided, using proper phenotyping and genotyping methods are provided, and different genetic validation approaches paving the way for future treatments are described.
  • Evidence snippets:
  • Snippet 1 (score: 0.373) > Skeletal development is regulated by numerous genetic factors that guide the growth, modeling and remodeling of skeletal structures starting in early fetal development and continuing throughout life. These processes are crucial for attainment of normal height, skeletal patterning, bone shape, and mobility, but also for maintenance of normal bone mass and fracture resistance. Defects in the involved genes result in a large and heterogeneous group of disorders, collectively called skeletal dysplasias, in which the primary features are confined to the skeleton. More than 460 different forms of skeletal dysplasia, most of them monogenic, have been recognized (1). They are estimated to affect approximately 1/5,000 children (2,3), and can have distinct clinical manifestations and course. Clinical outcomes range in severity from neonatal lethality to only mild growth retardation, deformity or fracture risk. Diagnosis is based on growth pattern and other clinical characteristics, skeletal imaging, bone density testing, biochemical diagnostics, and genetic tests. Although the genetic basis has been described and mutations in the responsible genes identified in a significant proportion of these conditions, for several distinct skeletal dysplasia phenotypes the genetic cause is still not known (1). > Within this large group of genetic skeletal disorders, monogenic disorders affecting bone mass comprise an expanding subgroup (1,4). This includes disorders with low bone mass and skeletal fragility, and disorders leading to increased bone mass, both commonly associated with extraskeletal complications (5,6). Due to significant variability in severity, diagnosis can be challenging. Importantly, the underlying molecular genetic mechanisms for these disorders remain inadequately explored and, in several entities, the causative genetic defect, and underlying cellular and molecular pathophysiology are still uncharacterized. > The various skeletal dysplasia delineated to date have provided important information about the molecular pathways governing skeletal health both in these conditions and in the general population, underscoring the significance of new gene discoveries not only for the individuals affected by the monogenic rare bone mass disorder, but also more widely to the musculoskeletal research field (7). Indeed, the large wealth of data generated from monogenic and polygenic bone mass disorders, frailty and other musculoskeletal traits, have led

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