Evidence map›Paper›PMID 36317459›Full record

ArticleHuman mutation2022

The pathogenic c.1171A>G (p.Arg391Gly) and c.2359G>A (p.Val787Ile) ABCC6 variants display incomplete penetrance causing pseudoxanthoma elasticum in a subset of individuals.

Flora Szeri, Agnes Miko, Nastassia Navasiolava, Ambrus Kaposi, Shana Verschuere, Beatrix Molnar, Qiaoli Li, Sharon F Terry, Federica Boraldi, Jouni Uitto and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Human mutation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Observational
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  4. CommonGenome research · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 5 countries.

Flora SzeriDepartment of Dermatology and Cutaneous Biology, The Sidney Kimmel Medical College, and The PXE International Center of Excellence in Research and Clinical Care, Thomas Jefferson University, Pennsylvania, Philadelphia, USA.ORCID 0000-0003-2572-6820
Agnes MikoMTA-SE Lendület Nephrogenetic Laboratory, Budapest, Hungary.
Nastassia NavasiolavaPXE Consultation Center, MAGEC Nord Reference Center for Rare Skin Diseases, Angers University Hospital, Angers, France.
Ambrus KaposiMTA-SE Lendület Nephrogenetic Laboratory, Budapest, Hungary.
Shana VerschuereCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0001-6366-1939
Beatrix MolnarInstitute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary.
Qiaoli LiDepartment of Dermatology and Cutaneous Biology, The Sidney Kimmel Medical College, and The PXE International Center of Excellence in Research and Clinical Care, Thomas Jefferson University, Pennsylvania, Philadelphia, USA.ORCID 0000-0002-8495-7103
Sharon F TerryPXE International, District of Columbia, Washington, USA.
Federica BoraldiDepartment of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID 0000-0002-0277-9017
Jouni UittoDepartment of Dermatology and Cutaneous Biology, The Sidney Kimmel Medical College, and The PXE International Center of Excellence in Research and Clinical Care, Thomas Jefferson University, Pennsylvania, Philadelphia, USA.ORCID 0000-0003-4639-807X
Koen van de WeteringDepartment of Dermatology and Cutaneous Biology, The Sidney Kimmel Medical College, and The PXE International Center of Excellence in Research and Clinical Care, Thomas Jefferson University, Pennsylvania, Philadelphia, USA.ORCID 0000-0003-1905-2743
Ludovic MartinPXE Consultation Center, MAGEC Nord Reference Center for Rare Skin Diseases, Angers University Hospital, Angers, France.
Daniela QuaglinoDepartment of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID 0000-0002-4302-5078
Olivier M VanakkerCenter for Medical Genetics, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0003-4491-0332
Kalman ToryMTA-SE Lendület Nephrogenetic Laboratory, Budapest, Hungary.ORCID 0000-0002-0316-6212
Tamas AranyiInstitute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary.ORCID 0000-0002-2087-6275
Semmelweis University · HUThomas Jefferson University · USGhent University Hospital · BEUniversité d'Angers · FRUniversity of Modena and Reggio Emilia · ITInstitute of Molecular Life Sciences · HUPeterson Institute for International Economics · US

Funding

Novel Treatments for PXER01AR072695 · NIAMS · THOMAS JEFFERSON UNIVERSITY · PI LI, QIAOLI, VAN DE WETERING, KOEN · 2018 to 2022
$1.7M
NIAMS NIH HHS R01 AR072695
6 · The paper itself

Abstract

ABCC6 promotes ATP efflux from hepatocytes to bloodstream. ATP is metabolized to pyrophosphate, an inhibitor of ectopic calcification. Pathogenic variants of ABCC6 cause pseudoxanthoma elasticum, a highly variable recessive ectopic calcification disorder. Incomplete penetrance may initiate disease heterogeneity, hence symptoms may not, or differently manifest in carriers. Here, we investigated whether incomplete penetrance is a source of heterogeneity in pseudoxanthoma elasticum. By integrating clinical and genetic data of 589 patients, we created the largest European cohort. Based on allele frequency alterations, we identified two incomplete penetrant pathogenic variants, c.2359G>A (p.Val787Ile) and c.1171A>G (p.Arg391Gly), with 6.5% and 2% penetrance, respectively. However, when penetrant, the c.1171A>G (p.Arg391Gly) manifested a clinically unaltered severity. After applying in silico and in vitro characterization, we suggest that incomplete penetrant variants are only deleterious if a yet unknown interacting partner of ABCC6 is mutated simultaneously. The low penetrance of these variants should be contemplated in genetic counseling.

Indexed as

Pseudoxanthoma ElasticumAdenosine TriphosphateATP-Binding Cassette, Sub-Family C ProteinsHumansMutationPenetranceABCC6 protein, humanAdenosine TriphosphateATP-Binding Cassette, Sub-Family C Proteinscalcificationgenetic diagnosisincomplete penetrancepseudoxanthoma elasticumpyrophosphaterare disease

Identifiers

PMID36317459
PMCPMC9772137
OpenAlexW4307840284

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.