Program for diagnosis and prevention of inherited metabolic diseases of cellular organelles

A programme for diagnosis and prevention of lysosomal, peroxisomal, and mitochondrial [respiratory chain diseases (RCD)] diseases was developed on clinical, biochemical, and molecular approaches. The authors made postnatal diagnosis was made in 674 patients from 516 families and prenatal diagnosis in 124 fetuses in 94 families at risk. DNA analysis of mutant alleles in the mucopolysaccharidoses (MPS) I, II, and VI revealed 14, 13, and 4 new mutant alleles in IDS, ASB, IDUA genes, respectively. The pressure of a mutation process played a major role in the distribution of mutant alleles leading to MPS I and VI, but along with this factor genetic drift and migration undoubtedly influenced the observed spectrum of IDUA alleles in Russia. A clinical phenotype of patients with different MPS was analyzed on the basis of uniform registration of 167 symptoms and signs in 249 patients. Special statistical approaches were developed to characterize early manifestations of different MPS and "unique" signs and symptoms for many of them and "phenotypic distances" between them. The similar problems were solved for RCD through uniform registration of 110 symptoms and signs in 54 patients with different syndromes: pathognomonic symptoms for the whole RCD and "unique" symptoms for syndromes were defined.