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Thatcher K, Mattern CR, Chaparro D, Goveas V, McDermott MR, Fulton J, Hutcheson JD, Hoffmann BR, Lincoln J. Temporal Progression of Aortic Valve Pathogenesis in a Mouse Model of Osteogenesis Imperfecta. J Cardiovasc Dev Dis 2023; 10:355. [PMID: 37623368 PMCID: PMC10455328 DOI: 10.3390/jcdd10080355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Organization of extracellular matrix (ECM) components, including collagens, proteoglycans, and elastin, is essential for maintaining the structure and function of heart valves throughout life. Mutations in ECM genes cause connective tissue disorders, including Osteogenesis Imperfecta (OI), and progressive debilitating heart valve dysfunction is common in these patients. Despite this, effective treatment options are limited to end-stage interventions. Mice with a homozygous frameshift mutation in col1a2 serve as a murine model of OI (oim/oim), and therefore, they were used in this study to examine the pathobiology of aortic valve (AoV) disease in this patient population at structural, functional, and molecular levels. Temporal echocardiography of oim/oim mice revealed AoV dysfunction by the late stages of disease in 12-month-old mice. However, structural and proteomic changes were apparent much earlier, at 3 months of age, and were associated with disturbances in ECM homeostasis primarily related to collagen and proteoglycan abnormalities and disorganization. Together, findings from this study provide insights into the underpinnings of late onset AoV dysfunction in connective tissue disease patients that can be used for the development of mechanistic-based therapies administered early to halt progression, thereby avoiding late-stage surgical intervention.
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Affiliation(s)
- Kaitlyn Thatcher
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (K.T.); (C.R.M.); (V.G.)
- Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI 53226, USA
| | - Carol R. Mattern
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (K.T.); (C.R.M.); (V.G.)
- Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI 53226, USA
| | - Daniel Chaparro
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (D.C.); (J.D.H.)
| | - Veronica Goveas
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (K.T.); (C.R.M.); (V.G.)
- Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI 53226, USA
| | - Michael R. McDermott
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (M.R.M.); (J.F.)
| | - Jessica Fulton
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (M.R.M.); (J.F.)
| | - Joshua D. Hutcheson
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (D.C.); (J.D.H.)
| | - Brian R. Hoffmann
- Mass Spectrometry and Protein Chemistry, Protein Sciences, The Jackson Laboratory, Bar Harbor, ME 04609, USA;
| | - Joy Lincoln
- Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (K.T.); (C.R.M.); (V.G.)
- Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI 53226, USA
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2
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Masroor T, Chappell AG, Shahzad F. Anesthetic and Surgical Considerations in Osteogenesis Imperfecta: A Case Report of Mandible Fracture Management. EPLASTY 2022; 22:e12. [PMID: 35611149 PMCID: PMC9108419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is a rare metabolic bone disorder in which collagen production is impaired. Patients have brittle bones that are prone to fracture with minor trauma. Whereas most of the fractures occur in the spine and extremities, fractures of the craniofacial bones are less common. METHODS This report describes the management of a 14-year-old boy with OI type 1 who sustained mandible fractures from an assault. Management consisted of open reduction and internal fixation of the parasymphyseal and angle fractures and closed reduction and mandibulomaxillary fixation of the subcondylar fracture. RESULTS Surgery resulted in return of premorbid occlusion and good jaw function. Removal of plates and screws was performed 10 months later without incident. CONCLUSIONS This case report discusses the unique anesthetic, surgical, and postoperative considerations for managing mandible fractures in patients with OI.
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Affiliation(s)
| | - Ava Ganson Chappell
- Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Farooq Shahzad
- Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL
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3
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Augustin D, Augustin DH, David D, Théodas JA, Derisier AF. Osteogenesis Imperfecta Type 3 in a 10-Year-Old Child With Acute Respiratory Distress Syndrome. Cureus 2022; 14:e22198. [PMID: 35308738 PMCID: PMC8925934 DOI: 10.7759/cureus.22198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Osteogenesis imperfecta (OI) represents a group of rare connective tissue disorders characterized by excessive bone fragility. Type 3 is a rare form with new mutations; osteopenia and bone fragility are significant with numerous fractures, continuous and severe deformity of the spine, and long bones. Our case study concerns a 10-year-old male child admitted to the pediatric department of the State University of Haiti Hospital. OI type 3 was diagnosed based on both clinical and radiological assessments. Multidisciplinary care was initiated. Although the evolution was still unsatisfactory, characterized by intermittent episodes of dyspnea and left lung hypoplasia, he was stabilized after 28 days of hospitalization and referred to the orthopedics department for follow-up care.
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4
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Liu Y, Feng X, Liu H, McComb DW, Breuer CK, Sacks MS. On the shape and structure of the murine pulmonary heart valve. Sci Rep 2021; 11:14078. [PMID: 34234231 PMCID: PMC8263753 DOI: 10.1038/s41598-021-93513-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 06/10/2021] [Indexed: 11/20/2022] Open
Abstract
Murine animal models are an established standard in translational research and provides a potential platform for studying heart valve disease. To date, studies on heart valve disease using murine models have been hindered by a lack of appropriate methodologies due to their small scale. In the present study, we developed a multi-scale, imaging-based approach to extract the functional structure and geometry for the murine heart valve. We chose the pulmonary valve (PV) to study, due to its importance in congenital heart valve disease. Excised pulmonary outflow tracts from eleven 1-year old C57BL/6J mice were fixed at 10, 20, and 30 mmHg to simulate physiological loading. Micro-computed tomography was used to reconstruct the 3D organ-level PV geometry, which was then spatially correlated with serial en-face scanning electron microscopy imaging to quantify local collagen fiber distributions. From the acquired volume renderings, we obtained the geometric descriptors of the murine PV under increasing transvalvular pressures, which demonstrated remarkable consistency. Results to date suggest that the preferred collagen orientation was predominantly in the circumferential direction, as in larger mammalian valves. The present study represents a first step in establishing organ-level murine models for the study of heart valve disease.
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Affiliation(s)
- Yifei Liu
- Center for Electron Microscopy and Analysis, The Ohio State University, Columbus, OH, 43210, USA
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Xinzeng Feng
- Willerson Center, Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, 78712, USA
| | - Hao Liu
- Willerson Center, Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, 78712, USA
- Department of Biomedical Engineering, The University of Texas At Austin, Austin, TX, 78712, USA
| | - David W McComb
- Center for Electron Microscopy and Analysis, The Ohio State University, Columbus, OH, 43210, USA
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Christopher K Breuer
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, 43205, USA
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Michael S Sacks
- Willerson Center, Oden Institute for Computational Engineering and Sciences, The University of Texas At Austin, Austin, TX, 78712, USA.
- Department of Biomedical Engineering, The University of Texas At Austin, Austin, TX, 78712, USA.
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5
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Biology and Biomechanics of the Heart Valve Extracellular Matrix. J Cardiovasc Dev Dis 2020; 7:jcdd7040057. [PMID: 33339213 PMCID: PMC7765611 DOI: 10.3390/jcdd7040057] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/02/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023] Open
Abstract
Heart valves are dynamic structures that, in the average human, open and close over 100,000 times per day, and 3 × 109 times per lifetime to maintain unidirectional blood flow. Efficient, coordinated movement of the valve structures during the cardiac cycle is mediated by the intricate and sophisticated network of extracellular matrix (ECM) components that provide the necessary biomechanical properties to meet these mechanical demands. Organized in layers that accommodate passive functional movements of the valve leaflets, heart valve ECM is synthesized during embryonic development, and remodeled and maintained by resident cells throughout life. The failure of ECM organization compromises biomechanical function, and may lead to obstruction or leaking, which if left untreated can lead to heart failure. At present, effective treatment for heart valve dysfunction is limited and frequently ends with surgical repair or replacement, which comes with insuperable complications for many high-risk patients including aged and pediatric populations. Therefore, there is a critical need to fully appreciate the pathobiology of biomechanical valve failure in order to develop better, alternative therapies. To date, the majority of studies have focused on delineating valve disease mechanisms at the cellular level, namely the interstitial and endothelial lineages. However, less focus has been on the ECM, shown previously in other systems, to be a promising mechanism-inspired therapeutic target. Here, we highlight and review the biology and biomechanical contributions of key components of the heart valve ECM. Furthermore, we discuss how human diseases, including connective tissue disorders lead to aberrations in the abundance, organization and quality of these matrix proteins, resulting in instability of the valve infrastructure and gross functional impairment.
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6
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Chougui K, Addab S, Palomo T, Morin SN, Veilleux LN, Bernstein M, Thorstad K, Hamdy R, Tsimicalis A. Clinical manifestations of osteogenesis imperfecta in adulthood: An integrative review of quantitative studies and case reports. Am J Med Genet A 2020; 182:842-865. [PMID: 32091187 DOI: 10.1002/ajmg.a.61497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/03/2019] [Accepted: 01/03/2020] [Indexed: 12/16/2022]
Abstract
Osteogenesis imperfecta (OI) is a rare genetic disorder of the bones caused by a mutation in Type I collagen genes. As adults with OI are aging, medical concerns secondary to OI may arise. This integrative review sought to review, appraise, and synthesize the clinical manifestations faced by adults with OI. Four electronic bibliographic databases were searched. Published quantitative, qualitative, and mixed-methods studies, as well as case reports from 2000 to March 2019, addressing a clinical manifestation in adulthood, were reviewed. Eligible studies and case reports were subsequently appraised using the Mixed Methods Appraisal Tool and Case Report Checklist, respectively. Twenty quantitative studies and 88 case reports were included for review regardless of the varying methodological quality score. These studies collectively included 2,510 adults with different OI types. Several clinical manifestations were studied, and included: hearing loss, cardiac diseases, pregnancy complications, cerebrovascular manifestations, musculoskeletal manifestations, respiratory manifestations, vision impairment, and other clinical manifestations. Increased awareness may optimize prevention, treatment, and follow-up. Opportunities to enhance the methodological quality of research including better design and methodology, multisite collaborations, and larger and diverse sampling will optimize the generalizability and transferability of findings.
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Affiliation(s)
- Khadidja Chougui
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Psychology, Universite de Montreal, Montreal, Quebec, Canada
| | - Sofia Addab
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Telma Palomo
- Bone Densitometry, Fleury Medicina e Saúde, São Paulo, Brazil
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,General Internal Medicine and Bone Metabolism Center, Montreal General Hospital, Montreal, Quebec, Canada
| | - Louis-Nicolas Veilleux
- Experimental Surgery, McGill University, Montreal, Quebec, Canada.,Motion Analysis Center, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Mitchell Bernstein
- Orthopedic Surgery, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada
| | - Kelly Thorstad
- Nursing and Patient Services, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Reggie Hamdy
- Orthopedic Surgery, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada
| | - Argerie Tsimicalis
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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7
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Jang WS, Choi HJ, Kim JB, Kim JH. Ventricular Septal Defect Closure in a Neonate with Osteogenesis Imperfecta. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 52:162-164. [PMID: 31236376 PMCID: PMC6559185 DOI: 10.5090/kjtcs.2019.52.3.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/23/2019] [Accepted: 02/08/2019] [Indexed: 11/29/2022]
Abstract
A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient’s father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient’s respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.
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Affiliation(s)
- Woo Sung Jang
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Hee Jeong Choi
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Bum Kim
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Hyun Kim
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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8
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Balasubramanian M, Verschueren A, Kleevens S, Luyckx I, Perik M, Schirwani S, Mortier G, Morisaki H, Rodrigus I, Van Laer L, Verstraeten A, Loeys B. Aortic aneurysm/dissection and osteogenesis imperfecta: Four new families and review of the literature. Bone 2019; 121:191-195. [PMID: 30684648 DOI: 10.1016/j.bone.2019.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/06/2019] [Accepted: 01/18/2019] [Indexed: 10/27/2022]
Abstract
Osteogenesis imperfecta (OI) is the commonest form of heritable bone fragility. It is mainly characterized by fractures, hearing loss and dentinogenesis imperfecta. OI patients are at increased risk of cardiovascular disease of variable severity. Aortic aneurysm/dissection is one of the rarer but potentially serious cardiovascular complications of OI. So far, only six patients with aortic dissection and OI have been reported. As such, present OI diagnostic guidelines do not recommend systematic screening of patients for aortopathy. Here, we report on the clinical and molecular characteristics of three new OI patients and one additional patient with a first degree relative who presented with aortic dissection and/or aneurysm surgery. This observation further opens up the discussion on the need for and extent of cardiovascular screening in adult patients with OI.
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Affiliation(s)
- Meena Balasubramanian
- Highly Specialised Severe, Complex & Atypical OI Service, Sheffield Children's NHS Foundation Trust, UK; Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, UK.
| | - Aline Verschueren
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Simon Kleevens
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Ilse Luyckx
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Melanie Perik
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Schaida Schirwani
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Geert Mortier
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Hiroko Morisaki
- Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Inez Rodrigus
- Department of Cardiac Surgery, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Lut Van Laer
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Aline Verstraeten
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium
| | - Bart Loeys
- Center for Medical Genetics, University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
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9
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Functional and structural studies of tolloid-like 1 mutants associated with atrial-septal defect 6. Biosci Rep 2019; 39:BSR20180270. [PMID: 30538173 PMCID: PMC6328869 DOI: 10.1042/bsr20180270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 11/07/2018] [Accepted: 11/29/2018] [Indexed: 11/23/2022] Open
Abstract
Inactive mammalian tolloid-like 1 (tll1) and mutations detected in tolloid-like 1 (TLL1) have been linked to the lack of the heart septa formation in mice and to a similar human inborn condition called atrial-septal defect 6 (ASD6; OMIM 613087, formerly ASD II). Previously, we reported four point mutations in TLL1 found in approximately 20% of ASD6 patients. Three mutations in the coding sequence were M182L, V238A, and I629V. In this work, we present the effects of these mutations on TLL1 function. Three recombinant cDNA constructs carrying the mutations and one wild-type construct were prepared and then expressed in HT-1080 cells. Corresponding recombinant proteins were analyzed for their metalloendopeptidase activity using a native substrate, chordin. The results of these assays demonstrated that in comparison with the native TLL1, mutants cleaved chordin and procollagen I at significantly lower rates. CD analyses revealed significant structural differences between the higher order structure of wild-type and mutant variants. Moreover, biosensor-based assays of binding interactions between TLL1 variants and chordin demonstrated a significant decrease in the binding affinities of the mutated variants. The results from this work indicate that mutations detected in TLL1 of ASD6 patients altered its metalloendopeptidase activity, structure, and substrate-binding properties, thereby suggesting a possible pathomechanism of ASD6.
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10
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Tosi LL, Floor MK, Dollar CM, Gillies AP, Hart TS, Cuthbertson DD, Sutton VR, Krischer JP. Assessing disease experience across the life span for individuals with osteogenesis imperfecta: challenges and opportunities for patient-reported outcomes (PROs) measurement: a pilot study. Orphanet J Rare Dis 2019; 14:23. [PMID: 30696467 PMCID: PMC6350324 DOI: 10.1186/s13023-019-1004-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/21/2019] [Indexed: 01/07/2023] Open
Abstract
Background Patient reported outcome (PRO) information is crucial for establishing better patient-provider communication, improving shared decision-making between clinicians and patients, assessing patient responses to therapeutic interventions, and increasing satisfaction with care. We used the Brittle Bones Disease Consortium (BBDC) Contact Registry for People with OI, managed by the Rare Disease Clinical Research Network (RDCRN) to (1) to evaluate the construct validity of the Patient-Reported Outcome Measurement Information System® (PROMIS®) to record important components of the disease experience among individuals with OI; and (2) explore the feasibility of using a registry to recruit individuals with OI to report on health status. Our long-term goal is to enhance communication of health and disease management findings back to the OI community, especially those who do not have access to major OI clinical centers. Results We demonstrated the construct validity of PROMIS instruments in OI. Our results confirm that the scores from most domains differ significantly from the general US population: individuals with OI have worse symptom burden and functioning. We found no excessive floor or ceiling effects. Our study demonstrates that the BBDC Contact Registry can be used to recruit participants for online health status surveys. However, there are numerous challenges that must be addressed: lack of self-knowledge of OI type, under-representation of men, limited ethnic diversity, and imperfect questionnaire completion rates. Conclusion Our pilot study demonstrated the feasibility of using a contact registry to recruit respondents from the OI community and to obtain analyzable PROMIS data regarding disease experience. Because the results differ from the general population and avoid excessive floor and ceiling effects, PROMIS instruments can be used to assess response to therapeutic interventions in individuals with OI. Future directions will include (1) development and validation of an OI-specific patient-based classification system that aggregates persons with similar clinical characteristics and risks for complications to identify treatment needs; and (2) integrating these PRO tools into routine patient care and research studies. Electronic supplementary material The online version of this article (10.1186/s13023-019-1004-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura L Tosi
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Marianne K Floor
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Christina M Dollar
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Austin P Gillies
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | | | - Tracy S Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Hospital, Houston, TX, USA
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11
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Tagliasacchi I, Martinelli L, Bardaro L, Chierchia S. Minimally invasive mitral valve repair in osteogenesis imperfecta. Interact Cardiovasc Thorac Surg 2017; 25:665-666. [DOI: 10.1093/icvts/ivx164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/22/2017] [Indexed: 11/13/2022] Open
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12
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Cravanas A, Bhatia A, Huang J. Delayed Recognition of Hypopharyngeal Perforation Injury Caused by Transesophageal Echocardiography in a Patient With Osteogenesis Imperfecta. J Cardiothorac Vasc Anesth 2017; 31:1724-1727. [PMID: 28242145 DOI: 10.1053/j.jvca.2016.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Alex Cravanas
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY
| | - Aneeta Bhatia
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Department of Anesthesiology, Jewish Hospital, KentuckyOne Health, Louisville, KY
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Department of Anesthesiology, Jewish Hospital, KentuckyOne Health, Louisville, KY.
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13
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Rush ET, Li L, Goodwin JL, Kreikemeier RM, Craft M, Danford DA, Kutty S. Echocardiographic phenotype in osteogenesis imperfecta varies with disease severity. Heart 2016; 103:443-448. [DOI: 10.1136/heartjnl-2016-310099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/16/2016] [Accepted: 08/25/2016] [Indexed: 01/09/2023] Open
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14
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Cardiological assessment of a cohort of Egyptian patients with osteogenesis imperfecta type III. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2016. [DOI: 10.1016/j.ejmhg.2015.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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15
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Abstract
Osteogenesis imperfecta (OI) is a rare disorder of type 1 collagen with 13 currently identified types attributable to inherited abnormalities in type 1 collagen amount, structure, or processing. The disease is characterized by an increased susceptibility to bony fracture. In addition to the skeletal phenotype, common additional extraskeletal manifestations include blue sclerae, dentinogenesis imperfecta, vascular fragility, and hearing loss. Medical management is focused on minimizing the morbidity of fractures, pain, and bone deformities by maximizing bone health. Along with optimizing Vitamin D status and calcium intake and physical/occupational therapy, individualized surgical treatment may be indicated. Pharmacological therapy with bisphosphonate medications is now routinely utilized for moderate to severe forms and appears to have a good safety profile and bone health benefits. New therapies with other anti-resorptives as well as anabolic agents and transforming growth factor (TGF)β antibodies are in development. Other potential treatment modalities could include gene therapy or mesenchymal cell transplant. In the future, treatment choices will be further individualized in order to reduce disease morbidity and mortality.
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Affiliation(s)
- Inas H Thomas
- Section of Pediatric Endocrinology, School of Medicine, University of Michigan, 1500 E. Medical Center Dr., D1205 MPB, SPC 5718, Ann Arbor, MI, 48109, USA.
| | - Linda A DiMeglio
- Section of Pediatric Endocrinology/Diabetology, School of Medicine, Indiana University, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN, 46202-5225, USA.
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16
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Heart disease in patients with osteogenesis imperfecta — A systematic review. Int J Cardiol 2015; 196:149-57. [DOI: 10.1016/j.ijcard.2015.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 06/02/2015] [Accepted: 06/12/2015] [Indexed: 11/24/2022]
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17
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Harrington J, Sochett E, Howard A. Update on the evaluation and treatment of osteogenesis imperfecta. Pediatr Clin North Am 2014; 61:1243-57. [PMID: 25439022 DOI: 10.1016/j.pcl.2014.08.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Osteogenesis imperfecta (OI) is a heritable bone fragility disorder that presents with a wide clinical phenotype spectrum: from perinatal lethality and severe deformities to very mild forms without fractures. Most cases of OI are due to autosomal dominant mutations of the type I collagen genes. A multidisciplinary approach with rehabilitation, orthopedic surgery, and consideration of medical therapy with bisphosphonates underpins current management. Greater understanding of the pathogenesis of OI may lead to novel, therapeutic approaches to help improve clinical symptoms of children with OI in the future.
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Affiliation(s)
- Jennifer Harrington
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
| | - Etienne Sochett
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
| | - Andrew Howard
- Division of Orthopedic Surgery, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
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Odelin G, Faure E, Kober F, Maurel-Zaffran C, Théron A, Coulpier F, Guillet B, Bernard M, Avierinos JF, Charnay P, Topilko P, Zaffran S. Loss of Krox20 results in aortic valve regurgitation and impaired transcriptional activation of fibrillar collagen genes. Cardiovasc Res 2014; 104:443-55. [PMID: 25344368 DOI: 10.1093/cvr/cvu233] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Heart valve maturation is achieved by the organization of extracellular matrix (ECM) and the distribution of valvular interstitial cells. However, the factors that regulate matrix components required for valvular structure and function are unknown. Based on the discovery of its specific expression in cardiac valves, we aimed to uncover the role of Krox20 (Egr-2) during valve development and disease. METHODS AND RESULTS Using series of mouse genetic tools, we demonstrated that loss of function of Krox20 caused significant hyperplasia of the semilunar valves, while atrioventricular valves appeared normal. This defect was associated with an increase in valvular interstitial cell number and ECM volume. Echo Doppler analysis revealed that adult mutant mice had aortic insufficiency. Defective aortic valves (AoVs) in Krox20(-/-) mice had features of human AoV disease, including excess of proteoglycan deposition and reduction of collagen fibres. Furthermore, examination of diseased human AoVs revealed decreased expression of KROX20. To identify downstream targets of Krox20, we examined expression of fibrillar collagens in the AoV leaflets at different stages in the mouse. We found significant down-regulation of Col1a1, Col1a2, and Col3a1 in the semilunar valves of Krox20 mutant mice. Utilizing in vitro and in vivo experiments, we demonstrated that Col1a1 and Col3a1 are direct targets of Krox20 activation in interstitial cells of the AoV. CONCLUSION This study identifies a previously unknown function of Krox20 during heart valve development. These results indicate that Krox20-mediated activation of fibrillar Col1a1 and Col3a1 genes is crucial to avoid postnatal degeneration of the AoV leaflets.
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Affiliation(s)
- Gaëlle Odelin
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
| | - Emilie Faure
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
| | - Frank Kober
- Faculté de Médecine, Aix Marseille Université, CNRS, CRMBM UMR7339, Marseille, France
| | | | - Alexis Théron
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France Département de Cardiologie, AP-HM, Hôpital de la Timone, Marseille, France
| | - Fanny Coulpier
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Benjamin Guillet
- Faculté de Médecine, Aix Marseille Université, CERIMED, Marseille, France
| | - Monique Bernard
- Faculté de Médecine, Aix Marseille Université, CNRS, CRMBM UMR7339, Marseille, France
| | - Jean-François Avierinos
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France Département de Cardiologie, AP-HM, Hôpital de la Timone, Marseille, France
| | - Patrick Charnay
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Piotr Topilko
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Stéphane Zaffran
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
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Sumi M, Ariyoshi T, Matsukuma S, Nakaji S, Hashizume K, Kinoshita N, Eishi K. Surgical technique of double valve replacement in a patient with osteogenesis imperfecta. Gen Thorac Cardiovasc Surg 2014; 64:220-3. [DOI: 10.1007/s11748-014-0433-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/14/2014] [Indexed: 10/25/2022]
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20
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Dimitrakakis G, Challoumas D, von Oppell UO. What type of valve is most appropriate for osteogenesis imperfecta patients? Interact Cardiovasc Thorac Surg 2014; 19:499-504. [DOI: 10.1093/icvts/ivu152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Vandersteen AM, Lund AM, Ferguson DJ, Sawle P, Pollitt RC, Holder SE, Wakeling E, Moat N, Pope FM. Four patients with Sillence type I osteogenesis imperfecta and mild bone fragility, complicated by left ventricular cardiac valvular disease and cardiac tissue fragility caused by type I collagen mutations. Am J Med Genet A 2013; 164A:386-91. [PMID: 24311407 DOI: 10.1002/ajmg.a.36285] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 09/14/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Anthony M. Vandersteen
- Ehlers-Danlos Syndrome National Diagnostic Service; North West London Hospitals NHS Trust; Harrow Middlesex United Kingdom
| | - Allan M. Lund
- Department of Clinical Genetics; Copenhagen University Hospital; Copenhagen Denmark
| | - David J.P. Ferguson
- Nuffield Department of Clinical Laboratory Science; University of Oxford, John Radcliffe Hospital; Oxford United Kingdom
| | - Philip Sawle
- Ehlers-Danlos Syndrome National Diagnostic Service; North West London Hospitals NHS Trust; Harrow Middlesex United Kingdom
| | - Rebecca C. Pollitt
- Ehlers-Danlos Syndrome National Diagnostic Service; Sheffield Children's Hospitals NHS Foundation Trust; Harrow Middlesex United Kingdom
| | - Susan E. Holder
- North West Thames Clinical Genetics Service; North West London Hospitals NHS Trust; Harrow Middlesex United Kingdom
| | - Emma Wakeling
- North West Thames Clinical Genetics Service; North West London Hospitals NHS Trust; Harrow Middlesex United Kingdom
| | - Neil Moat
- Department of Cardiac Surgery; Royal Brompton & Harefield NHS Foundation Trust; Harrow Middlesex United Kingdom
| | - F. Michael Pope
- Ehlers-Danlos Syndrome National Diagnostic Service; North West London Hospitals NHS Trust; Harrow Middlesex United Kingdom
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22
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Panda BR, Pandey R, Ranger M, Anderson B, Karl T, Alphonso N. Ventricular septal defect closure in a child with osteogenesis imperfecta: risk factors and management. Ann Thorac Surg 2013; 96:e125-6. [PMID: 24182511 DOI: 10.1016/j.athoracsur.2013.06.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/12/2013] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
Abstract
Cardiac surgery in patients with osteogenesis imperfecta is challenging as the friability of the tissues can be hazardous before, during, and after the operation. A multidisciplinary approach with a planned strategy is essential for the successful management of these patients. We present a 6-year old child with osteogenesis imperfecta, who underwent ventricular septal defect closure without any complication.
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Affiliation(s)
- Biswa Ranjan Panda
- Department of Paediatric Cardiac Surgery, Mater Children's Hospital, Brisbane.
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23
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Lamanna A, Fayers T, Clarke S, Parsonage W. Valvular and aortic diseases in osteogenesis imperfecta. Heart Lung Circ 2013; 22:801-10. [PMID: 23791715 DOI: 10.1016/j.hlc.2013.05.640] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 05/15/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
Abstract
Osteogenesis imperfecta (OI) is an inheritable connective tissue disorder caused by defective collagen synthesis with the principal manifestations of bone fragility. OI has been associated with left sided valvular regurgitation and aortic dilation. Valve and aortic surgery are technically feasible in patients with OI but are inherently high risk due to the underlying connective tissue defect. This report reviews the valvular and aortic pathology associated with OI and their management. We describe two cases of patients with OI who have significant aortic and mitral valve regurgitation, one of whom has been managed conservatively and the other who has undergone successful mitral valve repair and aortic valve replacement. The latter case represents the fifth case of mitral valve repair in a patient with OI reported in the medical literature.
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Affiliation(s)
- Arvin Lamanna
- Department of Cardiology, Royal Brisbane and Women's Hospital, Australia; School of Medicine, University of Queensland, Australia
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24
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Grimaldi A, De Gennaro L, Chiara Vermi A, Pappalardo F, Daniele Brunetti N, Di Biase M, La Canna G, Alfieri O. Cardiac valve involvement in systemic diseases: a review. Clin Cardiol 2013; 36:117-24. [PMID: 23408535 DOI: 10.1002/clc.22099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 01/13/2013] [Indexed: 11/06/2022] Open
Abstract
Increasing age and new trends of mixed populations have newly aroused interest in valvular heart disease in the developed countries still in need of new clinical insights. In the clinical setting of systemic diseases, the proper assessment of cardiovascular abnormalities may be challenging, and the characterization of valvular involvement might help to recognize the underlying disease and cardiac sequelae. Prompt identification of valvular lesions may, therefore, also be useful for differential diagnosis. This article reviews the cardiac involvement in systemic diseases from etiology and background definition to echocardiographic assessment and clinical interpretation.
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Affiliation(s)
- Antonio Grimaldi
- Cardiovascular and Thoracic Department, San Raffaele Scientific Institute and Università Vita-Salute, Milan, Italy.
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25
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Najib MQ, Schaff HV, Ganji J, Lee HR, Click RL, Miller DC, Chaliki HP. Valvular Heart Disease in Patients with Osteogenesis Imperfecta. J Card Surg 2013; 28:139-43. [DOI: 10.1111/jocs.12064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mohammad Q. Najib
- Division of Cardiovascular Diseases; Mayo Clinic; Scottsdale, Arizona
| | | | - Jhansi Ganji
- Division of Cardiovascular Diseases; Mayo Clinic; Scottsdale, Arizona
| | - Howard R. Lee
- Division of Cardiovascular Diseases; Mayo Clinic; Scottsdale, Arizona
| | - Roger L. Click
- Division of Cardiovascular Diseases; Mayo Clinic; Rochester, Minnesota
| | - D. Craig Miller
- Division of Cardiothoracic Surgery; Stanford University; Stanford, California
| | - Hari P. Chaliki
- Division of Cardiovascular Diseases; Mayo Clinic; Scottsdale, Arizona
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26
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Rohrbach M, Giunta C. Recessive osteogenesis imperfecta: clinical, radiological, and molecular findings. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2012; 160C:175-89. [PMID: 22791419 DOI: 10.1002/ajmg.c.31334] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Osteogenesis imperfecta (OI) or "brittle bone disease" is currently best described as a group of hereditary connective tissue disorders related to primary defects in type I procollagen, and to alterations in type I procollagen biosynthesis, both associated with osteoporosis and increased susceptibility to bone fractures. Initially, the autosomal dominant forms of OI, caused by mutations in either COL1A1 or COL1A2, were described. However, for decades, the molecular defect of a small percentage of patients clinically diagnosed with OI has remained elusive. It has been in the last 6 years that the genetic causes of several forms of OI with autosomal recessive inheritance have been characterized. These comprise defects of collagen chaperones, and proteins involved in type I procollagen assembly, processing and maturation, as well as proteins involved in the formation and homeostasis of bone tissue. This article reviews the recently characterized forms of recessive OI, focusing in particular on their clinical and molecular findings, and on their radiological characterisation. Clinical management and treatment of OI in general will be discussed, too.
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Affiliation(s)
- Marianne Rohrbach
- Connective Tissue Unit, Division of Metabolism, University Children's Hospital and Children's Research Center, Zurich, Switzerland
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27
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Abstract
"Osteogenesis imperfecta" is a term used to describe a group of genetic disorders of variable phenotype usually defined by recurrent fractures, low bone mass, and skeletal fragility. Most cases are associated with mutations in one of the type I collagen genes, but in recent years several other forms have been identified with recessive inheritance. In most instances the latter result from mutations in genes encoding proteins involved in type I collagen's complex posttranslational modification or in genes regulating bone matrix homeostasis. This article reviews the recent discoveries and an approach to classification and diagnosis. Bisphosphonates are widely used in patients with osteogenesis imperfecta, but some important questions about their optimal usage, their utility in children and adults with milder phenotypes, and their potential adverse effects are not yet resolved.
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Affiliation(s)
- Tim Cundy
- Department of Medicine, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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28
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Thiele F, Cohrs CM, Flor A, Lisse TS, Przemeck GKH, Horsch M, Schrewe A, Gailus-Durner V, Ivandic B, Katus HA, Wurst W, Reisenberg C, Chaney H, Fuchs H, Hans W, Beckers J, Marini JC, Hrabé de Angelis M. Cardiopulmonary dysfunction in the Osteogenesis imperfecta mouse model Aga2 and human patients are caused by bone-independent mechanisms. Hum Mol Genet 2012; 21:3535-45. [PMID: 22589248 PMCID: PMC3406754 DOI: 10.1093/hmg/dds183] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Osteogenesis imperfecta (OI) is an inherited connective tissue disorder with skeletal dysplasia of varying severity, predominantly caused by mutations in the collagen I genes (COL1A1/COL1A2). Extraskeletal findings such as cardiac and pulmonary complications are generally considered to be significant secondary features. Aga2, a murine model for human OI, was systemically analyzed in the German Mouse Clinic by means of in vivo and in vitro examinations of the cardiopulmonary system, to identify novel mechanisms accounting for perinatal lethality. Pulmonary and, especially, cardiac fibroblast of perinatal lethal Aga2/+ animals display a strong down-regulation of Col1a1 transcripts in vivo and in vitro, resulting in a loss of extracellular matrix integrity. In addition, dysregulated gene expression of Nppa, different types of collagen and Agt in heart and lung tissue support a bone-independent vicious cycle of heart dysfunction, including hypertrophy, loss of myocardial matrix integrity, pulmonary hypertension, pneumonia and hypoxia leading to death in Aga2. These murine findings are corroborated by a pediatric OI cohort study, displaying significant progressive decline in pulmonary function and restrictive pulmonary disease independent of scoliosis. Most participants show mild cardiac valvular regurgitation, independent of pulmonary and skeletal findings. Data obtained from human OI patients and the mouse model Aga2 provide novel evidence for primary effects of type I collagen mutations on the heart and lung. The findings will have potential benefits of anticipatory clinical exams and early intervention in OI patients.
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Affiliation(s)
- Frank Thiele
- Institute of Virology, Klinikum Rechts der Isar, Munich, Germany
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29
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Soma K, Abe H, Takeda N, Shintani Y, Takazawa Y, Kojima T, Fujiu K, Semba H, Yamashita H, Hirata Y, Fukayama M, Nagai R. Myocardial involvement in patients with osteogenesis imperfecta. Int Heart J 2012; 53:75-7. [PMID: 22398680 DOI: 10.1536/ihj.53.75] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mitral and aortic valve regurgitation is commonly found in osteogenesis imperfecta (OI) patients, however, little is known about the myocardial involvement in this disorder. An 82-year-old man with OI developed heart failure and was admitted to our hospital. Echocardiogram revealed severe mitral regurgitation without left ventricular (LV) dilatation, but with LV wall thickening. Histological analysis exhibited interstitial fibrosis of the myocardium in addition to myxoid changes of the mitral leaflet. These findings suggest that OI patients may develop LV remodeling together with diastolic dysfunction.
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Affiliation(s)
- Katsura Soma
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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30
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Cheek JD, Wirrig EE, Alfieri CM, James JF, Yutzey KE. Differential activation of valvulogenic, chondrogenic, and osteogenic pathways in mouse models of myxomatous and calcific aortic valve disease. J Mol Cell Cardiol 2012; 52:689-700. [PMID: 22248532 DOI: 10.1016/j.yjmcc.2011.12.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 12/01/2011] [Accepted: 12/29/2011] [Indexed: 10/14/2022]
Abstract
Studies of human diseased aortic valves have demonstrated increased expression of genetic markers of valve progenitors and osteogenic differentiation associated with pathogenesis. Three potential mouse models of valve disease were examined for cellular pathology, morphology, and induction of valvulogenic, chondrogenic, and osteogenic markers. Osteogenesis imperfecta murine (Oim) mice, with a mutation in Col1a2, have distal leaflet thickening and increased proteoglycan composition characteristic of myxomatous valve disease. Periostin null mice also exhibit dysregulation of the ECM with thickening in the aortic midvalve region, but do not have an overall increase in valve leaflet surface area. Klotho null mice are a model for premature aging and exhibit calcific nodules in the aortic valve hinge-region, but do not exhibit leaflet thickening, ECM disorganization, or inflammation. Oim/oim mice have increased expression of valve progenitor markers Twist1, Col2a1, Mmp13, Sox9 and Hapln1, in addition to increased Col10a1 and Asporin expression, consistent with increased proteoglycan composition. Periostin null aortic valves exhibit relatively normal gene expression with slightly increased expression of Mmp13 and Hapln1. In contrast, Klotho null aortic valves have increased expression of Runx2, consistent with the calcified phenotype, in addition to increased expression of Sox9, Col10a1, and osteopontin. Together these studies demonstrate that oim/oim mice exhibit histological and molecular characteristics of myxomatous valve disease and Klotho null mice are a new model for calcific aortic valve disease.
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Affiliation(s)
- Jonathan D Cheek
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
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Abstract
A new paradigm has emerged for osteogenesis imperfecta as a collagen-related disorder. The more prevalent autosomal dominant forms of osteogenesis imperfecta are caused by primary defects in type I collagen, whereas autosomal recessive forms are caused by deficiency of proteins which interact with type I procollagen for post-translational modification and/or folding. Factors that contribute to the mechanism of dominant osteogenesis imperfecta include intracellular stress, disruption of interactions between collagen and noncollagenous proteins, compromised matrix structure, abnormal cell-cell and cell-matrix interactions and tissue mineralization. Recessive osteogenesis imperfecta is caused by deficiency of any of the three components of the collagen prolyl 3-hydroxylation complex. Absence of 3-hydroxylation is associated with increased modification of the collagen helix, consistent with delayed collagen folding. Other causes of recessive osteogenesis imperfecta include deficiency of the collagen chaperones FKBP10 or Serpin H1. Murine models are crucial to uncovering the common pathways in dominant and recessive osteogenesis imperfecta bone dysplasia. Clinical management of osteogenesis imperfecta is multidisciplinary, encompassing substantial progress in physical rehabilitation and surgical procedures, management of hearing, dental and pulmonary abnormalities, as well as drugs, such as bisphosphonates and recombinant human growth hormone. Novel treatments using cell therapy or new drug regimens hold promise for the future.
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Affiliation(s)
- Antonella Forlino
- Bone and Extracellular Matrix Branch, NICHD, NIH, Bethesda, USA
- Department of Biochemistry, Section of Medicine and Pharmacy, University of Pavia, Italy
| | - Wayne A. Cabral
- Bone and Extracellular Matrix Branch, NICHD, NIH, Bethesda, USA
| | | | - Joan C. Marini
- Bone and Extracellular Matrix Branch, NICHD, NIH, Bethesda, USA
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32
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The response to valve injury. A paradigm to understand the pathogenesis of heart valve disease. Cardiovasc Pathol 2011; 20:183-90. [DOI: 10.1016/j.carpath.2010.09.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 08/23/2010] [Accepted: 09/09/2010] [Indexed: 12/21/2022] Open
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Bastos F, Perez LT, Narváes CPDL, Costa O, Silva RCSD, Van-Dunem JCVD, Miranda SMDRND, Cordeiro LB, Maia PCS, Airosa LDFLM, Menezes AD. Severe osteogenesis imperfecta: case report. EINSTEIN-SAO PAULO 2010; 8:480-2. [PMID: 26760334 DOI: 10.1590/s1679-45082010rc1863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The authors present a case of Osteogenesis Imperfecta, emphasizing the clinical and epidemiological characteristics, forms of classification and treatment of the disease. This is an important case not only to the knowledge of pediatricians and orthopedists, but also for other professionals involved with the problem. This article has been jointly described by the Departments of Pediatrics and Neonatology of the Girassol Clinic in Luanda Capital of the Republic of Angola, Africa.
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34
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Wirrig EE, Yutzey KE. Transcriptional regulation of heart valve development and disease. Cardiovasc Pathol 2010; 20:162-7. [PMID: 20705485 DOI: 10.1016/j.carpath.2010.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 06/28/2010] [Indexed: 10/19/2022] Open
Abstract
Aortic valve disease is estimated to affect 2% of the United States population. There is increasing evidence that aortic valve disease has a basis in development, as congenital valve malformations are prevalent in patients undergoing valve replacement surgery. In fact, a number of genetic mutations have been linked to valve malformations and disease. In the initial stages of aortic valve pathogenesis, the valvular interstitial cells become activated, undergo cell proliferation, and participate in extracellular matrix remodeling. Many of these cell properties are shared with mesenchymal progenitor cells of the normally developing valves and bones. Historically, valve calcification was thought to be a passive process reflecting end-stage disease. However, recent evidence describes the increased expression of transcription factors in diseased AoV that are common to valvulogenic and osteogenic processes. These studies lend support to the idea that a developmental gene program is reactivated in aortic valve disease and may contribute to the molecular mechanisms underlying valve calcification in disease.
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Affiliation(s)
- Elaine E Wirrig
- Division of Molecular Cardiovascular Biology, The Heart Institute, Cincinnati Children's Medical Center, Cincinnati, OH 45229, USA
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