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Ge Y, Hong M, Zhang Y, Wang J, Li L, Zhu H, Sheng Y, Wu WS, Zhang Z. miR-30e-5p regulates leukemia stem cell self-renewal through the Cyb561/ROS signaling pathway. Haematologica 2024; 109:411-421. [PMID: 37584287 PMCID: PMC10828755 DOI: 10.3324/haematol.2023.282837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023] Open
Abstract
Leukemia stem cells (LSC) represent a crucial and rare subset of cells present in acute myeloid leukemia (AML); they play a pivotal role in the initiation, maintenance, and relapse of this disease. Targeting LSC holds great promise for preventing AML relapse and improving long-term outcomes. However the precise molecular mechanisms governing LSC self-renewal are still poorly understood. Here, we present compelling evidence that the expression of miR-30e-5p, a potential tumor-suppressive microRNA, is significantly lower in AML samples than in healthy bone marrow samples. Forced expression of miR- 30e effectively inhibits leukemogenesis, impairs LSC self-renewal, and delays leukemia progression. Mechanistically, Cyb561 acts as a direct target of miR-30e-5p in LSC, and its deficiency restricts the self-renewal of LSC by activating reactive oxygen series signaling and markedly prolongs recipients' survival. Moreover, genetic or pharmacological overexpression of miR-30e-5p or knockdown of Cyb561 suppresses the growth of human AML cells. In conclusion, our findings establish the crucial role of the miR-30e-5p/Cyb561/ROS axis in finely regulating LSC self-renewal, highlighting Cyb561 as a potential therapeutic target for LSC-directed therapies.
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Affiliation(s)
- Yanwen Ge
- School of Life Sciences, Shanghai University, Shanghai, 200444
| | - Mei Hong
- School of Life Sciences, Shanghai University, Shanghai, 200444
| | - Yu Zhang
- School of Life Sciences, Shanghai University, Shanghai, 200444
| | - Jiachen Wang
- School of Life Sciences, Shanghai University, Shanghai, 200444
| | - Lei Li
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022
| | - Hongkai Zhu
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, 410011
| | - Yue Sheng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, 410011
| | - Wen-Shu Wu
- Division of Hematology/Oncology, Department of Medicine and University of Illinois Cancer Center, the University of Illinois at Chicago, IL 60612.
| | - Zhonghui Zhang
- School of Life Sciences, Shanghai University, Shanghai, 200444, China; Shaoxing Institute of Technology, Shanghai University, Shaoxing, 312000.
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2
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Fagius J, Klar J, Dahl N. Early-onset hereditary isolated non-neurogenic orthostatic hypotension in a Swedish family. Clin Auton Res 2023; 33:421-432. [PMID: 37460866 PMCID: PMC10439023 DOI: 10.1007/s10286-023-00963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/30/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Orthostatic hypotension is a common condition with heterogeneous and, in many cases, unclear underlying pathophysiology. Frequent symptoms are syncope and falls with a strong impact on daily life. A two-generation family with eight individuals segregating early-onset severe orthostatic hypotension with persistent tachycardia in upright position and repeated faints was identified. Our aim was to elucidate the underlying pathophysiology. METHODS One severely affected individual underwent thorough investigation with neurophysiological and blood pressure (BP) measurements, including direct recording of baroreflex-governed sympathetic nerve signalling and induction of BP rise with phenylephrine. Family members underwent parts of the examination. Genetic analysis using exome sequencing was performed. RESULTS Marked postural hypotension with greatly reduced cardiac preload was observed, but without signs of autonomic nervous system dysfunction: sympathetic nerve signalling was normal, as were catecholamine levels, and phenylephrine stimulation revealed a normal increase in BP. The results of the genetic analysis using exome sequencing comprising all known genes associated with the regulation of BP and catecholamine metabolism were normal. CONCLUSION The combined findings suggest an autosomal dominant form of early-onset orthostatic hypotension with variable clinical expression and without any additional autonomic dysfunction. It is possible that further investigation will reveal an as yet undescribed entity of orthostatic hypotension transmitted as an autosomal dominant trait.
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Affiliation(s)
- Jan Fagius
- Department of Medical Sciences/Neurology and Clinical Neurophysiology, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
| | - Joakim Klar
- Department of Immunology, Genetics and Pathology/Genetics, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Niklas Dahl
- Department of Immunology, Genetics and Pathology/Genetics, Faculty of Medicine, Uppsala University, Uppsala, Sweden
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3
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Sun D, Zhang A, Gao B, Zou L, Huang H, Zhao X, Xu D. Identification of Alternative Splicing-Related Genes CYB561 and FOLH1 in the Tumor-Immune Microenvironment for Endometrial Cancer Based on TCGA Data Analysis. Front Genet 2022; 13:770569. [PMID: 35836577 PMCID: PMC9274141 DOI: 10.3389/fgene.2022.770569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 06/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Advanced and recurrent endometrial cancer EC remains controversial. Immunotherapy will play a landmark role in cancer treatment, and alternative splicing (AS) of messenger RNA (mRNA) may offer the potential of a broadened target space.Methods: We downloaded the clinical information and mRNA expression profiles from The Cancer Genome Atlas (TCGA) database. Hub genes were extracted from 11 AS-related genes to analyze the correlation between clinical parameters and the tumor-immune microenvironment. We also analyzed the correlations between the copy numbers, gene expressions of hub genes, and immune cells. The correlation between the risk score and the six most important checkpoint genes was also investigated. The ESTIMATE algorithm was finally performed on each EC sample based on the high- and low-risk groups.Results: The risk score was a reliable and stable independent risk predictor in the Uterine Corpus Endometrial Carcinoma (UCEC) cohort. CYB561|42921|AP and FOLH1|15817|ES were extracted. The expression of CYB561 and FOLH1 decreased gradually with the increased grade and International Federation of Gynecology and Obstetrics (FIGO) stage (p < 0.05). Gene copy number changes in CYB561 and FOLH1 led to the deletion number of myeloid DC cells and T cell CD8+. Low expression of both CYB561 and FOLH1 was associated with poor prognosis (p < 0.001). The checkpoint genes, CTLA-4 and PDCD1, exhibited a negative correlation with the risk score of AS in UCEC.Conclusion: AS-related gene signatures were related to the immune-tumor microenvironment and prognosis. These outcomes were significant for studying EC’s immune-related mechanisms and exploring novel prognostic predictors and precise therapy methods.
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Affiliation(s)
| | | | | | | | | | | | - Dabao Xu
- *Correspondence: Xingping Zhao, ; Dabao Xu,
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4
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Zhou X, Shen G, Ren D, Guo X, Han J, Guo Q, Zhao F, Wang M, Dong Q, Li Z, Zhao J. Expression and clinical prognostic value of CYB561 in breast cancer. J Cancer Res Clin Oncol 2022; 148:1879-1892. [PMID: 35486183 DOI: 10.1007/s00432-022-03928-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/15/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The expression of cytochrome B561 (CYB561) and its role in breast cancer (BC) prognosis remain unclear. We analyzed the differential expression and prognostic value of CYB561 using online databases and a clinical cohort through bioinformatics and immunohistochemistry. METHODS The differential expression of CYB561 and its association with BC were analyzed using the tumor immune estimation resource (TIMER), gene expression profiling interaction analysis2 (GEPIA2), Human Protein Atlas, Cancer Cell Line Encyclopedia, and Kaplan-Meier Plotter website. Important pathways of CYB561 enrichment were explored using gene set enrichment analysis. Immunohistochemistry detected CYB561 expression in normal breast, breast hyperplasia, ductal carcinoma in situ (DCIS), para-cancer, and invasive BC groups. Association between CYB561 expression and BC prognosis was analyzed using Kaplan-Meier and Cox regression analyses. RESULTS CYB561 mRNA expression was higher in GEPIA and TIMER BC patients than in para-cancer tissues. CYB561 was expressed in the glandular epithelium and myoepithelium, with positive localization in the cytoplasm and cell membrane. CYB561 protein expression significantly differed among the groups. CYB561 expression was correlated with ERBB2/HER2 and infiltrating CD4+ T cells in GEPIA and TIMER BC patients and associated with HER2 status, histological grade, and molecular subtypes in the clinical cohort but not related to tumor-infiltrating lymphocytes. CYB561 mRNA overexpression predicted reduced recurrence-free survival and overall survival in BC. Patients with CYB561 expression had significantly reduced overall survival and increased risk of death. CONCLUSION CYB561 can serve as an effective clinical prognostic biomarker for BC.
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Affiliation(s)
- Xiaofeng Zhou
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Department of Pathology, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - GuoShuang Shen
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Dengfeng Ren
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Xinjian Guo
- Department of Pathology, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Jingqi Han
- Department of Pathology, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Qijing Guo
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Medical Oncology, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Fuxing Zhao
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Miaozhou Wang
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, 810000, China
| | - Qiuxia Dong
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China.,Department of Medical Oncology, The Fifth People's Hospital of Qinghai Province, Xining, 810001, China
| | - Zhanquan Li
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China. .,Hematology Department, Affiliated Hospital of Qinghai University, Xining, 810000, China.
| | - Jiuda Zhao
- Research Center for High Altitude Medicine, Qinghai University, Xining, 810000, China. .,Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, 810000, China.
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5
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Eigenschink M, Savran D, Zitterer CP, Granitzer S, Fritz M, Baron DM, Müllner EW, Salzer U. Redox Properties of Human Erythrocytes Are Adapted for Vitamin C Recycling. Front Physiol 2021; 12:767439. [PMID: 34938201 PMCID: PMC8685503 DOI: 10.3389/fphys.2021.767439] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/16/2021] [Indexed: 01/22/2023] Open
Abstract
Ascorbic acid (AA; or vitamin C) is an important physiological antioxidant and radical scavenger. Some mammalian species, including homo sapiens, have lost the ability to synthetize AA and depend on its nutritional uptake. Erythrocytes from AA-auxotroph mammals express high amounts of the glucose transporter GLUT1. This isoform enables rapid uptake of glucose as well as dehydroascorbate (DHA), the fully oxidized form of AA. Here, we explored the effects of DHA uptake on the redox metabolism of human erythrocytes. DHA uptake enhanced plasma membrane electron transport (PMET) activity. This process is mediated by DCytb, a membrane bound cytochrome catalyzing extracellular reduction of Fe3+ and ascorbate free radical (AFR), the first oxidized form of AA. DHA uptake also decreased cellular radical oxygen species (ROS) levels. Both effects were massively enhanced in the presence of physiological glucose concentrations. Reduction of DHA to AA largely depleted intracellular glutathione (GSH) and induced the efflux of its oxidized form, GSSG. GSSG efflux could be inhibited by MK-571 (IC50 = 5 μM), indicating involvement of multidrug resistance associated protein (MRP1/4). DHA-dependent GSH depletion and GSSG efflux were completely rescued in the presence of 5 mM glucose and, partially, by 2-deoxy-glucose (2-DG), respectively. These findings indicate that human erythrocytes are physiologically adapted to recycle AA both intracellularly via GLUT1-mediated DHA uptake and reduction and extracellularly via DCytb-mediated AFR reduction. We discuss the possibility that this improved erythrocyte-mediated AA recycling was a prerequisite for the emergence of AA auxotrophy which independently occurred at least twice during mammalian evolution.
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Affiliation(s)
- Michael Eigenschink
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
| | - Danylo Savran
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
| | - Christoph P Zitterer
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
| | - Sebastian Granitzer
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria.,Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - Magdalena Fritz
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
| | - David M Baron
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Ernst W Müllner
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
| | - Ulrich Salzer
- Center for Medical Biochemistry, Max Perutz Labs Vienna, Medical University of Vienna, Vienna, Austria
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6
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Shibao CA, Joos K, Phillips JA, Cogan J, Newman JH, Hamid R, Meiler J, Capra J, Sheehan J, Vetrini F, Yang Y, Black B, Diedrich A, Roberston D, Biaggioni I. Familial Autonomic Ganglionopathy Caused by Rare CHRNA3 Genetic Variants. Neurology 2021; 97:e145-e155. [PMID: 33947782 PMCID: PMC8279568 DOI: 10.1212/wnl.0000000000012143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/08/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the molecular basis of a new monogenetic recessive disorder that results in familial autonomic ganglionopathy with diffuse autonomic failure. METHODS Two adult siblings from one family (I-4 and I-5) and another participant from a second family (II-3) presented with severe neurogenic orthostatic hypotension (nOH), small nonreactive pupils, and constipation. All 3 affected members had low norepinephrine levels and diffuse panautonomic failure. RESULTS Whole exome sequencing of DNA from I-4 and I-5 showed compound heterozygosity for c.907_908delCT (p.L303Dfs*115)/c.688 G>A (p.D230N) pathologic variants in the acetylcholine receptor, neuronal nicotinic, α3 subunit gene (CHRNA3). II-3 from the second family was homozygous for the same frameshift (fs) variant (p.L303Dfs*115//p.L303Dfs*115). CHRNA3 encodes a critical subunit of the nicotinic acetylcholine receptors (nAChRs) responsible for fast synaptic transmission in the autonomic ganglia. The fs variant is clearly pathogenic and the p.D230N variant is predicted to be damaging (SIFT)/probably damaging (PolyPhen2). The p.D230N variant lies on the interface between CHRNA3 and other nAChR subunits based on structural modeling and is predicted to destabilize the nAChR pentameric complex. CONCLUSIONS We report a novel genetic disease that affected 3 individuals from 2 unrelated families who presented with severe nOH, miosis, and constipation. These patients had rare pathologic variants in the CHRNA3 gene that cosegregate with and are predicted to be the likely cause of their diffuse panautonomic failure.
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Affiliation(s)
- Cyndya A Shibao
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX.
| | - Karen Joos
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - John A Phillips
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Joy Cogan
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - John H Newman
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Rizwan Hamid
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Jens Meiler
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - John Capra
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Jonathan Sheehan
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Francesco Vetrini
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Yaping Yang
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Bonnie Black
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - André Diedrich
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - David Roberston
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
| | - Italo Biaggioni
- From the Department of Medicine (C.S., J.H.N., B.B., A.D., D.R., I.B.), Department of Ophthalmology and Visual Sciences, Biomedical Engineering (K.J.), Department of Pediatrics (J.A.P., J.C., R.H.), and Department of Biochemistry (J.M., J.C.), Vanderbilt University Medical Center, Nashville, TN; Department of Internal Medicine (J.S.), Washington University in St. Louis, MO; Department of Medical and Molecular Genetics (F.V.), Indiana University School of Medicine, Indianapolis, IN; and Baylor Genetics and Baylor College of Medicine (Y.Y.), Baylor College of Medicine, Houston, TX
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7
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Wassenberg T, Deinum J, van Ittersum FJ, Kamsteeg E, Pennings M, Verbeek MM, Wevers RA, van Albada ME, Kema IP, Versmissen J, van den Meiracker T, Lenders JW, Monnens L, Willemsen MA. Clinical presentation and long-term follow-up of dopamine beta hydroxylase deficiency. J Inherit Metab Dis 2021; 44:554-565. [PMID: 33034372 PMCID: PMC8246878 DOI: 10.1002/jimd.12321] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/26/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
Dopamine beta hydroxylase (DBH) deficiency is an extremely rare autosomal recessive disorder with severe orthostatic hypotension, that can be treated with L-threo-3,4-dihydroxyphenylserine (L-DOPS). We aimed to summarize clinical, biochemical, and genetic data of all world-wide reported patients with DBH-deficiency, and to present detailed new data on long-term follow-up of a relatively large Dutch cohort. We retrospectively describe 10 patients from a Dutch cohort and 15 additional patients from the literature. We identified 25 patients (15 females) from 20 families. Ten patients were diagnosed in the Netherlands. Duration of follow-up of Dutch patients ranged from 1 to 21 years (median 13 years). All patients had severe orthostatic hypotension. Severely decreased or absent (nor)epinephrine, and increased dopamine plasma concentrations were found in 24/25 patients. Impaired kidney function and anemia were present in all Dutch patients, hypomagnesaemia in 5 out of 10. Clinically, all patients responded very well to L-DOPS, with marked reduction of orthostatic complaints. However, orthostatic hypotension remained present, and kidney function, anemia, and hypomagnesaemia only partially improved. Plasma norepinephrine increased and became detectable, while epinephrine remained undetectable in most patients. We confirm the core clinical characteristics of DBH-deficiency and the pathognomonic profile of catecholamines in body fluids. Impaired renal function, anemia, and hypomagnesaemia can be part of the clinical presentation. The subjective response to L-DOPS treatment is excellent and sustained, although the neurotransmitter profile in plasma does not normalize completely. Furthermore, orthostatic hypotension as well as renal function, anemia, and hypomagnesaemia improve only partially.
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Affiliation(s)
- Tessa Wassenberg
- Department of Neurology, Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegenthe Netherlands
- Department of Pediatrics, Pediatric Neurology UnitUZ Brussel VUBBrusselsBelgium
| | - Jaap Deinum
- Department of Internal MedicineRadboud University Medical CenterNijmegenthe Netherlands
| | - Frans J. van Ittersum
- Department of NephrologyAmsterdam University Medical Center (location VUMC)Amsterdamthe Netherlands
| | - Erik‐Jan Kamsteeg
- Department of Human GeneticsRadboud University Medical CenterNijmegenthe Netherlands
| | - Maartje Pennings
- Department of Human GeneticsRadboud University Medical CenterNijmegenthe Netherlands
| | - Marcel M. Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegenthe Netherlands
- Department of Laboratory Medicine, Translational Metabolic LaboratoryRadboud University Medical CenterNijmegenthe Netherlands
| | - Ron A. Wevers
- Department of Laboratory Medicine, Translational Metabolic LaboratoryRadboud University Medical CenterNijmegenthe Netherlands
| | - Mirjam E. van Albada
- Department of PediatricsUniversity Medical Center GroningenGroningenthe Netherlands
| | - Ido P. Kema
- Department of Laboratory MedicineUniversity Medical Center Groningen, University of GroningenGroningenthe Netherlands
| | - Jorie Versmissen
- Department of Internal MedicineErasmus Medical CenterRotterdamthe Netherlands
| | | | - Jacques W.M. Lenders
- Department of Internal MedicineRadboud University Medical CenterNijmegenthe Netherlands
- Department of Medicine III, University Hospital Carl Gustav CarusTechnical University DresdenDresdenGermany
| | - Leo Monnens
- Department of PhysiologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Michèl A. Willemsen
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's HospitalRadboud University Medical CenterNijmegenthe Netherlands
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8
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Benarroch EE. What is the role of ascorbic acid in norepinephrine synthesis and orthostatic hypotension? Neurology 2020; 95:913-916. [DOI: 10.1212/wnl.0000000000010960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 11/15/2022] Open
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9
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Kiani AK, Amato B, Maitz S, Nodari S, Benedetti S, Agostini F, Lorusso L, Capelli E, Dautaj A, Bertelli M. Genetic test for Mendelian fatigue and muscle weakness syndromes. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020001. [PMID: 33170160 PMCID: PMC8023128 DOI: 10.23750/abm.v91i13-s.10642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/23/2022]
Abstract
Several inherited disorders involve chronic fatigue, muscle weakness and pain. These conditions can depend on muscle, nerve, brain, metabolic and mitochondrial defects. A major trigger of muscle weakness and fatigue is exercise. The amount of exercise that triggers symptoms and the frequency of symptoms are highly variable. In this review, the genetic causes and molecular pathways involved in these disorders are discussed along with the diagnostic and treatment options available, with the aim of fostering understanding of the disease and exploring therapeutic options. (www.actabiomedica.it)
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Affiliation(s)
| | - Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
| | - Silvia Maitz
- Department of Pediatrics, San Gerardo Hospital, Monza, Italy.
| | - Savina Nodari
- Department of Cardiology, University of Brescia and ASST "Spedali Civili" Hospital, Brescia.
| | | | | | | | - Enrica Capelli
- Department of Earth and Environmental Sciences and Centre for Health Technologies, University of Pavia, Pavia, Italy.
| | | | - Matteo Bertelli
- MAGI EUREGIO, Bolzano, Italy; MAGI'S LAB, Rovereto (TN), Italy; EBTNA-LAB, Rovereto (TN), Italy.
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10
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van Faassen M, Bischoff R, Eijkelenkamp K, de Jong WHA, van der Ley CP, Kema IP. In Matrix Derivatization Combined with LC-MS/MS Results in Ultrasensitive Quantification of Plasma Free Metanephrines and Catecholamines. Anal Chem 2020; 92:9072-9078. [PMID: 32484659 PMCID: PMC7349590 DOI: 10.1021/acs.analchem.0c01263] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
Abstract
Plasma-free metanephrines and catecholamines are essential markers in the biochemical diagnosis and follow-up of neuroendocrine tumors and inborn errors of metabolism. However, their low circulating concentrations (in the nanomolar range) and poor fragmentation characteristics hinder facile simultaneous quantification by liquid chromatography and tandem mass spectrometry (LC-MS/MS). Here, we present a sensitive and simple matrix derivatization procedure using propionic anhydride that enables simultaneous quantification of unconjugated l-DOPA, catecholamines, and metanephrines in plasma by LC-MS/MS. Dilution of propionic anhydride 1:4 (v/v) in acetonitrile in combination with 50 μL of plasma resulted in the highest mass spectrometric response. In plasma, derivatization resulted in stable derivatives and increased sensitivity by a factor of 4-30 compared with a previous LC-MS/MS method for measuring plasma metanephrines in our laboratory. Furthermore, propionylation increased specificity, especially for 3-methoxytyramine, by preventing interference from antihypertensive medication (β-blockers). The method was validated according to international guidelines and correlated with a hydrophilic interaction LC-MS/MS method for measuring plasma metanephrines (R2 > 0.99) and high-performance liquid chromatography with an electrochemical detection method for measuring plasma catecholamines (R2 > 0.85). Reference intervals for l-DOPA, catecholamines, and metanephrines in n = 115 healthy individuals were established. Our work shows that analytes in the subnanomolar range in plasma can be derivatized in situ without any preceding sample extraction. The developed method shows improved sensitivity and selectivity over existing methods and enables simultaneous quantification of several classes of amines.
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Affiliation(s)
- Martijn van Faassen
- Department
of Laboratory Medicine and Department of Endocrinology, University Medical Center Groningen, University of
Groningen, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Rainer Bischoff
- Analytical
Biochemistry, Department of Pharmacy, University
of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Karin Eijkelenkamp
- Department
of Laboratory Medicine and Department of Endocrinology, University Medical Center Groningen, University of
Groningen, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Wilhelmina H. A. de Jong
- Department
of Laboratory Medicine and Department of Endocrinology, University Medical Center Groningen, University of
Groningen, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Claude P. van der Ley
- Department
of Laboratory Medicine and Department of Endocrinology, University Medical Center Groningen, University of
Groningen, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Ido P. Kema
- Department
of Laboratory Medicine and Department of Endocrinology, University Medical Center Groningen, University of
Groningen, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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11
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Shibao CA, Garland EM, Black BK, Mathias CJ, Grant MB, Root AW, Robertson D, Biaggioni I. Congenital absence of norepinephrine due to CYB561 mutations. Neurology 2019; 94:e200-e204. [PMID: 31822578 DOI: 10.1212/wnl.0000000000008734] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/05/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Cytochrome b561 (CYB561) generates ascorbic acid, a cofactor in the enzymatic conversion of dopamine to norepinephrine by dopamine β-hydroxylase. We propose that the clinical relevance of this pathway can be revealed by characterizing the autonomic and biochemical characteristics of patients with CYB561 mutations. METHODS We performed autonomic evaluations in 4 patients with lifelong orthostatic hypotension in whom CYB561 mutations were determined by genomic sequencing. RESULTS Patients had disabling lifelong orthostatic hypotension (OH) and impaired blood pressure response to the Valsalva maneuver (VM), with exaggerated hypotension during phase 2 and lack of overshoot during phase 4. Heart rate ratios for sinus arrhythmia and the VM were normal. Plasma norepinephrine and metabolites were undetectable, and plasma dopamine and metabolites were normal. Droxidopa restored norepinephrine levels and improved OH. Patients 1 and 2 were sisters and homozygous for a nonsense mutation in exon 2, c.131G>A, p.Trp44 (Circ Res 2018). Their brother (patient 3) died at age 16 and his DNA was not available. Patient 4 was compound heterozygous; one allele had a missense mutation in exon 2, c157C>T, p.His.53Tyr, and the other had an exon 2 deletion. CONCLUSION CYB561 deficiency is characterized by selective sympathetic noradrenergic failure with lifelong, disabling OH but with normal sympathetic cholinergic (sweating) and parasympathetic (heart rate regulation) functions. We report a novel case of CYB561 deficiency due to an exon 2 deletion in one allele and a missense mutation in the other. These patients highlight the critical role CYB561 plays in sympathetic function and cardiovascular regulation.
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Affiliation(s)
- Cyndya A Shibao
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Emily M Garland
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Bonnie K Black
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Christopher J Mathias
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Maria B Grant
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Allen W Root
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - David Robertson
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL
| | - Italo Biaggioni
- From the Departments of Medicine (C.A.S., E.M.G., B.K.B., D.R., I.B.), Neurology (D.R.), and Pharmacology (D.R.), and the Vanderbilt Autonomic Dysfunction Center (C.A.S., E.M.G., B.K.B., D.R., I.B.), Vanderbilt University Medical Center, Nashville, TN; Autonomic & Neurovascular Medicine Center (C.J.M.), Hospital of St John & St Elizabeth; St Mary's Hospital (C.J.M.), Imperial College Healthcare Trust; Institute of Neurology/University College London (C.J.M.), UK; Department of Ophthalmology and Visual Sciences (M.B.G.), School of Medicine, University of Alabama at Birmingham; and Johns Hopkins All Children's Hospital (A.W.R.), St. Petersburg, FL.
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12
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Williams R. Circulation Research "In This Issue" Anthology. Circ Res 2019; 124:e123-e148. [PMID: 31170049 DOI: 10.1161/res.0000000000000275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Miglis MG, Muppidi S. A novel autosomal recessive orthostatic hypotension syndrome: and other updates on recent autonomic research. Clin Auton Res 2018; 28:565-567. [PMID: 30415401 DOI: 10.1007/s10286-018-0578-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 11/07/2018] [Indexed: 11/25/2022]
Affiliation(s)
| | - Srikanth Muppidi
- Stanford Neurosciences Health Center, 213 Quarry Road, 2nd Floor, Palo Alto, CA, 94304, USA.
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14
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Alhenc-Gelas F. A New Player in Circulatory Adaptation to Orthostatism: Better to Play With Than Without Him. Circ Res 2018; 122:802-803. [PMID: 29700080 DOI: 10.1161/circresaha.118.312749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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