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Cardiometabolic assessment of lamin A/C gene mutation carriers: a phenotype–genotype correlation. DIABETES & METABOLISM 2019; 45:382-389. [DOI: 10.1016/j.diabet.2018.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/16/2018] [Accepted: 09/07/2018] [Indexed: 01/01/2023]
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van Tienen FHJ, Lindsey PJ, Kamps MAF, Krapels IP, Ramaekers FCS, Brunner HG, van den Wijngaard A, Broers JLV. Assessment of fibroblast nuclear morphology aids interpretation of LMNA variants. Eur J Hum Genet 2018; 27:389-399. [PMID: 30420677 DOI: 10.1038/s41431-018-0294-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 01/26/2023] Open
Abstract
The phenotypic heterogeneity of Lamin A/C (LMNA) variants renders it difficult to classify them. As a consequence, many LMNA variants are classified as variant of unknown significance (VUS). A number of studies reported different types of visible nuclear abnormalities in LMNA-variant carriers, such as herniations, honeycomb-like structures and irregular Lamin staining. In this study, we used lamin A/C immunostaining and nuclear DAPI staining to assess the number and type of nuclear abnormalities in primary dermal fibroblast cultures of laminopathy patients and healthy controls. The total number of abnormal nuclei, which includes herniations, honeycomb-structures, and donut-like nuclei, was found to be the most discriminating parameter between laminopathy and control cell cultures. The percentage abnormal nuclei was subsequently scored in fibroblasts of 28 LMNA variant carriers, ranging from (likely) benign to (likely) pathogenic variant. Using this method, 27 out of 28 fibroblast cell cultures could be classified as either normal (n = 14) or laminopathy (n = 13) and no false positive results were obtained. The obtained specificity was 100% (CI 40-100%) and sensitivity 77% (46-95%). We conclude that assessing the percentage of abnormal nuclei is a quick and reliable method, which aids classification or confirms pathogenicity of identified LMNA variants causing formation of aberrant lamin A/C protein.
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Affiliation(s)
- Florence H J van Tienen
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands. .,GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Patrick J Lindsey
- Department of Genetics and Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Miriam A F Kamps
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Genetics and Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ingrid P Krapels
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frans C S Ramaekers
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Genetics and Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Han G Brunner
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arthur van den Wijngaard
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jos L V Broers
- Department of Genetics and Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.,CARIM-School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
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Limpitikul W, Ong CS, Tomaselli GF. Neuromuscular Disease: Cardiac Manifestations and Sudden Death Risk. Card Electrophysiol Clin 2017; 9:731-747. [PMID: 29173414 DOI: 10.1016/j.ccep.2017.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cardiovascular complications of neuromuscular diseases disproportionately affect the cardiac conduction system. Cardiomyopathy and cardiac arrhythmias produce significant morbidity and mortality. Patients with neuromuscular diseases should be carefully and frequently evaluated for the presence of bradycardia, heart block, and tachyarrhythmias. Preemptive treatment with permanent pacemakers or implanted defibrillators is appropriate in patients with conduction system disease or who are at risk for ventricular arrhythmias.
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Affiliation(s)
- Worawan Limpitikul
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Chin Siang Ong
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gordon F Tomaselli
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
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