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Li Y, Blakeley J, Ly I, Berman Y, Lau J, Wolkenstein P, Bergqvist C, Jia W, Milner TE, Katta N, Durkin AJ, Kennedy GT, Rowland R, Romo CG, Fleming J, Kelly KM. Current and Emerging Imaging Techniques for Neurofibromatosis Type 1-Associated Cutaneous Neurofibromas. J Invest Dermatol 2023:S0022-202X(23)01988-7. [PMID: 37330718 DOI: 10.1016/j.jid.2023.03.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/25/2023] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
A consistent set of measurement techniques must be applied to reliably and reproducibly evaluate the efficacy of treatments for cutaneous neurofibromas (cNFs) in people with neurofibromatosis type 1 (NF1). cNFs are neurocutaneous tumors that are the most common tumor in people with NF1 and represent an area of unmet clinical need. This review presents the available data regarding approaches in use or development to identify, measure, and track cNFs, including calipers, digital imaging, and high-frequency ultrasound sonography. We also describe emerging technologies such as spatial frequency domain imaging and the application of imaging modalities such as optical coherence tomography that may enable the detection of early cNFs and prevention of tumor-associated morbidity.
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Affiliation(s)
- Yingjoy Li
- Department of Dermatology, School of Medicine, University of California, Irvine, California, USA
| | - Jaishri Blakeley
- Comprehensive Neurofibromatosis Center, Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ina Ly
- Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yemima Berman
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, Australia
| | - Jonathan Lau
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, Australia; Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Pierre Wolkenstein
- Faculty of Medicine and Health, Université Paris-Est Créteil Val de Marne, Créteil, France; Department of Dermatology, National Referral Center for Neurofibromatoses, Henri-Mondor Hospital, Assistance Publique-Hôpital Paris (AP-HP), Créteil, France
| | - Christina Bergqvist
- Department of Dermatology, National Referral Center for Neurofibromatoses, Henri-Mondor Hospital, Assistance Publique-Hôpital Paris (AP-HP), Créteil, France
| | - Wangcun Jia
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA
| | - Thomas E Milner
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA; Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Nitesh Katta
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA
| | - Anthony J Durkin
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA; Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Gordon T Kennedy
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA
| | - Rebecca Rowland
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA
| | - Carlos G Romo
- Comprehensive Neurofibromatosis Center, Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jane Fleming
- Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, Australia
| | - Kristen M Kelly
- Department of Dermatology, School of Medicine, University of California, Irvine, California, USA; Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, USA.
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Basto DL, de Souza Vieira G, Andrade-Losso RM, Almeida PN, Riccardi VM, Rozza-de-Menezes RE, Cunha KS. Head circumference and anthropometric changes and their relation to plexiform and skin neurofibromas in sporadic and familial neurofibromatosis 1 Brazilian adults: a cross-sectional study. Orphanet J Rare Dis 2022; 17:341. [PMID: 36064430 PMCID: PMC9446792 DOI: 10.1186/s13023-022-02482-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a common autosomal dominant syndrome with complete penetrance and highly variable expressivity. The cutaneous neurofibroma (Cnf) and plexiform neurofibroma (Pnf), café-au-lait spots, and freckle-like lesions are common in NF1, but many other manifestations can occur. We aimed to evaluate head circumference, height, weight, body mass index (BMI), head circumference-to-height ratio (HCHR) and waist–hip ratio (WHR) in adult NF1 Brazilian individuals versus a paired control group and investigate their correlation with the presence of clinically visible Pnfs, and number of “skin neurofibromas” (Snf), which include both cutaneous and subcutaneous neurofibromas. Methods A case–control study was conducted with 168 individuals, 84 with NF1 and 84 without NF1, paired by sex and age. Head circumference and anthropometric measurements, Snf quantification, evaluation of clinically visible Pnf and familial inheritance were accessed. Results Prevalence of macrocephaly was significantly higher in NF1 women. Height and weight were significantly lower in both males and females with NF1. HCHR was higher in the NF1 group than in the control group for both sexes. BMI was significantly lower in men with NF1. Waist and hip circumferences were significantly reduced in NF compared with the controls, but the mean WHR was significantly lower only in NF1 women. No correlation was found between the Snf and head circumference and anthropometric measurements, sex or family history. The presence and larger size of clinically visible plexiform neurofibromas were associated with normal stature (p = 0.037 and p = 0.003, respectively). Conclusions NF1 individuals have increased prevalence of macrocephaly, short stature, low BMI, and reduced abdominal fat. There is no relation between head circumference and anthropometric data with family history, or neurofibromas.
Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02482-8.
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Affiliation(s)
- Diogo Lisbôa Basto
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Raquel M Andrade-Losso
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Paula Nascimento Almeida
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil.,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Cunha
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. .,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil. .,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil.
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Quigley A, Nguyen PY, Stone H, Heslop DJ, Chughtai AA, MacIntyre CR. Estimated Mask Use and Temporal Relationship to COVID-19 Epidemiology of Black Lives Matter Protests in 12 Cities. J Racial Ethn Health Disparities 2022; 10:1212-1223. [PMID: 35543865 PMCID: PMC9092928 DOI: 10.1007/s40615-022-01308-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/16/2022] [Indexed: 11/26/2022]
Abstract
There is an increased risk of SARS-CoV-2 transmission during mass gatherings and a risk of asymptomatic infection. We aimed to estimate the use of masks during Black Lives Matter (BLM) protests and whether these protests increased the risk of COVID-19. Two reviewers screened 496 protest images for mask use, with high inter-rater reliability. Protest intensity, use of tear gas, government control measures, and testing rates were estimated in 12 cities. A correlation analysis was conducted to assess the potential effect of mask use and other measures, adjusting for testing rates, on COVID-19 epidemiology 4 weeks (two incubation periods) post-protests. Mask use ranged from 69 to 96% across protests. There was no increase in the incidence of COVID-19 post-protest in 11 cities. After adjusting for testing rates, only Miami, which involved use of tear gas and had high protest intensity, showed a clear increase in COVID-19 after one incubation period post-protest. No significant correlation was found between incidence and protest factors. Our study showed that protests in most cities studied did not increase COVID-19 incidence in 2020, and a high level of mask use was seen. The absence of an epidemic surge within two incubation periods of a protest is indicative that the protests did not have a major influence on epidemic activity, except in Miami. With the globally circulating highly transmissible Alpha, Delta, and Omicron variants, layered interventions such as mandated mask use, physical distancing, testing, and vaccination should be applied for mass gatherings in the future.
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Affiliation(s)
- Ashley Quigley
- Biosecurity Research Program, The Kirby Institute, UNSW, Wallace Wurth Building, UNSW, High St, Kensington Campus, Sydney, NSW, 2052, Australia.
| | - Phi Yen Nguyen
- School of Population Health, UNSW, Level 3, Samuels Building, UNSW, Sydney, NSW, 2052, Australia
| | - Haley Stone
- Biosecurity Research Program, The Kirby Institute, UNSW, Wallace Wurth Building, UNSW, High St, Kensington Campus, Sydney, NSW, 2052, Australia
| | - David J Heslop
- School of Population Health, UNSW, Level 3, Samuels Building, UNSW, Sydney, NSW, 2052, Australia
| | - Abrar Ahmad Chughtai
- School of Population Health, UNSW, Level 3, Samuels Building, UNSW, Sydney, NSW, 2052, Australia
| | - C Raina MacIntyre
- Biosecurity Research Program, The Kirby Institute, UNSW, Wallace Wurth Building, UNSW, High St, Kensington Campus, Sydney, NSW, 2052, Australia
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Rozza-de-Menezes RE, Almeida LM, Andrade-Losso RM, de Souza Vieira G, Siqueira OHK, Brum CI, Riccardi VM, Cunha KS. A Clinicopathologic Study on the Role of Estrogen, Progesterone, and Their Classical and Nonclassical Receptors in Cutaneous Neurofibromas of Individuals With Neurofibromatosis 1. Am J Clin Pathol 2021; 155:738-747. [PMID: 33289020 DOI: 10.1093/ajcp/aqaa186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate the expression of progesterone receptor (PR), estrogen receptor (ER), and G protein-coupled estrogen receptor 1 (GPER-1) in cutaneous neurofibromas (cNFs) and their correlation with demographic, clinical, and laboratory data of individuals with neurofibromatosis 1 (NF1). The association of PROGINS polymorphism and PR expression in cNFs, as well as the serum steroidal hormones and the number of cNFs, was investigated. METHODS The sample comprised 80 large and 80 small cNFs from 80 individuals with NF1. PR, ER, GPER-1, and Ki-67 expression were investigated by immunohistochemistry in tissue micro- and macroarrays and quantified using a digital computer-assisted method. The number of cNFs, the levels of serum 17β estradiol and progesterone, and the PROGINS polymorphism were identified. RESULTS Twelve (8.5%) small cNFs were weakly positive for ER, 131 (92.3%) cNFs expressed PR, and all (100%) cNFs expressed GPER-1. Large cNFs showed a higher expression of PR (P < .0001) and GPER-1 (P = .019) and had a higher intensity of staining for these receptors (P < .0001). The cell proliferation index was positively correlated with PR (P = .001). Persons with more cNFs had higher serum levels of progesterone (P = .001). CONCLUSIONS These findings emphasize the role of estrogen and progesterone in cNF development and suggest that these hormones may act on cNF cells via a noncanonical pathway through GPER-1.
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Affiliation(s)
- Rafaela E Rozza-de-Menezes
- Graduate Program in Pathology, School of Medicine
- Department of Pathology, School of Medicine, Antonio Pedro University Hospital
- Department of General and Specialized Surgery, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | - Lilian M Almeida
- Graduate Program in Pathology, School of Medicine
- Department of Pathology, School of Medicine, Antonio Pedro University Hospital
| | - Raquel M Andrade-Losso
- Graduate Program in Pathology, School of Medicine
- Department of Pathology, School of Medicine, Antonio Pedro University Hospital
| | - Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine
- Department of Pathology, School of Medicine, Antonio Pedro University Hospital
| | - Orlando H K Siqueira
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, Brazil
| | - Carolina I Brum
- Department of Pathology, School of Medicine, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Karin S Cunha
- Graduate Program in Pathology, School of Medicine
- Department of Pathology, School of Medicine, Antonio Pedro University Hospital
- Department of General and Specialized Surgery, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
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Cannon A, Jarnagin K, Korf B, Widemann BC, Casey D, Ko HS, Blakeley JO, Verma SK, Pichard DC. Clinical trial design for cutaneous neurofibromas. Neurology 2019; 91:S31-S37. [PMID: 29987133 DOI: 10.1212/wnl.0000000000005790] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/13/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Several clinical trials targeting cutaneous neurofibromas (cNF) have been conducted; however, none has resulted in meaningful changes to care. The Clinical Trial Design and Development subgroup's goals were to (1) define key considerations in the design of clinical trials for cNF, (2) summarize existing data in relation to these considerations, and (3) provide consensus recommendations about key elements of trial design to accelerate the clinical development of therapies for cNF. METHODS The subgroup, with experts from genetics, dermatology, neurology, oncology, and basic science, spanning academia, government research, and regulatory programs, and industry, reviewed published and unpublished data on clinical trials for cNF and other diseases in the skin. Discussions of these data resulted in formulation of a list of priority issues to address in order to develop efficient and effective clinical trials for cNF. RESULTS The subgroup identified 2 natural history studies of cNF, 4 priority outcome measures, and 6 patient-reported outcome tools for potential use in efficacy trials of cNF. Time to initiate intervention, patient eligibility, mechanism of action, route of administration, safety monitoring, and regulatory agency interactions were identified as key factors to consider when designing clinical trials for cNF. CONCLUSIONS Alignment on endpoints and methods for the measurement and quantification of cNF represent a priority for therapeutic development for cNF. Advances in technological methods and outcome tools utilized in other skin diseases may be applicable to cNF studies. Patient age is an important factor guiding trial design and clinical development path.
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Affiliation(s)
- Ashley Cannon
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kurt Jarnagin
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bruce Korf
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brigitte C Widemann
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Denise Casey
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hon-Sum Ko
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jaishri O Blakeley
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sharad K Verma
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dominique C Pichard
- From the Department of Genetics (A.C., B.K.), University of Alabama at Birmingham; BioPharm Tech (K.J.), San Mateo, CA; Pediatric Oncology Branch (B.C.W.) and Dermatology Branch, Center for Cancer Research (D.C.P.), National Cancer Institute, NIH, Bethesda; Division of Oncology Products (D.C.) and Division of Dermatology and Dental Products (H.-S.K.), Food and Drug Administration, Silver Spring; and Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD.
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Yoshida Y, Ehara Y, Noma H, Yamamoto O. Simple method for estimating cutaneous neurofibromas in patients with neurofibromatosis 1. J Dermatol 2018; 45:626-627. [DOI: 10.1111/1346-8138.14246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yuichi Yoshida
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Faculty of Medicine; Tottori University; Yonago Japan
| | - Yuko Ehara
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Faculty of Medicine; Tottori University; Yonago Japan
| | - Hiroshi Noma
- Department of Data Science; The Institute of Statistical Mathematics; Tokyo Japan
| | - Osamu Yamamoto
- Division of Dermatology; Department of Medicine of Sensory and Motor Organs; Faculty of Medicine; Tottori University; Yonago Japan
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7
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Cannon A, Chen MJ, Li P, Boyd KP, Theos A, Redden DT, Korf B. Cutaneous neurofibromas in Neurofibromatosis type I: a quantitative natural history study. Orphanet J Rare Dis 2018; 13:31. [PMID: 29415745 PMCID: PMC5803843 DOI: 10.1186/s13023-018-0772-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/30/2018] [Indexed: 11/25/2022] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by a predisposition to develop multiple benign tumors. A major feature of NF1 is the development of localized cutaneous neurofibromas. Cutaneous neurofibromas manifest in > 99% of adults with NF1 and are responsible for major negative effects on quality of life. Previous reports have correlated increased burden of cutaneous neurofibromas with age and pregnancy, but longitudinal data are not available to establish a quantitative natural history of these lesions. The purpose of this study is to conduct a prospective natural history study of 22 adults with NF1 over an 8-year period to quantify cutaneous neurofibroma number and size. Results The average monthly increase in volume for cutaneous neurofibromas was 0.37 mm3 in the back region (95% CI (0.23, 0.51), p < 0.0001), 0.28 mm3 in the abdominal region (95% CI (0.16, 0.41), p < 0.0001), and 0.21 mm3 in the arm/leg region (95% CI (0.08, 0.34), p = 0.0022). The number of cutaneous neurofibromas significantly increased in the back (slope = 0.032, p = 0.011) and abdominal (slope = 0.018, p = 0.026) regions, while the leg/arm regions retained a positive trend (slope = 0.004, p = 0.055). Conclusions The number and volume of cutaneous neurofibromas significantly increased over an 8-year timespan; however, the rate of increase is variable by individual and body region. These findings may provide insight into cutaneous neurofibroma development and benefit researchers considering clinical trials targeting cutaneous neurofibromas. Electronic supplementary material The online version of this article (10.1186/s13023-018-0772-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ashley Cannon
- Department of Genetics, University of Alabama, 720 20th Street South, Birmingham, AL, 35294, USA.
| | - Mei-Jan Chen
- Department of Genetics, University of Alabama, 720 20th Street South, Birmingham, AL, 35294, USA
| | - Peng Li
- Department of Biostatistics, University of Alabama, Birmingham, AL, USA
| | - Kevin P Boyd
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - Amy Theos
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - David T Redden
- Department of Biostatistics, University of Alabama, Birmingham, AL, USA
| | - Bruce Korf
- Department of Genetics, University of Alabama, 720 20th Street South, Birmingham, AL, 35294, USA
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8
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Emerging genotype-phenotype relationships in patients with large NF1 deletions. Hum Genet 2017; 136:349-376. [PMID: 28213670 PMCID: PMC5370280 DOI: 10.1007/s00439-017-1766-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/08/2017] [Indexed: 02/07/2023]
Abstract
The most frequent recurring mutations in neurofibromatosis type 1
(NF1) are large deletions encompassing the NF1
gene and its flanking regions (NF1
microdeletions). The majority of these deletions encompass 1.4-Mb and are associated
with the loss of 14 protein-coding genes and four microRNA genes. Patients with
germline type-1 NF1 microdeletions frequently
exhibit dysmorphic facial features, overgrowth/tall-for-age stature, significant
delay in cognitive development, large hands and feet, hyperflexibility of joints and
muscular hypotonia. Such patients also display significantly more cardiovascular
anomalies as compared with patients without large deletions and often exhibit
increased numbers of subcutaneous, plexiform and spinal neurofibromas as compared
with the general NF1 population. Further, an extremely high burden of internal
neurofibromas, characterised by >3000 ml tumour volume, is encountered
significantly, more frequently, in non-mosaic NF1
microdeletion patients than in NF1 patients lacking such deletions. NF1 microdeletion patients also have an increased risk of
malignant peripheral nerve sheath tumours (MPNSTs); their lifetime MPNST risk is
16–26%, rather higher than that of NF1 patients with intragenic NF1 mutations (8–13%). NF1 microdeletion patients, therefore, represent a high-risk group for
the development of MPNSTs, tumours which are very aggressive and difficult to treat.
Co-deletion of the SUZ12 gene in addition to
NF1 further increases the MPNST risk in
NF1 microdeletion patients. Here, we summarise
current knowledge about genotype–phenotype relationships in NF1 microdeletion patients and discuss the potential role of the genes
located within the NF1 microdeletion interval
whose haploinsufficiency may contribute to the more severe clinical
phenotype.
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