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Alfonsi C, Stephan-Otto C, Cortès-Saladelafont E, Palacios NJ, Podzamczer-Valls I, Cruz NG, Jiménez MRD, Micó SI, Vila MT, Jeltsch K, Hübschmann OK, Opladen T, Fragua RV, Gómez T, Fortuny OA, Jiménez IG, Laso EL, Martínez AR, López JM, Garcia-Cazorla À. Volumetric study of brain MRI in a cohort of patients with neurotransmitter disorders. Neuroradiology 2022; 64:2179-2190. [PMID: 35662359 DOI: 10.1007/s00234-022-02989-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Inborn errors of neurotransmitters are rare monogenic diseases. In general, conventional neuroimaging is not useful for diagnosis. Nevertheless, advanced neuroimaging techniques could provide novel diagnosis and prognosis biomarkers. We aim to describe cerebral volumetric findings in a group of Spanish patients with neurotransmitter disorders. METHODS Fifteen 3D T1-weighted brain images from the International Working Group on Neurotransmitter related Disorders Spanish cohort were assessed (eight with monoamine and seven with amino acid disorders). Volumes of cortical and subcortical brain structures were obtained for each patient and then compared with those of two healthy individuals matched by sex and age. RESULTS Regardless of the underlying disease, patients showed a smaller total cerebral tissue volume, which was apparently associated with clinical severity. A characteristic volumetric deficit pattern, including the right Heschl gyrus and the bilateral occipital gyrus, was identified. In severe cases, a distinctive pattern comprised the middle and posterior portions of the right cingulate, the left superior motor area and the cerebellum. In succinate semialdehyde dehydrogenase deficiency, volumetric affection seems to worsen over life. CONCLUSION Despite the heterogeneity and limited size of our cohort, we found novel and relevant data. Total volume deficit appears to be a marker of severity, regardless of the specific neurotransmitter disease and irrespective of the information obtained from conventional neuroimaging. Volumetric assessment of individual brain structures could provide a deeper knowledge about pathophysiology, disease severity and specific clinical traits.
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Affiliation(s)
- Chiara Alfonsi
- Inborn Errors of Metabolism Unit, Pediatric Neurology Department, Institut de Recerca Sant Joan de Déu, and MetabERN, Hospital Sant Joan de Déu, Passeig Sant Joan De Deu Nº 2, 08950, Esplugues De Llobregat, Barcelona, Spain.,Department of Human Neuroscience, Sapienza, University of Rome, Via dei Sabelli n.108, 00185, Rome, Italy
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Pg Sant Joan De Deu Nº 2, 08950, Esplugues De Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Elisenda Cortès-Saladelafont
- Unit of Inherited Metabolic Diseases and Neuropediatrics, Hospital German Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain.,Universitat Autònoma de Barcelona, Plaza Cívica, Bellaterra, Cerdanyola del Vallès, 08193, Barcelona, Spain
| | - Natalia Juliá Palacios
- Inborn Errors of Metabolism Unit, Pediatric Neurology Department, Institut de Recerca Sant Joan de Déu, and MetabERN, Hospital Sant Joan de Déu, Passeig Sant Joan De Deu Nº 2, 08950, Esplugues De Llobregat, Barcelona, Spain
| | - Inés Podzamczer-Valls
- Universitat Autònoma de Barcelona, Plaza Cívica, Bellaterra, Cerdanyola del Vallès, 08193, Barcelona, Spain.,Hospital de La Santa Creu I Sant Pau, Carrer de Sant Antoni Maria Claret n. 167, 08025, Barcelona, Spain
| | - Nuria Gutiérrez Cruz
- Department of Pediatrics, Hospital Universitario Severo Ochoa, Av. de Orellana s/n, 28911, Leganés, Spain
| | - María Rosario Domingo Jiménez
- Department of Pediatric Neurology, Hospital Universitario Virgen de La Arrixaca, Ctra. Madrid-Cartagena s/n, 30120, El Palmar, Murcia, Murcia, Spain
| | - Salvador Ibáñez Micó
- Department of Pediatric Neurology, Hospital Universitario Virgen de La Arrixaca, Ctra. Madrid-Cartagena s/n, 30120, El Palmar, Murcia, Murcia, Spain
| | - Miguel Tomás Vila
- Department of Neurology, Hospital La Fe, Avinguda de Fernando Abril Martorell n.106, 46026, Valencia, Spain
| | - Kathrin Jeltsch
- Division of Child Neurology and Metabolic Disorders, University Children's Hospital Heidelberg and MetabERN, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Oya Kuseyri Hübschmann
- Division of Child Neurology and Metabolic Disorders, University Children's Hospital Heidelberg and MetabERN, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Thomas Opladen
- Division of Child Neurology and Metabolic Disorders, University Children's Hospital Heidelberg and MetabERN, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Ramón Velázquez Fragua
- Department of Pediatric Neurology, Hospital La Paz, C. de Pedro Rico n. 6, 28029, Madrid, Spain
| | - Teresa Gómez
- Department of Psychiatry, Hospital General de Granollers, Carrer de Francesc Ribas s/n, 08402, Granollers, Spain
| | - Oscar Alcoverro Fortuny
- Department of Psychiatry, Hospital General de Granollers, Carrer de Francesc Ribas s/n, 08402, Granollers, Spain
| | - Inmaculada García Jiménez
- Metabolic Disorders Unit, Hospital Universitario Miguel Servet, P.º Isabel La Católica, 1-3, 50009, Saragossa, Spain
| | - Eduardo López Laso
- Pediatric Neurology Unit, Department of Pediatrics, University Hospital Reina Sofía, IMIBIC, Av. Menendez Pidal S/N, 14004, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), C. de Melchor Fernández Almagro n. 3, 28029, Madrid, Spain
| | - Ana Roche Martínez
- Department of Pediatrics, Hospital Parc Tauli, Parc Taulí n. 1, 08208, Sabadell, Spain
| | - Jordi Muchart López
- Department of Radiology, Hospital Sant Joan de Déu, Pg Sant Joan De Deu Nº 2, 08950, Esplugues De Llobregat, Barcelona, Spain
| | - Àngels Garcia-Cazorla
- Inborn Errors of Metabolism Unit, Pediatric Neurology Department, Institut de Recerca Sant Joan de Déu, and MetabERN, Hospital Sant Joan de Déu, Passeig Sant Joan De Deu Nº 2, 08950, Esplugues De Llobregat, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), C. de Melchor Fernández Almagro n. 3, 28029, Madrid, Spain.
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Vidal S, Brandi N, Pacheco P, Gerotina E, Blasco L, Trotta JR, Derdak S, Del Mar O'Callaghan M, Garcia-Cazorla À, Pineda M, Armstrong J. Author Correction: The utility of Next Generation Sequencing for molecular diagnostics in Rett syndrome. Sci Rep 2021; 11:18146. [PMID: 34493777 PMCID: PMC8423842 DOI: 10.1038/s41598-021-97262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Silvia Vidal
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Núria Brandi
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Paola Pacheco
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Edgar Gerotina
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Laura Blasco
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jean-Rémi Trotta
- Centro Nacional de Análisis Genómica (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Sophia Derdak
- Centro Nacional de Análisis Genómica (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Maria Del Mar O'Callaghan
- Neurology Service, Hospital Sant Joan de Déu, Barcelona, Spain.,Institut de Recerca, Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.,CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Àngels Garcia-Cazorla
- Neurology Service, Hospital Sant Joan de Déu, Barcelona, Spain.,Institut de Recerca, Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.,CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Pineda
- Institut de Recerca, Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Judith Armstrong
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain. .,Institut de Recerca, Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain. .,CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain.
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3
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Trifunov S, Paredes-Fuentes AJ, Badosa C, Codina A, Montoya J, Ruiz-Pesini E, Jou C, Garrabou G, Grau-Junyent JM, Yubero D, Montero R, Muchart J, Ortigoza-Escobar JD, O'Callaghan MM, Nascimento A, Català A, Garcia-Cazorla À, Jimenez-Mallebrera C, Artuch R. Circulating Cell-Free Mitochondrial DNA in Cerebrospinal Fluid as a Biomarker for Mitochondrial Diseases. Clin Chem 2021; 67:1113-1121. [PMID: 34352085 DOI: 10.1093/clinchem/hvab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mitochondrial diseases (MD) are genetic metabolic disorders that impair normal mitochondrial structure or function. The aim of this study was to investigate the status of circulating cell-free mitochondrial DNA (ccfmtDNA) in cerebrospinal fluid (CSF), together with other biomarkers (growth differentiation factor-15 [GDF-15], alanine, and lactate), in a cohort of 25 patients with a molecular diagnosis of MD. METHODS Measurement of ccfmtDNA was performed by using droplet digital PCR. RESULTS The mean copy number of ccfmtDNA was approximately 6 times higher in the MD cohort compared to the control group; patients with mitochondrial deletion and depletion syndromes (MDD) had the higher levels. We also detected the presence of both wild-type mtDNA and mtDNA deletions in CSF samples of patients with single deletions. Patients with MDD with single deletions had significantly higher concentrations of GDF-15 in CSF than controls, whereas patients with point mutations in mitochondrial DNA presented no statistically significant differences. Additionally, we found a significant positive correlation between ccfmtDNA levels and GDF-15 concentrations (r = 0.59, P = 0.016). CONCLUSION CSF ccfmtDNA levels are significantly higher in patients with MD in comparison to controls and, thus, they can be used as a novel biomarker for MD research. Our results could also be valuable to support the clinical outcome assessment of MD patients.
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Affiliation(s)
- Selena Trifunov
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Abraham J Paredes-Fuentes
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Badosa
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Codina
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Julio Montoya
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology, Institute for Health Research of Aragón (IISAragón), University of Zaragoza, Zaragoza, Spain
| | - Eduardo Ruiz-Pesini
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology, Institute for Health Research of Aragón (IISAragón), University of Zaragoza, Zaragoza, Spain
| | - Cristina Jou
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Glòria Garrabou
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Laboratory of Muscle Research and Mitochondrial Function-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona (UB), Hospital Clínic of Barcelona (HCB), Barcelona, Spain
| | - Josep M Grau-Junyent
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Laboratory of Muscle Research and Mitochondrial Function-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona (UB), Hospital Clínic of Barcelona (HCB), Barcelona, Spain
| | - Dèlia Yubero
- Department of Genetics and Molecular Medicine, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Raquel Montero
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordi Muchart
- Department of Radiology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | | | - Andrés Nascimento
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Albert Català
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Hematology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Cecilia Jimenez-Mallebrera
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Artuch
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Vidal S, Brandi N, Pacheco P, Maynou J, Fernandez G, Xiol C, Pascual-Alonso A, Pineda M, Armstrong J, Garcia-Cazorla À, del Carmen Serrano Munuera M, García SC, Troncoso M, Fariña G, García Peñas JJ, Fournier BG, León SR, Guitart M, Baena N, de Nanclares GP, Oci IO, Gutiérrez-Delicado E, Abarrategui B, Barroso E, Santos-Simarro F, Lapunzina P, García FJ, Acedo JM, García A, Martinez MA, Martínez-Bermejo A. The most recurrent monogenic disorders that overlap with the phenotype of Rett syndrome. Eur J Paediatr Neurol 2019; 23:609-620. [PMID: 31105003 DOI: 10.1016/j.ejpn.2019.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/12/2019] [Accepted: 04/28/2019] [Indexed: 12/30/2022]
Abstract
Rett syndrome (RTT) is an early-onset neurodevelopmental disorder that is caused by mutations in the MECP2 gene; however, defects in other genes (CDKL5 and FOXG1) can lead to presentations that resemble classic RTT, although they are not completely identical. Here, we attempted to identify other monogenic disorders that share features of RTT. A total of 437 patients with a clinical diagnosis of RTT-like were studied; in 242 patients, a custom panel with 17 genes related to an RTT-like phenotype was run via a HaloPlex-Target-Enrichment-System. In the remaining 195 patients, a commercial TruSight-One-Sequencing-Panel was analysed. A total of 40 patients with clinical features of RTT had variants which affect gene function in six genes associated with other monogenic disorders. Twelve patients had variants in STXBP1, nine in TCF4, six in SCN2A, five in KCNQ2, four in MEF2C and four in SYNGAP1. Genetic studies using next generation sequencing (NGS) allowed us to study a larger number of genes associated with RTT-like simultaneously, providing a genetic diagnosis for a wider group of patients. These new findings provide the clinician with more information and clues that could help in the prevention of future symptoms or in pharmacologic therapy.
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Affiliation(s)
- S Vidal
- Sant Joan de Déu Research Foundation, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - N Brandi
- School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - P Pacheco
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - J Maynou
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - G Fernandez
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - C Xiol
- Sant Joan de Déu Research Foundation, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - A Pascual-Alonso
- Sant Joan de Déu Research Foundation, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - M Pineda
- Sant Joan de Déu Research Foundation, Barcelona, Spain
| | | | - J Armstrong
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; CIBER-ER (Biomedical Network Research Center for Rare Diseases), Institute of Health Carlos III (ISCIII), Madrid, Spain.
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Abstract
The specialty of inherited metabolic disease is at the forefront of progress in medicine, with new methods in metabolomics and genomics identifying the molecular basis for a growing number of conditions and syndromes. This review presents an updated pathophysiologic classification of inborn errors of metabolism and a method of clinical screening in neonates, late-onset emergencies, neurologic deterioration, and other common clinical scenarios. When and how to investigate a metabolic disorder is presented to encourage physicians to use sophisticated biochemical investigations and not miss a treatable disorder.
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Affiliation(s)
- Jean-Marie Saudubray
- Department of Neurology, Neurometabolic Unit, Hopital Pitié Salpétrière, 47-83 Boulevard de l'Hopital, Paris 75013, France.
| | - Àngels Garcia-Cazorla
- Neurology Department, Neurometabolic Unit, Hospital Sant Joan de Deu and CIBERER-ISCIII, Passeig Sant Joan de Deu 28950 Esplugues de Llobregat, Barcelona, Spain
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6
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Vidal S, Brandi N, Pacheco P, Gerotina E, Blasco L, Trotta JR, Derdak S, Del Mar O'Callaghan M, Garcia-Cazorla À, Pineda M, Armstrong J. The utility of Next Generation Sequencing for molecular diagnostics in Rett syndrome. Sci Rep 2017; 7:12288. [PMID: 28947817 PMCID: PMC5613000 DOI: 10.1038/s41598-017-11620-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/29/2017] [Indexed: 02/07/2023] Open
Abstract
Rett syndrome (RTT) is an early-onset neurodevelopmental disorder that almost exclusively affects girls and is totally disabling. Three genes have been identified that cause RTT: MECP2, CDKL5 and FOXG1. However, the etiology of some of RTT patients still remains unknown. Recently, next generation sequencing (NGS) has promoted genetic diagnoses because of the quickness and affordability of the method. To evaluate the usefulness of NGS in genetic diagnosis, we present the genetic study of RTT-like patients using different techniques based on this technology. We studied 1577 patients with RTT-like clinical diagnoses and reviewed patients who were previously studied and thought to have RTT genes by Sanger sequencing. Genetically, 477 of 1577 patients with a RTT-like suspicion have been diagnosed. Positive results were found in 30% by Sanger sequencing, 23% with a custom panel, 24% with a commercial panel and 32% with whole exome sequencing. A genetic study using NGS allows the study of a larger number of genes associated with RTT-like symptoms simultaneously, providing genetic study of a wider group of patients as well as significantly reducing the response time and cost of the study.
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Affiliation(s)
- Silvia Vidal
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Núria Brandi
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Paola Pacheco
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Edgar Gerotina
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Laura Blasco
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jean-Rémi Trotta
- Centro Nacional de Análisis Genómica (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Sophia Derdak
- Centro Nacional de Análisis Genómica (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Maria Del Mar O'Callaghan
- Neurology Service, Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Àngels Garcia-Cazorla
- Neurology Service, Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Pineda
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Judith Armstrong
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain.
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain.
- CIBER-ER (Biomedical Network Research Center for Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain.
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Díez H, Cortès-Saladelafont E, Ormazábal A, Marmiese AF, Armstrong J, Matalonga L, Bravo M, Briones P, Emperador S, Montoya J, Artuch R, Giros M, Garcia-Cazorla À. Severe infantile parkinsonism because of a de novo mutation on DLP1
mitochondrial-peroxisomal protein. Mov Disord 2017; 32:1108-1110. [DOI: 10.1002/mds.27021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/22/2017] [Accepted: 03/13/2017] [Indexed: 01/19/2023] Open
Affiliation(s)
- H. Díez
- Synaptic Metabolism Laboratory; Hospital Sant Joan de Déu, Institut de Recerca Pediatric; Barcelona Spain
| | - E. Cortès-Saladelafont
- Department of Neurology; Hospital Sant Joan de Déu, Institut de Recerca Pediatric; Barcelona Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
| | - A. Ormazábal
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Department of Clinical Biochemistry and Institut d'Investigació Sanitària Sant Joan de Déu; Hospital Sant Joan de Déu; Barcelona Spain
| | - A. Fernández Marmiese
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases; Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela; Santiago de Compostela Spain
| | - J. Armstrong
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Department of Clinical Biochemistry and Institut d'Investigació Sanitària Sant Joan de Déu; Hospital Sant Joan de Déu; Barcelona Spain
| | - Leslie Matalonga
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Hospital Clinic-IBC, IDIBAPS; Barcelona Spain
| | - Miren Bravo
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Hospital Clinic-IBC, IDIBAPS; Barcelona Spain
| | - Paz Briones
- Institut de Bioquímica Clínica; Hospital Clínic i Provincial; Barcelona Spain
| | - Sonia Emperador
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Department of Biochemistry; Molecular and Cellular Biology, Universidad de Zaragoza; Zaragoza Spain
| | - Julio Montoya
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Department of Biochemistry; Molecular and Cellular Biology, Universidad de Zaragoza; Zaragoza Spain
| | - Rafael Artuch
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Department of Clinical Biochemistry and Institut d'Investigació Sanitària Sant Joan de Déu; Hospital Sant Joan de Déu; Barcelona Spain
| | - Marisa Giros
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
- Hospital Clinic-IBC, IDIBAPS; Barcelona Spain
| | - Àngels Garcia-Cazorla
- Synaptic Metabolism Laboratory; Hospital Sant Joan de Déu, Institut de Recerca Pediatric; Barcelona Spain
- Department of Neurology; Hospital Sant Joan de Déu, Institut de Recerca Pediatric; Barcelona Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras; Instituto de Salud Carlos III; Barcelona Spain
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Nascimento A, Ortez C, Jou C, O'Callaghan M, Ramos F, Garcia-Cazorla À. Neuromuscular Manifestations in Mitochondrial Diseases in Children. Semin Pediatr Neurol 2016; 23:290-305. [PMID: 28284391 DOI: 10.1016/j.spen.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Mitochondrial diseases exhibit significant clinical and genetic heterogeneity. Mitochondria are highly dynamic organelles that are the major contributor of adenosine triphosphate, through oxidative phosphorylation. These disorders may be developed at any age, with isolated or multiple system involvement, and in any pattern of inheritance. Defects in the mitochondrial respiratory chain impair energy production and almost invariably involve skeletal muscle and peripheral nerves, causing exercise intolerance, cramps, recurrent myoglobinuria, or fixed weakness, which often affects extraocular muscles and results in droopy eyelids (ptosis), progressive external ophthalmoplegia, peripheral ataxia, and peripheral polyneuropathy. This review describes the main neuromuscular symptomatology through different syndromes reported in the literature and from our experience. We want to highlight the importance of searching for the "clue clinical signs" associated with inheritance pattern as key elements to guide the complex diagnosis process and genetic studies in mitochondrial diseases.
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Affiliation(s)
- Andrés Nascimento
- Department of Neurology, Neuromuscular Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBERER), Institute of Pediatric Research Sant Joan de Déu, Madrid, Spain.
| | - Carlos Ortez
- Department of Neurology, Neuromuscular Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain
| | - Cristina Jou
- Department of Neurology, Neuromuscular Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBERER), Institute of Pediatric Research Sant Joan de Déu, Madrid, Spain
| | - Mar O'Callaghan
- Center for Biomedical Research on Rare Diseases (CIBERER), Institute of Pediatric Research Sant Joan de Déu, Madrid, Spain; Department of Neurology, Neurometabolic Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain
| | - Federico Ramos
- Center for Biomedical Research on Rare Diseases (CIBERER), Institute of Pediatric Research Sant Joan de Déu, Madrid, Spain; Department of Neurology, Neurometabolic Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain
| | - Àngels Garcia-Cazorla
- Center for Biomedical Research on Rare Diseases (CIBERER), Institute of Pediatric Research Sant Joan de Déu, Madrid, Spain; Department of Neurology, Neurometabolic Units, Hospital Sant Joan de Déu, Instituto de Salud Carlos III, Barcelona, Spain
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Opladen T, Cortès-Saladelafont E, Mastrangelo M, Horvath G, Pons R, Lopez-Laso E, Fernández-Ramos JA, Honzik T, Pearson T, Friedman J, Scholl-Bürgi S, Wassenberg T, Jung-Klawitter S, Kuseyri O, Jeltsch K, Kurian MA, Garcia-Cazorla À. The International Working Group on Neurotransmitter related Disorders (iNTD): A worldwide research project focused on primary and secondary neurotransmitter disorders. Mol Genet Metab Rep 2016; 9:61-66. [PMID: 27830117 PMCID: PMC5094101 DOI: 10.1016/j.ymgmr.2016.09.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/29/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Neurotransmitters are chemical messengers that enable communication between the neurons in the synaptic cleft. Inborn errors of neurotransmitter biosynthesis, breakdown and transport are a group of very rare neurometabolic diseases resulting in neurological impairment at any age from newborn to adulthood. Methods and results The International Working Group on Neurotransmitter related Disorders (iNTD) is the first international network focusing on the study of primary and secondary neurotransmitter disorders. It was founded with the aim to foster exchange and improve knowledge in the field of these rare diseases. The newly established iNTD patient registry for neurotransmitter related diseases collects longitudinal data on the natural disease course, approach to diagnosis, therapeutic strategies, and quality of life of affected patients. The registry forms the evidence base for the development of consensus guidelines for patients with neurotransmitter related disorders. Conclusion The iNTD network and registry will improve knowledge and strengthen research capacities in the field of inborn neurotransmitter disorders. The evidence-based guidelines will facilitate standardized diagnostic procedures and treatment approaches.
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Key Words
- 3-PGDH, 3-phosphoglycerat dehydrogenase
- 3-PGH, 3-phosphoglycerat dehydrogenase
- 3-PSP, 3-phosphoserine phosphatase
- 5-MTHF, 5-methyltetrahydrofolate
- AADC, aromatic l-amino acid decarboxylase
- AR/ADGTPCH, autosomal recessive/dominant GTP-cyclohydrolase deficiency
- BH4, tetrahydrobiopterin
- DAT, dopamine transporter
- DHFR, dihydrofolate reductase deficiency
- DHPR, dihydropteridine reductase
- Database
- Dopamine
- DßH, dopamine β-hydroxylase
- FOLR1, folate receptor alpha
- GABA
- GABA, gamma aminobutyric acid
- Glycine
- Guideline
- MAOA, monoamine oxidase A
- NKH, nonketotic hyperglycinemia
- NOS, nitric oxide synthase
- Network
- Neurotransmitter
- PAH, phenylalanine hydroxylase
- PSAT, phosphoserine aminotransferase
- PTPS, 6-pyruvoyl-tetrahydropterin synthase
- Patient registry
- SR, sepiapterin reductase
- SSADH, succinic semialdehyde dehydrogenase
- Serine
- Serotonin
- TH, tyrosine hydroxylase
- TPH, tryptophan hydroxylase
- VMAT, vesicular monoamine transporter
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Affiliation(s)
- Thomas Opladen
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Germany
| | | | - Mario Mastrangelo
- Department of Pediatrics and Child Neuropsychiatry, Sapienza Università di Roma, Rome, Italy
| | - Gabriella Horvath
- Division of Biochemical Diseases, BC, Childrens Hospital, Vancouver, Canada
| | - Roser Pons
- First Department of Pediatrics, Pediatric Neurology Unit, Agia Sofia Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eduardo Lopez-Laso
- Department of Pediatric Neurology, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, CIBERER-ISCIII, Cordoba, Spain
| | - Joaquín A Fernández-Ramos
- Department of Pediatric Neurology, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, CIBERER-ISCIII, Cordoba, Spain
| | - Tomas Honzik
- Dep. of Pediatrics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Toni Pearson
- Department of Neurology, Washington University School of Medicine, St. Louis, USA
| | - Jennifer Friedman
- Department of Neurosciences, University of California San Diego, Division of Neurology Rady Children's Hospital, Rady Children's Institute Genomic Medicine, San Diego, USA
| | - Sabine Scholl-Bürgi
- Department of Pediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Tessa Wassenberg
- Department of Neurology and Child Neurology, Radboudumc Nijmegen, Donders Institute of Brain Cognition and Behaviour, The Netherlands
| | - Sabine Jung-Klawitter
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Germany
| | - Oya Kuseyri
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Germany
| | - Kathrin Jeltsch
- Division of Child Neurology and Metabolic Diseases, University Children's Hospital Heidelberg, Germany
| | - Manju A Kurian
- Developmental Neurosciences, UCL- Institute of Child Health and Department of Neurology, Great Ormond Street Hospital for Children NHS Foundations Trust, London, United Kingdom
| | - Àngels Garcia-Cazorla
- Department of Child Neurology, Neurometabolic Unit, CIBERER-ISCIII, Hospital Sant Joan de Déu Barcelona, Spain
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Tristán-Noguero A, Díez H, Jou C, Pineda M, Ormazábal A, Sánchez A, Artuch R, Garcia-Cazorla À. Study of a fetal brain affected by a severe form of tyrosine hydroxylase deficiency, a rare cause of early parkinsonism. Metab Brain Dis 2016; 31:705-9. [PMID: 26686676 DOI: 10.1007/s11011-015-9780-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 12/11/2015] [Indexed: 01/26/2023]
Abstract
Tyrosine hydroxylase (TH) deficiency is an inborn error of dopamine synthesis. Two clinical phenotypes have been described. The THD "B" phenotype produces a severe encephalopathy of early-onset with sub-optimal L-Dopa response, whereas the "A" phenotype has a better L-Dopa response and outcome. The objective of the study is to describe the expression of key synaptic proteins and neurodevelopmental markers in a fetal brain of THD "B" phenotype. The brain of a 16-week-old miscarried human fetus was dissected in different brain areas and frozen until the analysis. TH gene study revealed the p.R328W/p.T399M mutations, the same mutations that produced a B phenotype in her sister. After protein extraction, western blot analyses were performed to assess protein expression. The results were compared to an age-matched control. We observed a decreased expression in TH and in other dopaminergic proteins, such as VMAT 1 and 2 and dopamine receptors, especially D2DR. GABAergic and glutamatergic proteins such as GABA VT, NMDAR1 and calbindin were also altered. Developmental markers for synapses, axons and dendrites were decreased whereas markers of neuronal volume were preserved. Although this is an isolated case, this brain sample is unique and corresponds to the first reported study of a THD brain. It provides interesting information about the influence of dopamine as a regulator of other neurotransmitter systems, brain development and movement disorders with origin at the embryological state. This study could also contribute to a better understanding of the pathophysiology of THD at early fetal stages.
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Affiliation(s)
- Alba Tristán-Noguero
- Laboratory of Synaptic Metabolism, Fundació Sant Joan de Déu (FSJD), Barcelona, Spain
- Department of Neurology, Hospital Sant Joan de Déu (HSJD), Passeig Sant Joan de Déu, 2, Esplugues, 08950,, Barcelona, Spain
| | - Héctor Díez
- Laboratory of Synaptic Metabolism, Fundació Sant Joan de Déu (FSJD), Barcelona, Spain
- Department of Neurology, Hospital Sant Joan de Déu (HSJD), Passeig Sant Joan de Déu, 2, Esplugues, 08950,, Barcelona, Spain
| | - Cristina Jou
- Department of Pathology, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | - Mercè Pineda
- Department of Neurology, Hospital Sant Joan de Déu (HSJD), Passeig Sant Joan de Déu, 2, Esplugues, 08950,, Barcelona, Spain
- CIBERER (Biomedical Network Research Centre on Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Ormazábal
- Department of Clinical Biochemistry, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
- CIBERER (Biomedical Network Research Centre on Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Sánchez
- CIBERER (Biomedical Network Research Centre on Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
- Servei de Bioquímica i Genètica Molecular and IDIBAPS, Hospital Clínic, Barcelona, Spain
| | - Rafael Artuch
- Department of Clinical Biochemistry, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
- CIBERER (Biomedical Network Research Centre on Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Àngels Garcia-Cazorla
- Laboratory of Synaptic Metabolism, Fundació Sant Joan de Déu (FSJD), Barcelona, Spain.
- Department of Neurology, Hospital Sant Joan de Déu (HSJD), Passeig Sant Joan de Déu, 2, Esplugues, 08950,, Barcelona, Spain.
- CIBERER (Biomedical Network Research Centre on Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain.
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11
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Yubero D, Brandi N, Ormazabal A, Garcia-Cazorla À, Pérez-Dueñas B, Campistol J, Ribes A, Palau F, Artuch R, Armstrong J. Targeted Next Generation Sequencing in Patients with Inborn Errors of Metabolism. PLoS One 2016; 11:e0156359. [PMID: 27243974 PMCID: PMC4887012 DOI: 10.1371/journal.pone.0156359] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/12/2016] [Indexed: 12/11/2022] Open
Abstract
Background Next-generation sequencing (NGS) technology has allowed the promotion of genetic diagnosis and are becoming increasingly inexpensive and faster. To evaluate the utility of NGS in the clinical field, a targeted genetic panel approach was designed for the diagnosis of a set of inborn errors of metabolism (IEM). The final aim of the study was to compare the findings for the diagnostic yield of NGS in patients who presented with consistent clinical and biochemical suspicion of IEM with those obtained for patients who did not have specific biomarkers. Methods The subjects studied (n = 146) were classified into two categories: Group 1 (n = 81), which consisted of patients with clinical and biochemical suspicion of IEM, and Group 2 (n = 65), which consisted of IEM cases with clinical suspicion and unspecific biomarkers. A total of 171 genes were analyzed using a custom targeted panel of genes followed by Sanger validation. Results Genetic diagnosis was achieved in 50% of patients (73/146). In addition, the diagnostic yield obtained for Group 1 was 78% (63/81), and this rate decreased to 15.4% (10/65) in Group 2 (X2 = 76.171; p < 0.0001). Conclusions A rapid and effective genetic diagnosis was achieved in our cohort, particularly the group that had both clinical and biochemical indications for the diagnosis.
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Affiliation(s)
- Dèlia Yubero
- Department of Clinical Biochemistry and Institut d’Investigació Sanitària Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Núria Brandi
- Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Aida Ormazabal
- Department of Clinical Biochemistry and Institut d’Investigació Sanitària Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Àngels Garcia-Cazorla
- Department of Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Belén Pérez-Dueñas
- Department of Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Jaime Campistol
- Department of Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Antonia Ribes
- Institut de Bioquímica Clínica, Hospital Clínic i Provincial, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Francesc Palau
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Rafael Artuch
- Department of Clinical Biochemistry and Institut d’Investigació Sanitària Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Judith Armstrong
- Molecular and Genetics Medicine Section, Hospital Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- * E-mail:
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12
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Cortès-Saladelafont E, Molero-Luis M, Ormazábal A, Tristán-Noguero A, Sierra C, Armstrong J, Artuch R, Garcia-Cazorla À. Diagnosis of Biogenic Amines Synthesis Defects. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1558865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Marta Molero-Luis
- Department of Genetics and Biochemistry, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Aida Ormazábal
- Department of Genetics and Biochemistry, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Tristán-Noguero
- Department of Neurology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Sierra
- Department of Genetics and Biochemistry, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Judith Armstrong
- Department of Genetics and Biochemistry, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Rafael Artuch
- Department of Genetics and Biochemistry, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Àngels Garcia-Cazorla
- Department of Neurology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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13
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Bachmann-Gagescu R, Dempsey JC, Phelps IG, O'Roak BJ, Knutzen DM, Rue TC, Ishak GE, Isabella CR, Gorden N, Adkins J, Boyle EA, de Lacy N, O'Day D, Alswaid A, Ramadevi A R, Lingappa L, Lourenço C, Martorell L, Garcia-Cazorla À, Ozyürek H, Haliloğlu G, Tuysuz B, Topçu M, Chance P, Parisi MA, Glass IA, Shendure J, Doherty D. Joubert syndrome: a model for untangling recessive disorders with extreme genetic heterogeneity. J Med Genet 2015; 52:514-22. [PMID: 26092869 PMCID: PMC5082428 DOI: 10.1136/jmedgenet-2015-103087] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/01/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Joubert syndrome (JS) is a recessive neurodevelopmental disorder characterised by hypotonia, ataxia, cognitive impairment, abnormal eye movements, respiratory control disturbances and a distinctive mid-hindbrain malformation. JS demonstrates substantial phenotypic variability and genetic heterogeneity. This study provides a comprehensive view of the current genetic basis, phenotypic range and gene-phenotype associations in JS. METHODS We sequenced 27 JS-associated genes in 440 affected individuals (375 families) from a cohort of 532 individuals (440 families) with JS, using molecular inversion probe-based targeted capture and next-generation sequencing. Variant pathogenicity was defined using the Combined Annotation Dependent Depletion algorithm with an optimised score cut-off. RESULTS We identified presumed causal variants in 62% of pedigrees, including the first B9D2 mutations associated with JS. 253 different mutations in 23 genes highlight the extreme genetic heterogeneity of JS. Phenotypic analysis revealed that only 34% of individuals have a 'pure JS' phenotype. Retinal disease is present in 30% of individuals, renal disease in 25%, coloboma in 17%, polydactyly in 15%, liver fibrosis in 14% and encephalocele in 8%. Loss of CEP290 function is associated with retinal dystrophy, while loss of TMEM67 function is associated with liver fibrosis and coloboma, but we observe no clear-cut distinction between JS subtypes. CONCLUSIONS This work illustrates how combining advanced sequencing techniques with phenotypic data addresses extreme genetic heterogeneity to provide diagnostic and carrier testing, guide medical monitoring for progressive complications, facilitate interpretation of genome-wide sequencing results in individuals with a variety of phenotypes and enable gene-specific treatments in the future.
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Affiliation(s)
- R Bachmann-Gagescu
- Institute for Molecular Life Sciences and Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - J C Dempsey
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - I G Phelps
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - B J O'Roak
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - D M Knutzen
- Department of Oncology, Franciscan Health System, Tacoma, Washington, USA
| | - T C Rue
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - G E Ishak
- Department of Radiology, University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - C R Isabella
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - N Gorden
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - J Adkins
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - E A Boyle
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - N de Lacy
- Department of Psychiatry, University of Washington, Seattle, Washington, USA
| | - D O'Day
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - A Alswaid
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - L Lingappa
- Department of Child Neurology, Rainbow Children Hospital, Hyderabad, India
| | - C Lourenço
- Department of Neurosciences and Behavior Neurosciences, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - L Martorell
- Department of Genetica Molecular, Hospital Sant Joan de Deu, Barcelona, Spain
| | - À Garcia-Cazorla
- Department of Neurology, Neurometabolic Unit, Hospital Sant Joan de Déu and CIBERER, ISCIII, Barcelona, Spain
| | - H Ozyürek
- Department of Pediatric Neurology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - G Haliloğlu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - B Tuysuz
- Department of Pediatric Genetics, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - M Topçu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - P Chance
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - M A Parisi
- National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - I A Glass
- Department of Pediatrics, University of Washington, Seattle, Washington, USA Seattle Children's Research Institute, Seattle, Washington, USA
| | - J Shendure
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - D Doherty
- Department of Pediatrics, University of Washington, Seattle, Washington, USA Seattle Children's Research Institute, Seattle, Washington, USA
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Fernandes TG, Duarte ST, Ghazvini M, Gaspar C, Santos DC, Porteira AR, Rodrigues GMC, Haupt S, Rombo DM, Armstrong J, Sebastião AM, Gribnau J, Garcia-Cazorla À, Brüstle O, Henrique D, Cabral JMS, Diogo MM. Neural commitment of human pluripotent stem cells under defined conditions recapitulates neural development and generates patient-specific neural cells. Biotechnol J 2015; 10:1578-88. [DOI: 10.1002/biot.201400751] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/09/2015] [Accepted: 05/22/2015] [Indexed: 12/13/2022]
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15
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Garcia-Cazorla À, Mochel F, Lamari F, Saudubray JM. The clinical spectrum of inherited diseases involved in the synthesis and remodeling of complex lipids. A tentative overview. J Inherit Metab Dis 2015; 38:19-40. [PMID: 25413954 DOI: 10.1007/s10545-014-9776-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/16/2014] [Accepted: 09/23/2014] [Indexed: 12/19/2022]
Abstract
Over one hundred diseases related to inherited defects of complex lipids synthesis and remodeling are now reported. Most of them were described within the last 5 years. New descriptions and phenotypes are expanding rapidly. While the associated clinical phenotype is currently difficult to outline, with only a few patients identified, it appears that all organs and systems may be affected. The main clinical presentations can be divided into (1) Diseases affecting the central and peripheral nervous system. Complex lipid synthesis disorders produce prominent motor manifestations due to upper and/or lower motoneuron degeneration. Motor signs are often complex, associated with other neurological and extra-neurological signs. Three neurological phenotypes, spastic paraparesis, neurodegeneration with brain iron accumulation and peripheral neuropathies, deserve special attention. Many apparently well clinically defined syndromes are not distinct entities, but rather clusters on a continuous spectrum, like for the PNPLA6-associated diseases, extending from Boucher-Neuhauser syndrome via Gordon Holmes syndrome to spastic ataxia and pure hereditary spastic paraplegia; (2) Muscular/cardiac presentations; (3) Skin symptoms mostly represented by syndromic (neurocutaneous) and non syndromic ichthyosis; (4) Retinal dystrophies with syndromic and non syndromic retinitis pigmentosa, Leber congenital amaurosis, cone rod dystrophy, Stargardt disease; (5) Congenital bone dysplasia and segmental overgrowth disorders with congenital lipomatosis; (6) Liver presentations characterized mainly by transient neonatal cholestatic jaundice and non alcoholic liver steatosis with hypertriglyceridemia; and (7) Renal and immune presentations. Lipidomics and molecular functional studies could help to elucidate the mechanism(s) of dominant versus recessive inheritance observed for the same gene in a growing number of these disorders.
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Affiliation(s)
- Àngels Garcia-Cazorla
- Department of Neurology, Neurometabolic Unit, Hospital Sant Joan de Déu and CIBERER, ISCIII, Barcelona, Spain,
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16
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Quijada-Fraile P, O'Callaghan M, Martín-Hernández E, Montero R, Garcia-Cazorla À, de Aragón AM, Muchart J, Málaga I, Pardo R, García-Gonzalez P, Jou C, Montoya J, Emperador S, Ruiz-Pesini E, Arenas J, Martin MA, Ormazabal A, Pineda M, García-Silva MT, Artuch R. Follow-up of folinic acid supplementation for patients with cerebral folate deficiency and Kearns-Sayre syndrome. Orphanet J Rare Dis 2014; 9:217. [PMID: 25539952 PMCID: PMC4302586 DOI: 10.1186/s13023-014-0217-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/18/2014] [Indexed: 01/09/2023] Open
Abstract
Background Kearns-Sayre syndrome (KSS) is a mitochondrial DNA deletion syndrome that presents with profound cerebral folate deficiency and other features. Preliminary data support the notion that folinic acid therapy might be useful in the treatment of KSS patients. Our aim was to assess the clinical and neuroimaging outcomes of KSS patients receiving folinic acid therapy. Methods Patients: We recruited eight patients with diagnoses of KSS. Four cases were treated at 12 de Octubre Hospital, and the other two cases were treated at Sant Joan de Déu Hospital. Two patients refused to participate in the treatment protocol. Methods: Clinical, biochemical and neuroimaging data (magnetic resonance imaging or computed tomography scan) were collected in baseline conditions and at different time points after the initiation of therapy. Cerebrospinal fluid 5-methyltetrahydrofolate levels were analysed with HPLC and fluorescence detection. Large-scale mitochondrial DNA deletions were analysed by Southern blot. Treatment protocol: The follow-up periods ranged from one to eight years. Cases 1–4 received oral folinic acid at a dose of 1 mg/kg/day, and cases 6 and 8 received 3 mg/kg/day. Results No adverse effects of folinic acid treatment were observed. Cerebral 5-methyltetrahydrofolate deficiencies were observed in all cases in the baseline conditions. Moreover, all three patients who accepted lumbar puncture after folinic acid therapy exhibited complete recoveries of their decreased basal cerebrospinal fluid 5-methyltetrahydrofolate levels to normal values. Two cases neurologically improved after folinic therapy. Disease worsened in the other patients. Post-treatment neuroimaging was performed for the 6 cases that received folinic acid therapy. One patient exhibited improvements in white matter abnormalities. The remaining patients displayed progressions in subcortical cerebral white matter, the cerebellum and cerebral atrophy. Conclusions Four patients exhibited clinical and radiological progression of the disease following folinic acid treatment. Only one patient who was treated in an early stage of the disease exhibited both neurological and radiological improvements following elevated doses of folinic acid, and an additional patient experienced neurological improvement. Early treatment with high-dose folinic acid therapy seems to be advisable for the treatment of KSS. Trial registration EudracT2007-00-6748-23 Electronic supplementary material The online version of this article (doi:10.1186/s13023-014-0217-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pilar Quijada-Fraile
- Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain.
| | - Mar O'Callaghan
- Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Elena Martín-Hernández
- Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain.
| | - Raquel Montero
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Àngels Garcia-Cazorla
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Ana Martínez de Aragón
- Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain.
| | - Jordi Muchart
- Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Ignacio Málaga
- Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - Rafael Pardo
- Servicios de Pediatría y Radiología, Hospital de Cabueñes, Asturias, Spain.
| | | | - Cristina Jou
- Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Julio Montoya
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
| | - Sonia Emperador
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
| | - Eduardo Ruiz-Pesini
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
| | - Joaquín Arenas
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Mitochondrial Diseases Laboratory, Hospital 12 de Octubre Research Institute (i + 12), Madrid, Spain.
| | - Miguel Angel Martin
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Mitochondrial Diseases Laboratory, Hospital 12 de Octubre Research Institute (i + 12), Madrid, Spain.
| | - Aida Ormazabal
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - Mercè Pineda
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
| | - María T García-Silva
- Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain. .,Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain.
| | - Rafael Artuch
- Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. .,Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain.
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Molero-Luis M, Fernández-Ureña S, Jordán I, Serrano M, Ormazábal A, Garcia-Cazorla À, Artuch R. Cerebrospinal fluid neopterin analysis in neuropediatric patients: establishment of a new cut off-value for the identification of inflammatory-immune mediated processes. PLoS One 2013; 8:e83237. [PMID: 24367586 PMCID: PMC3867431 DOI: 10.1371/journal.pone.0083237] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 11/01/2013] [Indexed: 12/02/2022] Open
Abstract
Objective A high level of cerebrospinal fluid (CSF) neopterin is a marker of central nervous system inflammatory-immune mediated processes. We aimed to assess data from 606 neuropediatric patients, describing the clinical and biochemical features of those neurological disorders presenting CSF neopterin values above a new cut-off value that was defined in our laboratory. Methods To establish the new CSF neopterin cut-off value, we studied two groups of patients: Group 1 comprised 68 patients with meningoencephalitis, and Group 2 comprised 52 children with a confirmed peripheral infection and no central nervous system involvement. We studied 606 CSF samples from neuropediatric patients who were classified into 3 groups: genetic diagnosis (A), acquired/unknown etiologic neurologic diseases (B) and inflammatory-immune mediated processes (C). Results The CSF neopterin cut-off value was 61 nmol/L. Out of 606 cases, 56 presented a CSF neopterin level above this value. Group C had significantly higher CSF neopterin, protein and leukocyte values than the other groups. Sixteen of twenty-three patients in this group had a CSF neopterin level above the cut-off, whereas three and seven patients presented increased leukocyte and protein values, respectively. A significant association was found among CSF neopterin, proteins and leukocytes in the 606 patients. White matter disturbances were associated with high CSF neopterin concentrations. Conclusions Although children with inflammatory-immune mediated processes presented higher CSF neopterin values, patients with other neurological disorders also showed increased CSF neopterin concentrations. These results stress the importance of CSF neopterin analysis for the identification of inflammatory-immune mediated processes.
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Affiliation(s)
- Marta Molero-Luis
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
- * E-mail:
| | - Sergio Fernández-Ureña
- Intensive Pediatric Care Unit Service, University Hospital Saint Joan de Déu, Barcelona, Spain
| | - Iolanda Jordán
- Intensive Pediatric Care Unit Service, University Hospital Saint Joan de Déu, Barcelona, Spain
| | - Mercedes Serrano
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Aida Ormazábal
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Àngels Garcia-Cazorla
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Rafael Artuch
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - the Neopterin working group
- Clinical Biochemistry and Neuropediatrc Departments, University Hospital Sant Joan de Déu, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
- Intensive Pediatric Care Unit Service, University Hospital Saint Joan de Déu, Barcelona, Spain
- Molecular Microbiology Department, Microbiology Service, University Hospital Sant Joan de Déu, Barcelona, Spain
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