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Cárcel-Márquez J, Muiño E, Gallego-Fabrega C, Cullell N, Lledós M, Llucià-Carol L, Sobrino T, Campos F, Castillo J, Freijo M, Arenillas JF, Obach V, Álvarez-Sabín J, Molina CA, Ribó M, Jiménez-Conde J, Roquer J, Muñoz-Narbona L, Lopez-Cancio E, Millán M, Diaz-Navarro R, Vives-Bauza C, Serrano-Heras G, Segura T, Ibañez L, Heitsch L, Delgado P, Dhar R, Krupinski J, Delgado-Mederos R, Prats-Sánchez L, Camps-Renom P, Blay N, Sumoy L, de Cid R, Montaner J, Cruchaga C, Lee JM, Martí-Fàbregas J, Férnandez-Cadenas I. A Polygenic Risk Score Based on a Cardioembolic Stroke Multitrait Analysis Improves a Clinical Prediction Model for This Stroke Subtype. Front Cardiovasc Med 2022; 9:940696. [PMID: 35872910 PMCID: PMC9304625 DOI: 10.3389/fcvm.2022.940696] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Occult atrial fibrillation (AF) is one of the major causes of embolic stroke of undetermined source (ESUS). Knowing the underlying etiology of an ESUS will reduce stroke recurrence and/or unnecessary use of anticoagulants. Understanding cardioembolic strokes (CES), whose main cause is AF, will provide tools to select patients who would benefit from anticoagulants among those with ESUS or AF. We aimed to discover novel loci associated with CES and create a polygenetic risk score (PRS) for a more efficient CES risk stratification. Methods Multitrait analysis of GWAS (MTAG) was performed with MEGASTROKE-CES cohort (n = 362,661) and AF cohort (n = 1,030,836). We considered significant variants and replicated those variants with MTAG p-value < 5 × 10−8 influencing both traits (GWAS-pairwise) with a p-value < 0.05 in the original GWAS and in an independent cohort (n = 9,105). The PRS was created with PRSice-2 and evaluated in the independent cohort. Results We found and replicated eleven loci associated with CES. Eight were novel loci. Seven of them had been previously associated with AF, namely, CAV1, ESR2, GORAB, IGF1R, NEURL1, WIPF1, and ZEB2. KIAA1755 locus had never been associated with CES/AF, leading its index variant to a missense change (R1045W). The PRS generated has been significantly associated with CES improving discrimination and patient reclassification of a model with age, sex, and hypertension. Conclusion The loci found significantly associated with CES in the MTAG, together with the creation of a PRS that improves the predictive clinical models of CES, might help guide future clinical trials of anticoagulant therapy in patients with ESUS or AF.
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Affiliation(s)
- Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Stroke Pharmacogenomics and Genetics Laboratory, Fundación Docència i Recerca Mútua Terrassa, Hospital Mútua Terrassa, Terrassa, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Department de Genética i de Microbiologia, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Marimar Freijo
- Department of Neurology, Biocruces-Bizkaia Health Research Institute, Bilbao, Spain
| | | | - Victor Obach
- Department of Neurology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - José Álvarez-Sabín
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos A. Molina
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Marc Ribó
- Stroke Unit, Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi Jiménez-Conde
- Department of Neurology, IMIM-Hospital del Mar; Neurovascular Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autònoma de Barcelona/DCEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Jaume Roquer
- Department of Neurology, IMIM-Hospital del Mar; Neurovascular Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universitat Autònoma de Barcelona/DCEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Lucia Muñoz-Narbona
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Lopez-Cancio
- Department of Neurology, University Hospital Central de Asturias (HUCA).Oviedo, Spain
| | - Mònica Millán
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosa Diaz-Navarro
- Department of Neurology, Son Espases University Hospital, Illes Balears Health Research Institute (IdISBa), Palma, Spain
| | - Cristòfol Vives-Bauza
- Department of Neurology, Son Espases University Hospital, Illes Balears Health Research Institute (IdISBa), Palma, Spain
| | | | - Tomás Segura
- Department of Neurology, University Hospital of Albacete, Albacete, Spain
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
| | - Laura Heitsch
- Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Pilar Delgado
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rajat Dhar
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Jerzy Krupinski
- Neurology Service, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Raquel Delgado-Mederos
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Luis Prats-Sánchez
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pol Camps-Renom
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Natalia Blay
- GenomesForLife-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Lauro Sumoy
- High Content Genomics and Bioinformatics Unit, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Rafael de Cid
- GenomesForLife-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Joan Montaner
- Institute de Biomedicine of Seville, IBiS/Hospital Universitario Virgen del Rocío/CSIC/University of Seville and Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States
- Neurogenomics and Informatics Center at Washington University in St. Louis, Saint Louis, MO, United States
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Joan Martí-Fàbregas
- Stroke Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Israel Férnandez-Cadenas
- Stroke Pharmacogenomics and Genetics Group, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- *Correspondence: Israel Férnandez-Cadenas
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Torres-Aguila NP, Carrera C, Giese AK, Cullell N, Muiño E, Cárcel-Márquez J, Gallego-Fabrega C, González-Sánchez J, Del Mar Freijo M, Álvarez-Sabín J, Molina C, Ribó M, Jimenez-Conde J, Roquer J, Sobrino T, Campos F, Castillo J, Muñoz-Narbona L, Lopez-Cancio E, Dàvalos A, Diaz-Navarro R, Tur S, Vives-Bauza C, Serrano-Heras G, Segura T, Krupinski J, Delgado-Mederos R, Martí-Fàbregas J, Heitsch L, Ibañez L, Cruchaga C, Rost NS, Montaner J, Lee JM, Fernandez-Cadenas I. Genome-Wide Association Study of White Blood Cell Counts in Patients With Ischemic Stroke. Stroke 2019; 50:3618-3621. [PMID: 31587654 DOI: 10.1161/strokeaha.119.026593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background and Purpose- Immune cells play a key role in the first 24h poststroke (acute phase), being associated with stroke outcome. We aimed to find genetic risk factors associated with leukocyte counts during the acute phase of stroke. Methods- Ischemic stroke patients with leukocyte counts data during the first 24h were included. Genome-wide association study and gene expression studies were performed. Results- Our genome-wide association study, which included 2064 (Discovery) and 407 (Replication) patients, revealed a new locus (14q24.3) associated with leukocyte counts. After Joint analysis (n=2471) 5 more polymorphisms reached genome-wide significance (P<5×10-8). The 14q24.3 locus was associated with acute stroke outcome (rs112809786, P=0.036) and with ACOT1 and PTGR2 gene expression. Previous polymorphisms associated with leukocyte counts in general-population did not show any significance in our study. Conclusions- We have found the first locus associated with leukocyte counts in ischemic stroke, also associated with acute outcome. Genetic analysis of acute endophenotypes could be useful to find the genetic factors associated with stroke outcome. Our findings suggested a different modulation of immune cells in stroke compared with healthy conditions.
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Affiliation(s)
- Nuria P Torres-Aguila
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.)
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.)
| | - Anne-Katrine Giese
- Neurology Department, Massachusetts General Hospital, Boston (A.-K.G., N.S.R.)
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.)
| | - Elena Muiño
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
| | - Jara Cárcel-Márquez
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
| | - Cristina Gallego-Fabrega
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.)
| | - Jonathan González-Sánchez
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.).,Stroke Pharmacogenomics and Genetics Laboratory, Fundació Mútua Terrasa, Hospital Universitari Mútua Terrassa, Spain (N.C., C.G.-F., J.G.-S.).,School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom (J.G.-S., J.K.)
| | | | - José Álvarez-Sabín
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Carlos Molina
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Marc Ribó
- Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.Á.-S., C.M., M.R.)
| | - Jordi Jimenez-Conde
- Neurology Department, Institut Hospital del Mar d'Investigacions Mèdiques-Hospital del Mar Barcelona, Spain (J.J.-C., J.R.).,Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (J.J.-C., J.R.).,Universitat Autónoma de Barcelona/Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain (J.J.-C., J.R.)
| | - Jaume Roquer
- Neurology Department, Institut Hospital del Mar d'Investigacions Mèdiques-Hospital del Mar Barcelona, Spain (J.J.-C., J.R.).,Neurovascular Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain (J.J.-C., J.R.).,Universitat Autónoma de Barcelona/Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain (J.J.-C., J.R.)
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain (T.S., F.C., J.C.)
| | - Lucia Muñoz-Narbona
- Neurosciences Department, Hospital Germans Trias I Pujol-Universitat Autónoma de Barcelona, Barcelona, Spain (L.M.-N., A.D.)
| | - Elena Lopez-Cancio
- Stroke Unit, Hospital Universitario Central de Asturias, Oviedo, Spain (E.L.-C.)
| | - Antoni Dàvalos
- Neurosciences Department, Hospital Germans Trias I Pujol-Universitat Autónoma de Barcelona, Barcelona, Spain (L.M.-N., A.D.)
| | - Rosa Diaz-Navarro
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Silvia Tur
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Cristòfol Vives-Bauza
- Neuroscience Laboratory, Fundació Institut d'Investigació Sanitària Illes Balears, Mallorca, Spain (R.D.-N., S.T., C.V.-B.)
| | - Gemma Serrano-Heras
- Neurology Department, University Hospital of Albacete, Spain (G.S.-H., T.S.)
| | - Tomás Segura
- Neurology Department, University Hospital of Albacete, Spain (G.S.-H., T.S.)
| | - Jerzy Krupinski
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom (J.G.-S., J.K.).,Neurology Service, Hospital Universitari Mútua Terrassa, Spain (J.K.)
| | - Raquel Delgado-Mederos
- Stroke Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (R.D.-M., J.M.-F.)
| | - Joan Martí-Fàbregas
- Stroke Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (R.D.-M., J.M.-F.)
| | - Laura Heitsch
- Emergency Medicine (L.H.), Washington University School of Medicine, Saint Louis, MO.,Neurology Department (L.H., J.-M.L.), Washington University School of Medicine, Saint Louis, MO
| | - Laura Ibañez
- Psychiatry Department (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Carlos Cruchaga
- Psychiatry Department (L.I., C.C.), Washington University School of Medicine, Saint Louis, MO
| | - Natalia S Rost
- Neurology Department, Massachusetts General Hospital, Boston (A.-K.G., N.S.R.)
| | - Joan Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain (N.P.T.-A., C.C., J.M.).,Stroke Research Program, Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville (J.M.).,Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain (J.M.)
| | - Jin-Moo Lee
- Neurology Department (L.H., J.-M.L.), Washington University School of Medicine, Saint Louis, MO
| | - Israel Fernandez-Cadenas
- From the Stroke Pharmacogenomics and Genetics Laboratory, Hospital de la Santa Creu i Sant Pau Research Institute, Barcelona Spain (N.P.T.-A., E.M., J.C.-M., C.G.-F., J.G.-S., I.F.-C.)
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Arboleya S, Clemente A, Deng S, Bedmar M, Salvador I, Herbera P, Cunill V, Vives-Bauza C, Haro JM, Canellas F, Julià MR. Anti-NMDAR antibodies in new-onset psychosis. Positive results in an HIV-infected patient. Brain Behav Immun 2016; 56:56-60. [PMID: 26996305 DOI: 10.1016/j.bbi.2016.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 10/19/2015] [Revised: 03/07/2016] [Accepted: 03/17/2016] [Indexed: 01/10/2023] Open
Abstract
The role of neuronal surface autoantibodies (NSAs) in non-encephalitic psychosis is of recent and controversial interest. Most of the studies relating NSAs with psychosis are retrospective and only focused on the N-methyl-d-aspartate glutamate receptor (NMDAR). Our goal was to evaluate the prevalence of IgG antibodies against the NMDAR NR1 subunit (NMDAR-Abs) along with five additional NSAs in 61 first psychotic episode patients and 47 matched controls. We found two patients positive for NMDAR-Abs (3.3%). One of them was eventually considered to have been misdiagnosed and reclassified as encephalitis. The other met the criteria for bipolar I disorder, presented no neurological symptoms and had a comorbid HIV infection of vertical transmission. This is the first reported case of an HIV-infected patient with psychosis associated with NSAs. This study shows that patients presenting with clinically incomplete forms of anti-NMDAR encephalitis, with predominant or isolated psychiatric symptoms, can remain undetected if no ancillary tests are performed. To improve patient diagnosis and treatment of individuals with a first psychotic episode, more detailed neurological examinations might be needed. Further studies are required to better clarify the role of NSAs in the neuropsychiatric effects of HIV infection.
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Affiliation(s)
- Susana Arboleya
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Faculty of Medicine, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain.
| | - Antonio Clemente
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Savannah Deng
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Marta Bedmar
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Isabel Salvador
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Patricia Herbera
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Vanessa Cunill
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Cristòfol Vives-Bauza
- Research Unit, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAM, C/Antoni Pujadas 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain
| | - Francesca Canellas
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Maria Rosa Julià
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
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D'Aurelio M, Vives-Bauza C, Davidson MM, Manfredi G. Mitochondrial DNA background modifies the bioenergetics of NARP/MILS ATP6 mutant cells. Hum Mol Genet 2009; 19:374-86. [PMID: 19875463 DOI: 10.1093/hmg/ddp503] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Mutations in the mitochondrial DNA (mtDNA) encoded subunit 6 of ATPase (ATP6) are associated with variable disease expression, ranging from adult onset neuropathy, ataxia and retinitis pigmentosa (NARP) to fatal childhood maternally inherited Leigh's syndrome (MILS). Phenotypical variations have largely been attributed to mtDNA heteroplasmy. However, there is often a discrepancy between the levels of mutant mtDNA and disease severity. Therefore, the correlation among genetic defect, bioenergetic impairment and clinical outcome in NARP/MILS remains to be elucidated. We investigated the bioenergetics of cybrids from five patients carrying different ATP6 mutations: three harboring the T8993G, one with the T8993C and one with the T9176G mutation. The bioenergetic defects varied dramatically, not only among different ATP6 mutants, but also among lines carrying the same T8993G mutation. Mutants with the most severe ATP synthesis impairment showed defective respiration and disassembly of respiratory chain complexes. This indicates that respiratory chain defects modulate the bioenergetic impairment in NARP/MILS cells. Sequencing of the entire mtDNA from the different mutant cell lines identified variations in structural genes, resulting in amino acid changes that destabilize the respiratory chain. Taken together, these results indicate that the mtDNA background plays an important role in modulating the biochemical defects and clinical outcome in NARP/MILS.
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Affiliation(s)
- M D'Aurelio
- Weill Medical College of Cornell University, New York, NY 10065, USA
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Mancuso M, Vives-Bauza C, Filosto M, Marti R, Solano A, Montoya J, Gamez J, DiMauro S, Andreu AL. A mitochondrial DNA duplication as a marker of skeletal muscle specific mutations in the mitochondrial genome. J Med Genet 2004; 41:e73. [PMID: 15173239 PMCID: PMC1735801 DOI: 10.1136/jmg.2003.012278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vives-Bauza C, Del Toro M, Solano A, Montoya J, Andreu AL, Roig M. Genotype-phenotype correlation in the 5703G>A mutation in the tRNA(ASN) gene of mitochondrial DNA. J Inherit Metab Dis 2003; 26:507-8. [PMID: 14518831 DOI: 10.1023/a:1025133629685] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [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] [Indexed: 11/12/2022]
Abstract
The 5703G>A mutation in the tRNA gene of mitochondrial DNA seems to show a tissue-specific phenotype: early age of clinical presentation, progressive external ophthalmoplegia, fatigability and 'extremely thin appearance'. We report a second patient with the same mutation and phenotype.
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Affiliation(s)
- C Vives-Bauza
- Centre d'Investigacions en Bioquimica i Biologia Molecular, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Palenzuela L, Vives-Bauza C, Fernández-Cadenas I, Meseguer A, Font N, Sarret E, Schwartz S, Andreu AL. Familial expansile osteolysis in a large Spanish kindred resulting from an insertion mutation in the TNFRSF11A gene. J Med Genet 2002; 39:E67. [PMID: 12362049 PMCID: PMC1734982 DOI: 10.1136/jmg.39.10.e67] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- L Palenzuela
- Centre d'Investigacions en Bioquímica I Biologia Molecular (CIBBIM), Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Vives-Bauza C, Gamez J, Roig M, Briones P, Cervera C, Solano A, Montoya J, Andreu AL. Exercise intolerance resulting from a muscle-restricted mutation in the mitochondrial tRNA(Leu (CUN)) gene. Ann Med 2001; 33:493-6. [PMID: 11680798 DOI: 10.3109/07853890109002099] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Some patients presenting with isolated lifelong exercise intolerance and ragged-red fibres, harbour skeletal-muscle restricted mutations in their mitochondrial DNA. AIM To identify the molecular defect in a patient presenting with lifelong exercise intolerance, ragged-red fibres and deficiencies of complexes III and IV in skeletal muscle. METHODS The muscle biopsy was studied for activities of the respiratory chain, histochemical stains, and sequencing the tRNA genes of mitochondrial DNA. RESULTS The patient had a heteroplasmic mutation in the tRNA(Leu (CUN)) gene of mitochondrial DNA (G12334A). Clinical and morphological data as well as restriction fragment length polymorphism (RFLP) and single-fibre polymerase chain reaction (PCR) analyses strongly indicate that this molecular defect is the primary cause of the myopathy. CONCLUSION Mutations in any mitochondrial gene should be considered in the differential diagnosis of patients with lifelong exercise intolerance, even when the neurological examination is normal.
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Affiliation(s)
- C Vives-Bauza
- Research Centre for Biochemistry and Molecular Biology, Universitary Hospital Vall d'Hebron, Barcelona, Spain
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Anderson D, Yardley-Jones A, Vives-Bauza C, Chua-Anusorn W, Cole C, Webb J. Effect of iron salts, haemosiderins, and chelating agents on the lymphocytes of a thalassaemia patient without chelation therapy as measured in the comet assay. Teratog Carcinog Mutagen 2001; 20:251-64. [PMID: 10992272 DOI: 10.1002/1520-6866(2000)20:5<251::aid-tcm1>3.0.co;2-f] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Impairment of haemoglobin synthesis occurs in the genetic diseases known as thalassaemia. The consequent chronic anaemia leads to increased dietary iron absorption which results in iron overload. Treatment through regular blood transfusions increases oxygen capacity, but also adds iron from haemoglobin. An essential treatment, in parallel with transfusions, is the use of chelating agents to remove the excess iron. Thalassaemia patients are particularly at risk of free radical damage. Human lymphocytes from normal individuals can be investigated in vitro as a model system in the presence of free radicals in the Comet assay. This assay measures DNA damage, particularly DNA strand breakage. We examined cells from an Australian thalassaemic patient (sickle/beta thal double heterozygote-sickle phenotype) who had not yet received chelation therapy to determine if the cells were more sensitive to simulated iron overload and to haemosiderins. Lymphocytes from the patient were received as frozen samples after 28 h on dry ice and then placed in liquid nitrogen. Normal lymphocytes frozen under the same conditions and normal nonfrozen lymphocytes were compared. The lymphocytes from a normal female did not respond in vitro to ferric chloride (FeCl(3)) or haemosiderin but did to ferrous chloride (FeCl(2)) and ferrous sulphate (FeSO(4)). Deferoxamine appeared to reduce the response to FeCl(2) and FeSO(4) but deferiprone did not. When the lymphocytes from the nonchelated patient were treated with FeSO(4) and hydrogen peroxide, deferoxamine and deferiprone both reduced the response. Over the same dose range of iron salt (FeSO(4)), the lymphocytes from the thalassaemic patient were more sensitive, with much higher background levels of damage and induced damage. When deferiprone and deferoxamine were compared over a nontoxic range, deferiprone appeared to produce a greater reduction of damage in lymphocytes of the thalassaemia patient. Ferritin iron appears to be more available than haemosiderin iron in reactions leading to DNA damage. Haemosiderin containing higher amounts of the goethite-like (alpha-FeOOH) iron oxide phase leads to lower levels of DNA damage.
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Affiliation(s)
- D Anderson
- TNO BIBRA International Ltd, Carshalton, Surrey, UK
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Anderson D, Yardley-Jones A, Hambly RJ, Vives-Bauza C, Smykatz-Kloss V, Chua-Anusorn W, Webb J. Effects of iron salts and haemosiderin from a thalassaemia patient on oxygen radical damage as measured in the comet assay. Teratog Carcinog Mutagen 2000; 20:11-26. [PMID: 10607374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Thalassaemia is a group of genetic diseases where haemoglobin synthesis is impaired. This chronic anaemia leads to increased dietary iron absorption, which develops into iron overload pathology. Treatment through regular transfusions increases oxygen capacity but also provides iron through the red cells' haemoglobin. An essential treatment, in parallel with transfusions, is the use of chelating agents to remove the excess iron deposited in tissues. These deposits are found in the liver, spleen, heart, and pancreas and are associated with cardiac failure and diabetes. The deposits in these tissues of patients have been isolated as haemosiderin. Thalassaemia patients are particularly at risk of free radical induced damage. Thus, the present study has investigated, as a model system, human cells in vitro in the Comet assay in the presence of free radicals. This assay measures DNA damage, particularly DNA strand breakage. The effects of iron overload on cells oxidatively stressed with hydrogen peroxide (H(2)O(2)) have been determined as well as the effect of the chelating agent, deferoxamine. Iron overload was simulated with ferric (FeCl(3)) and ferrous chloride (FeCl(2)), ferrous sulphate (FeSO(4)) and haemosiderins. Both human lymphocytes from a male and a female donor and human adenocarcinoma colonic cells showed an increase in DNA damage in the Comet assay after treatment with H(2)O(2). Ferric chloride produced an increase in DNA damage in human colonic cells, but little or no damage in human lymphocytes. Ferrous chloride also produced weak DNA damage in human lymphocytes, but ferrous sulphate produced a dose-related response. Deferoxamine produced no DNA damage. When H(2)O(2) was combined with FeCl(3), FeCl(2), or FeSO(4), the DNA damage produced was as least as great as or slightly greater than with H(2)O(2) alone. When deferoxamine was combined with H(2)O(2) and FeSO(4) there was a consistent decrease in response. There was little or no decrease in response when deferoxamine was combined with H(2)O(2) and FeCl(3) or FeCl(2), but at high (100-300microm) doses there were changes in the appearance of cellular DNA from Comet tails to dense centres surrounded by a diffuse area. This was probably as a consequence of chelation processes. Haemosiderin produced no damage. The three fractions of haemosiderin examined were of three different densities and from a Thai patient where the oxyhydroxide phase is the ferrihydrite. The colour change was similar to that for FeCl(3), but the level of the ferric ion in the haemosiderin was possibly too low in the sample to produce a response. The next stage is to examine peripheral lymphocytes from thalassaemic patients, with and without chelation therapy, whose cells may be more sensitive to simulated iron overload and to lower levels of haemosiderin. Teratogenesis Carcinog. Mutagen. 20:11-26, 2000.
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Affiliation(s)
- D Anderson
- BIBRA International, Woodmansterne Road, Carshalton, Surrey, United Kingdom
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Anderson D, Yardley-Jones A, Hambly R, Vives-Bauza C, Smykatz-Kloss V, Chua-anusorn W, Webb J. Effects of iron salts and haemosiderin from a thalassaemia patient on oxygen radical damage as measured in the comet assay. ACTA ACUST UNITED AC 2000. [DOI: 10.1002/(sici)1520-6866(2000)20:1<11::aid-tcm2>3.0.co;2-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Davies MJ, Turner JG, Vives-Bauza C, Rumsby PC. Investigation of mutant frequency at the HPRT locus and changes in microsatellite sequences in healthy young adults. Mutat Res 1999; 431:317-23. [PMID: 10635997 DOI: 10.1016/s0027-5107(99)00175-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In an attempt to understand the inter-individual variation that occurs in in vivo mutant frequency at the HPRT locus, we have examined the effect of polymorphisms in genes for metabolic enzymes on the mutation rate. In the same population of human volunteers, the background variant frequency in a number of microsatellite sequences was studied to determine individual variation in the capacity to repair mismatches in these sequences. The HPRT mutant frequency of T-cells isolated from a group of 49 healthy, non-smoking adults varied from 0.25 to 9.64 x 10(-6). The frequency of polymorphisms in CYP1A1, GSTM1 and NAT2 among these individuals was similar to those published, and when subjected to univariate analysis these polymorphisms showed no influence on the HPRT mutant frequency. However, there was a significant interaction between the GSTM1 null genotype and the slow acetylator status in NAT2 (P < 0.05) which was associated with higher mutant frequency. Analysis of 30 microsatellite sequences in 20 HPRT proficient clones per individual showed only six alterations in total, giving an overall mutation rate per allele of 0.01%, whilst three alterations were found in five HPRT deficient clones per individual examined for changes in 10 microsatellites, giving an overall mutation rate per allele of 0.3%. Thus, the alterations detected are probably due to background mutations and not to differences in mismatch repair capacity.
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Affiliation(s)
- M J Davies
- Department of Molecular Biology, BIBRA International, Carshalton, Surrey, UK.
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