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Sanchez-Jimeno C, Cuadrado-Corrales N, Aller E, García M, Escámez MJ, Illera N, Trujillo-Tiebas MJ, Ayuso C, Millán JM, Del Río M. Recessive dystrophic epidermolysis bullosa: the origin of the c.6527insC mutation in the Spanish population. Br J Dermatol 2012; 168:226-9. [PMID: 22757647 DOI: 10.1111/j.1365-2133.2012.11128.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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García M, Santiago JL, Terrón A, Hernández-Martín A, Vicente A, Fortuny C, De Lucas R, López JC, Cuadrado-Corrales N, Holguín A, Illera N, Duarte B, Sánchez-Jimeno C, Llames S, García E, Ayuso C, Martínez-Santamaría L, Castiglia D, De Luca N, Torrelo A, Mechan D, Baty D, Zambruno G, Escámez MJ, Del Río M. Two novel recessive mutations in KRT14 identified in a cohort of 21 Spanish families with epidermolysis bullosa simplex. Br J Dermatol 2012; 165:683-92. [PMID: 21623745 DOI: 10.1111/j.1365-2133.2011.10428.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Basal epidermolysis bullosa simplex (EBS) is a group of blistering genodermatoses mostly caused by mutations in the keratin genes, KRT5 and KRT14. Recessive mutations represent about 5% of all EBS mutations, being common and specific in populations with high consanguinity, where affected patients show severe phenotypes. OBJECTIVES To accomplish the first mutational analysis in patients of Spanish origin with EBS and to delineate a comprehensive genotype-phenotype correlation. METHODS Twenty-one EBS families were analysed. Immunofluorescence mapping at the dermoepidermal junction level was performed on skin biopsies from patients. Mutation screening of the entire coding sequences of KRT5 and KRT14 in genomic DNA was assessed by polymerase chain reaction and direct sequencing. RESULTS KRT5 or KRT14 causative mutations were identified in 18 of the 21 EBS families. A total of 14 different mutations were disclosed, of which 12 were dominant missense mutations and two truncating recessive mutations. Five of the 14 mutations were novel including three dominant in KRT5 (p.V186E, p.T321P and p.A428T) and two recessive in KRT14 (p.K116X and p.K250RfsX8). The two patients with EBS carrying homozygous recessive mutations were affected by severe phenotypes and belonged to consanguineous families. All five families with the EBS Dowling-Meara subtype carried recurrent mutations affecting the highly conserved ends of the α-helical rod domain of K5 and K14. The seven mutations associated with the localized EBS subtype were widely distributed along the KRT5 and KRT14 genes. Two families with mottled pigmentation carried the P25L mutation in KRT5, commonly associated with this subtype. CONCLUSIONS This study further confirms the genotype-phenotype correlation established for EBS in other ethnic groups, and is the first in a Mediterranean country (excluding Israel). This study adds two novel recessive mutations to the worldwide record to date, which includes a total of 14 mutations. As in previous reports, the recessive mutations resulted in a lack of keratin K14, giving rise to a generalized and severe presentation.
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Affiliation(s)
- M García
- Regenerative Medicine Unit, Epithelial Biomedicine Division, Basic Research Department, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Av. Complutense 22, 28040 Madrid, Spain
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3
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Cuadrado-Corrales N, Sánchez-Jimeno C, García M, Ayuso C, De Lucas R, Vicario JL, Conti CJ, Zambruno G, Escamez MJ, Del Rio M. A recurrent nonsense mutation occurring as a de novo event in a patient with recessive dystrophic epidermolysis bullosa. Dermatology 2011; 223:219-21. [PMID: 21849769 DOI: 10.1159/000330331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Escámez MJ, García M, Cuadrado-Corrales N, Llames SG, Charlesworth A, De Luca N, Illera N, Sánchez-Jimeno C, Holguín A, Duarte B, Trujillo-Tiebas MJ, Vicario JL, Santiago JL, Hernández-Martín A, Torrelo A, Castiglia D, Ayuso C, Larcher F, Jorcano JL, Meana A, Meneguzzi G, Zambruno G, Del Rio M. The first COL7A1 mutation survey in a large Spanish dystrophic epidermolysis bullosa cohort: c.6527insC disclosed as an unusually recurrent mutation. Br J Dermatol 2010; 163:155-61. [PMID: 20184583 DOI: 10.1111/j.1365-2133.2010.09713.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dystrophic epidermolysis bullosa (DEB) is a genodermatosis caused by mutations in COL7A1. The clinical manifestations are highly variable from nail dystrophy to life-threatening blistering, making early molecular diagnosis and prognosis of utmost importance for the affected families. Mutation identification is mandatory for prenatal testing. OBJECTIVES To conduct the first mutational analysis of COL7A1 in a Spanish cohort, to assess mutation consequences at protein/mRNA level and to establish genotype-phenotype correlations. METHODS Forty-nine Spanish patients with DEB were studied. Antigen mapping was performed on patient skin biopsies. COL7A1 mutation screening in genomic DNA was performed by polymerase chain reaction (PCR) and direct sequencing. Mutation consequences were determined by reverse transcriptase-PCR. RESULTS Eight patients belonged to three unrelated families with dominant DEB. Forty-one were affected with recessive DEB (RDEB). Specifically, 27 displayed the severe generalized subtype, eight the other generalized subtype and six a localized phenotype (two pretibial, three acral and one inversa). Thirty-five mutations were identified, 20 of which are novel. The pathogenic mutation c.6527insC accounted for 46.3% of Spanish RDEB alleles. A consistent genotype-phenotype correlation was established. CONCLUSIONS Although the COL7A1 database indicates that most DEB mutations are family specific, the pathogenic mutation c.6527insC was highly recurrent in our cohort. This level of recurrence for a single genetic defect has never previously been reported for COL7A1. Our findings are essential to the clinicians caring for patients with DEB in Spain and in the large population of Spanish descendants in Latin America. They also provide geneticists a molecular clue for a priority mutation screening strategy.
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Affiliation(s)
- M J Escámez
- Basic Research Department, Epithelial Biomedicine Division, Regenerative Medicine Unit, CIEMAT-CIBERER U714, Av. Complutense 22, 28040 Madrid, Spain
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García M, Escamez MJ, Cuadrado-Corrales N, Sánchez-Jimeno C, Illera N, López-Martínez MA, Trujillo-Tiebas MJ, Ayuso C, Del Río M. Novel human pathological mutations. Gene symbol: COL7A1. Disease: Epidermolysis bullosa dystrophica. Hum Genet 2010; 127:116-117. [PMID: 20108428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Marta García
- Regenerative Medicine Unit, CIEMAT-CIBERER, Av Complutense, 22, 28040, Madrid, Spain.
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Escámez MJ, Cuadrado-Corrales N, García M, Sanchez-Jimeno C, Illera N, López-Martínez MA, Trujillo-Tiebas MJ, Ayuso C, Del Río M. Novel human pathological mutations. Gene symbol: COL7A1. Disease: Epidermolysis bullosa dystrophica. Hum Genet 2010; 127:121. [PMID: 20108434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- María José Escámez
- Regenerative Medicine Unit, CIEMAT-CIBERER, Av. Complutnese, 22, 28040, Madrid, Spain.
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Hernández-Martín A, Cuadrado-Corrales N, Ciria-Abad S, Arias-Palomo D, Mascaró-Galy J, Escámez M, García M, Del Río M, Torrelo A, González-Sarmiento R. X-Linked Ichthyosis along with Recessive Dystrophic Epidermolysis Bullosa in the Same Patient. Dermatology 2010; 221:113-6. [DOI: 10.1159/000313507] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 03/25/2010] [Indexed: 11/19/2022] Open
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García M, Escamez MJ, Cuadrado-Corrales N, Illera N, Sánchez Jimeno C, Vélez C, Trujillo-Tiebas MJ, Ayuso C, Del Río M. Novel human pathological mutations. Gene symbol: COL7A1. Disease: Epidermolysis bullosa dystrophica. Hum Genet 2010; 127:120-121. [PMID: 20108398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Marta García
- Regenerative Medicine Unit, CIEMAT-CIBERER, Av Complutense, 22, 28040, Madrid, Spain.
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Garcia M, Escamez MJ, Cuadrado-Corrales N, Carrillo A, Trujillo-Tiebas MJ, Ayuso C, Del Rio M. Novel human pathological mutations. Gene symbol: COL7A1. Disease: Epidermolysis bullosa dystrophica. Hum Genet 2009; 126:334-335. [PMID: 19694004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Marta Garcia
- Regenerative Medicine Unit, CIEMAT-CIBERER, Madrid, Spain.
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Cuadrado-Corrales N, Jiménez-Huete A, Albo C, Vega L, Hortigüela R, Cerrato L, Sierra-Moros M, Avellanal F, Rábano A, de Pedro-Cuesta J, Calero M. [Usefulness of the 14-3-3 test for the diagnosis of sCJD evaluated by a Spanish reference center]. Neurologia 2008; 23:91-97. [PMID: 18322827] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION The performance of the 14-3-3 protein test has been shown to be adequate for sporadic Creutzfeldt-Jakob disease (sCJD) diagnosis in selected populations, but its routine validity has been questioned. METHODS One thousand and sixty-eight patients with clinically suspected sCJD were analyzed in a Spanish reference center. In order to explore the influence of the clinical context on the performance of the immunoassay, the patients were classified at sample reception according to the World Health Organization (WHO) diagnostic criteria excluding the 14-3-3 test results. The yield of the immunoassay was evaluated in each subgroup with criteria of probable, possible sCJD or non-sCJD. RESULTS In the set of patients with suspicion of sCJD the inclusion of the 14-3-3 test produces a significant increase in the diagnosis certainty (positive likelihood ratio: 10.1) compared to the WHO's criteria, excluding the 14-3-3 test. For patients classified at sample reception as probable sCJD (n=166), possible sCJD (n=129) and non-sCJD (n=773), the positive predictive values for the test were 98.4%, 97.5% and 31%, and the negative predictive values were 22.2%, 73.4% and 100%, respectively. CONCLUSIONS The predictive values of the assay vary according to the previous diagnostic certainty. Therefore, in order to interpret correctly the test, it is necessary to evaluate the degree of initial clinical suspicion of the patient at the moment of the cerebrospinal fluid (CSF) extraction. This study offers up-to-date information, referenced to the Spanish population, and in useful format, and it is intended to serve as a guideline for 14-3-3 test results interpretation to the clinicians in our community.
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Affiliation(s)
- N Cuadrado-Corrales
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
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Sanchez-Juan P, Sánchez-Valle R, Green A, Ladogana A, Cuadrado-Corrales N, Mitrová E, Stoeck K, Sklaviadis T, Kulczycki J, Hess K, Krasnianski A, Equestre M, Slivarichová D, Saiz A, Calero M, Pocchiari M, Knight R, van Duijn CM, Zerr I. Influence of timing on CSF tests value for Creutzfeldt-Jakob disease diagnosis. J Neurol 2007; 254:901-6. [PMID: 17385081 PMCID: PMC2779401 DOI: 10.1007/s00415-006-0472-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [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: 06/17/2006] [Revised: 08/21/2006] [Accepted: 09/17/2006] [Indexed: 11/30/2022]
Abstract
Background The
analysis of markers in the cerebrospinal
fluid (CSF) is useful in
the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD). However,
the time at which the study
of these markers is most sensitive
remains controversal. Objective To assess the influence of time of
sampling on the value of CSF tests
in the diagnosis of sCJD. Method In the framework of a multinational
European study, we studied
the results of 14-3-3, S100b, neurone
specific enolase (NSE) and
tau protein in 833 CSF samples
from sCJD patients at different
stages of disease and in 66
sequentially repeated lumbar
punctures (LP). Results 14-3-3
and tau protein tended to increase
in sensitivity from onset (88%,
81%) to the advanced stage (91%,
90%). This was significant only in
the methionine-valine (MV) heterozygous
group of patients at
codon 129. The absolute levels of
S100b (p < 0.05), NSE and tau
protein increased in the last stage
of disease. High levels of tau
protein, NSE and S100b were
associated with shorter survival
times (p < 0.01). Sixty-six sCJD
patients underwent repeated LP.
These sCJD patients were younger,
had longer disease durations and
were more frequently MV at
codon 129 (p < 0.001) than the
whole group. 14-3-3 sensitivity
increased from 64% to 82% in the
second LP (p = 0.025) and 88%
sCJD patients had at least one
positive result. Conclusions Sensitivity
and absolute levels of CJD
markers increased with disease
progression and were modulated
by the codon 129 genotype. Early
negative results should be inter-preted with caution, especially in
young patients or those who are
MV at codon 129.
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Affiliation(s)
- P. Sanchez-Juan
- Dept. of Epidemiology and Biostatistics, Erasmus University Medical Center, 1738, 3000 DR Rotterdam, The Netherlands
| | - R. Sánchez-Valle
- Dept. of Neurology
Hospital Clínic, Institut d’Investigació
Biomèdica August Pi i Sunyer, Villarroel 170, 08036 Barcelona, Spain
| | - A. Green
- National CJD Surveillance Unit, The University of Edinburgh, EH4 2XU Edinburgh, UK
| | - A. Ladogana
- Dept. of Cell Biology and Neurosciences, Instituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | | | - E. Mitrová
- Institute of Preventive and Clinical
Medicine, Limbová str. 14, 83301 Bratislava, Slovakia
| | - K. Stoeck
- National Reference Center for Human
Prion Diseases (NRPE), Institute of Neuropathology, Schmelzbergstr.12, 8091 Zurich, Switzerland
| | - T. Sklaviadis
- Laboratory of Pharmacology, Dept. of Pharmaceutical Sciences, School of Health Sciences
Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - J. Kulczycki
- I-st Neurological Department, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - K. Hess
- Dept. of Neurology, University Hospital Zurich, Frauenklinikstr. 26, 8091 Zurich, Switzerland
| | - A. Krasnianski
- Dept. of Neurology, National TSE reference center
Georg-August-University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - M. Equestre
- Dept. of Cell Biology and Neurosciences, Instituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - D. Slivarichová
- Institute of Preventive and Clinical
Medicine, Limbová str. 14, 83301 Bratislava, Slovakia
| | - A. Saiz
- Dept. of Neurology
Hospital Clínic, Institut d’Investigació
Biomèdica August Pi i Sunyer, Villarroel 170, 08036 Barcelona, Spain
| | - M. Calero
- Instituto de Salud Carlos III, Sinesio Delgado 6, 28029 Madrid, Spain
| | - M. Pocchiari
- Dept. of Cell Biology and Neurosciences, Instituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - R. Knight
- National CJD Surveillance Unit, The University of Edinburgh, EH4 2XU Edinburgh, UK
| | - C. M. van Duijn
- Dept. of Epidemiology and Biostatistics, Erasmus University Medical Center, 1738, 3000 DR Rotterdam, The Netherlands
| | - I. Zerr
- Dept. of Neurology, National TSE reference center
Georg-August-University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
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Green A, Sanchez-Juan P, Ladogana A, Cuadrado-Corrales N, Sánchez-Valle R, Mitrová E, Stoeck K, Sklaviadis T, Kulczycki J, Heinemann U, Hess K, Slivarichová D, Saiz A, Calero M, Mellina V, Knight R, van Duijn CM, Zerr I. CSF analysis in patients with sporadic CJD and other transmissible spongiform encephalopathies. Eur J Neurol 2007; 14:121-4. [PMID: 17250717 DOI: 10.1111/j.1468-1331.2006.01630.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [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: 11/29/2022]
Abstract
Patients with suspected Creutzfeldt-Jakob disease (CJD) often have routine cerebrospinal fluid (CSF) analysis performed to exclude treatable inflammatory conditions; however, little information is available about the range of results obtained for CSF tests in patients with sporadic CJD and other transmissible spongiform encephalopathies (TSE). Data from 450 patients with sporadic CJD and 47 patients with other TSEs were collected as part of an EC-supported multinational study. Raised white cell counts of >5 cells/microl were found in three of 298 patients with sporadic CJD, with two cell counts of 7 cells/microl and one of 20 cells/microl. Total protein concentrations of >0.9 g/l were found in five of 438 patients with sporadic CJD, although none had a concentration of >1 g/l. CSF oligoclonal IgG was detected in eight of 182 sporadic CJD patients. Of the patients with other TSEs, six had elevated cell counts ranging from 6 to 14 cells/microl but none had total protein concentrations of >0.9 g/l and one patient had detectable oligoclonal IgG. None of the patients with sporadic CJD or other TSEs had abnormalities in all three tests.
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Affiliation(s)
- A Green
- National CJD Surveillance Unit, The University of Edinburgh, Edinburgh, UK.
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13
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Sanchez-Juan P, Green A, Ladogana A, Cuadrado-Corrales N, Sáanchez-Valle R, Mitrováa E, Stoeck K, Sklaviadis T, Kulczycki J, Hess K, Bodemer M, Slivarichová D, Saiz A, Calero M, Ingrosso L, Knight R, Janssens ACJW, van Duijn CM, Zerr I. CSF tests in the differential diagnosis of Creutzfeldt-Jakob disease. Neurology 2006; 67:637-43. [PMID: 16924018 DOI: 10.1212/01.wnl.0000230159.67128.00] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.5] [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: 11/15/2022] Open
Abstract
OBJECTIVES To analyze the diagnostic sensitivity and specificity of various brain-derived proteins (14-3-3, Tau, neuron specific enolase [NSE], and S100b) in the CSF of patients with Creutzfeldt-Jakob disease (CJD) and to analyze biologic factors that modify these parameters. METHODS CSF was tested for 14-3-3, Tau, NSE, and S100b in 1,859 patients with sporadic, genetic, iatrogenic, and variant CJD, and in 1,117 controls. RESULTS The highest sensitivity was achieved for 14-3-3 and Tau in sporadic CJD (85% and 86%), and a combined determination of 14-3-3 and Tau, S100b, or NSE increased the sensitivity to over 93%. A multivariate analysis showed that the sensitivity of all tests was highest in patients with the shortest disease duration, age at onset >40 years, and homozygosity at codon 129 of the prion protein gene. In a group of patients with repeated lumbar punctures, a second test also increased the diagnostic sensitivity. CONCLUSIONS The detection of elevated levels of brain-derived proteins in the CSF in patients with suspected Creutzfeldt-Jakob disease is a valuable diagnostic test. A second lumbar puncture may be of value in patients with atypical clinical course in whom the first test was negative.
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Affiliation(s)
- P Sanchez-Juan
- Department of Epidemiology &s Biostatistics, Erasmus University Medical Center Rotterdam, The Netherlands
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14
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Collins SJ, Sanchez-Juan P, Masters CL, Klug GM, van Duijn C, Poleggi A, Pocchiari M, Almonti S, Cuadrado-Corrales N, de Pedro-Cuesta J, Budka H, Gelpi E, Glatzel M, Tolnay M, Hewer E, Zerr I, Heinemann U, Kretszchmar HA, Jansen GH, Olsen E, Mitrova E, Alpérovitch A, Brandel JP, Mackenzie J, Murray K, Will RG. Determinants of diagnostic investigation sensitivities across the clinical spectrum of sporadic Creutzfeldt-Jakob disease. Brain 2006; 129:2278-87. [PMID: 16816392 DOI: 10.1093/brain/awl159] [Citation(s) in RCA: 197] [Impact Index Per Article: 10.9] [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: 11/13/2022] Open
Abstract
To validate the provisional findings of a number of smaller studies and explore additional determinants of characteristic diagnostic investigation results across the entire clinical spectrum of sporadic Creutzfeldt-Jakob disease (CJD), an international collaborative study was undertaken comprising 2451 pathologically confirmed (definite) patients. We assessed the influence of age at disease onset, illness duration, prion protein gene (PRNP) codon 129 polymorphism (either methionine or valine) and molecular sub-type on the diagnostic sensitivity of EEG, cerebral MRI and the CSF 14-3-3 immunoassay. For EEG and CSF 14-3-3 protein detection, we also assessed the influence of the time point in a patient's illness at which the investigation was performed on the likelihood of a typical or positive result. Analysis included a large subset of patients (n = 743) in whom molecular sub-typing had been performed using a combination of the PRNP codon 129 polymorphism and the form of protease resistant prion protein [type 1 or 2 according to Parchi et al. (Parchi P, Giese A, Capellari S, Brown P, Schulz-Schaeffer W, Windl O, Zerr I, Budka H, Kopp N, Piccardo P, Poser S, Rojiani A, Streichemberger N, Julien J, Vital C, Ghetti B, Gambetti P, Kretzschmar H. Classification of sporadic Creutzfeldt-Jakob disease based on molecular and phenotypic analysis of 300 subjects. Ann Neurol 1999; 46: 224-233.)] present in the brain. Findings for the whole group paralleled the subset with molecular sub-typing data available, showing that age at disease onset and disease duration were independent determinants of typical changes on EEG, while illness duration significantly influenced positive CSF 14-3-3 protein detection; changes on brain MRI were not influenced by either of these clinical parameters, but overall, imaging data were less complete and consequently conclusions are more tentative. In addition to age at disease onset and illness duration, molecular sub-type was re-affirmed as an important independent determinant of investigation results. In multivariate analyses that included molecular sub-type, time point of the investigation during a patient's illness was found not to influence the occurrence of a typical or positive EEG or CSF 14-3-3 protein result. A typical EEG was most often seen in MM1 patients and was significantly less likely in the MV1, MV2 and VV2 sub-types, whereas VV2 patients had an increased likelihood of a typical brain MRI. Overall, the CSF 14-3-3 immunoassay was the most frequently positive investigation (88.1%) but performed significantly less well in the very uncommon MV2 and MM2 sub-types. Our findings confirm a number of determinants of principal investigation results in sporadic CJD and underscore the importance of recognizing these pre-test limitations before accepting the diagnosis excluded or confirmed. Combinations of investigations offer the best chance of detection, especially for the less common molecular sub-types such as MV2 and MM2.
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Affiliation(s)
- S J Collins
- Australian National Creutzfeldt-Jakob disease Registry, Department of Pathology, The University of Melbourne, Parkville, Vic., Australia.
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15
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Gonzalo-Pascual I, Cuadrado-Corrales N. [Immunohistochemistry techniques in prion diseases]. Rev Neurol 2000; 31:156-9. [PMID: 10951674] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The prion diseases are characterized by showing a broad spectrum of phenotypes with different clinical and neuropathological presentations. Detection of the prion protein is the marker used as a tool for making the definite diagnosis in these neurodegenerative diseases. Its presence may be detected by immunohistochemical and biochemical techniques. On immunohistochemical studies the prion protein shows three types of staining: as plaques of PrP-amyloid, perivascular and diffuse-synaptic.
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Affiliation(s)
- I Gonzalo-Pascual
- Banco de Tejidos para Investigación Neurológica, Facultad de Medicina, Universidad Complutense de Madrid, España.
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Gonzalo-Pascual I, Cuadrado-Corrales N. [Neuropathology of the new variant of Creutzfeldt-Jakob disease]. Rev Neurol 2000; 31:160-1. [PMID: 10951675] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Identification in the United Kingdom of cases of Creutzfeldt-Jakob disease with clinical, genetic, neuropathological and phenotype characteristics different from those previously reported, together with its relation to bovine spongiform encephalopathy led to the establishment of a new condition known as a new variant of Creutzfeldt-Jakob disease. In this article we describe the neuropathology and immunohistochemistry of the prion protein involved.
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Affiliation(s)
- I Gonzalo-Pascual
- Banco de Tejidos para Investigación Neurológica, Facultad de Medicina, Universidad Complutense de Madrid, España
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