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Langhammer F, Maroofian R, Badar R, Gregor A, Rochman M, Ratliff JB, Koopmans M, Herget T, Hempel M, Kortüm F, Heron D, Mignot C, Keren B, Brooks S, Botti C, Ben-Zeev B, Argilli E, Sherr EH, Gowda VK, Srinivasan VM, Bakhtiari S, Kruer MC, Salih MA, Kuechler A, Muller EA, Blocker K, Kuismin O, Park KL, Kochhar A, Brown K, Ramanathan S, Clark RD, Elgizouli M, Melikishvili G, Tabatadze N, Stark Z, Mirzaa GM, Ong J, Grasshoff U, Bevot A, von Wintzingerode L, Jamra RA, Hennig Y, Goldenberg P, Al Alam C, Charif M, Boulouiz R, Bellaoui M, Amrani R, Al Mutairi F, Tamim AM, Abdulwahab F, Alkuraya FS, Khouj EM, Alvi JR, Sultan T, Hashemi N, Karimiani EG, Ashrafzadeh F, Imannezhad S, Efthymiou S, Houlden H, Sticht H, Zweier C. Genotype-phenotype correlations in RHOBTB2-associated neurodevelopmental disorders. Genet Med 2023; 25:100885. [PMID: 37165955 DOI: 10.1016/j.gim.2023.100885] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
PURPOSE Missense variants clustering in the BTB domain region of RHOBTB2 cause a developmental and epileptic encephalopathy with early-onset seizures and severe intellectual disability. METHODS By international collaboration, we assembled individuals with pathogenic RHOBTB2 variants and a variable spectrum of neurodevelopmental disorders. By western blotting, we investigated the consequences of missense variants in vitro. RESULTS In accordance with previous observations, de novo heterozygous missense variants in the BTB domain region led to a severe developmental and epileptic encephalopathy in 16 individuals. Now, we also identified de novo missense variants in the GTPase domain in 6 individuals with apparently more variable neurodevelopmental phenotypes with or without epilepsy. In contrast to variants in the BTB domain region, variants in the GTPase domain do not impair proteasomal degradation of RHOBTB2 in vitro, indicating different functional consequences. Furthermore, we observed biallelic splice-site and truncating variants in 9 families with variable neurodevelopmental phenotypes, indicating that complete loss of RHOBTB2 is pathogenic as well. CONCLUSION By identifying genotype-phenotype correlations regarding location and consequences of de novo missense variants in RHOBTB2 and by identifying biallelic truncating variants, we further delineate and expand the molecular and clinical spectrum of RHOBTB2-related phenotypes, including both autosomal dominant and recessive neurodevelopmental disorders.
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Affiliation(s)
- Franziska Langhammer
- Department of Human Genetics, Inselspital Bern, University of Bern, Bern, Switzerland; Department for Biomedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Reza Maroofian
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Rueda Badar
- Department of Human Genetics, Inselspital Bern, University of Bern, Bern, Switzerland; Department for Biomedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Anne Gregor
- Department of Human Genetics, Inselspital Bern, University of Bern, Bern, Switzerland; Department for Biomedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Michelle Rochman
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Jeffrey B Ratliff
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Marije Koopmans
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Theresia Herget
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fanny Kortüm
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Delphine Heron
- Department of Genetics, La Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Cyril Mignot
- Department of Genetics, La Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Boris Keren
- Department of Genetics, La Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Susan Brooks
- Division of Medical Genetics, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Christina Botti
- Division of Medical Genetics, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Bruria Ben-Zeev
- The Neurology Department at Sheba Medical Center, Ramat Gan, Israel
| | - Emanuela Argilli
- Brain Development Research Program, Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Elliot H Sherr
- Brain Development Research Program, Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Vykuntaraju K Gowda
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
| | - Varunvenkat M Srinivasan
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
| | - Somayeh Bakhtiari
- Pediatric Movement Disorders Program, Division of Pediatric Neurology, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ; Departments of Child Health, Neurology, and Cellular & Molecular Medicine, and Program in Genetics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ
| | - Michael C Kruer
- Pediatric Movement Disorders Program, Division of Pediatric Neurology, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ; Departments of Child Health, Neurology, and Cellular & Molecular Medicine, and Program in Genetics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ
| | - Mustafa A Salih
- Division of Pediatric Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, College of Medicine, Almughtaribeen University, Khartoum, Sudan
| | - Alma Kuechler
- Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eric A Muller
- Clinical Genetics, Stanford Children's Health, San Francisco, CA
| | - Karli Blocker
- Clinical Genetics, Stanford Children's Health, San Francisco, CA
| | - Outi Kuismin
- Department of Clinical Genetics, PEDEGO Research Unit and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kristen L Park
- Anschutz Medical Campus Department of Pediatrics and Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Aaina Kochhar
- Section of Genetics, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Kathleen Brown
- Section of Genetics, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | | | - Robin D Clark
- Division of Genetics, Loma Linda University Health, San Bernardino, CA
| | - Magdeldin Elgizouli
- Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gia Melikishvili
- Department of pediatrics, MediClubGeorgia Medical Center, Tbilisi, Georgia
| | - Nazhi Tabatadze
- Department of pediatrics, MediClubGeorgia Medical Center, Tbilisi, Georgia
| | - Zornitza Stark
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Ghayda M Mirzaa
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA; Brotman Baty Institute for Precision Medicine, Seattle, WA
| | - Jinfon Ong
- Child Neurology Consultants of Austin, Austin, TX
| | - Ute Grasshoff
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Andrea Bevot
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University Hospital of Tuebingen, Tuebingen, Germany
| | | | - Rami A Jamra
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Yvonne Hennig
- Department of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany
| | - Paula Goldenberg
- Division of Medical Genetics, Massachusetts General Hospital, Boston, MA
| | - Chadi Al Alam
- Pediatric Neurology Department, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates; Pediatric Neurology department, Haykel Hospital, El Koura, Lebanon
| | - Majida Charif
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco; BRO Biobank, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco; Genetics and Immuno-Cell Therapy Team, Mohammed First University, Oujda, Morocco
| | - Redouane Boulouiz
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco; BRO Biobank, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Mohammed Bellaoui
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco; BRO Biobank, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Rim Amrani
- Department of Neonatology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Fuad Al Mutairi
- Genetic and Precision Medicine Department, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah M Tamim
- Pediatric Neurology Section-Pediatric Department, King Faisal Specialist Hospital & Research Center (Gen. Org) - Jeddah Branch, Riyadh, Saudi Arabia
| | - Firdous Abdulwahab
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ebtissal M Khouj
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Javeria R Alvi
- Department of Pediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Tipu Sultan
- Department of Pediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Narges Hashemi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan G Karimiani
- Molecular and Clinical Sciences Institute, St. George's, University of London, Cranmer Terrace, London, United Kingdom
| | - Farah Ashrafzadeh
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Imannezhad
- Department of Pediatric Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Stephanie Efthymiou
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christiane Zweier
- Department of Human Genetics, Inselspital Bern, University of Bern, Bern, Switzerland; Department for Biomedical Research (DBMR), University of Bern, Bern, Switzerland.
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2
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Garza Flores A, Nordgren I, Pettersson M, Dias-Santagata D, Nilsson D, Hammarsjö A, Lindstrand A, Batkovskyte D, Wiggs J, Walton DS, Goldenberg P, Eisfeldt J, Lin AE, Lachman RS, Nishimura G, Grigelioniene G. Case report: Extending the spectrum of clinical and molecular findings in FOXC1 haploinsufficiency syndrome. Front Genet 2023; 14:1174046. [PMID: 37424725 PMCID: PMC10326848 DOI: 10.3389/fgene.2023.1174046] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/12/2023] [Indexed: 07/11/2023] Open
Abstract
FOXC1 is a ubiquitously expressed forkhead transcription factor that plays a critical role during early development. Germline pathogenic variants in FOXC1 are associated with anterior segment dysgenesis and Axenfeld-Rieger syndrome (ARS, #602482), an autosomal dominant condition with ophthalmologic anterior segment abnormalities, high risk for glaucoma and extraocular findings including distinctive facial features, as well as dental, skeletal, audiologic, and cardiac anomalies. De Hauwere syndrome is an ultrarare condition previously associated with 6p microdeletions and characterized by anterior segment dysgenesis, joint instability, short stature, hydrocephalus, and skeletal abnormalities. Here, we report clinical findings of two unrelated adult females with FOXC1 haploinsufficiency who have ARS and skeletal abnormalities. Final molecular diagnoses of both patients were achieved using genome sequencing. Patient 1 had a complex rearrangement involving a 4.9 kB deletion including FOXC1 coding region (Hg19; chr6:1,609,721-1,614,709), as well as a 7 MB inversion (Hg19; chr6:1,614,710-8,676,899) and a second deletion of 7.1 kb (Hg19; chr6:8,676,900-8,684,071). Patient 2 had a heterozygous single nucleotide deletion, resulting in a frameshift and a premature stop codon in FOXC1 (NM_001453.3): c.467del, p.(Pro156Argfs*25). Both individuals had moderate short stature, skeletal abnormalities, anterior segment dysgenesis, glaucoma, joint laxity, pes planovalgus, dental anomalies, hydrocephalus, distinctive facial features, and normal intelligence. Skeletal surveys revealed dolichospondyly, epiphyseal hypoplasia of femoral and humeral heads, dolichocephaly with frontal bossin gand gracile long bones. We conclude that haploinsufficiency of FOXC1 causes ARS and a broad spectrum of symptoms with variable expressivity that at its most severe end also includes a phenotype overlapping with De Hauwere syndrome.
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Affiliation(s)
- Alexandra Garza Flores
- Medical Genetics, Mass General for Children, Boston, MA, United States
- Genetics Department, Cook Children´s Hospital, Fort Worth, TX, United States
| | - Ida Nordgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Maria Pettersson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Dora Dias-Santagata
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Daniel Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Hammarsjö
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Lindstrand
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Dominyka Batkovskyte
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Janey Wiggs
- Department of Ophthalmology, Ocular Genomics Institute, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States
| | - David S. Walton
- Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Paula Goldenberg
- Medical Genetics, Mass General for Children, Boston, MA, United States
| | - Jesper Eisfeldt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Angela E. Lin
- Medical Genetics, Mass General for Children, Boston, MA, United States
| | - Ralph S. Lachman
- Department of Radiological Sciences and Pediatrics, UCLA School of Medicine, Los Angeles, CA, United States
- Department of Radiological Sciences Stanford University, Stanford, CA, United States
- Orthopedic Department, International Skeletal Dysplasia Registry, UCLA School of Medicine, Los Angeles, CA, United States
| | - Gen Nishimura
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Musashino-Yowakai Hospital, Musashino, Tokyo, Japan
| | - Giedre Grigelioniene
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Endocrine Unit, Massachusetts General Hospital, Boston, MA, United States
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3
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Srivastava S, Shaked HM, Gable K, Gupta SD, Pan X, Somashekarappa N, Han G, Mohassel P, Gotkine M, Doney E, Goldenberg P, Tan QKG, Gong Y, Kleinstiver B, Wishart B, Cope H, Pires CB, Stutzman H, Spillmann RC, Sadjadi R, Elpeleg O, Lee CH, Bellen HJ, Edvardson S, Eichler F, Dunn TM, Dai H, Dhar SU, Emrick LT, Goldman AM, Hanchard NA, Jamal F, Karaviti L, Lalani SR, Lee BH, Lewis RA, Marom R, Moretti PM, Murdock DR, Nicholas SK, Orengo JP, Posey JE, Potocki L, Rosenfeld JA, Samson SL, Scott DA, Tran AA, Vogel TP, Wangler MF, Yamamoto S, Eng CM, Liu P, Ward PA, Behrens E, Deardorff M, Falk M, Hassey K, Sullivan K, Vanderver A, Goldstein DB, Cope H, McConkie-Rosell A, Schoch K, Shashi V, Smith EC, Spillmann RC, Sullivan JA, Tan QKG, Walley NM, Agrawal PB, Beggs AH, Berry GT, Briere LC, Cobban LA, Coggins M, Cooper CM, Fieg EL, High F, Holm IA, Korrick S, Krier JB, Lincoln SA, Loscalzo J, Maas RL, MacRae CA, Pallais JC, Rao DA, Rodan LH, Silverman EK, Stoler JM, Sweetser DA, Walker M, Walsh CA, Esteves C, Kelley EG, Kohane IS, LeBlanc K, McCray AT, Nagy A, Dasari S, Lanpher BC, Lanza IR, Morava E, Oglesbee D, Bademci G, Barbouth D, Bivona S, Carrasquillo O, Chang TCP, Forghani I, Grajewski A, Isasi R, Lam B, Levitt R, Liu XZ, McCauley J, Sacco R, Saporta M, Schaechter J, Tekin M, Telischi F, Thorson W, Zuchner S, Colley HA, Dayal JG, Eckstein DJ, Findley LC, Krasnewich DM, Mamounas LA, Manolio TA, Mulvihill JJ, LaMoure GL, Goldrich MP, Urv TK, Doss AL, Acosta MT, Bonnenmann C, D’Souza P, Draper DD, Ferreira C, Godfrey RA, Groden CA, Macnamara EF, Maduro VV, Markello TC, Nath A, Novacic D, Pusey BN, Toro C, Wahl CE, Baker E, Burke EA, Adams DR, Gahl WA, Malicdan MCV, Tifft CJ, Wolfe LA, Yang J, Power B, Gochuico B, Huryn L, Latham L, Davis J, Mosbrook-Davis D, Rossignol F, Solomon B, MacDowall J, Thurm A, Zein W, Yousef M, Adam M, Amendola L, Bamshad M, Beck A, Bennett J, Berg-Rood B, Blue E, Boyd B, Byers P, Chanprasert S, Cunningham M, Dipple K, Doherty D, Earl D, Glass I, Golden-Grant K, Hahn S, Hing A, Hisama FM, Horike-Pyne M, Jarvik GP, Jarvik J, Jayadev S, Lam C, Maravilla K, Mefford H, Merritt JL, Mirzaa G, Nickerson D, Raskind W, Rosenwasser N, Scott CR, Sun A, Sybert V, Wallace S, Wener M, Wenger T, Ashley EA, Bejerano G, Bernstein JA, Bonner D, Coakley TR, Fernandez L, Fisher PG, Fresard L, Hom J, Huang Y, Kohler JN, Kravets E, Majcherska MM, Martin BA, Marwaha S, McCormack CE, Raja AN, Reuter CM, Ruzhnikov M, Sampson JB, Smith KS, Sutton S, Tabor HK, Tucker BM, Wheeler MT, Zastrow DB, Zhao C, Byrd WE, Crouse AB, Might M, Nakano-Okuno M, Whitlock J, Brown G, Butte MJ, Dell’Angelica EC, Dorrani N, Douine ED, Fogel BL, Gutierrez I, Huang A, Krakow D, Lee H, Loo SK, Mak BC, Martin MG, Martínez-Agosto JA, McGee E, Nelson SF, Nieves-Rodriguez S, Palmer CGS, Papp JC, Parker NH, Renteria G, Signer RH, Sinsheimer JS, Wan J, Wang LK, Perry KW, Woods JD, Alvey J, Andrews A, Bale J, Bohnsack J, Botto L, Carey J, Pace L, Longo N, Marth G, Moretti P, Quinlan A, Velinder M, Viskochi D, Bayrak-Toydemir P, Mao R, Westerfield M, Bican A, Brokamp E, Duncan L, Hamid R, Kennedy J, Kozuira M, Newman JH, PhillipsIII JA, Rives L, Robertson AK, Solem E, Cogan JD, Cole FS, Hayes N, Kiley D, Sisco K, Wambach J, Wegner D, Baldridge D, Pak S, Schedl T, Shin J, Solnica-Krezel L, Sadjadi R, Elpeleg O, Lee CH, Bellen HJ, Edvardson S, Eichler F, Dunn TM. SPTSSA variants alter sphingolipid synthesis and cause a complex hereditary spastic paraplegia. Brain 2023; 146:1420-1435. [PMID: 36718090 PMCID: PMC10319774 DOI: 10.1093/brain/awac460] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 06/17/2022] [Revised: 11/03/2022] [Accepted: 11/19/2022] [Indexed: 02/01/2023] Open
Abstract
Sphingolipids are a diverse family of lipids with critical structural and signalling functions in the mammalian nervous system, where they are abundant in myelin membranes. Serine palmitoyltransferase, the enzyme that catalyses the rate-limiting reaction of sphingolipid synthesis, is composed of multiple subunits including an activating subunit, SPTSSA. Sphingolipids are both essential and cytotoxic and their synthesis must therefore be tightly regulated. Key to the homeostatic regulation are the ORMDL proteins that are bound to serine palmitoyltransferase and mediate feedback inhibition of enzymatic activity when sphingolipid levels become excessive. Exome sequencing identified potential disease-causing variants in SPTSSA in three children presenting with a complex form of hereditary spastic paraplegia. The effect of these variants on the catalytic activity and homeostatic regulation of serine palmitoyltransferase was investigated in human embryonic kidney cells, patient fibroblasts and Drosophila. Our results showed that two different pathogenic variants in SPTSSA caused a hereditary spastic paraplegia resulting in progressive motor disturbance with variable sensorineural hearing loss and language/cognitive dysfunction in three individuals. The variants in SPTSSA impaired the negative regulation of serine palmitoyltransferase by ORMDLs leading to excessive sphingolipid synthesis based on biochemical studies and in vivo studies in Drosophila. These findings support the pathogenicity of the SPTSSA variants and point to excessive sphingolipid synthesis due to impaired homeostatic regulation of serine palmitoyltransferase as responsible for defects in early brain development and function.
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Affiliation(s)
- Siddharth Srivastava
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, BostonChildren's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Hagar Mor Shaked
- Department of Genetics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Kenneth Gable
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Sita D Gupta
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Xueyang Pan
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA
| | - Niranjanakumari Somashekarappa
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Gongshe Han
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Payam Mohassel
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20814, USA
| | - Marc Gotkine
- Department of Genetics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | | | - Paula Goldenberg
- Department of Pediatrics, Section on Medical Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Queenie K G Tan
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Yi Gong
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Benjamin Kleinstiver
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.,Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Brian Wishart
- Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Heidi Cope
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Claudia Brito Pires
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Hannah Stutzman
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Rebecca C Spillmann
- Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, NC 27710, USA
| | | | - Reza Sadjadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Orly Elpeleg
- Department of Genetics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Chia-Hsueh Lee
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Hugo J Bellen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA
| | - Simon Edvardson
- Pediatric Neurology Unit, Hadassah University Hospital, Mount Scopus, Jerusalem 91240, Israel
| | - Florian Eichler
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Teresa M Dunn
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Reza Sadjadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA 02114 , USA
| | - Orly Elpeleg
- Department of Genetics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem , Jerusalem 91120 , Israel
| | - Chia-Hsueh Lee
- Department of Structural Biology, St. Jude Children’s Research Hospital , Memphis, TN 38105 , USA
| | - Hugo J Bellen
- Department of Molecular and Human Genetics, Baylor College of Medicine , Houston, TX 77030 , USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital , Houston, TX 77030 , USA
| | - Simon Edvardson
- Pediatric Neurology Unit, Hadassah University Hospital, Mount Scopus , Jerusalem 91240 , Israel
| | - Florian Eichler
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA 02114 , USA
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School , Boston, MA 02114 , USA
| | - Teresa M Dunn
- Department of Biochemistry and Molecular Biology, Uniformed Services University of the Health Sciences , Bethesda, MD 20814 , USA
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4
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Lines MA, Goldenberg P, Wong A, Srivastava S, Bayat A, Hove H, Karstensen HG, Anyane-Yeboa K, Liao J, Jiang N, May A, Guzman E, Morleo M, D'Arrigo S, Ciaccio C, Pantaleoni C, Castello R, McKee S, Ong J, Zibdeh-Lough H, Tran-Mau-Them F, Gerasimenko A, Heron D, Keren B, Margot H, de Sainte Agathe JM, Burglen L, Voets T, Vriens J, Innes AM, Dyment DA. Phenotypic spectrum of the recurrent TRPM3 p.(Val837Met) substitution in seven individuals with global developmental delay and hypotonia. Am J Med Genet A 2022; 188:1667-1675. [PMID: 35146895 DOI: 10.1002/ajmg.a.62673] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 11/11/2022]
Abstract
TRPM3 encodes a transient receptor potential cation channel of the melastatin family, expressed in the central nervous system and in peripheral sensory neurons of the dorsal root ganglia. The recurrent substitution in TRPM3: c.2509G>A, p.(Val837Met) has been associated with syndromic intellectual disability and seizures. In this report, we present the clinical and molecular features of seven previously unreported individuals, identified by exome sequencing, with the recurrent p.(Val837Met) variant and global developmental delay. Other shared clinical features included congenital hypotonia, dysmorphic facial features (broad forehead, deep-set eyes, and down turned mouth), exotropia, and musculoskeletal issues (hip dysplasia, hip dislocation, scoliosis). Seizures were observed in two of seven individuals (febrile seizure in one and generalized tonic-clonic seizures with atonic drops in another), and epileptiform activity was observed in an additional two individuals. This report extends the number of affected individuals to 16 who are heterozygous for the de novo recurrent substitution p.(Val837Met). In contrast with the initial report, epilepsy was not a mandatory feature observed in this series. TRPM3 pathogenic variation should be considered in individuals with global developmental delays, moderate-severe intellectual disability with, or without, childhood-onset epilepsy.
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Affiliation(s)
- Matthew A Lines
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paula Goldenberg
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts, USA
| | - Ashley Wong
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts, USA
| | | | - Allan Bayat
- Department of Epilepsy Genetics and Personalized Medicine, Filadelfia Epilepsy Hospital, Dianalund, Denmark.,Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark
| | - Hanne Hove
- Department of Pediatrics, Center of Rare Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Helena Gásdal Karstensen
- Department of Genetics, Center of Diagnostics, Copenhagen University Hospital - Rigshospitalet, Rigshospitalet, Denmark
| | - Kwame Anyane-Yeboa
- Division of Clinical Genetics, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Jun Liao
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Nan Jiang
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Alison May
- Division of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Edwin Guzman
- Division of Clinical Genetics, Department of Pediatrics, New York Presbyterian Hospital, Columbia University, New York, New York, USA
| | - Manuela Morleo
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy.,Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano D'Arrigo
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Claudia Ciaccio
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pantaleoni
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Raffaele Castello
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
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- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Shane McKee
- Northern Ireland Regional Genetics Service, Belfast, UK
| | - Jinfon Ong
- Child Neurology Consultants of Austin, Austin, Texas, USA
| | - Hana Zibdeh-Lough
- Department of Pediatrics, Dell Children's Medical Center of Central Texas, Austin, Texas, USA
| | | | - Anna Gerasimenko
- APHP Sorbonne Université, GH Pitié Salpêtriére et Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Delphine Heron
- APHP Sorbonne Université, GH Pitié Salpêtriére et Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Boris Keren
- APHP Sorbonne Université, GH Pitié Salpêtriére et Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Henri Margot
- Universitie Bordeaux, MRGM INSERM U1211, CHU de Bordeaux, Service de Génétique Médicale, Bordeaux, France
| | - Jean-Madeleine de Sainte Agathe
- APHP Sorbonne Université, GH Pitié Salpêtriére et Trousseau, Département de Génétique, Centre de référence "déficiences intellectuelles de causes rares", Paris, France
| | - Lydie Burglen
- APHP, Sorbonne Université, Hôpital TROUSSEAU, Centre de Référence des Malformations et Maladies Congénitales du Cervelet et Département de Génétique, Paris, France
| | - Thomas Voets
- Laboratory of Ion Channel Research and TRP Research Platform Leuven (TRPLe), Department of Cellular and Molecular Medicine, University of Leuven, Leuven, Belgium.,VIB Center for Brain & Disease Research, Leuven, Belgium
| | - Joris Vriens
- Laboratory of Experimental Gynecology and Obstetrics, Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - A Micheil Innes
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
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5
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Bayat A, Pendziwiat M, Obersztyn E, Goldenberg P, Zacher P, Döring JH, Syrbe S, Begtrup A, Borovikov A, Sharkov A, Karasińska A, Giżewska M, Mitchell W, Morava E, Møller RS, Rubboli G. Deep-Phenotyping the Less Severe Spectrum of PIGT Deficiency and Linking the Gene to Myoclonic Atonic Seizures. Front Genet 2021; 12:663643. [PMID: 34046058 PMCID: PMC8148046 DOI: 10.3389/fgene.2021.663643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/03/2021] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
The two aims of this study were (i) to describe and expand the phenotypic spectrum of PIGT deficiency in affected individuals harboring the c.1582G>A; p.Val528Met or the c.1580A > G; p.Asn527Ser variant in either homozygous or compound heterozygous state, and (ii) to identify potential genotype-phenotype correlations and any differences in disease severity among individuals with and without the PIGT variants. The existing literature was searched to identify individuals with and without the two variants. A detailed phenotypic assessment was performed of 25 individuals (both novel and previously published) with the two PIGT variants. We compared severity of disease between individuals with and without these PIGT variants. Twenty-four individuals carried the PIGT variant Val528Met in either homozygous or compound heterozygous state, and one individual displayed the Asn527Ser variant in a compound heterozygous state. Disease severity in the individual with the Asn527Ser variant was compatible with that in the individuals harboring the Val528Met variant. While individuals without the Asn527Ser or Val528Met variant had focal epilepsy, profound developmental delay (DD), and risk of premature death, those with either of the two variants had moderate to severe DD and later onset of epilepsy with both focal and generalized seizures. Individuals homozygous for the Val528Met variant generally became seizure-free on monotherapy with antiepileptic drugs, compared to other PIGT individuals who were pharmaco-resistant. Two patients were diagnosed with myoclonic-atonic seizures, and a single patient was diagnosed with eyelid myoclonia. Our comprehensive analysis of this large cohort of previously published and novel individuals with PIGT variants broadens the phenotypical spectrum and shows that both Asn527Ser and Val528Met are associated with a milder phenotype and less severe outcome. Our data show that PIGT is a new candidate gene for myoclonic atonic epilepsy. Our genotype-phenotype correlation will be useful for future genetic counseling. Natural history studies of this mild spectrum of PIGT-related disorder may shed light on hitherto unknown aspects of this rare disorder.
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Affiliation(s)
- Allan Bayat
- Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark.,Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark
| | - Manuela Pendziwiat
- Department of Neuropediatrics, Children's Hospital, University Medical Center Schleswig-Holstein, University of Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Ewa Obersztyn
- Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland
| | - Paula Goldenberg
- Division of Medical Genetics, Massachusetts General Hospital, Boston, MA, United States
| | - Pia Zacher
- The Saxon Epilepsy Center Kleinwachau, Radeberg, Germany
| | - Jan Henje Döring
- Department of General Pediatrics, Division of Child Neurology and Inherited Metabolic Diseases, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Steffen Syrbe
- Department of General Pediatrics, Division of Child Neurology and Inherited Metabolic Diseases, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Artem Sharkov
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russia
| | - Aneta Karasińska
- Department of Dermatology, The Nicolas Copernicus State Hospital, Koszalin, Poland
| | - Maria Giżewska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Wendy Mitchell
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Eva Morava
- Department of Clinical Genomics, Laboratory of Medicine and Pathology, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, United States
| | - Rikke S Møller
- Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark.,Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark
| | - Guido Rubboli
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark.,Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
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6
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Patel KR, Partain M, Ryan DP, Hersh C, Goldenberg P, Hartnick CJ. Carotid artery mobilization prior to pharyngeal flap inset for patients with 22q11.2 deletion syndrome. Int J Pediatr Otorhinolaryngol 2021; 141:110573. [PMID: 33359933 DOI: 10.1016/j.ijporl.2020.110573] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
The management of velopharyngeal insufficiency (VPI) in patients with 22q11.2 deletion syndrome (22q11DS) poses a significant clinical challenge due to presence of a large velopharyngeal gap and a relatively high rate of internal carotid artery (ICA) medialization. To our knowledge, we are the first group to have successfully managed VPI in a series of seven pediatric patients with 22q11DS with medialized ICAs via a novel surgical technique involving carotid artery mobilization followed by pharyngeal flap insertion. Thus far, we have found this technique to be reliably safe with no significant morbidity and caregivers have reported postoperative improvement in speech, swallowing and nasal regurgitation symptoms. Herein, we provide a detailed description of our novel surgical approach, including an instructional video, for correction of VPI in patients with medialized ICAs, who have previously had limited management options.
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Affiliation(s)
- Krupa R Patel
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Matthew Partain
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Daniel P Ryan
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Cheryl Hersh
- Pediatric Airway, Voice and Swallowing Center, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Paula Goldenberg
- Division of Medical Genetics, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher J Hartnick
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
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7
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Shikany AR, Landis BJ, Parrott A, Miller EM, Coyan A, Walters L, Hinton RB, Goldenberg P, Ware SM. A Comprehensive Clinical Genetics Approach to Critical Congenital Heart Disease in Infancy. J Pediatr 2020; 227:231-238.e14. [PMID: 32717230 PMCID: PMC8424561 DOI: 10.1016/j.jpeds.2020.07.065] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the frequency of genetic diagnoses among infants with critical congenital heart disease (CHD) using a comprehensive cardiovascular genetics approach and to identify genotype-phenotype correlations. STUDY DESIGN A retrospective chart review of patients evaluated by cardiovascular genetics in a pediatric cardiac intensive care unit from 2010 to 2015 was performed. Infants with CHD who were <1 month of age were included. CHD was classified using structured phenotype definitions. Cardiac and noncardiac phenotypes were tested for associations with abnormal genetic testing using χ1 and Fisher exact tests. RESULTS Genetic evaluation was completed in 293 infants with CHD, of whom 213 had isolated congenital heart disease (iCHD) and 80 had multiple congenital anomalies. Overall, the yield of abnormal genetic testing was 26%. The multiple congenital anomalies cohort had a greater yield of genetic testing (39%) than the iCHD cohort (20%) (OR 2.7). Using a non-hierarchical CHD classification and excluding 22q11.2 deletion and common aneuploidies, right ventricular obstructive defects were associated with abnormal genetic testing (P = .0005). Extracardiac features associated with abnormal genetic testing included ear, nose, and throat (P = .003) and brain (P = .0001) abnormalities. A diagnosis of small for gestational age or intrauterine growth retardation also was associated with abnormal genetic testing (P = .0061), as was presence of dysmorphic features (P = .0033, OR 3.5). Infants without dysmorphia with iCHD or multiple congenital anomalies had similar frequencies of abnormal genetic testing. CONCLUSIONS The present study provides evidence to support a comprehensive cardiovascular genetics approach in evaluating infants with critical CHD while also identifying important genotype-phenotype considerations.
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Affiliation(s)
- Amy R Shikany
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Benjamin J Landis
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Erin M Miller
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Alyxis Coyan
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Robert B Hinton
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Paula Goldenberg
- Massachusetts General Hospital, Medical Genetics, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Stephanie M Ware
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
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8
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Lin AE, Santoro S, High FA, Goldenberg P, Gutmark-Little I. Congenital heart defects associated with aneuploidy syndromes: New insights into familiar associations. Am J Med Genet C Semin Med Genet 2019; 184:53-63. [PMID: 31868316 DOI: 10.1002/ajmg.c.31760] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022]
Abstract
The frequent occurrence of congenital heart defects (CHDs) in chromosome abnormality syndromes is well-known, and among aneuploidy syndromes, distinctive patterns have been delineated. We update the type and frequency of CHDs in the aneuploidy syndromes involving trisomy 13, 18, 21, and 22, and in several sex chromosome abnormalities (Turner syndrome, trisomy X, Klinefelter syndrome, 47,XYY, and 48,XXYY). We also discuss the impact of noninvasive prenatal screening (mainly, cell-free DNA analysis), critical CHD screening, and the growth of parental advocacy on their surgical management and natural history. We encourage clinicians to view the cardiac diagnosis as a "phenotype" which supplements the external dysmorphology examination. When detected prenatally, severe CHDs may influence decision-making, and postnatally, they are often the major determinants of survival. This review should be useful to geneticists, cardiologists, neonatologists, perinatal specialists, other pediatric specialists, and general pediatricians. As patients survive (and thrive) into adulthood, internists and related adult specialists will also need to be informed about their natural history and management.
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Affiliation(s)
- Angela E Lin
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Stephanie Santoro
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Frances A High
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Paula Goldenberg
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Iris Gutmark-Little
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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9
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Kang SK, Vanoye CG, Misra SN, Echevarria DM, Calhoun JD, O'Connor JB, Fabre KL, McKnight D, Demmer L, Goldenberg P, Grote LE, Thiffault I, Saunders C, Strauss KA, Torkamani A, van der Smagt J, van Gassen K, Carson RP, Diaz J, Leon E, Jacher JE, Hannibal MC, Litwin J, Friedman NR, Schreiber A, Lynch B, Poduri A, Marsh ED, Goldberg EM, Millichap JJ, George AL, Kearney JA. Spectrum of K V 2.1 Dysfunction in KCNB1-Associated Neurodevelopmental Disorders. Ann Neurol 2019; 86:899-912. [PMID: 31600826 DOI: 10.1002/ana.25607] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Pathogenic variants in KCNB1, encoding the voltage-gated potassium channel KV 2.1, are associated with developmental and epileptic encephalopathy (DEE). Previous functional studies on a limited number of KCNB1 variants indicated a range of molecular mechanisms by which variants affect channel function, including loss of voltage sensitivity, loss of ion selectivity, and reduced cell-surface expression. METHODS We evaluated a series of 17 KCNB1 variants associated with DEE or other neurodevelopmental disorders (NDDs) to rapidly ascertain channel dysfunction using high-throughput functional assays. Specifically, we investigated the biophysical properties and cell-surface expression of variant KV 2.1 channels expressed in heterologous cells using high-throughput automated electrophysiology and immunocytochemistry-flow cytometry. RESULTS Pathogenic variants exhibited diverse functional defects, including altered current density and shifts in the voltage dependence of activation and/or inactivation, as homotetramers or when coexpressed with wild-type KV 2.1. Quantification of protein expression also identified variants with reduced total KV 2.1 expression or deficient cell-surface expression. INTERPRETATION Our study establishes a platform for rapid screening of KV 2.1 functional defects caused by KCNB1 variants associated with DEE and other NDDs. This will aid in establishing KCNB1 variant pathogenicity and the mechanism of dysfunction, which will enable targeted strategies for therapeutic intervention based on molecular phenotype. ANN NEUROL 2019;86:899-912.
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Affiliation(s)
- Seok Kyu Kang
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Carlos G Vanoye
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Sunita N Misra
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL.,Departments of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Dennis M Echevarria
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jeffrey D Calhoun
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - John B O'Connor
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Katarina L Fabre
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Laurie Demmer
- Department of Pediatrics, Atrium Health's Levine Children's Hospital, Charlotte, NC
| | - Paula Goldenberg
- Medical Genetics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA
| | - Lauren E Grote
- Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, MO.,University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Isabelle Thiffault
- University of Missouri-Kansas City School of Medicine, Kansas City, MO.,Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, MO.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO
| | - Carol Saunders
- University of Missouri-Kansas City School of Medicine, Kansas City, MO.,Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, MO.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO
| | | | - Ali Torkamani
- Scripps Translational Science Institute and Scripps Research Institute, La Jolla, CA
| | - Jasper van der Smagt
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Koen van Gassen
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert P Carson
- Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN
| | - Jullianne Diaz
- Rare Disease Institute, Children's National Medical Center, Washington, DC
| | - Eyby Leon
- Rare Disease Institute, Children's National Medical Center, Washington, DC
| | - Joseph E Jacher
- Division of Pediatric Genetics, Metabolism, and Genomic Medicine, University of Michigan, Ann Arbor, MI
| | - Mark C Hannibal
- Division of Pediatric Genetics, Metabolism, and Genomic Medicine, University of Michigan, Ann Arbor, MI
| | - Jessica Litwin
- University of California, San Francisco Benioff Children's Hospital, San Francisco, CA
| | | | | | - Bryan Lynch
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's University Hospital, Dublin, Ireland
| | - Annapurna Poduri
- Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Eric D Marsh
- Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ethan M Goldberg
- Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - John J Millichap
- Departments of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.,Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alfred L George
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jennifer A Kearney
- Departments of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
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10
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Greenberg M, Caloway C, Hersh C, Ryan D, Goldenberg P, Hartnick C. Pharyngeal flap using carotid artery mobilization in 22q11.2 deletion syndrome with velopharyngeal insufficiency. Int J Pediatr Otorhinolaryngol 2019; 120:130-133. [PMID: 30784809 DOI: 10.1016/j.ijporl.2019.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/09/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION 22q11.2 deletion syndrome is the most common microdeletion syndrome in children. Many patients with this disease develop craniofacial defects including cleft palate, bifid uvula, and velopharyngeal insufficiency. Our study adds to the current body of literature by describing a novel technique of carotid mobilization performed in conjunction with pharyngeal flap surgery in patients with extensive medialization of the carotid artery. METHODS Carotid artery mobilization followed by insertion of a superiorly based pharyngeal flap was performed on two patients, a 10-year-old girl and a 5-year-old boy, with 22q11.2 deletion syndrome concurrent with velopharyngeal insufficiency. RESULTS Neither patient experienced significant post-operative issues. Following the procedure, parents of both patients noted significant speech and voice improvement. Both patients had improvements in VPI Effects On Life Outcome (VELO) scores, nasometry, and production of paragraph passages following surgery. CONCLUSIONS Our study describes a novel surgical treatment for children with 22q11.2 deletion syndrome with significant velopharyngeal insufficiency (VPI). The procedure wherein is characterized by an extensive mobilization of the carotid artery followed by implantation of a pharyngeal flap. This technique resulted in no significant intra-operative bleeding, and was measured to be successful as noted by nasometry scores and changes in pre- and post-op VELO scores.
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Affiliation(s)
- Max Greenberg
- Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, IL, USA; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Christen Caloway
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Cheryl Hersh
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Daniel Ryan
- Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA
| | - Paula Goldenberg
- Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA
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Levin MD, Saitta SC, Gripp KW, Wenger TL, Ganesh J, Kalish JM, Epstein MR, Smith R, Czosek RJ, Ware SM, Goldenberg P, Myers A, Chatfield KC, Gillespie MJ, Zackai EH, Lin AE. Nonreentrant atrial tachycardia occurs independently of hypertrophic cardiomyopathy in RASopathy patients. Am J Med Genet A 2018; 176:1711-1722. [PMID: 30055033 DOI: 10.1002/ajmg.a.38854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/29/2017] [Revised: 04/04/2018] [Accepted: 05/01/2018] [Indexed: 11/12/2022]
Abstract
Multifocal atrial tachycardia (MAT) has a well-known association with Costello syndrome, but is rarely described with related RAS/MAPK pathway disorders (RASopathies). We report 11 patients with RASopathies (Costello, Noonan, and Noonan syndrome with multiple lentigines [formerly LEOPARD syndrome]) and nonreentrant atrial tachycardias (MAT and ectopic atrial tachycardia) demonstrating overlap in cardiac arrhythmia phenotype. Similar overlap is seen in RASopathies with respect to skeletal, musculoskeletal and cutaneous abnormalities, dysmorphic facial features, and neurodevelopmental deficits. Nonreentrant atrial tachycardias may cause cardiac compromise if sinus rhythm is not restored expeditiously. Typical first-line supraventricular tachycardia anti-arrhythmics (propranolol and digoxin) were generally not effective in restoring or maintaining sinus rhythm in this cohort, while flecainide or amiodarone alone or in concert with propranolol were effective anti-arrhythmic agents for acute and chronic use. Atrial tachycardia resolved in all patients. However, a 4-month-old boy from the cohort was found asystolic (with concurrent cellulitis) and a second patient underwent cardiac transplant for heart failure complicated by recalcitrant atrial arrhythmia. While propranolol alone frequently failed to convert or maintain sinus rhythm, fleccainide or amiodarone, occasionally in combination with propranolol, was effective for RASopathy patient treatment for nonreentrant atrial arrhythmia. Our analysis shows that RASopathy patients may have nonreentrant atrial tachycardia with and without associated cardiac hypertrophy. While nonreentrant arrhythmia has been traditionally associated with Costello syndrome, this work provides an expanded view of RASopathy cardiac arrhythmia phenotype as we demonstrate mutant proteins throughout this signaling pathway can also give rise to ectopic and/or MAT.
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Affiliation(s)
- Mark D Levin
- Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Sulagna C Saitta
- Division of Genomic Medicine, Department of Pathology, Children's Hospital Los Angeles and Keck-USC School of Medicine, Los Angeles, California
| | - Karen W Gripp
- Division of Medical Genetics, A. I. du Pont Hospital for Children, Wilmington, Delaware
| | - Tara L Wenger
- Division of Craniofacial Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Jaya Ganesh
- Department of Pediatrics, Cooper Medical School at Rowan University, Camden, New Jersey
| | - Jennifer M Kalish
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michael R Epstein
- Division of Cardiology, Department of Pediatrics, Maine Medical Center, Portland, Maine
| | - Rosemarie Smith
- Division of Genetics, Department of Pediatrics, Maine Medical Center, Portland, Maine
| | - Richard J Czosek
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stephanie M Ware
- Departments of Pediatrics and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Paula Goldenberg
- Genetics Unit, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Angela Myers
- Division of Medical Genetics, Sanford Health, Sioux Falls, South Dakota
| | - Kathryn C Chatfield
- Department of Pediatrics, Section of Cardiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Matthew J Gillespie
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Angela E Lin
- Genetics Unit, MassGeneral Hospital for Children, Boston, Massachusetts
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12
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Abstract
This review summarizes common microdeletion and microduplication syndromes and highlights important updates in patient-care needs for people with these conditions (22q11.2, 7q11.23, 17p11.2, and 16p11.2). These conditions are in chromosomal "hotspots" and have an estimated prevalence of 1 in 1,000 to 1 in 25,000. Some conditions have possible increased or decreased genetic risk of schizophrenia (22q11.2 deletion and duplication), or risk of aortic dilation (7q11.23 duplication) versus aortic stenosis (7q11.23 deletion). Many of these conditions are associated with developmental delay, autism, and/or multiple congenital anomalies and would not be detected with a karyotype. Chromosomal microarray analysis will detect all these conditions with a single screening test, allowing for the appropriate diagnosis and management of these patients. [Pediatr Ann. 2018;47(5):e198-e203.].
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13
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Hickey CL, Sherman JC, Goldenberg P, Kritzer A, Caruso P, Schmahmann JD, Colvin MK. Cerebellar cognitive affective syndrome: insights from Joubert syndrome. Cerebellum Ataxias 2018; 5:5. [PMID: 29568536 PMCID: PMC5861599 DOI: 10.1186/s40673-018-0085-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 02/20/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Joubert syndrome (JS) is a rare, autosomal recessively inherited genetic disorder characterized morphologically by unique developmental malformations of the cerebellum and brainstem (the molar tooth sign), and clinically by impaired motor functions and intellectual disability. Patients with JS often face multiple cognitive challenges, but the neuropsychological profile of this condition has not been well characterized. METHODS We performed comprehensive neurological and neuropsychological evaluations in three adult brothers with JS, ages 32, 27, and 25 years. RESULTS They all exhibited impaired motor control, global developmental delay most evident in executive function, affect regulation, and social skill set, and similar patterns of neuropsychiatric symptoms. CONCLUSIONS These findings provide new insights into the intellectual and neurobehavioral phenotype of JS, which we regard as a developmental form of the cerebellar cognitive affective / Schmahmann syndrome (CCAS). These observations have direct clinical relevance for the diagnosis and care of patients with JS, and they help further the understanding of the multiple manifestations of atypical cerebrocerebellar development.
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Affiliation(s)
- Chelsea L. Hickey
- Departments of Psychiatry, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Janet C. Sherman
- Departments of Psychiatry, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Paula Goldenberg
- Departments of Genetics, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Amy Kritzer
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115 USA
| | - Paul Caruso
- Departments of Radiology, Massachusetts General Hospital, Boston, MA 02114 USA
| | | | - Mary K. Colvin
- Departments of Psychiatry, Massachusetts General Hospital, Boston, MA 02114 USA
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14
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Saunier C, Støve SI, Popp B, Gérard B, Blenski M, AhMew N, de Bie C, Goldenberg P, Isidor B, Keren B, Leheup B, Lampert L, Mignot C, Tezcan K, Mancini GMS, Nava C, Wasserstein M, Bruel AL, Thevenon J, Masurel A, Duffourd Y, Kuentz P, Huet F, Rivière JB, van Slegtenhorst M, Faivre L, Piton A, Reis A, Arnesen T, Thauvin-Robinet C, Zweier C. Expanding the Phenotype Associated with NAA10-Related N-Terminal Acetylation Deficiency. Hum Mutat 2016; 37:755-64. [PMID: 27094817 PMCID: PMC5084832 DOI: 10.1002/humu.23001] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [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: 02/02/2016] [Accepted: 04/08/2016] [Indexed: 11/10/2022]
Abstract
N-terminal acetylation is a common protein modification in eukaryotes associated with numerous cellular processes. Inherited mutations in NAA10, encoding the catalytic subunit of the major N-terminal acetylation complex NatA have been associated with diverse, syndromic X-linked recessive disorders, whereas de novo missense mutations have been reported in one male and one female individual with severe intellectual disability but otherwise unspecific phenotypes. Thus, the full genetic and clinical spectrum of NAA10 deficiency is yet to be delineated. We identified three different novel and one known missense mutation in NAA10, de novo in 11 females, and due to maternal germ line mosaicism in another girl and her more severely affected and deceased brother. In vitro enzymatic assays for the novel, recurrent mutations p.(Arg83Cys) and p.(Phe128Leu) revealed reduced catalytic activity. X-inactivation was random in five females. The core phenotype of X-linked NAA10-related N-terminal-acetyltransferase deficiency in both males and females includes developmental delay, severe intellectual disability, postnatal growth failure with severe microcephaly, and skeletal or cardiac anomalies. Genotype-phenotype correlations within and between both genders are complex and may include various factors such as location and nature of mutations, enzymatic stability and activity, and X-inactivation in females.
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Affiliation(s)
- Chloé Saunier
- Centre de Référence maladies rares « Anomalies du Développement et syndrome malformatifs » de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.,Service de Pédiatrie, Hôpital d'Enfants, CHU Dijon, Dijon, France
| | - Svein Isungset Støve
- Department of Molecular Biology, University of Bergen, Bergen, Norway.,Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - Bernt Popp
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bénédicte Gérard
- Laboratoire de Génétique Moléculaire, CHRU Strasbourg, Strasbourg, France
| | - Marina Blenski
- Department of Molecular Biology, University of Bergen, Bergen, Norway
| | - Nicholas AhMew
- Division of Genetics and Metabolism, Children's National Medical Center, Washington DC
| | | | - Paula Goldenberg
- Medical Genetics, Massachusetts General Hospital, Boston, Massachusetts
| | - Bertrand Isidor
- Service de Génétique Médicale, CHU Nantes, Nantes, France.,INSERM, UMR-S 957, Nantes, France
| | - Boris Keren
- AP-HP, Hôpital de la Pitié-Salpêtrière, Département de Génétique, Paris, France.,UPMC, Inserm, CNRS, UM 75, U 1127, UMR 7225, ICM, Paris, F-75013, France
| | - Bruno Leheup
- Service de Génétique Médicale, Hôpital Brabois, CHU Nancy, Nancy, France
| | - Laetitia Lampert
- Service de Génétique Médicale, Hôpital Brabois, CHU Nancy, Nancy, France
| | - Cyril Mignot
- APHP, Département de Génétique et Centre de Référence Déficiences Intellectuelles de Causes Rares, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Kamer Tezcan
- Kaiser Permanente, Department of Genetics, Sacramento, California
| | - Grazia M S Mancini
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Caroline Nava
- AP-HP, Hôpital de la Pitié-Salpêtrière, Département de Génétique, Paris, France.,UPMC, Inserm, CNRS, UM 75, U 1127, UMR 7225, ICM, Paris, F-75013, France
| | - Melissa Wasserstein
- Departments of Genetics and Genomic Sciences and Pediatrics, Icahn School of Medicine at Mount Sinai, New York
| | - Ange-Line Bruel
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Julien Thevenon
- Centre de Référence maladies rares « Anomalies du Développement et syndrome malformatifs » de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Alice Masurel
- Centre de Référence maladies rares « Anomalies du Développement et syndrome malformatifs » de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France
| | - Yannis Duffourd
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Paul Kuentz
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Frédéric Huet
- Service de Pédiatrie, Hôpital d'Enfants, CHU Dijon, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Jean-Baptiste Rivière
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Laboratoire de Génétique Moléculaire, PTB, CHU Dijon, Dijon, France
| | - Marjon van Slegtenhorst
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Laurence Faivre
- Centre de Référence maladies rares « Anomalies du Développement et syndrome malformatifs » de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Amélie Piton
- Laboratoire de Génétique Moléculaire, CHRU Strasbourg, Strasbourg, France
| | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Arnesen
- Department of Molecular Biology, University of Bergen, Bergen, Norway.,Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - Christel Thauvin-Robinet
- Centre de Référence maladies rares « Anomalies du Développement et syndrome malformatifs » de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - Christiane Zweier
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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15
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Goldenberg P, Shikany A, Parrott A, Ware SM, Hinton RB. Persistent Left Superior Vena Cava: An Overlooked Feature of CHARGE Syndrome? Cardiogenetics 2015. [DOI: 10.4081/cardiogenetics.2015.5511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
CHARGE is a well-characterized syndrome (OMIM 2148400) associated with multiple congenital anomalies including cardiovascular malformations. Mutations in CHD7 are the most common cause of CHARGE syndrome. Persistent left superior vena cava (LSVC) has been described in patients with CHARGE syndrome in one study of LSVC associations. A retrospective chart review was conducted for all patients with CHARGE syndrome, diagnosed by Blake criterion features and/or the presence of a pathogenic CHD7 mutation. Echocardio - grams were performed on a clinical basis for all patients and were systematically reviewed and classified. Persistent LSVC was present in 50% of patients with CHARGE syndrome (4/8) and was seen in 3 out of 33 patients seen by cardiovascular genetics with 22q11.2 deletion syndrome. Persistent LSVC is a common finding in patients with CHARGE syndrome and its presence may increase the index of suspicion in patients with other characteristic congenital anomalies.
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16
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Parrott A, James J, Goldenberg P, Hinton RB, Miller E, Shikany A, Aylsworth AS, Kaiser-Rogers K, Ferns SJ, Lalani SR, Ware SM. Aortopathy in the 7q11.23 microduplication syndrome. Am J Med Genet A 2014; 167A:363-70. [DOI: 10.1002/ajmg.a.36859] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ashley Parrott
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Jeanne James
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Paula Goldenberg
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Robert B. Hinton
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Erin Miller
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Amy Shikany
- Department of Pediatrics; Cincinnati Children's Hospital Medical Center; Heart Institute; Cincinnati Ohio
| | - Arthur S. Aylsworth
- Department of Pediatrics; University of North Carolina; Chapel Hill North Carolina
- Department of Genetics; University of North Carolina; Chapel Hill North Carolina
| | - Kathleen Kaiser-Rogers
- Department of Pediatrics; University of North Carolina; Chapel Hill North Carolina
- Department of Genetics; University of North Carolina; Chapel Hill North Carolina
- Department of Pathology and Laboratory Medicine; University of North Carolina; Chapel Hill North Carolina
| | - Sunita J. Ferns
- Department of Pediatrics; University of North Carolina; Chapel Hill North Carolina
| | - Seema R. Lalani
- Department of Molecular and Human Genetics; Baylor College of Medicine; Houston Texas
| | - Stephanie M. Ware
- Department of Pediatrics and Medical and Molecular Genetics; Indiana University School of Medicine; Indianapolis Indiana
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17
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Ryan TD, Gupta A, Gupta D, Goldenberg P, Taylor MD, Lorts A, Jefferies JL. Dilated cardiomyopathy in a 32-year-old woman with Russell-Silver syndrome. Cardiovasc Pathol 2013; 23:21-7. [PMID: 24075556 DOI: 10.1016/j.carpath.2013.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 07/02/2013] [Revised: 08/08/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Russell-Silver Syndrome (RSS) is a genetically determined condition characterized by severe intrauterine and postnatal growth retardation; relative macrocephaly; a small, triangular face; and fifth-finger clinodactyly. The etiology of RSS involves epigenetic regulation through either uniparental disomy or genomic imprinting via DNA methylation. There has been no documented association between RSS and cardiomyopathy. METHODS We present an original case of a 32-year-old woman with RSS with dilated a cardiomyopathy who on cardiac biopsy showed occasional hypertrophic and atrophic myocytes with no evidence of inflammation, abnormal sarcomeres and disintegration of the Z bands on ultrastructural analysis, abnormal desmin, and normal C9 immunoreactivity. CONCLUSION This case represents the first reported association between RSS and cardiomyopathy. Given the complex mechanisms of disease etiology in RSS, this novel case provides insights into the mechanism of progressive dilated cardiomyopathy in an older individual with RSS.
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Affiliation(s)
- Thomas D Ryan
- The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA
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18
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Czosek RJ, Goldenberg P, Miller EM, Spicer R, Towbin JA, Ware SM. Cardiac electrical system involvement in Alström syndrome: uncommon causes of dilated cardiomyopathies. Cardiogenetics 2012. [DOI: 10.4081/cardiogenetics.2012.e2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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19
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Bassett AS, McDonald-McGinn DM, Devriendt K, Digilio MC, Goldenberg P, Habel A, Marino B, Oskarsdottir S, Philip N, Sullivan K, Swillen A, Vorstman J. Practical guidelines for managing patients with 22q11.2 deletion syndrome. J Pediatr 2011; 159:332-9.e1. [PMID: 21570089 PMCID: PMC3197829 DOI: 10.1016/j.jpeds.2011.02.039] [Citation(s) in RCA: 362] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 01/24/2011] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
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20
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Toriello HV, Goldenberg P. Evidence-based medicine and practice guidelines: application to genetics. Am J Med Genet C Semin Med Genet 2009; 151C:235-40. [PMID: 19621463 DOI: 10.1002/ajmg.c.30222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Professional Practice and Guidelines Committee of the American College of Medical Genetics has the responsibility of overseeing the development of guidelines for the practice of clinical genetics. In the past, most, if not all, guidelines were primarily based on expert opinion. However, recently the goal has become to develop guidelines that are more evidence-based, or at least, to recognize the level of evidence available to the authors of these documents. This article reviews the challenges that are faced by geneticists who are charged with the development of practice guidelines.
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Affiliation(s)
- Helga V Toriello
- Spectrum Health-Genetics, 25 Michigan St. Suite 2000, Grand Rapids, MI 49503, USA.
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21
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Abstract
This study characterizes cesarean rates among women giving birth in São José do Rio Preto in 1992. Household interviews were conducted with 553 women selected through records on live births. Estimated incidence of cesarean sections was 80.5%, highlighting the procedure's widespread use in the study sample. Confirming a prior hypothesis, cesarean rates increased with parity and were statistically associated with age and tubal ligation. As for socioeconomic status, cesarean rates increased according to income and were higher among women using private health care (with or without health insurance). Interviews with professors in the local medical school and a related survey of the local media showed an increase in the valorization of cesareans. Confirming this trend, women interviewed in the survey expressed their own active valorization of this procedure.
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Affiliation(s)
- M S de Moraes
- Departamento de Epidemiologia e Saúde Coletiva, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, 15091-060, Brasil
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22
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Franco LJ, Mameri C, Pagliaro H, Iochida LC, Goldenberg P. [Diabetes as primary or associated cause of death in the state of São Paulo, Brazil, 1992]. Rev Saude Publica 1998; 32:237-45. [PMID: 9778858 DOI: 10.1590/s0034-89101998000300006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 11/21/2022] Open
Abstract
INTRODUCTION Analysis of mortality data are usually performed with reference to the underlying cause of death. The importance of diabetes as a cause of death is always underestimated, because diabetics generally die from chronic complications of the disease, these being considered as the underlying cause of the death. To attenuate this problem, mortality data should be analyzed on the basis of all the causes listed on the death certificate. Frequency of references to diabetes on death certificates and the principal associated causes were evaluated as a contribution to the solution of this problem. METHODOLOGY Specific death rates and proportional mortality by diabetes, as underlying or associated cause, were calculated on the basis of information derived from death certificates by the ACME program (Automated Classification of Medical Entities), for the State of S. Paulo, in 1992. RESULTS AND CONCLUSIONS Of a total of 202,141 deaths, diabetes was mentioned in 13,786 (6.8%) and as being the underlying cause in 5,305(2.6%). The proportion was higher for women than men (10.1 vs. 4.6% as mentioned, and 6.1 vs 2.9% as underlying cause). Among deaths with a mention of diabetes on the certificate, the main underlying causes were: diabetes (38.5%), cardiovascular (37.2%) and respiratory (8.5%) diseases, and neoplasias (4.8%). When diabetes was the underlying cause, the main associated causes were: cardiovascular (42.2%), respiratory (10.7%) and genitourinary (10.1%) diseases. When diabetes was an associated cause, the main underlying causes were: cardiovascular (60.5%) and respiratory (13.8%) diseases, and neoplasias (7.9%). In spite of the limitation of the data from death certificates, it is possible to observe the importance of diabetes as cause of death, reflecting its magnitude as a health problem. Also, the analysis by multiple causes of deaths gives an idea of the morbidity profile associated with diabetes at the time of death, showing the importance of the group of cardiovascular diseases.
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Affiliation(s)
- L J Franco
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Brasil.
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23
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Abstract
PURPOSE Partial results of a continuous evaluation process of the undergraduate medical course at Escola Paulista de Medicina (EPM) started in 1989 are presented. METHODS A survey on expectations and opinions about the medical course of EPM was carried out among faculty members, students and alumni. RESULTS The authors call into question that the medical formation is non-terminal as indicated by the late entry to labor market. CONCLUSION The authors consider that the phenomenon is not related to quality aspects but to the specialization process started during the medical course and completed only with graduated studies.
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Affiliation(s)
- R C Stella
- Universidade Federal de São Paulo, Escola Paulista de Medicina
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Tudisco ES, Manoel NDJ, Goldenberg P, Juliano Y, Novo NF, Sigulem DM. [Comparison of dietary patterns of mothers of low socioeconomic level during the lactation period and after weaning]. Rev Saude Publica 1985; 19:133-45. [PMID: 4089510 DOI: 10.1590/s0034-89101985000200004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Analisou-se a ingestão de alimentos de 190 mães de baixo nível sócio-econômico, residentes no município de São Paulo, SP (Brasil) em dois momentos; durante a fase de lactação (Inquérito I) e após o seu término (Inquérito II). Para caracterizar o padrão alimentar do grupo e dimensionar o risco, utilizou-se o inquérito alimentar recordatório de 24 horas. Os resultados mostraram que o padrão alimentar das mães é constituído por alimentos pertencentes aos grupos de protetores (feijão, leite C e carne de vaca); reguladores (banana, laranja, alface e tomate) e energéticos (arroz, pão, batata, macarrão, açúcar refinado e óleo vegetal), indicando uma dieta qualitativamente adequada. Encontrou-se, ainda, diferença estatisticamente significante no consumo de leite, feijão e café nos dois momentos analisados, indicando um maior consumo do primeiro durante o aleitamento natural (Inquérito I) e um aumento na ingestão de feijão e café após o desmame (Inquérito II). Além disso, o déficit apresentado no Inquérito I foi na maioria das vezes calórico-protéico, enquanto que no Inquérito II foi predominantemente calórico, verificando-se que a amostra analisada representa grupo de risco à desnutrição protéico-calórica.
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Tudisco ES, Manoel NDJ, Goldenberg P, Novo NF, Sigulem DM. [Evaluation of maternal nutritional status and duration of breast feeding]. Rev Saude Publica 1984; 18:313-22. [PMID: 6515304 DOI: 10.1590/s0034-89101984000400006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Estudou-se o estado nutricional de 190 mães de baixa renda, primíparas ou não, residentes no município de São Paulo (Brasil), e sua relação com a duração do aleitamento natural. Na avaliação do estado nutricional empregou-se o critério de adequação de peso para a estatura. Investigou-se a participação do setor Saúde no processo de desmame. Descreveu-se também a prevalência de desnutrição no período pré-gestacional, no pós-parto e no pós-desmame, verificando-se o comportamento do estado nutricional nos três períodos. Observou-se que apenas entre as mulheres não-primíparas houve diferença estatisticamente significante do estado de nutrição nos períodos analisados. Quanto ao estudo da duração do aleitamento natural com o estado nutricional materno, não se encontrou associação significante entre estes eventos. Na tentativa de explorar outras variáveis, que estariam associadas com a ocorrência de desmame precoce na amostra estudada, enfocou-se a influência do setor Saúde, percebendo-se a falha qualitativa do mesmo quanto a orientação sobre aleitamento natural.
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Goldenberg P, Pardo RM, Regina Neto D, Ribeiro SA, Pernambuco M, Iunes M. [The social dimension of diseases. II. Positive Wassermann and VDRL reactions in draftees of the State of São Paulo (Brazil), 1972-1978]. Rev Saude Publica 1982; 16:133-43. [PMID: 7156845 DOI: 10.1590/s0034-89101982000300001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Em seqüência à série histórica iniciada em 1968, com o objetivo de obter indicações sobre a evolução da sífilis no Estado de São Paulo (Brasil), foi feito levantamento dos dados de 1972 a 1978 que mostrou que ao longo do tempo e apesar das oscilações, não houve variações substanciais dos coeficientes de positividade das reações de Wasserman e VDRL em convocados apresentados no município de São Paulo. No interior do Estado o aumento dos valores dos coeficiente de 1973, invertendo a tendência anteriormente observada, aproxima esses índices aos do município. O estudo da subamostra indicou a presença de proporções maiores de positividade em convocados apresentados no município comparados com os apresentados no interior do Estado, independentes da naturalidade, o que poderia sugerir semelhanças com os quadros epidemiológicos descritos para os países desenvolvidos. Entre convocados apresentados na capital observou-se maiores proporções de positividade nos convocados nascidos em outros Estados do país, o que evidenciaria a presença da doença associada à pobreza ou ao subdesenvolvimento. Nesse sentido, foi chamada a atenção para as peculiaridades epidemiológicas das doenças em vista da singularidade das respectivas organizações sociais num dado momento histórico.
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Goldenberg P, de Morais MB, Cainelli M, Nery CA, Moron AF, Nioni AS, Tebexreni AS, José FF, Khouri S, Iunes M. [Social dimension of the occurrence of diseases. I. Positiveness of Machado-Guerreiro reaction among draftees for military service in São Paulo State (Brazil), 1972-1975]. Rev Saude Publica 1979; 13:271-80. [PMID: 121488 DOI: 10.1590/s0034-89101979000400003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
São destacados, diante da série histórica levantada, os valores elevados dos coeficientes de positividade da reação de Machado-Guerreiro entre convocados apresentados na Capital de São Paulo (Brasil), onde não é referida a ocorrência de transmissão de Chagas. Esses valores atingem, inclusive, níveis superiores aos dos convocados apresentados no Interior, onde existem áreas endêmicas. O estudo evidenciou a participação de migrantes, infectados nos locais de origem, na determinação dos níveis de positividade, especialmente da Capital de São Paulo. Esses dados ressaltariam o envolvimento de fatores sociais no condicionamento da ocorrência e distribuição da doença ao nível populacional.
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Sigulem DM, Tudisco ES, Goldenberg P, Athaide MM, Vaisman E. [Iron-deficiency anemia in children of the Municipality of São Paulo]. Rev Saude Publica 1978; 12:168-78. [PMID: 715358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Goldenberg P, Vaisman E, del Porto JA, Sbrissa E, Nagy M, Leser WP. [Positive coefficients of Wassermann and VDRL reactions among army recruits in the State of São Paulo, from 1968 to 1971]. AMB Rev Assoc Med Bras 1974; 20:265-6. [PMID: 4547068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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