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Zakeri Z, Heiderzadeh M, Kocaarslan A, Metin E, Hosseini Karimi SN, Saghati S, Vural A, Akyoldaş G, Baysal K, Yağcı Y, Gürsoy-Özdemir Y, Taşoğlu S, Rahbarghazi R, Sokullu E. Exosomes encapsulated in hydrogels for effective central nervous system drug delivery. Biomater Sci 2024; 12:2561-2578. [PMID: 38602364 DOI: 10.1039/d3bm01055d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
The targeted delivery of pharmacologically active molecules, metabolites, and growth factors to the brain parenchyma has become one of the major challenges following the onset of neurodegeneration and pathological conditions. The therapeutic effect of active biomolecules is significantly impaired after systemic administration in the central nervous system (CNS) because of the blood-brain barrier (BBB). Therefore, the development of novel therapeutic approaches capable of overcoming these limitations is under discussion. Exosomes (Exo) are nano-sized vesicles of endosomal origin that have a high distribution rate in biofluids. Recent advances have introduced Exo as naturally suitable bio-shuttles for the delivery of neurotrophic factors to the brain parenchyma. In recent years, many researchers have attempted to regulate the delivery of Exo to target sites while reducing their removal from circulation. The encapsulation of Exo in natural and synthetic hydrogels offers a valuable strategy to address the limitations of Exo, maintaining their integrity and controlling their release at a desired site. Herein, we highlight the current and novel approaches related to the application of hydrogels for the encapsulation of Exo in the field of CNS tissue engineering.
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Affiliation(s)
- Ziba Zakeri
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | - Morteza Heiderzadeh
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | - Azra Kocaarslan
- Chemistry Department, Faculty of Science, İstanbul Technical University, İstanbul, Turkey
| | - Ecem Metin
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | | | - Sepideh Saghati
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atay Vural
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Neurology, School of Medicine, KoÒ« University, Istanbul 34450, Turkey
| | - Göktuğ Akyoldaş
- Department of Neurosurgery, Koç University Hospital, Istanbul 34450, Turkey
| | - Kemal Baysal
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Biochemistry, School of Medicine, Koç University, Istanbul 34450, Turkey
| | - Yusuf Yağcı
- Chemistry Department, Faculty of Science, İstanbul Technical University, İstanbul, Turkey
| | - Yasemin Gürsoy-Özdemir
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Neurology, School of Medicine, KoÒ« University, Istanbul 34450, Turkey
| | - Savaş Taşoğlu
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Mechanical Engineering Department, School of Engineering, Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Emel Sokullu
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Biophysics Department, Koç University School of Medicine, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey
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Ferrari M, Mularoni F, Taboni S, Crosetti E, Pessina C, Carobbio ALC, Montalto N, Marchi F, Vural A, Paderno A, Caprioli S, Gaudioso P, Fermi M, Rigoni F, Saccardo T, Contro G, Ruaro A, Lo Manto A, Varago C, Baldovin M, Bandolin L, Filauro M, Sampieri C, Missale F, Ioppi A, Carta F, Ramanzin M, Ravanelli M, Maiolo V, Bertotto I, Del Bon F, Lancini D, Mariani C, Marrosu V, Tatti M, Cağlı S, Yüce I, Gündoğ M, Dogan S, Anile G, Gottardi C, Busato F, Vallin A, Gennarini F, Bossi P, Ghi MG, Lionello M, Zanoletti E, Marioni G, Maroldi R, Mattioli F, Puxeddu R, Bertolin A, Presutti L, Piazza C, Succo G, Peretti G, Nicolai P. How reliable is assessment of true vocal cord-arytenoid unit mobility in patients affected by laryngeal cancer? a multi-institutional study on 366 patients from the ARYFIX collaborative group. Oral Oncol 2024; 152:106744. [PMID: 38520756 DOI: 10.1016/j.oraloncology.2024.106744] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE In clinical practice the assessment of the "vocal cord-arytenoid unit" (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension. METHODS In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated. RESULTS Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal. CONCLUSIONS The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology.
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Affiliation(s)
- M Ferrari
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy.
| | - F Mularoni
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - S Taboni
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - E Crosetti
- Otorhinolaryngology Department - Head Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - C Pessina
- Radiology Unit, Sant'Antonio Hospital, University of Padova, Padova, Italy
| | - A L C Carobbio
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - N Montalto
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - F Marchi
- Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - A Vural
- Otorhinolaryngology Unit, Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - A Paderno
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - S Caprioli
- Radiology Unit, San Martino Hospital, Genoa, Italy
| | - P Gaudioso
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - M Fermi
- Otorhinolaryngology Unit, Azienda Ospedaliera Universitaria di Bologna IRCCS, Bologna, Italy; Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy
| | - F Rigoni
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - T Saccardo
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - G Contro
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - A Ruaro
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - A Lo Manto
- Otorhinolaryngology Unit, Infermi Hospital, Rimini, Italy
| | - C Varago
- Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy
| | - M Baldovin
- Otorhinolaryngology Unit, San Martino di Belluno Hospital, Belluno, Italy
| | - L Bandolin
- Otorhinolaryngology Unit, Hospital of Santorso, Vicenza, Italy
| | - M Filauro
- Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - C Sampieri
- Department of Experimental Medicine (DIMES), University of Genoa, Italy; Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain
| | - F Missale
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, the Netherlands
| | - A Ioppi
- Department of Otorhinolaryngology-Head and Neck Surgery, "S. Chiara" Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - F Carta
- Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - M Ramanzin
- Radiology Unit, Hospital of Vicenza, Vicenza, Italy
| | - M Ravanelli
- Radiology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - V Maiolo
- Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit (IRCCS AOUBO), University of Bologna, Italy
| | - I Bertotto
- Radiology Unit, IRCCS Istituto di Candiolo, Turin, Italy
| | - F Del Bon
- Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - D Lancini
- Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - C Mariani
- Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - V Marrosu
- Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - M Tatti
- Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - S Cağlı
- Otorhinolaryngology Unit, Erciyes University, Kayseri, Turkey
| | - I Yüce
- Otorhinolaryngology Unit, Erciyes University, Kayseri, Turkey
| | - M Gündoğ
- Department of Radiation Oncology, Erciyes University, Kayseri, Turkey
| | - S Dogan
- Department of Radiology, Erciyes University, Kayseri, Turkey
| | - G Anile
- Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy
| | - C Gottardi
- Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy
| | - F Busato
- Unit of Radiation Oncology, Policlinico Abano, Padova, Italy
| | - A Vallin
- Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - F Gennarini
- Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - P Bossi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - M G Ghi
- Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy
| | - M Lionello
- Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy
| | - E Zanoletti
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - G Marioni
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
| | - R Maroldi
- Radiology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - F Mattioli
- Otorhinolaryngology Unit, University of Modena, Modena, Italy
| | - R Puxeddu
- Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy; King's College Hospital London, Dubai, United Arab Emirates
| | - A Bertolin
- Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy
| | - L Presutti
- Otorhinolaryngology Unit, Azienda Ospedaliera Universitaria di Bologna IRCCS, Bologna, Italy; Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy
| | - C Piazza
- Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - G Succo
- Otorhinolaryngology Department - Head Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy; Oncology Department, University of Turin, Turin, Italy
| | - G Peretti
- Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - P Nicolai
- Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Università di Padova, Padova, Italy
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Ünlü S, Sánchez Navarro BG, Cakan E, Berchtold D, Meleka Hanna R, Vural S, Vural A, Meisel A, Fichtner ML. Exploring the depths of IgG4: insights into autoimmunity and novel treatments. Front Immunol 2024; 15:1346671. [PMID: 38698867 PMCID: PMC11063302 DOI: 10.3389/fimmu.2024.1346671] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/29/2024] [Indexed: 05/05/2024] Open
Abstract
IgG4 subclass antibodies represent the rarest subclass of IgG antibodies, comprising only 3-5% of antibodies circulating in the bloodstream. These antibodies possess unique structural features, notably their ability to undergo a process known as fragment-antigen binding (Fab)-arm exchange, wherein they exchange half-molecules with other IgG4 antibodies. Functionally, IgG4 antibodies primarily block and exert immunomodulatory effects, particularly in the context of IgE isotype-mediated hypersensitivity reactions. In the context of disease, IgG4 antibodies are prominently observed in various autoimmune diseases combined under the term IgG4 autoimmune diseases (IgG4-AID). These diseases include myasthenia gravis (MG) with autoantibodies against muscle-specific tyrosine kinase (MuSK), nodo-paranodopathies with autoantibodies against paranodal and nodal proteins, pemphigus vulgaris and foliaceus with antibodies against desmoglein and encephalitis with antibodies against LGI1/CASPR2. Additionally, IgG4 antibodies are a prominent feature in the rare entity of IgG4 related disease (IgG4-RD). Intriguingly, both IgG4-AID and IgG4-RD demonstrate a remarkable responsiveness to anti-CD20-mediated B cell depletion therapy (BCDT), suggesting shared underlying immunopathologies. This review aims to provide a comprehensive exploration of B cells, antibody subclasses, and their general properties before examining the distinctive characteristics of IgG4 subclass antibodies in the context of health, IgG4-AID and IgG4-RD. Furthermore, we will examine potential therapeutic strategies for these conditions, with a special focus on leveraging insights gained from anti-CD20-mediated BCDT. Through this analysis, we aim to enhance our understanding of the pathogenesis of IgG4-mediated diseases and identify promising possibilities for targeted therapeutic intervention.
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Affiliation(s)
- Selen Ünlü
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye
- Koç University School of Medicine, Istanbul, Türkiye
| | - Blanca G. Sánchez Navarro
- Department of Neurology with Experimental Neurology, Integrated Myasthenia Gravis Center, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Elif Cakan
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, United States
| | - Daniel Berchtold
- Department of Neurology with Experimental Neurology, Integrated Myasthenia Gravis Center, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Rafael Meleka Hanna
- Department of Neurology with Experimental Neurology, Integrated Myasthenia Gravis Center, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Secil Vural
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye
- Department of Dermatology and Venereology, Koç University School of Medicine, İstanbul, Türkiye
| | - Atay Vural
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye
- Department of Neurology, Koç University School of Medicine, İstanbul, Türkiye
| | - Andreas Meisel
- Department of Neurology with Experimental Neurology, Integrated Myasthenia Gravis Center, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Miriam L. Fichtner
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye
- Department of Neurology with Experimental Neurology, Integrated Myasthenia Gravis Center, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
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Belen BG, Gamze Bülbül N, Karsidag S, Köse E, Vural A, Özdağ F. COMBINED CENTRAL AND PERIPHERAL DEMYELINATION (CCPD): TWO CASE REPORTS. Eur Neurol 2024:000536167. [PMID: 38325357 DOI: 10.1159/000536167] [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] [Received: 09/20/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
Combined central and peripheral demyelination (CCPD) is is a rare disease characterized by demyelinating lesions in both the central nervous system (CNS) and peripheral nervous system (PNS). CCPD can present with acute, subacute or chronic onset. The initial symptom may be of CNS origin, PNS origin or both. The clinical manifestations of CCPD are quite heterogeneous, and there are no well-defined diagnostic criteria. In MRI imaging of CCPD cases, demyelinating lesions can be seen in areas such as the brain, cerebellum, brainstem, optic nerve, and spinal cord. Common EMG findings in patients with CCPD include decreased motor nerve conduction velocities, decreased or absent sensory nerve action potentials, prolonged F-wave latency, and decreased amplitude of compound muscle action potentials Neurofascin (NF) is a transmembrane protein and anti-neurofascin (anti-NF) antibodies directed against NF can be positive in cases of CCPD. Four main NF polypeptides are produced by alternative splicing: NF 186, NF 180, NF 166 and NF155. The investigation of anti-NF in CCPD cases is therefore important for etiological considerations. Here, we discussed two cases diagnosed with CCPD based on clinical, neuroimaging, electromyography (EMG) and anti-NF antibody results in light of the literature.
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Youssef H, Gönül MN, Sobeeh MG, Akar K, Feys P, Cuypers K, Vural A. Is High-Intensity Interval Training more effective than Moderate Continuous Training in Rehabilitation of Multiple Sclerosis: A Comprehensive Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00025-X. [PMID: 38199581 DOI: 10.1016/j.apmr.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The present study aimed to conduct meta-analysis to determine whether the high intensity interval training (HIIT) protocol is more beneficial in improving outcome measures compared to Moderate continuous training (MCT) in people with multiple sclerosis (pwMS). In addition, to systematically review the exercise protocols differences. DATA SOURCES A search strategy, locating HIIT in pwMS, was executed in six databases, PubMed, EMBASE, Web of Science, Central Cochrane, Pedro, and Ovid MEDLine. STUDY SELECTION Randomized control trials of HIIT utilizing cycle ergometer or recumbent stepper as exercise modalities were included in analysis. Intervention arms should include at least two intervention arms, including HIIT in one arm, and MCT in the other group. DATA EXTRACTION Data extracted from each study includes the following items: basic details of the study (such as author, date of publication, location, and study design), participant characteristics (sample size, mean age, gender, mean disease duration, and extended disability status scale), specifications of the HITT protocol (exercise modality, session duration, number of intervals/session, interval intensity, recovery intensity, recovery interval, and adverse effect), as well as primary outcomes at baseline and post-intervention (cardiorespiratory fitness, fatigue, body composition, muscle power, cognitive functions, and blood biomarkers). DATA SYNTHESIS 22 studies included in the systematic review, 11 were included in random effects model pooled analysis. There was a significant effect in favor of HIIT for VO2max of cardiorespiratory functions compared to MCT (ES = 0.45 95%, CI [0.14, 0.76], p = 0.004), and for memory domain of cognitive functions (ES = 0.34 95% CI [0.05, 0.63], p = 0.02). Statistical significance was not achieved for the other variables. CONCLUSION HIIT and MCT yield similar results in terms of fatigue, body composition, cognitive functions, and blood biomarkers. However, VO2max of cardiorespiratory functions and memory domain of cognitive functions were in favor of HIIT protocol.
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Affiliation(s)
- Hussein Youssef
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye; Koç University Graduate School of Health Sciences, İstanbul, Türkiye; Hasselt University, Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, Diepenbeek, Belgium.
| | - Mine Nur Gönül
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye; Koç University Graduate School of Health Sciences, İstanbul, Türkiye; University of Health Sciences, Department of Physical Therapy, İstanbul, Türkiye
| | - Mohamed Gomaa Sobeeh
- Cairo University, Faculty of Physical Therapy, Department of Physical Therapy for Musculoskeletal, Giza, Egypt; Sinai University, Faculty of Physical Therapy, Ismailia, Egypt
| | - Kardelen Akar
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye; Koç University Graduate School of Health Sciences, İstanbul, Türkiye
| | - Peter Feys
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, Diepenbeek, Belgium; Universitair MS Centrum Hasselt-Pelt, UMSC, Belgium
| | - Koen Cuypers
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, Diepenbeek, Belgium; Movement Control and Neuroplasticity Research Group, Biomedical Sciences, KU Leuven, Tervuurse Vest 101, Leuven 3001, Belgium; Leuven Brain Institute, KU Leuven-LBI, Leuven, Belgium
| | - Atay Vural
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Türkiye; Koç University Graduate School of Health Sciences, İstanbul, Türkiye; Koç University School of Medicine, Department of Neurology, İstanbul, Türkiye
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Khoshbakht S, Başkurt D, Vural A, Vural S. Behçet's Disease: A Comprehensive Review on the Role of HLA-B*51, Antigen Presentation, and Inflammatory Cascade. Int J Mol Sci 2023; 24:16382. [PMID: 38003572 PMCID: PMC10671634 DOI: 10.3390/ijms242216382] [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: 09/28/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Behçet's disease (BD) is a complex, recurring inflammatory disorder with autoinflammatory and autoimmune components. This comprehensive review aims to explore BD's pathogenesis, focusing on established genetic factors. Studies reveal that HLA-B*51 is the primary genetic risk factor, but non-HLA genes (ERAP1, IL-10, IL23R/IL-12RB2), as well as innate immunity genes (FUT2, MICA, TLRs), also contribute. Genome-wide studies emphasize the significance of ERAP1 and HLA-I epistasis. These variants influence antigen presentation, enzymatic activity, and HLA-I peptidomes, potentially leading to distinct autoimmune responses. We conducted a systematic review of the literature to identify studies exploring the association between HLA-B*51 and BD and further highlighted the roles of innate and adaptive immunity in BD. Dysregulations in Th1/Th2 and Th17/Th1 ratios, heightened clonal cytotoxic (CD8+) T cells, and reduced T regulatory cells characterize BD's complex immune responses. Various immune cell types (neutrophils, γδ T cells, natural killer cells) further contribute by releasing cytokines (IL-17, IL-8, GM-CSF) that enhance neutrophil activation and mediate interactions between innate and adaptive immunity. In summary, this review advances our understanding of BD pathogenesis while acknowledging the research limitations. Further exploration of genetic interactions, immune dysregulation, and immune cell roles is crucial. Future studies may unveil novel diagnostic and therapeutic strategies, offering improved management for this complex disease.
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Affiliation(s)
- Saba Khoshbakht
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
| | - Defne Başkurt
- School of Medicine, Koç University, Istanbul 34010, Turkey;
| | - Atay Vural
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
- Department of Neurology, Koç University School of Medicine, Istanbul 34010, Turkey
| | - Seçil Vural
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul 34010, Turkey
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Solmaz I, Öncel IH, Konuşkan B, Erol I, Orgun LT, Yılmaz Ü, Ünalp A, Atasoy E, Aksoy E, Yılmaz D, Öztürk M, Karaca NB, Yılmaz S, Yiş U, Dündar NO, Parlak Ş, Vural A, Günbey C, Anlar B. Role of serostatus in pediatric neuromyelitis optica spectrum disorders: A nationwide multicentric study. Mult Scler Relat Disord 2023; 77:104847. [PMID: 37393803 DOI: 10.1016/j.msard.2023.104847] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Neuromyelitis optica spectrum disorders (NMOSD) are immune-mediated inflammatory disorders of the central nervous system (CNS) mostly presenting as optic neuritis and acute myelitis. NMOSD can be associated with seropositivity for aquaporin 4 antibody (AQP4 IgG), myelin oligodendrocyte glycoprotein antibody (MOG IgG), or can be seronegative for both. In this study, we retrospectively examined our seropositive and seronegative pediatric NMOSD patients. METHOD Data were collected from all participating centres nationwide. Patients diagnosed with NMOSD were divided into three subgroups according to serology: AQP4 IgG NMOSD, MOG IgG NMOSD, and double seronegative (DN) NMOSD. Patients with at least six months of follow-up were compared statistically. RESULTS The study included 45 patients, 29 female and 16 male (ratio:1.8), mean age 15.16 ± 4.93 (range 5.5-27) years. Age at onset, clinical manifestations, and cerebrospinal fluid findings were similar between AQP4 IgG NMOSD (n = 17), MOG IgG NMOSD (n = 10), and DN NMOSD (n = 18) groups. A polyphasic course was more frequent in the AQP4 IgG and MOG IgG NMOSD groups than DN NMOSD (p = 0.007). The annualized relapse rate and rate of disability were similar between groups. Most common types of disability were related to optic pathway and spinal cord involvement. Rituximab in AQP4 IgG NMOSD, intravenous immunoglobulin in MOG IgG NMOSD, and azathioprine in DN NMOSD were usually preferred for maintenance treatment. CONCLUSION In our series with a considerable number of double seronegatives, the three major serological groups of NMOSD were indistinguishable based on clinical and laboratory findings at initial presentation. Their outcome is similar in terms of disability, but seropositive patients should be more closely followed-up for relapses.
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Affiliation(s)
- Ismail Solmaz
- Etlik City Hospital, Department of Pediatric Neurology, Ankara, Turkey.
| | - Ibrahim Halil Öncel
- Hacettepe University, Faculty of Medicine, Departmanet of Pediatric Neurology, Ankara, Turkey
| | - Bahadır Konuşkan
- Dr Sami Ulus Child Health and Diseases Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey
| | - Ilknur Erol
- Baskent University Faculty of Medicine, Department of Pediatric Neurology, Adana, Turkey
| | - Leman Tekin Orgun
- Baskent University Faculty of Medicine, Department of Pediatric Neurology, Adana, Turkey
| | - Ünsal Yılmaz
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatric Neurology, Izmir, Turkey
| | - Aycan Ünalp
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatric Neurology, Izmir, Turkey
| | - Ergin Atasoy
- Etlik City Hospital, Department of Pediatric Neurology, Ankara, Turkey
| | - Erhan Aksoy
- Dr Sami Ulus Child Health and Diseases Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey
| | - Deniz Yılmaz
- Bilkent City Hospital, Department of Pediatric Neurology, Ankara, Turkey
| | - Merve Öztürk
- Kocaeli University, Faculty of Medicine, Department of Pediatric Neurology, Kocaeli, Turkey
| | - Nazlı Balcan Karaca
- Gazi University, Faculty of Medicine, Department of Pediatric Neurology, Ankara, Turkey
| | - Sanem Yılmaz
- Ege University Faculty of Medicine, Department of Pediatric Neurology, Izmir, Turkey
| | - Uluç Yiş
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Neurology, Izmir, Turkey
| | - Nihal Olgaç Dündar
- Izmir Katip Celebi University Faculty of Medicine, Department of Pediatric Neurology, Izmir, Turkey
| | - Şafak Parlak
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Atay Vural
- Koç University, Department of Neurology, Istanbul, Turkey
| | - Ceren Günbey
- Hacettepe University, Faculty of Medicine, Departmanet of Pediatric Neurology, Ankara, Turkey
| | - Banu Anlar
- Hacettepe University, Faculty of Medicine, Departmanet of Pediatric Neurology, Ankara, Turkey
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Özkan E, Özler C, Akar K, Youssef H, Özmen K, Şen ZD, Vural A, Gürsoy-Özdemir Y. Individual-based predominance of visual input in multisensorial integration for balance is correlated with proprioceptive drift in rubber hand illusion. Sci Rep 2023; 13:11905. [PMID: 37488214 PMCID: PMC10366093 DOI: 10.1038/s41598-023-39253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/22/2023] [Indexed: 07/26/2023] Open
Abstract
Rubber hand illusion (RHI) is a traditional task that examines multisensory integration. The visual capture of tactile stimulus given to the seen rubber hand was considered to predominate the sensory processing and interfere with the bottom-up proprioceptive and tactile inputs received from the unseen real hand that results in mislocalization of participants hand towards rubber hand, namely proprioceptive drift (PD). Another task that requires multisensorial integration and shows a predominance of visual input is the maintenance of body posture. However, if the predominance of visual input in one task is generalizable to another task is yet to be elucidated. We aimed to examine if individual dependency on visual inputs in multisensorial integration in balance correlated with PD in RHI. Twenty healthy participants were recruited for the study and completed the RHI task. The contribution of visual inputs to the static body balance was measured with the instrumented clinical test of sensory interaction for balance and indexed with Romberg Quotient (RQ). We found a moderate positive correlation between PD and RQ. Individuals with more dependence on visual information in maintaining body posture had higher PD in RHI. Our results indicate that there can be an individual-based dependence on particular domains of sensory input preserved during different tasks of multisensorial integration. Future studies must clarify whether this tendency relates to certain physical or physiological traits.
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Affiliation(s)
- Esra Özkan
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey.
- Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey.
| | - Ceyda Özler
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
| | - Kardelen Akar
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
| | - Hussein Youssef
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
| | - Kaan Özmen
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
| | - Zümrüt Duygu Şen
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health, DZP, Jena, Germany
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Atay Vural
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
- Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey
| | - Yasemin Gürsoy-Özdemir
- Koç University Research Center for Translational Medicine, Koç University Hospital, Zeytinburnu, 34010, Istanbul, Turkey
- Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey
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9
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Cakmak OO, Akar K, Youssef H, Samanci MY, Ertan S, Vural A. Comparative Assessment of Gait and Balance in Patients with Parkinson's Disease and Normal Pressure Hydrocephalus. Sisli Etfal Hastan Tip Bul 2023; 57:232-237. [PMID: 37899810 PMCID: PMC10600622 DOI: 10.14744/semb.2023.79990] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 10/31/2023]
Abstract
Objectives We aim to compare balance and gait parameters in patients diagnosed with Parkinson's disease (PD) and normal pressure hydrocephalus (NPH). Methods A total of 13 patients with NPH, 20 with PD, and 13 healthy controls (HC) recruited in the study. Three IMU sensors (Ambulatory PD Monitoring Inc., OR, USA) were placed on the lumbar area and the feet of the participants. The balance evaluations comprised eight successive standing tasks; the modified clinical test of sensory interaction on balance test. These tasks involved standing with feet apart and eyes open as well as eyes closed on a firm and foam surface, standing with feet together and eyes open as well as eyes closed, and tandem stance with the right foot front and the left foot front. Functional evaluations of gait were conducted using the 10-M Walk Test (10 MWT), the 2 min-Walk Test (2 MWT), and the timed-up and go (TUG). Parameters of the gait and balance were analyzed and then compared. Results NPH patients displayed a notable decrease in both stride length and gait speed as compared with both PD patients and healthy participants. The balance tests revealed that the NPH group demonstrated significantly poorer performance, specifically in the feet-apart eyes-closed foam-surface test, and the tandem stance test. During the tasks while eyes were open on firm and foam surfaces, PD and NPH groups showed an increase in root mean square sway, range, and mean velocity (p<0.05) of sway in the anteroposterior plane. In addition, during the TUG test, the NPH group exhibited a significant prolongation in the time needed to complete the task and a decline in turning velocity as compared to PD, but no notable difference was seen in comparison to the HC group. Conclusion Our study indicated that the patients with NPH exhibited notably worse gait and balance measurements in comparison to both the PD patients and HC groups. These findings emphasize the significance of monitoring and managing gait and balance impairments in NPH patients. Sensor-based technologies may offer objective parameters for a more precise and efficient follow-up of these patients in terms of gait and balance.
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Affiliation(s)
- Ozgur Oztop Cakmak
- Department of Neurology, Koc University Faculty of Medicine, Istanbul, Türkiye
| | - Kardelen Akar
- Motion Analysis Laboratory, Koc University, KUTTAM, Istanbul, Türkiye
| | - Hussein Youssef
- Motion Analysis Laboratory, Koc University, KUTTAM, Istanbul, Türkiye
| | | | - Sibel Ertan
- Department of Neurology, Koc University Faculty of Medicine, Istanbul, Türkiye
| | - Atay Vural
- Department of Neurology, Koc University Faculty of Medicine, Istanbul, Türkiye
- Motion Analysis Laboratory, Koc University, KUTTAM, Istanbul, Türkiye
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10
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Sarıkaya Uzan G, Vural A, Yüksel D, Aksoy E, Öztoprak Ü, Canpolat M, Öztürk S, Yıldırım Ç, Güleç A, Per H, Gümüş H, Okuyaz Ç, Çobanoğulları Direk M, Kömür M, Ünalp A, Yılmaz Ü, Bektaş Ö, Teber S, Aliyeva N, Olgaç Dündar N, Gençpınar P, Gürkaş E, Keskin Yılmaz S, Kanmaz S, Tekgül H, Aksoy A, Öz Tuncer G, Acar Arslan E, Tosun A, Ayanoğlu M, Kızılırmak AB, Yousefi M, Bodur M, Ünay B, Hız Kurul S, Yiş U. Pediatric-Onset Chronic Inflammatory Demyelinating Polyneuropathy: A Multicenter Study. Pediatr Neurol 2023; 145:3-10. [PMID: 37245275 DOI: 10.1016/j.pediatrneurol.2023.04.018] [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: 12/26/2022] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND To evaluate the clinical features, demographic features, and treatment modalities of pediatric-onset chronic inflammatory demyelinating polyneuropathy (CIDP) in Turkey. METHODS The clinical data of patients between January 2010 and December 2021 were reviewed retrospectively. The patients were evaluated according to the Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society Guideline on the management of CIDP (2021). In addition, patients with typical CIDP were divided into two groups according to the first-line treatment modalities (group 1: IVIg only, group 2: IVIg + steroid). The patients were further divided into two separate groups based on their magnetic resonance imaging (MRI) characteristics. RESULTS A total of 43 patients, 22 (51.2%) males and 21 (48.8%) females, were included in the study. There was a significant difference between pretreatment and post-treatment modified Rankin scale (mRS) scores (P < 0.05) of all patients. First-line treatments include intravenous immunoglobulin (IVIg) (n = 19, 44.2%), IVIg + steroids (n = 20, 46.5%), steroids (n = 1, 2.3%), IVIg + steroids + plasmapheresis (n = 1, 2.3%), and IVIg + plasmapheresis (n = 1, 2.3%). Alternative agent therapy consisted of azathioprine (n = 5), rituximab (n = 1), and azathioprine + mycophenolate mofetil + methotrexate (n = 1). There was no difference between the pretreatment and post-treatment mRS scores of groups 1 and 2 (P > 0.05); however, a significant decrease was found in the mRS scores of both groups with treatment (P < 0.05). The patients with abnormal MRI had significantly higher pretreatment mRS scores compared with the group with normal MRI (P < 0.05). CONCLUSIONS This multicenter study demonstrated that first-line immunotherapy modalities (IVIg vs IVIg + steroids) had equal efficacy for the treatment of patients with CIDP. We also determined that MRI features might be associated with profound clinical features, but did not affect treatment response.
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Affiliation(s)
- Gamze Sarıkaya Uzan
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
| | - Atay Vural
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey; Department of Neurology, Koç University School of Medicine, İstanbul, Turkey
| | - Deniz Yüksel
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Erhan Aksoy
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ülkühan Öztoprak
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Canpolat
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Selcan Öztürk
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Çelebi Yıldırım
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ayten Güleç
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hüseyin Per
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hakan Gümüş
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Çetin Okuyaz
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Meltem Çobanoğulları Direk
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Mustafa Kömür
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Aycan Ünalp
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Ünsal Yılmaz
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Ömer Bektaş
- Division of Child Neurology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serap Teber
- Division of Child Neurology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nargiz Aliyeva
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nihal Olgaç Dündar
- Division of Child Neurology, Department of Pediatrics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Pınar Gençpınar
- Division of Child Neurology, Department of Pediatrics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Esra Gürkaş
- Department of Pediatric Neurology, Children's Hospital, Ankara City Hospital, Ankara, Turkey
| | - Sanem Keskin Yılmaz
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Seda Kanmaz
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hasan Tekgül
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Aksoy
- Division of Child Neurology, Department of Pediatrics, On Dokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Gökçen Öz Tuncer
- Division of Child Neurology, Department of Pediatrics, On Dokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Elif Acar Arslan
- Division of Child Neurology, Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ayşe Tosun
- Division of Child Neurology, Department of Pediatrics, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Müge Ayanoğlu
- Division of Child Neurology, Department of Pediatrics, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ali Burak Kızılırmak
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey
| | - Mohammadreza Yousefi
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey
| | - Muhittin Bodur
- Division of Child Neurology, Department of Pediatrics, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Bülent Ünay
- Gülhane Faculty of Medicine, Department of Pediatric Neurology, University of Health Sciences, Ankara, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Öztop-Çakmak Ö, Akar K, Youssef H, Kahraman AD, Özkan E, Samancı MY, Vural A. Gait Analysis in Idiopathic Normal Pressure Hydrocephalus: A Single Centre Experience. Istanbul Med J 2023. [DOI: 10.4274/imj.galenos.2023.60251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Ho S, Oswald E, Wong HK, Vural A, Yilmaz V, Tüzün E, Türkoğlu R, Straub T, Meinl I, Thaler F, Kümpfel T, Meinl E, Mader S. Ocrelizumab Treatment Modulates B-Cell Regulating Factors in Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2023; 10:10/2/e200083. [PMID: 36702538 PMCID: PMC9880874 DOI: 10.1212/nxi.0000000000200083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/22/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Antibodies to CD20 efficiently reduce new relapses in multiple sclerosis (MS), and ocrelizumab has been shown to be effective also in primary progressive MS. Although anti-CD20 treatments efficiently deplete B cells in blood, some B cells and CD20- plasma cells persist in lymphatic organs and the inflamed CNS; their survival is regulated by the B cell-activating factor (BAFF)/A proliferation-inducing ligand (APRIL) system. The administration of a soluble receptor for BAFF and APRIL, atacicept, unexpectedly worsened MS. Here, we explored the long-term effects of ocrelizumab on immune cell subsets as well as on cytokines and endogenous soluble receptors comprising the BAFF-APRIL system. METHODS We analyzed immune cell subsets and B cell-regulating factors longitudinally for up to 2.5 years in patients with MS treated with ocrelizumab. In a second cohort, we determined B-cell regulatory factors in the CSF before and after ocrelizumab. We quantified the cytokines BAFF and APRIL along with their endogenous soluble receptors soluble B-cell maturation antigen (sBCMA) and soluble transmembrane activator and calcium-modulator and cyclophilin ligand (CAML) interactor (sTACI) using enzyme-linked immunosorbent assays (ELISAs). In addition, we established an in-house ELISA to measure sTACI-BAFF complexes. RESULTS Ocrelizumab treatment of people with MS persistently depleted B cells and CD20+ T cells. This treatment enhanced BAFF and reduced the free endogenous soluble receptor and decoy sTACI in both serum and CSF. Levels of sTACI negatively correlated with BAFF levels. Reduction of sTACI was associated with formation of sTACI-BAFF complexes. DISCUSSION We describe a novel effect of anti-CD20 therapy on the BAFF-APRIL system, namely reduction of sTACI. Because sTACI is a decoy for APRIL, its reduction may enhance local APRIL activity, thereby promoting regulatory IgA+ plasma cells and astrocytic interleukin (IL)-10 production. Thus, reducing sTACI might contribute to the beneficial effect of anti-CD20 as exogenous sTACI (atacicept) worsened MS. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that endogenous sTACI in blood and CSF is decreased after ocrelizumab treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Edgar Meinl
- From the Institute of Clinical Neuroimmunology (S.H., E.O., H.K.W., A.V., I.M., F.T., T.K., E.M., S.M.), Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München; Graduate School of Systemic Neurosciences (S.H.), Ludwig-Maximilians-Universität München, Germany; Department of Neurology (A.V.), Koc University School of Medicine; Department of Neuroscience (V.Y., E.T.), Aziz Sancar Institute of Experimental Medicine, Istanbul University; Department of Neurology (R.T.), Haydarpasa Numune Education and Research Hospital, Istanbul, Türkiye; Core Facility Bioinformatics (T.S.), Biomedical Center, Ludwig-Maximilians-Universität München, Germany; Munich Cluster for Systems Neurology (SyNergy) (F.T.), Germany.
| | - Simone Mader
- From the Institute of Clinical Neuroimmunology (S.H., E.O., H.K.W., A.V., I.M., F.T., T.K., E.M., S.M.), Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München; Graduate School of Systemic Neurosciences (S.H.), Ludwig-Maximilians-Universität München, Germany; Department of Neurology (A.V.), Koc University School of Medicine; Department of Neuroscience (V.Y., E.T.), Aziz Sancar Institute of Experimental Medicine, Istanbul University; Department of Neurology (R.T.), Haydarpasa Numune Education and Research Hospital, Istanbul, Türkiye; Core Facility Bioinformatics (T.S.), Biomedical Center, Ludwig-Maximilians-Universität München, Germany; Munich Cluster for Systems Neurology (SyNergy) (F.T.), Germany.
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13
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Şekerdağ-Kılıç E, Ulusoy C, Atak D, Özkan E, Gökyüzü AB, Seyaj S, Deniz G, Uçar EA, Budan AS, Zeybel M, Öztop-Çakmak Ö, Vural A, Tuncer A, Karabudak R, Kücükali CI, Tüzün E, Gürsoy-Özdemir Y. Perivascular PDGFRB+ cells accompany lesion formation and clinical evolution differentially in two different EAE models. Mult Scler Relat Disord 2023; 69:104428. [PMID: 36450174 DOI: 10.1016/j.msard.2022.104428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/31/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) that may lead to progressive disability. Here, we explored the behavioral pattern and the role of vasculature especially PDGFRB+ pericytes/ perivascular cells, in MS pathogenesis. METHODS We have evaluated vascular changes in two different experimental allergic encephalomyelitis (EAE) mice models (MOG and PLP-induced). PDGFRB+ cells demonstrated distinct and different behavioral patterns. In both models, fibrosis formation was detected via collagen, fibronectin, and extracellular matrix accumulation. RESULTS The PLP-induced animal model revealed that fibrosis predominantly occurs in perivascular locations and that PDGFRB+ cells are accumulated around vessels. Also, the expression of fibrotic genes and genes coding extracellular matrix (ECM) proteins are upregulated. Moreover, the perivascular thick wall structures in affected vessels of this model presented primarily increased PDGFRB+ cells but not NG2+ cells in the transgenic NG2-DsRed transgenic animal model. On the other hand, in MOG induced model, PDGFRB+ perivascular cells were accumulated at the lesion sites. PDGFRB+ cells colocalized with ECM proteins (collagen, fibronectin, and lysyl oxidase L3). Nevertheless, both MOG and PLP-immunized mice showed increasing EAE severity, and disability parallel with enhanced perivascular cell accumulation as the disease progressed from earlier (day 15) to later (day 40). CONCLUSION As a result, we have concluded that PDGFRB+ perivascular cells may be participating in lesion progression and as well as demonstrating different responses in different EAE models.
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Affiliation(s)
- Emine Şekerdağ-Kılıç
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Canan Ulusoy
- Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Dila Atak
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Esra Özkan
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Aysu Bilge Gökyüzü
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Seddiq Seyaj
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Gülsüm Deniz
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Ege Anil Uçar
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Abdullah Salih Budan
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey
| | - Müjdat Zeybel
- Department of Gastroenterology and Hepatology, School of Medicine, Koҫ University, Istanbul, Turkey
| | - Özgür Öztop-Çakmak
- Department of Neurology, School of Medicine, Koҫ University, Istanbul, Turkey
| | - Atay Vural
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey; Department of Neurology, School of Medicine, Koҫ University, Istanbul, Turkey
| | - Asli Tuncer
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rana Karabudak
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Erdem Tüzün
- Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Yasemin Gürsoy-Özdemir
- Research Center for Translational Medicine (KUTTAM), Koҫ University, Istanbul, Turkey; Department of Neurology, School of Medicine, Koҫ University, Istanbul, Turkey.
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14
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Eroglu-Ertugrul NG, Yousefi M, Pekgül F, Doran T, Günbey C, Topcu M, Oguz KK, Ozkara HA, Vural A, Anlar B. Myelin oligodendrocyte glycoprotein antibodies in genetic leukodystrophies. J Neuroimmunol 2022; 369:577916. [PMID: 35752102 DOI: 10.1016/j.jneuroim.2022.577916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
Accumulation of intermediate metabolites due to enzyme deficiencies and demyelination can provoke inflammation in genetic leukodystrophies. Thirty patients with genetic leukodystrophy and 48 healthy control sera were tested for anti-myelin oligodendrocyte glycoprotein (MOG) antibodies by fixed and/or live cell-based assays. MOG-IgG was detected in two late infantile metachromatic leukodystrophy (MLD) cases, both of which were also weakly positive for IgG1, and one with IgG3 as the dominant anti-MOG IgG subclass. MOG-IgG was borderline positive in a vanishing white matter (VWM) disease patient. These results suggest that inherited metabolic or degenerative processes can have an autoimmune component, possibly as an epiphenomenon.
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Affiliation(s)
| | - Mohammadreza Yousefi
- Research Center for Translational Medicine, Koç University School of Medicine, Istanbul, Turkey
| | - Faruk Pekgül
- Department of Medical Biochemistry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tansu Doran
- Research Center for Translational Medicine, Koç University School of Medicine, Istanbul, Turkey
| | - Ceren Günbey
- Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meral Topcu
- Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kader K Oguz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hatice Asuman Ozkara
- Department of Medical Biochemistry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Atay Vural
- Research Center for Translational Medicine, Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, Koç University School of Medicine, Istanbul, Turkey
| | - Banu Anlar
- Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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15
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Van de Vondel L, De Winter J, Beijer D, Coarelli G, Wayand M, Palvadeau R, Pauly MG, Klein K, Rautenberg M, Guillot-Noël L, Deconinck T, Vural A, Ertan S, Dogu O, Uysal H, Brankovic V, Herzog R, Brice A, Durr A, Klebe S, Stock F, Bischoff AT, Rattay TW, Sobrido MJ, De Michele G, De Jonghe P, Klopstock T, Lohmann K, Zanni G, Santorelli FM, Timmerman V, Haack TB, Züchner S, Schüle R, Stevanin G, Synofzik M, Basak AN, Baets J. De Novo and Dominantly Inherited SPTAN1 Mutations Cause Spastic Paraplegia and Cerebellar Ataxia. Mov Disord 2022; 37:1175-1186. [PMID: 35150594 DOI: 10.1002/mds.28959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/29/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Pathogenic variants in SPTAN1 have been linked to a remarkably broad phenotypical spectrum. Clinical presentations include epileptic syndromes, intellectual disability, and hereditary motor neuropathy. OBJECTIVES We investigated the role of SPTAN1 variants in rare neurological disorders such as ataxia and spastic paraplegia. METHODS We screened 10,000 NGS datasets across two international consortia and one local database, indicative of the level of international collaboration currently required to identify genes causative for rare disease. We performed in silico modeling of the identified SPTAN1 variants. RESULTS We describe 22 patients from 14 families with five novel SPTAN1 variants. Of six patients with cerebellar ataxia, four carry a de novo SPTAN1 variant and two show a sporadic inheritance. In this group, one variant (p.Lys2083del) is recurrent in four patients. Two patients have novel de novo missense mutations (p.Arg1098Cys, p.Arg1624Cys) associated with cerebellar ataxia, in one patient accompanied by intellectual disability and epilepsy. We furthermore report a recurrent missense mutation (p.Arg19Trp) in 15 patients with spastic paraplegia from seven families with a dominant inheritance pattern in four and a de novo origin in one case. One further patient carrying a de novo missense mutation (p.Gln2205Pro) has a complex spastic ataxic phenotype. Through protein modeling we show that mutated amino acids are located at crucial interlinking positions, interconnecting the three-helix bundle of a spectrin repeat. CONCLUSIONS We show that SPTAN1 is a relevant candidate gene for ataxia and spastic paraplegia. We suggest that for the mutations identified in this study, disruption of the interlinking of spectrin helices could be a key feature of the pathomechanism. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Liedewei Van de Vondel
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Jonathan De Winter
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Danique Beijer
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Dr John T. Macdonald Foundation Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giulia Coarelli
- Sorbonne University, ICM-Paris Brain Institute, INSERM, CNRS, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Melanie Wayand
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Robin Palvadeau
- Koc University, School of Medicine, Suna and Inan Kirac Foundation, Istanbul, Turkey
| | - Martje G Pauly
- Department of Neurology, University Hospital Schleswig Holstein, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Katrin Klein
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tübingen, Germany
| | - Maren Rautenberg
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tübingen, Germany
| | - Léna Guillot-Noël
- Sorbonne University, ICM-Paris Brain Institute, INSERM, CNRS, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Tine Deconinck
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Atay Vural
- School of Medicine, Department of Neurology, Koc University, Istanbul, Turkey
| | - Sibel Ertan
- School of Medicine, Department of Neurology, Koc University, Istanbul, Turkey
| | - Okan Dogu
- Department of Neurology, School of Medicine, Mersin University, Mersin, Turkey
| | - Hilmi Uysal
- Department of Neurology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Vesna Brankovic
- Clinic for Child Neurology and Psychiatry, University of Belgrade, Belgrade, Serbia
| | - Rebecca Herzog
- Department of Neurology, University Hospital Schleswig Holstein, Lübeck, Germany
| | - Alexis Brice
- Sorbonne University, ICM-Paris Brain Institute, INSERM, CNRS, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Alexandra Durr
- Sorbonne University, ICM-Paris Brain Institute, INSERM, CNRS, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Stephan Klebe
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Friedrich Stock
- Institute of Human Genetics, University Hospital Essen, Essen, Germany
| | | | - Tim W Rattay
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - María-Jesús Sobrido
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Santiago de Compostela, Spain.,Neurogenetics Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario, SERGAS, Santiago de Compostela, Spain
| | - Giovanna De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Peter De Jonghe
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ginevra Zanni
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Vincent Timmerman
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tübingen, Germany.,Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Stephan Züchner
- Dr John T. Macdonald Foundation Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Rebecca Schüle
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Giovanni Stevanin
- Sorbonne University, ICM-Paris Brain Institute, INSERM, CNRS, APHP, Pitié Salpêtrière Hospital, Paris, France.,Paris Sciences Lettres Research University, Ecole Pratique des Hautes Etudes, Paris, France
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - A Nazli Basak
- Koc University, School of Medicine, Suna and Inan Kirac Foundation, Istanbul, Turkey
| | - Jonathan Baets
- Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
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16
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Oncel I, Yousefi M, Inci A, Arslan Gulten Z, Teke Kisa P, Karaca M, Ünal Ö, Gündüz M, Kor D, Onenli Mungan N, Arslan N, Tumer L, Gucuyener K, Vural A, Anlar B. Investigating myelin oligodendrocyte glycoprotein antibodies in hereditary citrullinemia. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Al Khleifat A, Iacoangeli A, van Vugt JJFA, Bowles H, Moisse M, Zwamborn RAJ, van der Spek RAA, Shatunov A, Cooper-Knock J, Topp S, Byrne R, Gellera C, López V, Jones AR, Opie-Martin S, Vural A, Campos Y, van Rheenen W, Kenna B, Van Eijk KR, Kenna K, Weber M, Smith B, Fogh I, Silani V, Morrison KE, Dobson R, van Es MA, McLaughlin RL, Vourc'h P, Chio A, Corcia P, de Carvalho M, Gotkine M, Panades MP, Mora JS, Shaw PJ, Landers JE, Glass JD, Shaw CE, Basak N, Hardiman O, Robberecht W, Van Damme P, van den Berg LH, Veldink JH, Al-Chalabi A. Structural variation analysis of 6,500 whole genome sequences in amyotrophic lateral sclerosis. NPJ Genom Med 2022; 7:8. [PMID: 35091648 PMCID: PMC8799638 DOI: 10.1038/s41525-021-00267-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 10/21/2021] [Indexed: 02/01/2023] Open
Abstract
There is a strong genetic contribution to Amyotrophic lateral sclerosis (ALS) risk, with heritability estimates of up to 60%. Both Mendelian and small effect variants have been identified, but in common with other conditions, such variants only explain a little of the heritability. Genomic structural variation might account for some of this otherwise unexplained heritability. We therefore investigated association between structural variation in a set of 25 ALS genes, and ALS risk and phenotype. As expected, the repeat expansion in the C9orf72 gene was identified as associated with ALS. Two other ALS-associated structural variants were identified: inversion in the VCP gene and insertion in the ERBB4 gene. All three variants were associated both with increased risk of ALS and specific phenotypic patterns of disease expression. More than 70% of people with respiratory onset ALS harboured ERBB4 insertion compared with 25% of the general population, suggesting respiratory onset ALS may be a distinct genetic subtype.
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Affiliation(s)
- Ahmad Al Khleifat
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Alfredo Iacoangeli
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joke J F A van Vugt
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Harry Bowles
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Matthieu Moisse
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology; VIB Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Ramona A J Zwamborn
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Rick A A van der Spek
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Aleksey Shatunov
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Simon Topp
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Ross Byrne
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Cinzia Gellera
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano and Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milano, Italy
| | - Victoria López
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano and Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milano, Italy
| | - Ashley R Jones
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Sarah Opie-Martin
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Atay Vural
- Koc University, School of Medicine, Translational Medicine Research Center- NDAL, Istanbul, Turkey
| | - Yolanda Campos
- Mitochondrial pathology Unit, Instituto de Salud Carlos III, Madrid, Spain
| | - Wouter van Rheenen
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Brendan Kenna
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Kristel R Van Eijk
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Kevin Kenna
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Markus Weber
- Neuromuscular Diseases Unit/ALS Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Bradley Smith
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Isabella Fogh
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano and Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milano, Italy
| | - Karen E Morrison
- Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Michael A van Es
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Russell L McLaughlin
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | | | - Adriano Chio
- Rita Levi Montalcini, Department of Neuroscience, ALS Centre, University of Torino, Turin, Italy
- Azienda Ospedaliera Citta della Salute e della Scienza, Torino, Italy
| | - Philippe Corcia
- Centre SLA, CHRU de Tours, Tours, France
- Federation des Centres SLA Tours and Limoges, LITORALS, Tours, France
| | - Mamede de Carvalho
- Physiology Institute, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | | | - Monica P Panades
- Neurology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - John E Landers
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jonathan D Glass
- Department of Neurology, Center for Neurodegenerative Diseases, Emory University, Atlanta, GA, USA
| | - Christopher E Shaw
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK
- King's College Hospital, Denmark Hill, London, UK
| | - Nazli Basak
- Koc University, School of Medicine, Translational Medicine Research Center- NDAL, Istanbul, Turkey
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, Trinity Biomedical Sciences Institute, Dublin, Republic of Ireland
- Department of Neurology, Beaumont Hospital, Dublin, Republic of Ireland
| | - Wim Robberecht
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology; VIB Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology; VIB Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Ammar Al-Chalabi
- King's College London, Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, De Crespigny Park, London, UK.
- King's College Hospital, Denmark Hill, London, UK.
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18
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Onder H, Vural A, Duzkale N, Kocer B, Comoglu S. Illustration of a rare case of hereditary spastic paraplegia type 30 associated with a missense variant in the non-motor domain of KIF1A. J Neurol 2022; 269:3343-3346. [PMID: 34999958 DOI: 10.1007/s00415-021-10924-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey.
| | - Atay Vural
- Koc University School of Medicine, Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Neslihan Duzkale
- Department of Medical Genetics, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bilge Kocer
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
| | - Selcuk Comoglu
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, Ankara, 06110, Turkey
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19
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Al Khleifat A, Iacoangeli A, Jones AR, van Vugt JJFA, Moisse M, Shatunov A, Zwamborn RAJ, van der Spek RAA, Cooper-Knock J, Topp S, van Rheenen W, Kenna B, Van Eijk KR, Kenna K, Byrne R, López V, Opie-Martin S, Vural A, Campos Y, Weber M, Smith B, Fogh I, Silani V, Morrison KE, Dobson R, van Es MA, McLaughlin RL, Vourc’h P, Chio A, Corcia P, de Carvalho M, Gotkine M, Panades MP, Mora JS, Shaw PJ, Landers JE, Glass JD, Shaw CE, Basak N, Hardiman O, Robberecht W, Van Damme P, van den Berg LH, Veldink JH, Al-Chalabi A. Telomere length analysis in amyotrophic lateral sclerosis using large-scale whole genome sequence data. Front Cell Neurosci 2022; 16:1050596. [PMID: 36589292 PMCID: PMC9799999 DOI: 10.3389/fncel.2022.1050596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the loss of upper and lower motor neurons, leading to progressive weakness of voluntary muscles, with death following from neuromuscular respiratory failure, typically within 3 to 5 years. There is a strong genetic contribution to ALS risk. In 10% or more, a family history of ALS or frontotemporal dementia is obtained, and the Mendelian genes responsible for ALS in such families have now been identified in about 50% of cases. Only about 14% of apparently sporadic ALS is explained by known genetic variation, suggesting that other forms of genetic variation are important. Telomeres maintain DNA integrity during cellular replication, differ between sexes, and shorten naturally with age. Sex and age are risk factors for ALS and we therefore investigated telomere length in ALS. Methods Samples were from Project MinE, an international ALS whole genome sequencing consortium that includes phenotype data. For validation we used donated brain samples from motor cortex from people with ALS and controls. Ancestry and relatedness were evaluated by principal components analysis and relationship matrices of DNA microarray data. Whole genome sequence data were from Illumina HiSeq platforms and aligned using the Isaac pipeline. TelSeq was used to quantify telomere length using whole genome sequence data. We tested the association of telomere length with ALS and ALS survival using Cox regression. Results There were 6,580 whole genome sequences, reducing to 6,195 samples (4,315 from people with ALS and 1,880 controls) after quality control, and 159 brain samples (106 ALS, 53 controls). Accounting for age and sex, there was a 20% (95% CI 14%, 25%) increase of telomere length in people with ALS compared to controls (p = 1.1 × 10-12), validated in the brain samples (p = 0.03). Those with shorter telomeres had a 10% increase in median survival (p = 5.0×10-7). Although there was no difference in telomere length between sporadic ALS and familial ALS (p=0.64), telomere length in 334 people with ALS due to expanded C9orf72 repeats was shorter than in those without expanded C9orf72 repeats (p = 5.0×10-4). Discussion Although telomeres shorten with age, longer telomeres are a risk factor for ALS and worsen prognosis. Longer telomeres are associated with ALS.
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Affiliation(s)
- Ahmad Al Khleifat
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
- Ahmad Al Khleifat,
| | - Alfredo Iacoangeli
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ashley R. Jones
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Joke J. F. A. van Vugt
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Matthieu Moisse
- Department of Neurosciences, Experimental Neurology, KU Leuven—University of Leuven, Leuven, Belgium
- VIB Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Aleksey Shatunov
- Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom
| | - Ramona A. J. Zwamborn
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Rick A. A. van der Spek
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Simon Topp
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Wouter van Rheenen
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Brendan Kenna
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Kristel R. Van Eijk
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Kevin Kenna
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Ross Byrne
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Victoria López
- Computational Biology Unit, Instituto de Salud Carlos III, Madrid, Spain
| | - Sarah Opie-Martin
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Atay Vural
- School of Medicine, Translational Medicine Research Center-NDAL, Koc University, Istanbul, Turkey
| | - Yolanda Campos
- Computational Biology Unit, Instituto de Salud Carlos III, Madrid, Spain
| | - Markus Weber
- School of Medicine, Translational Medicine Research Center-NDAL, Koc University, Istanbul, Turkey
- Neuromuscular Diseases Unit/ALS Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Bradley Smith
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Isabella Fogh
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Karen E. Morrison
- Faculty of Medicine, Health and Life Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Michael A. van Es
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Russell L. McLaughlin
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | | | - Adriano Chio
- Department of Neuroscience, ALS Centre, University of Torino, Turin, Italy
- Azienda Ospedaliera Citta della Salute e della Scienza, Turin, Italy
| | - Philippe Corcia
- Centre SLA, CHRU de Tours, Tours, France
- Federation des Centres SLA Tours and Limoges, LITORALS, Tours, France
| | - Mamede de Carvalho
- Physiology Institute, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Marc Gotkine
- Department of Neurology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | - Pamela J. Shaw
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - John E. Landers
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jonathan D. Glass
- Department of Neurology, Center for Neurodegenerative Diseases, Emory University, Atlanta, GA, United States
| | - Christopher E. Shaw
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
- King’s College Hospital, London, United Kingdom
| | - Nazli Basak
- School of Medicine, Translational Medicine Research Center-NDAL, Koc University, Istanbul, Turkey
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Wim Robberecht
- Department of Neurosciences, Experimental Neurology, KU Leuven—University of Leuven, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- Department of Neurosciences, Experimental Neurology, KU Leuven—University of Leuven, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Leonard H. van den Berg
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Jan H. Veldink
- Department of Neurology, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
- King’s College Hospital, London, United Kingdom
- *Correspondence: Ammar Al-Chalabi,
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20
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Lak H, Chawla S, Verma B, Vural A, Gad M, Shekhar S, Nair R, Yun J, Burns D, Puri R, Reed G, Harb S, Krishnaswamy A, Kapadia S. Outcomes of transfemoral-transcatheter aortic valve replacement with Sapien-3 valve in liver cirrhosis patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Little is known about the outcomes of liver cirrhosis patients with severe aortic stenosis (AS) who undergo transcatheter aortic valve replacement (TAVR).
Methods
We undertook a retrospective analysis of consecutive patients with severe symptomatic AS who underwent transfemoral-TAVR with Sapien-3 valve at our Clinic between April 2015 and December 2018, yielding 32 patients with liver cirrhosis on imaging including ultrasound and/or computed tomography. Their baseline characteristics, procedural and long-term outcomes after TAVR with the non-cirrhotic group were compared, along with their management strategies as per the hepatology team.
Results
Among 1028 patients, 32 were assigned to the cirrhosis, and 996 were assigned to the non-cirrhosis (control) group. Compared with the control group cirrhotic patients were slightly younger in age (74.5 vs 81.2 years), had a slightly higher BMI (31.3 vs 29.3), and had a higher incidence of prior history of myocardial infarction (38% vs 33%). Baseline variables including the history of smoking, hypertension, diabetes, and atrial fibrillation were comparable in both groups. Among cirrhotic patients (n=32), the most common etiologies were non-alcoholic steatohepatitis (NASH) (37.5%), Alcoholism (18.75%), and Hepatitis C (12.5%). The mean MELD-NA score was 11.8 and 67% of patients were Child PUGH Class A and 33% were Child PUGH Class B and all patients had a Child PUGH score of ≥5. 53% of patients (n=17) in the cirrhosis group were evaluated by Hepatology and 12.5% (n=4) were evaluated for a liver transplant but only 1 patient had a liver transplant post-TAVR. Compared with the control group cirrhotic patients had similar 1-year mortality (12% vs 12%, p=1), had a lower rate of 30-day new pacemaker post tavr (6% vs 9% p=0.85), had a higher rate of 1-year readmission for heart failure (12% vs 5% p=0.12) and similar 1-year major adverse cardiac and cerebrovascular event (MACCE) rate (15% vs 14% p=0.98)
Conclusion
Patients with severe AS undergoing TAVR with concomitant liver cirrhosis demonstrate comparable outcomes compared with their non- cirrhotic counterparts. NASH followed by alcoholic cirrhosis was found to be most common etiology.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - B Verma
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Vural
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - M Gad
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Shekhar
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Nair
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Yun
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - D Burns
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
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21
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Macrini C, Gerhards R, Winklmeier S, Bergmann L, Mader S, Spadaro M, Vural A, Smolle M, Hohlfeld R, Kümpfel T, Lichtenthaler SF, Franquelim HG, Jenne D, Meinl E. Features of MOG required for recognition by patients with MOG antibody-associated disorders. Brain 2021; 144:2375-2389. [PMID: 33704436 DOI: 10.1093/brain/awab105] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/03/2023] Open
Abstract
Antibodies (Abs) to myelin oligodendrocyte glycoprotein (MOG) define a distinct disease entity. Here we aimed to understand essential structural features of MOG required for recognition by autoantibodies from patients. We produced the N-terminal part of MOG in a conformationally correct form; this domain was insufficient to identify patients with MOG-Abs by ELISA even after site-directed binding. This was neither due to a lack of lipid embedding nor to a missing putative epitope at the C-terminus, which we confirmed to be an intracellular domain. When MOG was displayed on transfected cells, patients with MOG-Abs recognized full-length MOG much better than its N-terminal part with the first hydrophobic domain (p < 0.0001). Even antibodies affinity-purified with the extracellular part of MOG recognized full-length MOG better than the extracellular part of MOG after transfection. The second hydrophobic domain of MOG enhanced the recognition of the extracellular part of MOG by antibodies from patients as seen with truncated variants of MOG. We confirmed the pivotal role of the second hydrophobic domain by fusing the intracellular part of MOG from the evolutionary distant opossum to the human extracellular part; the chimeric construct restored the antibody-binding completely. Further, we found that in contrast to 8-18C5, MOG-Abs from patients bound preferentially as F(ab')2 rather than Fab. It was previously found that bivalent binding of human IgG1, the prominent isotype of MOG-Abs, requires that its target antigen is displayed at a distance of 13-16 nm. We found that, upon transfection, molecules of MOG did not interact so closely to induce a Förster resonance energy transfer (FRET) signal, indicating that they are more than 6 nm apart. We propose that the intracellular part of MOG holds the monomers apart at a suitable distance for bivalent binding; this could explain why a cell-based assay is needed to identify MOG-Abs. Our finding that MOG-Abs from most patients require bivalent binding has implications for understanding the pathogenesis of MOG-antibody-associated-disorders. Since bivalently bound antibodies have been reported to only poorly bind C1q, we speculate that the pathogenicity of MOG-Abs is mostly mediated by other mechanisms than complement activation. Therefore, therapeutic inhibition of complement activation should be less efficient in MOG-Ab associated disorders than in patients with Abs to aquaporin-4.
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Affiliation(s)
- Caterina Macrini
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Ramona Gerhards
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Stephan Winklmeier
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Lena Bergmann
- Physiological Chemistry, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
| | - Simone Mader
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Melania Spadaro
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Atay Vural
- Department of Neurology, Koc University School of Medicine, 34450 Istanbul, Turkey
| | - Michaela Smolle
- Physiological Chemistry, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
- BioPhysics Core Facility, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Stefan F Lichtenthaler
- German Center for Neurodegenerative Diseases (DZNE) Munich and Neuroproteomics, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
| | - Henri G Franquelim
- Cellular and Molecular Biophysics, Max Planck Institute of Biochemistry, 82152 Munich, Germany
| | - Dieter Jenne
- Institute of Lung Biology and Disease (ILBD), Comprehensive Pneumology Center (CPC), 81377 Munich, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
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22
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Vural A, Şimşir G, Tekgül Ş, Koçoğlu C, Akçimen F, Kartal E, Şen NE, Lahut S, Ömür Ö, Saner N, Gül T, Bayraktar E, Palvadeau R, Tunca C, Pirkevi Çetinkaya C, Gündoğdu Eken A, Şahbaz I, Kovancılar Koç M, Öztop Çakmak Ö, Hanağası H, Bilgiç B, Eraksoy M, Gündüz A, Apaydın H, Kızıltan G, Özekmekçi S, Siva A, Altıntaş A, Kaya Güleç ZE, Parman Y, Oflazer P, Deymeer F, Durmuş H, Şahin E, Çakar A, Tüfekçioğlu Z, Tektürk P, Çorbalı MO, Tireli H, Akdal G, Yiş U, Hız S, Şengün İ, Bora E, Serdaroğlu G, Erer Özbek S, Ağan K, İnce Günal D, Us Ö, Kurt SG, Aksoy D, Bora Tokçaer A, Elmas M, Gültekin M, Kumandaş S, Acer H, Kaya Özçora GD, Yayla V, Soysal A, Genç G, Güllüoğlu H, Kotan D, Özözen Ayas Z, Şahin HA, Tan E, Topçu M, Topçuoğlu ES, Akbostancı C, Koç F, Ertan S, Elibol B, Başak AN. The Complex Genetic Landscape of Hereditary Ataxias in Turkey and Implications in Clinical Practice. Mov Disord 2021; 36:1676-1688. [PMID: 33624863 DOI: 10.1002/mds.28518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/13/2020] [Revised: 01/06/2021] [Accepted: 01/15/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The genetic and epidemiological features of hereditary ataxias have been reported in several populations; however, Turkey is still unexplored. Due to high consanguinity, recessive ataxias are more common in Turkey than in Western European populations. OBJECTIVE To identify the prevalence and genetic structure of hereditary ataxias in the Turkish population. METHODS Our cohort consisted of 1296 index cases and 324 affected family members. Polymerase chain reaction followed by Sanger sequencing or fragment analysis were performed to screen for the trinucleotide repeat expansions in families with a dominant inheritance pattern, as well as in sporadic cases. The expansion in the frataxin (FXN) gene was tested in all autosomal recessive cases and in sporadic cases with a compatible phenotype. Whole-exome sequencing was applied to 251 probands, selected based on the family history, age of onset, and phenotype. RESULTS Mutations in known ataxia genes were identified in 30% of 1296 probands. Friedreich's ataxia was found to be the most common recessive ataxia in Turkey, followed by autosomal recessive spastic ataxia of Charlevoix-Saguenay. Spinocerebellar ataxia types 2 and 1 were the most common dominant ataxias. Whole-exome sequencing was performed in 251 probands with an approximate diagnostic yield of 50%. Forty-eight novel variants were found in a plethora of genes, suggesting a high heterogeneity. Variants of unknown significance were discussed in light of clinical data. CONCLUSION With the large sample size recruited across the country, we consider that our results provide an accurate picture of the frequency of hereditary ataxias in Turkey. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Atay Vural
- Department of Neurology, School of Medicine, Koç University, İstanbul, Turkey
| | - Gülşah Şimşir
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey
| | - Şeyma Tekgül
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey
| | - Cemile Koçoğlu
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Fulya Akçimen
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Ece Kartal
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Nesli E Şen
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Suna Lahut
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Özgür Ömür
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Nazan Saner
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Tuğçe Gül
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey
| | - Elif Bayraktar
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey
| | - Robin Palvadeau
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey
| | - Ceren Tunca
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey.,Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Caroline Pirkevi Çetinkaya
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey.,Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Aslı Gündoğdu Eken
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Irmak Şahbaz
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey.,Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Müge Kovancılar Koç
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey.,Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
| | - Özgür Öztop Çakmak
- Department of Neurology, School of Medicine, Koç University, İstanbul, Turkey
| | - Haşmet Hanağası
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Başar Bilgiç
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Mefkure Eraksoy
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ayşegül Gündüz
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Hülya Apaydın
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Güneş Kızıltan
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Sibel Özekmekçi
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Aksel Siva
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Ayşe Altıntaş
- Department of Neurology, School of Medicine, Koç University, İstanbul, Turkey.,Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Zeynep E Kaya Güleç
- Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Yeşim Parman
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Piraye Oflazer
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Feza Deymeer
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hacer Durmuş
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Erdi Şahin
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Arman Çakar
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Zeynep Tüfekçioğlu
- Department of Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Pınar Tektürk
- Department of Pediatric Neurology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - M Osman Çorbalı
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Hülya Tireli
- Department of Neurology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Gülden Akdal
- Department of Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Semra Hız
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - İhsan Şengün
- Division of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Elçin Bora
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Gül Serdaroğlu
- Division of Child Neurology, Department of Pediatrics, Ege University Medical School, İzmir, Turkey
| | - Sevda Erer Özbek
- Department of Neurology, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Kadriye Ağan
- Department of Neurology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Dilek İnce Günal
- Department of Neurology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Önder Us
- Department of Neurology, Acıbadem Kozyatağı Hospital, İstanbul, Turkey
| | - Semiha G Kurt
- Department of Neurology, School of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Dürdane Aksoy
- Department of Neurology, School of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Ayşe Bora Tokçaer
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Muhsin Elmas
- Department of Medical Genetics, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Murat Gültekin
- Department of Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sefer Kumandaş
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Hamit Acer
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Gül D Kaya Özçora
- Department of Pediatric Neurology, Kayseri Training and Research City Hospital, Kayseri, Turkey
| | - Vildan Yayla
- Department of Neurology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Aysun Soysal
- Department of Neurology, Bakırköy Training and Research Hospital for Psychiatry, Neurology, Neurosurgery, İstanbul, Turkey
| | - Gençer Genç
- Department of Neurology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Halil Güllüoğlu
- Department of Neurology, Medical Park İzmir Hospital, İzmir, Turkey
| | - Dilcan Kotan
- Department of Neurology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | | | - Hüseyin A Şahin
- Department of Neurology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ersin Tan
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Meral Topçu
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esen Saka Topçuoğlu
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Cenk Akbostancı
- Department of Neurology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Filiz Koç
- Department of Neurology, Çukurova University, School of Medicine, Adana, Turkey
| | - Sibel Ertan
- Department of Neurology, School of Medicine, Koç University, İstanbul, Turkey.,Department of Neurology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Bülent Elibol
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - A Nazlı Başak
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, KUTTAM, School of Medicine, Koç University, İstanbul, Turkey.,Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory, Department of Molecular Biology and Genetics, Boğaziçi University, İstanbul, Turkey
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Ulusoy C, Şekerdağ E, Yilmaz V, Yilmaz AB, Atak D, Vural A, Küçükali Cİ, Karaaslan Z, Kürtüncü M, Türkoğlu R, Özdemir YG, Tüzün E. Impact of Autoimmune Demyelinating Brain Disease Sera on Pericyte Survival. ACTA ACUST UNITED AC 2021; 58:83-86. [PMID: 34188587 DOI: 10.29399/npa.27350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/07/2020] [Indexed: 01/13/2023]
Abstract
Introduction Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) characterized by demyelination and brain pericyte dysfunction might be involved in MS pathogenesis Our aim was to evaluate whether the factors in serum affect pericyte survival. Method C57BL/6 female mice were immunized with myelin oligodendrocyte glycoprotein (MOG) to induce experimental autoimmune encephalomyelitis (EAE). To confirm the animal model, the sera level of anti-MOG antibody in mice and platelet-derived growth factor-BB (PDGF-BB) in patients was measured by ELISA. Human brain vascular pericytes (HBVP) cell lines were incubated with sera of EAE mice and primer progressive MS (PPMS), seconder progressive MS (SPMS) and relapsing-remitting MS (RRMS) patients. The viability of HBVP is measured with Annexin V-FITC/propidium iodide staining with flow cytometry. Results Annexin V-FITC/propidium iodide staining with flow cytometry showed increased ratios of early apoptosis and decreased survival following incubation with sera of EAE and progressive MS. Levels of platelet-derived growth factor-BB were identical in serum and cerebrospinal fluids of patients with different forms of MS. Conclusion Our results suggest that serum factors might contribute to progressive MS pathogenesis via pericyte dysfunction.
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Affiliation(s)
- Canan Ulusoy
- Neuroscience Department, Aziz Sancar Institute for Experimental Medicine, İstanbul University, İstanbul, Turkey
| | - Emine Şekerdağ
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Vuslat Yilmaz
- Neuroscience Department, Aziz Sancar Institute for Experimental Medicine, İstanbul University, İstanbul, Turkey
| | - Aysu Bilge Yilmaz
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Dila Atak
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Atay Vural
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Cem İsmail Küçükali
- Neuroscience Department, Aziz Sancar Institute for Experimental Medicine, İstanbul University, İstanbul, Turkey
| | - Zerrin Karaaslan
- Neuroscience Department, Aziz Sancar Institute for Experimental Medicine, İstanbul University, İstanbul, Turkey
| | - Murat Kürtüncü
- Neurology Department, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Recai Türkoğlu
- Department of Neurology, İstanbul Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | | | - Erdem Tüzün
- Neuroscience Department, Aziz Sancar Institute for Experimental Medicine, İstanbul University, İstanbul, Turkey
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Vural A, Derle E, Sayat-Gürel G, Karabudak R, Tuncer A. Predictors of progression in primary progressive multiple sclerosis in a large Turkish cohort. Mult Scler Relat Disord 2020; 38:101520. [DOI: 10.1016/j.msard.2019.101520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
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Vural A, Goksu K, Kahraman AN, Boy FN, Anil BS, Fersahoglu MM. Increased gallstone formation after sleeve gastrectomy and the preventive role of ursodeoxycholic acid. Acta Gastroenterol Belg 2020; 83:33-38. [PMID: 32233269] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND STUDY AIMS To investigate the incidence of gallstone formation, and the use of Ursodeoxycholic Acid (UDCA), weight loss and serum lipid profile changes following obesity surgery. PATIENTS AND METHODS Patients who underwent bariatric surgery due to obesity were retrospectively reviewed and divided into 2 groups for their prophylactic UDCA use. Patients who had a previous gallbladder pathology and ones who did not have a preoperative ultrasonography (US) were excluded. The patients who have returned to our clinic for a control ultrasound between 6 and 18 months following the surgery were included in this study, but only if they did not have any gall bladder pathology demonstrated with an US prior to surgery. Body mass index (BMI) and lipid profile measurements were also recorded. RESULTS Of the 108 patients who had undergone obesity surgery, it is reported that 42 (38.9%) were given UDCA as a preventative medication, and 66 (61.1%) were not prescribed any preventative medications. During the ultrasound controls in the postoperative period between 6 and 18 months after surgery, gallbladder stones were seen in 42 patients (38.9%) and biliary sludge development was detected in 5 patients (4.6%). A total of 47 patients (43.5%) developed gallbladder pathology. Fewer patients who took UDCA developed gallstones when compared with the patients who did not take UDCA (10% vs 33%). Also, there is a correlation between BMI loss rate and the frequency of gallstone development. Though the decrease in triglyceride (TG) levels was higher in patients with gallstone development, this decrease was not statistically significant. CONCLUSIONS Stone or sludge development in the gallbladder due to rapid weight loss after obesity surgery is quite common. However, we observed that the gallstone development decreased significantly with the prophylactic use of UDCA in patients who had undergone obesity surgery.
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Affiliation(s)
- A Vural
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - K Goksu
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A N Kahraman
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - F N Boy
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - B S Anil
- Department of Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - M M Fersahoglu
- Department of General Surgery, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Winklmeier S, Schlüter M, Spadaro M, Thaler FS, Vural A, Gerhards R, Macrini C, Mader S, Kurne A, Inan B, Karabudak R, Özbay FG, Esendagli G, Hohlfeld R, Kümpfel T, Meinl E. Identification of circulating MOG-specific B cells in patients with MOG antibodies. Neurol Neuroimmunol Neuroinflamm 2019; 6:625. [PMID: 31611268 PMCID: PMC6857907 DOI: 10.1212/nxi.0000000000000625] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/20/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To identify circulating myelin oligodendrocyte glycoprotein (MOG)-specific B cells in the blood of patients with MOG antibodies (Abs) and to determine whether circulating MOG-specific B cells are linked to levels and epitope specificity of serum anti-MOG-Abs. METHODS We compared peripheral blood from 21 patients with MOG-Abs and 26 controls for the presence of MOG-specific B cells. We differentiated blood-derived B cells in vitro in separate culture wells to Ab-producing cells via engagement of Toll-like receptors 7 and 8. We quantified the anti-MOG reactivity with a live cell-based assay by flow cytometry. We determined the recognition of MOG epitopes with a panel of mutated variants of MOG. RESULTS MOG-Ab-positive patients had a higher frequency of MOG-specific B cells in blood than controls, but MOG-specific B cells were only detected in about 60% of these patients. MOG-specific B cells in blood showed no correlation with anti-MOG Ab levels in serum, neither in the whole group nor in the untreated patients. Epitope analysis of MOG-Abs secreted from MOG-specific B cells cultured in different wells revealed an intraindividual heterogeneity of the anti-MOG autoimmunity. CONCLUSIONS This study shows that patients with MOG-Abs greatly differ in the abundance of circulating MOG-specific B cells, which are not linked to levels of MOG-Abs in serum suggesting different sources of MOG-Abs. Identification of MOG-specific B cells in blood could be of future relevance for selecting patients with MOG-Abs for B cell-directed therapy.
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Affiliation(s)
- Stephan Winklmeier
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Miriam Schlüter
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Melania Spadaro
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Franziska S Thaler
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Atay Vural
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Ramona Gerhards
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Caterina Macrini
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Simone Mader
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Aslı Kurne
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Berin Inan
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Rana Karabudak
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Feyza Gül Özbay
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Gunes Esendagli
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Reinhard Hohlfeld
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Tania Kümpfel
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany
| | - Edgar Meinl
- From the Institute of Clinical Neuroimmunology (S.W., M. Schlüter, M. Spadaro, F.S.T., A.V., R.G., C.M., S.M., R.H., T.K., E.M.), Biomedical Center and University Hospitals, Ludwig Maximilian University Munich, Germany; Research Center for Translational Medicine (A.V.), Koç University School of Medicine, Istanbul, Turkey; Department of Neurology, (A.K., B.I., R.K.), Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Basic Oncology (F.G.Ö., G.E.), Hacettepe University Cancer Institute, Ankara Turkey; and Munich Cluster for Systems Neurology (SyNergy) (R.H.), Germany.
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Stengel H, Vural A, Brunder AM, Heinius A, Appeltshauser L, Fiebig B, Giese F, Dresel C, Papagianni A, Birklein F, Weis J, Huchtemann T, Schmidt C, Körtvelyessy P, Villmann C, Meinl E, Sommer C, Leypoldt F, Doppler K. Anti-pan-neurofascin IgG3 as a marker of fulminant autoimmune neuropathy. Neurol Neuroimmunol Neuroinflamm 2019; 6:6/5/e603. [PMID: 31454780 PMCID: PMC6705632 DOI: 10.1212/nxi.0000000000000603] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/25/2019] [Indexed: 12/31/2022]
Abstract
Objective To identify and characterize patients with autoantibodies against different neurofascin (NF) isoforms. Methods Screening of a large cohort of patient sera for anti-NF autoantibodies by ELISA and further characterization by cell-based assays, epitope mapping, and complement binding assays. Results Two different clinical phenotypes became apparent in this study: The well-known clinical picture of subacute-onset severe sensorimotor neuropathy with tremor that is known to be associated with IgG4 autoantibodies against the paranodal isoform NF-155 was found in 2 patients. The second phenotype with a dramatic course of disease with tetraplegia and almost locked-in syndrome was associated with IgG3 autoantibodies against nodal and paranodal isoforms of NF in 3 patients. The epitope against which these autoantibodies were directed in this second phenotype was the common Ig domain found in all 3 NF isoforms. In contrast, anti–NF-155 IgG4 were directed against the NF-155–specific Fn3Fn4 domain. The description of a second phenotype of anti–NF-associated neuropathy is in line with some case reports of similar patients that were published in the last year. Conclusions Our results indicate that anti–pan-NF-associated neuropathy differs from anti–NF-155-associated neuropathy, and epitope and subclass play a major role in the pathogenesis and severity of anti–NF-associated neuropathy and should be determined to correctly classify patients, also in respect to possible differences in therapeutic response.
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Affiliation(s)
- Helena Stengel
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Atay Vural
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Anna-Michelle Brunder
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Annika Heinius
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Luise Appeltshauser
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Bianca Fiebig
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Florian Giese
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Christian Dresel
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Aikaterini Papagianni
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Frank Birklein
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Joachim Weis
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Tessa Huchtemann
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Christian Schmidt
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Peter Körtvelyessy
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Carmen Villmann
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Edgar Meinl
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Claudia Sommer
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Frank Leypoldt
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Kathrin Doppler
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey.
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Marti Fernandez I, Macrini C, Krumbholz M, Hensbergen PJ, Hipgrave Ederveen AL, Winklmeier S, Vural A, Kurne A, Jenne D, Kamp F, Gerdes LA, Hohlfeld R, Wuhrer M, Kümpfel T, Meinl E. The Glycosylation Site of Myelin Oligodendrocyte Glycoprotein Affects Autoantibody Recognition in a Large Proportion of Patients. Front Immunol 2019; 10:1189. [PMID: 31244828 PMCID: PMC6579858 DOI: 10.3389/fimmu.2019.01189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/10/2019] [Indexed: 11/29/2022] Open
Abstract
Autoantibodies to myelin oligodendrocytes glycoprotein (MOG) are found in a fraction of patients with inflammatory demyelination and are detected with MOG-transfected cells. While the prototype anti-MOG mAb 8-18C5 and polyclonal anti-MOG responses from different mouse strains largely recognize the FG loop of MOG, the human anti-MOG response is more heterogeneous and human MOG-Abs recognizing different epitopes were found to be pathogenic. The aim of this study was to get further insight into details of antigen-recognition by human MOG-Abs focusing on the impact of glycosylation. MOG has one known N-glycosylation site at N31 located in the BC loop linking two beta-sheets. We compared the reactivity to wild type MOG with that toward two different mutants in which the neutral asparagine of N31 was mutated to negatively charged aspartate or to the neutral alanine. We found that around 60% of all patients (16/27) showed an altered reactivity to one or both of the mutations. We noted seven different patterns of recognition of the two glycosylation-deficient mutants by different patients. The introduced negative charge at N31 enhanced recognition in some, but reduced recognition in other patients. In 7/27 patients the neutral glycosylation-deficient mutant was recognized stronger. The folding of the extracellular domain of MOG with the formation of beta-sheets did not depend on its glycosylation as seen by circular dichroism. We determined the glycan structure of MOG produced in HEK cells by mass spectrometry. The most abundant glycoforms of MOG expressed in HEK cells are diantennary, contain a core fucose, an antennary fucose, and are decorated with α2,6 linked Neu5Ac, while details of the glycoforms of MOG in myelin remain to be identified. Together, we (1) increase the knowledge about heterogeneity of human autoantibodies to MOG, (2) show that the BC loop affects recognition in about 60% of the patients, (3) report that all patients recognized the unglycosylated protein backbone, while (4) in about 20% of the patients the attached sugar reduces autoantibody binding presumably via steric hindrance. Thus, a neutral glycosylation-deficient mutant of MOG might enhance the sensitivity to identify MOG-Abs.
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Affiliation(s)
- Iris Marti Fernandez
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Caterina Macrini
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markus Krumbholz
- Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Paul J Hensbergen
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | | | - Stephan Winklmeier
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Atay Vural
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany.,Koç University School of Medicine, Istanbul, Turkey
| | - Asli Kurne
- Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Dieter Jenne
- Comprehensive Pneumology Center (CPC), Institute of Lung Biology and Disease, Helmholtz Zentrum München, Munich, and Max Planck Institute of Neurobiology, Planegg, Germany
| | - Frits Kamp
- Biomedical Center (BMC), Metabolic Biochemistry, LMU Munich, Munich, Germany
| | - Lisa Ann Gerdes
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - Manfred Wuhrer
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | - Tania Kümpfel
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Edgar Meinl
- Biomedical Center and University Hospitals, Institute of Clinical Neuroimmunology, Ludwig-Maximilians-Universität München, Munich, Germany
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Vural S, Gündoğdu M, Gökpınar Ili E, Durmaz C, Vural A, Steinmüller‐Magin L, Kleinhempel A, Holdt L, Ruzicka T, Giehl K, Ruhi H, Boyvat A. 多发性化脓性汗腺炎患者 pyrin 突变. Br J Dermatol 2019. [DOI: 10.1111/bjd.17973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vural S, Gündoğdu M, Gökpınar İli E, Durmaz C, Vural A, Steinmüller‐Magin L, Kleinhempel A, Holdt L, Ruzicka T, Giehl K, Ruhi H, Boyvat A. Pyrin mutations in complex hidradenitis suppurativa. Br J Dermatol 2019. [DOI: 10.1111/bjd.17956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Celikyurt U, Açar B, Karauzum I, Karauzum K, Ural D, Agir A, Vural A. Shorter time to begin of QRS fragmentation predicts non-response to cardiac resynchronization therapy in non-ischemic heart failure patients. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2019.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Celikyurt U, Açar B, Karauzum I, Karauzum K, Ural D, Agir A, Vural A. El inicio rápido de la fragmentación del QRS predice la no respuesta a la terapia de resincronización cardíaca en pacientes con insuficiencia cardíaca no isquémica. Rev Clin Esp 2019; 219:243-250. [DOI: 10.1016/j.rce.2018.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 11/30/2022]
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Vural S, Gündoğdu M, Gökpınar İli E, Durmaz CD, Vural A, Steinmüller-Magin L, Kleinhempel A, Holdt LM, Ruzicka T, Giehl KA, Ruhi HI, Boyvat A. Association of pyrin mutations and autoinflammation with complex phenotype hidradenitis suppurativa: a case-control study. Br J Dermatol 2019; 180:1459-1467. [PMID: 30488432 DOI: 10.1111/bjd.17466] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a rare, debilitating neutrophilic dermatosis characterized by chronic inflammation of hair follicles. Many inflammatory conditions may accompany HS. OBJECTIVES To investigate the association of variants of the MEFV gene with a complex HS phenotype. METHODS Firstly, we identified the clinical characteristics of 119 patients with HS with a complex phenotype (Hurley stage III disease and/or additional inflammatory symptoms). Then, we searched for MEFV variants among these patients. The odds ratios (ORs) for pathogenic MEFV mutations were calculated using data from these patients with HS and 191 healthy controls. RESULTS The male/female ratio was higher, and the mean age of onset was earlier, in our complex HS group compared with patients with HS in general. Five of the patients with HS (4·2%) had a diagnosis of familial Mediterranean fever (FMF) with a standardized morbidity ratio of 45 [95% confidence interval (CI) 16·50-99·84, P < 0·001] when compared with the frequency of FMF in the general Turkish population. Of the patients with complex HS, 38% were positive for pathogenic variants of MEFV. The OR for carrying a pathogenic MEFV allele was 2·80 (95% CI 1·31-5·97, P < 0·001). CONCLUSIONS The frequency of MEFV mutations in the group of patients with complex HS was higher than that in healthy controls, suggesting that MEFV mutations may contribute to the pathogenesis of HS. Understanding the role of autoinflammation in HS is of fundamental importance for the development of novel therapies.
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Affiliation(s)
- S Vural
- Department of Dermatology and Venereology, Ankara University, Ankara, Turkey.,Department of Dermatology, Koç University, Istanbul, Turkey
| | - M Gündoğdu
- Department of Dermatology and Venereology, Ankara University, Ankara, Turkey
| | - E Gökpınar İli
- Department of Medical Genetics, Ankara University, Ankara, Turkey
| | - C D Durmaz
- Department of Medical Genetics, Ankara University, Ankara, Turkey
| | - A Vural
- Department of Neurology, Koç University, Istanbul, Turkey
| | | | - A Kleinhempel
- Institute of Laboratory Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - L M Holdt
- Institute of Laboratory Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
| | - K A Giehl
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
| | - H I Ruhi
- Department of Medical Genetics, Ankara University, Ankara, Turkey
| | - A Boyvat
- Department of Dermatology and Venereology, Ankara University, Ankara, Turkey
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Vural A, Okar S, Kurne A, Sayat-Gürel G, Acar NP, Karabulut E, Oğuz KK, Kadayıfçılar S, Karabudak R. Retinal degeneration is associated with brain volume reduction and prognosis in radiologically isolated syndrome. Mult Scler 2018; 26:38-47. [DOI: 10.1177/1352458518817987] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: The extent of neurodegeneration in the earliest stages of central nervous system (CNS) demyelination is not known. Optical coherence tomography (OCT) is a powerful tool to study neurodegeneration in demyelinating disorders. Objectives: To study neuroaxonal loss in the retina of individuals with radiologically isolated syndrome (RIS) and investigate whether OCT measurements are associated with brain volumetrics and clinical conversion to multiple sclerosis (MS). Methods: Subjects fulfilling the Okuda criteria for RIS ( n = 15 patients, 30 eyes) and age- and sex-matched healthy controls (HC) underwent spectral-domain OCT and magnetic resonance imaging for volumetric measurement of brain structures. Results: Macular ganglion cell-inner plexiform layer (mGCIPL), macular retinal nerve fiber layer (mRNFL), and temporal peripapillary RNFL (pRNFL) thickness; normalized total brain volume (nTBV); and normalized thalamic volume (nTV) were reduced in RIS compared to HC. mGCIPL, mRNFL, and pRNFL measurements were associated with nTBV, nTV, and normalized gray and white matter volumes in the RIS group. pRNFL was thinner in individuals with RIS who converted to MS in 5 years. Conclusions: Retinal neurodegeneration can be detected in the papillomacular region in the earliest stages of CNS demyelination and reflects global disease processes in the brain. OCT can be potentially useful for predicting prognosis in RIS.
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Affiliation(s)
- Atay Vural
- Department of Neurology, Hacettepe University, Ankara, Turkey
- Department of Neurology, Koç University Hospital, Koç University, İstanbul, Turkey
| | - Serhat Okar
- Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Aslı Kurne
- Department of Neurology, Hacettepe University, Ankara, Turkey
| | | | | | - Erdem Karabulut
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | | | | | - Rana Karabudak
- Department of Neurology, Hacettepe University, Ankara, Turkey
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Vural A, Doppler K, Meinl E. Autoantibodies Against the Node of Ranvier in Seropositive Chronic Inflammatory Demyelinating Polyneuropathy: Diagnostic, Pathogenic, and Therapeutic Relevance. Front Immunol 2018; 9:1029. [PMID: 29867996 PMCID: PMC5960694 DOI: 10.3389/fimmu.2018.01029] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 03/19/2018] [Accepted: 04/24/2018] [Indexed: 11/13/2022] Open
Abstract
Discovery of disease-associated autoantibodies has transformed the clinical management of a variety of neurological disorders. Detection of autoantibodies aids diagnosis and allows patient stratification resulting in treatment optimization. In the last years, a set of autoantibodies against proteins located at the node of Ranvier has been identified in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). These antibodies target neurofascin, contactin1, or contactin-associated protein 1, and we propose to name CIDP patients with these antibodies collectively as seropositive. They have unique clinical characteristics that differ from seronegative CIDP. Moreover, there is compelling evidence that autoantibodies are relevant for the pathogenesis. In this article, we review the current knowledge on the characteristics of autoantibodies against the node of Ranvier proteins and their clinical relevance in CIDP. We start with a description of the structure of the node of Ranvier followed by a summary of assays used to identify seropositive patients; and then, we describe clinical features and characteristics linked to seropositivity. We review knowledge on the role of these autoantibodies for the pathogenesis with relevance for the emerging concept of nodopathy/paranodopathy and summarize the treatment implications.
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Affiliation(s)
- Atay Vural
- Institute of Clinical Neuroimmunology, Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany.,Research Center for Translational Medicine, Koç University, Istanbul, Turkey
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany
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Vural S, Vural A, Akçimen F, Bağci IS, Tunca C, Gündoğdu Eken A, Ruzicka T, Başak AN. Clinical and molecular characterization and response to acitretin in three families with Sjögren-Larsson syndrome. Int J Dermatol 2018; 57:843-848. [PMID: 29704247 DOI: 10.1111/ijd.14013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Sjögren-Larsson syndrome (SLS) is a rare congenital disorder characterized by the triad of ichthyosis, spasticity, and mental retardation. Patients are usually referred to dermatology clinics during infancy. As paraplegia becomes the most debilitating symptom of the disease within a few years, ichthyosis, although a major burden for the patient, takes a back seat. Optimum treatment of ichthyosis in these children and the effect of treatment on different aspects such as severity of the ichthyosis, pruritus, or quality of life of the patients' and their caregivers is not well established. MATERIALS AND METHODS Genetic background of eight patients from three families diagnosed clinically with SLS was determined with whole-exome and Sanger sequencing. Clinical phenotypes, laboratory findings, magnetic resonance imaging (MRI), and treatment of the ichthyosis with acitretin were assessed. RESULTS All patients had the classical triad of Sjögren-Larsson syndrome. Genetic analysis revealed that one patient had a novel c.799-1 (+/+) homozygous splicing mutation in the ALDH3A2 gene. Other patients had the c.683G>A p.R228H (NM_000382.2) mutation in the same gene. Other manifestations included skeletal anomalies, enamel hypoplasia, bilateral T2-hyperintensities in white matter, and moderate-severe pruritus. Acitretin treatment in a maintenance dose of 0.25 mg/kg/day decreased the severity of ichthyosis in all children. It increased quality of life significantly in all of the children and their caregivers. CONCLUSION We conclude that ichthyosis can be treated effectively with low-dose acitretin in children with Sjögren-Larsson syndrome, and this treatment is associated with a significant improvement in the quality of life.
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Affiliation(s)
- Seçil Vural
- Ludwig Maximillians University, Dermatology and Allergology, Munich, Germany.,Adıyaman Besni State Hospital, Adiyaman, Turkey
| | - Atay Vural
- Adıyaman Besni State Hospital, Adiyaman, Turkey.,Department of Neurology, Koç University, Istanbul, Turkey
| | - Fulya Akçimen
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory (NDAL), Boğaziçi University, Istanbul, Turkey
| | - Işın S Bağci
- Ludwig Maximillians University, Dermatology and Allergology, Munich, Germany
| | - Ceren Tunca
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory (NDAL), Boğaziçi University, Istanbul, Turkey
| | - Asli Gündoğdu Eken
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory (NDAL), Boğaziçi University, Istanbul, Turkey
| | - Thomas Ruzicka
- Ludwig Maximillians University, Dermatology and Allergology, Munich, Germany
| | - A Nazli Başak
- Suna and İnan Kıraç Foundation, Neurodegeneration Research Laboratory (NDAL), Boğaziçi University, Istanbul, Turkey
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Vural A, Gülmez E, Yurdakul H. Tortuous internal carotid artery in the oropharynx: a rare cause of a mass. Int J Oral Maxillofac Surg 2018; 47:551-552. [PMID: 29287936 DOI: 10.1016/j.ijom.2017.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/09/2017] [Accepted: 11/30/2017] [Indexed: 10/18/2022]
Affiliation(s)
- A Vural
- Department of Otorhinolaryngology, Erciyes University, Kayseri, Turkey.
| | - E Gülmez
- Department of Otorhinolaryngology, Erciyes University, Kayseri, Turkey
| | - H Yurdakul
- Department of Otorhinolaryngology, Erciyes University, Kayseri, Turkey
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Kocoglu C, Gundogdu A, Kocaman G, Kahraman-Koytak P, Uluc K, Kiziltan G, Caglayan AO, Bilguvar K, Vural A, Basak AN. Homozygous CAPN1 mutations causing a spastic-ataxia phenotype in 2 families. Neurol Genet 2018; 4:e218. [PMID: 29379883 PMCID: PMC5773845 DOI: 10.1212/nxg.0000000000000218] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 11/12/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Cemile Kocoglu
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Asli Gundogdu
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Gulsen Kocaman
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Pinar Kahraman-Koytak
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Kayihan Uluc
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Gunes Kiziltan
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Ahmet Okay Caglayan
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Kaya Bilguvar
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - Atay Vural
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
| | - A Nazli Basak
- Suna and Inan Kirac Foundation (C.K., A.G., A.N.B.), Neurodegeneration Research Laboratory (NDAL), Molecular Biology and Genetics Department, Bogazici University, Istanbul, Turkey; Department of Neurology (G. Kocaman), Medical Faculty, Bezmialem Vakif University, Turkey; Department of Neurology (P.K.-K., K.U.), Faculty of Medicine, Marmara University, Istanbul, Turkey; Department of Neurology (G. Kiziltan), Cerrahpasa Faculty of Medicine, Istanbul University, Turkey; Department of Medical Genetics (A.O.C.), School of Medicine, Istanbul Bilim University, Turkey; Yale Program on Neurogenetics (A.O.C.), Departments of Neurosurgery, Neurobiology and Genetics, Yale University School of Medicine, New Haven, CT; Department of Genetics (K.B.), Yale Center for Genome Analysis, Yale University School of Medicine, New Haven, CT; and Department of Neurology (A.V.), Koc University Hospital, Istanbul, Turkey
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Yalcin Cakmakli G, Vural A, Eren Kocak E, Elibol B, Saka E. Striatal Neurotransmitter Release-related Presynaptic Proteins in L- dopa Induced Dyskinesia in a Model of Parkinsonism. Noro Psikiyatr Ars 2017; 55:73-79. [DOI: 10.5152/npa.2017.20531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/29/2017] [Indexed: 11/22/2022] Open
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Turan H, Vural A, Caliskan Kamisli O, Tokgozoglu N, Sal V, Kahramanoglu I. Clot behind the blood: Cerebral vein thrombosis presenting with subarachnoid haemorrhage in a 28-week pregnant woman. J OBSTET GYNAECOL 2016; 36:986-988. [PMID: 27760482 DOI: 10.1080/01443615.2016.1205558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hasan Turan
- a Department of Obstetrics and Gynecology , Istanbul University Cerrahpasa Medical Faculty , Istanbul , Turkey
| | - Atay Vural
- b Besni Government Hospital Neurology Clinic , Adıyaman , Turkey
| | | | - Nedim Tokgozoglu
- a Department of Obstetrics and Gynecology , Istanbul University Cerrahpasa Medical Faculty , Istanbul , Turkey
| | - Veysel Sal
- a Department of Obstetrics and Gynecology , Istanbul University Cerrahpasa Medical Faculty , Istanbul , Turkey
| | - Ilker Kahramanoglu
- a Department of Obstetrics and Gynecology , Istanbul University Cerrahpasa Medical Faculty , Istanbul , Turkey
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Saral S, Vural A, Wollenberg A, Ruzicka T. A practical approach to ichthyoses with systemic manifestations. Clin Genet 2016; 91:799-812. [DOI: 10.1111/cge.12828] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/06/2016] [Accepted: 06/22/2016] [Indexed: 12/20/2022]
Affiliation(s)
- S. Saral
- Department of Dermatology and Venereology; Ankara University; Ankara Turkey
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - A. Vural
- Department of Neurology; Hacettepe University; Ankara Turkey
| | - A. Wollenberg
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - T. Ruzicka
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
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Vural A, Gocmen R, Oguz KK, Topcuoglu MA, Arsava EM. Bright and dark vessels on stroke imaging: different sides of the same coin? Diagn Interv Radiol 2016; 22:284-90. [PMID: 27015319 DOI: 10.5152/dir.2015.15271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Prominent hypointense cerebral vessels on susceptibility-weighted imaging (SWI) and the hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) imaging are considered as markers of compromised tissue perfusion in cerebral ischemia. In this study, we aimed to identify the correlation between HVS on FLAIR and hypointense vessels on SWI, and to determine whether these imaging features provide independent prognostic information in patients with ischemic stroke. METHODS We retrospectively analyzed consecutive ischemic stroke patients with proximal middle cerebral artery (MCA) occlusion who underwent SWI and FLAIR within 24 h of symptom onset. The presence of hypointense vessels on SWI and hyperintense vessels on FLAIR in >4 of 10 slices encompassing the MCA territory were considered to represent prominent hypoperfusion. RESULTS Among 50 patients, 62% had a prominent HVS on FLAIR and 68% had prominent hypointense vessels on SWI. There was a moderate but significant correlation between the number of slices with HVS on FLAIR and prominent hypointense vessels on SWI (r=0.425, P = 0.002). In multivariate analyses, the prominence of hypointense vessels on SWI, but not HVS on FLAIR, was significantly associated with a higher discharge NIHSS score (P = 0.027), mRS score (P = 0.021), and lesion growth (P = 0.050). CONCLUSION The significant, albeit moderate, correlation between markers of compromised tissue perfusion on FLAIR and SWI suggests that these imaging features reflect different but interrelated aspects of cerebral hemodynamics during ischemic stroke. Our findings highlight that while HVS on FLAIR denotes the presence of leptomeningeal collaterals, hypointense vessels on SWI signify the sufficiency of cerebral blood flow at the tissue level and are therefore more critical in terms of prognosis.
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Affiliation(s)
- Atay Vural
- Department of Neurology, Hacettepe University School of Medicine, Ankara, Turkey.
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Erdener SE, Vural A, Temucin CM, Ozdamar SE, Nurlu G, Varli K, Dericioglu N. Brachial Diparesis due to Motor Neuronopathy as One of the Predominant Presenting Signs of Occult Small Cell Lung Carcinoma. Intern Med 2016; 55:1641-3. [PMID: 27301520 DOI: 10.2169/internalmedicine.55.4888] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Sensory neuronopathy is a well-established presentation in paraneoplastic neurological syndromes that is mostly associated with small cell lung cancer and anti-Hu antibodies. Motor neuronopathy, on the other hand, is an extremely rare observation in this syndrome. A 56-year-old man presented with asymmetric brachial diparesis and sensory ataxia. Electrophysiological studies revealed sensory ganglionopathy and progressive anterior horn degeneration in cervical segments. Small cell lung carcinoma with associated anti-Hu antibodies was later diagnosed. The patient did not improve despite the administration of steroids and chemotherapy. Paraneoplastic syndromes may exceptionally present with a bilateral arm weakness. Cases accompanied by sensory ganglionopathy should therefore be promptly investigated for any underlying malignancy.
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Karabudak R, Vural A, Acar N, Tuncer M, Sayat G, Kadayıfcılar S. Is there early axonal trans-section in radiologically isolated syndrome? J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vural A, Acar NP, Soylemezoglu F, Oguz KK, Dericioğlu N, Saka E. Isolated central nervous system Whipple's disease: Two cases. Clin Neurol Neurosurg 2015; 139:91-4. [PMID: 26407049 DOI: 10.1016/j.clineuro.2015.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/02/2015] [Accepted: 08/22/2015] [Indexed: 11/17/2022]
Abstract
Although it is an orphan disease, isolated central nervous system Whipple's disease is one of the "must be known" conditions in neurology because it belongs to the list of "treatable disorders". Here, we present two cases which highlight the importance of early diagnosis. Additionally, we provide a discussion on up to date diagnostic approach to this life-threatening disorder.
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Affiliation(s)
- Atay Vural
- Hacettepe University, Department of Neurology, Ankara, Turkey.
| | | | | | - Kader K Oguz
- Hacettepe University, Department of Radiology, Ankara, Turkey.
| | - Neşe Dericioğlu
- Hacettepe University, Department of Radiology, Ankara, Turkey
| | - Esen Saka
- Hacettepe University, Department of Neurology, Ankara, Turkey.
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Karagöz A, Vural A, Günaydın ZY, Bektaş O, Gül M, Çelik A, Uzunoğlu E, Usta S, Sarıtaş A, Elalmış ÖU. The role of neutrophil to lymphocyte ratio as a predictor of diastolic dysfunction in hypertensive patients. Eur Rev Med Pharmacol Sci 2015; 19:433-440. [PMID: 25720715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Neutrophil to lymphocyte ratio (NLR) is a novel parameter for cardiovascular research area. The higher values of NLR have been found to be associated with worse clinical outcomes in atherosclerotic heart disease, heart failure, heart valve disease and other various cardiovascular disorders. Although the relationship between NLR and almost all cardiovascular disorders have been investigated, the association between NLR and diastolic dysfunction remains unclear. We herein evaluated the association between NLR and diastolic dysfunction. PATIENTS AND METHODS The study population consisted of 41 hypertensive patients with any grade of diastolic dysfunction and 41 hypertensive patients without diastolic dysfunction determined by echocardiographic evaluation constituted the control group. RESULTS Mean NLR value was found to be 2.07 ± 0.82 in the diastolic dysfunction group while the control group had a mean value of 1.69 ± 0.60 (p = 0.020). The patients with diastolic dysfunction had significantly higher values of NLR. When grades of diastolic dysfunction were evaluated, NLR was 1.80 ± 0.82, 2.32 ± 0.73 and 2.75 ± 0.45 in patients with grade 1, grade 2 and grade 3 diastolic dysfunction, respectively. The patients with higher grade of diastolic dysfunction had higher values of NLR (p = 0.001). None of the other hematologic parameters differed significantly in patients with diastolic dysfunction when compared to controls. CONCLUSIONS Patients with diastolic dysfunction had higher values of NLR compared to subjects without diastolic dysfunction. Furthermore higher grades of diastolic dysfunction were associated with higher levels of NLR. Further studies are needed to search the possible use of NLR as a marker for prognostic stratification in diastolic dysfunction which is associated with worse cardiovascular outcomes.
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Affiliation(s)
- A Karagöz
- Department of Cardiology, Giresun University, Giresun, Turkey.
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Yıldırım T, Eylen A, Lule S, Erdener SE, Vural A, Karatas H, Ozveren MF, Dalkara T, Gursoy-Ozdemir Y. Poloxamer-188 and citicoline provide neuronal membrane integrity and protect membrane stability in cortical spreading depression. Int J Neurosci 2014; 125:941-6. [PMID: 25340256 DOI: 10.3109/00207454.2014.979289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Under pathological conditions such as brain trauma, subarachnoid hemorrhage and stroke, cortical spreading depression (CSD) or peri-infarct depolarizations contribute to brain damage in animal models of neurological disorders as well as in human neurological diseases. CSD causes transient megachannel opening on the neuronal membrane, which may compromise neuronal survival under pathological conditions. Poloxamer-188 (P-188) and citicoline are neuroprotectants with membrane sealing properties. The aim of this study is to investigate the effect of P-188 and citicoline on the neuronal megachannel opening induced by CSD in the mouse brain. We have monitored megachannel opening with propidium iodide, a membrane impermeable fluorescent dye and, demonstrate that P-188 and citicoline strikingly decreased CSD-induced neuronal PI influx in cortex and hippocampal dentate gyrus. Therefore, these agents may be providing neuroprotection by blocking megachannel opening, which may be related to their membrane sealing action and warrant further investigation for treatment of traumatic brain injury and ischemic stroke.
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Affiliation(s)
- Timur Yıldırım
- a Department of Neurosurgery, Ankara Atatürk Education and Research Hospital , Ankara , Turkey
| | - Alpaslan Eylen
- b Department of Neurosurgery, Konya Numune Hospital , Konya , Turkey
| | - Sevda Lule
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey
| | - Sefik Evren Erdener
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey.,d Department of Neurology, Faculty of Medicine, Hacettepe University , Ankara , Turkey
| | - Atay Vural
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey.,d Department of Neurology, Faculty of Medicine, Hacettepe University , Ankara , Turkey
| | - Hulya Karatas
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey.,d Department of Neurology, Faculty of Medicine, Hacettepe University , Ankara , Turkey
| | - Mehmet Faik Ozveren
- e Department of Neurosurgery, Faculty of Medicine, Ordu University , Ordu , Turkey
| | - Turgay Dalkara
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey.,d Department of Neurology, Faculty of Medicine, Hacettepe University , Ankara , Turkey
| | - Yasemin Gursoy-Ozdemir
- c Institute of Neurological Sciences and Psychiatry, Hacettepe University , Ankara , Turkey.,d Department of Neurology, Faculty of Medicine, Hacettepe University , Ankara , Turkey
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Yilmaz MI, Demirkaya E, Acikel C, Saldir M, Akar S, Cayci T, Saglam M, Unal HU, Gok M, Polat A, Cetinkaya H, Eyileten T, Sari S, Yildirim AO, Sonmez A, Oguz Y, Vural A, Ozen S, Carrero JJ. Endothelial function in patients with familial Mediterranean fever-related amyloidosis and association with cardiovascular events. Rheumatology (Oxford) 2014; 53:2002-8. [DOI: 10.1093/rheumatology/keu231] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Poesen R, Viaene L, Bammens B, Claes K, Evenepoel P, Meijers B, Bozic M, De Pablo C, Alvarez A, Sanchez-Nino MD, Ortiz A, Fernandez E, Valdivielso JM, Speer T, Zewinger S, Holy EW, Stahli BE, Triem S, Cvija H, Rohrer L, Seiler S, Heine GH, Jankowski V, Jankowski J, Camici G, Akhmedov A, Luscher TF, Tanner FC, Fliser D, Isoyama N, Leurs P, Qureshi AR, Anderstam B, Heimburger O, Barany P, Stenvinkel P, Lindholm B, Bolasco P, Palleschi S, Rossi B, Atti M, Amore A, Coppo R, Loiacono E, Ghezzi PM, Palladino G, Caiazzo M, Di Napoli A, Tazza L, Franco F, Chicca S, Bossola M, Di Lallo D, Michelozzi P, Davoli M, Lucisano S, Arena A, Lupica R, Cernaro V, Trimboli D, Aloisi C, Montalto G, Santoro D, Buemi M, Burtey S, Poitevin S, Darbousset R, Gondouin B, Dubois C, Erkmen Uyar M, Bal Z, Bayraktar N, Gurlek Demirci B, Sayin B, Sezer S, Rogacev K, Zawada A, Emrich I, Seiler S, Bohm M, Fliser D, Woollard K, Heine G, Gbandjaba NY, Ghalim N, Saile R, Khalil A, Fujii H, Yamashita Y, Yonekura Y, Nakai K, Kono K, Goto S, Sugano M, Goto S, Ito Y, Nishi S, Leurs P, Meuwese C, Carrero JJ, Qureshi AR, Anderstam B, Barany P, Heimburger O, Stenvinkel P, Lindholm B, Riccio E, Sabbatini M, Bellizzi V, Pisani A, Svedberg O, Stenvinkel P, Qureshi AR, Barany P, Heimburger O, Leurs P, Isoyama N, Lindholm B, Anderstam B, Barreto-Silva MI, Lemos C, Costa-Silva F, Mendes R, Bregman R, Barreto - Silva MI, Lemos C, Vargas S, Barja-Fidalgo TC, Bregman R, Sidoti A, Lusini ML, Biagioli M, Sereni L, Ghezzi PM, Caiazzo M, Palladino G, Kara E, Ahbap E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Sevinc M, Akgol C, Unsal A, Snaedal S, Qureshi AR, Carrero JJ, Heimburger O, Stenvinkel P, Barany P, Paliouras C, Haviatsos T, Lamprianou F, Papagiannis N, Ntetskas G, Roufas K, Karvouniaris N, Anastasakis E, Moschos N, Alivanis P, Santoro D, Ingegneri MT, Vita G, Pisacane A, Bellinghieri G, Savica V, Buemi M, Lucisano S, Kim HK, Kim SC, Kim MG, Jo SK, Cho WY, Altunoglu A, Yavuz D, Canoz MB, Yavuz R, Karakas LA, Bayraktar N, Colak T, Sezer S, Ozdemir FN, Haberal M, Akbasli AC, Keven K, Erbay B, Nebio lu S, Loboda O, Dudar I, Krot V, Alekseeva V, Grabulosa CC, De Carvalho JTG, Manfredi SR, Canziani ME, Quinto BMR, Peres AT, Batista MC, Cendoroglo M, Dalboni MA, Zingerman B, Azoulay O, Gamzo Z, Rozen-Zvi B, Stefan G, Capusa C, Stancu S, Ilyes A, Viasu L, Mircescu G, Yilmaz MI, Solak Y, Saglam M, Cayci T, Acikel C, Unal HU, Eyileten T, Oguz Y, Sari S, Carrero JJ, Stenvinkel P, Covic A, Kanbay M, Kim YN, Park K, Gwoo S, Shin HS, Jung YS, Rim H, Rhew HY, Gok M, Kurt Y, Unal HU, CetInkaya H, Karaman M, EyIeten T, Vural A, Yilmaz MI, Oguz Y, Flisi Ski M, Brymora A, StrozEcki P, Stefa Ska A, Manitius J, Donderski R, Mi Kowiec-Wi Niewska I, Kretowicz M, Johnson R, Kami Ska A, Junik R, Siodmiak J, Stefa Ska A, Odrowaz-Sypniewska G, Manitius J, Tasic D, Radenkovic S, Kocic G, Wyskida K, Spiechowicz-Zato U, Rotkegel S, Ciepal J, Klein D, Bozentowicz-Wikarek M, Brzozowska A, Olszanecka-Glinianowicz M, Chudek J, Dimitrijevic Z, Cvetkovic T, Mitic B, Paunovic K, Paunovic G, Stojanovic M, Velickovic-Radovanovic R, Gliga ML, Gliga PM, Stoica C, Tarta D, Dogaru G. CKD NUTRITION, INFLAMMATION AND OXIDATIVE STRESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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