Intra-individual stability over time of standardized anti-Mullerian hormone in FMR1 premutation carriers

BACKGROUND

Carriers of a premutation (CGG repeat length 55-200) in the fragile X mental retardation (FMR1) gene are at risk for primary ovarian insufficiency (FXPOI). The anti-Müllerian hormone (AMH) level acts as a useful marker of ovarian follicle reserve and, thus, may serve to predict when this ovarian reserve becomes too low to sustain ovarian function. We investigated the intra-individual variation of AMH levels over time for premutation carriers compared with non-carriers.

METHODS

We determined AMH levels in blood samples from 240 women ascertained through fragile X families, of which 127 were premutation carriers and 113 were non-carriers. Linear mixed models were used to assess the effect of age and premutation status on AMH levels and to determine a modeled AMH value. The stability over time of the deviation of observed AMH levels from modeled levels, referred to as standardized AMH values, was assessed through correlation coefficients of 41 longitudinal samples.

RESULTS

At all ages, premutation carriers exhibited lower AMH levels. For all women, AMH was found to decrease by 10% per year. The added effect of having a premutation decreased AMH levels by 54%. The deviation of an individual's AMH level from the modeled value showed a reasonable intra-individual correlation. The Pearson correlation coefficient of two samples taken at different ages was 0.36 (P = 0.05) for non-carriers and 0.69 (P = 0.01) for carriers.

CONCLUSIONS

We developed a unique standardized AMH value, taking FMR1 premutation status and the subject's age into account, which appears to be stable over time and may serve as a predictor for FXPOI after further longitudinal assessment.

Anti-Mullerian hormone indicates early ovarian decline in fragile X mental retardation (FMR1) premutation carriers: a preliminary study

BACKGROUND

Women who carry the fragile X mental retardation (FMR1) premutation are at risk for fragile X-associated primary ovarian insufficiency. Past studies have shown that carriers who are still cycling have increased levels FSH compared with non-carriers. As anti-Mullerian hormone (AMH) has been shown as an excellent marker of ovarian decline, we examined AMH levels among premutation carriers to characterize their ovarian function.

METHODS

We determined the level of FSH and AMH in serum samples collected during early follicular phase from women who carried longer FMR1 repeat alleles (defined as >or=70 repeats, n = 40) and those with shorter repeat alleles (<70 repeats, n = 75), identified by DNA analysis. Comparisons were made stratified by age and carrier status.

RESULTS

For all age groups, AMH levels were significantly lower among longer repeat allele carriers compared to shorter repeat allele carriers (P = 0.002, 0.006 and 0.020 for women ages 18-30, 31-40 and 41-50 years, respectively). In contrast, increased FSH indicative of early ovarian decline was only evident for longer repeat allele carriers aged 31-40 years (P = 0.089, 0.001 and 0.261 for women ages 18-30, 31-40 and 41-50 years, respectively).

CONCLUSIONS

These preliminary data suggest that AMH levels indicate early ovarian decline among women with longer FMR1 repeat alleles; moreover, AMH appears to be a better marker than FSH in identifying this early decline.

Detection of early FXTAS motor symptoms using the CATSYS computerised neuromotor test battery

BACKGROUND

Carriers of the FMR1 premutation allele are at a significantly increased risk for a late-onset neurodegenerative disorder, fragile X-associated tremor/ataxia syndrome (FXTAS). This disorder is distinct from fragile X syndrome (FXS) in its molecular aetiology and clinical presentation. The primary features of FXTAS are late-onset intention tremor and gait ataxia. Associated features include parkinsonism, neuropsychological dysfunction, autonomic dysfunction and peripheral neuropathy.

AIM

To investigate the usefulness of a quantitative neurological test battery implemented through the CATSYS instrument to identify preclinical symptoms of FXTAS.

METHODS

Both premutation carriers with 70-199 repeats (62 men) and their low-repeat allele carrier siblings (27 men), identified through families with an individual affected with FXS, were tested.

RESULTS

As expected, because of its sensitivity, use of the instrument allowed identification of tremor in 23% of men who had not self-reported tremor, and ataxia in 30% of men who had not self-reported ataxia. Among subjects with self-reported tremor and ataxia, we found significant concordance between measures of the CATSYS system and the self-report.

CONCLUSION

Rates of these traits among premutation carriers and low-repeat allele carrier siblings could be identified, and are presented in this paper, along with the minimum estimates of age-related prevalence.

Examination of reproductive aging milestones among women who carry the FMR1 premutation

BACKGROUND

The fragile X premutation is characterized by a large CGG repeat track (55-199 repeats) in the 5' UTR of the FMR1 gene. This X-linked mutation leads to an increased risk for premature ovarian failure; interestingly, the association of repeat size with risk is non-linear. We hypothesize that the premutation-associated ovarian insufficiency is due to a diminished oocyte pool and examined reproductive aging milestones by repeat size group to determine if the same non-linear association is observed.

METHODS

We analyzed cross-sectional reproductive history questionnaire data from 948 women with a wide range of repeat sizes.

RESULTS

We have confirmed the non-linear relationship among premutation carriers for ovarian insufficiency. The mid-range repeat size group (80-100 repeats), not the highest group, had an increased risk for: altered cycle traits (shortened cycle length, irregular cycles and skipped cycles), subfertility and dizygotic twinning. Smoking, a modifiable risk, decreased the reproductive lifespan of women with the premutation by about 1 year, similar to its effect on non-carriers. As expected, premutation carriers were found to be at an increased risk for osteoporosis.

CONCLUSIONS

Possible molecular mechanisms to explain the non-linear repeat size risk for ovarian insufficiency are discussed.

Examination of reproductive aging milestones among women who carry the FMR1 premutation

BACKGROUND

The fragile X premutation is characterized by a large CGG repeat track (55-199 repeats) in the 5' UTR of the FMR1 gene. This X-linked mutation leads to an increased risk for premature ovarian failure; interestingly, the association of repeat size with risk is non-linear. We hypothesize that the premutation-associated ovarian insufficiency is due to a diminished oocyte pool and examined reproductive aging milestones by repeat size group to determine if the same non-linear association is observed.

METHODS

We analyzed cross-sectional reproductive history questionnaire data from 948 women with a wide range of repeat sizes.

RESULTS

We have confirmed the non-linear relationship among premutation carriers for ovarian insufficiency. The mid-range repeat size group (80-100 repeats), not the highest group, had an increased risk for: altered cycle traits (shortened cycle length, irregular cycles and skipped cycles), subfertility and dizygotic twinning. Smoking, a modifiable risk, decreased the reproductive lifespan of women with the premutation by about 1 year, similar to its effect on non-carriers. As expected, premutation carriers were found to be at an increased risk for osteoporosis.

CONCLUSIONS

Possible molecular mechanisms to explain the non-linear repeat size risk for ovarian insufficiency are discussed.

Risk factors for nondisjunction of trisomy 21

The leading cause of Down syndrome (DS) is nondisjunction of chromosome 21 occurring during the formation of gametes. In this review, we discuss the progress made to identify risk factors associated with this type of chromosome error occurring in oogenesis and spermatogenesis. For errors occurring in oocytes, the primary risk factors are maternal age and altered recombination. We review the current progress made with respect to these factors and briefly outline the potential environmental and genetic influences that may play a role. Although the studies of paternal nondisjunction are limited due to the relatively small proportion of errors of this type, we review the potential influence of paternal age, recombination and other environmental and genetic factors on susceptibility. Although progress has been made to understand the mechanisms and risk factors that underlie nondisjunction, considerably more research needs to be conducted to dissect this multifactorial trait, one that has a considerable impact on our species.

Association of FMR1 repeat size with ovarian dysfunction

BACKGROUND

Women who carry the FMR1 premutation allele have a significantly increased risk for ovarian dysfunction. We hypothesize that molecular characteristics of the FMR1 gene may explain this increased risk.

METHODS

Thus, we examined the effect of FMR1 CGG repeat size and related factors on measures of ovarian dysfunction using data from 507 women with a wide range of repeat sizes.

RESULTS AND CONCLUSIONS

We found a significant positive association of repeat size with ovarian dysfunction, but have preliminary evidence that this relationship is non-linear. We suggest that FMR1 repeat size in the lower range (<80 repeats) contributes to the variation in age at menopause; thus, FMR1 could be considered a quantitative trait locus. More importantly, when repeat size exceeds this threshold, the increase in risk for ovarian dysfunction is clinically significant. Intriguingly, this risk appears to plateau, or perhaps decrease, among women with very high repeats (> or =100 repeats).

Protection of mice against vaccinia virus by bacterial infection and sustained stimulation with specific bacterial antigens

In these experiments, mice which have a strong delayed-type hypersensitivity to mycobacteria were found, when elicited with old tuberculin, to be more resistant to intravenous vaccinia virus challenge than controls. This was manifest as protection from killing when large amounts of virus were injected, or as significantly less tail swelling and damage as well as lower titers of infectious virus when a lesser inoculum was used. Preliminary experiments indicate that animals sensitized with Staphylococcus aureus and elicited with phage lysate of staphylococcus are also more resistant to vaccinia infection.

Preservation of Borrelia kansas and Plasmodium berghei

Borrelia kansas and Plasmodium berghei have been stored after slow freezing in thioglycollate-glycerol medium for a 6-month period. During this time, 75% or more of the Borrelia remained motile, many intracellular malarial parasites exhibited amoeboid movement, and the growth pattern of both organisms in mice remained unchanged.

Use of tetrazolium salts for electron transport studies in meningopneumonitis. 3. Separation and examination of large and small particles

Purified suspensions of meningopneumonitis can be separated on potassium tartrate gradient into populations which are 80 to 90% large particles and those which are 90% small particles. Examination of the tetrazole reduction of both particle types indicates that the small particle has associated with it all of the enzymatic activity of the preparation; it also has associated with it most of the infectivity as well.

Use of tetrazolium salts for electron transport studies in meningopneumonitis. II. Reduced nicotinamide adenine dinucleotide phosphate system

Allen, Emma G. (Downstate Medical School, State University of New York, Brooklyn). Use of tetrazolium salts for electron transport studies in meningopneumonitis. II. Reduced nicotinamide adenine dinucleotide phosphate system. J. Bacteriol. 92:1041-1046. 1966.-The conditions of electron transfer from nicotinamide adenine dinucleotide phosphate in meningopneumonitis (MP) are described and compared with electron transfer from nicotinamide adenine dinucleotide by this organism. The observations suggest that, in either system, there may be more than one pathway of electron flow, and that these pathways differ from those in normal membrane particulates. It was also found that after trypsin treatment, particulates from pools of normal allantoic fluids and membranes retain the normal characteristics, whereas those from pools of MP-infected fluids and membranes assume the characteristics of MP particles from fluids.

Use of tetrazolium salts for electron transport studies in meningopneumonitis. I. Reduced nicotinamide adenine dinucleotide system

Allen, Emma G. (Downstate Medical Center, Brooklyn, N.Y.). Use of tetrazolium salts for electron transport studies in meningopneumonitis. I. Reduced nicotinamide adenine dinucleotide system. J. Bacteriol. 90:1505-1512. 1965.-Purified preparations of meningopneumonitis virus (MP) prepared from allantoic fluids of infected chick embryo reduce several tetrazolium salts in the presence of reduced nicotinamide adenine dinucleotide under both aerobic and anaerobic conditions. The pattern of reduction by MP differs from that seen in normal allantoic membrane homogenates, and is inhibited by several cations but not by KCN, atabrine, amytal, antimycin A, or 2,3-dimercaptopropanol (BAL). The reduction of cytochrome c by purified preparations of MP differs from its reduction of tetrazolium salts in that the cytochrome reaction is completely inhibited by BAL and partially inhibited by amytal, atabrine, and antimycin A. The cytochrome reductase of normal allantoic membrane preparations is completely inhibited by each of these compounds.