1
|
Robaszkiewicz K, Siatkowska M, Wadman RI, Kamsteeg EJ, Chen Z, Merve A, Parton M, Bugiardini E, de Bie C, Moraczewska J. A Novel Variant in TPM3 Causing Muscle Weakness and Concomitant Hypercontractile Phenotype. Int J Mol Sci 2023; 24:16147. [PMID: 38003336 PMCID: PMC10671854 DOI: 10.3390/ijms242216147] [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: 10/12/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
A novel variant of unknown significance c.8A > G (p.Glu3Gly) in TPM3 was detected in two unrelated families. TPM3 encodes the transcript variant Tpm3.12 (NM_152263.4), the tropomyosin isoform specifically expressed in slow skeletal muscle fibers. The patients presented with slowly progressive muscle weakness associated with Achilles tendon contractures of early childhood onset. Histopathology revealed features consistent with a nemaline rod myopathy. Biochemical in vitro assays performed with reconstituted thin filaments revealed defects in the assembly of the thin filament and regulation of actin-myosin interactions. The substitution p.Glu3Gly increased polymerization of Tpm3.12, but did not significantly change its affinity to actin alone. Affinity of Tpm3.12 to actin in the presence of troponin ± Ca2+ was decreased by the mutation, which was due to reduced interactions with troponin. Altered molecular interactions affected Ca2+-dependent regulation of the thin filament interactions with myosin, resulting in increased Ca2+ sensitivity and decreased relaxation of the actin-activated myosin ATPase activity. The hypercontractile molecular phenotype probably explains the distal joint contractions observed in the patients, but additional research is needed to explain the relatively mild severity of the contractures. The slowly progressive muscle weakness is most likely caused by the lack of relaxation and prolonged contractions which cause muscle wasting. This work provides evidence for the pathogenicity of the TPM3 c.8A > G variant, which allows for its classification as (likely) pathogenic.
Collapse
Affiliation(s)
- Katarzyna Robaszkiewicz
- Department of Biochemistry and Cell Biology, Kazimierz Wielki University, 85-671 Bydgoszcz, Poland; (K.R.); (M.S.)
| | - Małgorzata Siatkowska
- Department of Biochemistry and Cell Biology, Kazimierz Wielki University, 85-671 Bydgoszcz, Poland; (K.R.); (M.S.)
| | - Renske I. Wadman
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands;
| | - Erik-Jan Kamsteeg
- Department of Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Zhiyong Chen
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, The National Hospital for Neurology, London WC1N 3BG, UK; (Z.C.); (M.P.); (E.B.)
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore
| | - Ashirwad Merve
- Department of Neuropathology, UCL Queen Square Institute of Neurology, The National Hospital for Neurology, London WC1N 3BG, UK;
| | - Matthew Parton
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, The National Hospital for Neurology, London WC1N 3BG, UK; (Z.C.); (M.P.); (E.B.)
| | - Enrico Bugiardini
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, The National Hospital for Neurology, London WC1N 3BG, UK; (Z.C.); (M.P.); (E.B.)
| | - Charlotte de Bie
- Department of Genetics, University Medical Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Joanna Moraczewska
- Department of Biochemistry and Cell Biology, Kazimierz Wielki University, 85-671 Bydgoszcz, Poland; (K.R.); (M.S.)
| |
Collapse
|
2
|
Bugiardini E, Nunes AM, Oliveira‐Santos A, Dagda M, Fontelonga TM, Barraza‐Flores P, Pittman AM, Morrow JM, Parton M, Houlden H, Elliott PM, Syrris P, Maas RP, Akhtar MM, Küsters B, Raaphorst J, Schouten M, Kamsteeg E, van Engelen B, Hanna MG, Phadke R, Lopes LR, Matthews E, Burkin DJ. Integrin α7 Mutations Are Associated With Adult-Onset Cardiac Dysfunction in Humans and Mice. J Am Heart Assoc 2022; 11:e026494. [PMID: 36444867 PMCID: PMC9851448 DOI: 10.1161/jaha.122.026494] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/02/2022] [Indexed: 11/30/2022]
Abstract
Background Integrin α7β1 is a major laminin receptor in skeletal and cardiac muscle. In skeletal muscle, integrin α7β1 plays an important role during muscle development and has been described as an important modifier of skeletal muscle diseases. The integrin α7β1 is also highly expressed in the heart, but its precise role in cardiac function is unknown. Mutations in the integrin α7 gene (ITGA7) have been reported in children with congenital myopathy. Methods and Results In this study, we described skeletal and cardiac muscle pathology in Itga7-/- mice and 5 patients from 2 unrelated families with ITGA7 mutations. Proband in family 1 presented a homozygous c.806_818del [p.S269fs] variant, and proband in family 2 was identified with 2 intron variants in the ITGA7 gene. The complete absence of the integrin α7 protein in muscle supports the ITGA7 mutations are pathogenic. We performed electrocardiography, echocardiography, or cardiac magnetic resonance imaging, and histological biopsy analyses in patients with ITGA7 deficiency and Itga7-/- mice. The patients exhibited cardiac dysrhythmia and dysfunction from the third decade of life and late-onset respiratory insufficiency, but with relatively mild limb muscle involvement. Mice demonstrated corresponding abnormalities in cardiac conduction and contraction as well as diaphragm muscle fibrosis. Conclusions Our data suggest that loss of integrin α7 causes a novel form of adult-onset cardiac dysfunction indicating a critical role for the integrin α7β1 in normal cardiac function and highlights the need for long-term cardiac monitoring in patients with ITGA7-related congenital myopathy.
Collapse
Affiliation(s)
- Enrico Bugiardini
- Queen Square Centre for Neuromuscular DiseasesQueen Square Institute of Neurology, UCL and National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
| | - Andreia M. Nunes
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| | - Ariany Oliveira‐Santos
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| | - Marisela Dagda
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| | - Tatiana M. Fontelonga
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| | - Pamela Barraza‐Flores
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| | - Alan M. Pittman
- Department of Neuromuscular DiseasesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
- St George’sUniversity of LondonLondonUnited Kingdom
| | - Jasper M. Morrow
- Queen Square Centre for Neuromuscular DiseasesQueen Square Institute of Neurology, UCL and National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
| | - Matthew Parton
- Queen Square Centre for Neuromuscular DiseasesQueen Square Institute of Neurology, UCL and National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
| | - Henry Houlden
- Department of Neuromuscular DiseasesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Perry M. Elliott
- Barts Heart Centre, Barts Health NHS TrustLondonUnited Kingdom
- Centre for Heart Muscle DiseaseInstitute of Cardiovascular Science, University College LondonLondonUnited Kingdom
| | - Petros Syrris
- Centre for Heart Muscle DiseaseInstitute of Cardiovascular Science, University College LondonLondonUnited Kingdom
| | - Roderick P. Maas
- Department of Neurology, Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegenThe Netherlands
| | - Mohammed M. Akhtar
- Barts Heart Centre, Barts Health NHS TrustLondonUnited Kingdom
- Centre for Heart Muscle DiseaseInstitute of Cardiovascular Science, University College LondonLondonUnited Kingdom
| | - Benno Küsters
- Department of PathologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Joost Raaphorst
- Department of Neurology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam NeuroscienceAmsterdamThe Netherlands
| | - Meyke Schouten
- Department of Human GeneticsRadboud University Medical CenterNijmegenThe Netherlands
| | - Erik‐Jan Kamsteeg
- Department of Human GeneticsRadboud University Medical CenterNijmegenThe Netherlands
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegenThe Netherlands
| | - Michael G. Hanna
- Queen Square Centre for Neuromuscular DiseasesQueen Square Institute of Neurology, UCL and National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
| | - Rahul Phadke
- Division of NeuropathologyUCL Institute of NeurologyLondonUnited Kingdom
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular DiseasesUCL Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Luis R. Lopes
- Barts Heart Centre, Barts Health NHS TrustLondonUnited Kingdom
- Centre for Heart Muscle DiseaseInstitute of Cardiovascular Science, University College LondonLondonUnited Kingdom
| | - Emma Matthews
- The Atkinson Morley Neuromuscular Centre and Regional Neurosciences CentreSt George’s University Hospitals NHS Foundation TrustLondonUnited Kingdom
- Molecular and Clinical Sciences Research Institute, St George’s University of LondonLondonUnited Kingdom
| | - Dean J. Burkin
- Department of PharmacologyUniversity of Nevada Reno, School of Medicine, Center for Molecular MedicineRenoNV
| |
Collapse
|
3
|
Geyer C, Garber J, Gelber R, Yothers G, Taboada M, Ross L, Rastogi P, Cui K, Arahmani A, Aktan G, Armstrong A, Arnedos M, Balmaña J, Bergh J, Bliss J, Delaloge S, Domchek S, Eisen A, Elsafy F, Fein L, Fielding A, Ford J, Friedman S, Gelmon K, Gianni L, Gnant M, Hollingsworth S, Im SA, Jager A, Jóhannsson Ó, Lakhani S, Janni W, Linderholm B, Liu TW, Loman N, Korde L, Loibl S, Lucas P, Marmé F, Martinez de Dueñas E, McConnell R, Phillips KA, Piccart M, Rossi G, Schmutzler R, Senkus E, Shao Z, Sharma P, Singer C, Španić T, Stickeler E, Toi M, Traina T, Viale G, Zoppoli G, Park Y, Yerushalmi R, Yang H, Pang D, Jung K, Mailliez A, Fan Z, Tennevet I, Zhang J, Nagy T, Sonke G, Sun Q, Parton M, Colleoni M, Schmidt M, Brufsky A, Razaq W, Kaufman B, Cameron D, Campbell C, Tutt A. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high risk, early breast cancer. Ann Oncol 2022; 33:1250-1268. [PMID: 36228963 DOI: 10.1016/j.annonc.2022.09.159] [Citation(s) in RCA: 121] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The randomized, double-blind OlympiA trial compared 1 year of the oral poly(adenosine diphosphate-ribose) polymerase inhibitor, olaparib, to matching placebo as adjuvant therapy for patients with pathogenic or likely pathogenic variants in germline BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative, early breast cancer (EBC). The first pre-specified interim analysis (IA) previously demonstrated statistically significant improvement in invasive disease-free survival (IDFS) and distant disease-free survival (DDFS). The olaparib group had fewer deaths than the placebo group, but the difference did not reach statistical significance for overall survival (OS). We now report the pre-specified second IA of OS with updates of IDFS, DDFS, and safety. PATIENTS AND METHODS One thousand eight hundred and thirty-six patients were randomly assigned to olaparib or placebo following (neo)adjuvant chemotherapy, surgery, and radiation therapy if indicated. Endocrine therapy was given concurrently with study medication for hormone receptor-positive cancers. Statistical significance for OS at this IA required P < 0.015. RESULTS With a median follow-up of 3.5 years, the second IA of OS demonstrated significant improvement in the olaparib group relative to the placebo group [hazard ratio 0.68; 98.5% confidence interval (CI) 0.47-0.97; P = 0.009]. Four-year OS was 89.8% in the olaparib group and 86.4% in the placebo group (Δ 3.4%, 95% CI -0.1% to 6.8%). Four-year IDFS for the olaparib group versus placebo group was 82.7% versus 75.4% (Δ 7.3%, 95% CI 3.0% to 11.5%) and 4-year DDFS was 86.5% versus 79.1% (Δ 7.4%, 95% CI 3.6% to 11.3%), respectively. Subset analyses for OS, IDFS, and DDFS demonstrated benefit across major subgroups. No new safety signals were identified including no new cases of acute myeloid leukemia or myelodysplastic syndrome. CONCLUSION With 3.5 years of median follow-up, OlympiA demonstrates statistically significant improvement in OS with adjuvant olaparib compared with placebo for gBRCA1/2pv-associated EBC and maintained improvements in the previously reported, statistically significant endpoints of IDFS and DDFS with no new safety signals.
Collapse
|
4
|
Muni-Lofra R, Murphy L, Adcock K, Farrugia M, Irwin J, Lilleker J, McConville J, Merrison A, Parton M, Ryburn L, Scoto M, Marini-Bettolo C, Mayhew A. SMA – OUTCOME MEASURES AND REGISTRIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.285] [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]
|
5
|
Alobaidan A, Bugiardini E, Morrow J, Shah S, MacDonald S, Carr A, Machado P, Quinlivan R, Turner C, Yousry T, Parton M, Hanna M. FSHD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.197] [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: 11/26/2022]
|
6
|
Vivekanandam V, Bugiardini E, Merve A, Parton M, Morrow JM, Hanna MG, Machado PM. Differential Diagnoses of Inclusion Body Myositis. Neurol Clin 2020; 38:697-710. [PMID: 32703477 DOI: 10.1016/j.ncl.2020.03.014] [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] [Indexed: 10/23/2022]
Abstract
Inclusion body myositis is a slowly progressive myopathy, characteristically affecting quadriceps and long finger flexors. Atypical presentations do occur, however, and there is overlap with other myopathies, including inflammatory and hereditary etiologies. This article discusses atypical cases and differential diagnoses and considers the role of imaging and histopathology in differentiating inclusion body myositis.
Collapse
Affiliation(s)
- Vinojini Vivekanandam
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK
| | - Enrico Bugiardini
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK
| | - Ashirwad Merve
- Department of Neuropathology, UCL Institute of Neurology, 1st Floor, Queen Square House, 22 Queen Square, London WC1N 3BG, UK
| | - Matthew Parton
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, Ground Floor, 8-11 Queen Square, London WC1N3BG, UK
| | - Jasper M Morrow
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK
| | - Michael G Hanna
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, Ground Floor, 8-11 Queen Square, London WC1N3BG, UK
| | - Pedro M Machado
- Department of Neuromuscular Diseases, Queen Square Centre for Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK; Division of Medicine, Centre for Rheumatology, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK.
| |
Collapse
|
7
|
Bugiardini E, Khan A, Phadke R, Lynch D, Cortese A, Feng L, Gang Q, Pittman A, Morrow J, Turner C, Carr A, Quinlivan R, Rossor A, Holton J, Parton M, Blake J, Reilly M, Houlden H, Matthews E, Hanna M. EP.103Genetic and phenotypic characterisation of inherited myopathies in a tertiary neuromuscular centre. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.509] [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: 10/25/2022]
|
8
|
Irfan T, Turkes F, Asare B, Mohammed K, Osin P, Nerurkar A, Smith I, Parton M, Johnston S, Turner N, Okines A. Clinical Outcomes in Triple-negative Lobular Breast Cancer: a Single-institution Experience. Clin Oncol (R Coll Radiol) 2019. [DOI: 10.1016/j.clon.2019.03.021] [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] [Indexed: 10/26/2022]
|
9
|
Okines A, Kipps E, Irfan T, Coakley M, Aggelis V, Asare B, Johnston S, Parton M, Turner N, Smith I. Impact of delayed adjuvant chemotherapy: The Royal Marsden Hospital (RMH) experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz096.003] [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] [Indexed: 11/12/2022] Open
|
10
|
Shepherd S, Lee K, Mohammed K, Patel K, Allen M, Johnston S, Parton M, Ring A, Turner N, Okines A. Efficacy and tolerability of neratinib in advanced HER-2 positive breast cancer: A single institution experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.033] [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: 11/13/2022] Open
|
11
|
Bugiardini E, Phadke R, Maas R, Pittman A, Kusters B, Morrow J, Parton M, Nunes A, Akhtar M, Syrris P, Lopes L, Fotelonga T, Houlden H, Elliott P, Hanna M, Raaphorst J, Burkin D, Matthews E. CONGENITAL MUSCULAR DYSTROPHIES. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.382] [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: 10/28/2022]
|
12
|
Kipps E, Irfan T, Fribbens C, Osin P, Nerurkar A, Mohammed K, Parton M, Johnston S, Turner N, Okines A. Metaplastic Breast Cancer (MBC): A Single Centre Experience. Clin Oncol (R Coll Radiol) 2018. [DOI: 10.1016/j.clon.2018.02.015] [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: 10/17/2022]
|
13
|
Scalco R, Savvatis K, Desikan M, Parton M, Turner C. CAV3 p.Ala93Thr pathogenic mutation causing hypertrophic cardiomyopathy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.177] [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: 11/26/2022]
|
14
|
Crolley V, Marashi H, Rawther S, Parton M, Graham J, Vinayan A, Sutherland S, Rigg A, Wadhawan A, Harper-Wynne C, Spurrell E, Bond H, Raja F, King J. The impact of Oncotype DX breast cancer assay results on clinical practice: A UK experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Okonji D, Assersohn L, Rigg A, Sheri A, Parton M, Dowsett M. A Multi-institutional Study of Risk Estimates Derived from Oncotype DX. Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.01.029] [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]
|
16
|
Schutz PW, Scalco RS, Barresi R, Houlden H, Parton M, Holton JL. Calpainopathy with macrophage-rich, regional inflammatory infiltrates. Neuromuscul Disord 2017; 27:738-741. [PMID: 28602176 DOI: 10.1016/j.nmd.2017.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 11/19/2016] [Revised: 04/18/2017] [Accepted: 04/24/2017] [Indexed: 11/28/2022]
Abstract
Mutations in calpain-3 cause limb girdle muscular dystrophy 2A. Biopsy pathology is typically dystrophic, sometimes characterized by frequent lobulated fibres. More recently calpain mutations have been shown in association with eosinophilic myositis, suggesting that calpain mutations may render muscle susceptible to inflammatory change. We present the case of a 33-year old female with mild proximal muscle weakness and high CK levels (6698 IU/L at presentation). Muscle biopsy showed clusters of fibre necrosis associated with very dense macrophage infiltrates and small numbers of lymphocytes, raising the possibility of an inflammatory myopathy. No eosinophils were observed. Immunosuppressive treatment was started without clinical improvement. MRI demonstrated bilateral fatty replacement in posterior thigh and calf muscles. Western blot results prompted Sanger sequencing of the calpain-3 gene revealing compound heterozygous mutations c.643_663del and c.1746-20C>G. Our case widens the myopathological spectrum of calpainopathies to include focal macrophage rich inflammatory change.
Collapse
Affiliation(s)
- Peter W Schutz
- Division of Neuropathology, UCL Institute of Neurology, Queen Square, London, UK
| | - Renata S Scalco
- Division of Neuropathology, UCL Institute of Neurology, Queen Square, London, UK
| | - Rita Barresi
- Muscle Immunoanalysis Unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; The John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Matthew Parton
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Janice L Holton
- Division of Neuropathology, UCL Institute of Neurology, Queen Square, London, UK; Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
| |
Collapse
|
17
|
Kingston C, Kayhanian H, Brooks C, Cox N, Chaabouni N, Redana S, Kalaitzaki E, Smith I, O’Brien M, Johnston S, Allen M, Parton M, Noble J, Stanway S, Ring A, Turner N, Okines A. Treatment and prognosis of leptomeningeal disease secondary to metastatic breast cancer: a single-centre experience. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30124-7] [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]
|
18
|
Gang Q, Bettencourt C, Machado PM, Brady S, Holton JL, Pittman AM, Hughes D, Healy E, Parton M, Hilton-Jones D, Shieh PB, Needham M, Liang C, Zanoteli E, de Camargo LV, De Paepe B, De Bleecker J, Shaibani A, Ripolone M, Violano R, Moggio M, Barohn RJ, Dimachkie MM, Mora M, Mantegazza R, Zanotti S, Singleton AB, Hanna MG, Houlden H. Rare variants in SQSTM1 and VCP genes and risk of sporadic inclusion body myositis. Neurobiol Aging 2016; 47:218.e1-218.e9. [PMID: 27594680 PMCID: PMC5082791 DOI: 10.1016/j.neurobiolaging.2016.07.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/27/2016] [Accepted: 07/29/2016] [Indexed: 12/14/2022]
Abstract
Genetic factors have been suggested to be involved in the pathogenesis of sporadic inclusion body myositis (sIBM). Sequestosome 1 (SQSTM1) and valosin-containing protein (VCP) are 2 key genes associated with several neurodegenerative disorders but have yet to be thoroughly investigated in sIBM. A candidate gene analysis was conducted using whole-exome sequencing data from 181 sIBM patients, and whole-transcriptome expression analysis was performed in patients with genetic variants of interest. We identified 6 rare missense variants in the SQSTM1 and VCP in 7 sIBM patients (4.0%). Two variants, the SQSTM1 p.G194R and the VCP p.R159C, were significantly overrepresented in this sIBM cohort compared with controls. Five of these variants had been previously reported in patients with degenerative diseases. The messenger RNA levels of major histocompatibility complex genes were upregulated, this elevation being more pronounced in SQSTM1 patient group. We report for the first time potentially pathogenic SQSTM1 variants and expand the spectrum of VCP variants in sIBM. These data suggest that defects in neurodegenerative pathways may confer genetic susceptibility to sIBM and reinforce the mechanistic overlap in these neurodegenerative disorders.
Collapse
Affiliation(s)
- Qiang Gang
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK
| | - Conceição Bettencourt
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London, UK
| | - Pedro M Machado
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK; Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Stefen Brady
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Janice L Holton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK
| | - Alan M Pittman
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; Reta Lila Weston Laboratories, UCL Institute of Neurology, London, UK
| | - Deborah Hughes
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK
| | - Estelle Healy
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK
| | - Matthew Parton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK
| | - David Hilton-Jones
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Perry B Shieh
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Merrilee Needham
- Western Australian Neurosciences Research Institute (WANRI), University of Western Australia and Murdoch University, Fiona Stanley Hospital, Perth, Australia
| | - Christina Liang
- Department of Neurology, Royal North Shore Hospital, New South Wales, Australia
| | - Edmar Zanoteli
- Department of Neurology, Medical School of the University of São Paulo (FMUSP), São Paulo, Brazil
| | | | - Boel De Paepe
- Department of Neurology and Neuromuscular Reference Centre, Ghent University Hospital, Ghent, Belgium
| | - Jan De Bleecker
- Department of Neurology and Neuromuscular Reference Centre, Ghent University Hospital, Ghent, Belgium
| | | | - Michela Ripolone
- Neuromuscular Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Raffaella Violano
- Neuromuscular Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, University of Milan, Milan, Italy
| | - Maurizio Moggio
- Neuromuscular Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, University of Milan, Milan, Italy
| | | | | | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Isitituto Neurologico C. Besta, Milano, Italy
| | - Renato Mantegazza
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Isitituto Neurologico C. Besta, Milano, Italy
| | - Simona Zanotti
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Isitituto Neurologico C. Besta, Milano, Italy
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institute of Health, Bethesda, MD, USA
| | - Michael G Hanna
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK.
| | - Henry Houlden
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Queen Square, London, UK; Neurogenetics Laboratory, Institute of Neurology, University College London, Queen Square, London, UK.
| |
Collapse
|
19
|
Nastasi L, Desikan M, Turner C, Parton M, Morrow J, Carr A, Manji H, Hanna M, Quinlivan R. Quality of care in the first neuromuscular complex care centre in the UK from the patients' perspective. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.435] [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: 10/21/2022]
|
20
|
Irfan T, Turner N, Johnston S, Smith I, O'Brien M, Parton M, Ring A, Noble J, Stanway S, Somaiah N, Khabra K, Okines A. Central nervous system (CNS) disease during trastuzumab emtansine (T-DM1) for HER2 positive advanced breast cancer (ABC): A single institution experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.48] [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: 11/13/2022] Open
|
21
|
Devine H, Parton M. Seizure: acute investigation and management. Br J Hosp Med (Lond) 2016; 77:C134-7. [PMID: 27640668 DOI: 10.12968/hmed.2016.77.9.c134] [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: 11/11/2022]
Affiliation(s)
- Helen Devine
- Clinical Research Fellow at the MRC Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, London WC1N 3BG
| | - Matthew Parton
- Consultant in Neurology in the MRC Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, London
| |
Collapse
|
22
|
Affiliation(s)
| | | | | | | | | | | | - Katie Sidle
- National Hospital for Neurology & Neurosurgery
| | | |
Collapse
|
23
|
Gardiner A, Scalco R, Parton M, Hanna M, Pitceathly R, Zanoteli E, Murphy E, Treves S, Houlden H, Wilmshurst J, Straub V, Hilton-Jones D, Voermans N, Manzur A, Oflazer P, Reed U, Lachmann R, Quinlivan R, Jungbluth H. RYR1-related exertional rhabdomyolysis: Expanding spectrum and diagnostic challenges. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.263] [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: 10/23/2022]
|
24
|
Jaffer F, Avbersek A, Vavassori R, Fons C, Campistol J, Stagnaro M, De Grandis E, Veneselli E, Rosewich H, Gianotta M, Zucca C, Ragona F, Granata T, Nardocci N, Mikati M, Helseth AR, Boelman C, Minassian BA, Johns S, Garry SI, Scheffer IE, Gourfinkel-An I, Carrilho I, Aylett SE, Parton M, Hanna MG, Houlden H, Neville B, Kurian MA, Novy J, Sander JW, Lambiase PD, Behr ER, Schyns T, Arzimanoglou A, Cross JH, Kaski JP, Sisodiya SM. Faulty cardiac repolarization reserve in alternating hemiplegia of childhood broadens the phenotype. Brain 2015; 138:2859-74. [PMID: 26297560 PMCID: PMC4671482 DOI: 10.1093/brain/awv243] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 11/03/2014] [Accepted: 06/30/2015] [Indexed: 12/29/2022] Open
Abstract
Alternating hemiplegia of childhood is a rare disorder caused by de novo mutations in the ATP1A3 gene, expressed in neurons and cardiomyocytes. As affected individuals may survive into adulthood, we use the term 'alternating hemiplegia'. The disorder is characterized by early-onset, recurrent, often alternating, hemiplegic episodes; seizures and non-paroxysmal neurological features also occur. Dysautonomia may occur during hemiplegia or in isolation. Premature mortality can occur in this patient group and is not fully explained. Preventable cardiorespiratory arrest from underlying cardiac dysrhythmia may be a cause. We analysed ECG recordings of 52 patients with alternating hemiplegia from nine countries: all had whole-exome, whole-genome, or direct Sanger sequencing of ATP1A3. Data on autonomic dysfunction, cardiac symptoms, medication, and family history of cardiac disease or sudden death were collected. All had 12-lead electrocardiogram recordings available for cardiac axis, cardiac interval, repolarization pattern, and J-point analysis. Where available, historical and prolonged single-lead electrocardiogram recordings during electrocardiogram-videotelemetry were analysed. Half the cohort (26/52) had resting 12-lead electrocardiogram abnormalities: 25/26 had repolarization (T wave) abnormalities. These abnormalities were significantly more common in people with alternating hemiplegia than in an age-matched disease control group of 52 people with epilepsy. The average corrected QT interval was significantly shorter in people with alternating hemiplegia than in the disease control group. J wave or J-point changes were seen in six people with alternating hemiplegia. Over half the affected cohort (28/52) had intraventricular conduction delay, or incomplete right bundle branch block, a much higher proportion than in the normal population or disease control cohort (P = 0.0164). Abnormalities in alternating hemiplegia were more common in those ≥16 years old, compared with those <16 (P = 0.0095), even with a specific mutation (p.D801N; P = 0.045). Dynamic, beat-to-beat or electrocardiogram-to-electrocardiogram, changes were noted, suggesting the prevalence of abnormalities was underestimated. Electrocardiogram changes occurred independently of seizures or plegic episodes. Electrocardiogram abnormalities are common in alternating hemiplegia, have characteristics reflecting those of inherited cardiac channelopathies and most likely amount to impaired repolarization reserve. The dynamic electrocardiogram and neurological features point to periodic systemic decompensation in ATP1A3-expressing organs. Cardiac dysfunction may account for some of the unexplained premature mortality of alternating hemiplegia. Systematic cardiac investigation is warranted in alternating hemiplegia of childhood, as cardiac arrhythmic morbidity and mortality are potentially preventable.
Collapse
Affiliation(s)
- Fatima Jaffer
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Andreja Avbersek
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Rosaria Vavassori
- 5 A.I.S.EA Onlus, Via Sernovella, 37 - Verderio Superiore, 23878 Lecco, Italy
| | - Carmen Fons
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Jaume Campistol
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Michela Stagnaro
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Elisa De Grandis
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Edvige Veneselli
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Hendrik Rosewich
- 8 University Medical Center Göttingen, Georg August University, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, Georg August University, Robert Koch Strasse 40, 37099 Göttingen, Germany
| | - Melania Gianotta
- 9 Child Neurology Unit IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy
| | - Claudio Zucca
- 10 Clinical Neurophysiology Unit, IRCCS "E. Medea", Via Don L. Monza 20, 23842 Bosisio Parini (LC), Italy
| | - Francesca Ragona
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Tiziana Granata
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Nardo Nardocci
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Mohamed Mikati
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Ashley R Helseth
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Cyrus Boelman
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Berge A Minassian
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Sophia Johns
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sarah I Garry
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Ingrid E Scheffer
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Isabelle Gourfinkel-An
- 16 Centre de reference epilepsies rares et Sclérose tubéreuse de Bourneville (site Parisien adolescents-adultes), Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital 75651 Paris cedex 13, France
| | - Ines Carrilho
- 17 Neuropediatric Department Centro Hospitalar do Porto, Rua da Boavista, 8274050-111, Porto, Portugal
| | - Sarah E Aylett
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Matthew Parton
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Michael G Hanna
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Henry Houlden
- 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Brian Neville
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Manju A Kurian
- 19 Molecular Neurosciences, Developmental Neurosciences Programme, UCL Institute of Child Health and Department of Neurology, Great Ormond Street Hospital, London, London, WC1N 3JH, UK
| | - Jan Novy
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Josemir W Sander
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Pier D Lambiase
- 20 Department of Cardiac Electrophysiology, The Heart Hospital, Institute of Cardiovascular Science, University College London, 16-18 Westmoreland St, London W1G 8PH, UK
| | - Elijah R Behr
- 21 Cardiac and Cell Sciences Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Tsveta Schyns
- 22 European Network for Research on Alternating Hemiplegia, ENRAH, Brussels, Belgium
| | - Alexis Arzimanoglou
- 23 Epilepsy, Sleep and Paediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), and DYCOG team, Lyon Neuroscience Research Centre (CRNL), INSERM U1028; CNRS UMR 5292, Lyon, France
| | - J Helen Cross
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK 24 Young Epilepsy, St. Piers Lane, Lingfield, Surrey RH7 6PW, UK
| | - Juan P Kaski
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sanjay M Sisodiya
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| |
Collapse
|
25
|
Machado PM, Ahmed M, Brady S, Gang Q, Healy E, Morrow JM, Wallace AC, Dewar L, Ramdharry G, Parton M, Holton JL, Houlden H, Greensmith L, Hanna MG. Ongoing developments in sporadic inclusion body myositis. Curr Rheumatol Rep 2014; 16:477. [PMID: 25399751 PMCID: PMC4233319 DOI: 10.1007/s11926-014-0477-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Sporadic inclusion body myositis (IBM) is an acquired muscle disorder associated with ageing, for which there is no effective treatment. Ongoing developments include: genetic studies that may provide insights regarding the pathogenesis of IBM, improved histopathological markers, the description of a new IBM autoantibody, scrutiny of the diagnostic utility of clinical features and biomarkers, the refinement of diagnostic criteria, the emerging use of MRI as a diagnostic and monitoring tool, and new pathogenic insights that have led to novel therapeutic approaches being trialled for IBM, including treatments with the objective of restoring protein homeostasis and myostatin blockers. The effect of exercise in IBM continues to be investigated. However, despite these ongoing developments, the aetiopathogenesis of IBM remains uncertain. A translational and multidisciplinary collaborative approach is critical to improve the diagnosis, treatment, and care of patients with IBM.
Collapse
Affiliation(s)
- Pedro M. Machado
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Mhoriam Ahmed
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG UK
| | - Stefen Brady
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Qiang Gang
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Estelle Healy
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Jasper M. Morrow
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Amanda C. Wallace
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Liz Dewar
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Gita Ramdharry
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Matthew Parton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Janice L. Holton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Linda Greensmith
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG UK
| | - Michael G. Hanna
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| |
Collapse
|
26
|
Graeser M, Gevensleben H, Daley F, McCarthy A, Orr N, Parton M, Lord C, Reis-Filho J, Dowsett M, Smith I, Ashworth A, Turner N. Marker für die defekte homologe Rekombination beim sporadischen Mammakarzinom. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388576] [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: 10/24/2022] Open
|
27
|
Ahmed RM, Murphy E, Davagnanam I, Parton M, Schott JM, Mummery CJ, Rohrer JD, Lachmann RH, Houlden H, Fox NC, Chataway J. A practical approach to diagnosing adult onset leukodystrophies. J Neurol Neurosurg Psychiatry 2014; 85:770-81. [PMID: 24357685 DOI: 10.1136/jnnp-2013-305888] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- R M Ahmed
- Department of Neurodegenerative Disease, Dementia Research Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - E Murphy
- The Charles Dent Metabolic Unit, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - I Davagnanam
- Lysholm Department of Neuroradiology, National Hospital for Neurology & Neurosurgery and Brain Repair and Rehabilitation unit UCL Institute of Neurology, London, UK
| | - M Parton
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - J M Schott
- Department of Neurodegenerative Disease, Dementia Research Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - C J Mummery
- Department of Neurodegenerative Disease, Dementia Research Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - J D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - R H Lachmann
- The Charles Dent Metabolic Unit, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - H Houlden
- Department of Molecular Neurosciences, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - N C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| | - J Chataway
- Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, National Hospital for Neurology & Neurosurgery and UCL Institute of Neurology, London, UK
| |
Collapse
|
28
|
Georgieva Z, Parton M. Cerebellar ataxia and epilepsy with anti-GAD antibodies: treatment with IVIG and plasmapheresis. BMJ Case Rep 2014; 2014:bcr-2013-202314. [PMID: 24419643 DOI: 10.1136/bcr-2013-202314] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Glutamic acid decarboxylase autoantibody (GAD-65) catalyses glutamate conversion into γ-aminobutyric acid (GABA) in the central nervous system and in the pancreatic β cells. Antibodies targeting GAD-65 are of uncertain pathogenic significance and occur in stiff person syndrome, cerebellar ataxia, epilepsy, limbic encephalitis and combinations thereof and diabetes mellitus. A 45-year-old man with a cerebellar gait ataxia, dysmetria, nystagmus and mild cerebellar dysarthria was diagnosed with insulin-dependent diabetes mellitus a year after the onset of neurological symptoms. He also developed complex and tonic-clonic seizures, resistant to anticonvulsant medication and deteriorated cognitively. Blood and cerebrospinal fluid serology, and imaging supported the diagnosis of GAD-65 cerebellar ataxia and epilepsy. He was treated with intravenous immunoglobulin and subsequently plasmapheresis. We report the outcome of 3 years of treatment, which resulted in the improvement of cerebellar signs (particularly gait), with some ultimate decline of efficacy.
Collapse
|
29
|
Sheri A, Smith IE, A'Hern R, Jones R, Parton M, Johnston SRD, Dowsett M. Abstract P1-08-03: Prediction of response to neoadjuvant chemotherapy in estrogen receptor positive (ER+) breast cancer by IHC4 or Ki67 alone. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-08-03] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Aims To determine whether IHC4 score assessed on pre-treatment core biopsies (i) predicts response to neoadjuvant chemotherapy in ER positive breast cancer; (ii) provides more predictive information than Ki67 alone.
Background The IHC4 score, a composite of ER, PgR, Ki67 and HER2 scores provides prognostic information similar to the OncotypeDx 21-gene Recurrence Score in ER + primary breast cancer treated with endocrine therapy but it is unknown if it also predicts response to chemotherapy. Pathological complete response (pCR) following neoadjuvant chemotherapy is established as an intermediate marker of long-term outcome. More recently the residual cancer burden (RCB) has also been shown to be prognostic, with those patients with minimal residual disease (RCB1) following neoadjuvant chemotherapy having a similar prognosis to those with a pCR (RCB0). The development of these intermediate markers provides an opportunity to study the predictive role of pre-treatment biomarkers for benefit to a particular therapy.
Methods A total of 114 ER+ patients treated with neoadjuvant chemotherapy at the Royal Marsden Hospital between 2002-2010 were included in the study.
An assessment of the excision specimen was made for residual disease. IHC4 was determined on pre-treatment core biopsies, blinded to clinical outcome, by immunohistochemistry using quantitative scoring of ER (H-score), PgR (%) and Ki67 (%). Determination of HER2 status was made by immunohistochemistry and fluorescent in situ hybridization for 2+ cases. IHC4 and Ki67 scores were tested for their association with pCR rate and RCB score.
Results 19 (17%) of the 114 patients and 9 (10%) of the 90 HER2-ve cases showed a pCR. Ki67 and the IHC4 score were both positively associated with achievement of pCR (P<10-7 and P<10-9 respectively) and RCB0+1 (P<10-5 and P<10-9 respectively) following neoadjuvant chemotherapy in all patients. Rates of RCB0+1 were 45% and 66% in the highest quartiles of Ki67 and IHC4 scores respectively. In ER + HER2-ve cases pCR and RCB0+ 1 rates were 35% and 39%, respectively in the highest quartile of IHC4 and 30% and 39%, respectively in the highest quartile of Ki67 (Table 1). There were no pCRs in the lower half of IHC4 or Ki67 scores.
Conclusions A high IHC4 was strongly predictive of a pCR or near pCR in ER + breast cancers following neoadjuvant chemotherapy. Ki67 was an important component of this predictive ability.
Response according to IHC4 and Ki67 quartile in HER2 negative, ER+ breast cancersIntermediate endpointpCRpCRRCB0+RCB1RCB0+RCB1ScoreIHC4Ki67IHC4Ki67Quartile 10% (0/22)0% (0/22)5% (1/22)9% (2/22)Quartile 20% (0/23)0% (0/23)4% (1/23)0% (0/23)Quartile 35%(1/22)9% (2/23)9% (2/22)9% (2/23)Quartile 435% (8/23)30% (7/23)39% (9/23)39% (9/23)
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-03.
Collapse
Affiliation(s)
- A Sheri
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - IE Smith
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - R A'Hern
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - R Jones
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - M Parton
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - SRD Johnston
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - M Dowsett
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| |
Collapse
|
30
|
Lluch-Hernández A, Ruiz Simon A, Huang CS, Cortés Castán J, Ruiz-Borrego M, Telli M, Ismail-Khan R, Parton M, Tseng LM, Chen SC, Schmid P, Mayer I, Hurvitz S, García-Estévez L, Atienza R, Wu M, Cameron S, Beck JT, Bardia A. Abstract OT1-4-04: A phase II randomized, open-label, neoadjuvant study of LCL161, an oral antagonist of inhibitor of apoptosis proteins, in combination with paclitaxel in patients with triple-negative breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-ot1-4-04] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inhibitor of apoptosis proteins (IAPs) negatively regulate cell death through a variety of mechanisms. LCL161 is an oral small-molecule antagonist of IAPs that has demonstrated single-agent activity and synergy with paclitaxel in breast cancer tumor models. In preclinical studies, a gene expression signature has been shown to enrich for response to LCL161. The recommended dose of LCL161 1800 mg once weekly has demonstrated preliminary antitumor activity with paclitaxel in an ongoing Phase Ib study in patients with breast cancer.
Trial design: This is a Phase II, randomized, open-label study of neoadjuvant paclitaxel with or without LCL161 in women with operable, newly diagnosed triple-negative breast cancer (NCT01617668). Key inclusion criteria include women with histologically confirmed diagnosis of triple-negative breast cancer; clinical stages T2, N0–N2, M0; candidates for mastectomy or breast-conserving surgery; ECOG performance status ≤1; known status of the LCL161-predictive gene expression signature (positive and negative gene signature is a stratification factor); and adequate bone marrow and organ function. Key exclusion criteria are: bilateral or inflammatory breast cancer; locally recurrent breast cancer; patients currently receiving systemic therapy for any other malignancy, or having received systemic therapy for a malignancy in the preceding 3 months; impaired gastrointestinal function that may affect the absorption of LCL161; or uncontrolled cardiac disease.
Patients are randomized 1:1 to receive paclitaxel IV (80 mg/m2 weekly) with or without oral LCL161 (1800 mg once weekly) for 12 weeks (corresponding to 4 treatment cycles). Each treatment arm is stratified 1:1 based on gene expression signature status (positive or negative).
Endpoints: The primary endpoint is pathologic complete response (pCR), defined as the absence of invasive disease in the breast after 12 weeks of therapy, analyzed separately in the gene expression signature positive and negative groups. The key secondary endpoint is the pCR rate following treatment with LCL161 and paclitaxel in gene expression signature-positive or -negative tumors. Other secondary endpoints include: pCR rate in breast after 12 weeks of therapy in the full study population, and in patients with gene expression signature-positive and -negative tumors treated with paclitaxel alone; pCR rate in breast, regional nodes and axilla; biomarker evaluation including caspase 3 activation in tumor; safety; and pharmacokinetics of LCL161.
Statistical methods: pCR analysis will be performed according to treatment group and gene expression signature status. An absolute increase of at least 7.5% in pCR rate of the experimental arm over the control arm will be considered as evidence of clinically relevant efficacy.
Target accrual: Approximately 200 patients will be randomized into this study. Recruitment is ongoing across America, Europe, and Asia.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT1-4-04.
Collapse
Affiliation(s)
- A Lluch-Hernández
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - A Ruiz Simon
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - C-S Huang
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - J Cortés Castán
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Ruiz-Borrego
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Telli
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - R Ismail-Khan
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Parton
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - L-M Tseng
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - S-C Chen
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - P Schmid
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - I Mayer
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - S Hurvitz
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - L García-Estévez
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - R Atienza
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Wu
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - S Cameron
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - JT Beck
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - A Bardia
- Hospital Clinico Universitario de Valencia, Valencia, Spain; Instituto Valenciano de Oncologia, Valencia, Spain; National Taiwan University Hospital, Taipei, Taiwan; Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Stanford University Medical Center, Stanford, CA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Taipei Veterans General Hospital, Taipei, Taiwan; Chang Gung Memorial Hospital Linkou, Taipei, Taiwan; Royal Sussex County Hospital, Brighton; Vanderbilt University Medical Center, Nashville, TN; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Hospital de Sanchinarro, Madrid, Spain; Novartis Pharmaceuticals Corp., East Hanover, NJ; Novartis Pharmaceuticals Corp., Cambridge, MA; Highlands Oncology Group, Fayetteville, AR; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| |
Collapse
|
31
|
Jaffer F, Reilly MM, Quinlivan R, Muntoni F, Turner C, Parton M, Lunn M, Hilton–Jones D, Korkodilos M, Hanna MG. EMERGENCY NEUROMUSCULAR ADMISSIONS ARE AVOIDABLE: A REGIONAL AUDIT OF UNPLANNED HOSPITAL ADMISSIONS OF NEUROMUSCULAR PATIENTS 2009–2011: FINAL RESULTS AND RECOMMENDATIONS. J Neurol Neurosurg Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306573.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Hiscock A, Dewar L, Parton M, Machado P, Hanna M, Ramdharry G. Frequency and circumstances of falls in people with inclusion body myositis: a questionnaire survey to explore falls management and physiotherapy provision. Physiotherapy 2013; 100:61-5. [PMID: 23954023 DOI: 10.1016/j.physio.2013.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 10/10/2012] [Accepted: 06/11/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To survey the incidence and circumstances of falls for people with inclusion body myositis (IBM) in the UK, and to investigate the provision of physiotherapy and falls management. DESIGN Postal questionnaire survey. SETTING Participants completed questionnaires at home. PARTICIPANTS Ninety-four people diagnosed with IBM were screened against the inclusion criteria. Seventy-two potential participants were sent a questionnaire, and 62 were completed and returned. Invited participants were sent an adapted Falls Event Questionnaire pertaining to falls, perceived causes of falls and the provision of physiotherapy. Questionnaires were returned anonymously. MAIN OUTCOME MEASURES The proportions of respondents who reported a fall or a near fall, along with the frequencies of falls and near falls were calculated. Descriptive data of falls were collected pertaining to location and cause. Data analysis was performed to investigate provision of physiotherapy services. RESULTS The response rate was 86% [62/72, mean (standard deviation) age 68 (8) years]. Falls were reported by 98% (61/62) of respondents, with 60% (37/62) falling frequently. In this study, age was not found to be an indicator of falls risk or frequency. Twenty-one percent (13/62) of respondents had not seen a physiotherapist in relation to their IBM symptoms, and of those that had, 31% (15/49) had not seen a physiotherapist until more than 12 months after IBM was diagnosed. Only 18% (11/61) of fallers reported that they had received falls management input. CONCLUSIONS Falls are a common occurrence for people with IBM, independent of age and years since symptoms first presented, and are poorly addressed by appropriate physiotherapy management. National falls guidelines are not being followed, and referral rates to physiotherapy need to improve.
Collapse
Affiliation(s)
- A Hiscock
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - L Dewar
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - M Parton
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - P Machado
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - M Hanna
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - G Ramdharry
- School of Rehabilitation Sciences, Faculty of Health and Social Care Sciences, St George's University of London/Kingston University, London, UK.
| |
Collapse
|
33
|
Jaffer F, Reilly MM, Quinlivan RR, Muntoni F, Orrell R, Wraige E, Saha R, Radunovic A, Mummery C, Parton M, Hanna M. AVOIDING UNPLANNED HOSPITAL ADMISSIONS IN PATIENTS WITH NEUROMUSCULAR DISEASES: A REGIONAL COLLABORATIVE AUDIT OF HOSPITAL ADMISSIONS. J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2012-304200a.88] [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: 11/04/2022]
|
34
|
Matthews E, Plotz PH, Portaro S, Parton M, Elliott P, Humbel RL, Holton JL, Keegan BM, Hanna MG. A case of necrotizing myopathy with proximal weakness and cardiomyopathy. Neurology 2012; 78:1527-32. [PMID: 22565568 DOI: 10.1212/wnl.0b013e3182553baa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- E Matthews
- MRC Centre for Neuromuscular Disease, UCL, Institute of Neurology, Queen Square, London, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Doherty KM, Silveira-Moriyama L, Nisbet A, Noyce A, Quinn N, Parton M, Lees AJ. 0854 Camptocormia: what is the cause? J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.40] [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: 11/04/2022]
|
36
|
Machado P, Hudson J, Miller A, Morrow J, Parton M, Bushby K, Hanna M. 097 Valosin Containing Protein (VCP) and Myofibrillar Myopathies (MFM) genes' mutations are not associated with sporadic Inclusion Body Myositis (sIBM). J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.139] [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: 11/04/2022]
|
37
|
Cortese A, Machado P, Morrow J, Dewar L, Hiscock A, Miller A, Brady S, Hilton-Jones D, Parton M, Hanna M. P73 The natural history of sporadic inclusion body myositis: data from the IBM-Net prospective cohort study. Neuromuscul Disord 2012. [DOI: 10.1016/s0960-8966(12)70081-0] [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: 10/28/2022]
|
38
|
Hiscock A, Dewar L, Parton M, Machado P, Hanna M, Ramdharry G. P85 Frequency and circumstances of falls in people with Inclusion Body Myositis. Neuromuscul Disord 2012. [DOI: 10.1016/s0960-8966(12)70093-7] [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: 11/26/2022]
|
39
|
Cortese A, Machado P, Miller A, Brady S, Hilton-Jones D, Morrow J, Hiscock A, Dewar E, Parton M, Hanna M. 1130 Clinical features and clinical course of sporadic inclusion body myositis (IBM): a prospective cohort study: IBM-net. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
40
|
Machado P, Hudson J, Miller A, Morrow J, Parton M, Bushby K, Hanna M. P82 Myofibrillar myopathies (MFM), valosin containing protein (VCP) and glucosamine (UDP-N-acetyl)-2-epimerase/N-acetylmannosamine kinase (GNE) genes' mutations are not associated with sporadic inclusion body myositis (sIBM). Neuromuscul Disord 2012. [DOI: 10.1016/s0960-8966(12)70090-1] [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: 10/28/2022]
|
41
|
Miller A, Machado P, Morrow J, Hiscock A, Dewar L, Brady S, Hilton-Jones D, Hanna M, Parton M. P79 The natural history of sporadic inclusion body myositis: development of an electronic database IBM net. Neuromuscul Disord 2011. [DOI: 10.1016/s0960-8966(11)70098-0] [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: 12/01/2022]
|
42
|
Waddell T, Kotsori A, Constantinidou A, Yousaf N, Ashley S, Parton M, Johnston S, Smith I. Abstract P6-11-11: Trastuzumab beyond Progression in HER2-Positive Advanced Breast Cancer: The Royal Marsden Experience. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p6-11-11] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Routine clinical practice and a growing body of evidence support the continuation of trastuzumab (T) in patients with HER-2 positive (+ve) advanced breast cancer progressing on previous T-based therapy. Despite this, recent UK clinical guidance advises against continuing T on evidence of disease progression (PD) in the absence of brain metastases. This retrospective study therefore evaluated the outcome of patients (pts) with HER-2+ve locally advanced (LA) or metastatic breast cancer (MBC) who continued T beyond PD, treated in our Unit. Patients and methods: HER-2+ve pts receiving T for LA or MBC were identified from our prospectively maintained database and pharmacy records. Those receiving T beyond PD after adjuvant or one line of T for advanced disease were assessed for response and outcome. From thetimepoint of T continuation beyond PD we calculated the overall disease control rate (response or stable disease), time to progression (TTP), and overall survival (OS).
Results: 114 pts with HER-2+ve LA or MBC treated with T beyond PD were identified. At the time of analysis 35 (31%) pts were still alive with a median follow up of 20 months (mo). The main site of disease was visceral in 84 (74%) pts, including 37 (32%) pts with CNS involvement. 30 (26%) pts had soft tissue or bone metastases only. Fifty nine (52%) pts had received adjuvant chemotherapy and 13 (11%) pts had received adjuvant T. Seventy six (66%) pts had 1 line of chemotherapy prior to continuation of T beyond PD and 21 (19%) had 2 or more lines. Fifty three (46%) pts had previously received taxanes + T for their LA or MBC. Post-progression, 66 (58%) pts received T combined with chemotherapy; 12 (11%) taxane-based, 32 (28%) capecitabine and 22 (19%) vinorelbine. Information regarding response was not available in 21(18%) pts. Of the ninety three (82%) pts with documented clinical (n=16) or radiological (n=77) response evaluation, 68 (60%) pts were considered as having stable disease (SD) or better and 25 (22%) as having PD. The median duration of T was 10 mo (95% CI: 8-11 mo), the median TTP was 24wks (95% CI: 21-28 wks) and the median OS was 19 mo (95% CI:12-24mo). In a sub-group analysis of the 81(71%) pts who received T as first-line Rx or relapsed within 12 wks of adjuvant T, overall disease control was achieved in 50 (61%) pts, the median TTP was 25wks (95% CI:18-33 wks) and the median OS was 22 mo(95% CI:17-27mo). In terms of safety, only 6 (5%) pts overall had to discontinue T secondary to decline in left ventricular ejection fraction.
Conclusion: Our results from an unselected group of patients are supported by positive results from other studies and provide additional evidence that continuation of trastuzumab beyond disease progression is of clinical benefit.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-11-11.
Collapse
Affiliation(s)
- T Waddell
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - A Kotsori
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - A Constantinidou
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - N Yousaf
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - S Ashley
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - M Parton
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - S Johnston
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| | - I. Smith
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London
| |
Collapse
|
43
|
Kotsori A, Dolly S, Sheri A, Parton M, Shaunak N, Ashley S, Walsh G, Johnston S, Smith I. Is Capecitabine Efficacious in Triple Negative Metastatic Breast Cancer? Oncology 2010; 79:331-6. [DOI: 10.1159/000323175] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 10/18/2010] [Indexed: 11/19/2022]
|
44
|
|
45
|
Abstract
BACKGROUND Amyotrophic lateral sclerosis, also known as motor neuron disease, is a progressive neuromuscular disease that causes disability and eventual death. Various amino acid preparations, the three branched-chain amino acids (L-leucine, L-valine and L-isoleucine) or, alternatively, L-threonine have been used as experimental therapy. OBJECTIVES To examine the efficacy of amino acid therapies in prolonging survival and/or slowing the progression of amyotrophic lateral sclerosis/motor neuron disease. SEARCH STRATEGY We searched the Cochrane Neuromuscular Disease Group trials register (searched February 2003), MEDLINE (from January 1966 to December 2002) and EMBASE (from January 1980 to December 2002) databases and reports of specialist conferences. Authors of known studies were contacted. SELECTION CRITERIA We included randomised or quasi-randomised trials of participants with a clinical diagnosis of amyotrophic lateral sclerosis/motor neuron disease treated with all combinations of amino acids. Our primary outcome measure was survival determined by a pooled hazard ratio of all studies. Our secondary outcome measures were (in order of priority): survival at six and 12 months, muscle strength, any validated rating scale of physical function, quality of life, proportion of patients completing therapy and proportion of patients reporting adverse events attributable to treatment. DATA COLLECTION AND ANALYSIS We identified six eligible trials and rejected a further seven because of incomplete data or inadequate duration. Eligible studies were rated for methodological quality and missing data sought from the authors. After this examination two studies were excluded from analysis. Our pooled survival analysis was performed by the Parmar method, other statistical calculations were done using the Review Manager 4.2 software package. MAIN RESULTS No benefit could be demonstrated for either branched-chain amino acids or L-threonine in improving survival in amyotrophic lateral sclerosis/motor neuron disease. Neither could we find evidence of an effect of either treatment on muscle strength or disability as measured by functional rating scales. No study assessed quality of life. Both branched-chain amino acids and L-threonine appeared well tolerated and caused a degree of adverse events comparable to that of the control medication. AUTHORS' CONCLUSIONS There is no evidence to support a beneficial effect of either branched-chain amino acids or L-threonine in amyotrophic lateral sclerosis/motor neuron disease.
Collapse
Affiliation(s)
- M Parton
- National Hospital for Neurology and Neurosurgery, Centre for Neuromuscular Disease, Queen Square, London, UK, W1N 3BG.
| | | | | |
Collapse
|
46
|
Jones RL, Salter J, Nerurkar A, Parton M, A’Hern R, Smith IE, Dowsett M. Prognostic (Px) significance of Ki67 before and after neoadjuvant chemotherapy (CT) in early breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
573 Background: High levels of the proliferation marker Ki67 are associated with a higher response rate to CT but poorer long-term outcome. The Px significance of Ki67 before CT and at surgical excision was compared. Methods: 103 patients treated with CT with pre- and post- (excision) CT tissue and a further 181 with only excision tissue available were identified, 37 and 76 of these respectively were ER+ and also received tamoxifen. The following factors were considered pre-CT and at excision (where relevant) for their relationship with relapse-free (RFS) and overall (OS) survival: ER, PR, HER2, grade, Ki67, histological type, vascular invasion, age/menses, T and N stage, pre-therapy operability, clinical response, CT regimen, type of surgery, adjuvant therapy, pathological tumour size and nodal involvement. Results: In the paired cohort univariate analysis of RFS the following factors were associated with poorer Px (a) pre-CT: ER- (p=0.003); increasing T stage (p<0.001), N stage (p=0.002) and Ki67 (p<0.001); (b) at excision: increasing grade (p=0.01), tumour size (p=0.02), nodal status (p<0.001) and Ki67 (p<0.001); no adjuvant endocrine therapy (p<0.001). On multivariate analysis only excision Ki67 (p<0.001) was significant although there was a suggestion pre-therapy Ki67 was important (p<0.10). On univariate analysis of OS the following factors associated with poorer Px (a) pre-CT: ER- (p=0.006); increasing T stage (p<0.001) and Ki67 (p<0.001); (b) at excision: increasing grade (p=0.04), tumour size (p=0.005), nodal status (p<0.03) and Ki67 (p<0.001); no adjuvant endocrine therapy (p=0.001). On multivariate analysis both pre-CT and excision Ki67 were significant independent predictors but the latter was more highly significant. (p<0.02 + p<0.0001, respectively) Assessing the combined group of 284 patients, after 5 years the highest and lowest tertiles of excision Ki67 had strikingly different Px: RFS 36% and 73%; OS 50% and 85%, respectively. Conclusions: Ki67 after CT is a strong predictor of long-term outcome. The greater significance of Ki67 in the excision sample may be due to this identifying patients in whom residual highly proliferative disease remains after CT. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- R. L. Jones
- Royal Marsden Hospital, London, United Kingdom
| | - J. Salter
- Royal Marsden Hospital, London, United Kingdom
| | - A. Nerurkar
- Royal Marsden Hospital, London, United Kingdom
| | - M. Parton
- Royal Marsden Hospital, London, United Kingdom
| | - R. A’Hern
- Royal Marsden Hospital, London, United Kingdom
| | - I. E. Smith
- Royal Marsden Hospital, London, United Kingdom
| | - M. Dowsett
- Royal Marsden Hospital, London, United Kingdom
| |
Collapse
|
47
|
Parton M, Maisey N, Banerjee S, Harper-Wynne C, Sumpter K, Ashley S, Eisen T, Obrien M. Gefitinib in patients with non-small cell lung cancer (NSCLC): The Royal Marsden experience. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Parton
- Royal Marsden Hospital, London, United Kingdom
| | - N. Maisey
- Royal Marsden Hospital, London, United Kingdom
| | - S. Banerjee
- Royal Marsden Hospital, London, United Kingdom
| | | | - K. Sumpter
- Royal Marsden Hospital, London, United Kingdom
| | - S. Ashley
- Royal Marsden Hospital, London, United Kingdom
| | - T. Eisen
- Royal Marsden Hospital, London, United Kingdom
| | - M. Obrien
- Royal Marsden Hospital, London, United Kingdom
| |
Collapse
|
48
|
Parton M, Dowsett M, Ashley S, Hills M, Lowe F, Smith IE. High incidence of HER-2 positivity in inflammatory breast cancer. Breast 2004; 13:97-103. [PMID: 15019688 DOI: 10.1016/j.breast.2003.08.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2003] [Revised: 08/11/2003] [Accepted: 08/14/2003] [Indexed: 11/25/2022] Open
Abstract
HER-2 is over-expressed in around 25% of human breast cancers, and is associated with poor outcome. We examined the incidence of HER-2 status in inflammatory breast cancer (IBC). Forty-nine newly diagnosed IBCs were studied. Formalin-fixed paraffin-embedded pre-treatment tissue biopsies were examined immunohistochemically for the over-expression of the HER-2 protein and gene using the HercepTest and FISH assay. Clinical outcome was compared between the HER-2 positive (HercepTest score 3 + and FISH positive) and negative groups. Fifty-two per cent of the IBCs examined were HER-2 positive. The HER-2 positive group were demographically comparable to the HER-2 negative group. Ninety-six per cent of the HER-2 positive patients responded to primary chemotherapy compared to 76% of the HER-2 negative (P = 0.09). No significant differences in outcome emerged between the two groups. In conclusion, this study found the incidence of HER-2 protein over-expression in IBC is higher than previously reported in non-IBC. Early HER-2 directed therapy (such as the monoclonal antibody trastuzumab) as a part of multimodal treatment may improve outcome in this poor prognosis cancer.
Collapse
Affiliation(s)
- M Parton
- Breast Unit, Royal Marsden Hospital Trust and Institute of Cancer Research, Fulham Rd, London SW3 6JJ, UK.
| | | | | | | | | | | |
Collapse
|
49
|
Archer CD, Parton M, Smith IE, Ellis PA, Salter J, Ashley S, Gui G, Sacks N, Ebbs SR, Allum W, Nasiri N, Dowsett M. Early changes in apoptosis and proliferation following primary chemotherapy for breast cancer. Br J Cancer 2003; 89:1035-41. [PMID: 12966422 PMCID: PMC2376965 DOI: 10.1038/sj.bjc.6601173] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Patients undergoing primary chemotherapy for invasive breast cancer consented to a core biopsy of the invasive breast primary pre- and 24 h postchemotherapy. The resulting tissue was analysed for apoptosis, Ki67, ER and HER-2 using immunohistochemical techniques. These data were then used to evaluate the relationship between these biological markers and response to chemotherapy and overall survival. Response rate to chemotherapy in this group was 86%, 16 patients (25%) achieved a clinical complete response and 41 (63%) a partial response. Prechemotherapy there was a significant correlation between Ki67 and apoptotic index (AI), r=0.6, (P<0.001). A significant rise in AI (P<0.001), and fall in Ki67 (P=0.002) was seen 24 h following chemotherapy. No relationship was seen between pretreatment AI and clinical response, but higher Ki67 and growth index (Ki67/AI ratio, GI) did correlate with clinical response (both r=0.31, P<0.025). No correlation was seen between the change in AI or Ki67 at 24 h and clinical response or survival. Significant changes in apoptosis and proliferation can be demonstrated 24 h following chemotherapy, but these changes do not relate to clinical response or outcome in this study. Pretreatment proliferation and GI are however predictive of response to chemotherapy in breast cancer.
Collapse
MESH Headings
- Adult
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Cell Division/drug effects
- Female
- Humans
- Immunoenzyme Techniques
- Ki-67 Antigen/metabolism
- Middle Aged
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Survival Rate
- Treatment Outcome
Collapse
Affiliation(s)
- C D Archer
- Breast Unit, Royal Marsden NHS Trust, Fulham Road, London SW3 6JJ, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
BACKGROUND Amyotrophic lateral sclerosis, also known as motor neuron disease, is a progressive neuromuscular disease that causes disability and eventual death. Various amino acid preparations, the three branched-chain amino acids (L-leucine, L-valine and L-isoleucine) or, alternatively, L-threonine have been used as experimental therapy. OBJECTIVES To examine the efficacy of amino acid therapies in prolonging survival and/or slowing the progression of amyotrophic lateral sclerosis/motor neuron disease. SEARCH STRATEGY We searched the Cochrane Neuromuscular Disease Group trials register (searched February 2003), MEDLINE (from January 1966 to December 2002) and EMBASE (from January 1980 to December 2002) databases and reports of specialist conferences. Authors of known studies were contacted. SELECTION CRITERIA We included randomised or quasi-randomised trials of participants with a clinical diagnosis of amyotrophic lateral sclerosis/motor neuron disease treated with all combinations of amino acids. Our primary outcome measure was survival determined by a pooled hazard ratio of all studies. Our secondary outcome measures were (in order of priority): survival at six and 12 months, muscle strength, any validated rating scale of physical function, quality of life, proportion of patients completing therapy and proportion of patients reporting adverse events attributable to treatment. DATA COLLECTION AND ANALYSIS We identified six eligible trials and rejected a further seven because of incomplete data or inadequate duration. Eligible studies were rated for methodological quality and missing data sought from the authors. After this examination two studies were excluded from analysis. Our pooled survival analysis was performed by the Parmar method, other statistical calculations were done using the Review Manager 4.2 software package. MAIN RESULTS No benefit could be demonstrated for either branched-chain amino acids or L-threonine in improving survival in amyotrophic lateral sclerosis/motor neuron disease. Neither could we find evidence of an effect of either treatment on muscle strength or disability as measured by functional rating scales. No study assessed quality of life. Both branched-chain amino acids and L-threonine appeared well tolerated and caused a degree of adverse events comparable to that of the control medication. REVIEWER'S CONCLUSIONS There is no evidence to support a beneficial effect of either branched-chain amino acids or L-threonine in amyotrophic lateral sclerosis/motor neuron disease.
Collapse
Affiliation(s)
- M Parton
- Department of Neurology, Guy's, King's and St. Thomas's School of Medicine and The Institute of Psychiatry, De Crespigny Park, London, UK, SE5 8AF
| | | | | |
Collapse
|