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Kimura-Ohba S, Kitamura M, Tsukamoto Y, Kogaki S, Sakai S, Fushimi H, Matsuoka K, Takeuchi M, Itoh K, Ueda K, Kimura T. Viral entry and translation in brain endothelia provoke influenza-associated encephalopathy. Acta Neuropathol 2024; 147:77. [PMID: 38687393 PMCID: PMC11061015 DOI: 10.1007/s00401-024-02723-z] [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: 12/12/2023] [Revised: 03/01/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
Influenza-associated encephalopathy (IAE) is extremely acute in onset, with high lethality and morbidity within a few days, while the direct pathogenesis by influenza virus in this acute phase in the brain is largely unknown. Here we show that influenza virus enters into the cerebral endothelium and thereby induces IAE. Three-weeks-old young mice were inoculated with influenza A virus (IAV). Physical and neurological scores were recorded and temporal-spatial analyses of histopathology and viral studies were performed up to 72 h post inoculation. Histopathological examinations were also performed using IAE human autopsy brains. Viral infection, proliferation and pathogenesis were analyzed in cell lines of endothelium and astrocyte. The effects of anti-influenza viral drugs were tested in the cell lines and animal models. Upon intravenous inoculation of IAV in mice, the mice developed encephalopathy with brain edema and pathological lesions represented by micro bleeding and injured astrocytic process (clasmatodendrosis) within 72 h. Histologically, massive deposits of viral nucleoprotein were observed as early as 24 h post infection in the brain endothelial cells of mouse models and the IAE patients. IAV inoculated endothelial cell lines showed deposition of viral proteins and provoked cell death, while IAV scarcely amplified. Inhibition of viral transcription and translation suppressed the endothelial cell death and the lethality of mouse models. These data suggest that the onset of encephalopathy should be induced by cerebral endothelial infection with IAV. Thus, IAV entry into the endothelium, and transcription and/or translation of viral RNA, but not viral proliferation, should be the key pathogenesis of IAE.
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Affiliation(s)
- Shihoko Kimura-Ohba
- Division of Virology, Department of Microbiology and Immunology, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka, 565-0871, Japan.
- Reverse Translational Research Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan.
- KAGAMI Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan.
- Department of Pediatrics and Neonatology, Osaka General Medical Center, Osaka, Japan.
| | - Mieko Kitamura
- KAGAMI Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
| | - Yusuke Tsukamoto
- Reverse Translational Research Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
- KAGAMI Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
| | - Shigetoyo Kogaki
- Department of Pediatrics and Neonatology, Osaka General Medical Center, Osaka, Japan
| | - Shinsuke Sakai
- Reverse Translational Research Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
- KAGAMI Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Fushimi
- Department of Pathology, Osaka General Medical Center, Osaka, Japan
| | - Keiko Matsuoka
- Department of Pathology, Osaka General Medical Center, Osaka, Japan
- Department of Pathology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Makoto Takeuchi
- Department of Pathology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Kyoko Itoh
- Department of Pathology and Applied Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiji Ueda
- Division of Virology, Department of Microbiology and Immunology, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka, 565-0871, Japan
| | - Tomonori Kimura
- Reverse Translational Research Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
- KAGAMI Project, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, Osaka, Japan
- Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan
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2
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Sakai S, Tanaka Y, Tsukamoto Y, Kimura-Ohba S, Hesaka A, Hamase K, Hsieh CL, Kawakami E, Ono H, Yokote K, Yoshino M, Okuzaki D, Matsumura H, Fukushima A, Mita M, Nakane M, Doi M, Isaka Y, Kimura T. d -Alanine Affects the Circadian Clock to Regulate Glucose Metabolism in the Kidney. Kidney360 2024; 5:237-251. [PMID: 38098136 PMCID: PMC10914205 DOI: 10.34067/kid.0000000000000345] [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] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/07/2023] [Indexed: 03/01/2024]
Abstract
Key Points d -Alanine affects the circadian clock to regulate gluconeogenesis in the kidney. d -Alanine itself has a clear intrinsic circadian rhythm, which is regulated by urinary excretion, and acts on the circadian rhythm. d -Alanine is a signal activator for circadian rhythm and gluconeogenesis through circadian transcriptional network. Background The aberrant glucose circadian rhythm is associated with the pathogenesis of diabetes. Similar to glucose metabolism in the kidney and liver, d -alanine, a rare enantiomer of alanine, shows circadian alteration, although the effect of d- alanine on glucose metabolism has not been explored. Here, we show that d- alanine acts on the circadian clock and affects glucose metabolism in the kidney. Methods The blood and urinary levels of d -alanine in mice were measured using two-dimensional high-performance liquid chromatography system. Metabolic effects of d -alanine were analyzed in mice and in primary culture of kidney proximal tubular cells from mice. Behavioral and gene expression analyses of circadian rhythm were performed using mice bred under constant darkness. Results d- Alanine levels in blood exhibited a clear intrinsic circadian rhythm. Since this rhythm was regulated by the kidney through urinary excretion, we examined the effect of d -alanine on the kidney. In the kidney, d -alanine induced the expressions of genes involved in gluconeogenesis and circadian rhythm. Treatment of d- alanine mediated glucose production in mice. Ex vivo glucose production assay demonstrated that the treatment of d -alanine induced glucose production in primary culture of kidney proximal tubular cells, where d -amino acids are known to be reabsorbed, but not in that of liver cells. Gluconeogenetic effect of d -alanine has an intraday variation, and this effect was in part mediated through circadian transcriptional network. Under constant darkness, treatment of d- alanine normalized the circadian cycle of behavior and kidney gene expressions. Conclusions d- Alanine induces gluconeogenesis in the kidney and adjusts the period of the circadian clock. Normalization of circadian cycle by d -alanine may provide the therapeutic options for life style–related diseases and shift workers.
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Affiliation(s)
- Shinsuke Sakai
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | - Youichi Tanaka
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Yusuke Tsukamoto
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | - Shihoko Kimura-Ohba
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | - Atsushi Hesaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | - Kenji Hamase
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Chin-Ling Hsieh
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiryo Kawakami
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- Department of Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Advanced Data Science (ADSP), RIKEN Information R&D and Strategy Headquarters, Yokohama, Kanagawa, Japan
- Institute for Advanced Academic Research (IAAR), Chiba University, Chiba, Japan
| | - Hiraku Ono
- Department of Endocrinology, Hematology and Gerontorogy, Graduate School of Medicine, Chiba University,Chiba, Japan
| | - Kotaro Yokote
- Department of Endocrinology, Hematology and Gerontorogy, Graduate School of Medicine, Chiba University,Chiba, Japan
| | - Mitsuaki Yoshino
- Laboratory of Rare Disease Information and Resource library, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Osaka, Japan
| | - Daisuke Okuzaki
- Genome Information Research Center, Research Institute for Microbial Disease, Osaka University, Suita, Osaka, Japan
| | - Hiroyo Matsumura
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | - Atsuko Fukushima
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
| | | | | | - Masao Doi
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tomonori Kimura
- Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Reverse Translational Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
- KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka, Japan
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Kimura-Ohba S, Takabatake Y, Takahashi A, Tanaka Y, Sakai S, Isaka Y, Kimura T. Blood levels of d-amino acids reflect the clinical course of COVID-19. Biochem Biophys Rep 2023; 34:101452. [PMID: 36909453 PMCID: PMC9988715 DOI: 10.1016/j.bbrep.2023.101452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
d-Amino acids, rare enantiomers of amino acids, have been identified as biomarkers and therapeutic options for COVID-19. Methods for monitoring recovery are necessary for managing COVID-19. On the other hand, the presence of SARS-CoV2 virus in the blood is associated with worse outcomes. We investigated the potential of d-amino acids for assessing recovery from severe COVID-19. In patients with severe COVID-19 requiring artificial ventilation, the blood levels of d-amino acids, including d-alanine, d-proline, d-serine, and d-asparagine, which were lower than the normal range before treatment, quickly and transiently increased and surpassed the upper limit of the normal range. This increase preceded the recovery of respiratory function, as indicated by ventilation weaning. The increase in blood d-amino acid levels was associated with the disappearance of the virus in the blood, but not with inflammatory manifestations or blood cytokine levels. d-Amino acids are sensitive biomarkers that reflect the recovery of the clinical course and blood viral load. Dynamic changes in blood d-amino acid levels are key indicators of clinical course.
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Affiliation(s)
- Shihoko Kimura-Ohba
- Reverse Translational Research Project, Center for Rare Disease Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan
| | - Yoshitsugu Takabatake
- Department of Nephrology, Osaka University Graduate School of Medicine, 565-0871, Japan
| | - Atsushi Takahashi
- Department of Nephrology, Osaka University Graduate School of Medicine, 565-0871, Japan
| | - Yoko Tanaka
- Reverse Translational Research Project, Center for Rare Disease Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan
| | - Shinsuke Sakai
- Reverse Translational Research Project, Center for Rare Disease Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,Department of Nephrology, Osaka University Graduate School of Medicine, 565-0871, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, 565-0871, Japan
| | - Tomonori Kimura
- Reverse Translational Research Project, Center for Rare Disease Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,KAGAMI Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), 567-0085, Japan.,Department of Nephrology, Osaka University Graduate School of Medicine, 565-0871, Japan
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4
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Taniguchi A, Kawamura M, Sakai S, Kimura-Ohba S, Tanaka Y, Fukae S, Tanaka R, Nakazawa S, Yamanaka K, Horio M, Takahara S, Nonomura N, Isaka Y, Imamura R, Kimura T. D-Asparagine is an Ideal Endogenous Molecule for Measuring the Glomerular Filtration Rate. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.03.009] [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: 04/07/2023] Open
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5
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Tachibana M, Mohri I, Hirata I, Kuwada A, Kimura-Ohba S, Kagitani-Shimono K, Fushimi H, Inoue T, Shiomi M, Kakuta Y, Takeuchi M, Murayama S, Nakayama M, Ozono K, Taniike M. Clasmatodendrosis is associated with dendritic spines and does not represent autophagic astrocyte death in influenza-associated encephalopathy. Brain Dev 2019; 41:85-95. [PMID: 30057207 DOI: 10.1016/j.braindev.2018.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/02/2018] [Accepted: 07/13/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Influenza-associated encephalopathy (IAE) is one of the most serious CNS complications of an influenza virus infection, with unclear pathophysiology. Clasmatodendrosis is a complex of morphological changes in astrocytes characterized by fragmentation of the distal processes and swollen cell bodies. Although pathologists in Japan have long been aware of the presence of clasmatodendrosis in IAE brains, no details of the phenomenon have been published to date. We aimed to confirm the existence, and characterize the spatial distribution of clasmatodendrosis in postmortem IAE brains. METHODS Autopsied brains from 7 patients with IAE and 8 non-IAE subjects were examined immunohistochemically. In addition, immunofluorescent staining and electron microscopy were performed. RESULTS Clasmatodendrosis was present in all examined regions of the IAE brains, but none of the control brains. Fragmented processes of astrocytes in IAE brains were closely adjacent to synapses on the dendritic spines, with the fragmentation especially prominent in the cerebellar molecular layer. In addition, the clasmatodendrotic astrocytes were negative for autophagy markers. Furthermore, whereas aquaporin 4 was predominantly detected in the perivascular endfeet of astrocytes in the control brains, its primary localization site shifted to the fragmented perisynaptic processes in the IAE brains. CONCLUSION Clasmatodendrosis was distributed diffusely in the IAE brains in close association with synapses, and was not caused by astrocyte autophagy. Clasmatodendrosis may be a suggestive pathological feature of IAE.
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Affiliation(s)
- Masaya Tachibana
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ikuko Mohri
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ikuko Hirata
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ayano Kuwada
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shihoko Kimura-Ohba
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kuriko Kagitani-Shimono
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroaki Fushimi
- Department of Pathology, Osaka General Medical Center, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Masashi Shiomi
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Yukio Kakuta
- Department of Pathology, Japan Organization of Occupational Health and Safety, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Makoto Takeuchi
- Division of Clinical Laboratory Medicine and Anatomic Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | | | - Masahiro Nakayama
- Division of Clinical Laboratory Medicine and Anatomic Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masako Taniike
- Department of Child Development, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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6
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Yang Y, Kimura-Ohba S, Thompson JF, Salayandia VM, Cossé M, Raz L, Jalal FY, Rosenberg GA. Vascular tight junction disruption and angiogenesis in spontaneously hypertensive rat with neuroinflammatory white matter injury. Neurobiol Dis 2018; 114:95-110. [PMID: 29486300 DOI: 10.1016/j.nbd.2018.02.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [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: 09/14/2017] [Revised: 01/29/2018] [Accepted: 02/21/2018] [Indexed: 12/21/2022] Open
Abstract
Vascular cognitive impairment is a major cause of dementia caused by chronic hypoxia, producing progressive damage to white matter (WM) secondary to blood-brain barrier (BBB) opening and vascular dysfunction. Tight junction proteins (TJPs), which maintain BBB integrity, are lost in acute ischemia. Although angiogenesis is critical for neurovascular remodeling, less is known about its role in chronic hypoxia. To study the impact of TJP degradation and angiogenesis during pathological progression of WM damage, we used the spontaneously hypertensive/stroke prone rats with unilateral carotid artery occlusion and Japanese permissive diet to model WM damage. MRI and IgG immunostaining showed regions with BBB damage, which corresponded with decreased endothelial TJPs, claudin-5, occludin, and ZO-1. Affected WM had increased expression of angiogenic factors, Ki67, NG2, VEGF-A, and MMP-3 in vascular endothelial cells and pericytes. To facilitate the study of angiogenesis, we treated rats with minocycline to block BBB disruption, reduce WM lesion size, and extend survival. Minocycline-treated rats showed increased VEGF-A protein, TJP formation, and oligodendrocyte proliferation. We propose that chronic hypoxia disrupts TJPs, increasing vascular permeability, and initiating angiogenesis in WM. Minocycline facilitated WM repair by reducing BBB damage and enhancing expression of TJPs and angiogenesis, ultimately preserving oligodendrocytes.
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Affiliation(s)
- Yi Yang
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; Memory and Aging Center, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.
| | - Shihoko Kimura-Ohba
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Jeffrey F Thompson
- Memory and Aging Center, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Victor M Salayandia
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Melissa Cossé
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Limor Raz
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Fakhreya Y Jalal
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gary A Rosenberg
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; Memory and Aging Center, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; Department of Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
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7
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Miyake N, Wolf NI, Cayami FK, Crawford J, Bley A, Bulas D, Conant A, Bent SJ, Gripp KW, Hahn A, Humphray S, Kimura-Ohba S, Kingsbury Z, Lajoie BR, Lal D, Micha D, Pizzino A, Sinke RJ, Sival D, Stolte-Dijkstra I, Superti-Furga A, Ulrick N, Taft RJ, Ogata T, Ozono K, Matsumoto N, Neubauer BA, Simons C, Vanderver A. X-linked hypomyelination with spondylometaphyseal dysplasia (H-SMD) associated with mutations in AIFM1. Neurogenetics 2017; 18:185-194. [PMID: 28842795 PMCID: PMC5705759 DOI: 10.1007/s10048-017-0520-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 08/04/2017] [Indexed: 01/12/2023]
Abstract
An X-linked condition characterized by the combination of hypomyelinating leukodystrophy and spondylometaphyseal dysplasia (H-SMD) has been observed in only four families, with linkage to Xq25-27, and recent genetic characterization in two families with a common AIFM1 mutation. In our study, 12 patients (6 families) with H-SMD were identified and underwent comprehensive assessment accompanied by whole-exome sequencing (WES). Pedigree analysis in all families was consistent with X-linked recessive inheritance. Presentation typically occurred between 12 and 36 months. In addition to the two disease-defining features of spondylometaphyseal dysplasia and hypomyelination on MRI, common clinical signs and symptoms included motor deterioration, spasticity, tremor, ataxia, dysarthria, cognitive defects, pulmonary hypertension, nystagmus, and vision loss due to retinopathy. The course of the disease was slowly progressive. All patients had maternally inherited or de novo mutations in or near exon 7 of AIFM1, within a region of 70 bp, including synonymous and intronic changes. AIFM1 mutations have previously been associated with neurologic presentations as varied as intellectual disability, hearing loss, neuropathy, and striatal necrosis, while AIFM1 mutations in this small region present with a distinct phenotype implicating bone. Analysis of cell lines derived from four patients identified significant reductions in AIFM1 mRNA and protein levels in osteoblasts. We hypothesize that AIFM1 functions in bone metabolism and myelination and is responsible for the unique phenotype in this condition.
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Affiliation(s)
- Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Nicole I Wolf
- Department of Child Neurology, and Amsterdam Neuroscience, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Ferdy K Cayami
- Department of Child Neurology, and Amsterdam Neuroscience, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.,Department of Clinical Genetics, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.,Center for Biomedical Research, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Joanna Crawford
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Annette Bley
- University Children's Hospital, University Medical Center Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Dorothy Bulas
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC, USA
| | - Alex Conant
- Department of Neurology, Children's National Medical Center, Suite 4800, Washington, DC, USA
| | - Stephen J Bent
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Karen W Gripp
- Division of Medical Genetics, A.I. duPont Hospital for Children/Nemours, Wilmington, DE, USA
| | - Andreas Hahn
- Department of Pediatric Neurology, Univ.-Klinikum Giessen/Marburg; Standort Giessen, Feulgenstr. 12, 35389, Giessen, Germany
| | - Sean Humphray
- Chesterford Research Park, Illumina, Inc., Little Chesterford, CB10 1XL, UK
| | - Shihoko Kimura-Ohba
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Zoya Kingsbury
- Chesterford Research Park, Illumina, Inc., Little Chesterford, CB10 1XL, UK
| | | | - Dennis Lal
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute, Cambridge, USA
| | - Dimitra Micha
- Department of Clinical Genetics, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Amy Pizzino
- Department of Neurology, Children's National Medical Center, Suite 4800, Washington, DC, USA
| | - Richard J Sinke
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Deborah Sival
- Department of Child Neurology, University Hospital Groningen, Groningen, Netherlands
| | - Irene Stolte-Dijkstra
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrea Superti-Furga
- Division of Genetic Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Nicole Ulrick
- Department of Neurology, Children's National Medical Center, Suite 4800, Washington, DC, USA
| | - Ryan J Taft
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.,Illumina, Inc, San Diego, CA, USA.,George Washington University School of Medicine, Washington, DC, USA
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Bernd A Neubauer
- Department of Pediatric Neurology, Univ.-Klinikum Giessen/Marburg; Standort Giessen, Feulgenstr. 12, 35389, Giessen, Germany
| | - Cas Simons
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Adeline Vanderver
- Department of Neurology, Children's National Medical Center, Suite 4800, Washington, DC, USA.,Division of Genetic Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.,Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Kimura-Ohba S, Yang Y, Thompson J, Kimura T, Salayandia VM, Cosse M, Yang Y, Sillerud LO, Rosenberg GA. Transient increase of fractional anisotropy in reversible vasogenic edema. J Cereb Blood Flow Metab 2016; 36:1731-1743. [PMID: 26865662 PMCID: PMC5076788 DOI: 10.1177/0271678x16630556] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/11/2016] [Indexed: 11/17/2022]
Abstract
Brain vasogenic edema, involving disruption of the blood-brain barrier, is a common pathological condition in several neurological diseases, with a heterogeneous prognosis. It is sometimes reversible, as in posterior reversible encephalopathy syndrome, but often irreversible and our current clinical tools are insufficient to reveal its reversibility. Here, we show that increased fractional anisotropy in magnetic resonance imaging is associated with the reversibility of vasogenic edema. Spontaneously, hypertensive rats-stroke prone demonstrated posterior reversible encephalopathy syndrome-like acute encephalopathy in response to high-dose cyclosporine A treatment; the deteriorating neurological symptoms and worsening scores in behavioral tests, which were seen in acute phase, dissappered after recovery by cessation of cyclosporine A. In the acute phase of encephalopathy, the fractional anisotropy and apparent diffusion coefficient increased in areas with IgG leakage. This increase of fractional anisotropy occurred in the absence of demyelination: fluid leakage into the myelinated space increased the axial, but not the radial, diffusivity, resulting in the increased fractional anisotropy. This increased fractional anisotropy returned to pre-encephalopathy values in the recovery phase. Our results highlight the importance of the fractional anisotropy increase as a marker for the reversibility of brain edema, which can delineate the brain areas for which recovery is possible.
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Affiliation(s)
| | - Yi Yang
- Department of Neurology, University of New Mexico, Albuquerque, USA
| | - Jeffrey Thompson
- Department of Neurology, University of New Mexico, Albuquerque, USA
| | - Tomonori Kimura
- Department of Molecular Genetics and Microbiology, University of New Mexico, Albuquerque, USA
| | | | - Melissa Cosse
- Department of Neurology, University of New Mexico, Albuquerque, USA
| | - Yirong Yang
- BRaIN Imaging Center and College of Pharmacy, University of New Mexico, Albuquerque, USA
| | - Laurel O Sillerud
- Department of Neurology, University of New Mexico, Albuquerque, USA BRaIN Imaging Center and College of Pharmacy, University of New Mexico, Albuquerque, USA
| | - Gary A Rosenberg
- Department of Neurology, University of New Mexico, Albuquerque, USA Department of Neurosciences, University of New Mexico, Albuquerque, USA Department of Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
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Yang Y, Kimura-Ohba S, Thompson J, Rosenberg GA. Rodent Models of Vascular Cognitive Impairment. Transl Stroke Res 2016; 7:407-14. [PMID: 27498679 DOI: 10.1007/s12975-016-0486-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/09/2016] [Accepted: 07/19/2016] [Indexed: 01/03/2023]
Abstract
Vascular cognitive impairment dementia (VCID), which is an increasingly important cause of dementia in the elderly, lacks effective treatments. Many different types of vascular disease are included under the diagnosis of VCID, including large vessel disease with multiple strokes and small vessel disease with lacunar infarcts and white matter disease. Animal models have been developed to study the multiple forms of VCID. Because of its progressive course, small vessel disease (SVD) is thought to be the optimal form of VCID for treatment. One theory is that the pathophysiology involves hypoxic hypoperfusion resulting in injury to the white matter and neuronal death. Bilateral occlusion of the common carotid arteries (BCAO) in a normotensive rat, which reduces cerebral blood flow, induces hypoxia with white matter damage; this model has been used to test drugs to block the injury. Another model is the spontaneously hypertensive/stroke prone rat (SHR/SP). Hypertension leads to small vessel disease resulting in progressive damage to the white matter, cortex, and hippocampus. Bilateral carotid artery stenosis (BCAS) with coils or ameroid constrictors produces a slower development of changes than BCAO, avoiding the acute ischemia. A few studies have been done with the two-clip, two-vessel occlusion renal model for induction of hypertension. There are benefits and drawbacks to each of these models with the model selected depending on the type of vascular damage that is to be studied. This review describes the most commonly used models, and the drugs that have been used to reduce the damage.
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Affiliation(s)
- Yi Yang
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA
| | - Shihoko Kimura-Ohba
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA
| | - Jeffrey Thompson
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA
| | - Gary A Rosenberg
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.
- Department of Neurosciences, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.
- Department of Cell Biology and Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA.
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Yang Y, Kimura-Ohba S, Thompson JF, Salayandia VM, Cosse M, Raz L, Jalal FY, Rosenberg GA. Abstract TMP110: Minocycline Reduces Hypoxia-mediated BBB Disruption by Protecting TJP Degradation and Promoting Angiogenesis in SHR/SP With Chronic White-matter Injury. Stroke 2016. [DOI: 10.1161/str.47.suppl_1.tmp110] [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
Introduction:
Our previous study indicated that blood-brain barrier (BBB) disruption occurred secondary to hypoxia-induced and MMP-mediated neuroinflammatory white matter (WM) damage in spontaneously hypertensive/stroke prone rats (SHR/SP). Tight junction proteins (TJPs) maintain the normal BBB functions. Here, we investigated the effects of hypoxia on TJP degradation and hypoxia-induced angiogenesis, and tested the effect of long-term minocycline treatment on the BBB integrity and repair.
Methods:
Male SHR/SPs at 12W (weeks) old were subjected to unilateral carotid artery occlusion (UCAO) and fed a Japanese permissive diet (JPD) for 4W. For the treatment study, the SHR/SP/UCAO/JPD were given minocycline (50 mg/kg in DMSO, i.p.) and the vehicle rats received DMSO from 12W to 20W of life.
Results:
Sham-operated SHR/SP with normal chow had abnormal TJPs in blood vessels (BVs) at 16W compared to Wistar; they showed a slight increase of BBB permeability and NG2-positive microglia in WM. In the UCAO/JDP group, by 4W, multimodal MRI (T2, ADC, FA, and ASL) showed that WM damage of varying degree reflected the extent of injury corresponding to variable BBB leakage by dynamic contrast-enhanced MRI and IgG staining. TJP levels (claudin-5, occludin, and ZO-1) in WM were significantly decreased. Angiogenesis in WM was detected with increased expression of Ki67 and NG2 in vascular endothelial cells and/or pericytes. UCAO/JPD typically causes the death of SHR-SP/JPD/UCAO rats after 4W. However, minocycline treatment extended survival to 9W after UCAO/JPD and significantly reduced lesion size and vascular damage. TJPs, VEGF-A, and GST-π (mature oligodendrocytes) were increased by minocycline at 8W compared to sham and vehicle. Minocycline also increased the expression of factors involved in angiogenesis and WM repair (Ki67, NG2, MMP-2, MMP-3) in vascular endothelial cells, pericytes, astrocytes, and oligodendrocytes compared to controls.
Conclusions:
Our results support the hypothesis that damage to the BVs by chronic hypertension and UCAO/JPD produces TJP degradation and increases BBB permeability. Minocycline treatment significantly protects WM from damage by preventing BBB disruption and enhances TJP formation and angiogenesis.
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Affiliation(s)
- Yi Yang
- Neurology, Univ of New Mexico, Albuquerque, NM
| | | | | | | | | | - Limor Raz
- Neurology, Univ of New Mexico, Albuquerque, NM
| | - Fakhreya Y Jalal
- Pharmacology and Therapeutics College, United Arab Emirates Univ, Al Ain, United Arab Emirates
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Inoue T, Kawawaki H, Kuki I, Nabatame S, Tomonoh Y, Sukigara S, Horino A, Nukui M, Okazaki S, Tomiwa K, Kimura-Ohba S, Inoue T, Hirose S, Shiomi M, Itoh M. A case of severe progressive early-onset epileptic encephalopathy: unique GABAergic interneuron distribution and imaging. J Neurol Sci 2013; 327:65-72. [PMID: 23422026 DOI: 10.1016/j.jns.2013.01.038] [Citation(s) in RCA: 2] [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] [Received: 11/05/2012] [Revised: 12/26/2012] [Accepted: 01/29/2013] [Indexed: 11/17/2022]
Abstract
Early-onset epileptic encephalopathies include various diseases such as early-infantile epileptic encephalopathy with suppression burst. We experimentally investigated the unique clinicopathological features of a 28-month-old girl with early-onset epileptic encephalopathy. Her initial symptom was intractable epilepsy with a suppression-burst pattern of electroencephalography (EEG) from 7 days of age. The suppression-burst pattern was novel, appearing during sleep, but disappearing upon waking and after becoming 2 months old. The EEG showed multifocal spikes and altered with age. Her seizures demonstrated various clinical features and continued until death. She did not show any developmental features, including no social smiling or head control. Head MRI revealed progressive atrophy of the cerebral cortex and white matter after 1 month of age. (123)IMZ-SPECT demonstrated hypo-perfusion of the cerebral cortex, but normo-perfusion of the diencephalon and cerebellum. Such imaging information indicated GABA-A receptor dysfunction of the cerebral cortex. The genetic analyses of major neonatal epilepsies showed no mutation. The neuropathology revealed atrophy and severe edema of the cerebral cortex and white matter. GAD-immunohistochemistry exhibited imbalanced distribution of GABAergic interneurons between the striatum and cerebral cortex. The results were similar to those of focal cortical dysplasia with transmantle sign and X-linked lissencephaly with ARX mutation. We performed various metabolic examinations, detailed pathological investigations and genetic analyses, but could not identify the cause. To our knowledge, her clinical and pathological courses have never been described in the literature.
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Affiliation(s)
- T Inoue
- Department of Child Neurology, Osaka City General Hospital, Osaka, Japan
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Kimura-Ohba S, Kagitani-Shimono K, Hashimoto N, Nabatame S, Okinaga T, Murakami A, Miyake N, Matsumoto N, Osaka H, Hojo K, Tomita R, Taniike M, Ozono K. A case of cerebral hypomyelination with spondylo-epi-metaphyseal dysplasia. Am J Med Genet A 2012; 161A:203-7. [PMID: 23239615 DOI: 10.1002/ajmg.a.35686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 09/07/2012] [Indexed: 11/12/2022]
Abstract
We reported on a male patient with rare leukoencephalopathy and skeletal abnormalities. The condition was first noticed as a developmental delay, nystagmus and ataxia at 1 year of age. At 4 years of age, he was diagnosed as hypomyelination with skeletal abnormalities from clinical features, brain magnetic resonance imaging (MRI) and skeletal X-rays. His brain MRI revealed diffuse hypomyelination. These findings suggested the classical type of Pelizaeus-Merzbacher disease (PMD) caused by proteolipid protein (PLP)-1 gene or Pelizaeus-Merzbacher-like disease (PMLD). However, we found neither mutation nor duplication of PLP-1. The patient had severe growth retardation and general skeletal dysplasia compatible with spondylo-epi-metaphyseal dysplasia; however the mutation of discoidin domain receptor (DDR) 2 gene was absent. The co-morbidity of hypomyelination with skeletal abnormalities is rare. We performed array CGH and no causal copy number variation was recognized. Alternatively, this condition may have been caused by a mutation of the gene encoding a molecule that functions in both cerebral myelination and skeletal development.
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Affiliation(s)
- Shihoko Kimura-Ohba
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
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Mohri I, Kato-Nishimura K, Kagitani-Shimono K, Kimura-Ohba S, Ozono K, Tachibana N, Taniike M. Evaluation of oral iron treatment in pediatric restless legs syndrome (RLS). Sleep Med 2012; 13:429-32. [DOI: 10.1016/j.sleep.2011.12.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 12/19/2011] [Accepted: 12/23/2011] [Indexed: 11/29/2022]
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Kimura-Ohba S, Sawada A, Shiotani Y, Matsuzawa S, Awaya T, Ikeda H, Okada M, Tomiwa K. Variations in early gross motor milestones and in the age of walking in Japanese children. Pediatr Int 2011; 53:950-5. [PMID: 21752149 DOI: 10.1111/j.1442-200x.2011.03423.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Gross motor development is usually assessed in terms of age of achievement of motor milestones. Although there is generally an impression of faster development if the milestones are achieved at younger ages, no longitudinal studies have been done on the associations between the milestones, especially in Japan. As a part of the Japan Children's Study, the purpose of the present study was to determine whether the achievement of gross motor milestones in infancy is related with the age of walking. METHODS This was a prospective cohort study of 290 healthy and term infants born in a district of Osaka City, Japan. Three milestones (rolling over, sitting, and crawling) were observed in the laboratory for infants aged at 4 and 9 months by a pediatrician and a developmental psychologist, and the age of walking was confirmed in questionnaires filled in by the parents at 18 and 27 months. RESULTS Children who could roll over at 4 months, and sit and crawl at 9 months, walked earlier than children who could not roll over, sit and crawl, respectively. With regard to crawling, children who were creeping had a 1 month delay in walking, and those who could not move forward had a 2 month delay compared to typical crawlers. On multiple regression analysis these three milestones were positively associated with walking: rolling over (β= 0.567), sitting (β= 1.973) and crawling (β= 1.473). CONCLUSION The age and the patterns of sitting, crawling and rolling over were all related to the age of independent walking among Japanese infants. Consideration of milestone definition and variations is essential in medical check-up.
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Affiliation(s)
- Shihoko Kimura-Ohba
- Osaka Research Group, Japan Children's Study, Japan Science and Technology Agency, Osaka, Japan.
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15
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Kuki I, Kawawaki H, Okazaki S, Kimura-Ohba S, Nakano T, Fukushima H, Inoue T, Tomiwa K, Itoh M. Progressive leukoencephalopathy with intracranial calcification, congenital deafness, and developmental deterioration. Am J Med Genet A 2011; 155A:2832-7. [PMID: 21964701 DOI: 10.1002/ajmg.a.34256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 06/27/2011] [Indexed: 11/08/2022]
Abstract
We report on a 12-year-old male with a unique cerebral white matter disease. His initial symptoms were congenital hearing loss and multiple intracranial calcifications on head CT. He developed severe intellectual disability and epilepsy. MRI showed signal abnormalities in the posterior limbs of the internal capsules, thalami, and cerebral white matter. The abnormalities were progressive over time. The neuropathology revealed diffuse and severe disruption of myelin and axons of the cerebral white matter and cerebrospinal tracts. We performed various metabolic examinations, detailed pathological investigations and genetic analyses, but could not identify the cause. To our knowledge his clinical course has not been described in the literature.
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Affiliation(s)
- Ichiro Kuki
- Department of Pediatrics, Medical Center for Children, Osaka City General Hospital, Osaka, Japan
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16
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Abstract
BACKGROUND Head circumference (HC) trajectories are held to reflect neurological development and the acquirement of intelligence. It is important to assess HC growth accurately because atypical HC growth is an indicator of various developmental disorders. HC growth is determined by both familial and physical factors but, hitherto, no one has considered both factors together. The aim of the present study was thus to investigate the relationship between HC, physical growth, and parental HC. METHODS The study group in the Japan Children's Study consisted of 192 healthy full-term Japanese children. HC (maximum occiptofrontal circumference), height and bodyweight were measured at the ages of 4, 9 and 18 months. Multiple regression analysis were conducted predicting the HC from the body measurements and mid-parental HC (defined as the average of standardized paternal and maternal HC). RESULTS Adjusted multiple R(2) were 0.336, 0.307 and 0.259, measured at the aforementioned three stages. Bodyweight and mid-parental HC predicted the HC on each occasion (P < 0.01). Bodyweight was more relevant than mid-parental HC. CONCLUSIONS HC growth is influenced by physical growth and parental HC; therefore, it is important to consider both physical and familial factors. A formula is herein proposed to assess HC using bodyweight and mid-parental HC.
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Affiliation(s)
- Akiko Sawada
- Osaka Research Group, Japan Children's Study, Japan Science and Technology Agency (JST), Osaka, Japan
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17
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Miyoshi Y, Sakai N, Hamada Y, Tachibana M, Hasegawa Y, Kiyohara Y, Yamada H, Murakami M, Kondou H, Kimura-Ohba S, Mine J, Sato T, Kamio N, Ueda H, Suzuki Y, Shiomi M, Ohta H, Shimozawa N, Ozono K. Clinical aspects and adrenal functions in eleven Japanese children with X-linked adrenoleukodystrophy. Endocr J 2010; 57:965-72. [PMID: 20859061 DOI: 10.1507/endocrj.k10e-204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
X-linked adrenoleukodystrophy (X-ALD) is a genetic disease associated with demyelination of the central nervous system, adrenocortical insufficiency and accumulation of very long chain fatty acids. It is a clinically heterogeneous disorder ranging from a severe childhood cerebral form to an asymptomatic form. The incidence in Japan is estimated to be between 1:30,000 and 1:50,000 boys as determined by a nationwide retrospective survey between 1990 and 1999, which found no cases with Addison's form. We reviewed the medical records of eleven Japanese boys with X-ALD from 1990 to 2010 in our institute. Eight patients were detected by neuropsychological abnormalities, whereas a higher prevalence of unrecognized adrenocortical insufficiency (5/11: 45%) was observed than previously recognized. While no neurological abnormalities were demonstrated in two brothers, the elder brother had moderate Addison's disease at diagnosis and the presymptomatic younger brother progressed to Addison's disease six months after the diagnosis of X-ALD. Early detection of impaired adrenal function as well as early identification of neurologically presymptomatic patients by genetic analysis is essential for better prognosis. Addison's form might be overlooked in Japan; therefore, X-ALD should be suspected in patients with adrenocortical insufficiency.
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Affiliation(s)
- Yoko Miyoshi
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, Japan
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