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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2017: 4419-4422, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29060877

RESUMO

We present an automatic image processing framework to study moving intracellular structures from live cell fluorescence microscopy. The system includes the identification of static and dynamic structures from time-lapse images using data clustering as well as the identification of the trajectory of moving objects with a probabilistic tracking algorithm. The method has been successfully applied to study mitochondrial movement in neurons. The approach provides excellent performance under different experimental conditions and is robust to common sources of noise including experimental, molecular and biological fluctuations.


Assuntos
Movimento (Física) , Algoritmos , Processamento de Imagem Assistida por Computador , Microscopia de Fluorescência , Movimento
3.
Eur J Neurol ; 22(12): 1548-55, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26204789

RESUMO

BACKGROUND AND PURPOSE: A three-generation family affected by axonal Charcot-Marie-Tooth disease (CMT) was investigated with the aim of discovering genetic defects and to further characterize the phenotype. METHODS: The clinical, nerve conduction studies and muscle magnetic resonance images of the patients were reviewed. A whole exome sequencing was performed and the changes were investigated by genetic studies, in silico analysis and luciferase reporter assays. RESULTS: A novel c.1226G>A change (p.R409Q) in the EGR2 gene was identified. Patients presented with a typical, late-onset axonal CMT phenotype with variable severity that was confirmed in the ancillary tests. The in silico studies showed that the residue R409 is an evolutionary conserved amino acid. The p.R409Q mutation, which is predicted as probably damaging, would alter the conformation of the protein slightly and would cause a decrease of gene expression. CONCLUSIONS: This is the first report of an EGR2 mutation presenting as an axonal CMT phenotype with variable severity. This study broadens the phenotype of the EGR2-related neuropathies and suggests that the genetic testing of patients suffering from axonal CMT should include the EGR2 gene.


Assuntos
Doença de Charcot-Marie-Tooth/genética , Doença de Charcot-Marie-Tooth/fisiopatologia , Proteína 2 de Resposta de Crescimento Precoce/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Axônios/patologia , Doença de Charcot-Marie-Tooth/patologia , Exoma , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Linhagem , Fenótipo , Índice de Gravidade de Doença , Adulto Jovem
4.
Gut ; 64(3): 406-17, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24939571

RESUMO

OBJECTIVE: Intestinal dysbiosis has been associated with coeliac disease (CD), but whether the alterations are cause or consequence of the disease is unknown. This study investigated whether the human leukocyte antigen (HLA)-DQ2 genotype is an independent factor influencing the early gut microbiota composition of healthy infants at family risk of CD. DESIGN: As part of a larger prospective study, a subset (n=22) of exclusively breastfed and vaginally delivered infants with either high genetic risk (HLA-DQ2 carriers) or low genetic risk (non-HLA-DQ2/8 carriers) of developing CD were selected from a cohort of healthy infants with at least one first-degree relative with CD. Infant faecal microbiota was analysed by 16S rRNA gene pyrosequencing and real time quantitative PCR. RESULTS: Infants with a high genetic risk had significantly higher proportions of Firmicutes and Proteobacteria and lower proportions of Actinobacteria compared with low-risk infants. At genus level, high-risk infants had significantly less Bifidobacterium and unclassified Bifidobacteriaceae proportions and more Corynebacterium, Gemella, Clostridium sensu stricto, unclassified Clostridiaceae, unclassified Enterobacteriaceae and Raoultella proportions. Quantitative real time PCR also revealed lower numbers of Bifidobacterium species in infants with high genetic risk than in those with low genetic risk. In high-risk infants negative correlations were identified between Bifidobacterium species and several genera of Proteobacteria (Escherichia/Shigella) and Firmicutes (Clostridium). CONCLUSIONS: The genotype of infants at family risk of developing CD, carrying the HLA-DQ2 haplotypes, influences the early gut microbiota composition. This finding suggests that a specific disease-biased host genotype may also select for the first gut colonisers and could contribute to determining disease risk.


Assuntos
Doença Celíaca/genética , Antígenos HLA-DQ/genética , Intestinos/microbiologia , Microbiota/genética , Doença Celíaca/microbiologia , Clostridium/genética , Fezes/microbiologia , Feminino , Marcadores Genéticos/genética , Genótipo , Haplótipos/genética , Humanos , Lactente , Masculino , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco
5.
Neuromuscul Disord ; 24(8): 660-5, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24878226

RESUMO

Hereditary recurrent neuropathies are uncommon. Disorders with a known molecular basis falling within this group include hereditary neuropathy with liability to pressure palsies (HNPP) due to the deletion of the PMP22 gene or to mutations in this same gene, and hereditary neuralgic amyotrophy (HNA) caused by mutations in the SEPT9 gene. We report a three-generation family presenting a hereditary recurrent neuropathy without pathological changes in either PMP22 or SEPT9 genes. We performed a genome-wide mapping, which yielded a locus of 12.4 Mb on chromosome 21q21. The constructed haplotype fully segregated with the disease and we found significant evidence of linkage. After mutational screening of genes located within this locus, encoding for proteins and microRNAs, as well as analysis of large deletions/insertions, we identified 71 benign polymorphisms. Our findings suggest a novel genetic locus for a recurrent hereditary neuropathy of which the molecular defect remains elusive. Our results further underscore the clinical and genetic heterogeneity of this group of neuropathies.


Assuntos
Cromossomos Humanos Par 21 , Loci Gênicos , Doenças do Sistema Nervoso Periférico/genética , Adolescente , Mapeamento Cromossômico , Análise Mutacional de DNA , Família , Haplótipos , Humanos , Masculino , Proteínas da Mielina/genética , Doenças do Sistema Nervoso Periférico/fisiopatologia , Polimorfismo Genético , Septinas/genética
6.
Clin Genet ; 83(6): 565-70, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22978647

RESUMO

Four private mutations responsible for three forms demyelinating of Charcot-Marie-Tooth (CMT) or hereditary motor and sensory neuropathy (HMSN) have been associated with the Gypsy population: the NDRG1 p.R148X in CMT type 4D (CMT4D/HMSN-Lom); p.C737_P738delinsX and p.R1109X mutations in the SH3TC2 gene (CMT4C); and a G>C change in a novel alternative untranslated exon in the HK1 gene causative of CMT4G (CMT4G/HMSN-Russe). Here we address the findings of a genetic study of 29 Gypsy Spanish families with autosomal recessive demyelinating CMT. The most frequent form is CMT4C (57.14%), followed by HMSN-Russe (25%) and HMSN-Lom (17.86%). The relevant frequency of HMSN-Russe has allowed us to investigate in depth the genetics and the associated clinical symptoms of this CMT form. HMSN-Russe probands share the same haplotype confirming that the HK1 g.9712G>C is a founder mutation, which arrived in Spain around the end of the 18th century. The clinical picture of HMSN-Russe is a progressive CMT disorder leading to severe weakness of the lower limbs and prominent distal sensory loss. Motor nerve conduction velocity was in the demyelinating or intermediate range.


Assuntos
Doença de Charcot-Marie-Tooth/genética , Predisposição Genética para Doença/genética , Haplótipos , Neuropatia Hereditária Motora e Sensorial/genética , Mutação , Roma (Grupo Étnico)/genética , Adolescente , Adulto , Proteínas de Ciclo Celular/genética , Doença de Charcot-Marie-Tooth/patologia , Criança , Análise Mutacional de DNA , Saúde da Família , Feminino , Efeito Fundador , Geografia , Neuropatia Hereditária Motora e Sensorial/patologia , Hexoquinase/genética , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Masculino , Pessoa de Meia-Idade , Proteínas/genética , Espanha , Adulto Jovem
7.
Clin Genet ; 78(6): 554-9, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20584029

RESUMO

Hereditary cystathioninuria is due to mutations in the CTH gene that encodes for cystathionase, a pyridoxal-5'-phosphate (PLP) dependent enzyme. To date, mutations in this gene have been described in 10 unrelated cystathioninuric patients. Enzyme assays have showed that mutated cystathionase exhibits lower activity than controls. As cystathioninuria is usually accompanied by a wide variety of symptoms, it has been questioned whether it is a disease or just a biochemical finding not associated with the clinical picture of these patients. This is the first report of Spanish patients with cystathioninuria and mild to severe neurological symptoms in childhood. After oral pyridoxine therapy biochemical parameters have normalized but clinical amelioration was not evident. All patients were homozygotes for the c.200C>T (p.T67I) variant which is the most prevalent inactivating mutation in the CTH gene. To further investigate the history of the alleles carrying the c.200C>T transition in Europe, we also constructed the haplotypes on the CTH locus in our Spanish patients as well as in a clinical series of cystathioninuric patients from the Czech Republic harboring the same nucleotide change. We suggest that the CTH p.T67I substitution could have an ancient common origin, which probably occurred in the Neolithic Era and spread throughout Europe.


Assuntos
Alelos , Cistationina gama-Liase/genética , Variação Genética/genética , Criança , Pré-Escolar , República Tcheca , Europa (Continente) , Feminino , Humanos , Hiper-Homocisteinemia/genética
8.
Curr Issues Mol Biol ; 12(1): 1-10, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19478349

RESUMO

Coeliac disease (CD) development involves genetic (HLA-DQ2/DQ8) and environmental factors. Herein, the influence of the HLA-DQ genotype on the gut colonization process of breast-fed children was determined. A cohort of 20 newborns, with at least one first-degree relative with CD, were classified according to their HLA-DQ genotype into high, intermediate and low genetic risk groups, showing 24-28%, 7-8% and less than 1% probability to develop CD, respectively. Faecal microbiota was analysed at 7 days, 1 and 4 months of children's age by fluorescence in situ hybridization. When considering all data, Gram-negative bacteria and Bacteroides-Prevotella group proportions were higher (P<0.05) in the high than in the intermediate and low genetic risk groups. E. coli, Streptococcus-Lactococcus, E. rectale-C. coccoides, sulphate-reducing bacteria, C. lituseburense and C. histolyticum group proportions were also significantly higher (P<0.05) in the high than in the low genetic risk group. Correlations between these bacterial groups and the genetic risk were also detected (P<0.05). In addition, the number and type of CD relative seemed to influence (P<0.050) these bacterial proportions in children at CD risk. At 4 months of age, similar relationships were established between the high genetic risk to develop CD and the proportions of Streptococcus-Lactococcus (P<0.05), E. rectale-C. coccoides (P<0.05), C. lituseburense (P<0.05), C. histolyticum (P<0.05), Bacteroides-Prevotella (P<0.10) groups and total Gram-negative bacteria (P<0.05). The results suggest a relationship between HLA-DQ genes and the gut microbial colonization process that could lead to a change in the way this disorder is investigated.


Assuntos
Antígenos HLA-DQ/genética , Intestinos/microbiologia , Bacteroides/crescimento & desenvolvimento , Bacteroides/isolamento & purificação , Citometria de Fluxo , Genótipo , Cadeias alfa de HLA-DQ , Cadeias beta de HLA-DQ , Humanos , Hibridização in Situ Fluorescente , Lactente , Recém-Nascido , Lactococcus/crescimento & desenvolvimento , Lactococcus/isolamento & purificação , Prevotella/crescimento & desenvolvimento , Prevotella/isolamento & purificação , Streptococcus/crescimento & desenvolvimento , Streptococcus/isolamento & purificação
9.
J Med Genet ; 46(6): 407-11, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19304569

RESUMO

Urocanase is an enzyme in the histidine pathway encoded by the UROC1 gene. This report describes the first putative mutations, p.L70P and p.R450C, in the coding region of the UROC1 gene in a girl with urocanic aciduria presenting with mental retardation and intermittent ataxia. Computed (in silico) predictions, protein expression studies and enzyme activity assays suggest that none of the mutations can produce a fully functional enzyme. The p.L70P substitution, which probably implies the disruption of an alpha-helix in the N-terminus, would alter its properties and therefore, its function. The p.R450C change would render impossible any interaction between urocanase and its substrate and would loss its enzyme activity. Consequently, these studies suggest that both mutations could alter the correct activity of urocanase, which would explain the clinical and biochemical findings described in this patient.


Assuntos
Erros Inatos do Metabolismo dos Aminoácidos/genética , Mutação , Urocanato Hidratase/deficiência , Urocanato Hidratase/genética , Ácido Urocânico/urina , Sequência de Aminoácidos , Ataxia , Biomarcadores/líquido cefalorraquidiano , Criança , Simulação por Computador , Feminino , Ácido Fólico/líquido cefalorraquidiano , Histidina/metabolismo , Humanos , Deficiência Intelectual/genética , Modelos Moleculares , Dados de Sequência Molecular , Alinhamento de Sequência , Urocanato Hidratase/química
10.
Tissue Antigens ; 73(3): 255-61, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19254257

RESUMO

The association between human leukocyte antigen (HLA) class II antigens and celiac disease (CD) was analyzed in a Spanish population. No association with DRB1*04 and DQB1*0302 was noted. The main associated haplotype (70.8%) was DRB1*03-DQB1*0201-DQA1*0501(DR3-DQ2), followed by DRB1*07-DQB1*0202-DQA1*0201 (DR7-DQ2) haplotype, which is associated with DRB1*11-DQB1*0301-DQA1*0505 (DR11-DQ7). The combinations of DR3-DQ2 with DR7-DQ2, and DR7-DQ2 with DR11-DQ7, present a twofold risk compared with each haplotype in homozygosis. An independence test in DR3-DQ2 haplotype found that association with CD was attributable to the whole haplotype, but for DR7-DQ2 was secondary to DQB1/DQA1. There is no need of a double gene dosage to increase the risk. CD-associated alleles typing demonstrates a very high negative predictive value to exclude CD in risk groups.


Assuntos
Alelos , Antígenos HLA-D/genética , Haplótipos/genética , Doença Celíaca/genética , Predisposição Genética para Doença , Genótipo , Humanos , Grupos Populacionais , Espanha
11.
Tissue Antigens ; 70(4): 324-9, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17767555

RESUMO

Genetic predisposition to celiac disease (CD) is determined primarily by the human leukocyte antigen (HLA) genes (CELIAC1 region; 6p21), although many loci are involved in disease susceptibility. First, we have analysed a large series of CD patients from the Spanish Mediterranean region who had previously been characterised for the HLA complex. We have investigated how relevant regions contribute to CD susceptibility: CELIAC3 (CD28/CTLA4/ICOS region on 2q33) and CELIAC4 (19p13) as well as the tumour necrosis factor alpha (TNF-alpha) and the linfotoxin loci by case-control and association analyses. We highlight the association with the +49*A allele of cytotoxic T-lymphocyte-associated antigen 4 locus (P = 0.01), and the -308*A of TNF-alpha locus (P = 0.0008) in DQ2 individuals, although an independent role for TNF-alpha as risk factor has not been proven. Moreover, we do not confirm the association with the CELIAC4 region polymorphisms described in other populations.


Assuntos
Antígenos CD/genética , Antígenos de Diferenciação/genética , Doença Celíaca/genética , Predisposição Genética para Doença , Miosinas/genética , Alelos , Antígeno CTLA-4 , Estudos de Casos e Controles , Doença Celíaca/metabolismo , Feminino , Genótipo , Haplótipos , Humanos , Masculino , Polimorfismo Genético , Espanha , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
12.
Clin Genet ; 71(4): 343-9, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17470135

RESUMO

Charcot-Marie-Tooth (CMT) disease type 4 (CMT4) is the name given to autosomal recessive forms of hereditary motor and sensory neuropathy (HMSN). When we began this study, three genes or loci associated with inherited peripheral neuropathies had already been identified in the European Gypsy population: HMSN-Lom (MIM 601455), HMSN-Russe (MIM 605285) and the congenital cataracts facial dysmorphism neuropathy syndrome (MIM 604168). We have carried out genetic analyses in a series of 20 Spanish Gypsy families diagnosed with a demyelinating CMT disease compatible with an autosomal recessive trait. We found the p.R148X mutation in the N-myc downstream-regulated gene 1 gene to be responsible for the HMSN-Lom in four families and also possible linkage to the HMSN-Russe locus in three others. We have also studied the CMT4C locus because of the clinical similarities and showed that in 10 families, the disease is caused by mutations located on the SH3 domain and tetratricopeptide repeats 2 (SH3TC2) gene: p.R1109X in 20 out of 21 chromosomes and p.C737_P738delinsX in only one chromosome. Moreover, the SH3TC2 p.R1109X mutation is associated with a conserved haplotype and, therefore, may be a private founder mutation for the Gypsy population. Estimation of the allelic age revealed that the SH3TC2 p.R1109X mutation may have arisen about 225 years ago, probably as the consequence of a bottleneck.


Assuntos
Doença de Charcot-Marie-Tooth/genética , Mutação Puntual , Proteínas/genética , Doença de Charcot-Marie-Tooth/classificação , Mapeamento Cromossômico , Cromossomos Humanos Par 10/genética , Cromossomos Humanos Par 5/genética , Evolução Molecular , Feminino , Efeito Fundador , Genes Recessivos , Haplótipos , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Linhagem , Roma (Grupo Étnico)/genética , Espanha
14.
Clin Genet ; 64(2): 153-9, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12859412

RESUMO

Mutations in the DYT1 gene cause idiopathic torsion dystonia (ITD) transmitted in families as an autosomal dominant trait with incomplete penetrance. The most common mutation, 946delGAG, has been observed in populations with different ethnic and geographic origins. We have investigated 40 individuals from 22 unrelated families with ITD originating from the Land of Valencia, Spain, for the presence of this mutation and we found 5 patients and 6 unaffected subjects from 4 families who were carriers of the mutation. This finding indicates that 18% of families may be diagnosed as DYT1 and that penetrance is reduced. We detected two different geographic and linguistic origins of the Valencian families. However, by haplotype analysis using D9S1260, D9S1261, D9S63 and D9S1262 as flanking markers, we demonstrated that all affected and unaffected carriers shared a common chromosome confirming identical origin of the mutation in the four families. We postulate a unique origin for the 946delGAG mutation in the Land of Valencia and, based on linguistic criterion, we propose that the mutation might have occurred at the beginning of the second millennium. Genetic analysis of another family from Castilla-La Mancha showed a different haplotype segregating with the disease, suggesting that at least two distinct mutational events for the 946delGAG mutation have occurred in Spain.


Assuntos
Proteínas de Transporte/genética , Distonia Muscular Deformante/genética , Chaperonas Moleculares , Penetrância , Deleção de Sequência/genética , Alelos , Cromossomos Humanos Par 9/genética , Eletroforese em Gel de Poliacrilamida , Testes Genéticos , Geografia , Humanos , Repetições de Microssatélites/genética , Linhagem , Espanha
15.
Neurology ; 59(12): 1865-72, 2002 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-12499475

RESUMO

BACKGROUND: Mutations in the ganglioside-induced differentiation-associated protein 1 gene (GDAP1) were recently shown to be responsible for autosomal recessive (AR) demyelinating Charcot-Marie-Tooth disease (CMT) type 4A (CMT4A) as well as AR axonal CMT with vocal cord paralysis. METHODS: The coding region of GDAP1 was screened for the presence of mutations in seven families with AR CMT in which the patients were homozygous for markers of the CMT4A locus at chromosome 8q21.1. RESULTS: A nonsense mutation was detected in exon 5 (c.581C>G, S194X), a 1-bp deletion in exon 6 (c.786delG, G262fsX284), and a missense mutation in exon 6 (c.844C>T, R282C). CONCLUSIONS: Mutations in GDAP1 are a frequent cause of AR CMT. They result in an early-onset, severe clinical phenotype. The range of nerve conduction velocities (NCV) is variable. Some patients have normal or near normal NCV, suggesting an axonal neuropathy, whereas others have severely slowed NCV compatible with demyelination. The peripheral nerve biopsy findings are equally variable and show features of demyelination and axonal degeneration.


Assuntos
Axônios/patologia , Doença de Charcot-Marie-Tooth/genética , Doenças Desmielinizantes/genética , Genes Recessivos/genética , Mutação/genética , Proteínas do Tecido Nervoso/genética , Idade de Início , Doença de Charcot-Marie-Tooth/patologia , Doença de Charcot-Marie-Tooth/fisiopatologia , Criança , Pré-Escolar , Cromossomos Humanos Par 8/genética , Doenças Desmielinizantes/patologia , Doenças Desmielinizantes/fisiopatologia , Eletrofisiologia , Família , Feminino , Ligação Genética/genética , Testes Genéticos , Humanos , Lactente , Masculino , Condução Nervosa/fisiologia , Linhagem , Nervo Sural/patologia , Turquia
16.
Rev Neurol ; 35(3): 246-53, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12235587

RESUMO

OBJECTIVE: We reviewed current knowledge of the molecular and genetic bases of hereditary peripheral neuropathies, with special emphasis on the senso motor neuropathies and their different clinical phenotypes. DEVELOPMENT: The peripheral neuropathies show great clinical variability and genetic heterogeneity. To date 12 genes and over 20 genetic loci have been described in relation to Charcot Marie Tooth disease and related neuropathies. The commonest form is the type 1A Charcot Marie Tooth disease (CMT1A) caused by tandem duplication of a monomer of 1.5 megabases (Mb) on chromosome 17q11.2. The CMT 1A duplication is found in 70% of the patients with CMT 1. The deletion of 1.5 Mb is the most prevalent mutation (85%) in hereditary neuropathy with susceptibility to paralysis due to pressure. This monomer includes the PMP22 gene which is affected by a genetic dose effect. The different proteins encoded by the genes described are well expressed in the Schwann cell and in the nerve axon. They have different functions. There are the structural proteins of myelin, transcription factors, cytoskeleton components, molecular motors of the microtubules, proteins involved in growth and cellular differentiation or with presumed enzyme activity. CONCLUSIONS: Diagnosis of molecular pathology is important for genetic counselling. The development of new treatment for hereditary neuropathies is based on the generation of animal models for the different genes and on understanding the role of the proteins involved in axon Schwann cell interaction.


Assuntos
Neuropatias Hereditárias Sensoriais e Autônomas/genética , Neuropatia Hereditária Motora e Sensorial/genética , Animais , Doença de Charcot-Marie-Tooth/genética , Modelos Animais de Doenças , Aconselhamento Genético , Neuropatias Hereditárias Sensoriais e Autônomas/patologia , Neuropatia Hereditária Motora e Sensorial/patologia , Humanos , Mutação
17.
Neurologia ; 16(8): 348-52, 2001 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-11738012

RESUMO

OBJECTIVE: To know the uptake of predictive testing of Huntington's disease, the characteristics of the applicants, as well as the consequences for them. METHODS: Prospective observational study between January of 1994 and December of 1999 of the predictive testing applicants who entered in the protocol consisted of: informative interview, psychiatric interview, blood extraction for molecular study, as well as outcome and follow-up interviews. RESULTS: There were 87 applicants with a 50% risk. The mean age of the applicants was 28 years (SD = 7). Thirty one per cent already had children in the moment of predictive testing. The application rate according to the estimate population with 50% risk for the Comunidad Valenciana is 13,4%. The rate varies depending on the access to the information of the population in risk, being of 24,7% when they have direct access and of 8,3% when they do not have it (p < 0,01). Forty per cent did not come to the post-outcome visit, the positive or negative result for the mutation not influencing over it. Only 6,8% had some adverse event in the six years of follow-up all being slight. CONCLUSIONS: The application rate is determined by the access to the information of the population in risk. The fulfilment of the protocol designed for presymptomatic diagnosis of Huntington's disease keeps the adverse events presentation to a minimum.


Assuntos
Predisposição Genética para Doença , Doença de Huntington/diagnóstico , Acesso à Informação , Adulto , Feminino , Aconselhamento Genético , Humanos , Doença de Huntington/genética , Doença de Huntington/psicologia , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos
18.
Muscle Nerve ; 24(9): 1149-55, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11494267

RESUMO

Clinical, electrophysiologic and molecular studies were performed on at-risk members of 14 families with hereditary neuropathy with liability to pressure palsies (HNPP), in order to detect asymptomatic carriers of the 17p11.2 deletion. Sporadic cases due to de novo deletion accounted for 21% of the investigated HNPP families. Approximately one half of deletion carriers were asymptomatic and did not display significant signs on clinical examination. The electrophysiologic hallmark in both symptomatic and asymptomatic deletion carriers was the presence of a nonuniform sensorimotor demyelinating polyneuropathy with conduction abnormalities preferentially located at common entrapment sites and distal nerve segments. A perfect correlation was found between the molecular and electrophysiologic analyses. A reliable screening method to detect clinically unaffected carriers of the deletion in families with HNPP was the evaluation of motor conduction in at least two nerves across usual entrapment sites, especially the ulnar nerve at the elbow, and evaluation of sensory conduction in the sural nerve. In sporadic cases due to a de novo deletion, electrophysiologic studies were suggestive but not sufficient for the diagnosis, and molecular analysis represented the most sensitive diagnostic tool.


Assuntos
Doença de Charcot-Marie-Tooth/diagnóstico , Doença de Charcot-Marie-Tooth/genética , Cromossomos Humanos Par 17 , Deleção de Genes , Adulto , Idoso , Criança , Saúde da Família , Feminino , Humanos , Masculino , Nervo Mediano/fisiologia , Pessoa de Meia-Idade , Condução Nervosa , Paralisia/diagnóstico , Paralisia/genética , Linhagem , Nervo Fibular/fisiologia , Nervo Sural/fisiologia , Nervo Ulnar/fisiologia
19.
Int J Mol Med ; 7(6): 581-9, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11351269

RESUMO

Friedreich's ataxia is an autosomal recessive neuro-degenerative disorder involving both central and peripheral nervous system. Patients also show a systemic clinical picture presenting heart disease and diabetes mellitus or glucose intolerance. The disease is caused by mutations in the FRDA gene mapped on chromosome 9q13. The product of the gene is frataxin, an 18 kDa soluble mitochondrial protein with 210 amino acids. Crystal structure suggests a new, not previously reported, protein fold. The most frequent mutation is the expansion of a GAA trinucleotide repeat located within the first intron of the gene, and represents 98% of the mutations. Point mutations are described in compound heterozygous subjects with one expanded allele. A two-step model of GAA normal alleles towards premutation alleles, which might generate further full expanded mutations in the population with Indo-European ancestry, has been postulated. Clinical phenotype is variable and an inverse correlation with the GAA expansion size has been observed. Analysis of the GAA triplet is a strong molecular tool for clinical diagnosis, genetic counselling and prenatal diagnosis. Friedreich's ataxia patho-genesis is not solved yet. Substantial data from organism models, such the S. cerevisae yeast and more recently conditioned knock-outs in mouse, and studies in heart biopsies and fibroblast cultures from patients suggest an important role of mitochondrial iron in the development of the disease. Iron is accumulated in the mitochondrial matrix of both the yeast frataxin deficient mutant and the patient fibroblasts. It has been postulated that iron-induced oxygen radical affects the oxidative phosphorylation in frataxin deficiency states favouring the disease pathology. A second hypothesis postulates a direct role of frataxin in the mitochondrial energy activation and oxidative phosphorylation. Iron chelator drugs and antioxidant drugs have been postulated for Friedreich's treatment. No results from clinical trials are available yet, but idebenone, a short-chain quinone, seems to reduce the size of hypertrophic cardiomyopathy and levels of oxidative stress molecules in patients.


Assuntos
Evolução Molecular , Ataxia de Friedreich/diagnóstico , Ataxia de Friedreich/genética , Proteínas de Ligação ao Ferro , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Alelos , Sequência de Aminoácidos , Animais , Cromossomos Humanos Par 9 , Fibroblastos/metabolismo , Ataxia de Friedreich/terapia , Heterozigoto , Humanos , Íntrons , Camundongos , Mitocôndrias/metabolismo , Modelos Genéticos , Dados de Sequência Molecular , Mutação , Estresse Oxidativo , Fenótipo , Mutação Puntual , Homologia de Sequência de Aminoácidos , Expansão das Repetições de Trinucleotídeos , Frataxina
20.
Neurologia ; 16(3): 105-11, 2001 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-11333779

RESUMO

BACKGROUND: Hereditary and idiopathic ataxias are neurodegenerative disorders affecting diverse neuronal systems, particularly the cerebellum and its tracts. They are currently classified according to clinical and genetic criteria. Neuroimaging is a useful tool to help diagnosis but studies using quantitative methodology are scarce. OBJECTIVE: To apply digital morphometry to cerebral MRI and define objective patterns for clinical evaluation and follow up. PATIENTS AND METHODS: The study was carried out on 48 patients of whom 17 were Friedreich ataxia (FA), 6 non-Friedreich early onset spinocerebellar ataxia (EOCA), 9 autosomal dominant cerebellar ataxia type 1 (ADCA 1), 7 ADCA 3 and 9 idiopathic late onset cerebellar ataxia (ILOCA); 35 controls were grouped on early (< 30 years-old) and late age. Morphometric measures were done on previously selected MRI planes by image analyser digital software. RESULTS: Six out of 21 measurements and 3 ratios were significantly discriminant. By categories, the structures mainly involved were as follows: atrophy of cervical spinal cord (p = 0.001), cerebellum (p = 0.038) and protuberance (p = 0.002) in FA; atrophy of spinal cord (p = 0.009), cerebellum (p = 0.035) and widening of IV ventricle (p = 0.044) in EOCA; shrinkage of protuberance (p = 0.009), middle cerebellar peduncles (p = 0.004) and spinal cord atrophy (p = 0.001) in ADCA 1; cerebellar atrophy (p = 0.041) in ADCA 3; and cerebellar atrophy (p = 0.041) and shortening of middle cerebellar peduncles (p = 0.038) in ILOCA. CONCLUSIONS: This quantitative morphometric study confirms the existence of different pattern of cerebral involvement that is closely related with the distints clinical forms of hereditary and idiopathic ataxias. Only a few measurements can be used to obtain a morphometric profile for diagnostic and follow up purposes.


Assuntos
Imageamento por Ressonância Magnética , Degenerações Espinocerebelares/patologia , Adulto , Humanos , Pessoa de Meia-Idade
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