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1.
J Intern Med ; 290(2): 386-391, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33720468

RESUMO

INTRODUCTION: To end the tuberculosis (TB) epidemic, efficient diagnostic tools are needed. In a previous calibration study, a portable 'point of care' electronic nose device (AeonoseTM ) proved to be a promising tool in a hospital setting. We evaluated this technology to detect TB in an indigenous population in Paraguay. METHODS: A total of 131 participants were enrolled. eNose results were compared with anamnesis, physical examinations, chest radiography and mycobacterial cultures in individuals with signs and symptoms compatible with TB. The eNose analysis was performed in two stages: first, the training with a combination of a previous study population plus 47 participants from the new cohort (total n = 153), and second, the 'blind prediction' of 84 participants. RESULTS: 21% of all participants (n = 131) showed symptoms and/or chest radiography abnormalities suspicious of TB. No sputum samples resulted culture positive for Mycobacterium tuberculosis complex. Only one patient had a positive smell print analysis. In the training model, the specificity was 92% (95% confidence interval (CI): 85%-96%) and the negative predictive value (NPV) was 95%. In the blind prediction model, the specificity and the NPV were 99% (95% CI: 93%-99%) and 100%, respectively. Although the sensitivity and positive predictive value of the eNose could not be assessed in this cohort due to the small sample size, no active TB cases were found during a one year of follow-up period. CONCLUSION: The eNose showed promising specificity and negative predictive value and might therefore be developed as a rule-out test for TB in vulnerable populations.


Assuntos
Nariz Eletrônico , Sistemas Automatizados de Assistência Junto ao Leito , Grupos Populacionais , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/etnologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paraguai , Projetos Piloto , Sensibilidade e Especificidade , Adulto Jovem
2.
Br J Surg ; 108(12): 1438-1447, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34535796

RESUMO

BACKGROUND: Few surgical studies have provided adjusted comparative postoperative outcome data among contemporary patients with and without COVID-19 infection and patients treated before the pandemic. The aim of this study was to determine the impact of performing emergency surgery in patients with concomitant COVID-19 infection. METHODS: Patients who underwent emergency general and gastrointestinal surgery from March to June 2020, and from March to June 2019 in 25 Spanish hospitals were included in a retrospective study (COVID-CIR). The main outcome was 30-day mortality. Secondary outcomes included postoperative complications and failure to rescue (mortality among patients who developed complications). Propensity score-matched comparisons were performed between patients who were positive and those who were negative for COVID-19; and between COVID-19-negative cohorts before and during the pandemic. RESULTS: Some 5307 patients were included in the study (183 COVID-19-positive and 2132 COVID-19-negative during pandemic; 2992 treated before pandemic). During the pandemic, patients with COVID-19 infection had greater 30-day mortality than those without (12.6 versus 4.6 per cent), but this difference was not statistically significant after propensity score matching (odds ratio (OR) 1.58, 95 per cent c.i. 0.88 to 2.74). Those positive for COVID-19 had more complications (41.5 versus 23.9 per cent; OR 1.61, 1.11 to 2.33) and a higher likelihood of failure to rescue (30.3 versus 19.3 per cent; OR 1.10, 0.57 to 2.12). Patients who were negative for COVID-19 during the pandemic had similar rates of 30-day mortality (4.6 versus 3.2 per cent; OR 1.35, 0.98 to 1.86) and complications (23.9 versus 25.2 per cent; OR 0.89, 0.77 to 1.02), but a greater likelihood of failure to rescue (19.3 versus 12.9 per cent; OR 1.56, 95 per cent 1.10 to 2.19) than prepandemic controls. CONCLUSION: Patients with COVID-19 infection undergoing emergency general and gastrointestinal surgery had worse postoperative outcomes than contemporary patients without COVID-19. COVID-19-negative patients operated on during the COVID-19 pandemic had a likelihood of greater failure-to-rescue than prepandemic controls.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/mortalidade , Pandemias , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Operatórios/mortalidade , Adulto , Idoso , COVID-19/epidemiologia , Estudos de Coortes , Emergências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia
3.
Eur J Neurol ; 28(2): 660-669, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33051934

RESUMO

BACKGROUND AND PURPOSE: To describe a large series of patients with α, ß, and γ sarcoglycanopathies (LGMD-R3, R4, and R5) and study phenotypic correlations and disease progression. METHODS: A multicentric retrospective study in four centers in the Paris area collecting neuromuscular, respiratory, cardiac, histologic, and genetic data. The primary outcome of progression was age of loss of ambulation (LoA); disease severity was established according to LoA before or after 18 years of age. Time-to-event analysis was performed. RESULTS: One hundred patients (54 γ-SG; 41 α-SG; 5 ß-SG) from 80 families were included. The γ-SG patients had earlier disease onset than α-SG patients (5.5 vs. 8 years; p = 0.022) and ß-SG patients (24.4 years). Axial muscle weakness and joint contractures were frequent and exercise intolerance was observed. At mean follow-up of 22.9 years, 65.3% of patients were wheelchair-bound (66.7% α-SG, 67.3% γ-SG, 40% ß-SG). Dilated cardiomyopathy occurred in all sarcoglycanopathy subtypes, especially in γ-SG patients (p = 0.01). Thirty patients were ventilated and six died. Absent sarcoglycan protein expression on muscle biopsy and younger age at onset were associated with earlier time to LoA (p = 0.021 and p = 0.002). Age at onset was an independent predictor of both severity and time to LoA (p = 0.0004 and p = 0.009). The α-SG patients showed genetic heterogeneity, whereas >90% of γ-SG patients carried the homozygous c.525delT frameshift variant. Five new mutations were identified. CONCLUSIONS: This large multicentric series delineates the clinical spectrum of patients with sarcoglycanopathies. Age at disease onset is an independent predictor of severity of disease and LoA, and should be taken into account in future clinical trials.


Assuntos
Sarcoglicanopatias , Adolescente , Seguimentos , Homozigoto , Humanos , Músculo Esquelético , Estudos Retrospectivos , Sarcoglicanopatias/epidemiologia , Sarcoglicanopatias/genética , Sarcoglicanas/genética
4.
BMC Med ; 18(1): 142, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32564774

RESUMO

BACKGROUND: Glioblastoma (GBM) is one of the most aggressive and vascularized brain tumors in adults, with a median survival of 20.9 months. In newly diagnosed and recurrent GBM, bevacizumab demonstrated an increase in progression-free survival, but not in overall survival. METHODS: We conducted an in silico analysis of VEGF expression, in a cohort of 1082 glioma patients. Then, to determine whether appropriate bevacizumab dose adjustment could increase the anti-angiogenic response, we used in vitro and in vivo GBM models. Additionally, we analyzed VEGFA expression in tissue, serum, and plasma in a cohort of GBM patients before and during bevacizumab treatment. RESULTS: We identified that 20% of primary GBM did not express VEGFA suggesting that these patients would probably not respond to bevacizumab therapy as we proved in vitro and in vivo. We found that a specific dose of bevacizumab calculated based on VEGFA expression levels increases the response to treatment in cell culture and serum samples from mice bearing GBM tumors. Additionally, in a cohort of GBM patients, we observed a correlation of VEGFA levels in serum, but not in plasma, with bevacizumab treatment performance. CONCLUSIONS: Our data suggest that bevacizumab dose adjustment could improve clinical outcomes in Glioblastoma treatment.


Assuntos
Bevacizumab/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/tratamento farmacológico , Adulto , Inibidores da Angiogênese/farmacologia , Inibidores da Angiogênese/uso terapêutico , Animais , Bevacizumab/farmacologia , Linhagem Celular Tumoral , Estudos de Coortes , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Camundongos Nus
5.
J Transl Med ; 17(1): 75, 2019 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-30871557

RESUMO

BACKGROUND: Extracellular vesicles (EVs) are small membrane-bound vesicles which play an important role in cell-to-cell communication. Their molecular cargo analysis is presented as a new source for biomarker detection, and it might provide an alternative to traditional solid biopsies. However, the most effective approach for EV isolation is not yet well established. RESULTS: Here, we study the efficiency of the most common EV isolation methods-ultracentrifugation, Polyethlyene glycol and two commercial kits, Exoquick® and PureExo®. We isolated circulating EVs from the bloodstream of healthy donors, characterized the size and yield of EVs and analyzed their protein profiles and concentration. Moreover, we have used for the first time Digital-PCR to identify and detect specific gDNA sequences, which has several implications for diagnostic and monitoring many types of diseases. CONCLUSIONS: Our findings present Polyethylene glycol precipitation as the most feasible and less cost-consuming EV isolation technique.


Assuntos
Ácidos Nucleicos Livres/isolamento & purificação , Vesículas Extracelulares/metabolismo , Polietilenoglicóis/farmacologia , Biomarcadores/metabolismo , Ácidos Nucleicos Livres/genética , Precipitação Química , Exossomos/metabolismo , Humanos , Tamanho da Partícula
6.
Eur J Neurol ; 25(5): 790-794, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29437287

RESUMO

BACKGROUND AND PURPOSE: The aim was to determine the genetic background of unknown muscular dystrophy in five French families. METHODS: Twelve patients with limb girdle muscular dystrophy or distal myopathy were clinically evaluated. Gene mutations were identified using targeted exon sequencing and mutated DNAJB6 was tested in vitro. RESULTS: Five patients presented with distal lower limb weakness whilst others had proximal presentation with a variable rate of progression starting at the mean age of 38.5 years. Two novel mutations (c.284A>T, p.Asn95Ile, two families; and c.293_295delATG, p.Asp98del, one family) as well as the previously reported c.279C>G (p.Phe93Leu, two families) mutation in DNAJB6 were identified. All showed a reduced capacity to prevent protein aggregation. CONCLUSIONS: The mutational and phenotypical spectrum of DNAJB6-caused muscle disease is larger than previously reported, including also dysphagia. The originally reported c.279C>G (p.Phe93Leu) mutation is now identified in four different populations and appears to be a mutational hotspot. Our report confirms that some DNAJB6 mutations cause distal-onset myopathy and hence DNAJB6 defects should be considered broadly in dominant muscular dystrophy families.


Assuntos
Miopatias Distais/genética , Proteínas de Choque Térmico HSP40/genética , Chaperonas Moleculares/genética , Distrofia Muscular do Cíngulo dos Membros/genética , Mutação , Proteínas do Tecido Nervoso/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/genética , Linhagem , Fenótipo
7.
Acta Neurol Scand ; 137(5): 452-461, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29635721

RESUMO

OBJECTIVES: Rhabdomyolysis and myalgia are common conditions, and mutation in the ryanodine receptor 1 gene (RYR1) is suggested to be a common cause. Due to the large size of RYR1, however, sequencing has not been widely accessible before the recent advent of next-generation sequencing technology and limited phenotypic descriptions are therefore available. MATERIAL & METHODS: We present the medical history, clinical and ancillary findings of patients with RYR1 mutations and rhabdomyolysis and myalgia identified in Denmark, France and The Netherlands. RESULTS: Twenty-two patients with recurrent rhabdomyolysis (CK > 10 000) or myalgia with hyperCKemia (>1.5 × ULN) and a RYR1 mutation were identified. One had mild wasting of the quadriceps muscle, but none had fixed weakness. Symptoms varied from being restricted to intense exercise to limiting ADL function. One patient developed transient kidney failure during rhabdomyolysis. Two received immunosuppressants on suspicion of myositis. None had episodes of malignant hyperthermia. Muscle biopsies were normal, but CT/MRI showed muscle hypertrophy in most. Delay from first symptom to diagnosis was 12 years on average. Fifteen different dominantly inherited mutations were identified. Ten were previously described as pathogenic and 5 were novel, but rare/absent from the background population, and predicted to be pathogenic by in silico analyses. Ten of the mutations were reported to give malignant hyperthermia susceptibility. CONCLUSION: Mutations in RYR1 should be considered as a significant cause of rhabdomyolysis and myalgia syndrome in patients with the characteristic combination of rhabdomyolysis, myalgia and cramps, creatine kinase elevation, no weakness and often muscle hypertrophy.


Assuntos
Mialgia/genética , Rabdomiólise/genética , Canal de Liberação de Cálcio do Receptor de Rianodina/genética , Adolescente , Adulto , Criança , Dinamarca , Feminino , França , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Mialgia/fisiopatologia , Países Baixos , Fenótipo , Rabdomiólise/fisiopatologia , Síndrome , Adulto Jovem
8.
Rev Neurol (Paris) ; 174(10): 731-735, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30318261

RESUMO

We describe two patients with mitochondrial DNA mutations in the gene encoding cytochrome b (m.15579A>G, p.Tyr278Cys and m.15045G>A p.Arg100Gln), which presented as a pure myopathic form (exercise intolerance), with an onset in childhood. Diagnosis was delayed, because acylcarnitine profile showed an increase in medium and long-chain acylcarnitines, suggestive of multiple acyl-CoA dehydrogenase deficiency, riboflavin transporter deficiency or FAD metabolism disorder. Implication of cytochrome b in fatty acid oxidation, and physiopathology of the mutations are discussed.


Assuntos
Citocromos b/genética , Deficiência Múltipla de Acil Coenzima A Desidrogenase/diagnóstico , Doenças Musculares/diagnóstico , Doenças Musculares/genética , Mutação de Sentido Incorreto , Adulto , Idoso , DNA Mitocondrial/genética , Diagnóstico Diferencial , Tolerância ao Exercício/genética , Humanos , Masculino , Deficiência Múltipla de Acil Coenzima A Desidrogenase/genética
11.
Clin Genet ; 91(5): 780-786, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27882542

RESUMO

We present three members of an Italian family affected by tubular aggregate myopathy (TAM) and congenital miosis harboring a novel missense mutation in ORAI1. All patients had a mild, late onset TAM revealed by asymptomatic creatine kinase (CK) elevation and congenital miosis consistent with a Stormorken-like Syndrome, in the absence of thrombocytopathy. Muscle biopsies showed classical histological findings but ultrastructural analysis revealed atypical tubular aggregates (TAs). The whole body muscle magnetic resonance imaging (MRI) showed a similar pattern of muscle involvement that correlated with clinical severity. The lower limbs were more severely affected than the scapular girdle, and thighs were more affected than legs. Molecular analysis revealed a novel c.290C>G (p.S97C) mutation in ORAI1 in all affected patients. Functional assays in both human embryonic kidney (HEK) cells and myotubes showed an increased rate of Ca2+ entry due to a constitutive activation of the CRAC channel, consistent with a 'gain-of-function' mutation. In conclusion, we describe an Italian family harboring a novel heterozygous c.290C>G (p.S97C) mutation in ORAI1 causing a mild- and late-onset TAM and congenital miosis via constitutive activation of the CRAC channel. Our findings extend the clinical and genetic spectrum of the ORAI1-related TAM.


Assuntos
Mutação , Miopatias Congênitas Estruturais/genética , Proteína ORAI1/genética , Distúrbios Pupilares/congênito , Idade de Início , Canais de Cálcio Ativados pela Liberação de Cálcio/metabolismo , Feminino , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Miopatias Congênitas Estruturais/fisiopatologia , Proteína ORAI1/metabolismo , Linhagem , Distúrbios Pupilares/genética
13.
Rev Neurol (Paris) ; 172(10): 614-619, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27659899

RESUMO

Nemaline myopathy (NM) is one of the most common forms of congenital myopathy. The condition is defined by the histopathological finding of nemaline bodies (rods) on muscle biopsy and is associated with hypotonia and muscle weakness. The clinical spectrum encompasses lethal forms presenting in the neonatal period with profound weakness and less severe congenital diseases of later onset. NM is significantly heterogeneous from a genetic point of view, and its inheritance can be autosomal-dominant (AD), sporadic or autosomal-recessive (AR). To date, 11 genes encoding proteins of skeletal muscle thin filaments, Kelch domain-associated proteins and an unconventional myosin have been implicated in NM. The mechanisms leading to nemaline body formation and muscle weakness are still largely unclear. This report reviews the clinical, histopathological and genetic features of NM, with a focus on some of the recently discovered forms.


Assuntos
Miopatias da Nemalina/genética , Miopatias da Nemalina/terapia , Biópsia , Humanos , Miopatias da Nemalina/patologia
14.
Rev Neurol (Paris) ; 172(10): 594-606, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27633507

RESUMO

Myofibrillar myopathies (MFM) are mostly adult-onset diseases characterized by progressive morphological alterations of the muscle fibers beginning in the Z-disk and the presence of protein aggregates in the sarcoplasm. They are mostly caused by mutations in different genes that encode Z-disk proteins, including DES, CRYAB, LDB3, MYOT, FLNC and BAG3. A large family of French origin, presenting an autosomal dominant pattern, characterized by cardiac arrhythmia associated to late-onset muscle weakness, was evaluated to clarify clinical, morphological and genetic diagnosis. Muscle weakness began during adult life (over 30 years of age), and had a proximal distribution. Histology showed clear signs of a myofibrillar myopathy, but with unusual, large inclusions. Subsequently, genetic testing was performed in MFM genes available for screening at the time of clinical/histological diagnosis, and desmin (DES), αB-crystallin (CRYAB), myotilin (MYOT) and ZASP (LDB3), were excluded. LMNA gene screening found the p.R296C variant which did not co-segregate with the disease. Genome wide scan revealed linkage to 7q.32, containing the FLNC gene. FLNC direct sequencing revealed a heterozygous c.3646T>A p.Tyr1216Asn change, co-segregating with the disease, in a highly conserved amino acid of the protein. Normal filamin C levels were detected by Western-blot analysis in patient muscle biopsies and expression of the mutant protein in NIH3T3 showed filamin C aggregates. This is an original FLNC mutation in a MFM family with an atypical clinical and histopathological presentation, given the presence of significantly focal lesions and prominent sarcoplasmic masses in muscle biopsies and the constant heart involvement preceding significantly the onset of the myopathy. Though a rare etiology, FLNC gene should not be excluded in early-onset arrhythmia, even in the absence of myopathy, which occurs later in the disease course.


Assuntos
Arritmias Cardíacas/etiologia , Filaminas/genética , Debilidade Muscular/etiologia , Doenças Musculares/complicações , Doenças Musculares/genética , Mutação de Sentido Incorreto/genética , Adolescente , Adulto , Idade de Início , Idoso , Sequência de Aminoácidos , Análise Mutacional de DNA , Família , Feminino , Genoma Humano , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Miofibrilas/patologia , Linhagem , Adulto Jovem
15.
Cir Pediatr ; 29(4): 175-179, 2016 Oct 10.
Artigo em Espanhol | MEDLINE | ID: mdl-28481072

RESUMO

OBJECTIVES: To analyze, depending on the technique employed, recurrence, symptomatic improvement and testicular growth following treatment of testicular varicocele. MATERIAL AND METHODS: Descriptive retrospective study of 69 pediatric and adolescent males diagnosed with varicocele treated in our center by open technique according Ivanissevich technique (IT), Palomo (PT) and percutaneous embolization (PE) between 2000-2014. Variables analyzed were age, symptoms, differential testicular volume (RV), employed technique, recurrence, symptomatic improvement and RV after treatment. Association between qualitative variables was evaluated (chi-square test or Fisher's exact test). RESULTS: 69 patients with a median age of 14 years (7-19) were studied. PE was performed in 37 patients (53,6%), PT in 23 (33,3%) and IT in 9 (13%). Recurrence occurred in 16 patients (23,2%), 80% of them had been treated with PE. Eleven patients had pain (15.9%), there was improvement in 100% of patients treated with PE, but none of those treated by PT or IT improved. At diagnosis, 37 patients (53.6%) had decreased testicular volume (left testicular hypotrophy), in 28 cases the RV was >20%. After treatment, the RV was normalized in 11 cases (39,2%). CONCLUSIONS: The choice of therapeutic technique in pediatric varicocele should be based on patient characteristics, symptoms, experience center for embolization and previous recurrence. Regardless of the chosen technique, 39,2% of testicular hypotrophy with VD >20% present at diagnosis normalized after treatment.


OBJETIVOS: Analizar en función de la técnica empleada para tratamiento de varicocele, la recurrencia, alivio sintomático y crecimiento testicular en pacientes pediátricos y adolescentes. MATERIAL Y METODOS: Estudio descriptivo retrospectivo de 69 pacientes pediátricos y adolescentes diagnosticados de varicocele tratados en nuestro centro mediante abordaje abierto según técnica de Ivanissevich (TI), Palomo (TP) y embolización percutánea (EP) entre 2000-2014. Las variables fueron edad, síntomas, volumen testicular diferencial (VD), técnica empleada, recurrencia, mejoría sintomática y VD tras el tratamiento. Se evaluó la asociación entre variables cualitativas (test de Chi cuadrado o prueba exacta de Fisher). RESULTADOS: Se estudiaron 69 pacientes con mediana de edad de 14 años (7-19). Se realizó EP a 37 pacientes (53,6%), TP a 23 (33,3%) y TI a 9 (13%). Presentaron recurrencia 16 (23,2%), de ellos el 80% habían sido tratados mediante EP. Once pacientes tenían dolor al diagnóstico (15,9%), tras el tratamiento 100% de los tratados mediante EP presentaron alivio, mientras que en ninguno de los tratados mediante TI o TP mejoró el dolor. Al diagnóstico 37 pacientes (53,6%) presentaron hipotrofia testicular izquierda, en 28 casos el VD fue >20%. Tras el tratamiento, el VD se normalizó en 11 casos (39,2%). CONCLUSIONES: La elección de la técnica terapéutica de varicocele en pacientes pediátricos y adolescentes debería depender de las características del paciente, presencia de síntomas, experiencia del centro y recurrencia previa. Independientemente de la técnica elegida el 39,2% de hipotrofias testiculares con DV >20% al diagnóstico alcanzaron la normalización del volumen testicular tras el tratamiento.


Assuntos
Embolização Terapêutica/métodos , Testículo/crescimento & desenvolvimento , Varicocele/terapia , Adolescente , Criança , Embolização Terapêutica/estatística & dados numéricos , Humanos , Masculino , Tamanho do Órgão , Recidiva , Estudos Retrospectivos , Testículo/patologia , Varicocele/cirurgia , Adulto Jovem
16.
J Neurol Neurosurg Psychiatry ; 86(12): 1337-46, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25535305

RESUMO

OBJECTIVE: Mutations in one of the 3 genes encoding collagen VI (COLVI) are responsible for a group of heterogeneous phenotypes of which Bethlem myopathy (BM) represents the milder end of the spectrum. Genotype-phenotype correlations and long-term follow-up description in BM remain scarce. METHODS: We retrospectively evaluated the long-term clinical evolution, and genotype-phenotype correlations in 35 genetically identified BM patients (23 index cases). RESULTS: Nineteen patients showed a typical clinical picture with contractures, proximal weakness and slow disease progression while 11 presented a more severe evolution. Five patients showed an atypical presentation, namely a limb girdle muscle weakness in 2 and a congenital myopathy pattern with either no contractures, or only limited to ankles, in 3 of them. Pathogenic COL6A1-3 mutations were mostly missense or in frame exon-skipping resulting in substitutions or deletions. Twenty one different mutations were identified including 12 novel ones. The mode of inheritance was, autosomal dominant in 83% of the index patients (including 17% (N=4) with a de novo mutation), recessive in 13%, and undetermined in one patient. Skipping of exon 14 of COL6A1 was found in 35% of index cases and was mostly associated with a severe clinical evolution. Missense mutations were detected in 39% of index cases and associated with milder forms of the disease. CONCLUSIONS: Long-term follow-up identified important phenotypic variability in this cohort of 35 BM patients. However, worsening of the functional disability appeared typically after the age of 40 in 47% of our patients, and was frequently associated with COL6A1 exon 14 skipping.


Assuntos
Colágeno Tipo VI/genética , Contratura/genética , Distrofias Musculares/congênito , Adolescente , Adulto , Idade de Início , Envelhecimento , Biópsia , Criança , Pré-Escolar , Estudos de Coortes , Contratura/patologia , Progressão da Doença , Éxons/genética , Feminino , Seguimentos , Genótipo , Humanos , Imageamento por Ressonância Magnética , Masculino , Debilidade Muscular/etiologia , Distrofias Musculares/genética , Distrofias Musculares/patologia , Mutação , Mutação de Sentido Incorreto/genética , Exame Neurológico , Fenótipo , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Rev Neurol (Paris) ; 171(10): 715-29, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26342832

RESUMO

Myofibrillar myopathies (MFM) have been described in the mid-1990s as a group of diseases sharing common histological features, including an abnormal accumulation of intrasarcoplasmic proteins, the presence of vacuoles and a disorganization of the intermyofibrillar network beginning at the Z-disk. The boundaries of this concept are still uncertain, and whereas six genes (DES, CRYAB, LDB3/ZASP, MYOT, FLNC and BAG3) are now classically considered as responsible for MFM, other entities such as FHL1 myopathy or Hereditary Myopathy with Early Respiratory Failure linked to mutations of titin can now as well be included in this group. The diagnosis of MFM is not always easy; as histological lesions can be focal, and muscle biopsy may be disappointing; this has led to a growing importance of muscle imaging, and the selectivity of muscle involvement has now been described in several disorders. Due to the rarity of these myopathies, if some clinical patterns (such as distal myopathy associated with cardiomyopathy due to desmin mutations) are now well known, surprises remain possible and should lead to systematic testing of the known genes in case of a typical histological presentation. In this paper, we aim at reviewing the data acquired on the six main genes listed above as well as presenting the experience from two French reference centres, Paris and Marseilles.


Assuntos
Miofibrilas/patologia , Miopatias Congênitas Estruturais/patologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Musculares/genética , Músculo Esquelético/patologia , Miofibrilas/genética , Miopatias Congênitas Estruturais/genética , Miopatias Congênitas Estruturais/terapia , Adulto Jovem
18.
Nat Genet ; 29(1): 17-8, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11528383

RESUMO

One form of congenital muscular dystrophy, rigid spine syndrome (MIM 602771), is a rare neuromuscular disorder characterized by early rigidity of the spine and respiratory insufficiency. A locus on 1p35-36 (RSMD1) was recently found to segregate with rigid spine muscular dystrophy 1 (ref. 1). Here we refine the locus and find evidence of linkage disequilibrium associated with SEPN1, which encodes the recently described selenoprotein N (ref. 2). Our identification and analysis of mutations in SEPN1 is the first description of a selenoprotein implicated in a human disease.


Assuntos
Pneumopatias/genética , Proteínas Musculares/genética , Distrofias Musculares/genética , Mutação , Coluna Vertebral/fisiopatologia , Sequência de Aminoácidos , Animais , Mapeamento Cromossômico , Cromossomos Humanos Par 1 , Humanos , Dados de Sequência Molecular , Proteínas Musculares/química , Distrofias Musculares/congênito , Reação em Cadeia da Polimerase , Polimorfismo Conformacional de Fita Simples , Selenoproteínas , Homologia de Sequência de Aminoácidos
19.
Rev Neurol (Paris) ; 169 Suppl 1: S45-55, 2013 Feb.
Artigo em Francês | MEDLINE | ID: mdl-23452772

RESUMO

Congenital myasthenic syndromes (CMS) are a heterogeneous group of disorders caused by genetic defects affecting neuromuscular transmission and leading to muscle weakness accentuated by exertion. Three different aspects have been investigated by members of the national French CMS Network: the difficulties in making a proper diagnosis; the course and long-term prognosis; and the response to therapy, especially for CMS that do not respond to cholinesterase inhibitors. CMS diagnosis is late in most cases because of confusion with other entities such as: congenital myopathies, due to the frequent presentation in patients of myopathies such as permanent muscle weakness, atrophy and scoliosis, and the abnormalities of internal structure, diameter and distribution of fibers (type I predominance, type II atrophy) seen on biopsy; seronegative autoimmune myasthenia gravis, when CMS is of late onset; and metabolic myopathy, with the presence of lipidosis in muscle. The long-term prognosis of CMS was studied in a series of 79 patients recruited with the following gene mutations: CHRNA; CHRNE; DOK7; COLQ; RAPSN; AGRN; and MUSK. Disease-course patterns (progressive worsening, exacerbation, stability, improvement) could be variable throughout life in a given patient. DOK7 patients had the most severe disease course with progressive worsening: of the eight wheelchair-bound and ventilated patients, six had mutations of this gene. Pregnancy was a frequent cause of exacerbation. Anticholinesterase agents are the first-line therapy for CMS patients, except for cases of slow-channel CMS, COLQ and DOK7. In our experience, 3,4-DAP was a useful complement for several patients harboring CMS with AChR loss or RAPSN gene mutations. Ephedrine was given to 18 patients (eight DOK7, five COLQ, four AGRN and one RAPSN). Tolerability was good. Therapeutic responses were encouraging even in the most severely affected patients, particularly with DOK7 and COLQ. Salbutamol was a good alternative in one patient who was allergic to ephedrine.


Assuntos
Centros de Informação/organização & administração , Síndromes Miastênicas Congênitas/terapia , Adolescente , Adulto , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Diagnóstico Tardio , Erros de Diagnóstico , Progressão da Doença , Efedrina/uso terapêutico , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes Miastênicas Congênitas/diagnóstico , Síndromes Miastênicas Congênitas/genética , Gravidez , Prognóstico , Adulto Jovem
20.
J Anim Physiol Anim Nutr (Berl) ; 97 Suppl 1: 80-8, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23639021

RESUMO

Methane is the most important anthropogenic contribution to climate change after carbon dioxide and represents a loss of feed energy for the animal, mainly for herbivorous species. However, our knowledge about the ecology of Archaea, the microbial group responsible for methane synthesis in the gut, is very poor. Moreover, it is well known that hindgut fermentation differs from rumen fermentation. The composition of archaeal communities in fermentation compartments of goats and rabbits were investigated using DGGE to generate fingerprints of archaeal 16S rRNA gene. Ruminal contents and faeces from five Murciano-Granadina goats and caecal contents of five commercial White New Zealand rabbits were compared. Diversity profile of methanogenic archaea was carried out by PCR-DGGE. Quantification of methanogenic archaea and the abundance relative to bacteria was determined by real-time PCR. Methanogenic archaeal species were relatively constant across species. Dendrogram from DGGE of the methanogen community showed one cluster for goat samples with two sub-clusters by type of sample (ruminal and faeces). In a second cluster, samples from rabbit were grouped. No differences were found either in richness or Shannon index as diversity indexes. Although the primer sets used was developed to investigate rumen methanogenic archaeal community, primers specificity did not affect the assessment of rabbit methanogen community structure. Rumen content showed the highest number or methanogenic archaea (log10 9.36), followed by faeces (log10 8.52) and showing rabbit caecum the lower values (log10 5.52). DGGE profile showed that pre-gastric and hindgut fermenters hold a very different methanogen community. Rabbits hold a microbial community of similar complexity than that in ruminants but less abundant, which agrees with the type of fermentation profile.


Assuntos
Archaea/isolamento & purificação , Trato Gastrointestinal/microbiologia , Cabras/fisiologia , Coelhos/fisiologia , Animais , Archaea/classificação , Fezes/microbiologia , Fermentação , Conteúdo Gastrointestinal/microbiologia , RNA Arqueal/genética , RNA Ribossômico 16S/genética
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