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2.
J Chem Phys ; 153(3): 034307, 2020 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-32716191

RESUMEN

Atmospheric new particle formation is the process by which atmospheric trace gases, typically acids and bases, cluster and grow into potentially climatically relevant particles. Here, we evaluate the structures and structural motifs present in small cationic ammonium and aminium bisulfate clusters that have been studied both experimentally and computationally as seeds for new particles. For several previously studied clusters, multiple different minimum-energy structures have been predicted. Vibrational spectra of mass-selected clusters and quantum chemical calculations allow us to assign the minimum-energy structure for the smallest cationic cluster of two ammonium ions and one bisulfate ion to a CS-symmetry structure that is persistent under amine substitution. We derive phenomenological vibrational frequency scaling factors for key bisulfate vibrations to aid in the comparison of experimental and computed spectra of larger clusters. Finally, we identify a previously unassigned spectral marker for intermolecular bisulfate-bisulfate hydrogen bonds and show that it is present in a class of structures that are all lower in energy than any previously reported structure. Tracking this marker suggests that this motif is prominent in larger clusters as well as ∼180 nm ammonium bisulfate particles. Taken together, these results establish a set of structural motifs responsible for binding of gases at the surface of growing clusters that fully explain the spectrum of large particles and provide benchmarks for efforts to improve structure predictions, which are critical for the accurate theoretical treatment of this process.

3.
Mol Vis ; 24: 847-852, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30713423

RESUMEN

Purpose: To identify the genetic variation in two unrelated probands with congenital cataract and to perform functional analysis of the detected variants. Methods: Clinical examination and phenotyping, segregation, and functional analysis were performed for the two studied pedigrees. Results: A novel OCRL gene variant (c.1964A>T, p. (Asp655Val)) was identified. This variant causes defects in OCRL protein folding and mislocalization to the cytoplasm. In addition, the variant's location close to the Rab binding site is likely to be associated with membrane targeting abnormalities. Conclusions: The results highlight the importance of early genetic diagnosis in infants with congenital cataract and show that mutations in the OCRL gene can present as apparently isolated congenital cataract.


Asunto(s)
Catarata/genética , Síndrome Oculocerebrorrenal/genética , Monoéster Fosfórico Hidrolasas/genética , Mutación Puntual , Proteínas de Unión al GTP rab/genética , Sustitución de Aminoácidos , Sitios de Unión , Catarata/congénito , Catarata/metabolismo , Catarata/patología , Niño , Expresión Génica , Hemicigoto , Humanos , Masculino , Síndrome Oculocerebrorrenal/metabolismo , Síndrome Oculocerebrorrenal/patología , Linaje , Fenotipo , Monoéster Fosfórico Hidrolasas/química , Monoéster Fosfórico Hidrolasas/metabolismo , Unión Proteica , Conformación Proteica en Hélice alfa , Conformación Proteica en Lámina beta , Pliegue de Proteína , Dominios y Motivos de Interacción de Proteínas , Proteínas de Unión al GTP rab/química , Proteínas de Unión al GTP rab/metabolismo
4.
J Phys Chem A ; 120(9): 1508-19, 2016 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-26878402

RESUMEN

A systematic comparison of MxOy(-) + ROH (M = Mo vs W; R = Me vs Et) reaction rate coefficients and product distributions combined with results of calculations on weakly bound MxOy(-)·ROH complexes suggest that the overall reaction mechanism has three distinct steps, consistent with recently reported results on analogous MxOy(-) + H2O reactivity studies. MxOy(-) + ROH → MxOy+1(-) + RH oxidation reactions are observed for the least oxidized clusters, and MxOy(-) + ROH → MxOyROH(-) addition reactions are observed for clusters in intermediate oxidation states, as observed previously in MxOy(-) + H2O reactions. The first step is weakly bound complex formation, the rate of which is governed by the relative stability of the MxOy(-)·ROH charge-dipole complexes and the Lewis acid-base complexes. Calculations predict that MoxOy(-) clusters form more stable Lewis acid-base complexes than WxOy(-), and the stability of EtOH complexes is enhanced relative to MeOH. Consistent with this result, MoxOy(-) + ROH rate coefficients are higher than analogous WxOy(-) clusters. Rate coefficients range from 2.7 × 10(-13) cm(3) s(-1) for W3O8(-) + MeOH to 3.4 × 10(-11) cm(3) s(-1) for Mo2O4(-) + EtOH. Second, a covalently bound complex is formed, and anion photoelectron spectra of the several MxOyROH(-) addition products observed are consistent with hydroxyl-alkoxy structures that are formed readily from the Lewis acid-base complexes. Calculations indicate that addition products are trapped intermediates in the MxOy(-) + ROH → MxOy+1(-) + RH reaction, and the third step is rearrangement of the hydroxyl group to a metal hydride group to facilitate RH release. Trapped intermediates are more prevalent in MoxOy(-) reaction product distributions, indicating that the rate of this step is higher for WxOy+1RH(-) than for MoxOy+1RH(-). This result is consistent with previous computational studies on analogous MxOy(-) + H2O reactions predicting that barriers along the pathway in the rearrangement step are higher for MoxOy(-) reactions than for WxOy(-).

5.
J Phys Chem A ; 118(37): 8493-504, 2014 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-24661103

RESUMEN

To test recent computational studies on the mechanism of metal oxide cluster anion reactions with water [Ramabhadran, R. O.; et al. J. Phys. Chem. Lett. 2010, 1, 3066; Ramabhadran, R. O.; et al. J. Am. Chem. Soc. 2013, 135, 17039], the reactivity of molybdenum oxo­cluster anions, Mo(x)O(y)(­) (x = 1 ­ 4; y ≤ 3x) toward both methanol (MeOH) and ethanol (EtOH) has been studied using mass spectrometric analysis of products formed in a high-pressure, fast-flow reactor. The size-dependent product distributions are compared to previous Mo(x)O(y)(­) + H2O/D2O reactivity studies, with particular emphasis on the Mo2O(y)(­) and Mo3O(y)(­) series. In general, sequential oxidation, Mo(x)O(y)(­) + ROH → Mo(x)O(y+1)(­) + RH, and addition reactions, Mo(x)O(y)(­) + ROH → Mo(x)O(y+1)RH(­), largely corresponded with previously studied Mo(x)O(y)(­) + H2O/D2O reactions [Rothgeb, D. W., Mann, J. E., and Jarrold, C. C. J. Chem. Phys. 2010, 133, 054305], though with much lower rate constants than those determined for Mo(x)O(y)(­) + H2O/D2O reactions. This finding is consistent with the computational studies that suggested that −H mobility on the cluster­water complex was an important feature in the overall reactivity. There were several notable differences between cluster­ROH and cluster­water reactions associated with lower R­OH bond dissociation energies relative to the HO­H dissociation energy.

6.
J Phys Chem A ; 118(43): 9960-9, 2014 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-25310627

RESUMEN

Reactions between small cerium oxide cluster anions and deuterated water were monitored as a function of both water concentration and temperature in order to determine the temperature dependence of the rate constants. Sequential oxidation reactions of the Ce(x)O(y)⁻ (x = 2, 3) suboxide cluster anions were found to exhibit anti-Arrhenius behavior, with activation energies ranging from 0 to -18 kJ mol⁻¹. Direct oxidation of species up to y = x was observed, after which, -OD abstraction and D2O addition reactions were observed. However, the stoichiometric Ce2O4⁻ and Ce3O6⁻ cluster anions also emerge in reactions between D2O and the respective precursors, Ce2O3D⁻ and Ce3O5D2⁻. Ce2O4⁻ and Ce3O6⁻ product intensities diminish relative to deuteroxide complex intensities with increasing temperature. The kinetics of these reactions are compared to the kinetics of the previously studied Mo(x)O(y)⁻ and W(x)O(y)⁻ reactions with water, and the possible implications for the reaction mechanisms are discussed.

7.
J Chem Phys ; 141(10): 104310, 2014 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-25217919

RESUMEN

A computational investigation of the Mo2O(y)(-) + H2O (y = 4, 5) reactions as well as a photoelectron spectroscopic probe of the deuterated Mo2O6D2(-) product have been carried out to understand a puzzling question from a previous study: Why is the rate constant determined for the Mo2O5(-) + H2O/D2O reaction, the terminal reaction in the sequential oxidation of Mo2O(y)(-) by water, higher than the W2O5(-) + H2O/D2O reaction? This disparity was intriguing because W3O(y)(-) clusters were found to be more reactive toward water than their Mo3O(y)(-) analogs. A comparison of molecular structures reveals that the lowest energy structure of Mo2O5(-) provides a less hindered water addition site than the W2O5(-) ground state structure. Several modes of water addition to the most stable molecular and electronic structures of Mo2O4(-) and Mo2O5(-) were explored computationally. The various modes are discussed and compared with previous computational studies on W2O(y)(-) + H2O reactions. Calculated free energy reaction profiles show lower barriers for the initial Mo2O(y)(-) + H2O addition, consistent with the higher observed rate constant. The terminal Mo2O(y)(-) sequential oxidation product predicted computationally was verified by the anion photoelectron spectrum of Mo2O6D2(-). Based on the computational results, this anion is a trapped dihydroxide intermediate in the Mo2O5(-) + H2O/D2O → Mo2O6(-) + H2/D2 reaction.

8.
J Am Chem Soc ; 135(45): 17039-51, 2013 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-24171388

RESUMEN

Molecular hydrogen (H2) is an excellent alternative fuel. It can be produced from the abundantly present water on earth. Transition-metal oxides are widely used in the environmentally benign photocatalytic generation of H2 from water, thus actively driving scientific research on the mechanisms for this process. In this study, we investigate the chemical reactions of W3O5(-) and Mo3O5(-) clusters with water that shed light on a variety of key factors central to H2 generation. Our computational results explain why experimentally Mo3O5(-) forms a unique kinetic trap in its reaction while W3O5(-) undergoes a facile oxidation to form the lowest-energy isomer of W3O6(-) and liberates H2. Mechanistic insights on the reaction pathways that occur, as well as the reaction pathways that do not occur, are found to be of immense assistance to comprehend the hitherto poorly understood pivotal roles of (a) differing metal-oxygen and metal-hydrogen bond strengths, (b) the initial electrostatic complex formed, (c) the loss of entropy when these TMO clusters react with water, and (d) the geometric factors involved in the liberation of H2.

9.
BMC Med Genet ; 14: 48, 2013 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-23621912

RESUMEN

BACKGROUND: COL11A1 is a large complex gene around 250 kb in length and consisting of 68 exons. Pathogenic mutations in the gene can result in Stickler syndrome, Marshall syndrome or Fibrochondrogenesis. Many of the mutations resulting in either Stickler or Marshall syndrome alter splice sites and result in exon skipping, which because of the exon structure of collagen genes usually leaves the message in-frame. The mutant protein then exerts a dominant negative effect as it co-assembles with other collagen gene products. To date only one large deletion of 40 kb in the COL11A1, which was detected by RT-PCR, has been characterized. However, commonly used screening protocols, utilizing genomic amplification and exon sequencing, are unlikely to detect such large deletions. Consequently the frequency of this type of mutation is unknown. CASE PRESENTATIONS: We have used Multiplex Ligation-Dependent Probe Amplification (MLPA) in conjunction with exon amplification and sequencing, to analyze patients with clinical features of Stickler syndrome, and have detected six novel deletions that were not found by exon sequencing alone. CONCLUSION: Exon deletions appear to represent a significant proportion of type 2 Stickler syndrome. This observation was previously unknown and so diagnostic screening of COL11A1 should include assays capable of detecting both large and small deletions, in addition to exon sequencing.


Asunto(s)
Colágeno Tipo XI/genética , Enfermedades del Tejido Conjuntivo/genética , Eliminación de Gen , Reacción en Cadena de la Polimerasa Multiplex/métodos , Desprendimiento del Vítreo/genética , Adolescente , Adulto , Preescolar , Colágeno Tipo XI/deficiencia , Enfermedades del Tejido Conjuntivo/diagnóstico , Exones , Femenino , Frecuencia de los Genes , Humanos , Lactante , Masculino , Mutación , Empalme del ARN , Análisis de Secuencia de ADN , Desprendimiento del Vítreo/diagnóstico
10.
J Phys Chem A ; 117(8): 1765-72, 2013 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-23413829

RESUMEN

While high-power laser ablation of metal alloys indiscriminately produces gas-phase atomic ions in proportion to the abundance of the various metals in the alloy, gas-phase ions produced by moderate-power laser ablation sources coupled with molecular beams are formed by more complicated mechanisms. A mass spectrometric study that directly compares the mass distributions of cluster anions and cations generated from laser ablation of pure aluminum, an aluminum/molybdenum mixed target, and an aluminum/tungsten mixed target is detailed. Mass spectra of anionic species generated from the mixed targets showed that both tungsten and molybdenum were in higher abundance in the negatively charged species than in the target material. Mass spectra of the cationic species showed primarily Al(+) and aluminum oxide and hydroxide cluster cations. No molybdenum- or tungsten-containing cluster cations were definitively assigned. The asymmetric distribution of aluminum and Group 6 transition metals in cation and anion cluster composition is attributed to the low ionization energy of atomic aluminum and aluminum suboxide clusters. In addition, the propensity of both molybdenum and tungsten to form metal oxide cluster anions under the same conditions that favor metallic aluminum cluster anions is attributed to differences in the optical properties of the surface oxide that is present in the metal powders used to prepare the ablation targets. Mechanisms of mixed metal oxide clusters are considered.

11.
J Phys Chem A ; 117(46): 12116-24, 2013 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-23862722

RESUMEN

The electronic and molecular structures of Al2MoO(y) (y = 2-4) anion and neutral complexes were studied using anion photoelectron spectroscopy and density functional theory calculations. The spectra are broad, reflecting significant structural changes in the transition from anion to neutral, and the neutral electron affinities determined from the spectra are similar for all three species. The calculations suggest that the lowest energy isomers of the neutral clusters can be described as predominantly (Al(+))2[MoO(y)(-2)] ionic complexes, in which the Al(+) cations bond with O(2-) anions in a way that minimizes repulsion with the positively charged Mo center. The anion structures for all three complexes favor closer Mo-Al and Al-Al internuclear distances, with the extra negative charge distributed more evenly among all three metal centers. Energetically, the fully occupied 3s orbitals on the Al centers are lower than the Mo-local 4d-like orbitals and above the O-local 2p-like orbitals. In the case of Al2MoO2(-), there is direct Al-Al covalent bonding. The calculated spectroscopic parameters for these species are consistent with the observed spectra, though definitive assignments are not possible due to the broad, unresolved spectra observed and predicted.

12.
J Phys Chem A ; 117(50): 13919-25, 2013 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-24168153

RESUMEN

The photoelectron spectra of WO3H(-) and WO2F(-) are presented and analyzed in the context of a series of previous similar measurements on MO(y)(-) (M = Mo, W; y = 0-3), MO4H(-) and AlMOy(-) (y ≤ 4) complexes. The electronic structures of the WO3H and WO2F anion and neutral complexes were investigated using the B3LYP hybrid density functional method. The spectra of WO3H(-), WO2F(-), and previously measured AlWO3(-) photoelectron spectra show that the corresponding neutrals, in which the transition metal centers are all in a +5 oxidation state, have comparable electron affinities. In addition, the electron affinities fit the general trend of monotonically increasing electron affinity with oxidation state, in spite of the WO3H(-), WO2F(-), and AlWO3(-) having closed shell ground states, suggesting that the oxidation state of the metal atom has more influence than shell closing on the electron affinity of these transition metal-oxo complexes. Results of DFT calculations suggest that the neutrals are pyramidal and the anions are planar. However, the barriers for inversion on the neutral surface are low, and attempts to generate simple Franck-Condon simulations based on simple normal coordinate displacement, ignoring the effects of inversion, are inadequate.

13.
Genes (Basel) ; 14(4)2023 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-37107549

RESUMEN

Non-traumatic ectopia lentis can be isolated or herald an underlying multisystemic disorder. Technological advances have revolutionized genetic testing for many ophthalmic disorders, and this study aims to provide insights into the clinical utility of genetic analysis in paediatric ectopia lentis. Children that underwent lens extraction for ectopia lentis between 2013 and 2017 were identified, and gene panel testing findings and surgical outcomes were collected. Overall, 10/11 cases received a probable molecular diagnosis. Genetic variants were identified in four genes: FBN1 (associated with Marfan syndrome and cardiovascular complications; n = 6), ADAMTSL4 (associated with non-syndromic ectopia lentis; n = 2), LTBP2 (n = 1) and ASPH (n = 1). Parents appeared unaffected in 6/11 cases; the initial presentation of all six of these children was to an ophthalmologist, and only 2/6 had FBN1 variants. Notably, 4/11 cases required surgery before the age of 4 years, and only one of these children carried an FBN1 variant. In summary, in this retrospective cohort study, panel-based genetic testing pointed to a molecular diagnosis in >90% of paediatric ectopia lentis cases requiring surgery. In a subset of study participants, genetic analysis revealed changes in genes that have not been linked to extraocular manifestations and highlighted that extensive systemic investigations were not required in these individuals. We propose the introduction of genetic testing early in the diagnostic pathway in children with ectopia lentis.


Asunto(s)
Desplazamiento del Cristalino , Cristalino , Síndrome de Marfan , Humanos , Niño , Preescolar , Desplazamiento del Cristalino/genética , Desplazamiento del Cristalino/cirugía , Estudios Retrospectivos , Pruebas Genéticas , Síndrome de Marfan/diagnóstico , Síndrome de Marfan/genética , Síndrome de Marfan/cirugía , Proteínas de Unión a TGF-beta Latente/genética
14.
Am J Obstet Gynecol ; 206(2): 113-8, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22177186

RESUMEN

A comprehensive classification system for preterm birth requires expanded gestational boundaries that recognize the early origins of preterm parturition and emphasize fetal maturity over fetal age. Exclusion of stillbirths, pregnancy terminations, and multifetal gestations prevents comprehensive consideration of the potential causes and presentations of preterm birth. Any step in parturition (cervical softening and ripening, decidual-membrane activation, and/or myometrial contractions) may initiate preterm parturition, and should be recorded for every preterm birth, as should the condition of the mother, fetus, newborn, and placenta, before a phenotype is assigned.


Asunto(s)
Nacimiento Prematuro/clasificación , Nacimiento Prematuro/diagnóstico , Mortinato , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Parto , Embarazo
15.
Am J Obstet Gynecol ; 206(2): 119-23, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22177191

RESUMEN

Preterm birth is a syndrome with many causes and phenotypes. We propose a classification that is based on clinical phenotypes that are defined by ≥ 1 characteristics of the mother, the fetus, the placenta, the signs of parturition, and the pathway to delivery. Risk factors and mode of delivery are not included. There are 5 components in a preterm birth phenotype: (1) maternal conditions that are present before presentation for delivery, (2) fetal conditions that are present before presentation for delivery, (3) placental pathologic conditions, (4) signs of the initiation of parturition, and (5) the pathway to delivery. This system does not force any preterm birth into a predefined phenotype and allows all relevant conditions to become part of the phenotype. Needed data can be collected from the medical records to classify every preterm birth. The classification system will improve understanding of the cause and improve surveillance across populations.


Asunto(s)
Nacimiento Prematuro/clasificación , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Parto , Fenotipo , Embarazo , Complicaciones del Embarazo , Nacimiento Prematuro/diagnóstico
16.
Am J Obstet Gynecol ; 206(2): 108-12, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22118964

RESUMEN

In 2009, the Global Alliance to Prevent Prematurity and Stillbirth Conference charged the authors to propose a new comprehensive, consistent, and uniform classification system for preterm birth. This first article reviews issues related to measurement of gestational age, clinical vs etiologic phenotypes, inclusion vs exclusion of multifetal and stillborn infants, and separation vs combination of pathways to preterm birth. The second article proposes answers to the questions raised here, and the third demonstrates how the proposed system might work in practice.


Asunto(s)
Nacimiento Prematuro/diagnóstico , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Embarazo , Nacimiento Prematuro/clasificación , Nacimiento Prematuro/prevención & control
17.
J Phys Chem A ; 116(39): 9639-52, 2012 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-22958081

RESUMEN

Results of a study combining anion photoelectron spectroscopy and density functional theory calculations on the heteronuclear MoNbO(y)(-) (y = 2-5) transition metal suboxide cluster series are reported and analyzed. The photoelectron spectra, which exhibit broad electronic bands with partially resolved vibrational structure, were compared to spectral simulations generated from calculated spectroscopic parameters for all computationally determined energetically competitive structures. Although computational results on the less oxidized clusters could not be satisfactorily reconciled with experimental spectra, possibly because of heavy spin contamination found in a large portion of the computational results, the results suggest that (1) neutral cluster electron affinity is a strong indicator of whether O-atoms are bound in M-O-M bridge positions or M═O terminal positions, (2) MoNbO(y) anions and neutrals have structures that can be described as intermediate with respect to the unary (homonuclear) Mo(2)O(y) and Nb(2)O(y) clusters, and (3) structures in which O-atoms preferentially bind to the Nb center are slightly more stable than alternative structures. Several challenges associated with the calculations are considered, including spin contamination, which appears to cause spurious single point calculations used to determine vertical detachment energies.

18.
J Chem Phys ; 137(4): 044301, 2012 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-22852612

RESUMEN

The anion photoelectron spectra of WAlO(y)(-) (y = 2-4) are presented and assigned based on results of density functional theory calculations. The WAlO(2)(-) and WAlO(3)(-) spectra are both broad, with partially resolved vibrational structure. In contrast, the WAlO(4)(-) spectrum features well-resolved vibrational structure with contributions from three modes. There is reasonable agreement between experiment and theory for all oxides, and calculations are in particular validated by the near perfect agreement between the WAlO(4)(-) photoelectron spectrum and a Franck-Condon simulation based on computationally determined spectroscopic parameters. The structures determined from this study suggest strong preferential W-O bond formation, and ionic bonding between Al(+) and WO(y)(-2) for all anions. Neutral species are similarly ionic, with WAlO(2) and WAlO(3) having electronic structure that suggests Al(+) ionically bound to WO(y)(-) and WAlO(4) being described as Al(+2) ionically bound to WO(4)(-2). The doubly-occupied 3sp hybrid orbital localized on the Al center is energetically situated between the bonding O-local molecular orbitals and the anti- or non-bonding W-local molecular orbitals. The structures determined in this study are very similar to structures recently determined for the analogous MoAlO(y)(-)/MoAlO(y) cluster series, with subtle differences found in the electronic structures [S. E. Waller, J. E. Mann, E. Hossain, M. Troyer, and C. C. Jarrold, J. Chem. Phys. 137, 024302 (2012)].

19.
J Chem Phys ; 137(2): 024302, 2012 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-22803531

RESUMEN

Vibrationally-resolved photoelectron spectra of AlMoO(y)(-) (y = 1-4) are presented and analyzed in conjunction with density functional theory computational results. The structures determined for the AlMoO(y) anion and neutral clusters suggest ionic bonding between Al(+) and a MoO(y)(-) or MoO(y)(-2) moiety, and point to the relative stability of Mo=O versus Al=O bonds. The highest occupied and partially occupied orbitals in the anions and neutrals can be described as Mo atomic-like orbitals, so while the Mo is in a higher oxidation state than Al, the most energetically accessible electrons are localized on the molybdenum center.

20.
BMC Nephrol ; 13: 79, 2012 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-22863349

RESUMEN

BACKGROUND: ADPKD affects approximately 1:1000 of the worldwide population. It is caused by mutations in two genes, PKD1 and PKD2. Although allelic variation has some influence on disease severity, genic effects are strong, with PKD2 mutations predicting later onset of ESRF by up to 20 years. We therefore screened a cohort of ADPKD patients attending a nephrology out-patient clinic for PKD2 mutations, to identify factors that can be used to offer targeted gene testing and to provide patients with improved prognostic information. METHODS: 142 consecutive individuals presenting to a hospital nephrology out-patient service with a diagnosis of ADPKD and CKD stage 4 or less were screened for mutations in PKD2, following clinical evaluation and provision of a detailed family history (FH). RESULTS: PKD2 mutations were identified in one fifth of cases. 12% of non-PKD2 patients progressed to ESRF during this study whilst none with a PKD2 mutation did (median 38.5 months of follow-up, range 16-88 months, p < 0.03). A significant difference was found in age at ESRF of affected family members (non-PKD2 vs. PKD2, 54 yrs vs. 65 yrs; p < 0.0001). No PKD2 mutations were identified in patients with a FH of ESRF occurring before age 50 yrs, whereas a PKD2 mutation was predicted by a positive FH without ESRF. CONCLUSIONS: PKD2 testing has a clinically significant detection rate in the pre-ESRF population. It did not accurately distinguish those individuals with milder renal disease defined by stage of CKD but did identify a group less likely to progress to ESRF. When used with detailed FH, it offers useful prognostic information for individuals and their families. It can therefore be offered to all but those whose relatives have developed ESRF before age 50.


Asunto(s)
Instituciones de Atención Ambulatoria/estadística & datos numéricos , Marcadores Genéticos/genética , Predisposición Genética a la Enfermedad/epidemiología , Predisposición Genética a la Enfermedad/genética , Enfermedades Renales Poliquísticas/epidemiología , Enfermedades Renales Poliquísticas/genética , Canales Catiónicos TRPP/genética , Adulto , Anciano , Femenino , Pruebas Genéticas , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Nefrología/estadística & datos numéricos , Enfermedades Renales Poliquísticas/diagnóstico , Polimorfismo de Nucleótido Simple/genética , Prevalencia , Factores de Riesgo , Reino Unido/epidemiología , Adulto Joven
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