RESUMEN
Ataxi A-T elangiectasia (AT) is a multisystem, complex and rare disease inherited in an autosomal recessive manner. Homozygous individuals have a variety of pathological manifestations, however, heterozygotes only present a higher risk of developing cancer. We evaluated the background levels of DNA damage (basal damage) and cell response to bleomycin or ionizing radiation using Comet assay and the cytokinesis-block micronucleus (CBMN) test in individuals with AT, their parents and controls. To evaluate DNA repair, the challenge experiment with ionizing radiation was performed using Comet assay, and different recovery times were evaluated. Results showed that basal MN frequencies differ between patients, parents and controls. Meanwhile, using the Comet assay, the results from the basal analysis do not differ between the groups, but monitoring the kinetics of DNA repair, we verified that the group of patients showed a delay in repair, compared to controls. Another finding was the nuclear bud (NBUD) frequency: spontaneous and induced cell cultures (with bleomycin and radiation) showed clear differences between patients, parents and controls. The CBMN assay and repair measurement with the Comet assay can help in the diagnosis of AT patients and ATM gene carriers, as complementary methods. The use of genomic instability evaluation techniques for the identification of the heterozygotes in families, where at least one member is affected, may be of great clinical importance.
Asunto(s)
Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Ensayo Cometa/métodos , Daño del ADN , Reparación del ADN , Pruebas de Micronúcleos/métodos , Adolescente , Adulto , Proteínas de la Ataxia Telangiectasia Mutada/genética , Estudios de Casos y Controles , Femenino , Inestabilidad Genómica , Heterocigoto , Humanos , Masculino , Mutación , PadresRESUMEN
OBJECTIVE: To evaluate the carotid intima-media complex (CIMC) thickness and lipid metabolism biomarkers associated with cardiovascular risk (CR) in parents of patients with ataxia-telangiectasia and verify an association with gender. METHOD: A cross-sectional and controlled study with 29 ATM heterozygotes and 14 healthy controls. Biochemical tests and CIMC thickness measurement were performed. RESULTS: The mean CIMC measurement in heterozygous ATM was 0.72 ± 0.1 mm (minimum: 0.5 mm and maximum: 1.0 mm). Noticed high percentage of amounts above 75 percentile compared to the population referential (16 [76.2%]), without any significant statistical differences between the female and the male gender (11/15 [73.3%] vs. 5/6 [83.3%]; p=0.550). The comparison between heterozygous and controls, stratified by gender, showed that in heterozygous ATMs, women had higher concentrations of HDL-c compared to men, as well as higher values of hs-CRP in relation to the control women. In heterozygous ATMs, stratified by gender, the correlation between HDL-c and hs-CRP was inversely proportional and stronger among women, with a tendency to statistical significance. CONCLUSION: Heterozygous ATMs did not differ from controls in relation to the biomarkers studied related to CR. However, most of them presented increased CIMC, independent predictor of death, risk for myocardial infarction and stroke, compared to the referential for the same age group. This finding suggests CR in the heterozygous ATM and shows to the need to monitor CIMC thickness and nutritional orientations.
Asunto(s)
Ataxia Telangiectasia/sangre , Enfermedades Cardiovasculares/diagnóstico , Grosor Intima-Media Carotídeo , Heterocigoto , Adulto , Ataxia Telangiectasia/genética , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Arterias Carótidas , Estudios de Casos y Controles , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Padres , Medición de Riesgo , Factores de Riesgo , Factores SexualesRESUMEN
Summary Objective: To evaluate the carotid intima-media complex (CIMC) thickness and lipid metabolism biomarkers associated with cardiovascular risk (CR) in parents of patients with ataxia-telangiectasia and verify an association with gender. Method: A cross-sectional and controlled study with 29 ATM heterozygotes and 14 healthy controls. Biochemical tests and CIMC thickness measurement were performed. Results: The mean CIMC measurement in heterozygous ATM was 0.72 ± 0.1 mm (minimum: 0.5 mm and maximum: 1.0 mm). Noticed high percentage of amounts above 75 percentile compared to the population referential (16 [76.2%]), without any significant statistical differences between the female and the male gender (11/15 [73.3%] vs. 5/6 [83.3%]; p=0.550). The comparison between heterozygous and controls, stratified by gender, showed that in heterozygous ATMs, women had higher concentrations of HDL-c compared to men, as well as higher values of hs-CRP in relation to the control women. In heterozygous ATMs, stratified by gender, the correlation between HDL-c and hs-CRP was inversely proportional and stronger among women, with a tendency to statistical significance. Conclusion: Heterozygous ATMs did not differ from controls in relation to the biomarkers studied related to CR. However, most of them presented increased CIMC, independent predictor of death, risk for myocardial infarction and stroke, compared to the referential for the same age group. This finding suggests CR in the heterozygous ATM and shows to the need to monitor CIMC thickness and nutritional orientations.
Resumo Objetivo: Avaliar a espessura do complexo médio-intimal da carótida (CMIC) e os biomarcadores do metabolismo lipídico associados ao risco cardiovascular (RC) em pais de pacientes com ataxia-telangiectasia (AT) e verificar associação com gênero. Método: Estudo transversal prospectivo e controlado com 29 ATM heterozigotos e 14 controles saudáveis. Foram realizados exames bioquímicos e a espessura do CMIC por ultrassonografia. Resultados: A média da medida do CMIC nos ATM heterozigotos foi de 0,72± 0,1 mm (mínimo: 0,5 mm e máximo: 1,0 mm). Observou-se elevado percentual de valores acima do percentil 75 em relação ao referencial populacional (16 [76,2%]), sem diferença estatisticamente significante entre o gênero feminino e o masculino (11/15 [73,3%] vs. 5/6 [83,3%]; p=0.550). A comparação entre os ATM heterozigotos e os controles, estratificados por gênero, mostrou que, nos ATM heterozigotos, as mulheres tinham maiores concentrações de HDL-c em comparação aos homens, e valores mais elevados de PCR-us em relação às mulheres controle. Nos ATM heterozigotos, estratificando segundo gênero, a correlação entre HDL-c e PCR-us foi inversamente proporcional e mais forte entre as mulheres, com tendência à significância estatística. Conclusão: Os ATM heterozigotos não diferiram dos controles em relação aos biomarcadores estudados relacionados ao RC. Entretanto, a maioria deles apresentou aumento na espessura do CMIC, preditor independente de morte, risco para infarto do miocárdio e AVC, quando comparado ao referencial para a mesma faixa etária. Esse achado sugere RC nos ATM heterozigotos e aponta para a necessidade de monitoramento da espessura do CMIC e de orientações nutricionais.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Ataxia Telangiectasia/sangre , Enfermedades Cardiovasculares/diagnóstico , Grosor Intima-Media Carotídeo , Heterocigoto , Padres , Proteína C-Reactiva/análisis , Ataxia Telangiectasia/genética , Biomarcadores/sangre , Arterias Carótidas , Estudios de Casos y Controles , Factores Sexuales , Estado Nutricional , Estudios Transversales , Factores de Riesgo , Medición de Riesgo , HDL-Colesterol/sangre , Persona de Mediana EdadAsunto(s)
Ataxia Telangiectasia/diagnóstico , Linfoma de Burkitt/diagnóstico , Proteínas Proto-Oncogénicas c-myc/metabolismo , Ataxia Telangiectasia/complicaciones , Ataxia Telangiectasia/genética , Linfoma de Burkitt/complicaciones , Linfoma de Burkitt/genética , Niño , Cromosomas Humanos Par 8 , Humanos , Hibridación Fluorescente in Situ , Cariotipo , Masculino , Proteínas Proto-Oncogénicas c-myc/genética , Translocación Genética , TrisomíaRESUMEN
DNA is constantly being damaged, either by endogenous or exogenous genotoxins. In that regard, DNA repair activities are essential for maintaining genomic stability and to life itself. Mutations in genes encoding DNA repair proteins cause severe human syndromes, but DNA repair defects have also been linked to several other diseases, notably to cancer and normal aging. Recently, new evidence has emerged indicating that some DNA repair diseases display mitochondrial and metabolic dysfunction through mechanisms that are yet being uncovered. These results suggest that mitochondria play an import role in the DNA damage response pathways and that damage accumulation may lead to mitochondrial dysfunction via metabolic imbalance and mitophagy impairment. Here we review the recent findings linking mitochondrial impairment and cell death to DNA damage accumulation in the context of DNA repair defects. In addition, the general involvement of DNA damage in cellular dysfunction suggests that these phenomena may be also involved in other human pathologies in which mitochondrial dysfunction and metabolic disruption play causative roles.
Asunto(s)
Anomalías Congénitas/etiología , Reparación del ADN , Mitocondrias/metabolismo , Animales , Ataxia Telangiectasia/etiología , Ataxia Telangiectasia/genética , Síndrome de Cockayne/etiología , Síndrome de Cockayne/genética , Anomalías Congénitas/genética , Daño del ADN , Humanos , Mitofagia , Xerodermia Pigmentosa/etiología , Xerodermia Pigmentosa/genéticaRESUMEN
INTRODUCTION: The ataxia telangiectasia syndrome (AT) is a genetic disease with an autosomal recessive inheritance pattern, with multisystem involvement and a broad clinical spectrum. It is caused by the mutation of the ATM gene, causing reduction or absence of the ATM proteinkinase, altering processes in the cell cycle, DNA repair and apoptosis. The objective of this article is to report the case of a patient with ataxia telangiectasia syndrome, caused by a mutation not previously reported in the literature. CASE REPORT: A 14 year-old patient native to Colombia, with classic clinical and phenotypical manifestations of AT syndrome, which started at 6 years of age with pondostatural alteration, recurrent respiratory infections, oculocutaneus telangiectasias and progressive neurological disorder that included: regression in her psychomotor development, ataxia and oculomotor apraxia. ATM gene sequencing is performed evidencing a homozygous mutation not reported in literature. DISCUSSION: In Latin America are sparse the number of reports of patients with ataxia telangiectasia and only few of these describe their molecular findings. Molecular studies allow the diagnosis and a better orientation in the management and prognosis of patients with neurodegenerative diseases. The report of undescribed molecular variants is of great importance to establish the etiology of such diseases in diverse population groups, such as the countries of Latin America.
Asunto(s)
Proteínas de la Ataxia Telangiectasia Mutada/genética , Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Mutación , Adolescente , Femenino , Marcadores Genéticos , HumanosRESUMEN
Introducción: El síndrome de ataxia telangiectasia (AT) es una enfermedad genética autosómica recesiva de compromiso multisistémico, con un espectro clínico amplio, ocasionada por la mutación del gen ATM, lo que causa la disminución o ausencia de la proteinkinasa ATM, por lo que se alteran procesos del ciclo celular, reparación del ADN y apoptosis. El objetivo de este artículo es el de reportar el caso de una paciente con síndrome de AT causada por una mutación no reportada previamente en la literatura. Caso clínico: Paciente originaria de Colombia, de 14 años de edad, con manifestaciones clínicas y fenotípicas clásicas del síndrome de AT a partir de los 6 años de edad, con alteración pondoestatural, infecciones respiratorias a repetición, telangiectasias oculocutáneas y compromiso neurológico progresivo, caracterizado por regresión en su desarrollo psicomotor, ataxia y apraxia oculomotora. Se realizó secuenciación del gen ATM que demostró mutación en homocigosis no reportada previamente en la literatura. Discusión: En Latinoamérica son escasos los reportes de pacientes con AT y pocos aquellos en donde se describen los hallazgos moleculares. Los estudios moleculares son una herramienta que facilita el diagnóstico y permite orientar mejor el manejo y pronóstico de pacientes con enfermedades neurodegenerativas. El reporte de variantes moleculares no descritas es de gran importancia para establecer la causa etiológica de este tipo de patologías en grupos poblacionales diversos, como lo son los países de Latinoamérica.
Introduction: The ataxia telangiectasia syndrome (AT) is a genetic disease with an autosomal recessive inheritance pattern, with multisystem involvement and a broad clinical spectrum. It is caused by the mutation of the ATM gene, causing reduction or absence of the ATM proteinkinase, altering processes in the cell cycle, DNA repair and apoptosis. The objective of this article is to report the case of a patient with ataxia telangiectasia syndrome, caused by a mutation not previously reported in the literature. Case report: A 14 year-old patient native to Colombia, with classic clinical and phenotypical manifestations of AT syndrome, which started at 6 years of age with pondostatural alteration, recurrent respiratory infections, oculocutaneus telangiectasias and progressive neurological disorder that included: regression in her psychomotor development, ataxia and oculomotor apraxia. ATM gene sequencing is performed evidencing a homozygous mutation not reported in literature. Discussion: In Latin America are sparse the number of reports of patients with ataxia telangiectasia and only few of these describe their molecular findings. Molecular studies allow the diagnosis and a better orientation in the management and prognosis of patients with neurodegenerative diseases. The report of undescribed molecular variants is of great importance to establish the etiology of such diseases in diverse population groups, such as the countries of Latin America.
Asunto(s)
Humanos , Femenino , Adolescente , Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Proteínas de la Ataxia Telangiectasia Mutada/genética , Mutación , Marcadores GenéticosRESUMEN
Ataxia telangiectasia (AT) is a rare neurodegenerative disorder, inherited in an autosomal recessive manner. Total blood samples were collected from 20 patients with AT, 13 parents of patients, and 17 healthy volunteers. This study aimed at evaluating the frequency of chromosomal breaks in spontaneous cultures, induced by bleomycin and ionizing radiation, and further evaluated the rates of oxidative stress in AT patients and in their parents, compared to a control group. Three cell cultures were performed to each individual: the first culture did not receive induction to chromosomal instability, the second was exposed to bleomycin, and the last culture was exposed to ionizing radiation. To evaluate the rates of oxidative stress, the markers superoxide dismutase (SOD), catalase (CAT), and thiobarbituric acid (TBARS) were utilized. Significant differences were observed between the three kinds of culture treatments (spontaneous, bleomycin, and radiation induced) and the breaks and chromosomal aberrations in the different groups. The oxidative stress showed no significant differences between the markers. This study showed that techniques of chromosomal instability after the induction of ionizing radiation and bleomycin are efficient in the identification of syndrome patients, with the ionizing radiation being the most effective.
Asunto(s)
Ataxia Telangiectasia/genética , Inestabilidad Cromosómica/efectos de los fármacos , Inestabilidad Cromosómica/efectos de la radiación , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/efectos de la radiación , Adulto , Ataxia Telangiectasia/patología , Bleomicina/farmacología , Células Cultivadas , Inestabilidad Cromosómica/genética , Aberraciones Cromosómicas/efectos de los fármacos , Aberraciones Cromosómicas/efectos de la radiación , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Estrés Oxidativo/genética , Linaje , Radiación IonizanteRESUMEN
La ataxia telangiectasia o síndrome de Louis Barr es un raro desorden neurodegenerativo de carácter autosómico recesivo, caracterizado por afectación multisistémica: neurológica, oftalmológica, inmunológica, endocrina, hepática y cutánea. El complejo clínico comprende la presencia de ataxia cerebelosa progresiva, telangiectasias oculocutáneas, enfermedad sinopulmonar crónica, elevada incidencia de neoplasias y una inmunodeficiencia combinada. Es causada por mutación en el gen ataxia telangiectasia, localizado en el locus 11 q22-23, lo que da lugar a deficiencias en su expresión. Su frecuencia se calcula en 1:80.000 y 1,4 % de la población es portadora del gen. Se presenta el caso de una paciente con documentación fotográfica.
The syndrome of ataxia telangiectasia or Louis Barr disease is a rare neurodegenerative disorder autosomal recessive, characterized by multisystem involvement: neurological, immunological, endocrine, ophthalmological, hepatic and cutaneous. The clinical complex includes the presence of progressive cerebellar ataxia, ocular and cutaneous telangiectasia, chronic sinopulmonar disease, high incidence of neoplasms and combined immunodeficiency. It is caused by mutation in the gene for ataxia telangiectasia, located in the q22-23 11 locus, which leads in its expression to numerous deficiencies. Its frequency is calculated in 1:80.000, and 1,4% of the population is a carrier of the gene. The case of a patient with photographic documentation is presented.
Asunto(s)
Humanos , Femenino , Niño , Ataxia Telangiectasia/genética , Ataxia Telangiectasia/patología , Blefaritis/patología , Conjuntivitis Alérgica/patología , Disartria/etiología , Enfermedades Cerebelosas/patología , Hemiatrofia Facial/etiologíaRESUMEN
OBJECTIVE: To define the neurologic characteristics and course of ataxia-telangiectasia (A-T). STUDY DESIGN: Retrospective cross-sectional chart study of 57 children (ages 2 to 19 years) followed at an A-T clinic. Cerebellar and extracerebellar symptoms were graded according to degree of functional impairment. Head circumferences were plotted from the charts and z-scores were calculated and compared with that of family members. RESULTS: Ataxia was present in 87.7%, followed by dysarthria (82.1%), dysmetria (75.4%), bradykinesia (69.2%), hyperkinetic movements (58.9%), and dystonia (15.8%). All features aggravated with age. The most striking clinical observation in our patients was low head circumference (z-score below 1), which was present in 60.9%; 17% had true microcephaly (z-score below 2). Microcephaly appeared postnatally, was proportionate to height and weight, and did not correlate with severity of ataxia or genotype. CONCLUSIONS: In addition to cerebellar ataxia, extrapyramidal symptoms, especially bradykinesia, were frequent and disabling. Microcephaly is an integral part of A-T; understanding its pathogenesis may shed light on the mechanism by which ATM mutation causes dysfunction in the nervous system.
Asunto(s)
Ataxia Telangiectasia/epidemiología , Cefalometría , Microcefalia/epidemiología , Adolescente , Envejecimiento , Ataxia Telangiectasia/genética , Niño , Preescolar , Estudios Transversales , Disartria/epidemiología , Disartria/etiología , Discinesias/epidemiología , Discinesias/etiología , Femenino , Humanos , Masculino , Mutación , Trastornos de la Motilidad Ocular/epidemiología , Trastornos de la Motilidad Ocular/etiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
We report on 2 brothers with ataxia-telangiectasia-like disorder with lung adenocarcinoma. They both had ataxia with cerebellar atrophy and mental retardation. They had the same mutation of the MRE11 gene, which has not been reported previously (c.727T>C and g.24994G>A).
Asunto(s)
Adenocarcinoma/genética , Ataxia Telangiectasia/genética , Neoplasias Pulmonares/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/radioterapia , Adolescente , Antineoplásicos/uso terapéutico , Ataxia Telangiectasia/diagnóstico , Autopsia , Antígeno Ca-125/sangre , Carboplatino/uso terapéutico , Niño , Terapia Combinada , Proteínas de Unión al ADN/genética , Docetaxel , Quimioterapia Combinada , Resultado Fatal , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/radioterapia , Proteína Homóloga de MRE11 , Masculino , Mutación , Hermanos , Taxoides/uso terapéuticoRESUMEN
Illegitimate V(D)J-recombination in lymphoid malignancies involves rearrangements in immunoglobulin or T-cell receptor genes, and these rearrangements may play a role in oncogenic events. High frequencies of TRGV-BJ hybrid gene (rearrangement between the TRB and TRG loci at 7q35 and 7p14-15, respectively) have been detected in lymphocytes from patients with ataxia telangiectasia (AT), and also in patients with lymphoid malignancies. Although the TRGV-BJ gene has been described only in T-lymphocytes, we previously detected the presence of TRGV-BJ hybrid gene in the genomic DNA extracted from SV40-transformed AT5BIVA fibroblasts from an AT patient. Aiming to determine whether the AT phenotype or the SV40 transformation could be responsible for the production of the hybrid gene by illegitimate V(D)J-recombination, DNA samples were extracted from primary and SV40-transformed (normal and AT) cell lines, following Nested-PCR with TRGV- and TRBJ-specific primers. The hybrid gene was only detected in SV40-transformed fibroblasts (AT-5BIVA and MRC-5). Sequence alignment of the cloned PCR products using the BLAST program confirmed that the fragments corresponded to the TRGV-BJ hybrid gene. The present results indicate that the rearrangement can be produced in nonlymphoid cells, probably as a consequence of the genomic instability caused by the SV40-transformation, and independently of ATM gene mutation.
Asunto(s)
Transformación Celular Viral/genética , Fibroblastos/citología , Fibroblastos/virología , Recombinación Genética , Virus 40 de los Simios/fisiología , Ataxia Telangiectasia/genética , Secuencia de Bases , Ciclo Celular , Línea Celular Transformada , Ensayo de Unidades Formadoras de Colonias , Electroforesis en Gel de Agar , Fibroblastos/metabolismo , Reordenamiento Génico , Humanos , Cinética , Datos de Secuencia Molecular , MutaciónRESUMEN
Ataxia telangiectasia mutated (ATM) is a phosphatidyl-3-kinase-related protein kinase that functions as a central regulator of the DNA damage response in eukaryotic cells. In humans, mutations in ATM cause the devastating neurodegenerative disease ataxia telangiectasia. Previously, we characterized the homolog of ATM (AtmA) in the filamentous fungus Aspergillus nidulans. In addition to its expected role in the DNA damage response, we found that AtmA is also required for polarized hyphal growth. Here, we extended these studies by investigating which components of the DNA damage response pathway are interacting with AtmA. The AtmA(ATM) loss of function caused synthetic lethality when combined with mutation in UvsB(ATR). Our results suggest that AtmA and UvsB are interacting and they are probably partially redundant in terms of DNA damage sensing and/or repairing and polar growth. We identified and inactivated A. nidulans chkA(CHK1) and chkB(CHK2) genes. These genes are also redundantly involved in A. nidulans DNA damage response. We constructed several combinations of double mutants for DeltaatmA, DeltauvsB, DeltachkA, and DeltachkB. We observed a complex genetic relationship with these mutations during the DNA replication checkpoint and DNA damage response. Finally, we observed epistatic and synergistic interactions between AtmA, and bimE(APC1), ankA(WEE1) and the cdc2-related kinase npkA, at S-phase checkpoint and in response to DNA-damaging agents.
Asunto(s)
Aspergillus nidulans/genética , Daño del ADN , ADN de Hongos/genética , Aspergillus nidulans/citología , Ataxia Telangiectasia/enzimología , Ataxia Telangiectasia/genética , Proteínas de la Ataxia Telangiectasia Mutada , Proteínas de Ciclo Celular/genética , Medios de Cultivo , Cartilla de ADN , Proteínas de Unión al ADN/genética , Genotipo , Humanos , Mitosis , Proteínas Serina-Treonina Quinasas/genética , ARN de Hongos/genética , ARN de Hongos/aislamiento & purificación , Proteínas Supresoras de Tumor/genética , Uracilo/metabolismo , Uridina/metabolismoRESUMEN
We report four patients with ataxia-telangiectasia syndrome that presented varied neurologic evolution. Three patients initially presented neurologic alterations of slow progression, evolving to late immunocompromised conditions. The fourth patient presented, from symptom onset, immune and neurologic debilitation, that were both severe and of fast progression. The chronological sequence of the most commonly observed immunocompromised conditions were in our patients, in ascending order, IgA deficiency, IgG2 deficiency and the neutrophil phagocytosis stage and common variable immunodeficiency. The first two reports are of sisters in whom the diagnosis was done between the ages of three and six years, having ocular apraxia, cerebellar ataxia and telangiectasia. Slow progression of neurologic debilitation was observed, without presentation of intermittent infections. The patients began presenting accentuated immunocompromised conditions at the ages of 14 and 17 years, dying at the ages of 16 and 20 years, respectively, due to severe infections that were resistant to treatment. The diagnosis of the third case was established when the patient was two years old, presenting ataxia and telangiectasia. Syndrome progression was slow, presenting at the age of eight years more accentuated neurologic disorders and IgA deficiency. The fourth case presented significant neurologic compromise at the age of five, simultaneous to IgA and IgG2 deficiency, and repeating pneumonias and sinusitis. At this time, intravenous gammaglobulin reposition was done. The neurologic and immune disorders progressed rapidly, and at the age of eight presented the inability to walk. At this time inversion of the CD4/CD8 ration was verified through laboratory tests.
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Ataxia Telangiectasia/inmunología , Adolescente , Edad de Inicio , Ataxia Telangiectasia/complicaciones , Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Relación CD4-CD8 , Niño , Preescolar , Consanguinidad , Progresión de la Enfermedad , Susceptibilidad a Enfermedades , Resultado Fatal , Femenino , Humanos , Deficiencia de IgA/etiología , Huésped Inmunocomprometido , Lactante , Infecciones del Sistema Respiratorio/etiología , Vitíligo/etiología , alfa-Fetoproteínas/análisisRESUMEN
Checkpoint response to DNA damage involves the activation of DNA repair and G2 lengthening subpathways. The roles of nibrin (NBS1) and the ATM/ATR kinases in the G2 DNA damage checkpoint, evoked by endogenous and radio-induced DNA damage, were analyzed in control, A-T and NBS lymphoblast cell lines. Short-term responses to G2 treatments were evaluated by recording changes in the yield of chromosomal aberrations in the ensuing mitosis, due to G2 checkpoint adaptation, and also in the duration of G2 itself. The role of ATM/ATR in the G2 checkpoint pathway repairing chromosomal aberrations was unveiled by caffeine inhibition of both kinases in G2. In the control cell lines, nibrin and ATM cooperated to provide optimum G2 repair for endogenous DNA damage. In the A-T cells, ATR kinase substituted successfully for ATM, even though no G2 lengthening occurred. X-ray irradiation (0.4 Gy) in G2 increased chromosomal aberrations and lengthened G2, in both mutant and control cells. However, the repair of radio-induced DNA damage took place only in the controls. It was associated with nibrin-ATM interaction, and ATR did not substitute for ATM. The absence of nibrin prevented the repair of both endogenous and radio-induced DNA damage in the NBS cells and partially affected the induction of G2 lengthening.
Asunto(s)
/citología , Daño del ADN , Daño del ADN/efectos de la radiación , Proteínas/farmacología , Proteínas/fisiología , Proteínas/síntesis química , Aberraciones Cromosómicas/efectos de la radiación , Ataxia Telangiectasia/etiología , Ataxia Telangiectasia/genética , Ataxia Telangiectasia/inducido químicamenteRESUMEN
We have studied the molecular genetics of 27 Brazilian families with ataxia telangiectasia (AT). Five founder effect haplotypes accounted for 55.5% of the families. AT is an autosomal recessive disorder of childhood onset characterized by progressive cerebellar ataxia, ocular apraxia, telangiectasia, immunodeficiency, radiation sensitivity, chromosomal instability, and predisposition to cancer. The ATM gene spans more than 150 kb on chromosome region 11q23.1 and encodes a product of 3056 amino acids. The ATM protein is a member of the phosphatidylinositol 3-kinase (PI-3K) family of proteins and is involved in cell cycle control and DNA repair pathways. DNA was isolated from lymphoblastoid cell lines and haplotyped using four STR markers (D11S1818, NS22, D11S2179, D11S1819) within and flanking the ATM gene; all allele sizes were standardized in advance. In addition to the STR haplotypes, SNP haplotypes were determined using 10 critical polymorphisms. The entire gene was screened sequentially by protein truncation testing (PTT), single strand conformation polymorphism (SSCP), and then denaturing high performance liquid chromatography (dHPLC) to identify the disease-causing mutations. Of the expected 54 mutations, 50 were identified. All mutations but one, led to a truncated or null form of the ATM protein (nonsense, splice site, or frameshift). Five families (18.5%) carried a deletion of 3450nt (from IVS28 to Ex31), making this one of the two most common Brazilian mutations. Mutations were located throughout the entire gene, with no clustering or hotspots. Standardized STR haplotype analysis greatly enhanced the efficiency of mutation screening.
Asunto(s)
Ataxia Telangiectasia/genética , Haplotipos , Mutación/genética , Polimorfismo de Nucleótido Simple/genética , Proteínas Serina-Treonina Quinasas/genética , Proteínas de la Ataxia Telangiectasia Mutada , Brasil , Proteínas de Ciclo Celular , Cromatografía Líquida de Alta Presión , Proteínas de Unión al ADN , Variación Genética , Humanos , Polimorfismo Conformacional Retorcido-Simple , Proteínas Supresoras de TumorRESUMEN
Mutations in the ATM gene are responsible for the autosomal recessive disorder ataxia-telangiectasia (A-T). Many different mutations have been identified using various techniques, with detection efficiencies ranging from 57 to 85%. In this study, we employed short tandem repeat (STR) haplotypes to enhance mutation identification in 55 unrelated A-T families of Iberian origin (20 Spanish, 17 Brazilian, and 18 Hispanic-American); we were able to identify 95% of the expected mutations. Allelic sizes were standardized based on a reference sample (CEPH 1347-2). Subsequent mutation screening was performed by PTT, SSCP, and DHPLC, and abnormal regions were sequenced. Many STR haplotypes were found within each population and six haplotypes were observed across several of these populations. Single nucleotide polymorphism (SNP) haplotypes further suggested that most of these common mutations are ancestrally related, and not hot spots. However, two mutations (8977C>T and 8264_8268delATAAG) may indeed be recurring mutational events. Common haplotypes were present in 13 of 20 Spanish A-T families (65%), in 11 of 17 Brazilian A-T families (65%), and, in contrast, in only eight of 18 Hispanic-American families (44%). Three mutations were identified that would be missed by conventional screening strategies. In all, 62 different mutations (28 not previously reported) were identified and their associated haplotypes defined, thereby establishing a new database for Iberian A-T families, and extending the spectrum of worldwide ATM mutations.
Asunto(s)
Pruebas Genéticas/métodos , Haplotipos/genética , Mutagénesis/genética , Proteínas Serina-Treonina Quinasas/genética , Ataxia Telangiectasia/epidemiología , Ataxia Telangiectasia/etnología , Ataxia Telangiectasia/genética , Proteínas de la Ataxia Telangiectasia Mutada , Brasil/epidemiología , Proteínas de Ciclo Celular , Costa Rica/epidemiología , Proteínas de Unión al ADN , Bases de Datos Genéticas , Efecto Fundador , Hispánicos o Latinos/genética , Humanos , Internet , Fosfatidilinositol 3-Quinasas/genética , Polimorfismo de Nucleótido Simple/genética , Portugal/epidemiología , España/epidemiología , Secuencias Repetidas en Tándem/genética , Proteínas Supresoras de Tumor , Estados Unidos/epidemiologíaRESUMEN
La ataxia telangiectasia es una enfermedad multisistémica causada por mutaciones en el gen de la ataxia telangiectasia mutado (ATM), localizado en el locus 11 q22-23, que dan lugar a deficiencias en la expresión de la proteína de la ataxia telangiectasia mutada (ATM). Se actualizan los criterios diagnósticos, las enfermedades con las cuales debe realizarse el diagnóstico diferencial, los mecanismos moleculares involucrados en la fisiopatogenia de la enfermedad y finalmente, las terapias empleadas y en vías de experimentación(AU)
Asunto(s)
Humanos , Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Ataxia Telangiectasia/tratamiento farmacológico , Diagnóstico DiferencialRESUMEN
BACKGROUND: In ataxia telangiectasia (A-T), the lack of a functional ATM kinase is associated with disturbances in the processing of DNA damage and a chronic oxidative stress. These disturbances may be responsible for an increment of chromosomal damage in A-T cells. AIM: To study the in vitro effect of vitamin E (DL-alpha-tocopherol) on the frequency of chromosomal damage of lymphocytes from patients with A-T. PATIENTS AND METHODS: Seven patients with A-T and age-sex matched controls were studied. Chromosomal damage in mitosis was evaluated in lymphocytes cultures both under basal conditions and when G2 repair was prevented by 5 mM caffeine. RESULTS: In cells from patients with A-T, vitamin E induced a 57.1 and 47.9% decrease in chromosomal damage under basal and inhibited G2 repair conditions, respectively. However, there was a non significant improvement in their repair activity. Vitamin E effects on chromosomal damage was not significant in control subjects. CONCLUSIONS: Vitamin E reduces chromosomal damage in lymphocytes from patients with ataxia telangiectasia.