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1.
Eur J Neurol ; 20(12): 1571-3, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23398167

RESUMO

BACKGROUND AND PURPOSE: Common genetic variants (rs5848 and rs646776) have been reported as regulators of blood progranulin (GRN) levels in healthy individuals. METHODS: To assess the influence of rs5848 and rs646776 polymorphisms in both serum GRN level and risk for common neurodegenerative diseases, we studied 304 patients with Parkinson's disease (PD), 217 individuals with Alzheimer's disease, 131 subjects with mild cognitive impairment, and 126 controls. RESULTS: The mean concentration of GRN in the serum of patients with PD (319.6 ng/ml) was significantly lower than that of controls (371.5 ng/ml; P = 0.009), whereas there were no significant differences between other groups. Rs646776 minor allele carriers had lower serum GRN levels in each of the four subgroups. There was no correlation between rs5848 genotypes and serum GRN concentrations. Genotype frequencies of both polymorphisms did not differ between groups. CONCLUSION: Reduced circulating GRN levels might be associated with PD risk by pathogenic factors different from rs5848 and rs646776 polymorphisms.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/sangue , Doença de Parkinson/sangue , Idoso , Idoso de 80 Anos ou mais , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Masculino , Doença de Parkinson/genética , Polimorfismo de Nucleotídeo Único , Progranulinas
2.
J Neural Transm (Vienna) ; 120(5): 807-12, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23180304

RESUMO

Aside from APOE, the genetic factors that influence the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD) remain largely unknown. We assessed whether a genetic risk score (GRS), based on eight non-APOE genetic variants previously associated with AD risk in genome-wide association studies, is associated with either risk of conversion or with rapid progression from MCI to AD. Among 288 subjects with MCI, follow-up (mean 26.3 months) identified 118 MCI-converters to AD and 170 MCI-nonconverters. We genotyped ABCA7 rs3764650, BIN1 rs744373, CD2AP rs9296559, CLU rs1113600, CR1 rs1408077, MS4A4E rs670139, MS4A6A rs610932, and PICALM rs3851179. For each subject we calculated a cumulative GRS, defined as the number of risk alleles (range 0-16) with each allele weighted by the AD risk odds ratio. GRS was not associated with risk of conversion from MCI to AD. However, MCI-converters to AD harboring six or more risk alleles (second and third GRS tertiles) progressed twofold more rapidly to AD when compared with those with less than six risk alleles (first GRS tertile). Our GRS is a first step toward development of prediction models for conversion from MCI to AD that incorporate aggregate genetic factors.


Assuntos
Doença de Alzheimer/genética , Disfunção Cognitiva/genética , Predisposição Genética para Doença , Transportadores de Cassetes de Ligação de ATP/genética , Proteínas Adaptadoras de Transdução de Sinal/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Apolipoproteínas E/genética , Clusterina/genética , Disfunção Cognitiva/complicações , Progressão da Doença , Feminino , Seguimentos , Frequência do Gene , Estudos de Associação Genética , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Proteínas Monoméricas de Montagem de Clatrina/genética , Receptores de Complemento 3b/genética , Risco
3.
Mol Psychiatry ; 16(9): 903-7, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21556001

RESUMO

Apolipoprotein E (APOE) dependent lifetime risks (LTRs) for Alzheimer Disease (AD) are currently not accurately known and odds ratios alone are insufficient to assess these risks. We calculated AD LTR in 7351 cases and 10 132 controls from Caucasian ancestry using Rochester (USA) incidence data. At the age of 85 the LTR of AD without reference to APOE genotype was 11% in males and 14% in females. At the same age, this risk ranged from 51% for APOE44 male carriers to 60% for APOE44 female carriers, and from 23% for APOE34 male carriers to 30% for APOE34 female carriers, consistent with semi-dominant inheritance of a moderately penetrant gene. Using PAQUID (France) incidence data, estimates were globally similar except that at age 85 the LTRs reached 68 and 35% for APOE 44 and APOE 34 female carriers, respectively. These risks are more similar to those of major genes in Mendelian diseases, such as BRCA1 in breast cancer, than those of low-risk common alleles identified by recent GWAS in complex diseases. In addition, stratification of our data by age groups clearly demonstrates that APOE4 is a risk factor not only for late-onset but for early-onset AD as well. Together, these results urge a reappraisal of the impact of APOE in Alzheimer disease.


Assuntos
Doença de Alzheimer/genética , Apolipoproteína E3/genética , Apolipoproteína E4/genética , Predisposição Genética para Doença/genética , Hereditariedade/genética , Fatores Etários , Idoso , Alelos , Doença de Alzheimer/epidemiologia , Estudos de Casos e Controles , Feminino , França/epidemiologia , Genótipo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estados Unidos/epidemiologia
4.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 55(2): 140-149, mar.-abr. 2011. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-86276

RESUMO

La enfermedad de Charcot-Marie-Tooth es la neuropatía hereditaria más frecuente con una prevalencia en España de 28,2 casos/100.000 habitantes. Se trata de un síndrome polineuropático sensitivo-motor, desmielinizante o axonal, que puede transmitirse con herencia autosómica dominante, autosómica recesiva, o ligada al cromosoma X. Pese a su semiología estereotipada, es un síndrome genéticamente complejo, dado que se han localizado 36 loci con una treintena de genes mutantes clonados. Analizamos los mecanismos patogénicos de estas mutaciones génicas. Abordamos la fisiopatología del pie cavo, que es manifestación cardinal de la enfermedad. En estadios clínicos iniciales, el pie cavo probablemente sea desencadenado por una desnervación selectiva de la musculatura intrínseca del pie, que causa un desequilibrio entre sus músculos intrínsecos y extrínsecos con dedos en garra, retracción de la fascia plantar, elevación del arco plantar, y acortamiento del tendón de Aquiles. Revisamos el diagnóstico y tratamiento de la enfermedad (AU)


Charcot-Marie-Tooth disease is the most frequent inherited neuropathy with a prevalence ratio in Spain of 28.2 cases/100,000 inhabitants. It is a sensory-motor polyneuropathic syndrome, either demyelinating or axonal, which might be transmitted with autosomal dominant, autosomal recessive or X-linked pattern. Despite presenting with a stereotyped semiology, this a genetically complex syndrome comprising 36 localized loci with 30 cloned mutated genes. Here we briefly review the pathogenic mechanisms of these gene mutations. We address the pathophysiology of pes cavus, which is a cardinal manifestation of the disease. In the early clinical stages, forefoot pes cavus is most probably due to selective denervation of foot musculature, and particularly of the lumbricals, which causes an imbalance between intrinsic and extrinsic foot muscles leading to toe clawing, retraction of plantar fascia, approximation of the pillars of the longitudinal arch, and shortening of the Achilles tendon. We review the disease diagnosis and treatment (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Doença de Charcot-Marie-Tooth/diagnóstico , Doença de Charcot-Marie-Tooth/fisiopatologia , Deformidades do Pé/diagnóstico , Deformidades do Pé/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética , Ácido Ascórbico/uso terapêutico , Doença de Charcot-Marie-Tooth/reabilitação , Doença de Charcot-Marie-Tooth/terapia , Deformidades do Pé/cirurgia , Deformidades do Pé , Tendão do Calcâneo/anormalidades , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo
5.
Eur J Neurol ; 17(5): 760-2, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20039940

RESUMO

BACKGROUND: Oxidative stress is a central factor in the pathogenesis of Parkinson's disease (PD). Heme oxygenase-1 (HO-1) is an antioxidant protein expressed in response to oxidative challenge, and its expression levels are inversely correlated with glycogen synthase kinase-3beta (GSK3beta) activity. Underexpression of HO-1 in concert with an upregulation of GSK3beta would result in a less effective antioxidant response and might increase the risk of PD. METHODS: We examined two functional polymorphism in the promoter regions of HO-1 (-413, rs2071746) and GSK3beta (-157, rs6438552) in a group of 251 Spanish patients with PD and 234 controls. RESULTS: Subjects carrying both the HO-1 (-413, rs2071746) TT genotype and the GSK3beta (-157, rs6438552) TT genotype had a four times higher risk of developing PD than subjects without these genotypes (adjusted by age and sex OR = 4.12; 95% CI = 1.45-11.71; Bonferroni corrected P = 0.024). CONCLUSIONS: Considering synergistic effects between polymorphisms in oxidative stress-related genes may help in determining the risk profile for PD.


Assuntos
Predisposição Genética para Doença/genética , Quinase 3 da Glicogênio Sintase/genética , Heme Oxigenase-1/genética , Estresse Oxidativo/genética , Doença de Parkinson/enzimologia , Doença de Parkinson/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Frequência do Gene/genética , Genótipo , Glicogênio Sintase Quinase 3 beta , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético/genética , Regiões Promotoras Genéticas/genética , Medição de Risco
6.
Acta Neurol Scand ; 121(2): 136-8, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19785642

RESUMO

OBJECTIVE: Oxidative stress is implicated in Parkinson's disease (PD) and Alzheimer's disease (AD), and heme oxygenase-1 (HO-1) is a potent antioxidant overexpressed in PD substantia nigra and AD cerebral cortex and hippocampus, indicating a possible up-regulation of antioxidant defenses in both neurodegenerative diseases. The role of HO-1 in peripheral blood of PD and AD patients remains unresolved. METHODS: We measured serum HO-1 levels in 107 patients with PD, 105 patients with AD, 104 controls for PD and 120 controls for AD. RESULTS: The median serum concentration of HO-1 was significantly higher in PD patients (2.04 ng/ml) compared with that of PD controls (1.69 ng/ml, P = 0.016), with PD patients predominating over controls in the upper tertile of serum HO-1 levels, whereas there was more PD controls than PD patients in the lower tertile (P = 0.006). Median serum levels of HO-1 did not differ significantly between AD patients and AD controls. CONCLUSION: The increase of serum HO-1 levels in PD patients could indicate a systemic antioxidant reaction related to a chronic oxidative stress state in PD brain.


Assuntos
Doença de Alzheimer/sangue , Heme Oxigenase-1/sangue , Doença de Parkinson/sangue , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/genética , Apolipoproteína E4/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Índice de Gravidade de Doença , Fatores Sexuais , Fatores de Tempo
7.
Acta Neurol Scand ; 120(2): 130-3, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19154537

RESUMO

OBJECTIVE: Glycogen synthase kinase-3beta (GSK-3beta) and cyclin-dependent kinase 5 (CDK5) have been implicated as two major protein kinases involved in the abnormal hyperphosphorylation of tau in Alzheimer's disease (AD) brain, and the development of neurofibrillary tangles. CDK5 regulatory subunit 1 (CDK5R1) encodes for p35, a protein required for activation of CDK5. As both CDK5R1 and GSK-3beta genes are related to phosphorylation of tau, we examined the combined contribution of these genes to the susceptibility for AD. METHODS: In a case-control study in 283 AD patients and 263 healthy controls, we examined the combined effects between CDK5R1 (3'-UTR, rs735555) and GSK-3beta (-50, rs334558) polymorphisms on susceptibility to AD. RESULTS: Subjects carrying both the CDK5R1 (3'-UTR, rs735555) AA genotype and the GSK-3beta (-50, rs334558) CC genotype had a 12.5-fold decrease in AD risk (adjusted by age, sex and APOE status OR = 0.08, 95% CI = 0.01-0.76, P = 0.03), suggesting synergistic effects (epistasis) between both genes. CONCLUSION: These data support a role for tau phosphorylation regulating genes in risk for AD.


Assuntos
Doença de Alzheimer/genética , Quinase 5 Dependente de Ciclina/genética , Epistasia Genética , Quinase 3 da Glicogênio Sintase/genética , Subunidades Proteicas/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/etiologia , Estudos de Casos e Controles , Feminino , Glicogênio Sintase Quinase 3 beta , Humanos , Masculino , Pessoa de Meia-Idade , Fosforilação/genética , Fatores de Risco , Proteínas tau/genética
8.
Eur J Neurol ; 15(4): 431-3, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18284424

RESUMO

For the first time, the multilocus approach by the set-association method has been applied for the analysis of a cluster of five genes [tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), IL-8, IL-1alpha and IL-10] involved in the brain neuroinflammatory pathway in Parkinson's disease (PD), in a well-defined group of 197 PD patients and 173 control subjects from Spain. Set-association analysis did not reveal an independent or an interactive effect of these inflammatory genes on the PD risk.


Assuntos
Inflamação/genética , Doença de Parkinson/etiologia , Doença de Parkinson/genética , Polimorfismo de Nucleotídeo Único/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/metabolismo , Feminino , Genótipo , Humanos , Inflamação/complicações , Inflamação/metabolismo , Interleucina-10/genética , Interleucina-1alfa/genética , Interleucina-6/genética , Interleucina-8/genética , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/metabolismo , Doença de Parkinson/patologia , Espanha/epidemiologia , Fator de Necrose Tumoral alfa/genética
9.
Eur J Neurol ; 15(3): 219-22, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18290843

RESUMO

A loss in the regulatory mechanism that controls tau phosphorylation in normal brain is suggested to cause tau hyperphosphorylation in Alzheimer's disease (AD) brain and the development of neurofibrillary tangles (NFT). 14-3-3 zeta protein and butyrylcholinesterase (BCHE) are associated with NFT in AD brain and stimulate tau phosphorylation. In a case-control study in 231 AD patients and 221 healthy controls, we examined whether the combined effects between 14-3-3 zeta (rs964917 and rs983583) and BCHE (K variant) polymorphisms might be responsible for susceptibility to AD. Subjects carrying both the BCHE K allele and the 14-3-3 zeta rs964917 G/G genotype (OR = 0.44, 95% CI = 0.20-0.95, P = 0.03), or 14-3-3 zeta rs983583 G/G genotype (OR = 0.46, 95% CI = 0.21-1.00, P = 0.05) had a lower risk of developing AD than subjects without these risk genotypes. Considering synergistic effects between polymorphisms in tau phosphorylation relate-genes may help in determining the risk profile for AD.


Assuntos
Proteínas 14-3-3/genética , Doença de Alzheimer/genética , Butirilcolinesterase/genética , Predisposição Genética para Doença , Polimorfismo Genético , Risco , Proteínas 14-3-3/metabolismo , Idoso , Idoso de 80 Anos ou mais , Butirilcolinesterase/metabolismo , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
10.
J Neural Transm (Vienna) ; 115(6): 863-7, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18299793

RESUMO

A chronic inflammatory process with activation of microglial cells contribute to the neurodegeneration associated with Alzheimer's disease (AD). Estrogen could protect the brain from neurodegeneration by augmenting the secretion of the anti-inflammatory interleukin (IL)-10 from microglial cells. In a case-control study in 231 AD patients and 194 healthy controls, we examined whether the combined effects between the genes coding for aromatase (a critical enzyme in the peripheral synthesis of estrogens) and IL-10 might be responsible for susceptibility to AD. Subjects carrying both the aromatase (5 -UTR) GG and the IL-10 (-1082) GG genotypes had a six times lower risk of developing AD than subjects without these risk genotypes (OR = 0.17, 95% CI = 0.04-0.77, P = 0.02).


Assuntos
Doença de Alzheimer/genética , Aromatase/genética , Estrogênios/biossíntese , Predisposição Genética para Doença/genética , Interleucina-10/genética , Polimorfismo Genético/genética , Regiões 5' não Traduzidas/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/enzimologia , Encéfalo/enzimologia , Encéfalo/fisiopatologia , Química Encefálica/genética , Estudos de Casos e Controles , Análise Mutacional de DNA , Feminino , Frequência do Gene , Testes Genéticos , Variação Genética/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances
11.
J Neurol Neurosurg Psychiatry ; 79(2): 205-8, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17698502

RESUMO

OBJECTIVE: To describe the clinical phenotype of an autosomal-dominant pedigree with myotilinopathy. METHODS: Two symptomatic patients and six asymptomatic gene mutation carriers were examined. We performed serum chemistry, electrophysiological assessments, magnetic resonance imaging (MRI) of lower limb musculature, histochemical and immunohistochemical studies of a muscle biopsy and mutation analysis of the myotilin gene. RESULTS: Both symptomatic patients, aged 76 and 61 years, presented with late-onset, distal lower-limb weakness involving the ankle and toe flexo-extensor muscles extending up to the thigh muscles; there was mild weakness of the intrinsic hand musculature in the eldest patient. Electromyography revealed a myopathic pattern. Serum creatine kinase levels were slightly elevated. Muscle biopsy revealed myopathic changes with myotilin- and desmin-positive aggregates. Gene sequencing identified a myotilin S55F mutation. In both patients, MRI showed moderate to severe fatty atrophy of all four leg muscle compartments, extending up to the thigh musculature, mainly involving the biceps, femoris, semimembranosus, vasti and glutei muscles; intrinsic foot musculature was involved but to a lesser degree. In all six gene mutation carriers, aged from 21 to 63 years, clinical examinations showed no myopathic signs. MRI was normal in the youngest individual, whereas in the remaining five individuals the outstanding finding was fatty infiltration of the soleus muscles. CONCLUSIONS: Myotilin S55F mutations may cause a clinically distinct autosomal-dominant late-onset and lower-limb distal myopathic syndrome involving all four leg muscle compartments. MRI helps to reliably depict the topography of fatty muscle atrophy and to detect early leg muscle changes in asymptomatic gene mutation carriers.


Assuntos
Aberrações Cromossômicas , Proteínas do Citoesqueleto/genética , Análise Mutacional de DNA , Genes Dominantes/genética , Proteínas Musculares/genética , Doenças Musculares/genética , Fenótipo , Fenilalanina/genética , Serina/genética , Tecido Adiposo/patologia , Adulto , Idoso , Substituição de Aminoácidos/genética , Atrofia , Biópsia , Códon/genética , Conectina , Creatina Quinase/sangue , Eletromiografia , Éxons/genética , Feminino , Triagem de Portadores Genéticos , Humanos , Perna (Membro) , Imageamento por Ressonância Magnética , Masculino , Proteínas dos Microfilamentos , Pessoa de Meia-Idade , Debilidade Muscular/diagnóstico , Debilidade Muscular/genética , Músculo Esquelético/patologia , Atrofia Muscular/diagnóstico , Atrofia Muscular/genética , Doenças Musculares/diagnóstico , Distrofia Muscular do Cíngulo dos Membros/diagnóstico , Distrofia Muscular do Cíngulo dos Membros/genética , Mutação de Sentido Incorreto , Exame Neurológico , Linhagem
12.
Acta Neurol Scand ; 117(1): 1-14, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17854420

RESUMO

BACKGROUND: Variants in genes encoding enzymes involved in production, aggregation or degradation of beta-amyloid are potential risk factors for sporadic Alzheimer's disease (AD). METHODS: Meta-analyses on AD association with BACE1 exon 5, BACE1 intron 5, FE65 intron 13, CYP46 intron 2, alpha(1)-antichymotrypsine Ala17Thr, bleomycin hydrolase I443V, lectin-like oxidized low-density lipoprotein receptor (OLR1) 3'-UTR (+1071) and (+1073), and very-low-density lipoprotein receptor (VLDLR) 5'-UTR (CGG-repeat) polymorphisms. RESULTS: In BACE1 exon 5, genotype CC+CT acts as a protective factor in Apolipoprotein E (ApoE) epsilon 4 carriers [odds ratio (OR) = 0.57; 95% confidence interval (CI): 0.38-0.88], and as a risk factor in ApoE epsilon 4 non-carriers (OR = 1.33; 95% CI: 1.00-1.78). OLR1 3'-UTR (+1073) allele C is associated with increased risk (OR = 1.23; 95% CI: 1.01-1.50). VLDLR 5'-UTR genotype 2 is associated with increased risk (OR = 1.70; 95% CI: 1.09-2.63) in the Asian population and is protective (OR = 0.48; 95% CI: 0.26-0.86) in the non-Asian population. Other studied polymorphisms are not associated with AD. CONCLUSIONS: The overall impact on AD risk of the genes for which meta-analyses are now available is rather limited. Additional meta-analyses of other different genes encoding for A beta production, aggregation and degradation mediators might help in determining the risk profile for AD.


Assuntos
Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Encéfalo/metabolismo , Predisposição Genética para Doença/genética , Variação Genética/genética , Doença de Alzheimer/fisiopatologia , Secretases da Proteína Precursora do Amiloide/genética , Asiáticos/genética , Ácido Aspártico Endopeptidases/genética , Encéfalo/fisiopatologia , Genótipo , Humanos , Polimorfismo Genético/genética , Receptores de LDL/genética , Receptores Depuradores Classe E/genética
13.
Acta Neurol Scand ; 116(6): 409-12, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17986101

RESUMO

OBJECTIVE: As transforming growth factor-beta1 (TGF-beta1) determines important neurotrophic and neuroprotective actions, we postulated serum TGF-beta1 levels could be low in Alzheimer's disease (AD), and TGF-beta1 genetic variation could be associated with AD risk through modulating serum TGF-beta1 levels. METHODS: TGF-beta1 (-800) (rs 1800468), (-509) (rs 1800469) and (+869) (rs 1982073) polymorphisms were genotyped in 412 AD patients and 406 controls. We measured serum TGF-beta1 levels (by ELISA) in 63 AD patients and compared them with 77 age- and gender-matched non-demented controls. RESULTS: Serum TGF-beta1 levels were not different in AD patients than in controls. Distribution of the allele and genotype frequencies of TGF-beta1 polymorphisms did not differ between AD patients and controls. There was no significant correlation between serum TGF-beta1 levels and TGF-beta1 polymorphisms. CONCLUSION: Serum TGF-beta1 concentration is not a potential biomarker for AD, and TGF-beta1 genetic variants (-800, -509, and +869) are not risk factors for AD.


Assuntos
Doença de Alzheimer/sangue , Doença de Alzheimer/genética , Variação Genética/genética , Polimorfismo Genético/genética , Fator de Crescimento Transformador beta1/sangue , Fator de Crescimento Transformador beta1/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Análise Mutacional de DNA , Feminino , Frequência do Gene/genética , Marcadores Genéticos/genética , Predisposição Genética para Doença/genética , Testes Genéticos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Sensibilidade e Especificidade
15.
Acta Neurol Scand ; 116(1): 56-8, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17587256

RESUMO

OBJECTIVE: As vascular endothelial growth factor (VEGF) determines important neurotrophic and neuroprotective actions, we postulated serum VEGF levels could be abnormally low in patients with Alzheimer's disease (AD). METHODS: We measured serum VEGF levels (VEGF(165) isoform by ELISA) in 51 patients with AD by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorder Association criteria and compared with 66 age- and gender-matched non-demented controls. Patients with AD were stratified into levels of dementia severity by the Clinical Dementia Rating scale. Serum VEGF levels were stratified into upper (>309 pg/ml), middle (207-309 pg/ml), and lower (<207 pg/ml) tertiles. VEGF (-2,578) (rs 699,947) and VEGF (-634) (rs 2,010,963) polymorphisms were genotyped in patients with AD and controls. RESULTS: The mean concentration of VEGF in the serum of patients with AD (215.9 pg/ml, SD 101.5) was significantly lower than that of the controls (308.6 pg/ml, SD 223.9, P = 0.004), and decreased serum VEGF levels were associated with AD in a dose-dependent manner, the lower tertile of serum VEGF levels being associated with a fivefold increased risk for AD when compared with the upper tertile. There was no significant correlation between serum VEGF levels and age, sex, APOE alleles, AD dementia severity nor VEGF gene polymorphisms. CONCLUSION: Decrease in serum VEGF levels could contribute to the neurodegenerative process in AD.


Assuntos
Doença de Alzheimer/sangue , Fator A de Crescimento do Endotélio Vascular/sangue , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/genética , Apolipoproteína E4/genética , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Índice de Gravidade de Doença , Fatores Sexuais , Fator A de Crescimento do Endotélio Vascular/genética
16.
J Neurol Neurosurg Psychiatry ; 77(10): 1169-76, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16788010

RESUMO

OBJECTIVE: To describe a large pedigree with Charcot-Marie-Tooth disease type 1A (CMT1A) duplication in which severe pelvic and thigh musculature weakness occurred in two patients, detected by analysing the leg muscle atrophy pattern on magnetic resonance imaging (MRI). METHODS: The pedigree comprised 18 patients, aged between 15 and 85 (median 46) years, who were serially evaluated for up to three decades. All 18 patients and 13 non-affected at-risk people underwent electrophysiological examination. An MRI study of lower limb musculature was carried out in four patients. Three patients underwent sural-nerve biopsy. Genetic testing was carried out in 17 patients and in all 13 at-risk normal people. RESULTS: Fourteen patients were asymptomatic or slightly disabled. The two oldest patients, aged 84 and 80, showed a moderate phenotype. Two other patients, aged 70 and 53, showed late-onset and gradually progressive peroneal paresis extending up to the thigh and pelvic musculature, resulting in waddling gait. MRI scans of all three patients with a mild phenotype showed subtle and subclinical fatty infiltration of calf anterolateral muscle compartments, with thigh muscle involvement in one patient, and extensive atrophy of intrinsic foot muscles. In the youngest patient with proximal leg weakness, the MRI scan showed massive fatty atrophy of all the calf muscles, posteromedial thigh muscle compartments, and internal and external hip rotator muscles. Sural-nerve biopsy specimens showed hypertrophic neuropathy with no superimposed inflammation. Good correlation was seen between electrophysiological and genetic testing. CONCLUSIONS: Late in the clinical course, a small proportion of patients with CMT1A develop severe proximal leg weakness, and long-term follow-up is essential for its detection. MRI scans may show subclinical involvement of the thigh musculature.


Assuntos
Doença de Charcot-Marie-Tooth/genética , Doença de Charcot-Marie-Tooth/patologia , Músculo Esquelético/patologia , Paresia/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Charcot-Marie-Tooth/complicações , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Atrofia Muscular , Paresia/fisiopatologia , Linhagem , Pelve , Fenótipo , Coxa da Perna/patologia
18.
J Neurol ; 253(2): 181-5, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16096813

RESUMO

Cholesterol regulates the production of amyloid beta (Abeta), which is central to the pathogenesis of Alzheimer's disease (AD), with high cellular cholesterol promoting and low cellular cholesterol reducing Abeta in vitro and in vivo. High density lipoprotein (HDL) plays a central role in the removal of excess cholesterol from cells, and cholesteryl ester transfer protein (CETP) is a crucial protein involved in the regulation of HDL levels. Two common polymorphisms in the promoter region (C-629A) and exon 14 I405V of the CETP gene are associated with CETP activity and HDL levels. To investigate if these sequence variants in CETP might be of importance in mediating susceptibility to AD, independently or in concert with apolipoprotein E (APOE) epsilon4 allele, we studied a sample of 286 Spanish AD patients and 315 healthy controls. In APOE epsilon4 carriers, homozygous for the CETP (-629) A allele had approximately a three times lower risk of developing AD (odds ratio 2.33, 95% CI 1.01-5.37), than homozygous and heterozygous carriers of the CETP (-629) C allele (odds ratio 7.12, 95% CI 4.51-11.24, P for APOE epsilon4/CETP (-629) AA genotype interaction < 0.001). Our data suggest that CETP behaves as a modifier gene of the AD risk associated with the APOE epsilon4 allele, possibly through modulation of brain cholesterol metabolism.


Assuntos
Doença de Alzheimer/genética , Apolipoproteínas E/genética , Proteínas de Transporte/genética , Predisposição Genética para Doença , Glicoproteínas/genética , Polimorfismo Genético , Idoso , Idoso de 80 Anos ou mais , Alelos , Apolipoproteína E4 , Proteínas de Transferência de Ésteres de Colesterol , Intervalos de Confiança , Análise Mutacional de DNA/métodos , Éxons , Feminino , Frequência do Gene , Genótipo , Humanos , Isoleucina/genética , Masculino , Pessoa de Meia-Idade , Razão de Chances , Regiões Promotoras Genéticas , Estudos Retrospectivos , Fatores de Risco , Espanha , Valina/genética
19.
Acta Neurol Scand ; 111(6): 391-9, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15876341

RESUMO

INTRODUCTION: The genetic and clinical profile of autosomal dominant cerebellar ataxias (ADCA) displays marked geographical and ethnical variability. MATERIALS AND METHODS: We have analysed the molecular and clinical correlations in an ethnically homogeneous sample of 30 Spanish ADCA kindreds. Minimal point prevalence for the region of Cantabria was estimated. RESULTS: Seventy per cent of the families harboured known mutations. Areflexia, slow saccades and hypopallesthesia predominated in SCA2; nystagmus, pyramidal signs or areflexia restricted to the legs in SCA 3; and retinal degeneration, pyramidal signs and slow saccades in SCA 7. Anticipation and intergenerational instability were greater in SCA 7. Length of expansions and age at onset were inversely correlated in all SCA subtypes. Larger expansions correlated with areflexia in SCA 2, with pyramidal signs in SCA 3 and with early visual impairment in SCA 7. Survival was similar among the different SCA subtypes. Prevalence of ADCA in Cantabria was 1.6 cases per 100,000 population. CONCLUSIONS: This report shows the epidemiological, clinical and genetic profile of ADCA in Spain, providing additional data regarding the broad clinical heterogeneity of these disorders and the variability of the genotype-phenotype correlations.


Assuntos
Ataxia Cerebelar/epidemiologia , Ataxia Cerebelar/genética , Transtornos Cromossômicos/epidemiologia , Transtornos Cromossômicos/genética , Genes Dominantes , Adolescente , Adulto , Sistema Nervoso Central/patologia , Sistema Nervoso Central/fisiopatologia , Ataxia Cerebelar/diagnóstico , Criança , Pré-Escolar , Transtornos Cromossômicos/diagnóstico , Análise Mutacional de DNA , Feminino , Testes Genéticos , Variação Genética/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Transtornos da Motilidade Ocular/genética , Fenótipo , Prevalência , Tratos Piramidais/fisiopatologia , Reflexo Anormal/genética , Degeneração Retiniana/genética , Espanha/epidemiologia , Análise de Sobrevida , Expansão das Repetições de Trinucleotídeos
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