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Abstract
Autoinflammatory disorders are sterile inflammatory conditions characterized by episodes of early-onset fever, rash, and disease-specific patterns of organ inflammation. Gain-of-function mutations in innate danger-sensing pathways, including the inflammasomes and the nucleic acid sensing pathways, play critical roles in the pathogenesis of IL-1 and Type-I IFN-mediated disorders and point to an important role of excessive proinflammatory cytokine signaling, including interleukin (IL)-1b , Type-I interferons, IL-18, TNF and others in causing the organ specific immune dysregulation. The article discusses the concept of targeting proinflammatory cytokines and their signaling pathways with cytokine blocking treatments that have been life changing for some patients.
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Affiliation(s)
- Kyawt Win Shwin
- Translational Autoinflammatory Disease Studies, Rheumatology Fellowship Program, National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Building 10, Room 6D-52, 10 Center Drive, Bethesda, MD 20892, USA; Division of Rheumatic Diseases, UT Southwestern Medical Center, Dallas VA Medical Center, North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA
| | - Chyi-Chia Richard Lee
- Dermatopathology Section, Laboratory of Pathology, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Building 10, Room 2S235J, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Raphaela Goldbach-Mansky
- Translational Autoinflammatory Disease Studies, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Building 10, Room 6D-47B, 10 Center Drive, Bethesda, MD 20892, USA.
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Moore CA, Staples JE, Dobyns WB, Pessoa A, Ventura CV, da Fonseca EB, Ribeiro EM, Ventura LO, Neto NN, Arena JF, Rasmussen SA. Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians. JAMA Pediatr 2017; 171:288-295. [PMID: 27812690 PMCID: PMC5561417 DOI: 10.1001/jamapediatrics.2016.3982] [Citation(s) in RCA: 625] [Impact Index Per Article: 89.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance Zika virus infection can be prenatally passed from a pregnant woman to her fetus. There is sufficient evidence to conclude that intrauterine Zika virus infection is a cause of microcephaly and serious brain anomalies, but the full spectrum of anomalies has not been delineated. To inform pediatric clinicians who may be called on to evaluate and treat affected infants and children, we review the most recent evidence to better characterize congenital Zika syndrome. Observations We reviewed published reports of congenital anomalies occurring in fetuses or infants with presumed or laboratory-confirmed intrauterine Zika virus infection. We conducted a comprehensive search of the English literature using Medline and EMBASE for Zika from inception through September 30, 2016. Congenital anomalies were considered in the context of the presumed pathogenetic mechanism related to the neurotropic properties of the virus. We conclude that congenital Zika syndrome is a recognizable pattern of structural anomalies and functional disabilities secondary to central and, perhaps, peripheral nervous system damage. Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital infections, there are 5 features that are rarely seen with other congenital infections or are unique to congenital Zika virus infection: (1) severe microcephaly with partially collapsed skull; (2) thin cerebral cortices with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early hypertonia and symptoms of extrapyramidal involvement. Conclusions and Relevance Although the full spectrum of adverse reproductive outcomes caused by Zika virus infection is not yet determined, a distinctive phenotype-the congenital Zika syndrome-has emerged. Recognition of this phenotype by clinicians for infants and children can help ensure appropriate etiologic evaluation and comprehensive clinical investigation to define the range of anomalies in an affected infant as well as determine essential follow-up and ongoing care.
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Affiliation(s)
- Cynthia A. Moore
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - J. Erin Staples
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO
| | - William B. Dobyns
- University of Washington and Seattle Children’s Research Institute, Seattle, WA
| | - André Pessoa
- Hospital Infantil Albert Sabin, Fortaleza, Ceará, Brazil
| | - Camila V. Ventura
- Altino Ventura Foundation, Recife, Pernambuco, Brazil
- HOPE Eye Hospital, Recife, Pernambuco, Brazil
- Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - Eduardo Borges da Fonseca
- NOVA Diagnóstico Por Imagem, João Pessoa, Paraíba, Brazil
- Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
| | - Erlane Marques Ribeiro
- Hospital Infantil Albert Sabin, Fortaleza, Ceará, Brazil
- Estacio Faculdade de Medicina de Juazeiro do Norte, Juazeiro do Norte, Ceará, Brazil
| | - Liana O. Ventura
- Altino Ventura Foundation, Recife, Pernambuco, Brazil
- HOPE Eye Hospital, Recife, Pernambuco, Brazil
| | | | | | - Sonja A. Rasmussen
- Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA
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Karikkineth AC, Scheibye-Knudsen M, Fivenson E, Croteau DL, Bohr VA. Cockayne syndrome: Clinical features, model systems and pathways. Ageing Res Rev 2017; 33:3-17. [PMID: 27507608 PMCID: PMC5195851 DOI: 10.1016/j.arr.2016.08.002] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/29/2016] [Accepted: 08/04/2016] [Indexed: 12/12/2022]
Abstract
Cockayne syndrome (CS) is a disorder characterized by a variety of clinical features including cachectic dwarfism, severe neurological manifestations including microcephaly and cognitive deficits, pigmentary retinopathy, cataracts, sensorineural deafness, and ambulatory and feeding difficulties, leading to death by 12 years of age on average. It is an autosomal recessive disorder, with a prevalence of approximately 2.5 per million. There are several phenotypes (1-3) and two complementation groups (CSA and CSB), and CS overlaps with xeroderma pigmentosum (XP). It has been considered a progeria, and many of the clinical features resemble accelerated aging. As such, the study of CS affords an opportunity to better understand the underlying mechanisms of aging. The molecular basis of CS has traditionally been ascribed to defects in transcription and transcription-coupled nucleotide excision repair (TC-NER). However, recent work suggests that defects in base excision DNA repair and mitochondrial functions may also play key roles. This opens up the possibility for molecular interventions in CS, and by extrapolation, possibly in aging.
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Affiliation(s)
- Ajoy C Karikkineth
- Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA
| | - Morten Scheibye-Knudsen
- Laboratory of Molecular Gerontology, National Institute on Aging, Baltimore, MD, USA; Department of Cellular and Molecular Medicine, University of Copenhagen, Denmark
| | - Elayne Fivenson
- Laboratory of Molecular Gerontology, National Institute on Aging, Baltimore, MD, USA
| | - Deborah L Croteau
- Laboratory of Molecular Gerontology, National Institute on Aging, Baltimore, MD, USA
| | - Vilhelm A Bohr
- Laboratory of Molecular Gerontology, National Institute on Aging, Baltimore, MD, USA.
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Truong DT, Shriberg LD, Smith SD, Chapman KL, Scheer-Cohen AR, DeMille MMC, Adams AK, Nato AQ, Wijsman EM, Eicher JD, Gruen JR. Multipoint genome-wide linkage scan for nonword repetition in a multigenerational family further supports chromosome 13q as a locus for verbal trait disorders. Hum Genet 2016; 135:1329-1341. [PMID: 27535846 PMCID: PMC5065602 DOI: 10.1007/s00439-016-1717-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/22/2016] [Indexed: 12/19/2022]
Abstract
Verbal trait disorders encompass a wide range of conditions and are marked by deficits in five domains that impair a person's ability to communicate: speech, language, reading, spelling, and writing. Nonword repetition is a robust endophenotype for verbal trait disorders that is sensitive to cognitive processes critical to verbal development, including auditory processing, phonological working memory, and motor planning and programming. In the present study, we present a six-generation extended pedigree with a history of verbal trait disorders. Using genome-wide multipoint variance component linkage analysis of nonword repetition, we identified a region spanning chromosome 13q14-q21 with LOD = 4.45 between 52 and 55 cM, spanning approximately 5.5 Mb on chromosome 13. This region overlaps with SLI3, a locus implicated in reading disability in families with a history of specific language impairment. Our study of a large multigenerational family with verbal trait disorders further implicates the SLI3 region in verbal trait disorders. Future studies will further refine the specific causal genetic factors in this locus on chromosome 13q that contribute to language traits.
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Affiliation(s)
- D T Truong
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA
| | - L D Shriberg
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - S D Smith
- Department of Pediatrics, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - K L Chapman
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT, 84112, USA
| | - A R Scheer-Cohen
- Department of Speech-Language Pathology, California State University, San Marcos, CA, 92096, USA
| | - M M C DeMille
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA
| | - A K Adams
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06510, USA
| | - A Q Nato
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, 98195, USA
| | - E M Wijsman
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, 98195, USA
- Department of Biostatistics and Department of Genome Sciences, University of Washington, Seattle, WA, 98195, USA
| | - J D Eicher
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06510, USA
| | - J R Gruen
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06510, USA.
- Department of Genetics, Yale School of Medicine, New Haven, CT, 06510, USA.
- Investigative Medicine Program, Yale School of Medicine, New Haven, CT, 06510, USA.
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Tonduti D, Orcesi S, Jenkinson EM, Dorboz I, Renaldo F, Panteghini C, Rice GI, Henneke M, Livingston JH, Elmaleh M, Burglen L, Willemsen MAAP, Chiapparini L, Garavaglia B, Rodriguez D, Boespflug-Tanguy O, Moroni I, Crow YJ. Clinical, radiological and possible pathological overlap of cystic leukoencephalopathy without megalencephaly and Aicardi-Goutières syndrome. Eur J Paediatr Neurol 2016; 20:604-10. [PMID: 27091087 DOI: 10.1016/j.ejpn.2016.03.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/05/2016] [Accepted: 03/27/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cystic leukoencephalopathy without megalencephaly is a disorder related in some cases to RNASET2 mutations and characterized by bilateral anterior temporal subcortical cysts and multifocal lobar white matter lesions with sparing of central white matter structures. This phenotype significantly overlaps with the sequelae of in utero cytomegalovirus (CMV) infection, including the presence of intracranial calcification in some cases. Aicardi-Goutières syndrome (AGS) is another inherited leukodystrophy with cerebral calcification mimicking congenital infection. Clinical, radiological and biochemical criteria for the diagnosis of AGS have been established, although the breadth of phenotype associated with mutations in the AGS-related genes is much greater than previously envisaged. PATIENTS AND METHODS We describe the clinical, biochemical and radiological findings of five patients demonstrating a phenotype reminiscent of AGS. RESULTS All patients were found to carry biallelic mutations of RNASET2. CONCLUSIONS Our patients illustrate the clinical and radiological overlap that can be seen between RNASET2-related leukodystrophy and AGS in some cases. Our data highlight the need to include both disorders in the same differential diagnosis, and hint at possible shared pathomechanisms related to auto-inflammation which are worthy of further investigation.
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Affiliation(s)
- Davide Tonduti
- Child Neurology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, Milan, Italy; Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Italy.
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy
| | - Emma M Jenkinson
- Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, United Kingdom
| | - Imen Dorboz
- PROTECT, INSERM U1141 Paris Diderot University, Sorbonne Paris Cité, France
| | - Florence Renaldo
- AP-HP, Departement of Neuropediatrics and Metabolic Diseases, Robert Debré Hospital, Paris, France; AP-HP, Department of Child Neurology, Hôpital Armand-Trousseau, GHUEP, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Celeste Panteghini
- Unit of Molecular Neurogenetics, Neurological Institute C. Besta Foundation IRCCS, Milan, Italy
| | - Gillian I Rice
- Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, United Kingdom
| | - Marco Henneke
- University Medical Center, Department of Pediatrics and Adolescent Medicine, Georg August University, Göttingen, Germany
| | - John H Livingston
- Department of Paediatric Neurology, F Floor, Martin Wing, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom
| | - Monique Elmaleh
- AP-HP, Department of Child Radiology, Robert Debré Hospital, Paris, France
| | - Lydie Burglen
- AP-HP, Service de Génétique et d'Embryologie Médicale, Hôpital Armand Trousseau, Paris, France
| | - Michèl A A P Willemsen
- Department of Paediatric Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luisa Chiapparini
- Neuroradiology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Barbara Garavaglia
- Unit of Molecular Neurogenetics, Neurological Institute C. Besta Foundation IRCCS, Milan, Italy
| | - Diana Rodriguez
- PROTECT, INSERM U1141 Paris Diderot University, Sorbonne Paris Cité, France; AP-HP, Department of Child Neurology, Hôpital Armand-Trousseau, GHUEP, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Odile Boespflug-Tanguy
- PROTECT, INSERM U1141 Paris Diderot University, Sorbonne Paris Cité, France; AP-HP, Departement of Neuropediatrics and Metabolic Diseases, Robert Debré Hospital, Paris, France
| | - Isabella Moroni
- Child Neurology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Yanick J Crow
- Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, United Kingdom; INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation, Paris, France; Paris Descartes, Sorbonne Paris Cité University, Institute Imagine, Paris, France
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