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Liberton DK, Almpani K, Mishra R, Bassim C, Van Ryzin C, Webb BD, Jabs EW, Engle EC, Collins FS, Manoli I, Lee JS. Oral Health-Related Quality of Life in Rare Disorders of Congenital Facial Weakness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:615. [PMID: 38791829 PMCID: PMC11121611 DOI: 10.3390/ijerph21050615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
Congenital facial weakness (CFW) encompasses a heterogenous set of rare disorders presenting with decreased facial movement from birth, secondary to impaired function of the facial musculature. The aim of the present study is to provide an analysis of subject-reported oral health-related quality of life (OHRQoL) in congenital facial weakness (CFW) disorders. Forty-four subjects with CFW and age- and sex- matched controls were enrolled in an Institutional Review Board (IRB)-approved study. Demographic data, medical and surgical history, comprehensive oral examination, and the Oral Health Impact Profile (OHIP-14) were obtained. Compared to unaffected controls, subjects with CFW had higher OHIP-14 scores overall (mean ± SD: 13.11 ± 8.11 vs. 4.46 ± 4.98, p < 0.0001) and within five of seven oral health domains, indicating decreased OHRQoL. Although subjects with Moebius syndrome (MBS) were noted to have higher OHIP-14 scores than those with Hereditary Congenital Facial Paresis (HCFP), there was no significant correlation in OHIP-14 score to age, sex, or specific diagnosis. An increase in OHIP-14 scores in subjects was detected in those who had undergone reanimation surgery. In conclusion, subjects with CFW had poorer OHRQoL compared to controls, and subjects with MBS had poorer OHRQoL than subjects with HCFP. This study provides better understanding of oral health care needs and quality of life in a CFW cohort and suggests that guidelines for dental treatment are required.
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Affiliation(s)
- Denise K. Liberton
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA; (D.K.L.); (K.A.); (C.B.)
| | - Konstantinia Almpani
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA; (D.K.L.); (K.A.); (C.B.)
| | - Rashmi Mishra
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA;
| | - Carol Bassim
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA; (D.K.L.); (K.A.); (C.B.)
| | - Carol Van Ryzin
- Metabolic Medicine Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | | | - Bryn D. Webb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (B.D.W.); (E.W.J.)
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (B.D.W.); (E.W.J.)
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN 55902, USA
| | - Elizabeth C. Engle
- Departments of Neurology and Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA;
- Departments of Neurology and Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA
| | - Francis S. Collins
- Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Irini Manoli
- Metabolic Medicine Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Janice S. Lee
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA; (D.K.L.); (K.A.); (C.B.)
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2
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Asencio-Durán M, Fernández-Gutiérrez E, Larrañaga-Cores M, Klein-Burgos C, Dabad-Moreno JV, Capote-Díez M. Ocular side effects of oncological therapies: Review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:109-132. [PMID: 37949110 DOI: 10.1016/j.oftale.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Abstract
With the advance of cancer therapy in recent years, the knowledge of the mechanisms involved in this disease has increased, which has meant an increase in the quality of life and survival of patients with tumor pathologies previously considered incurable or refractory to treatment. The number of drugs used has increased exponentially in number, and although the implicit toxicity is lower than that of conventional antineoplastic therapy, they lead to the appearance of new associated adverse effects that the ophthalmologist must recognize and manage.
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Affiliation(s)
- M Asencio-Durán
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain.
| | - E Fernández-Gutiérrez
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain
| | - M Larrañaga-Cores
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain
| | - C Klein-Burgos
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain
| | - J V Dabad-Moreno
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain
| | - M Capote-Díez
- Servicio de Oftalmología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz (IDIPAZ), Madrid, Spain
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3
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Monawwer SA, Ali S, Naeem R, Ali SH, Rabbani A, Khan M, Qazi SS, Shah SMI, Farooqui SK. Moebius Syndrome: An Updated Review of Literature. Child Neurol Open 2023; 10:2329048X231205405. [PMID: 37868706 PMCID: PMC10588417 DOI: 10.1177/2329048x231205405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 10/24/2023] Open
Abstract
Moebius Syndrome, is a rare, non-progressive congenital neuropathological syndrome characterized primarily by the underdevelopment of the facial (CN VII) and abducens nerve (CN VI). Other features of Moebius Syndrome include facial nerve paresis, ophthalmoplegias, orthodontic deficiencies (including crowded dentition, swollen and hyperplastic gingiva, dental calculus, etc.), musculoskeletal abnormalities, and impaired mental function. Due to the rarity of the disorder, very few case studies have been reported in the literature. This article summarizes the significant features of the disease according to commonalities in reported cases, along with several newly recognized features cited in recent literature. We have explored the different diagnostic criteria and the newly recognized imaging modalities that may be used. Understandably, the condition detrimentally affects a patient's quality of life; thus, treatment measures have also been outlined. This study aims to provide updated literature on Moebius Syndrome MBS and improve understanding of the condition.
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Affiliation(s)
| | - Sajjad Ali
- Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Raahim Naeem
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Hasan Ali
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Azkah Rabbani
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Maria Khan
- Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Saba Saleem Qazi
- Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan
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4
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Webb BD, Manoli I, Engle EC, Jabs EW. A framework for the evaluation of patients with congenital facial weakness. Orphanet J Rare Dis 2021; 16:158. [PMID: 33827624 PMCID: PMC8028830 DOI: 10.1186/s13023-021-01736-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
There is a broad differential for patients presenting with congenital facial weakness, and initial misdiagnosis unfortunately is common for this phenotypic presentation. Here we present a framework to guide evaluation of patients with congenital facial weakness disorders to enable accurate diagnosis. The core categories of causes of congenital facial weakness include: neurogenic, neuromuscular junction, myopathic, and other. This diagnostic algorithm is presented, and physical exam considerations, additional follow-up studies and/or consultations, and appropriate genetic testing are discussed in detail. This framework should enable clinical geneticists, neurologists, and other rare disease specialists to feel prepared when encountering this patient population and guide diagnosis, genetic counseling, and clinical care.
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Affiliation(s)
- Bryn D Webb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Irini Manoli
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth C Engle
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Ethylin W Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Piras IS, Picinelli C, Iennaco R, Baccarin M, Castronovo P, Tomaiuolo P, Cucinotta F, Ricciardello A, Turriziani L, Nanetti L, Mariotti C, Gellera C, Lintas C, Sacco R, Zuccato C, Cattaneo E, Persico AM. Huntingtin gene CAG repeat size affects autism risk: Family-based and case-control association study. Am J Med Genet B Neuropsychiatr Genet 2020; 183:341-351. [PMID: 32652810 DOI: 10.1002/ajmg.b.32806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/20/2020] [Accepted: 05/04/2020] [Indexed: 11/10/2022]
Abstract
The Huntingtin (HTT) gene contains a CAG repeat in exon 1, whose expansion beyond 39 repeats consistently leads to Huntington's disease (HD), whereas normal-to-intermediate alleles seemingly modulate brain structure, function and behavior. The role of the CAG repeat in Autism Spectrum Disorder (ASD) was investigated applying both family-based and case-control association designs, with the SCA3 repeat as a negative control. Significant overtransmission of "long" CAG alleles (≥17 repeats) to autistic children and of "short" alleles (≤16 repeats) to their unaffected siblings (all p < 10-5 ) was observed in 612 ASD families (548 simplex and 64 multiplex). Surprisingly, both 193 population controls and 1,188 neurological non-HD controls have significantly lower frequencies of "short" CAG alleles compared to 185 unaffected siblings and higher rates of "long" alleles compared to 548 ASD patients from the same families (p < .05-.001). The SCA3 CAG repeat displays no association. "Short" HTT alleles seemingly exert a protective effect from clinically overt autism in families carrying a genetic predisposition for ASD, while "long" alleles may enhance autism risk. Differential penetrance of autism-inducing genetic/epigenetic variants may imply atypical developmental trajectories linked to HTT functions, including excitation/inhibition imbalance, cortical neurogenesis and apoptosis, neuronal migration, synapse formation, connectivity and homeostasis.
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Affiliation(s)
- Ignazio Stefano Piras
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Chiara Picinelli
- Mafalda Luce Center for Pervasive Developmental Disorders, Milan, Italy
| | - Raffaele Iennaco
- Department of Biosciences, Università degli Studi di Milano, Milan, Italy.,Istituto Nazionale di Genetica Molecolare "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Marco Baccarin
- Mafalda Luce Center for Pervasive Developmental Disorders, Milan, Italy
| | - Paola Castronovo
- Mafalda Luce Center for Pervasive Developmental Disorders, Milan, Italy
| | - Pasquale Tomaiuolo
- Interdepartmental Program "Autism 0-90", "Gaetano Martino" University Hospital, University of Messina, Messina, Italy
| | - Francesca Cucinotta
- Interdepartmental Program "Autism 0-90", "Gaetano Martino" University Hospital, University of Messina, Messina, Italy
| | - Arianna Ricciardello
- Interdepartmental Program "Autism 0-90", "Gaetano Martino" University Hospital, University of Messina, Messina, Italy
| | - Laura Turriziani
- Interdepartmental Program "Autism 0-90", "Gaetano Martino" University Hospital, University of Messina, Messina, Italy
| | - Lorenzo Nanetti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Caterina Mariotti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cinzia Gellera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Carla Lintas
- Unit of Child and Adolescent NeuroPsychiatry & Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy
| | - Roberto Sacco
- Unit of Child and Adolescent NeuroPsychiatry & Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy
| | - Chiara Zuccato
- Department of Biosciences, Università degli Studi di Milano, Milan, Italy.,Istituto Nazionale di Genetica Molecolare "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Elena Cattaneo
- Department of Biosciences, Università degli Studi di Milano, Milan, Italy.,Istituto Nazionale di Genetica Molecolare "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Antonio M Persico
- Interdepartmental Program "Autism 0-90", "Gaetano Martino" University Hospital, University of Messina, Messina, Italy
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6
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Sadeghi N, Hutchinson E, Van Ryzin C, FitzGibbon EJ, Butman JA, Webb BD, Facio F, Brooks BP, Collins FS, Jabs EW, Engle EC, Manoli I, Pierpaoli C. Brain phenotyping in Moebius syndrome and other congenital facial weakness disorders by diffusion MRI morphometry. Brain Commun 2020; 2:fcaa014. [PMID: 32328577 DOI: 10.1093/braincomms/fcaa014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 11/13/2022] Open
Abstract
In this study, we used a novel imaging technique, DTI (diffusion tensor imaging)-driven tensor-based morphometry, to investigate brain anatomy in subjects diagnosed with Moebius syndrome (n = 21), other congenital facial weakness disorders (n = 9) and healthy controls (n = 15). First, we selected a subgroup of subjects who satisfied the minimum diagnostic criteria for Moebius syndrome with only mild additional neurological findings. Compared to controls, in this cohort, we found a small region of highly significant volumetric reduction in the paramedian pontine reticular formation and the medial longitudinal fasciculus, important structures for the initiation and coordination of conjugate horizontal gaze. Subsequently, we tested if volume measurements from this region could help differentiate individual subjects of the different cohorts that were included in our study. We found that this region allowed discriminating Moebius syndrome subjects from congenital facial weakness disorders and healthy controls with high sensitivity (94%) and specificity (89%). Interestingly, this region was normal in congenital facial weakness subjects with oculomotor deficits of myopathic origin, who would have been classified as Moebius on the basis of purely clinical diagnostic criteria, indicating a potential role for diffusion MRI morphometry for differential diagnosis in this condition. When the entire Moebius syndrome cohort was compared to healthy controls, in addition to this 'landmark' region, other areas of significantly reduced volume in the brainstem emerged, including the location of the nuclei and fibres of cranial nerve VI (abducens nerve), and fibres of cranial nerve VII (facial nerve), and a more rostral portion of the medial longitudinal fasciculus. The high sensitivity and specificity of DTI-driven tensor-based morphometry in reliably detecting very small areas of volumetric abnormality found in this study suggest broader applications of this analysis in personalized medicine to detect hypoplasia or atrophy of small pathways and/or brainstem nuclei in other neurological disorders.
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Affiliation(s)
- Neda Sadeghi
- Quantitative Medical Imaging Section, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA
| | - Elizabeth Hutchinson
- Quantitative Medical Imaging Section, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA.,Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85719, USA
| | - Carol Van Ryzin
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Edmond J FitzGibbon
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John A Butman
- Radiology & Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Bryn D Webb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Flavia Facio
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Brian P Brooks
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Francis S Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.,Office of the Director, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Elizabeth C Engle
- Department of Neurology and Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA
| | - Irini Manoli
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Carlo Pierpaoli
- Quantitative Medical Imaging Section, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA
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7
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Berge TLL, Lygre GB, Lie SA, Björkman L. Polymer-based dental filling materials placed during pregnancy and risk to the foetus. BMC Oral Health 2018; 18:144. [PMID: 30134965 PMCID: PMC6103982 DOI: 10.1186/s12903-018-0608-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/13/2018] [Indexed: 12/28/2022] Open
Abstract
Background Tooth-coloured polymer-based dental filling materials are currently the first choice for dental restorative treatment in many countries. However, there are some concerns about their safety. It has been shown that substances known as endocrine disrupters, which might pass through the placental barrier, are released from these materials within the first hours after curing. Thus, the placement of polymer-based dental fillings in pregnant women may put the vulnerable foetus at risk. Large epidemiological studies exploring the risk of having polymer-based dental materials placed during pregnancy are lacking. The aim of this study was to investigate the association between the placement of polymer-based dental fillings during pregnancy and adverse birth outcomes. Methods This study is based on data from the large Norwegian Mother and Child Cohort Study (MoBa). The information about dental treatment during pregnancy was obtained from questionnaires sent to the participating women during weeks 17 and 30 of pregnancy. Reported placement of “white fillings” was used as exposure marker for having received polymer-based dental filling materials. Only singleton births were included in the present study. Data were linked to the Medical Birth Registry of Norway. Logistic regression models that included the mother’s age, level of education, body mass index, parity, and smoking and alcohol consumption during pregnancy were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Different adverse birth outcomes were of interest in the present study. Results Valid data were available from 90,886 pregnancies. Dentist consultation during pregnancy was reported by 33,727 women, 10,972 of whom had white fillings placed. The adjusted logistic regression models showed no statistically significant association between having white dental fillings placed during pregnancy and stillbirth, malformations, preterm births, and low or high birth weight. Conclusions In this study, women who reported white fillings placed during pregnancy had no increased risk for adverse birth outcomes compared with women who did not consult a dentist during pregnancy. Thus, our findings do not support the hypothesis of an association between placement of polymer-based fillings during pregnancy and adverse birth outcomes.
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Affiliation(s)
- Trine Lise Lundekvam Berge
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway. .,Oral Health Centre of Expertise in Western Norway, Bergen, Hordaland, Norway.
| | | | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lars Björkman
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway.,Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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8
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Kumar P, Kumar HA, Sundaresan L, Ghosh A, Kathirvel P, Thilak A, Katakia YT, Sankaranarayanan K, Chatterjee S. Thalidomide remodels developing heart in chick embryo: discovery of a thalidomide mediated hematoma in heart muscle. Naunyn Schmiedebergs Arch Pharmacol 2018; 391:1093-1105. [PMID: 29982937 DOI: 10.1007/s00210-018-1532-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/22/2018] [Indexed: 12/28/2022]
Abstract
Despite of medical disaster caused by thalidomide in 1960s, the drug came to clinical use again for the treatment of erythema nodosum leprosum (ENL) and multiple myeloma. Recently, a new generation of children affected by thalidomide intake by their mothers during pregnancy has been identified in Brazil. In the past few years, there is the great enhancement in our understanding of the molecular mechanisms and targets of thalidomide with the help of modern OMICS technologies. However, understanding of cardiac-specific anomalies in fetus due to thalidomide intake by the respective mother has not been explored fully. At organ level, thalidomide causes congenital heart diseases, limb deformities in addition to ocular, and neural and ear abnormalities. The period of morning sickness and cardiogenesis is synchronized in pregnant women. Therefore, thalidomide intake during the first trimester could affect cardiogenesis severely. Thalidomide intake in pregnant women either causes miscarriage or heart abnormalities such as patent ductus arteriosus, ventricular septal defect (VSD), atrial septal defect (ASD), and pulmonary stenosis in survivors. In the present study, we identified a novel morphological defect (lump) in the heart of thalidomide-treated chick embryos. We characterized the lump at morphological, histo-pathological, oxidative stress, electro-physiological, and gene expression level. To our knowledge, here, we report the very first electrophysiological characterization of embryonic heart affected by thalidomide treatment.
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Affiliation(s)
- Pavitra Kumar
- Vascular Biology Laboratory, AU-KBC Research Centre, Chennai, Tamil Nadu, India
| | - Harish A Kumar
- Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India
| | - Lakshmikirupa Sundaresan
- Vascular Biology Laboratory, AU-KBC Research Centre, Chennai, Tamil Nadu, India.,Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India
| | - Anuran Ghosh
- Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India
| | | | - Apurva Thilak
- Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India
| | - Yash T Katakia
- Vascular Biology Laboratory, AU-KBC Research Centre, Chennai, Tamil Nadu, India.,Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India
| | | | - Suvro Chatterjee
- Vascular Biology Laboratory, AU-KBC Research Centre, Chennai, Tamil Nadu, India. .,Department of Biotechnology, Anna University, Chennai, Tamil Nadu, India. .,AU-KBC Research Centre, M.I.T Campus of Anna University, Chromepet, Chennai, 600044, India.
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9
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Tenorio JDR, Figueiredo MA, Espindula A, Gallottini M, Ortega KL. An interesting case of systemic lupus erythematosus in a patient with Moebius syndrome. SPECIAL CARE IN DENTISTRY 2018; 38:112-115. [PMID: 29356035 DOI: 10.1111/scd.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Moebius' syndrome (MS) is characterized by a nonprogressive facial palsy associated with impairment in eye abduction, which can be uni- or bilateral. Some authors raise the possibility that patients with MS may suffer from social stigmatism due to their facial dysmorphism and that constant teasing and bullying perpetrated by people in the same social circle are adjuvants in the development of low self-esteem, behavioral problems, and even psychiatric disorders. Psychological stress, anxiety, and depression are factors contributing to both development and impairment of autoimmune diseases, such as systemic lupus erythematosus (SLE). The objective of this work is to report the case of a patient with MS who developed SLE. In the present case report, we have emphasized the importance of both clinical dental examination and surgeon-dentist in the early diagnosis of systemic diseases by considering that these conditions can affect both syndromic and normoreactive patients.
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Affiliation(s)
| | | | - Aline Espindula
- Special Care Dentistry Center, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marina Gallottini
- Department of Oral Pathology, Special Care Dentistry Centre, University of São Paulo, São Paulo, Brazil
| | - Karem López Ortega
- Department of Oral Pathology, Special Care Dentistry Centre, University of São Paulo, São Paulo, Brazil
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10
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Verner A, Agarwal-Sinha S, Han FY. Möbius syndrome with cardiac rhabdomyomas. Ophthalmic Genet 2018; 39:373-376. [PMID: 29336632 DOI: 10.1080/13816810.2017.1423336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Möbius syndrome is a rare congenital condition which presents not merely with 6th and 7th nerve palsies, but involves gaze paresis associated with craniofacial, limb, and other abnormalities. Heterogeneity is well known in patients with Möbius syndrome and rather than being of familial inheritance based on rare cases, it is much more recognized as a sporadic syndrome. We report an infant with features of congenital Möbius syndrome associated with cardiac rhabdomyomas in the absence of tuberous sclerosis. MATERIALS AND METHODS Observational case report of an infant seen at a tertiary academic center with genetic testing, ophthalmic, neurological, and cardiac clinical examination and imaging. RESULTS A newborn baby boy at birth was seen with multiple congenital craniofacial malformations, and respiratory distress. He was noted to have micrognathia, retrognathia, wide nasal bridge, low set ears, high arched palate, nonreducing bilateral talipes equinovarus and bilateral large angle esotropia with -4 abduction deficit and facial palsy, findings suggestive of Möbius Syndrome. MRI of the brain was unremarkable except for syringomyelia in the cervical spine. Echocardiography showed two cardiac rhabdomyomas in the right ventricle and ulltrasound of the abdomen showed mild right hydroneprosis. Cytogenetics revealed segmental loss at 21q21.2. Testing for tuberous sclerosis was negative for deletion or duplications of genes TSC1 and TSC2. CONCLUSION This case highlights the rare co-occurrence of cardiac rhabdomyomas with Möbius syndrome and new segmental loss at 21q21.2 on genetic testing. Findings could indicate not a "suggestion of Möbius", but rather the syndrome itself in association with cardiac defects.
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Affiliation(s)
- Aimee Verner
- a Department of Ophthalmology , University of Florida , Gainesville , FL , USA
| | - Swati Agarwal-Sinha
- a Department of Ophthalmology , University of Florida , Gainesville , FL , USA
| | - Frank Yanfeng Han
- b Department of Congenital Heart Center , University of Florida , Gainesville , FL , USA
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An exome sequencing study of Moebius syndrome including atypical cases reveals an individual with CFEOM3A and a TUBB3 mutation. Cold Spring Harb Mol Case Stud 2017; 3:a000984. [PMID: 28299356 PMCID: PMC5334472 DOI: 10.1101/mcs.a000984] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Moebius syndrome is characterized by congenital unilateral or bilateral facial and abducens nerve palsies (sixth and seventh cranial nerves) causing facial weakness, feeding difficulties, and restricted ocular movements. Abnormalities of the chest wall such as Poland anomaly and variable limb defects are frequently associated with this syndrome. Most cases are isolated; however, rare families with autosomal dominant transmission with incomplete penetrance and variable expressivity have been described. The genetic basis of this condition remains unknown. In a cohort study of nine individuals suspected to have Moebius syndrome (six typical, three atypical), we performed whole-exome sequencing to try to identify a commonly mutated gene. Although no such gene was identified and we did not find mutations in PLXND1 and REV3L, we found a de novo heterozygous mutation, p.E410K, in the gene encoding tubulin beta 3 class III (TUBB3), in an individual with atypical Moebius syndrome. This individual was diagnosed with near-complete ophthalmoplegia, agenesis of the corpus callosum, and absence of the septum pellucidum. No substantial limb abnormalities were noted. Mutations in TUBB3 have been associated with complex cortical dysplasia and other brain malformations and congenital fibrosis of extraocular muscles type 3A (CFEOM3A). Our report highlights the overlap of genetic etiology and clinical differences between CFEOM and Moebius syndrome and describes our approach to identifying candidate genes for typical and atypical Moebius syndrome.
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12
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Hosseinpour M, Mashayekhi F, Bidabadi E, Salehi Z. Neuropilin-2 rs849563 gene variations and susceptibility to autism in Iranian population: A case-control study. Metab Brain Dis 2017; 32:1471-1474. [PMID: 28484884 DOI: 10.1007/s11011-017-0024-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental disruptions usually diagnosed in the first three years of child's life that characterized by some impairments in verbal and nonverbal communication, problems in social interactions and repetitive behaviors. The neuropilin-2 (NRP2) gene has been shown to both guide axons and control neuronal migration in the central nervous system (CNS). In this study the association between the NRP2 gene and autism using a cohort of 120 Iranian children (50 cases with autism and 70 control cases) was analyzed. Single nucleotide polymorphism (SNP) was genotyped by the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analyses. There was significant difference between the genotype and allele frequency between control and patient groups (P = 0.003 and P = 0.01, respectively). The prevalence of genotype frequencies of TT and TG in autistic children were 40% and 60%, respectively, while in controls were 68.5% and 31.5%, respectively. The heterozyote TG was associated with an increased risk of autism compared with TT genotype (OR = 3.72, 95%CI = 1.53-6.95, P = 0.02). The allele frequencies of T and G in autistic children were 78.5% and 21.4%, respectively and in controls were 84.2% and 15.7%, respectively. The NRP2 G allele conferred a 2.29-fold increased risk to autism relative to the T allele (OR = 2.29, 95%CI = 1.23-4.29, P = 0.009). The results of this study showed that there is a significant association between rs849563 polymorphism and autism in the studied population. However in order to obtain a definitive conclusion larger studies with more samples are required to confirm the results of this study.
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Affiliation(s)
| | - Farhad Mashayekhi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
| | - Elham Bidabadi
- Faculty of Medicine, Department of Child Neurology, Guilan University of Medical Sciences, Rasht, Iran
| | - Zivar Salehi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
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Kusuma VRM, Ashton A, Moschanos D, Patil K, Perry M. Robotic assisted radical prostatectomy for localised prostate cancer in thalidomide generation. J Robot Surg 2017; 12:373-376. [PMID: 28849319 DOI: 10.1007/s11701-017-0739-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Abstract
Thalidomide was used in the late 1950s and early 1960s as a sedative for morning sickness in pregnant women. It resulted in thousands of babies being born with various congenital anomalies, such as phocomelia. Subsequently, the drug was banned for this indication. Most of the survivors have become thalidomide adults and now they are in their fifties. We report the first case of a robot-assisted radical prostatectomy in a 54-year-old male with prostate cancer and phocomelia as a result of thalidomide embryopathy. He presented with a PSA of 3.3 and was diagnosed with Gleason 3 + 4 prostate cancer. An extra peritoneal approach was chosen due to his body habitus and to avoid extreme Trendelenburg tilt. Side docking with the da Vinci robot was employed and the prostatectomy was carried out in the standard extra peritoneal fashion. At 6 months' follow-up his PSA is unrecordable and he is voiding well with minimal urinary incontinence, requiring 1 pad/day. We aim to outline our approach and highlight the technical modifications in this rare physically disabling condition.
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Affiliation(s)
| | - Annelisse Ashton
- Department of Urology, Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, GU2 7XX, UK
| | - Dimitrios Moschanos
- Department of Urology, Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, GU2 7XX, UK
| | - Krishna Patil
- Department of Urology, Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, GU2 7XX, UK
| | - Matthew Perry
- Department of Urology, Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, GU2 7XX, UK
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14
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Arterial dysgenesis and limb defects: Clinical and experimental examples. Reprod Toxicol 2017; 70:21-29. [DOI: 10.1016/j.reprotox.2016.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/07/2016] [Accepted: 10/19/2016] [Indexed: 11/21/2022]
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15
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Park JG, Tischfield MA, Nugent AA, Cheng L, Di Gioia SA, Chan WM, Maconachie G, Bosley TM, Summers CG, Hunter DG, Robson CD, Gottlob I, Engle EC. Loss of MAFB Function in Humans and Mice Causes Duane Syndrome, Aberrant Extraocular Muscle Innervation, and Inner-Ear Defects. Am J Hum Genet 2016; 98:1220-1227. [PMID: 27181683 DOI: 10.1016/j.ajhg.2016.03.023] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/21/2016] [Indexed: 11/16/2022] Open
Abstract
Duane retraction syndrome (DRS) is a congenital eye-movement disorder defined by limited outward gaze and retraction of the eye on attempted inward gaze. Here, we report on three heterozygous loss-of-function MAFB mutations causing DRS and a dominant-negative MAFB mutation causing DRS and deafness. Using genotype-phenotype correlations in humans and Mafb-knockout mice, we propose a threshold model for variable loss of MAFB function. Postmortem studies of DRS have reported abducens nerve hypoplasia and aberrant innervation of the lateral rectus muscle by the oculomotor nerve. Our studies in mice now confirm this human DRS pathology. Moreover, we demonstrate that selectively disrupting abducens nerve development is sufficient to cause secondary innervation of the lateral rectus muscle by aberrant oculomotor nerve branches, which form at developmental decision regions close to target extraocular muscles. Thus, we present evidence that the primary cause of DRS is failure of the abducens nerve to fully innervate the lateral rectus muscle in early development.
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Affiliation(s)
- Jong G Park
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, Boston, MA 02115, USA; Duke University School of Medicine, Durham, NC 27710, USA
| | - Max A Tischfield
- Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Alicia A Nugent
- Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Program in Neuroscience, Harvard Medical School, Boston, MA 02115, USA
| | - Long Cheng
- Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Silvio Alessandro Di Gioia
- Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Wai-Man Chan
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Gail Maconachie
- Ulverscroft Eye Unit, University of Leicester, Leicester LE2 7LX, UK; Department of Neuroscience, Psychology, and Behavior, University of Leicester, Leicester LE2 7LX, UK
| | - Thomas M Bosley
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA
| | - C Gail Summers
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN 55455, USA; Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - David G Hunter
- Department of Ophthalmology, Boston Children's Hospital, Boston, MA 02115, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Boston, MA 02115, USA; Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| | - Irene Gottlob
- Ulverscroft Eye Unit, University of Leicester, Leicester LE2 7LX, UK; Department of Neuroscience, Psychology, and Behavior, University of Leicester, Leicester LE2 7LX, UK
| | - Elizabeth C Engle
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, Boston, MA 02115, USA; Program in Neuroscience, Harvard Medical School, Boston, MA 02115, USA; Department of Ophthalmology, Boston Children's Hospital, Boston, MA 02115, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA.
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16
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Lubinsky M. Blastogenetic associations: General considerations. Am J Med Genet A 2015; 167A:2589-93. [PMID: 26174333 DOI: 10.1002/ajmg.a.37239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 06/03/2015] [Indexed: 12/22/2022]
Abstract
Associations of anomalies, with VACTERL as the prototype, have been the source of much debate, including questions about the validity and definition of this category. Evidence is presented for a teratologic basis for associations involving interactions between disruptive events and specific vulnerabilities. Because the embryo is organized in time and space, differences in the timing, location, and severity of exposures will create variable sequelae for any specific vulnerability, creating associations. The blastogenetic stage of development involves distinct properties that affect the nature of associations arising during this time, including relatively undifferentiated developmental fields and causally nonspecific malformations. With this, single anomalies can be part of the spectrum of findings that comprise a specific association. A specific defect defines a subset of disturbances, biasing frequencies of other defects. Processes are basic, integrated, and general, so disruptions are often lethal, and can have multiple effects, accounting for high incidences of multiple anomalies, and overlaps between associations. Blastogenetic disturbances also do not affect the late "fine tuning" of minor anomalies, although pathogenetic sequences can occur. This model suggests that certain combinations of congenital anomalies can arise from causally nonspecific teratogenetic fields determined by timing, location, and vulnerabilities, rather than polytopic developmental fields.
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Affiliation(s)
- Mark Lubinsky
- 6003 W. Washington Blvd, Wauwatosa, Wisconsin, 53213
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Vargesson N. Thalidomide-induced teratogenesis: history and mechanisms. ACTA ACUST UNITED AC 2015; 105:140-56. [PMID: 26043938 PMCID: PMC4737249 DOI: 10.1002/bdrc.21096] [Citation(s) in RCA: 458] [Impact Index Per Article: 50.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/12/2015] [Indexed: 12/19/2022]
Abstract
Nearly 60 years ago thalidomide was prescribed to treat morning sickness in pregnant women. What followed was the biggest man‐made medical disaster ever, where over 10,000 children were born with a range of severe and debilitating malformations. Despite this, the drug is now used successfully to treat a range of adult conditions, including multiple myeloma and complications of leprosy. Tragically, a new generation of thalidomide damaged children has been identified in Brazil. Yet, how thalidomide caused its devastating effects in the forming embryo remains unclear. However, studies in the past few years have greatly enhanced our understanding of the molecular mechanisms the drug. This review will look at the history of the drug, and the range and type of damage the drug caused, and outline the mechanisms of action the drug uses including recent molecular advances and new findings. Some of the remaining challenges facing thalidomide biologists are also discussed. Birth Defects Research (Part C) 105:140–156, 2015. © 2015 The Authors Birth Defects Research Part C: Embryo Today: Reviews Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Neil Vargesson
- School of Medical Sciences, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
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18
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Ghassemi Jahani SA, Danielson B, Karlsson J, Danielsson AJ. Long-term follow-up of thalidomide embryopathy: malformations and development of osteoarthritis in the lower extremities and evaluation of upper extremity function. J Child Orthop 2014; 8:423-33. [PMID: 25301261 PMCID: PMC4391049 DOI: 10.1007/s11832-014-0609-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 08/28/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Between 1959 and 1962, several children with multiple malformations were born after maternal intake of thalidomide during pregnancy, known as thalidomide embryopathy (TE). OBJECTIVES The aim of this study was to evaluate the malformations, their long-term effect on the function of the extremities and the development of degenerative osteoarthritis (OA) in the lower extremities. METHODS All living persons with TE in Sweden were invited to participate in the study. Thirty-one patients were examined clinically as a part of a multi-disciplinary follow-up programme. Evaluation of upper and lower limb function was performed by validated questionnaires [Disabilities of the Arm, Shoulder and Hand (DASH) and Rheumatoid and Arthritis Outcome Score (RAOS), respectively] and radiographic appearance of lower limbs by the use of spiral computed tomography. RESULTS Five individuals had severe malformations of the lower limbs and proximal femoral focal deficiency (PFFD), with significantly reduced function as found on the RAOS values. Twenty-seven patients had two fully functional arms and hands, despite the fact that 8% of shoulders, 26% of elbows/forearms and 70% of hands were malformed. Loss of gripping function did not significantly affect the upper extremity function, as measured by the DASH score. Ten patients without major deformities had OA in the hips and 15 in the knees, mostly mild and with no effect on the RAOS value. CONCLUSION A wide variety of malformations in the upper and lower limbs was found in the study group. Degenerative changes were found in the hips and the knees but were mostly mild and without major clinical significance. Despite upper limb anomalies that affected the fine motor skills, upper extremity function was not significantly reduced for most individuals. Individuals with PFFD along with major deformities of upper limbs had a reduced function of upper as well as lower limbs.
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Affiliation(s)
- Shadi A. Ghassemi Jahani
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden ,Department of Orthopaedics, Kungälv Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Barbro Danielson
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aina J. Danielsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Guedes ZCF. Möbius syndrome: misoprostol use and speech and language characteristics. Int Arch Otorhinolaryngol 2014; 18:239-43. [PMID: 25992099 PMCID: PMC4297037 DOI: 10.1055/s-0033-1363466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 08/23/2013] [Indexed: 11/15/2022] Open
Abstract
Introduction Möbius syndrome (MS; VI and VII palsy) is a rare disease that in Brazil has a great frequency because of the use of misoprostol during pregnancy. Objective Verify if the speech and language performance of children with MS whose mothers reported use of misoprostol (Cytotec, Pfizer, Connecticut, USA) are different from the performance of children of mothers who did not report use. Methods The stomatognathic system beyond receptive and expressive language and speech was evaluated in children with MS, and their mothers were questioned whether they used misoprostol during the pregnancy. Results During the interview, 61.11% of mothers reported that they took misoprostol during the pregnancy. Most of the subjects (83.3%) whose mothers took misoprostol presented bilateral palsy beyond bad mobility of the tongue (90.9%) and speech disorders (63.6%). Conclusion The number of mothers who took misoprostol without knowing the risk for MS was great. The lack of facial expressions and speech disorders were common characteristics of the individuals with MS, whether the mothers took misoprostol during the pregnancy or not.
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Persico AM, Merelli S. Environmental Factors in the Onset of Autism Spectrum Disorder. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2014. [DOI: 10.1007/s40474-013-0002-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hall JG. Arthrogryposis (multiple congenital contractures) associated with failed termination of pregnancy. Am J Med Genet A 2012; 158A:2214-20. [DOI: 10.1002/ajmg.a.35531] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 05/21/2012] [Indexed: 11/06/2022]
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Koenig CM, Walker CK, Qi L, Pessah IN, Berman RF. Lack of evidence for neonatal misoprostol neurodevelopmental toxicity in C57BL6/J mice. PLoS One 2012; 7:e38911. [PMID: 22719983 PMCID: PMC3374803 DOI: 10.1371/journal.pone.0038911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 05/16/2012] [Indexed: 11/18/2022] Open
Abstract
Misoprostol is a synthetic analogue of prostaglandin E1 that is administered to women at high doses to induce uterine contractions for early pregnancy termination and at low doses to aid in cervical priming during labor. Because of the known teratogenic effects of misoprostol when given during gestation and its effects on axonal growth in vitro, we examined misoprostol for its potential as a neurodevelopmental toxicant when administered to neonatal C57BL6/J mice. Mice were injected subcutaneously (s.c.) with 0.4, 4 or 40 µg/kg misoprostol on postnatal day 7, the approximate developmental stage in mice of human birth, after which neonatal somatic growth, and sensory and motor system development were assessed. These doses were selected to span the range of human exposure used to induce labor. In addition, adult mice underwent a battery of behavioral tests relevant to neurodevelopmental disorders such as autism including tests for anxiety, stereotyped behaviors, social communication and interactions, and learning and memory. No significant effects of exposure were found for any measure of development or behavioral endpoints. In conclusion, the results of the present study in C57BL/6J mice do not provide support for neurodevelopmental toxicity after misoprostol administration approximating human doses and timed to coincide with the developmental stage of human birth.
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Affiliation(s)
- Claire M. Koenig
- Center for Children's Environmental Health, University of California Davis, Davis, California, United States of America
- Department of Neurological Surgery, University of California Davis, Davis, California, United States of America
| | - Cheryl K. Walker
- Center for Children's Environmental Health, University of California Davis, Davis, California, United States of America
- Department of Obstetrics and Gynecology, University of California Davis, Davis, California, United States of America
| | - Lihong Qi
- Center for Children's Environmental Health, University of California Davis, Davis, California, United States of America
- Division of Biostatistics, Department of Public Health, University of California Davis, Davis, California, United States of America
| | - Isaac N. Pessah
- Center for Children's Environmental Health, University of California Davis, Davis, California, United States of America
- Department of VM: Molecular Biosciences, University of California Davis, Davis, California, United States of America
| | - Robert F. Berman
- Center for Children's Environmental Health, University of California Davis, Davis, California, United States of America
- Department of Neurological Surgery, University of California Davis, Davis, California, United States of America
- * E-mail:
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Abstract
PURPOSE OF REVIEW The thalidomide tragedy of the early 1960s resulted in a great number of studies and reports involving many specialties of medicine. Because of the estimated large number of affected children (5000+) worldwide exposed to this potent teratogen, and the many informative cases in which the exposure time was known, a teratogenic timetable was constructed relating affected structures to the time of exposure. This demonstrated that thalidomide had a teratogenic effect between approximately 20 to 36 days after fertilization. RECENT FINDINGS We found that Duane syndrome and its variants were prominent in individuals who were exposed to thalidomide early in the sensitive period (days 20 to 26±). Other anomalies associated with this early effect were aberrant tearing, facial nerve palsy, ear malformations, and autism. Structural eye malformations were less frequent in this early phase, appearing slightly later in the sensitive period. SUMMARY This study summarizes the ophthalmologic findings from a number of studies and compares them with respect to the implications of time of exposure. Because the timing of anomalies such as external ear and limb malformations are well established in the thalidomide literature, correlation with associated eye anomalies gives insight into the approximate timing of the causative teratogen exposure.
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Di Martino A, Kelly C, Grzadzinski R, Zuo XN, Mennes M, Mairena MA, Lord C, Castellanos FX, Milham MP. Aberrant striatal functional connectivity in children with autism. Biol Psychiatry 2011; 69:847-56. [PMID: 21195388 PMCID: PMC3091619 DOI: 10.1016/j.biopsych.2010.10.029] [Citation(s) in RCA: 330] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 10/18/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Models of autism spectrum disorders (ASD) as neural disconnection syndromes have been predominantly supported by examinations of abnormalities in corticocortical networks in adults with autism. A broader body of research implicates subcortical structures, particularly the striatum, in the physiopathology of autism. Resting state functional magnetic resonance imaging has revealed detailed maps of striatal circuitry in healthy and psychiatric populations and vividly captured maturational changes in striatal circuitry during typical development. METHODS Using resting state functional magnetic resonance imaging, we examined striatal functional connectivity (FC) in 20 children with ASD and 20 typically developing children between the ages of 7.6 and 13.5 years. Whole-brain voxelwise statistical maps quantified within-group striatal FC and between-group differences for three caudate and three putamen seeds for each hemisphere. RESULTS Children with ASD mostly exhibited prominent patterns of ectopic striatal FC (i.e., functional connectivity present in ASD but not in typically developing children), with increased functional connectivity between nearly all striatal subregions and heteromodal associative and limbic cortex previously implicated in the physiopathology of ASD (e.g., insular and right superior temporal gyrus). Additionally, we found striatal functional hyperconnectivity with the pons, thus expanding the scope of functional alterations implicated in ASD. Secondary analyses revealed ASD-related hyperconnectivity between the pons and insula cortex. CONCLUSIONS Examination of FC of striatal networks in children with ASD revealed abnormalities in circuits involving early developing areas, such as the brainstem and insula, with a pattern of increased FC in ectopic circuits that likely reflects developmental derangement rather than immaturity of functional circuits.
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Affiliation(s)
- Adriana Di Martino
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY
| | - Clare Kelly
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY
| | - Rebecca Grzadzinski
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY
| | - Xi-Nian Zuo
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY
| | - Maarten Mennes
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY
| | | | - Catherine Lord
- University of Michigan Autism and Communication Disorders Center, Ann Arbor, MI
| | - F. Xavier Castellanos
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
| | - Michael P Milham
- Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience at the Child Study Center of the NYU Langone Medical Center, NY, NY,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
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25
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Kim JH, Scialli AR. Thalidomide: the tragedy of birth defects and the effective treatment of disease. Toxicol Sci 2011; 122:1-6. [PMID: 21507989 DOI: 10.1093/toxsci/kfr088] [Citation(s) in RCA: 245] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Thalidomide was a widely used drug in the late 1950s and early 1960s for the treatment of nausea in pregnant women. It became apparent in the 1960s that thalidomide treatment resulted in severe birth defects in thousands of children. Though the use of thalidomide was banned in most countries at that time, thalidomide proved to be a useful treatment for leprosy and later, multiple myeloma. In rural areas of the world that lack extensive medical surveillance initiatives, thalidomide treatment of pregnant women with leprosy has continued to cause malformations. Research on thalidomide mechanisms of action is leading to a better understanding of molecular targets. With an improved understanding of these molecular targets, safer drugs may be designed. The thalidomide tragedy marked a turning point in toxicity testing, as it prompted United States and international regulatory agencies to develop systematic toxicity testing protocols; the use of thalidomide as a tool in developmental biology led to important discoveries in the biochemical pathways of limb development. In celebration of the Society of Toxicology's 50th Anniversary, which coincides with the 50th anniversary of the withdrawal of thalidomide from the market, it is appropriate to revisit the lessons learned from the thalidomide tragedy of the 1960s.
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Affiliation(s)
- James H Kim
- ILSI Health and Environmental Sciences Institute, Washington, DC 20005, USA.
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Holmes LB. Human teratogens: Update 2010. ACTA ACUST UNITED AC 2011; 91:1-7. [DOI: 10.1002/bdra.20748] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 09/13/2010] [Accepted: 09/14/2010] [Indexed: 12/28/2022]
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The natural history of Möbius syndrome in a 32-year-old man. Neurol Neurochir Pol 2011; 45:74-9. [DOI: 10.1016/s0028-3843(14)60063-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Tamiji J, Crawford DA. Misoprostol elevates intracellular calcium in Neuro-2a cells via protein kinase A. Biochem Biophys Res Commun 2010; 399:565-70. [PMID: 20678471 DOI: 10.1016/j.bbrc.2010.07.112] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 07/27/2010] [Indexed: 11/15/2022]
Abstract
Misoprostol, a prostaglandin type E analogue, has been implicated in a number of neurodevelopmental disorders. However, its mode of action in the nervous system is not well understood. Misoprostol acts on the same receptors as prostaglandin E(2) (PGE(2)), a natural lipid-derived compound, which mediates important physiological functions in the nervous system via activation of four EP receptors (EP1-4). In this study we use a ratiometric calcium imaging with fura-2 AM as a calcium indicator to show that misoprostol alters intracellular calcium levels in mouse neuroblastoma (Neuro-2a) cells via similar mechanisms as PGE(2). We demonstrate that the misoprostol-induced increase in calcium is mediated by a protein kinase A (PKA)-dependent mechanism and that the EP4 receptor signaling pathway may play an inhibitory role on calcium regulation. Overall, this study provides further support for the involvement of PGE(2) signaling in calcium homeostasis and suggests its important role in the nervous system.
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Affiliation(s)
- Javaneh Tamiji
- School of Kinesiology and Health Science, York University, Toronto, Canada; Neuroscience Graduate Diploma Program, York University, Toronto, Canada
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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