1
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Rauen KA, Tidyman WE. RASopathies - what they reveal about RAS/MAPK signaling in skeletal muscle development. Dis Model Mech 2024; 17:dmm050609. [PMID: 38847227 PMCID: PMC11179721 DOI: 10.1242/dmm.050609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024] Open
Abstract
RASopathies are rare developmental genetic syndromes caused by germline pathogenic variants in genes that encode components of the RAS/mitogen-activated protein kinase (MAPK) signal transduction pathway. Although the incidence of each RASopathy syndrome is rare, collectively, they represent one of the largest groups of multiple congenital anomaly syndromes and have severe developmental consequences. Here, we review our understanding of how RAS/MAPK dysregulation in RASopathies impacts skeletal muscle development and the importance of RAS/MAPK pathway regulation for embryonic myogenesis. We also discuss the complex interactions of this pathway with other intracellular signaling pathways in the regulation of skeletal muscle development and growth, and the opportunities that RASopathy animal models provide for exploring the use of pathway inhibitors, typically used for cancer treatment, to correct the unique skeletal myopathy caused by the dysregulation of this pathway.
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Affiliation(s)
- Katherine A Rauen
- Department of Pediatrics, Division of Genomic Medicine, University of California Davis, Sacramento, CA, 95817, USA
- University of California Davis MIND Institute, Sacramento, CA 95817, USA
| | - William E Tidyman
- University of California Davis MIND Institute, Sacramento, CA 95817, USA
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2
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Chippalkatti R, Parisi B, Kouzi F, Laurini C, Ben Fredj N, Abankwa DK. RAS isoform specific activities are disrupted by disease associated mutations during cell differentiation. Eur J Cell Biol 2024; 103:151425. [PMID: 38795504 DOI: 10.1016/j.ejcb.2024.151425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024] Open
Abstract
The RAS-MAPK-pathway is aberrantly regulated in cancer and developmental diseases called RASopathies. While typically the impact of Ras on the proliferation of various cancer cell lines is assessed, it is poorly established how Ras affects cellular differentiation. Here we implement the C2C12 myoblast cell line to systematically study the effect of Ras mutants and Ras-pathway drugs on differentiation. We first provide evidence that a minor pool of Pax7+ progenitors replenishes a major pool of transit amplifying cells that are ready to differentiate. Our data indicate that Ras isoforms have distinct roles in the differentiating culture, where K-Ras depletion increases and H-Ras depletion decreases terminal differentiation. This assay could therefore provide significant new insights into Ras biology and Ras-driven diseases. In line with this, we found that all oncogenic Ras mutants block terminal differentiation of transit amplifying cells. By contrast, RASopathy associated K-Ras variants were less able to block differentiation. Profiling of eight targeted Ras-pathway drugs on seven oncogenic Ras mutants revealed their allele-specific activities and distinct abilities to restore normal differentiation as compared to triggering cell death. In particular, the MEK-inhibitor trametinib could broadly restore differentiation, while the mTOR-inhibitor rapamycin broadly suppressed differentiation. We expect that this quantitative assessment of the impact of Ras-pathway mutants and drugs on cellular differentiation has great potential to complement cancer cell proliferation data.
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Affiliation(s)
- Rohan Chippalkatti
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg
| | - Bianca Parisi
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg
| | - Farah Kouzi
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg
| | - Christina Laurini
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg
| | - Nesrine Ben Fredj
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg
| | - Daniel Kwaku Abankwa
- Cancer Cell Biology and Drug Discovery group, Department of Life Sciences and Medicine, University of Luxembourg, Esch-sur-Alzette 4362, Luxembourg.
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3
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Pugliese A, Della Marina A, de Paula Estephan E, Zanoteli E, Roos A, Schara-Schmidt U, Hentschel A, Azuma Y, Töpf A, Thompson R, Polavarapu K, Lochmüller H. Mutations in PTPN11 could lead to a congenital myasthenic syndrome phenotype: a Noonan syndrome case series. J Neurol 2024; 271:1331-1341. [PMID: 37923938 DOI: 10.1007/s00415-023-12070-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/06/2023]
Abstract
The RASopathies are a group of genetic rare diseases caused by mutations affecting genes involved in the RAS/MAPK (RAS-mitogen activated protein kinase) pathway. Among them, PTPN11 pathogenic variants are responsible for approximately 50% of Noonan syndrome (NS) cases and, albeit to a lesser extent, of Leopard syndrome (LPRD1), which present a few overlapping clinical features, such as facial dysmorphism, developmental delay, cardiac defects, and skeletal deformities. Motor impairment and decreased muscle strength have been recently reported. The etiology of the muscle involvement in these disorders is still not clear but probably multifactorial, considering the role of the RAS/MAPK pathway in skeletal muscle development and Acetylcholine Receptors (AChR) clustering at the neuromuscular junction (NMJ). We report, herein, four unrelated children carrying three different heterozygous mutations in the PTPN11 gene. Intriguingly, their phenotypic features first led to a clinical suspicion of congenital myasthenic syndrome (CMS), due to exercise-induced fatigability with a variable degree of muscle weakness, and serum proteomic profiling compatible with a NMJ defect. Moreover, muscle fatigue improved after treatment with CMS-specific medication. Although the link between PTPN11 gene and neuromuscular transmission is unconfirmed, an increasing number of patients with RASopathies are affected by muscle weakness and fatigability. Hence, NS or LPDR1 should be considered in children with suspected CMS but negative genetic workup for known CMS genes or additional symptoms indicative of NS, such as facial dysmorphism or intellectual disability.
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Affiliation(s)
- Alessia Pugliese
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Adela Della Marina
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
| | - Eduardo de Paula Estephan
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Department of Neurological Sciences, Psychiatry, and Medical Psychology, Sao Jose do Rio Preto State Medical School, Sao Jose do Rio Preto, São Paulo, Brazil
| | - Edmar Zanoteli
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Andreas Roos
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, 44789, Bochum, Germany
- Leibniz-Institut Für Analytische Wissenschaften-ISAS-e.V., 44227, Dortmund, Germany
| | - Ulrike Schara-Schmidt
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders, Centre for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, 45147, Essen, Germany
| | - Andreas Hentschel
- Leibniz-Institut Für Analytische Wissenschaften-ISAS-e.V., 44227, Dortmund, Germany
| | - Yoshiteru Azuma
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, University of Newcastle, Newcastle Upon Tyne, UK
| | - Rachel Thompson
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Kiran Polavarapu
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada
| | - Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd., Ottawa, ON, K1H 8L1, Canada.
- Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada.
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada.
- Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany.
- Centro Nacional de Análisis Genómico (CNAG), Barcelona, Catalonia, Spain.
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4
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Wei X, Rigopoulos A, Lienhard M, Pöhle-Kronawitter S, Kotsaris G, Franke J, Berndt N, Mejedo JO, Wu H, Börno S, Timmermann B, Murgai A, Glauben R, Stricker S. Neurofibromin 1 controls metabolic balance and Notch-dependent quiescence of murine juvenile myogenic progenitors. Nat Commun 2024; 15:1393. [PMID: 38360927 PMCID: PMC10869796 DOI: 10.1038/s41467-024-45618-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/30/2024] [Indexed: 02/17/2024] Open
Abstract
Patients affected by neurofibromatosis type 1 (NF1) frequently show muscle weakness with unknown etiology. Here we show that, in mice, Neurofibromin 1 (Nf1) is not required in muscle fibers, but specifically in early postnatal myogenic progenitors (MPs), where Nf1 loss led to cell cycle exit and differentiation blockade, depleting the MP pool resulting in reduced myonuclear accretion as well as reduced muscle stem cell numbers. This was caused by precocious induction of stem cell quiescence coupled to metabolic reprogramming of MPs impinging on glycolytic shutdown, which was conserved in muscle fibers. We show that a Mek/Erk/NOS pathway hypersensitizes Nf1-deficient MPs to Notch signaling, consequently, early postnatal Notch pathway inhibition ameliorated premature quiescence, metabolic reprogramming and muscle growth. This reveals an unexpected role of Ras/Mek/Erk signaling supporting postnatal MP quiescence in concert with Notch signaling, which is controlled by Nf1 safeguarding coordinated muscle growth and muscle stem cell pool establishment. Furthermore, our data suggest transmission of metabolic reprogramming across cellular differentiation, affecting fiber metabolism and function in NF1.
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Affiliation(s)
- Xiaoyan Wei
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
- Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Angelos Rigopoulos
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
- Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
- International Max Planck Research School for Biology and Computation IMPRS-BAC, Berlin, Germany
| | - Matthias Lienhard
- Department of Computational Molecular Biology, Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Sophie Pöhle-Kronawitter
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Georgios Kotsaris
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Julia Franke
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
- Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Nikolaus Berndt
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Computer-assisted Cardiovascular Medicine, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joy Orezimena Mejedo
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Hao Wu
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité University Medicine Berlin, 12203, Berlin, Germany
| | - Stefan Börno
- Sequencing Core Unit, Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Bernd Timmermann
- Sequencing Core Unit, Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Arunima Murgai
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - Rainer Glauben
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité University Medicine Berlin, 12203, Berlin, Germany
| | - Sigmar Stricker
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany.
- Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany.
- International Max Planck Research School for Biology and Computation IMPRS-BAC, Berlin, Germany.
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5
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Trajković N, Rančić D, Ilić T, Herodek R, Korobeynikov G, Pekas D. Measuring handgrip strength in school children: inter-instrument reliability between Takei and Jamar. Sci Rep 2024; 14:1074. [PMID: 38212414 PMCID: PMC10784289 DOI: 10.1038/s41598-024-51368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
The aim of this study was to determine inter-instrument reliability between Takei and Jamar dynamometers in school children. Fifty-six five grade participants aged eleven to twelve (n = 32 boys, n = 24 girls) performed handgrip strength test on two different occasions, with a 5-day gap between them, as test-retest. The Pearson correlation coefficient showed very large to almost perfect correlation between both devices (r = 0.76-0.91) which was graphically confirmed by Bland-Altman method. Test-retest also showed high reliability (ICC = 0.78-0.85) for Jamar and Takei. Trivial, nonsignificant differences (p > 0.05) were observed between for test-retest trials for Takei left hand (ES = 0.04), right hand (ES = 0.12) and Jamar left hand (ES = 0.15). According to the results, both the Jamar and Takei dynamometers are valid and reliable for measuring schoolchildren, and both devices may be used to assess a student's handgrip strength for this age group.
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Affiliation(s)
- Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Doroteja Rančić
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Tamara Ilić
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Romina Herodek
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Georgiy Korobeynikov
- National University of Physical Education and Sport, Kyiv, Ukraine.
- Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
| | - Damir Pekas
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
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6
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Zenker M. Clinical overview on RASopathies. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2022; 190:414-424. [PMID: 36428239 DOI: 10.1002/ajmg.c.32015] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 11/28/2022]
Abstract
RASopathies comprise a group of clinically overlapping developmental disorders caused by genetic variations affecting components or modulators of the RAS-MAPK signaling cascade, which lead to dysregulation of signal flow through this pathway. Noonan syndrome and the less frequent, clinically related disorders, Costello syndrome, cardiofaciocutaneous syndrome, Noonan syndrome with multiple lentigines, and Noonan syndrome-like disorder with loose anagen hair are part of the RASopathy spectrum and share a recognizable pattern of multisystem involvement. This review describes the "Noonan syndrome-like" phenotype as a common phenotypic signature of generalized developmental RAS pathway dysregulation. Distinctive features of the different entities are revisited against the background of the understanding of underlying genetic alterations and genotype correlations, which has evolved rapidly during the past 20 years, thereby leading to suggestions regarding the nosology of RASopathies.
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Affiliation(s)
- Martin Zenker
- Institute of Human Genetics, University Hospital Magdeburg, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
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7
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Stevenson DA, Viscogliosi G, Leoni C. Bone health in RASopathies. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2022; 190:459-470. [PMID: 36461161 DOI: 10.1002/ajmg.c.32020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/07/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
The RASopathies are a group of disorders due to pathogenic variants in genes involved in the Ras/MAPK pathway, many of which have overlapping clinical features (e.g., neurofibromatosis type 1, Costello syndrome, cardiofaciocutaneous syndrome and Noonan syndrome) including musculoskeletal manifestations. Osteopenia and osteoporosis are reported in many of the RASopathies suggesting a shared pathogenesis. Even though osteopenia and osteoporosis are often detected and fractures have been reported, the clinical impact of bone mineralization defects on the skeleton of the various syndromes is poorly understood. Further knowledge of the role of the Ras/MAPK pathway on the bone cellular function, and more detailed musculoskeletal phenotyping will be critical in helping to develop therapies to improve bone health in the RASopathies.
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Affiliation(s)
- David A Stevenson
- Department of Pediatrics, Division of Medical Genetics, Stanford University, Stanford, California, USA
| | - Germana Viscogliosi
- Center for Rare Diseases and Birth Defect, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Chiara Leoni
- Center for Rare Diseases and Birth Defect, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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8
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Fleming J, Morgan O, Wong C, Schlub TE, Berman Y. Characterization of health concerns in people with neurofibromatosis type 1. Mol Genet Genomic Med 2022; 11:e2077. [PMID: 36444392 PMCID: PMC9834143 DOI: 10.1002/mgg3.2077] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Neurofibromatosis 1 (NF1) is a common cancer predisposition syndrome. Affected individuals require lifelong surveillance and often suffer progressive disfigurement due to cutaneous neurofibromas. The aim of this research was to characterize health concerns and quality of life (QOL) in a population cohort. METHODS An online survey was completed by 68 adults and 32 parents of children with NF1, and 60 controls. The survey included the Skindex-29 QOL scale, 5D-itch scale, and additional health questions. RESULTS Frequency of itch was high in children (50%) and adults (69%), with most expressing interest in treatment for itch. The presence of itch and increased visibility of NF1 were predictors of poorer QoL. Many adults (53%) and parents (44%) desired access to treatment to improve cosmetic appearance. Muscle weakness/tiredness was also prevalent amongst (60-70%) adults and children with NF1. Two-thirds of adults with NF1 reported limited awareness of NF1 services and poor knowledge of surveillance, particularly breast screening in young women. CONCLUSION This study highlights the impact of NF1-related itch and visibility in adults and children with a need for cosmetic and itch treatment. The findings emphasize a need for strategies to promote awareness, and access to management and treatment of NF1 in adults.
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Affiliation(s)
- Jane Fleming
- Department of Clinical GeneticsNorthern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Oliver Morgan
- Faculty of Health and MedicineUniversity of Sydney, Northern Clinical SchoolSydneyNew South WalesAustralia
| | - Claire Wong
- Department of Clinical GeneticsNorthern Sydney Local Health DistrictSydneyNew South WalesAustralia,Department of Clinical GeneticsThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Timothy E. Schlub
- Sydney School of Public Health, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Yemima Berman
- Department of Clinical GeneticsNorthern Sydney Local Health DistrictSydneyNew South WalesAustralia
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9
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Gurler G, Altunbuker H, Cankaya O, Esen-Aydinli F, Incebay O, Sel SA, Lay I, Kerem-Gunel M, Anlar B. Clinical evaluation of muscle functions in neurofibromatosis type 1. J Paediatr Child Health 2022; 58:1997-2002. [PMID: 35869836 DOI: 10.1111/jpc.16133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 11/28/2022]
Abstract
AIM Muscle weakness, fatigue and speech problems can occur in neurofibromatosis type 1 (NF1). The pathogenesis of these symptoms is unclear, likely multifactorial. We examined motor function in limb and speech muscles in NF1 patients. METHODS We evaluated NF1 and control groups aged 4-18 years for muscle strength, tone and mobility using standard manual testing, joint motion and Beighton score measurements. Speech and language functions were assessed by speech articulation and resonance. As a marker of muscle tissue turnover, we determined collagen degradation products in urine before and after submaximal exercise. RESULTS NF1 patients had reduced strength in proximal limb muscles compared to control subjects. Speech articulation problems and hypernasality were more common in NF1 (47% and 38%, respectively). Collagen products excreted in urine correlated with gluteal and biceps muscle strength. CONCLUSION Muscle dysfunction can be detected in some children with NF1 and may explain certain clinical features including fatigue, speech and articulation problems. If confirmed by further research, these findings may be relevant to the management of this condition.
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Affiliation(s)
- Gokce Gurler
- Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ozge Cankaya
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatma Esen-Aydinli
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Onal Incebay
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Sinem A Sel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Incilay Lay
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mintaze Kerem-Gunel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Banu Anlar
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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10
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De Ridder W, Engelen B, Alfen N. Neurological features of Noonan syndrome and related
RASopathies
: Pain and nerve enlargement characterized by nerve ultrasound. Am J Med Genet A 2022; 188:1801-1807. [DOI: 10.1002/ajmg.a.62714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/23/2022] [Accepted: 02/18/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Willem De Ridder
- Department of Neurology, Neuromuscular Reference Centre University Hospital of Antwerp Antwerp Belgium
| | - Baziel Engelen
- Institute Born‐Bunge University of Antwerp Antwerp Belgium
| | - Nens Alfen
- Department of Neurology and Clinical Neurophysiology Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center Nijmegen The Netherlands
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11
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Tidyman WE, Goodwin AF, Maeda Y, Klein OD, Rauen KA. MEK-inhibitor-mediated rescue of skeletal myopathy caused by activating Hras mutation in a Costello syndrome mouse model. Dis Model Mech 2022; 15:272258. [PMID: 34553752 PMCID: PMC8617311 DOI: 10.1242/dmm.049166] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
Costello syndrome (CS) is a congenital disorder caused by heterozygous activating germline HRAS mutations in the canonical Ras/mitogen-activated protein kinase (Ras/MAPK) pathway. CS is one of the RASopathies, a large group of syndromes caused by mutations within various components of the Ras/MAPK pathway. An important part of the phenotype that greatly impacts quality of life is hypotonia. To gain a better understanding of the mechanisms underlying hypotonia in CS, a mouse model with an activating HrasG12V allele was utilized. We identified a skeletal myopathy that was due, in part, to inhibition of embryonic myogenesis and myofiber formation, resulting in a reduction in myofiber size and number that led to reduced muscle mass and strength. In addition to hyperactivation of the Ras/MAPK and PI3K/AKT pathways, there was a significant reduction in p38 signaling, as well as global transcriptional alterations consistent with the myopathic phenotype. Inhibition of Ras/MAPK pathway signaling using a MEK inhibitor rescued the HrasG12V myopathy phenotype both in vitro and in vivo, demonstrating that increased MAPK signaling is the main cause of the muscle phenotype in CS. Summary: A Costello syndrome (CS) mouse model carrying a heterozygous Hras p.G12V mutation was utilized to investigate Ras pathway dysregulation, revealing that increased MAPK signaling is the main cause of the muscle phenotype in CS.
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Affiliation(s)
- William E Tidyman
- Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA.,UC Davis MIND Institute, Sacramento, CA 95817, USA
| | - Alice F Goodwin
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, CA 94143, USA
| | - Yoshiko Maeda
- Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA.,UC Davis MIND Institute, Sacramento, CA 95817, USA
| | - Ophir D Klein
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, CA 94143, USA.,Department of Pediatrics and Institute for Human Genetics, University of California, San Francisco, CA 94143, USA
| | - Katherine A Rauen
- Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA.,UC Davis MIND Institute, Sacramento, CA 95817, USA
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12
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Delagrange M, Rousseau V, Cessans C, Pienkowski C, Oliver I, Jouret B, Cartault A, Diene G, Tauber M, Salles JP, Yart A, Edouard T. Low bone mass in Noonan syndrome children correlates with decreased muscle mass and low IGF-1 levels. Bone 2021; 153:116170. [PMID: 34492361 DOI: 10.1016/j.bone.2021.116170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/20/2021] [Accepted: 08/30/2021] [Indexed: 12/23/2022]
Abstract
Although musculoskeletal abnormalities have long been described in patients with Noonan syndrome (NS), only a few studies have investigated the bone status of these patients. The aim of this retrospective observational study was to describe the bone health of children with NS. Thirty-five patients with a genetically confirmed diagnosis of NS were enrolled. We analyzed the axial skeleton (lumbar spine) using dual energy X-ray absorptiometry and the appendicular skeleton (hand) with the BoneXpert system. Bone metabolism markers, including mineral homeostasis parameters, serum 25-hydroxy vitamin D (25-OHD) levels and markers of bone formation and resorption were also reported. Compared to the general population, axial and appendicular bone mass was significantly decreased in children with NS (p < 0.0001). Serum 25-OHD levels were low in about half of the patients and were negatively correlated with age (r = -0.52; p < 0.0001). Patients with NS exhibited reduced bone formation marker levels and increased bone resorption marker levels (p < 0.0001). No gender difference or genotype-phenotype correlations were found for the different bone parameters. Muscle mass and, to a lesser extent, serum insulin-like growth factor 1 (IGF-1) levels were independent predictors of whole-body bone mineral content (p < 0.0001 for both parameters; adjusted R2 = 0.97). In conclusion, bone mass is reduced in children with NS and correlates with decreased muscle mass and low serum IGF-1 levels. These data justify addressing all potential threats to bone health including sufficient calcium and vitamin D intake, regular physical exercise, and hormone replacement therapy.
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Affiliation(s)
- Marine Delagrange
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Vanessa Rousseau
- MeDatAS-CIC unit, CIC1436, Toulouse University Hospital, Toulouse, France
| | - Catie Cessans
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Catherine Pienkowski
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Isabelle Oliver
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Béatrice Jouret
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Audrey Cartault
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Gwenaelle Diene
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Maithé Tauber
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Jean-Pierre Salles
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Armelle Yart
- RESTORE, INSERM UMR1301, CNRS UMR5070, Université Paul Sabatier, Université de Toulouse, Toulouse, France
| | - Thomas Edouard
- Endocrine, Bone Diseases and Genetics Unit, Reference Center for Rare Diseases of Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Pediatric Research Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France; RESTORE, INSERM UMR1301, CNRS UMR5070, Université Paul Sabatier, Université de Toulouse, Toulouse, France.
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13
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Akshintala S, Khalil N, Yohay K, Muzikansky A, Allen J, Yaffe A, Gross AM, Fisher MJ, Blakeley JO, Oberlander B, Pudel M, Engelson C, Obletz J, Mitchell C, Widemann BC, Stevenson DA, Plotkin SR. Reliability of Handheld Dynamometry to Measure Focal Muscle Weakness in Neurofibromatosis Types 1 and 2. Neurology 2021; 97:S99-S110. [PMID: 34230196 DOI: 10.1212/wnl.0000000000012439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/05/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine a suitable outcome measure for assessing muscle strength in neurofibromatosis (NF) type 1 and NF2 clinical trials, we evaluated the intraobserver reliability of handheld dynamometry (HHD) and developed consensus recommendations for its use in NF clinical trials. METHODS Patients ≥5 years of age with weakness in at least 1 muscle group by manual muscle testing (MMT) were eligible. Maximal isometric muscle strength of a weak muscle group and the biceps of the dominant arm was measured by HHD. An average of 3 repetitions per session was used as an observation, and 3 sessions with rest period between each were performed on the same day by a single observer. Intrasession and intersession intraclass correlation coefficients (ICCs) and coefficients of variation (CVs) were calculated to assess reliability and measurement error. RESULTS Twenty patients with NF1 and 13 with NF2 were enrolled; median age was 12 years (interquartile range [IQR] 9-17 years) and 29 years (IQR 22-38 years), respectively. By MMT, weak muscle strength ranged from 2-/5 to 4+/5. Biceps strength was 5/5 in all patients. Intersession ICCs for the weak muscles were 0.98 and 0.99 in the NF1 and NF2 cohorts, respectively, and for biceps were 0.97 and 0.97, respectively. The median CVs for average session strength were 5.4% (IQR 2.6%-7.3%) and 2.9% (IQR 2.0%-6.2%) for weak muscles and biceps, respectively. CONCLUSION HHD performed by a trained examiner with a well-defined protocol is a reliable technique to measure muscle strength in NF1 and NF2. Recommendations for strength testing in NF1 and NF2 trials are provided.
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Affiliation(s)
- Srivandana Akshintala
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston.
| | - Nashwa Khalil
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Kaleb Yohay
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Alona Muzikansky
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Jeffrey Allen
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Anna Yaffe
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Andrea M Gross
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Michael J Fisher
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Jaishri O Blakeley
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Beverly Oberlander
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Miriam Pudel
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Celia Engelson
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Jaime Obletz
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Carole Mitchell
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Brigitte C Widemann
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - David A Stevenson
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
| | - Scott R Plotkin
- From New York University (NYU) School of Medicine and NYU Langone Health (S.A., N.K., K.Y., J.A., A.Y., M.P., C.E., J.O., C.M.), New York; Pediatric Oncology Branch (S.A., A.M.G., B.C.W.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD; Massachusetts General Hospital (A.M.), Boston; Division of Oncology (M.J.F.), The Children's Hospital of Philadelphia, PA; Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Neurofibromatosis Network (B.O.); Department of Pediatrics (D.A.S.), Division of Medical Genetics, Stanford University School of Medicine, Palo Alto, CA; and Cancer Center and Department of Neurology (S.R.P.), Massachusetts General Hospital, Boston
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Maeda Y, Tidyman WE, Ander BP, Pritchard CA, Rauen KA. Ras/MAPK dysregulation in development causes a skeletal myopathy in an activating Braf L597V mouse model for cardio-facio-cutaneous syndrome. Dev Dyn 2021; 250:1074-1095. [PMID: 33522658 DOI: 10.1002/dvdy.309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/03/2021] [Accepted: 01/19/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cardio-facio-cutaneous (CFC) syndrome is a human multiple congenital anomaly syndrome that is caused by activating heterozygous mutations in either BRAF, MEK1, or MEK2, three protein kinases of the Ras/mitogen-activated protein kinase (MAPK) pathway. CFC belongs to a group of syndromes known as RASopathies. Skeletal muscle hypotonia is a ubiquitous phenotype of RASopathies, especially in CFC syndrome. To better understand the underlying mechanisms for the skeletal myopathy in CFC, a mouse model with an activating BrafL597V allele was utilized. RESULTS The activating BrafL597V allele resulted in phenotypic alterations in skeletal muscle characterized by a reduction in fiber size which leads to a reduction in muscle size which are functionally weaker. MAPK pathway activation caused inhibition of myofiber differentiation during embryonic myogenesis and global transcriptional dysregulation of developmental pathways. Inhibition in differentiation can be rescued by MEK inhibition. CONCLUSIONS A skeletal myopathy was identified in the CFC BrafL597V mouse validating the use of models to study the effect of Ras/MAPK dysregulation on skeletal myogenesis. RASopathies present a novel opportunity to identify new paradigms of myogenesis and further our understanding of Ras in development. Rescue of the phenotype by inhibitors may help advance the development of therapeutic options for RASopathy patients.
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Affiliation(s)
- Yoshiko Maeda
- Department of Pediatrics, University of California Davis, Sacramento, California, USA.,UC Davis MIND Institute, Sacramento, California, USA
| | - William E Tidyman
- Department of Pediatrics, University of California Davis, Sacramento, California, USA.,UC Davis MIND Institute, Sacramento, California, USA
| | - Bradley P Ander
- UC Davis MIND Institute, Sacramento, California, USA.,Department of Neurology, University of California Davis, Sacramento, California, USA
| | - Catrin A Pritchard
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | - Katherine A Rauen
- Department of Pediatrics, University of California Davis, Sacramento, California, USA.,UC Davis MIND Institute, Sacramento, California, USA
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15
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Leoni C, Romeo DM, Pelliccioni M, Di Già M, Onesimo R, Giorgio V, Flex E, Tedesco M, Tartaglia M, Rigante D, Valassina A, Zampino G. Musculo-skeletal phenotype of Costello syndrome and cardio-facio-cutaneous syndrome: insights on the functional assessment status. Orphanet J Rare Dis 2021; 16:43. [PMID: 33482860 PMCID: PMC7821553 DOI: 10.1186/s13023-021-01674-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022] Open
Abstract
Background Costello syndrome (CS)
and cardio-facio-cutaneous syndrome (CFCS) belong to the RASopathies, a group of neurodevelopmental disorders with skeletal anomalies. Due to their rarity, the characterization of the musculo-skeletal phenotype in both disorders has been poorly characterized. Patients and methods Herein we reported data on orthopedic findings and functional status of a large sample of CS and CFCS patients. Thirty-four patients (CS = 17 and CFCS = 17) were recruited. Functional and disability evaluations were performed by assessing the 6-min walking test (6MWT) and Pediatric Outcomes Data Collection Instrument (PODCI). Genotype/phenotype correlation was also provided. Results Orthopedic manifestations are highly prevalent in CS and CFCS and overlap in the two disorders. Overall, patients with CS harboring the recurrent HRAS Gly12Ser substitution show a more severe skeletal phenotype compared to patients carrying the Gly12Ala and Gly13Cys variants. Among CFCS patients, those with the MAP2K1/2 variant show different skeletal characteristics compared to BRAF variants, with a higher prevalence of orthopedic abnormalities. Functional assessment showed that patients with CS and CFCS reached lower values compared to the general population, with CFCS patients displaying the lowest scores. Conclusions Orthopedic manifestations appear universal features of CS and CFCS and they can evolve across patients’ life. Longitudinal assessment of disability status by using 6MWT and PODCI could be useful to evaluate the functional impact of orthopedic manifestations on patients’ outcome and help planning a tailored treatment of these comorbidities.
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Affiliation(s)
- Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy.
| | - Domenico Marco Romeo
- Pediatric Neurology Unit, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michele Pelliccioni
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy
| | - Mariangela Di Già
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy
| | - Roberta Onesimo
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy
| | - Valentina Giorgio
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy
| | - Elisabetta Flex
- Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità, Rome, Italy
| | - Marta Tedesco
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Donato Rigante
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy.,Università Cattolica Sacro Cuore, Rome, Italy
| | - Antonio Valassina
- Università Cattolica Sacro Cuore, Rome, Italy.,Unit of Neurophysiopathology and Sleep Medicine, Neurosciences and Orthopedics, Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Center for Rare Diseases and Birth Defects, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, 00168, Rome, Italy.,Università Cattolica Sacro Cuore, Rome, Italy
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16
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Wei X, Franke J, Ost M, Wardelmann K, Börno S, Timmermann B, Meierhofer D, Kleinridders A, Klaus S, Stricker S. Cell autonomous requirement of neurofibromin (Nf1) for postnatal muscle hypertrophic growth and metabolic homeostasis. J Cachexia Sarcopenia Muscle 2020; 11:1758-1778. [PMID: 33078583 PMCID: PMC7749575 DOI: 10.1002/jcsm.12632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/09/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a multi-organ disease caused by mutations in neurofibromin 1 (NF1). Amongst other features, NF1 patients frequently show reduced muscle mass and strength, impairing patients' mobility and increasing the risk of fall. The role of Nf1 in muscle and the cause for the NF1-associated myopathy are mostly unknown. METHODS To dissect the function of Nf1 in muscle, we created muscle-specific knockout mouse models for NF1, inactivating Nf1 in the prenatal myogenic lineage either under the Lbx1 promoter or under the Myf5 promoter. Mice were analysed during prenatal and postnatal myogenesis and muscle growth. RESULTS Nf1Lbx1 and Nf1Myf5 animals showed only mild defects in prenatal myogenesis. Nf1Lbx1 animals were perinatally lethal, while Nf1Myf5 animals survived only up to approximately 25 weeks. A comprehensive phenotypic characterization of Nf1Myf5 animals showed decreased postnatal growth, reduced muscle size, and fast fibre atrophy. Proteome and transcriptome analyses of muscle tissue indicated decreased protein synthesis and increased proteasomal degradation, and decreased glycolytic and increased oxidative activity in muscle tissue. High-resolution respirometry confirmed enhanced oxidative metabolism in Nf1Myf5 muscles, which was concomitant to a fibre type shift from type 2B to type 2A and type 1. Moreover, Nf1Myf5 muscles showed hallmarks of decreased activation of mTORC1 and increased expression of atrogenes. Remarkably, loss of Nf1 promoted a robust activation of AMPK with a gene expression profile indicative of increased fatty acid catabolism. Additionally, we observed a strong induction of genes encoding catabolic cytokines in muscle Nf1Myf5 animals, in line with a drastic reduction of white, but not brown adipose tissue. CONCLUSIONS Our results demonstrate a cell autonomous role for Nf1 in myogenic cells during postnatal muscle growth required for metabolic and proteostatic homeostasis. Furthermore, Nf1 deficiency in muscle drives cross-tissue communication and mobilization of lipid reserves.
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Affiliation(s)
- Xiaoyan Wei
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany.,Development and Disease Group, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Julia Franke
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany.,Development and Disease Group, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Mario Ost
- Department of Physiology of Energy Metabolism, German Institute for Human Nutrition, Nuthetal, Germany.,Department of Neuropathology, University Hospital Leipzig, Leipzig, Germany
| | - Kristina Wardelmann
- Junior Research Group Central Regulation of Metabolism, German Institute for Human Nutrition, Nuthetal, Germany.,Institute of Nutritional Science, Department of Molecular and Experimental Nutritional Medicine, University of Potsdam, Potsdam, Germany
| | - Stefan Börno
- Sequencing Core Unit, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Bernd Timmermann
- Sequencing Core Unit, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - David Meierhofer
- Mass Spectrometry Core Unit, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Andre Kleinridders
- Junior Research Group Central Regulation of Metabolism, German Institute for Human Nutrition, Nuthetal, Germany.,Institute of Nutritional Science, Department of Molecular and Experimental Nutritional Medicine, University of Potsdam, Potsdam, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Susanne Klaus
- Department of Physiology of Energy Metabolism, German Institute for Human Nutrition, Nuthetal, Germany.,Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Sigmar Stricker
- Musculoskeletal Development and Regeneration Group, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany.,Development and Disease Group, Max Planck Institute for Molecular Genetics, Berlin, Germany
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17
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Vassallo G, Mughal Z, Robinson L, Weisberg D, Roberts SA, Hupton E, Eelloo J, Burkitt Wright EM, Garg S, Lewis L, Evans DG, Stivaros SM. Perceived fatigue in children and young adults with neurofibromatosis type 1. J Paediatr Child Health 2020; 56:878-883. [PMID: 31916647 DOI: 10.1111/jpc.14764] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/24/2019] [Accepted: 12/15/2019] [Indexed: 12/15/2022]
Abstract
AIM This study describes the prevalence and severity of perceived fatigue in a young neurofibromatosis type 1 (NF1) population. METHODS Ethical approval was obtained and NF1 affected Individuals aged 2-18 years from the Manchester's NF1 clinic invited along with any unaffected siblings. The PedsQL Multidimensional Fatigue Scale Parental and child report was used. This validated measure explores cognitive, physical and sleep/rest domains on a 0-100 scale. Higher scores indicate less fatigue. Fatigue scores in affected children were compared to unaffected siblings after adjusting for age, sex and Index of Multiple Deprivation and with published population standards using z-scores. RESULTS A total of 286 families were invited and 75 affected and 16 siblings participated. There were significant differences between NF1 and controls in the aggregated fatigue core (child report 55 ± 19 vs. 75 (14), P < 0.001; parent 54 ± 20 vs. 73 ± 18, P = 0.001) and the three sub-domains: cognitive (child 48 ± 27 vs. 75 ± 23, P < 0.001), physical (child 59 ± 19 vs. 82 ± 14, P < 0.001) and sleep/rest (child 59 ± 19 vs. 71 ± 15, P = 0.018). Similar differences were seen when compared with published controls (aggregated child z-score -1.9 ± 1.4, P < 0.001; parent -3.2 ± 1.8, P < 0.001). Prevalence of severe fatigue indicated by scores <2 standard deviation below published means for healthy controls were also higher for children with NF on both parent and child reports. Agreement between child and parent reports were limited as is frequently seen in the literature. CONCLUSION This study suggests that children with NF1 are affected by perceived fatigue when compared with healthy children who do not have NF1.
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Affiliation(s)
- Grace Vassallo
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,NW Genomics Hub, Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, United Kingdom
| | - Zulf Mughal
- Department of Paediatric Endocrinology and Bone Metabolism, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Louise Robinson
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Daniel Weisberg
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Stephen A Roberts
- Centres for Biostatistics, University of Manchester, Manchester, United Kingdom
| | - Eileen Hupton
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Judith Eelloo
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Emma Mm Burkitt Wright
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,NW Genomics Hub, Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, United Kingdom
| | - Shruti Garg
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Lauren Lewis
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - D Gareth Evans
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,NW Genomics Hub, Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, United Kingdom
| | - Stavros M Stivaros
- Nationally Commissioned Complex NF1 Service, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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18
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Gripp KW, Morse LA, Axelrad M, Chatfield KC, Chidekel A, Dobyns W, Doyle D, Kerr B, Lin AE, Schwartz DD, Sibbles BJ, Siegel D, Shankar SP, Stevenson DA, Thacker MM, Weaver KN, White SM, Rauen KA. Costello syndrome: Clinical phenotype, genotype, and management guidelines. Am J Med Genet A 2019; 179:1725-1744. [PMID: 31222966 DOI: 10.1002/ajmg.a.61270] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/22/2019] [Accepted: 06/01/2019] [Indexed: 12/16/2022]
Abstract
Costello syndrome (CS) is a RASopathy caused by activating germline mutations in HRAS. Due to ubiquitous HRAS gene expression, CS affects multiple organ systems and individuals are predisposed to cancer. Individuals with CS may have distinctive craniofacial features, cardiac anomalies, growth and developmental delays, as well as dermatological, orthopedic, ocular, and neurological issues; however, considerable overlap with other RASopathies exists. Medical evaluation requires an understanding of the multifaceted phenotype. Subspecialists may have limited experience in caring for these individuals because of the rarity of CS. Furthermore, the phenotypic presentation may vary with the underlying genotype. These guidelines were developed by an interdisciplinary team of experts in order to encourage timely health care practices and provide medical management guidelines for the primary and specialty care provider, as well as for the families and affected individuals across their lifespan. These guidelines are based on expert opinion and do not represent evidence-based guidelines due to the lack of data for this rare condition.
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Affiliation(s)
- Karen W Gripp
- Division of Medical Genetics, Department of Pediatrics, A.I. duPont Hospital for Children, Wilmington, Delaware
| | | | - Marni Axelrad
- Psychology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Kathryn C Chatfield
- Section of Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Aaron Chidekel
- Division of Pulmonology, Department of Pediatrics, A.I. duPont Hospital for Children, Wilmington, Delaware
| | - William Dobyns
- Division of Medical Genetics, Seattle Children's Hospital, Seattle, Washington
| | - Daniel Doyle
- Division of Endocrinology, A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Bronwyn Kerr
- Manchester Center for Genomic Medicine, University of Manchester, Manchester, UK
| | - Angela E Lin
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - David D Schwartz
- Psychology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Barbara J Sibbles
- Division of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Dawn Siegel
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Suma P Shankar
- Division of Genomic Medicine, Department of Pediatrics, University of California Davis, Sacramento, California
| | - David A Stevenson
- Division of Medical Genetic, Department of Pediatrics, Stanford University, Palo Alto, California
| | - Mihir M Thacker
- Department of Orthopedic Surgery, Nemoirs-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - K Nicole Weaver
- Division of Human Genetics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sue M White
- Victorian Clinical Genetics Services, Royal Children's Hospital, Victoria, Australia
| | - Katherine A Rauen
- Division of Genomic Medicine, Department of Pediatrics, University of California Davis, Sacramento, California
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19
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Souza MLRD, Jansen AK, Rodrigues LOC, Vilela DLDS, Kakehasi AM, Martins AS, Souza JFD, Rezende NAD. Increased resting metabolism in neurofibromatosis type 1. Clin Nutr ESPEN 2019; 32:44-49. [PMID: 31221289 DOI: 10.1016/j.clnesp.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/10/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease that is characterized by neurocutaneous changes with multisystem involvement. A previous study with adults with NF1 revealed that changes in total energy expenditure were related to food consumption and body composition. Resting energy expenditure (REE), a measure of energy that the body expends to maintain vital functions, has not been assessed in NF1 populations. This study aimed to assess REE in individuals with NF1 using indirect calorimetry (IC) and evaluate its correlation with body composition and muscle strength. METHODS Twenty-six adults with NF1 (14 men) aged 18-45 years underwent IC for assessing REE, respiratory quotient (RQ), and substrate utilization. Body composition was assessed by dual energy X-ray absorptiometry. Weight, height, and waist circumference (WC) were also measured. Maximum muscular strength (Smax) was measured by handgrip test using a dynamometer. Patients in the NF1 group were compared to 26 healthy controls in the control group, who were matched by sex, age, body mass index (BMI), and physical activity level. RESULTS There were no differences in weight, WC, fat mass, and body fat percentage (BFP). Appendicular lean mass (ALM) adjusted by BMI (ALMBMI) (0.828 ± 0.161 versus 0.743 ± 0.190; P = 0.048) and Smax (37.5 ± 10.6 versus 31.1 ± 12.2; P = 0.035) was lower in the NF1 group than in the control group. No differences in body composition, strength, and anthropometric parameters were observed in men, but women with NF1 presented lower body surface area (BSA), lean body mass (LBM), ALM, ALMBMI, and Smax. REE adjusted by weight, LBM, or ALM was higher in the NF1 group than in the control group (medians, 21.9 versus 26.3, P = 0.046; 36.5 versus 41.1, P = 0.012; and 82.3 versus 92.4, P = 0.006, respectively), and these differences were observed only among women. RQ was lower in the NF1 group than in the control group (0.9 ± 0.1 versus 0.8 ± 0.1; P = 0.008), revealing that individuals with NF1 oxidized more lipids and fewer carbohydrates than controls. REE correlated negatively with BFP and positively with weight, height, BMI, WC, BSA, LBM, ALM, ALMBMI, bone mineral content, and Smax. CONCLUSIONS Individuals with NF1, particularly women, presented with increased REE (adjusted by weight, LBM, or ALM) and lower RQ compared to healthy controls. These findings were associated with lower ALMBMI and Smax, possibly indicating premature sarcopenia in this population. Further investigation concerning energy metabolism in NF1 and gender differences may be helpful in explaining underlying mechanisms of these changes.
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Affiliation(s)
| | - Ann Kristine Jansen
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | | | | | - Adriana Maria Kakehasi
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Aline Stangherlin Martins
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Juliana Ferreira de Souza
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Nilton Alves de Rezende
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
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20
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Fisher MJ, Belzberg AJ, de Blank P, De Raedt T, Elefteriou F, Ferner RE, Giovannini M, Harris GJ, Kalamarides M, Karajannis MA, Kim A, Lázaro C, Le LQ, Li W, Listernick R, Martin S, Morrison H, Pasmant E, Ratner N, Schorry E, Ullrich NJ, Viskochil D, Weiss B, Widemann BC, Zhu Y, Bakker A, Serra E. 2016 Children's Tumor Foundation conference on neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. Am J Med Genet A 2019; 176:1258-1269. [PMID: 29681099 DOI: 10.1002/ajmg.a.38675] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/13/2018] [Indexed: 12/13/2022]
Abstract
Organized and hosted by the Children's Tumor Foundation (CTF), the Neurofibromatosis (NF) conference is the premier annual gathering for clinicians and researchers interested in neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis (SWN). The 2016 edition constituted a blend of clinical and basic aspects of NF research that helped in clarifying different advances in the field. The incorporation of next generation sequencing is changing the way genetic diagnostics is performed for NF and related disorders, providing solutions to problems like genetic heterogeneity, overlapping clinical manifestations, or the presence of mosaicism. The transformation from plexiform neurofibroma (PNF) to malignant peripheral nerve sheath tumor (MPNST) is being clarified, along with new management and treatments for benign and premalignant tumors. Promising new cellular and in vivo models for understanding the musculoskeletal abnormalities in NF1, the development of NF2 or SWN associated schwannomas, and clarifying the cells that give rise to NF1-associated optic pathway glioma were presented. The interaction of neurofibromin and SPRED1 was described comprehensively, providing functional insight that will help in the interpretation of pathogenicity of certain missense variants identified in NF1 and Legius syndrome patients. Novel promising imaging techniques are being developed, as well as new integrative and holistic management models for patients that take into account psychological, social, and biological factors. Importantly, new therapeutic approaches for schwannomas, meningiomas, ependymomas, PNF, and MPNST are being pursued. This report highlights the major advances that were presented at the 2016 CTF NF conference.
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Affiliation(s)
- Michael J Fisher
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Allan J Belzberg
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Peter de Blank
- Division of Oncology and Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Thomas De Raedt
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Florent Elefteriou
- Center for Skeletal Medicine and Biology, Department of Molecular and Human Genetics and Orthopedic Surgery, Baylor College of Medicine, Houston, Texas
| | - Rosalie E Ferner
- Neurofibromatosis Centre, Guy's and St. Thomas NHS Foundation Trust, London, United Kingdom
| | - Marco Giovannini
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Gordon J Harris
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michel Kalamarides
- Department of Neurosurgery, Hospital Pitie-Salpetriere, AP-HP, Paris, France; Université Pierre et Marie Curie, Sorbonne Universités, Paris, France
| | - Matthias A Karajannis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - AeRang Kim
- Division of Oncology, Children's National Medical Center, Washington, District of Columbia
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lu Q Le
- Department of Dermatology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas
| | - Wei Li
- Department of Pediatrics, Department of Biochemistry & Molecular Biology, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Robert Listernick
- Division of Academic General Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Staci Martin
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Helen Morrison
- Leibniz Institute on Aging Research, Fritz Lipmann Institute, Jena, Germany
| | - Eric Pasmant
- EA7331 and Cochin Hospital, Paris Descartes University, Faculty of Pharmacy of Paris, France
| | - Nancy Ratner
- Division of Experimental Hematology and Cancer Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Elisabeth Schorry
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Nicole J Ullrich
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Viskochil
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Brian Weiss
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Yuan Zhu
- The Gilbert Family Neurofibromatosis Institute, Centers for Cancer and Immunology Research and Neuroscience Research, Children's National Medical Center, Washington, District of Columbia
| | | | - Eduard Serra
- Hereditary Cancer Group, The Institute for Health Science Research Germans Trias i Pujol (IGTP)-PMPPC, Barcelona, Spain
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21
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Mullin RL, Golding JF, Smith R, Williams V, Thomas M, Ferner RE. Reliability of functional outcome measures in adults with neurofibromatosis 1. SAGE Open Med 2018; 6:2050312118786860. [PMID: 30046444 PMCID: PMC6056787 DOI: 10.1177/2050312118786860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/05/2018] [Indexed: 01/20/2023] Open
Abstract
Objectives: To determine intra-rater and inter-rater reliability of functional outcome
measures in adults with neurofibromatosis 1 and to ascertain how closely
objective and subjective measures align. Methods: A total of 49 ambulant adults with neurofibromatosis 1 aged 16 years and over
were included in this observational study: median age 31 years (range:
16–66 years), 29 females, 20 males. Participants were video-recorded or
photographed performing four functional outcome measures. Four raters from
the neurofibromatosis centre multi-disciplinary team independently scored
the measures to determine inter-rater reliability. One rater scored the
measures a second time on a separate occasion to determine intra-rater
reliability. The measures evaluated were the functional reach, timed up and
go, 10 m walk and a modified nine-hole peg tests. Participants also
completed a disease-specific quality-of-life questionnaire. Results: Inter-rater reliability and intra-rater reliability scores (intra-class
coefficient) were similar for each outcome measure. Excellent rater
agreement (intra-class coefficient, r ⩾ 0.9) was found for the functional
reach, timed up and go and the 10 m walk tests. Rater agreement was good for
the modified nine-hole peg test: intra-class coefficient r = 0.75 for
intra-rater reliability and 0.76 for inter-rater reliability. The timed up
and go and the 10 m walk tests correlated highly with perceived mobility
challenges in the quality-of-life questionnaire. Conclusion: The functional reach, timed up and go and 10 m walk tests are potentially
useful outcome measures for monitoring neurofibromatosis 1 treatment and
will be assessed in multi-centre and longitudinal studies.
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Affiliation(s)
- Rebecca L Mullin
- National Centre for Neurofibromatosis, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Physiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - John F Golding
- Department of Psychology, University of Westminster, London, UK
| | - Rebecca Smith
- National Centre for Neurofibromatosis, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Physiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Victoria Williams
- National Centre for Neurofibromatosis, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mary Thomas
- National Centre for Neurofibromatosis, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rosalie E Ferner
- National Centre for Neurofibromatosis, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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22
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Summers MA, Vasiljevski ER, Mikulec K, Peacock L, Little DG, Schindeler A. Developmental dosing with a MEK inhibitor (PD0325901) rescues myopathic features of the muscle-specific but not limb-specific Nf1 knockout mouse. Mol Genet Metab 2018; 123:518-525. [PMID: 29477258 DOI: 10.1016/j.ymgme.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 12/11/2022]
Abstract
Neurofibromatosis Type 1 (NF1) is a common autosomal dominant genetic disorder While NF1 is primarily associated with predisposition for tumor formation, muscle weakness has emerged as having a significant impact on quality of life. NF1 inactivation is linked with a canonical upregulation Ras-MEK-ERK signaling. This in this study we tested the capacity of the small molecule MEK inhibitor PD0325901 to influence the intramyocellular lipid accumulation associated with NF1 deficiency. Established murine models of tissue specific Nf1 deletion in skeletal muscle (Nf1MyoD-/-) and limb mesenchyme (Nf1Prx1-/-) were tested. Developmental PD0325901 dosing of dams pregnant with Nf1MyoD-/- progeny rescued the phenotype of day 3 pups including body weight and lipid accumulation by Oil Red O staining. In contrast, PD0325901 treatment of 4 week old Nf1Prx1-/- mice for 8 weeks had no impact on body weight, muscle wet weight, activity, or intramyocellular lipid. Examination of day 3 Nf1Prx1-/- pups showed differences between the two tissue-specific knockout strains, with lipid staining greatest in Nf1MyoD-/- mice, and fibrosis higher in Nf1Prx1-/- mice. These data show that a MEK/ERK dependent mechanism underlies NF1 muscle metabolism during development. However, crosstalk from Nf1-deficient non-muscle mesenchymal cells may impact upon muscle metabolism and fibrosis in neonatal and mature myofibers.
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Affiliation(s)
- Matthew A Summers
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Kathy Mikulec
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Lauren Peacock
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.
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23
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Summers MA, Rupasinghe T, Vasiljevski ER, Evesson FJ, Mikulec K, Peacock L, Quinlan KGR, Cooper ST, Roessner U, Stevenson DA, Little DG, Schindeler A. Dietary intervention rescues myopathy associated with neurofibromatosis type 1. Hum Mol Genet 2017; 27:577-588. [DOI: 10.1093/hmg/ddx423] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/29/2017] [Indexed: 02/07/2023] Open
Affiliation(s)
- Matthew A Summers
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | | | - Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Frances J Evesson
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
| | - Kathy Mikulec
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Lauren Peacock
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
| | - Kate G R Quinlan
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, NSW, Australia
| | - Sandra T Cooper
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
- Institute for Neuroscience and Muscle Research, The Children’s Hospital Westmead, Sydney, NSW, Australia
| | - Ute Roessner
- Metabolomics Australia, University of Melbourne, VIC, Australia
| | - David A Stevenson
- Division of Medical Genetics, Stanford University, Stanford, CA, USA
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children’s Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
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24
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Croonen EA, Essink M, van der Burgt I, Draaisma JM, Noordam C, Nijhuis-van der Sanden MWG. Motor performance in children with Noonan syndrome. Am J Med Genet A 2017. [PMID: 28627718 DOI: 10.1002/ajmg.a.38322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although problems with motor performance in daily life are frequently mentioned in Noonan syndrome, the motor performance profile has never been systematically investigated. The aim of this study was to examine whether a specific profile in motor performance in children with Noonan syndrome was seen using valid norm-referenced tests. The study assessed motor performance in 19 children with Noonan syndrome (12 females, mean age 9 years 4 months, range 6 years 1 month to 11 years and 11 months, SDS 1 year and 11 months). More than 60% of the parents of the children reported pain, decreased muscle strength, reduced endurance, and/or clumsiness in daily functioning. The mean standard scores on the Visual Motor Integration (VMI) test and Movement Assessment Battery for Children 2, Dutch version (MABC-2-NL) items differed significantly from the reference scores. Grip strength, muscle force, and 6 min Walking Test (6 MWT) walking distance were significantly lower, and the presence of generalized hypermobility was significantly higher. All MABC-2-NL scores (except manual dexterity) correlated significantly with almost all muscle strength tests, VMI total score, and VMI visual perception score. The 6 MWT was only significantly correlated to grip strength. This is the first study that confirms that motor performance, strength, and endurance are significantly impaired in children with Noonan syndrome. Decreased functional motor performance seems to be related to decreased visual perception and reduced muscle strength. Research on causal relationships and the effectiveness of interventions is needed. Physical and/or occupational therapy guidance should be considered to enhance participation in daily life.
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Affiliation(s)
- Ellen A Croonen
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marlou Essink
- Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ineke van der Burgt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos M Draaisma
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cees Noordam
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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25
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Croonen EA, Harmsen M, Van der Burgt I, Draaisma JM, Noordam K, Essink M, Nijhuis-van der Sanden MWG. Perceived motor problems in daily life: Focus group interviews with people with Noonan syndrome and their relatives. Am J Med Genet A 2016; 170:2349-56. [PMID: 27338165 DOI: 10.1002/ajmg.a.37814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 06/13/2016] [Indexed: 12/27/2022]
Abstract
Studies from a patient perspective on motor performance problems in Noonan syndrome in daily life are lacking. The aims of this study were to provide insight into the motor performance problems that people with Noonan syndrome and/or their relatives experienced, the major consequences they suffered, the benefits of interventions they experienced, and the experiences with healthcare professionals they mentioned. We interviewed 10 adults with Noonan syndrome (two were joined by their parent), and 23 mothers (five of whom had Noonan syndrome), nine fathers (one of whom had Noonan syndrome) and one cousin who reported on 28 children with Noonan syndrome. People with Noonan syndrome reported particular problems related to pain, decreased muscle strength, fatigue, and clumsiness, which had an evident impact on functioning in daily life. Most participants believed that problems with motor performance improved with exercise, appropriate physiotherapy guidance, and other supportive interventions. Nevertheless, people with Noonan syndrome and/or their relatives did not feel heard and supported and experienced no understanding of their problems by healthcare professionals. This was the first study from a patient perspective that described the motor performance problems in people with Noonan syndrome, the major consequences in daily life, the positive experiences of interventions and the miscommunication with healthcare professionals. To achieve optimal support, healthcare professionals, as well as people with Noonan syndrome and/or their relatives themselves, should be aware of these frequently presented problems with motor performance. Research on these different aspects is needed to better understand and support people with Noonan syndrome.© 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ellen A Croonen
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mirjam Harmsen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ineke Van der Burgt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos M Draaisma
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kees Noordam
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marlou Essink
- Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands
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26
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Xing L, Larsen RS, Bjorklund GR, Li X, Wu Y, Philpot BD, Snider WD, Newbern JM. Layer specific and general requirements for ERK/MAPK signaling in the developing neocortex. eLife 2016; 5. [PMID: 26848828 PMCID: PMC4758957 DOI: 10.7554/elife.11123] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/04/2016] [Indexed: 12/11/2022] Open
Abstract
Aberrant signaling through the Raf/MEK/ERK (ERK/MAPK) pathway causes pathology in a family of neurodevelopmental disorders known as 'RASopathies' and is implicated in autism pathogenesis. Here, we have determined the functions of ERK/MAPK signaling in developing neocortical excitatory neurons. Our data reveal a critical requirement for ERK/MAPK signaling in the morphological development and survival of large Ctip2+ neurons in layer 5. Loss of Map2k1/2 (Mek1/2) led to deficits in corticospinal tract formation and subsequent corticospinal neuron apoptosis. ERK/MAPK hyperactivation also led to reduced corticospinal axon elongation, but was associated with enhanced arborization. ERK/MAPK signaling was dispensable for axonal outgrowth of layer 2/3 callosal neurons. However, Map2k1/2 deletion led to reduced expression of Arc and enhanced intrinsic excitability in both layers 2/3 and 5, in addition to imbalanced synaptic excitation and inhibition. These data demonstrate selective requirements for ERK/MAPK signaling in layer 5 circuit development and general effects on cortical pyramidal neuron excitability. DOI:http://dx.doi.org/10.7554/eLife.11123.001 In the nervous system, cells called neurons form networks that relay information in the form of electrical signals around the brain and the rest of the body. Typically, an electrical signal travels from branch-like structures at one end of the cell, through the cell body and then along a long fiber called an axon to reach junctions with another neurons. The connections between neurons start to form as the nervous system develops in the embryo, and any errors or delays in this process can cause severe neurological disorders and intellectual disabilities. For example, genetic mutations affecting a communication system within cells known as the ERK/MAPK pathway can lead to a family of syndromes called the “RASopathies”. Abnormalities in this pathway may also contribute to certain types of autism. However, it is not clear how alterations to the ERK/MAPK pathway cause these conditions. Xing et al. investigated whether ERK/MAPK signaling regulates the formation of connections between neurons and the activity of neurons in mouse brains. The experiments showed that the growth of axons that extend from an area of the brain called the cerebral cortex towards the spinal cord are particularly sensitive to changes in the level of signaling through the ERK/MAPK pathway. On the other hand, inhibiting the pathway has relatively little effect on the growth of axons within the cerebral cortex. Further experiments showed that many neurons in the cerebral cortex require the ERK/MAPK pathway to activate genes that alter neuronal activity and the strength of the connections between neurons. Xing et al.’s findings suggest that defects in the connections between the cerebral cortex and different regions of the nervous system may contribute to the symptoms observed in patients with conditions linked to alterations in ERK/MAPK activity. Future studies will focus on understanding the molecular mechanisms by which ERK/MAPK pathway influences the organization and activity of neuron circuits during the development of the nervous system. DOI:http://dx.doi.org/10.7554/eLife.11123.002
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Affiliation(s)
- Lei Xing
- University of North Carolina Neuroscience Center, The University of North Carolina School of Medicine, Chapel Hill, United States
| | - Rylan S Larsen
- Allen Institute for Brain Science, Seattle, United States
| | | | - Xiaoyan Li
- University of North Carolina Neuroscience Center, The University of North Carolina School of Medicine, Chapel Hill, United States
| | - Yaohong Wu
- University of North Carolina Neuroscience Center, The University of North Carolina School of Medicine, Chapel Hill, United States
| | - Benjamin D Philpot
- University of North Carolina Neuroscience Center, The University of North Carolina School of Medicine, Chapel Hill, United States.,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Carolina Institute for Developmental Disabilities, The University of North Carolina School of Medicine, Chapel Hill, United States
| | - William D Snider
- University of North Carolina Neuroscience Center, The University of North Carolina School of Medicine, Chapel Hill, United States.,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Carolina Institute for Developmental Disabilities, The University of North Carolina School of Medicine, Chapel Hill, United States
| | - Jason M Newbern
- School of Life Sciences, Arizona State University, Tempe, United States
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27
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Capturing the wide variety of impaired fracture healing phenotypes in Neurofibromatosis Type 1 with eight key factors: a computational study. Sci Rep 2016; 7:20010. [PMID: 26822862 PMCID: PMC4731811 DOI: 10.1038/srep20010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 11/27/2015] [Indexed: 02/07/2023] Open
Abstract
Congenital pseudarthrosis of the tibia (CPT) is a rare disease which normally presents itself during early childhood by anterolateral bowing of the tibia and spontaneous tibial fractures. Although the exact etiology of CPT is highly debated, 40–80% of CPT patients are carriers of a mutation in the Neurofibromatosis Type 1 (NF1) gene, which can potentially result in an altered phenotype of the skeletal cells and impaired bone healing. In this study we use a computational model of bone regeneration to examine the effect of the Nf1 mutation on bone fracture healing by altering the parameter values of eight key factors which describe the aberrant cellular behaviour of Nf1 haploinsufficient and Nf1 bi-allelically inactivated cells. We show that the computational model is able to predict the formation of a hamartoma as well as a wide variety of CPT phenotypes through different combinations of altered parameter values. A sensitivity analysis by “Design of Experiments” identified the impaired endochondral ossification process and increased infiltration of fibroblastic cells as key contributors to the degree of severity of CPT. Hence, the computational model results have added credibility to the experimental hypothesis of a genetic cause (i.e. Nf1 mutation) for CPT.
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28
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Cornett KMD, North KN, Rose KJ, Burns J. Muscle weakness in children with neurofibromatosis type 1. Dev Med Child Neurol 2015; 57:733-6. [PMID: 25913846 DOI: 10.1111/dmcn.12777] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 12/17/2022]
Abstract
AIM To investigate if children with neurofibromatosis type 1 (NF1) have reduced muscle strength compared with children with typical development. METHOD Maximal isometric strength of 15 upper and lower limb muscle groups was evaluated in 30 children with NF1 (16 males, 14 females; aged 4-16y) and 30 age-, sex-, height-, and weight-matched controls using hand-held dynamometry by a single evaluator. Both the left and right sides were assessed. RESULTS Children with NF1 were significantly weaker than children with typical development across all 15 muscle groups assessed (p<0.05). Apart from elbow flexion, there were no differences between the left and right sides (p>0.05). Magnitude of differences between the children with NF1 compared with the controls ranged from 3% to 43%. Males and females were equally affected. INTERPRETATION This study shows that children with NF1 have reduced muscle strength compared with children with typical development. This muscle weakness is present from the earliest stages of the disease assessed and persists throughout childhood with no sex difference. These results support recent evidence from mouse studies that NF1 is associated with a primary myopathy.
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Affiliation(s)
- Kayla M D Cornett
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, Faculty of Medicine, University of Melbourne, Melbourne, Vic., Australia
| | - Kristy J Rose
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Joshua Burns
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospital Network (Randwick and Westmead), Sydney, NSW, Australia
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29
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Muscle-derived extracellular signal-regulated kinases 1 and 2 are required for the maintenance of adult myofibers and their neuromuscular junctions. Mol Cell Biol 2015; 35:1238-53. [PMID: 25605336 DOI: 10.1128/mcb.01071-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The Ras-extracellular signal-regulated kinase 1 and 2 (ERK1/2) pathway appears to be important for the development, maintenance, aging, and pathology of mammalian skeletal muscle. Yet no gene targeting of Erk1/2 in muscle fibers in vivo has been reported to date. We combined a germ line Erk1 mutation with Cre-loxP Erk2 inactivation in skeletal muscle to produce, for the first time, mice lacking ERK1/2 selectively in skeletal myofibers. Animals lacking muscle ERK1/2 displayed stunted postnatal growth, muscle weakness, and a shorter life span. Their muscles examined in this study, sternomastoid and tibialis anterior, displayed fragmented neuromuscular synapses and a mixture of modest fiber atrophy and loss but failed to show major changes in fiber type composition or absence of cell surface dystrophin. Whereas the lack of only ERK1 had no effects on the phenotypes studied, the lack of myofiber ERK2 explained synaptic fragmentation in the sternomastoid but not the tibialis anterior and a decrease in the expression of the acetylcholine receptor (AChR) epsilon subunit gene mRNA in both muscles. A reduction in AChR protein was documented in line with the above mRNA results. Evidence of partial denervation was found in the sternomastoid but not the tibialis anterior. Thus, myofiber ERK1/2 are differentially required for the maintenance of myofibers and neuromuscular synapses in adult mice.
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30
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Plotkin SR, Albers AC, Babovic-Vuksanovic D, Blakeley JO, Breakefield XO, Dunn CM, Evans DG, Fisher MJ, Friedman JM, Giovannini M, Gutmann DH, Kalamarides M, McClatchey AI, Messiaen L, Morrison H, Parkinson DB, Stemmer-Rachamimov AO, Van Raamsdonk CD, Riccardi VM, Rosser T, Schindeler A, Smith MJ, Stevenson DA, Ullrich NJ, van der Vaart T, Weiss B, Widemann BC, Zhu Y, Bakker AC, Lloyd AC. Update from the 2013 International Neurofibromatosis Conference. Am J Med Genet A 2014; 164A:2969-78. [PMID: 25255738 PMCID: PMC4236251 DOI: 10.1002/ajmg.a.36754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/14/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Scott R. Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Anne C. Albers
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | | | | | - Xandra O. Breakefield
- Neuroscience Center, Center for Molecular Imaging and Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Courtney M. Dunn
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - D. Gareth Evans
- Center for Genomic Medicine, St Mary's Hospital, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Michael J. Fisher
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jan M. Friedman
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - Marco Giovannini
- Center for Neural Tumor Research, House Research Institute, Los Angeles, CA
| | - David H. Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | | | - Andrea I. McClatchey
- Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Ludwine Messiaen
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL
| | | | - David B. Parkinson
- Centre for Biomedical Research, University of Plymouth, Peninsula College of Medicine and Dentistry, Plymouth, UK
| | | | | | | | - Tena Rosser
- Department of Neurology, Children's Hospital, Los Angeles, University of Southern California
| | - Aaron Schindeler
- Kids' Research Institute, The Children's Hospital at Westmead, University of Sydney, Westmead, Australia
| | - Miriam J. Smith
- Center for Genomic Medicine, St Mary's Hospital, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - David A. Stevenson
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Nicole J. Ullrich
- Departments of Neurology and Pediatric Oncology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Brian Weiss
- Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Yuan Zhu
- Gilbert Neurofibromatosis Institute, Children's National Medical Center, Washington, DC
| | | | - Alison C. Lloyd
- MRC Laboratory for Molecular Cell Biology, University College London, UK
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31
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Pierpont MEM, Magoulas PL, Adi S, Kavamura MI, Neri G, Noonan J, Pierpont EI, Reinker K, Roberts AE, Shankar S, Sullivan J, Wolford M, Conger B, Santa Cruz M, Rauen KA. Cardio-facio-cutaneous syndrome: clinical features, diagnosis, and management guidelines. Pediatrics 2014; 134:e1149-62. [PMID: 25180280 PMCID: PMC4179092 DOI: 10.1542/peds.2013-3189] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 12/22/2022] Open
Abstract
Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care.
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Affiliation(s)
- Mary Ella M Pierpont
- Division of Genetics and Metabolism, Department of Pediatrics and Ophthalmology, and Children's Hospitals and Clinics of Minnesota, Saint Paul, Minnesota;
| | - Pilar L Magoulas
- Department of Molecular and Human Genetics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Saleh Adi
- Madison Clinic for Pediatric Diabetes, Benioff Children's Hospital and University of California at San Francisco, San Francisco, California
| | | | - Giovanni Neri
- Institute of Medical Genetics, A Gemelli School of Medicine, Catholic University, Rome, Italy
| | - Jacqueline Noonan
- Department of Pediatrics, University of Kentucky, Lexington, Kentucky
| | - Elizabeth I Pierpont
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Kent Reinker
- Department of Orthopedics, University of Texas Health Sciences Center, San Antonio, Texas
| | - Amy E Roberts
- Department of Cardiology and Division of Genetics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Suma Shankar
- Departments of Human Genetics and Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Sullivan
- Departments of Neurology and Pediatrics, University of California at San Francisco, San Francisco, California
| | - Melinda Wolford
- Department of Counseling, Special Education and School Psychology, Youngstown State University, Youngstown, Ohio
| | | | | | - Katherine A Rauen
- Division of Genomic Medicine, Department of Pediatrics, UC Davis MIND Institute, University of California at Davis, Sacramento, California
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32
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Li CY, Prochazka J, Goodwin AF, Klein OD. Fibroblast growth factor signaling in mammalian tooth development. Odontology 2013; 102:1-13. [DOI: 10.1007/s10266-013-0142-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/05/2013] [Indexed: 12/28/2022]
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33
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Sullivan K, El-Hoss J, Quinlan KGR, Deo N, Garton F, Seto JTC, Gdalevitch M, Turner N, Cooney GJ, Kolanczyk M, North KN, Little DG, Schindeler A. NF1 is a critical regulator of muscle development and metabolism. Hum Mol Genet 2013; 23:1250-9. [PMID: 24163128 DOI: 10.1093/hmg/ddt515] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is emerging evidence for reduced muscle function in children with neurofibromatosis type 1 (NF1). We have examined three murine models featuring NF1 deficiency in muscle to study the effect on muscle function as well as any underlying pathophysiology. The Nf1(+/-) mouse exhibited no differences in overall weight, lean tissue mass, fiber size, muscle weakness as measured by grip strength or muscle atrophy-recovery with limb disuse, although this model lacks many other characteristic features of the human disease. Next, muscle-specific knockout mice (Nf1muscle(-/-)) were generated and they exhibited a failure to thrive leading to neonatal lethality. Intramyocellular lipid accumulations were observed by electron microscopy and Oil Red O staining. More mature muscle specimens lacking Nf1 expression taken from the limb-specific Nf1Prx1(-/-) conditional knockout line showed a 10-fold increase in muscle triglyceride content. Enzyme assays revealed a significant increase in the activities of oxidative metabolism enzymes in the Nf1Prx1(-/-) mice. Western analyses showed increases in the expression of fatty acid synthase and the hormone leptin, as well as decreased expression of a number of fatty acid transporters in this mouse line. These data support the hypothesis that NF1 is essential for normal muscle function and survival and are the first to suggest a direct link between NF1 and mitochondrial fatty acid metabolism.
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