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Circulating Biomarkers in Neuromuscular Disorders: What Is Known, What Is New. Biomolecules 2021; 11:biom11081246. [PMID: 34439911 PMCID: PMC8393752 DOI: 10.3390/biom11081246] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 02/07/2023] Open
Abstract
The urgent need for new therapies for some devastating neuromuscular diseases (NMDs), such as Duchenne muscular dystrophy or amyotrophic lateral sclerosis, has led to an intense search for new potential biomarkers. Biomarkers can be classified based on their clinical value into different categories: diagnostic biomarkers confirm the presence of a specific disease, prognostic biomarkers provide information about disease course, and therapeutic biomarkers are designed to predict or measure treatment response. Circulating biomarkers, as opposed to instrumental/invasive ones (e.g., muscle MRI or nerve ultrasound, muscle or nerve biopsy), are generally easier to access and less “time-consuming”. In addition to well-known creatine kinase, other promising molecules seem to be candidate biomarkers to improve the diagnosis, prognosis and prediction of therapeutic response, such as antibodies, neurofilaments, and microRNAs. However, there are some criticalities that can complicate their application: variability during the day, stability, and reliable performance metrics (e.g., accuracy, precision and reproducibility) across laboratories. In the present review, we discuss the application of biochemical biomarkers (both validated and emerging) in the most common NMDs with a focus on their diagnostic, prognostic/predictive and therapeutic application, and finally, we address the critical issues in the introduction of new biomarkers.
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McMillan HJ, Lochmüller H. Biomarkers in Duchenne and Becker muscular dystrophies. Muscle Nerve 2021; 64:4-5. [PMID: 34076279 DOI: 10.1002/mus.27342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Hugh J McMillan
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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3
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Fortunato F, Ferlini A. Clinical application of molecular biomarkers in Duchenne muscular dystrophy: challenges and perspectives. Expert Opin Orphan Drugs 2021. [DOI: 10.1080/21678707.2021.1903872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Fernanda Fortunato
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandra Ferlini
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Al-Khalili Szigyarto C. Duchenne Muscular Dystrophy: recent advances in protein biomarkers and the clinical application. Expert Rev Proteomics 2020; 17:365-375. [PMID: 32713262 DOI: 10.1080/14789450.2020.1773806] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Early biomarker discovery studies have praised the value of their emerging results, predicting an unprecedented impact on health care. Biomarkers are expected to provide tests with increased specificity and sensitivity compared to existing measures, improve the decision-making process, and accelerate the development of therapies. For rare disorders, like Duchenne Muscular Dystrophy (DMD) such biomarkers can assist the development of therapies, therefore also helping to find a cure for the disease. AREA COVERED State-of-the-art technologies have been used to identify blood biomarkers for DMD and efforts have been coordinated to develop and promote translation of biomarkers for clinical practice. Biomarker translation to clinical practice is however, adjoined by challenges related to the complexity of the disease, involving numerous biological processes, and the limited sample resources. This review highlights the current progress on the development of biomarkers, describing the proteomics technologies used, the most promising findings and the challenges encountered. EXPERT OPINION Strategies for effective use of samples combined with orthogonal proteomics methods for protein quantification are essential for translating biomarkers to the patient's bed side. Progress is achieved only if strong evidence is provided that the biomarker constitutes a reliable indicator of the patient's health status for a specific context of use.
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Affiliation(s)
- Cristina Al-Khalili Szigyarto
- Science for Life Laboratory, KTH - Royal Institute of Technology , Solna, Sweden.,School of Chemistry, Biotechnology and Health, KTH - Royal Institute of Technology , Stockholm, Sweden
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Grounds MD, Terrill JR, Al-Mshhdani BA, Duong MN, Radley-Crabb HG, Arthur PG. Biomarkers for Duchenne muscular dystrophy: myonecrosis, inflammation and oxidative stress. Dis Model Mech 2020; 13:13/2/dmm043638. [PMID: 32224496 PMCID: PMC7063669 DOI: 10.1242/dmm.043638] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a lethal, X-linked disease that causes severe loss of muscle mass and function in young children. Promising therapies for DMD are being developed, but the long lead times required when using clinical outcome measures are hindering progress. This progress would be facilitated by robust molecular biomarkers in biofluids, such as blood and urine, which could be used to monitor disease progression and severity, as well as to determine optimal drug dosing before a full clinical trial. Many candidate DMD biomarkers have been identified, but there have been few follow-up studies to validate them. This Review describes the promising biomarkers for dystrophic muscle that have been identified in muscle, mainly using animal models. We strongly focus on myonecrosis and the associated inflammation and oxidative stress in DMD muscle, as the lack of dystrophin causes repeated bouts of myonecrosis, which are the key events that initiate the resultant severe dystropathology. We discuss the early events of intrinsic myonecrosis, along with early regeneration in the context of histological and other measures that are used to quantify its incidence. Molecular biomarkers linked to the closely associated events of inflammation and oxidative damage are discussed, with a focus on research related to protein thiol oxidation and to neutrophils. We summarise data linked to myonecrosis in muscle, blood and urine of dystrophic animal species, and discuss the challenge of translating such biomarkers to the clinic for DMD patients, especially to enhance the success of clinical trials. Summary: This Review discusses biomarkers in blood and urine linked to myonecrosis, inflammation and oxidative stress, to enhance development of therapies for DMD, and the challenges to be overcome for clinical translation.
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Affiliation(s)
- Miranda D Grounds
- School of Human Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Jessica R Terrill
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Basma A Al-Mshhdani
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Marisa N Duong
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Hannah G Radley-Crabb
- School of Pharmacy and Biomedical Sciences, Curtin Health and Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Peter G Arthur
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
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Ropars J, Gravot F, Ben Salem D, Rousseau F, Brochard S, Pons C. Muscle MRI: A biomarker of disease severity in Duchenne muscular dystrophy? A systematic review. Neurology 2019; 94:117-133. [PMID: 31892637 DOI: 10.1212/wnl.0000000000008811] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/29/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To assess the evidence of a relationship between muscle MRI and disease severity in Duchenne muscular dystrophy (DMD). METHODS We conducted a systematic review of studies that analyzed correlations between MRI measurements and motor function in patients with DMD. PubMed, Cochrane, Scopus, and Web of Science were searched using relevant keywords and inclusion/exclusion criteria (January 1, 1990-January 31, 2019). We evaluated article quality using the Joanna Briggs Institute scale. Information regarding the samples included, muscles evaluated, MRI protocols and motor function tests used was collected from each article. Correlations between MRI measurements and motor function were reported exhaustively. RESULTS Seventeen of 1,629 studies identified were included. Most patients included were ambulant with a mean age of 8.9 years. Most studies evaluated lower limb muscles. Moderate to excellent correlations were found between MRI measurements and motor function. The strongest correlations were found for quantitative MRI measurements such as fat fraction or mean T2. Correlations were stronger for lower leg muscles such as soleus. One longitudinal study reported that changes in soleus mean T2 were highly correlated with changes in motor function. CONCLUSION The findings of this systematic review showed that MRI measurements can be used as biomarkers of disease severity in ambulant patients with DMD. Guidelines are proposed to help clinicians choose the most appropriate MRI measurements and muscles to evaluate. Studies exploring upper limb muscles, other stages of the disease, and sensitivity of measurements to change are needed.
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Affiliation(s)
- Juliette Ropars
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France.
| | - France Gravot
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France
| | - Douraied Ben Salem
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France
| | - François Rousseau
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France
| | - Sylvain Brochard
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France
| | - Christelle Pons
- From the Department of Pediatrics (J.R., F.G.), CHU Brest, Brest, France; Neuromuscular Center (J.R., S.B., C.P), Brest, France; Laboratoire du Traitement de l'Information Médicale (J.R., D.B.S., F.R, S.B., C.P.), LaTIM INSERM UMR1101, Brest, France; Department of Radiology (D.B.S.), CHU Brest, Brest, France; Institut Mines Télécom Atlantiques (F.R), Brest, France; and Department of Pediatric Physical and Medical Rehabilitation (S.B., C.P.), Fondation ILDYS, Brest, France
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Hu HH, Branca RT, Hernando D, Karampinos DC, Machann J, McKenzie CA, Wu HH, Yokoo T, Velan SS. Magnetic resonance imaging of obesity and metabolic disorders: Summary from the 2019 ISMRM Workshop. Magn Reson Med 2019; 83:1565-1576. [PMID: 31782551 DOI: 10.1002/mrm.28103] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
Abstract
More than 100 attendees from Australia, Austria, Belgium, Canada, China, Germany, Hong Kong, Indonesia, Japan, Malaysia, the Netherlands, the Philippines, Republic of Korea, Singapore, Sweden, Switzerland, the United Kingdom, and the United States convened in Singapore for the 2019 ISMRM-sponsored workshop on MRI of Obesity and Metabolic Disorders. The scientific program brought together a multidisciplinary group of researchers, trainees, and clinicians and included sessions in diabetes and insulin resistance; an update on recent advances in water-fat MRI acquisition and reconstruction methods; with applications in skeletal muscle, bone marrow, and adipose tissue quantification; a summary of recent findings in brown adipose tissue; new developments in imaging fat in the fetus, placenta, and neonates; the utility of liver elastography in obesity studies; and the emerging role of radiomics in population-based "big data" studies. The workshop featured keynote presentations on nutrition, epidemiology, genetics, and exercise physiology. Forty-four proffered scientific abstracts were also presented, covering the topics of brown adipose tissue, quantitative liver analysis from multiparametric data, disease prevalence and population health, technical and methodological developments in data acquisition and reconstruction, newfound applications of machine learning and neural networks, standardization of proton density fat fraction measurements, and X-nuclei applications. The purpose of this article is to summarize the scientific highlights from the workshop and identify future directions of work.
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Affiliation(s)
- Houchun H Hu
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
| | - Rosa Tamara Branca
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Diego Hernando
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research, Tübingen, Germany.,Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Charles A McKenzie
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Singapore BioImaging Consortium, Agency for Science Technology and Research, Singapore
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Cortés J, Ugalde I, Caviedes J, Ibarra JT. Semillas de montaña: recolección, usos y comercialización del piñón de la araucaria (<em>Araucaria araucana</em>) por comunidades Mapuche-Pewenche del sur de los Andes. PIRINEOS 2019. [DOI: 10.3989/pirineos.2019.174008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
La araucaria (Araucaria araucana), o pewen en lengua mapuche, es un árbol nativo de Chile y Argentina con fuerte importancia cultural para las comunidades mapuche-pewenche del sur de los Andes. Mediante el uso de metodologías cualitativas y técnicas etnográficas, se evaluaron los distintos usos actuales y los aspectos económicos y comerciales asociados al piñón, semilla de la araucaria, en una comuna cordillerana del centro-sur de Chile. Las prácticas locales relacionadas con el piñón dan cuenta de la importancia intrínseca y material de esta semilla, tanto para actores pewenche como para colonos. Nuestros resultados indican que estas prácticas incluyen desde la recolección, pasando por la venta a granel de las semillas, hasta la comercialización de productos elaborados (con valor añadido) de piñón y una creciente oferta de experiencias turísticas que integran piñones, araucarias, cultura y paisajes locales. Concluimos que los procesos de recolección, uso y comercialización del piñón tienen dos componentes fundamentales que dialogan constantemente entre sí: un componente económico, en el sentido comercial y de subsistencia, y un componente biocultural, en el sentido espiritual, social, ecológico y alimentario.
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Verhaart IE, Johnson A, Thakrar S, Vroom E, De Angelis F, Muntoni F, Aartsma-Rus AM, Niks EH. Muscle biopsies in clinical trials for Duchenne muscular dystrophy – Patients’ and caregivers’ perspective. Neuromuscul Disord 2019; 29:576-584. [DOI: 10.1016/j.nmd.2019.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/13/2019] [Accepted: 06/05/2019] [Indexed: 12/25/2022]
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Wong SC, Straub V, Ward LM, Quinlivan R. 236th ENMC International Workshop Bone protective therapy in Duchenne muscular dystrophy: Determining the feasibility and standards of clinical trials Hoofddorp, The Netherlands, 1-3 June 2018. Neuromuscul Disord 2019; 29:251-259. [PMID: 30803852 DOI: 10.1016/j.nmd.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Sze Choong Wong
- Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow, UK.
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Leanne M Ward
- Division of Endocrinology and Metabolism, Children's Hospital of East Ontario, University of Ottawa, Ottawa, Canada
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Disease and Division of Neuropathology, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
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