1
|
Garabano G, Jaime A, Alonso MI, Pesciallo CA. [Bilateral total hip arthroplasty in a 15-year-old patient with progressive pseudorheumatoid dysplasia. Case report and literature review]. ACTA ORTOPEDICA MEXICANA 2024; 38:188-192. [PMID: 38862149 DOI: 10.35366/115814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Progressive pseudorheumatoid dysplasia (PPD) is an autosomal recessive hereditary disease of very low prevalence. It is characterized by the affection of multiple joints, generating arthrosis and progressive deformities from a very young age, which significantly affect the quality of life of patients. Its diagnosis is only confirmed by genetic testing, and no specific pharmacological treatment is still available. In the case of hip involvement, one treatment option is arthroplasty. In this case report, we present a 15-year-old boy with bilateral coxarthrosis secondary to PPD who underwent bilateral total hip arthroplasty in two stages. We highlight the characteristics of this rare entity, the intraoperative findings, the functional outcomes, and the impact on quality of life.
Collapse
Affiliation(s)
- G Garabano
- Servicio de Ortopedia y Traumatología del Hospital Británico de Buenos Aires, Argentina
| | - A Jaime
- Servicio de Ortopedia y Traumatología del Hospital Británico de Buenos Aires, Argentina
| | - M I Alonso
- Servicio de Ortopedia y Traumatología del Hospital Británico de Buenos Aires, Argentina
| | - C A Pesciallo
- Servicio de Ortopedia y Traumatología del Hospital Británico de Buenos Aires, Argentina
| |
Collapse
|
2
|
Billich N, O'Brien K, Fredwall SO, Lee M, Savarirayan R, Davidson ZE. A scoping review of nutrition issues and management strategies in individuals with skeletal dysplasia. Genet Med 2023; 25:100920. [PMID: 37330695 DOI: 10.1016/j.gim.2023.100920] [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: 03/03/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023] Open
Abstract
PURPOSE Skeletal dysplasia are heterogeneous conditions affecting the skeleton. Common nutrition issues include feeding difficulties, obesity, and metabolic complications. This systematic scoping review aimed to identify key nutrition issues, management strategies, and gaps in knowledge regarding nutrition in skeletal dysplasia. METHODS The databases Ovid MEDLINE, Ovid EMBASE, Ebsco CINAHL, Scopus, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews were searched. Reference lists and citing literature for included studies were searched. Eligible studies included participants with skeletal dysplasia and described: anthropometry, body composition, nutrition-related biochemistry, clinical issues, dietary intake, measured energy or nutrition requirements, or nutrition interventions. RESULTS The literature search identified 8509 references from which 138 studies were included (130 observational, 3 intervention, 2 systematic reviews, and 3 clinical guidelines). Across 17 diagnoses identified, most studies described osteogenesis imperfecta (n = 50) and achondroplasia or hypochondroplasia (n = 47). Nutrition-related clinical issues, biochemistry, obesity, and metabolic complications were most commonly reported, and few studies measured energy requirements (n = 5). CONCLUSION Nutrition-related comorbidities are documented in skeletal dysplasia; yet, evidence to guide management is scarce. Evidence describing nutrition in rarer skeletal dysplasia conditions is lacking. Advances in skeletal dysplasia nutrition knowledge is needed to optimize broader health outcomes.
Collapse
Affiliation(s)
- Natassja Billich
- Murdoch Children's Research Institute, Parkville, VIC, Australia; The University of Queensland, St Lucia, QLD, Australia.
| | - Katie O'Brien
- Royal Children's Hospital, Parkville, VIC, Australia; Monash University, Clayton, VIC, Australia
| | - Svein O Fredwall
- Murdoch Children's Research Institute, Parkville, VIC, Australia; TRS National Resource Centre for Rare Disorders, Sunnaas Rehabiliation Hospital, Nesodden, Norway
| | | | - Ravi Savarirayan
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Parkville, VIC, Australia
| | - Zoe E Davidson
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Monash University, Clayton, VIC, Australia
| |
Collapse
|
3
|
El Dessouki D, Amr K, Kholoussi N, Rady HM, Temtamy SA, Abdou MMS, Aglan M. Clinical and molecular characterization in a cohort of patients with progressive pseudorheumatoid dysplasia. Am J Med Genet A 2023; 191:2329-2336. [PMID: 37377052 DOI: 10.1002/ajmg.a.63339] [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: 03/21/2023] [Revised: 06/05/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023]
Abstract
Progressive pseudorheumatoid dysplasia (PPRD), a rare autosomal recessive syndrome, is a type of skeletal dysplasia associated with pain, stiffness, swelling of multiple joints, and the absence of destructive changes. PPRD occurs due to loss of function pathogenic variants in WISP3 (CCN6) gene, located on chromosome 6q22. In this study, 23 unrelated Egyptian PPRD patients were clinically diagnosed based on medical history, physical and radiological examinations, and laboratory investigations. Sequencing of the whole WISP3 (CCN6) exons and introns boundaries was carried out for all patients. A total of 11 different sequence variations were identified in the WISP3 (CCN6) gene, five of them were new pathogenic variants: the NM_003880.3: c.80T>A (p.L27*), c.161delG (p.C54fs*12), c.737T>C (p.Leu246Pro), c.347-1G>A (IVS3-1G>A), and c.376C>T (p.Q126*). The results of this study expand the spectrum of WISP3 (CCN6) pathogenic variants associated with PPRD. Clinical and genetic analysis is important for proper genetic counseling to curb this rare disorder in the families.
Collapse
Affiliation(s)
- Dina El Dessouki
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Khalda Amr
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Naglaa Kholoussi
- Immunogenetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Hanaa M Rady
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samia Ali Temtamy
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Manal M S Abdou
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Aglan
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| |
Collapse
|
4
|
Ganguly A, Padhan DK, Sengupta A, Chakraborty P, Sen M. CCN6 influences transcription and controls mitochondrial mass and muscle organization. FASEB J 2023; 37:e22815. [PMID: 36794678 DOI: 10.1096/fj.202201533r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023]
Abstract
Mutations in Cellular Communication Network Factor 6 (CCN6) are linked to the debilitating musculoskeletal disease Progressive Pseudo Rheumatoid Dysplasia (PPRD), which disrupts mobility. Yet, much remains unknown about CCN6 function at the molecular level. In this study, we revealed a new function of CCN6 in transcriptional regulation. We demonstrated that CCN6 localizes to chromatin and associates with RNA Polymerase II in human chondrocyte lines. Using zebrafish as a model organism we validated the nuclear presence of CCN6 and its association with RNA Polymerase II in different developmental stages from 10 hpf embryo to adult fish muscle. In concurrence with these findings, we confirmed the requirement of CCN6 in the transcription of several genes encoding mitochondrial electron transport complex proteins in the zebrafish, both in the embryonic stages and in the adult muscle. Reduction in the expression of these genes upon morpholino-mediated knockdown of CCN6 protein expression led to reduced mitochondrial mass, which correlated with defective myotome organization during zebrafish muscle development. Overall, this study suggests that the developmental musculoskeletal abnormalities linked with PPRD could be contributed at least partly by impaired expression of genes encoding mitochondrial electron transport complexes due to defects in CCN6 associated transcriptional regulation.
Collapse
Affiliation(s)
- Ananya Ganguly
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Deepesh Kumar Padhan
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Archya Sengupta
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Pritam Chakraborty
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India.,Biochemistry and Molecular Biology, Southern Illinois University, USA
| | - Malini Sen
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| |
Collapse
|
5
|
Gait Alterations in Two Young Siblings with Progressive Pseudorheumatoid Dysplasia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121982. [PMID: 36553423 PMCID: PMC9776635 DOI: 10.3390/children9121982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Progressive pseudorheumatoid dysplasia (PPRD) is an autosomal recessive inherited skeletal dysplasia characterized by progressive non-inflammatory arthropathy affecting primarily the articular cartilage. Currently, little is known about the functional musculoskeletal aspects of these patients. In particular, an abnormal gait pattern has been described, without a clear hypothesis of the underlying causes in terms of muscular activity. This study presents the case of two siblings, 4 and 9 years old, a boy and a girl, respectively, suffering from PPRD at different stages of the disease. In addition to the clinical assessment, an instrumental gait analysis was performed. Swelling of the interphalangeal finger joints and fatigue were present in both cases. Gait abnormalities consisted of a relevant reduction in the ankle plantarflexion in the terminal phase of the gait cycle, associated with reduced gastrocnemius EMG activity and increased activity of the tibialis anterior, resulting in overloading at the initial peak of ground reaction forces. Gait anomalies observed were similar in both siblings with PPRD, although at different ages, and confirm walking patterns previously described in the literature. The calf muscle strength deficit and reduced activity during the stance phase of gait present in these two siblings indicate the typical absence of the propulsive phase. A stomping gait pattern, with the foot striking the ground hard on each step, was originally described. Further neurophysiological investigations are required to determine the origin of muscle weakness.
Collapse
|
6
|
Uludağ Alkaya D, Kasapçopur Ö, Bursalı A, Adrovic A, Demir B, Aykut A, Tüysüz B. Specific early signs and long-term follow-up findings of Progressive Pseudorheumatoid Dysplasia (PPRD) in the Turkish cohort. Rheumatology (Oxford) 2021; 61:3693-3703. [PMID: 34919662 DOI: 10.1093/rheumatology/keab926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/08/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Progressive pseudorheumatoid dysplasia (PPRD) is a spondyloepiphyseal dysplasia caused by biallelic variants in CCN6. This study aimed to describe the early signs and follow-up findings in forty-four Turkish PPRD patients. METHODS The patients with progressive stiffness of multiple joints, characteristic wide metaphysis of interphalangeal (IP) joints, and platyspondyly were clinically diagnosed with PPRD. Fifteen patients who had first symptoms under 3 years of age were grouped as early-onset, while others were grouped as classical. CCN6 sequencing was performed in 43 patients. RESULTS Thirteen pathogenic/likely pathogenic variants were identified, five were novel. c.156C>A(p.Cys52*) variant was found in 53.3% of the families. The initial symptom in the early-onset group was genu varum deformity, while it was widening of IP joints in the classical group. The median age of onset of symptoms and of diagnosis was 4 and 9.7 years, respectively. The mean follow-up duration was 5.6 years. The median age of onset of IP, elbow, knee, and hip stiffness, which became progressive with growth was 5, 9, 9, and 12.2 years, respectively. Waddling gait occurred in 97.7% of the patients. 47.7% lost independent walking ability at the median age of 12 years. In the early-onset group, waddling gait occurred earlier than in classical group (p< 0.001). Two patients had atypical presentation with late-onset and mild or lack of IP involvement. CONCLUSION We observed that genu varum deformity before the age of 3 years was an early sign for PPRD and almost half of the patients lost walking ability at the median age of 12 years.
Collapse
Affiliation(s)
- Dilek Uludağ Alkaya
- Department of Pediatric Genetics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Özgür Kasapçopur
- Department of Pediatric Rheumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayşegül Bursalı
- Department of Orthopedics and Traumatology, University of Health Sciences Turkey, Baltalimani Bone Diseases Training and Research Center, Istanbul, Turkey
| | - Amra Adrovic
- Department of Pediatric Rheumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bilal Demir
- Department of Orthopedics and Traumatology, University of Health Sciences Turkey, Baltalimani Bone Diseases Training and Research Center, Istanbul, Turkey
| | - Ayça Aykut
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Beyhan Tüysüz
- Department of Pediatric Genetics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
7
|
Kaya Akca U, Simsek Kiper PO, Urel Demir G, Sag E, Atalay E, Utine GE, Alikasifoglu M, Boduroglu K, Bilginer Y, Ozen S. Genetic disorders with symptoms mimicking rheumatologic diseases: A single-center retrospective study. Eur J Med Genet 2021; 64:104185. [PMID: 33662637 DOI: 10.1016/j.ejmg.2021.104185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/11/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
Musculoskeletal symptoms may be due to noninflammatory causes, including genetic disorders. We aimed to examine the final genetic diagnosis in patients who presented with musculoskeletal complaints to the rheumatology department. Patients who presented to the Department of Pediatric Rheumatology and were referred to the pediatric genetic department between January 2015 and May 2019 were evaluated retrospectively. A total of 60 patients, 19 boys (31.66%), with a mean age of 12.46 ± 1.41 years were included in the study. The total consanguinity rate was 25%. The most common (29.5%) cause of referral to the pediatric genetic department was the presence of skeletal anomalies (such as camptodactyly, clinodactyly, and short stature) with accompanying joint findings. Approximately one-third of the patients (n: 19) were diagnosed and followed up by the pediatric genetics department. The diagnoses of patients were as follows: camptodactyly, arthropathy, coxa vara, and pericarditis (CACP) syndrome (n: 3); trichorhinophalangeal syndrome (n: 1); progressive pseudorheumatoid dysplasia (n: 2); LIG4 syndrome (n: 1); H syndrome (n: 1); spondyloenchondrodysplasia (SPENCD) (n: 3); and nonspecific connective tissue disorders (n: 8). In the differential diagnosis of patients who are referred to the Department of Pediatric Rheumatology with complaints of the musculoskeletal system, genetic disorders should also be considered.
Collapse
Affiliation(s)
- Ummusen Kaya Akca
- Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Gizem Urel Demir
- Department of Pediatric Genetics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erdal Sag
- Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erdal Atalay
- Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gulen Eda Utine
- Department of Pediatric Genetics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Alikasifoglu
- Department of Medical Genetics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Koray Boduroglu
- Department of Pediatric Genetics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Bilginer
- Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seza Ozen
- Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| |
Collapse
|
8
|
Sengupta A, Padhan DK, Ganguly A, Sen M. Ccn6 Is Required for Mitochondrial Integrity and Skeletal Muscle Function in Zebrafish. Front Cell Dev Biol 2021; 9:627409. [PMID: 33644064 PMCID: PMC7905066 DOI: 10.3389/fcell.2021.627409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/05/2021] [Indexed: 11/21/2022] Open
Abstract
Mutations in the CCN6 (WISP3) gene are linked with a debilitating musculoskeletal disorder, termed progressive pseudorheumatoid dysplasia (PPRD). Yet, the functional significance of CCN6 in the musculoskeletal system remains unclear. Using zebrafish as a model organism, we demonstrated that zebrafish Ccn6 is present partly as a component of mitochondrial respiratory complexes in the skeletal muscle of zebrafish. Morpholino-mediated depletion of Ccn6 in the skeletal muscle leads to a significant reduction in mitochondrial respiratory complex assembly and activity, which correlates with loss of muscle mitochondrial abundance. These mitochondrial deficiencies are associated with notable architectural and functional anomalies in the zebrafish muscle. Taken together, our results indicate that Ccn6-mediated regulation of mitochondrial respiratory complex assembly/activity and mitochondrial integrity is important for the maintenance of skeletal muscle structure and function in zebrafish. Furthermore, this study suggests that defects related to mitochondrial respiratory complex assembly/activity and integrity could be an underlying cause of muscle weakness and a failed musculoskeletal system in PPRD.
Collapse
Affiliation(s)
- Archya Sengupta
- Division of Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Deepesh Kumar Padhan
- Division of Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Ananya Ganguly
- Division of Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Malini Sen
- Division of Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| |
Collapse
|
9
|
Fathalla BM, Elgabaly EA, Tayoun AA. Coexistence of a novel WISP3 pathogenic variant and an MEFV mutation in an Arabic family with progressive pseudorheumatoid dysplasia mimicking polyarticular juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2020; 18:69. [PMID: 32894151 PMCID: PMC7487543 DOI: 10.1186/s12969-020-00462-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A spectrum of rare noninflammatory disorders may present with arthropathy that arises from bony dysplasia, a thickened synovium, and noninflammatory effusion, leading to a constellation of clinical features that mimics chronic polyarticular juvenile idiopathic arthritis (JIA). We report a unique Arabic family harboring a novel pathogenic variant in the WISP3 gene and presenting with progressive pseudorheumatoid dysplasia (PPRD), a rare noninflammatory arthropathy mimicking polyarticular JIA. CASE PRESENTATION An Arabic family with PPRD was diagnosed using whole-exome sequencing (WES), revealing a novel c.707delG pathogenic variant in the WISP3 gene. The proband was referred at 10 years old for possible diagnosis of polyarticular JIA based on progressive arthropathy for three years. He was already on naproxen and methotrexate. We suspected familial noninflammatory arthropathy based on clinical manifestations, imaging findings, and family history. WES confirmed the molecular diagnosis of PPRD in the proband and one sister with a similar phenotype. An unexpected p.A744S MEFV pathogenic variant was detected in the proband, parents, and affected sister. CONCLUSIONS Early identification and diagnosis of familial noninflammatory arthropathies such as PPRD can prevent unnecessary use of immunosuppressive medications. Diagnosis requires high suspicion in children with early onset arthritic changes, absence of elevated inflammatory markers, specific imaging findings, and positive family history suggestive of an autosomal recessive disorder. We highlight the advantages of WES over single-gene analysis in such cases.
Collapse
Affiliation(s)
- Basil M. Fathalla
- Section of Pediatric Rheumatology, Department of Medical Subspecialties, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates
| | - Elham Ahmed Elgabaly
- Department of Radiology, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates
| | - Ahmad Abou Tayoun
- Department of Genomics, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates
| |
Collapse
|
10
|
Patel C, Khanshour AM, Wilkes D, Rios JJ, Sheff KW, Nassi L, Wise CA. Novel homozygous variant in WISP3 in a family with unrecognized progressive pseudorheumatoid dysplasia. Clin Case Rep 2020; 8:1452-1457. [PMID: 32884773 PMCID: PMC7455413 DOI: 10.1002/ccr3.2884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/19/2020] [Accepted: 03/29/2020] [Indexed: 11/18/2022] Open
Abstract
We present the use of whole-genome sequencing to correctly diagnose progressive pseudorheumatoid dysplasia in patients with atypical clinical and radiologic findings and prior diagnosis of juvenile idiopathic arthritis.
Collapse
Affiliation(s)
- Chandreshkumar Patel
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchTexas Scottish Rite Hospital for ChildrenDallasTXUSA
| | - Anas M. Khanshour
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchTexas Scottish Rite Hospital for ChildrenDallasTXUSA
| | - David Wilkes
- Radiology DepartmentTexas Scottish Rite Hospital for ChildrenDallasTXUSA
| | - Jonathan J. Rios
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchTexas Scottish Rite Hospital for ChildrenDallasTXUSA
- McDermott Center for Human Growth and DevelopmentUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Department of PediatricsUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Orthopaedic SurgeryUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Kelly W. Sheff
- North Texas Genome CenterUniversity of Texas at ArlingtonArlingtonTXUSA
| | - Lorien Nassi
- Department of PediatricsUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Carol A. Wise
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchTexas Scottish Rite Hospital for ChildrenDallasTXUSA
- McDermott Center for Human Growth and DevelopmentUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Department of PediatricsUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Orthopaedic SurgeryUniversity of Texas Southwestern Medical CenterDallasTXUSA
| |
Collapse
|
11
|
Padhan DK, Sengupta A, Patra M, Ganguly A, Mahata SK, Sen M. CCN6 regulates mitochondrial respiratory complex assembly and activity. FASEB J 2020; 34:12163-12176. [PMID: 32686858 DOI: 10.1096/fj.202000405rr] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/29/2022]
Abstract
Cellular communication network factor 6 (CCN6) mutations are linked with Progressive Pseudo Rheumatoid Dysplasia (PPRD) a debilitating musculoskeletal disorder. The function of CCN6 and the mechanism of PPRD pathogenesis remain unclear. Accordingly, we focused on the functional characterization of CCN6 and CCN6 mutants. Using size exclusion chromatography and native polyacrylamide gel electrophoresis we demonstrated that CCN6 is present as a component of the mitochondrial respiratory complex in human chondrocyte lines. By means of siRNA-mediated transfection and electron microscopy we showed that moderate reduction in CCN6 expression decreases the RER- mitochondria inter-membrane distance. Parallel native PAGE, immunoblotting and Complex I activity assays furthermore revealed increase in both mitochondrial distribution of CCN6 and mitochondrial respiratory complex assembly/activity in CCN6 depleted cells. CCN6 mutants resembling those linked with PPRD, which were generated by CRISPR-Cas9 technology displayed low level of expression of mutant CCN6 protein and inhibited respiratory complex assembly/activity. Electron microscopy and MTT assay of the mutants revealed abnormal mitochondria and poor cell viability. Taken together, our results indicate that CCN6 regulates mitochondrial respiratory complex assembly/activity as part of the mitochondrial respiratory complex by controlling the proximity of RER with the mitochondria, and CCN6 mutations disrupt mitochondrial respiratory complex assembly/activity resulting in mitochondrial defects and poor cell viability.
Collapse
Affiliation(s)
- Deepesh Kumar Padhan
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Archya Sengupta
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Milan Patra
- Hadassah Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ananya Ganguly
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Sushil Kumar Mahata
- VA San Diego Healthcare System, University of California, San Diego, CA, USA
| | - Malini Sen
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| |
Collapse
|
12
|
Wang Y, Xiao K, Yang Y, Wu Z, Jin J, Qiu G, Weng X, Zhao X. CCN6 mutation detection in Chinese patients with progressive pseudo-rheumatoid dysplasia and identification of four novel mutations. Mol Genet Genomic Med 2020; 8:e1261. [PMID: 32351055 PMCID: PMC7336755 DOI: 10.1002/mgg3.1261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/20/2020] [Accepted: 03/27/2020] [Indexed: 02/05/2023] Open
Abstract
Background No formal diagnostic criteria for progressive pseudo‐rheumatoid dysplasia (PPD) are available because of insufficient clinical data, which results in that PPD is often misdiagnosed with other diseases. Whole exome sequencing (WES) and Sanger sequencing were employed to reveal the novel mutations on CCN6 of five patients with PPD from China in order to increase the clinical data of PPD. Methods Four suspected PPD pedigrees containing five patients in total were collected from 1998 to 2018 in our medical center. The phenotypes of each suspected PPD case were recorded in detail, and peripheral blood samples were collected for subsequent sequencing. Genomic DNA was extracted from peripheral blood samples, and Agilent liquid phase chip capture system was utilized for efficient enrichment of whole exome region DNA. After acquiring raw sequenced reads of whole exome region, bioinformatics analysis was completed in conjunction with reference or genome sequence (GRCh37/hg19). Sanger sequencing was performed to identify the results of WES. Results In total, four novel PPD‐related mutation sites in CCN6 gene were identified including (CCN6):c.643 + 2T>C, (CCN6):c.1064_1065dupGT(p.Gln356ValfsTer33), (CCN6):c.1064G > A), and exon4:c.670dupA:p.W223fs. Conclusion Our findings increase the clinical data of PPD including the CCN6 mutation spectrum, the clinical symptoms and signs. Moreover, the study highlights the utility of WES in reaching definitive diagnoses for PPD.
Collapse
Affiliation(s)
- Yingjie Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Ke Xiao
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuemei Yang
- Central Laboratory, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Zhihong Wu
- Central Laboratory, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Jin Jin
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Guixing Qiu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Xisheng Weng
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China
| | - Xiuli Zhao
- Department of Medical Genetics, School of Basic Medicine, Peking Union Medical College, Beijing, China
| |
Collapse
|
13
|
Pomeranz CB, Reid JR. Progressive pseudorheumatoid dysplasia: a report of three cases and a review of radiographic and magnetic resonance imaging findings. Skeletal Radiol 2019; 48:1323-1328. [PMID: 30712121 DOI: 10.1007/s00256-019-3165-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 02/02/2023]
Abstract
Progressive pseudorheumatoid dysplasia (PPD) is a rare disorder of postnatal skeletal and cartilage development that often presents with similar clinical findings to juvenile idiopathic arthritis. Patients with PPD display findings of progressive cartilage loss and secondary osteoarthritis over serial imaging studies and have an absence of elevation of inflammatory markers. Awareness of the imaging features of PPD on radiographs and magnetic resonance imaging (MRI) may be important for early diagnosis and surveillance of the disease.
Collapse
Affiliation(s)
- Christy B Pomeranz
- Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medicine, 525 E. 68th St., F631E, New York, NY, 10065, USA.
| | - Janet R Reid
- Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA
| |
Collapse
|
14
|
Progressive Pseudorheumatoid Dysplasia resolved by whole exome sequencing: a novel mutation in WISP3 and review of the literature. BMC MEDICAL GENETICS 2019; 20:53. [PMID: 30922245 PMCID: PMC6439983 DOI: 10.1186/s12881-019-0787-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/18/2019] [Indexed: 12/23/2022]
Abstract
Background Progressive pseudorheumatoid dysplasia (PPRD) is a rare autosomal-recessive, non-inflammatory arthropathy, shown to be caused by mutations in the WNT1-inducible signaling pathway protein 3 (WISP3) gene. Although several hundred cases were reported worldwide, the diagnosis remains challenging. Subsequently, the syndrome is often unrecognized and misdiagnosed (for instance, as Juvenile Idiopathic Arthritis), leading to unnecessary procedures and treatments. The objective of the current study was to identify the molecular basis in a family with PPRD and describe their phenotype and course of illness. Patients and methods We present here a multiply affected consanguineous family of Iraqi-Jewish descent with PPRD. The proband, a 6.5 years old girl, presented with bilateral symmetric bony enlargements of the 1st interphalangeal joints of the hands, without signs of synovitis. Molecular analysis of the family was pursued using Whole Exome Sequencing (WES) and homozygosity mapping. Results WES analysis brought to the identification of a novel homozygous missense mutation (c.257G > T, p.C86F) in the WISP3 gene. Following this diagnosis, an additional 53 years old affected family member was found to harbor the mutation. Two other individuals in the family were reported to have had similar involvement however both had died of unrelated causes. Conclusion The reported family underscores the importance of recognition of this unique skeletal dysplasia by clinicians, and especially by pediatric rheumatologists and orthopedic surgeons. Electronic supplementary material The online version of this article (10.1186/s12881-019-0787-x) contains supplementary material, which is available to authorized users.
Collapse
|
15
|
Torreggiani S, Torcoletti M, Campos-Xavier B, Baldo F, Agostoni C, Superti-Furga A, Filocamo G. Progressive pseudorheumatoid dysplasia: a rare childhood disease. Rheumatol Int 2018; 39:441-452. [PMID: 30327864 DOI: 10.1007/s00296-018-4170-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/04/2018] [Indexed: 01/13/2023]
Abstract
Progressive pseudorheumatoid dysplasia (PPRD) is a genetic bone disorder characterised by the progressive degeneration of articular cartilage that leads to pain, stiffness and joint enlargement. As PPRD is a rare disease, available literature is mainly represented by single case reports and only a few larger case series. Our aim is to review the literature concerning clinical, laboratory and radiological features of PPRD. PPRD is due to a mutation in Wnt1-inducible signalling protein 3 (WISP3) gene, which encodes a signalling factor involved in cartilage homeostasis. The disease onset in childhood and skeletal changes progresses over time leading to significant disability. PPRD is a rare condition that should be suspected if a child develops symmetrical polyarticular involvement without systemic inflammation, knobbly interphalangeal joints of the hands, and gait abnormalities. A full skeletal survey, or at least a lateral radiograph of the spine, can direct towards a correct diagnosis that can be confirmed molecularly. More than 70 WISP3 mutations have so far been reported. Genetic testing should start with the study of genomic DNA extracted from blood leucocytes, but intronic mutations in WISP3 causing splicing aberrations can only be detected by analysing WISP3 mRNA, which can be extracted from cultured skin fibroblasts. A skin biopsy is, therefore, indicated in patients with typical PPRD findings and negative mutation screening of genomic DNA.
Collapse
Affiliation(s)
- Sofia Torreggiani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy.
| | - Marta Torcoletti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy
| | - Belinda Campos-Xavier
- Division of Genetic Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Francesco Baldo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy
| | - Andrea Superti-Furga
- Division of Genetic Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Giovanni Filocamo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy
| |
Collapse
|
16
|
Al-Mayouf SM. Noninflammatory disorders mimic juvenile idiopathic arthritis. Int J Pediatr Adolesc Med 2018; 5:1-4. [PMID: 30805524 PMCID: PMC6363254 DOI: 10.1016/j.ijpam.2018.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 12/17/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic childhood arthritis; unfortunately, no diagnostic tool is available. Genetic disorders with musculoskeletal involvement that mimic chronic polyarthritis should be considered in the differential diagnostics of JIA. Normal inflammatory markers and characteristic radiological features are able to distinguish these disorders from JIA. Timely diagnosis of these disorders is crucial to offer the family proper genetic counseling and avoid inappropriate therapy. This review highlights selected noninflammatory disorders that often present with articular manifestations and that are often mislabeled as JIA. The focus is on the clinical, biochemical, and imaging features of these disorders.
Collapse
Affiliation(s)
- Sulaiman M. Al-Mayouf
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
17
|
Sailani MR, Chappell J, Jingga I, Narasimha A, Zia A, Lynch JL, Mazrouei S, Bernstein JA, Aryani O, Snyder MP. WISP3 mutation associated with pseudorheumatoid dysplasia. Cold Spring Harb Mol Case Stud 2018; 4:mcs.a001990. [PMID: 29092958 PMCID: PMC5793776 DOI: 10.1101/mcs.a001990] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 09/28/2017] [Indexed: 01/28/2023] Open
Abstract
Progressive pseudorheumatoid dysplasia (PPD) is a skeletal dysplasia characterized by predominant involvement of articular cartilage with progressive joint stiffness. Here we report genetic characterization of a consanguineous family segregating an uncharacterized from of skeletal dysplasia. Whole-exome sequencing of four affected siblings and their parents identified a loss-of-function homozygous mutation in the WISP3 gene, leading to diagnosis of PPD in the affected individuals. The identified variant (Chr6: 112382301; WISP3:c.156C>A p.Cys52*) is rare and predicted to cause premature termination of the WISP3 protein.
Collapse
Affiliation(s)
- M Reza Sailani
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - James Chappell
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - Inlora Jingga
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - Anil Narasimha
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - Amin Zia
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - Janet Linnea Lynch
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| | - Safoura Mazrouei
- Clinic of Internal Medicine, Department of Cardiology, University Heart Center, Jena University Hospital, 07747 Jena, Germany
| | | | - Omid Aryani
- Department of Neuroscience, Iran University of Medical Sciences, Tehran 1449614535, Iran.,Endocrinology and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran 1599666615, Iran
| | - Michael P Snyder
- Department of Genetics, Stanford University, Stanford, California 94304, USA
| |
Collapse
|
18
|
Whole Exome Screening Identifies Novel and Recurrent WISP3 Mutations Causing Progressive Pseudorheumatoid Dysplasia in Jammu and Kashmir-India. Sci Rep 2016; 6:27684. [PMID: 27291587 PMCID: PMC4904372 DOI: 10.1038/srep27684] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/20/2016] [Indexed: 01/03/2023] Open
Abstract
We report identification and genetic characterization of a rare skeletal disorder that remained unidentified for decades in a village of Jammu and Kashmir, India. The population residing in this region is highly consanguineous and a lack of understanding of the disorder has hindered clinical management and genetic counseling for the many affected individuals in the region. We collected familial information and identified two large extended multiplex pedigrees displaying apparent autosomal recessive inheritance of an uncharacterized skeletal dysplasia. Whole exome sequencing (WES) in members of one pedigree revealed a rare mutation in WISP3:c.156C > A (NP_003871.1:p.Cys52Ter), that perfectly segregated with the disease in the family. To our surprise, Sanger sequencing the WISP3 gene in the second family identified a distinct, novel splice site mutation c.643 + 1G > A, that perfectly segregated with the disease. Combining our next generation sequencing data with careful clinical documentation (familial histories, genetic data, clinical and radiological findings), we have diagnosed the families with Progressive Pseudorheumatoid Dysplasia (PPD). Our results underscore the utility of WES in arriving at definitive diagnoses for rare skeletal dysplasias. This genetic characterization will aid in genetic counseling and management, critically required to curb this rare disorder in the families.
Collapse
|
19
|
Patra M, Mahata SK, Padhan DK, Sen M. CCN6 regulates mitochondrial function. J Cell Sci 2016; 129:2841-51. [PMID: 27252383 DOI: 10.1242/jcs.186247] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 04/08/2016] [Indexed: 12/29/2022] Open
Abstract
Despite established links of CCN6, or Wnt induced signaling protein-3 (WISP3), with progressive pseudo rheumatoid dysplasia, functional characterization of CCN6 remains incomplete. In light of the documented negative correlation between accumulation of reactive oxygen species (ROS) and CCN6 expression, we investigated whether CCN6 regulates ROS accumulation through its influence on mitochondrial function. We found that CCN6 localizes to mitochondria, and depletion of CCN6 in the chondrocyte cell line C-28/I2 by using siRNA results in altered mitochondrial electron transport and respiration. Enhanced electron transport chain (ETC) activity of CCN6-depleted cells was reflected by increased mitochondrial ROS levels in association with augmented mitochondrial ATP synthesis, mitochondrial membrane potential and Ca(2+) Additionally, CCN6-depleted cells display ROS-dependent PGC1α (also known as PPARGC1A) induction, which correlates with increased mitochondrial mass and volume density, together with altered mitochondrial morphology. Interestingly, transcription factor Nrf2 (also known as NFE2L2) repressed CCN6 expression. Taken together, our results suggest that CCN6 acts as a molecular brake, which is appropriately balanced by Nrf2, in regulating mitochondrial function.
Collapse
Affiliation(s)
- Milan Patra
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian institute of Chemical Biology, 4-Raja S.C. Mullick Road, Jadavpur, Kolkata 700032, India
| | - Sushil K Mahata
- Metabolic Physiology and Ultrastructure Biology Laboratory, University of California, San Diego, CA 92093-0732, USA Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Deepesh K Padhan
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian institute of Chemical Biology, 4-Raja S.C. Mullick Road, Jadavpur, Kolkata 700032, India
| | - Malini Sen
- Cancer Biology and Inflammatory Disorder Division, CSIR-Indian institute of Chemical Biology, 4-Raja S.C. Mullick Road, Jadavpur, Kolkata 700032, India
| |
Collapse
|
20
|
Montané LS, Marín OR, Rivera-Pedroza CI, Vallespín E, del Pozo Á, Heath KE. Early severe scoliosis in a patient with atypical progressive pseudorheumatoid dysplasia (PPD): Identification of twoWISP3mutations, one previously unreported. Am J Med Genet A 2016; 170:1595-9. [DOI: 10.1002/ajmg.a.37619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/26/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Lucia Sentchordi Montané
- Department of Pediatrics; Hospital Universitario Infanta Leonor; Madrid Spain
- Multidisciplinary Unit for Skeletal dysplasias (UMDE); Hospital Universitario La Paz; Madrid Spain
- Institute of Medical and Molecular Genetics (INGEMM); Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ; Madrid Spain
| | - Oliver R. Marín
- Department of Traumatology and Orthopedics; Hospital Universitario Infanta Leonor; Madrid Spain
| | - Carlos I. Rivera-Pedroza
- Multidisciplinary Unit for Skeletal dysplasias (UMDE); Hospital Universitario La Paz; Madrid Spain
- Institute of Medical and Molecular Genetics (INGEMM); Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ; Madrid Spain
| | - Elena Vallespín
- Institute of Medical and Molecular Genetics (INGEMM); Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ; Madrid Spain
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER); Instituto Carlos III; Madrid Spain
| | - Ángela del Pozo
- Institute of Medical and Molecular Genetics (INGEMM); Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ; Madrid Spain
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER); Instituto Carlos III; Madrid Spain
| | - Karen E. Heath
- Multidisciplinary Unit for Skeletal dysplasias (UMDE); Hospital Universitario La Paz; Madrid Spain
- Institute of Medical and Molecular Genetics (INGEMM); Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ; Madrid Spain
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER); Instituto Carlos III; Madrid Spain
| |
Collapse
|
21
|
Hartmann M, Merker J, Haefner R, Haas JP, Schwirtz A. Biomechanics of walking in adolescents with progressive pseudorheumatoid arthropathy of childhood leads to physical activity recommendations as therapeutic focus. Clin Biomech (Bristol, Avon) 2016; 31:93-9. [PMID: 26447781 DOI: 10.1016/j.clinbiomech.2015.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Progressive pseudorheumatoid arthropathy of childhood is a rare disease with an estimated prevalence of approximately 1/1,000,000. The disease manifests around the age of three to eight years and progresses with symptoms of early fatigue, muscle weakness, joint swelling and stiffness. The resulting functional limitations are often described as having a waddling gait. Walking is difficult and can be managed with multilevel compensation movements only. Aims of this study were to determine typical malpositions that arise during walking and to identify preventive strategies to reduce excessive joint damage. METHODS This study presents data of three-dimensional gait analysis of nine patients with progressive pseudorheumatoid arthropathy of childhood (♀=2; ♂=7; 13.3y; 47.0kg; 1.39m; BMI: 24.2kg/m(2)) performed with eight infrared cameras and the Plug-in-Gait Model. For comparison of spatiotemporal and kinematic parameters with age-matched healthy controls (♀=6; ♂=3; 13.4y; 49.0kg; 1.61m; BMI: 18.9kg/m(2)), the Mann-Whitney U-test was applied with a significance level of P<0.05. FINDINGS The patients had a significantly lower height, but higher BMI. Walking speed was reduced with wide, but short steps and significant motion anomalies in the pelvis, hips, knees and ankles. Small ranges of motion in propulsion-supporting movements were typical, especially in the sagittal plane. The gait analysis revealed dominant compensatory movements in pelvic obliquity and rotation. INTERPRETATION The deficits can be attributed to pronounced muscle weakness plus functional joint impairment and pain. Therapeutic preventive strategies therefore should consider continuous muscle power exercises, stretching programmes and restrictive weight control.
Collapse
Affiliation(s)
- Matthias Hartmann
- German Center for Pediatric and Adolescent Rheumatology, Gehfeldstraße 24, 82467 Garmisch-Partenkirchen, Germany.
| | - Josephine Merker
- German Center for Pediatric and Adolescent Rheumatology, Gehfeldstraße 24, 82467 Garmisch-Partenkirchen, Germany; Department of Biomechanics in Sports, Faculty of Sports and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany.
| | - Renate Haefner
- German Center for Pediatric and Adolescent Rheumatology, Gehfeldstraße 24, 82467 Garmisch-Partenkirchen, Germany.
| | - Johannes-Peter Haas
- German Center for Pediatric and Adolescent Rheumatology, Gehfeldstraße 24, 82467 Garmisch-Partenkirchen, Germany.
| | - Ansgar Schwirtz
- Department of Biomechanics in Sports, Faculty of Sports and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany.
| |
Collapse
|
22
|
|
23
|
Malhotra D, Yang Y. Wnts' fashion statement: from body stature to dysplasia. BONEKEY REPORTS 2014; 3:541. [PMID: 24991404 DOI: 10.1038/bonekey.2014.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 03/26/2014] [Accepted: 03/27/2014] [Indexed: 12/17/2022]
Abstract
Bone is constantly being made and remodeled to maintain bone volume and calcium homeostasis. Even small changes in the dosage, location and duration of int/Wingless (Wnt) signaling affect skeletal development and homeostasis. Wnt/β-catenin signaling controls cell fate determination, proliferation and survival by affecting a balance between bone-forming osteoblast and bone-resorbing osteoclast cell differentiation. During early skeletal development, Wnt/β-catenin signaling is required in directing mesenchymal progenitor cells toward the osteoblast lineage. Later, Wnt/β-catenin in chondrocytes of the growth plate promotes chondrocyte survival, hypertrophic differentiation and endochondral ossification. Gain- or loss-of-function mutations in the Wnt signaling components are causally linked to high or low bone mass in mice and humans. Inactivation of Wnt/β-catenin signaling leads to imbalance between bone formation and resorption because of accelerated osteoclastogenesis due to decline in the levels of osteoprotegerin (OPG) secreted by osteoblasts or directly via Frizzled 8 (Fzd8). In this review, we provide a landscape of the Wnt pathway components in influencing progenitor cell differentiation toward osteoblasts or osteoclasts under physiological conditions as well as pathological disorders resulting in various skeletal dysplasia syndromes.
Collapse
Affiliation(s)
- Deepti Malhotra
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health , Bethesda, MD, USA
| | - Yingzi Yang
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health , Bethesda, MD, USA
| |
Collapse
|