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Gu X, Jiang K, Chen R, Chen Z, Wu X, Xiang H, Huang X, Nan B. Identification of common stria vascularis cellular alteration in sensorineural hearing loss based on ScRNA-seq. BMC Genomics 2024; 25:213. [PMID: 38413848 PMCID: PMC10897997 DOI: 10.1186/s12864-024-10122-7] [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: 11/14/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The stria vascularis (SV), located in the lateral wall of the cochlea, maintains cochlear fluid homeostasis and mechanoelectrical transduction (MET) activity required for sound wave conduction. The pathogenesis of a number of human inheritable deafness syndromes, age related hearing loss, drug-induced ototoxicity and noise-induced hearing loss results from the morphological changes and functional impairments in the development of the SV. In this study, we investigate the implications of intercellular communication within the SV in the pathogenesis of sensorineural hearing loss (SNHL). We aim to identify commonly regulated signaling pathways using publicly available single-cell transcriptomic sequencing (scRNA-seq) datasets. METHODS We analyzed scRNA-seq data, which was derived from studying the cochlear SV in mice with SNHL compared to normal adult mice. After quality control and filtering, we obtained the major cellular components of the mouse cochlear SV and integrated the data. Using Seurat's FindAllMarkers and FindMarkers packages, we searched for novel conservative genes and differential genes. We employed KEGG and GSEA to identify molecular pathways that are commonly altered among different types of SNHL. We utilized pySCENIC to discover new specific regulatory factors in SV subpopulation cells. With the help of CellChat, we identified changes in subpopulation cells showing similar trends across different SNHL types and their alterations in intercellular communication pathways. RESULTS Through the analysis of the integrated data, we discovered new conserved genes to SV specific cells and identified common downregulated pathways in three types of SNHL. The enriched genes for these pathways showing similar trends are primarily associated with the Electron Transport Chain, related to mitochondrial energy metabolism. Using the CellChat package, we further found that there are shared pathways in the incoming signaling of specific intermediate cells in SNHL, and these pathways have common upstream regulatory transcription factor of Nfe2l2. Combining the results from pySCENIC and CellChat, we predicted the transcription factor Nfe2l2 as an upstream regulatory factor for multiple shared cellular pathways in IC. Additionally, it serves as an upstream factor for several genes within the Electron Transport Chain. CONCLUSION Our bioinformatics analysis has revealed that downregulation of the mitochondrial electron transport chain have been observed in various conditions of SNHL. E2f1, Esrrb, Runx1, Yy1, and Gata2 could serve as novel important common TFs regulating the electron transport chain. Adm has emerged as a potential new marker gene for intermediate cells, while Itgb5 and Tesc show promise as potential new marker genes for marginal cells in the SV. These findings offer a new perspective on SV lesions in SNHL and provide additional theoretical evidence for the same drug treatment and prevention of different pathologies of SNHL.
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Affiliation(s)
- Xi Gu
- Department of Otorhinolaryngology, Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Institute of Otolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology, Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Kanglun Jiang
- Department of Otorhinolaryngology-Head and Neck Surgery, Zhongshan Hospital, Fudan University, Fenglin Road 180, Xuhui District, Shanghai, 200030, People's Republic of China
| | - Ruru Chen
- Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhifeng Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Institute of Otolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology, Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xianmin Wu
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haijie Xiang
- Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinsheng Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Zhongshan Hospital, Fudan University, Fenglin Road 180, Xuhui District, Shanghai, 200030, People's Republic of China.
| | - Benyu Nan
- Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
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郭 丽, 刘 薇, 陈 敏, 徐 佳, 马 宁, 张 晓, 段 清, 刘 珊, 王 晓, 甄 俊, 倪 鑫, 张 杰. [Long-term auditory monitoring in children with Alport syndrome based on different degrees of renal injury]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2024; 38:44-49. [PMID: 38297848 PMCID: PMC11116163 DOI: 10.13201/j.issn.2096-7993.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Indexed: 02/02/2024]
Abstract
Objective:To investigate long-term auditory changes and characteristics of Alport syndrome(AS) patients with different degrees of renal injury. Methods:Retrospectively analyzing clinical data of patients diagnosed AS from January 2007 to September 2022, including renal pathology, genetic detection and hearing examination. A long-term follow-up focusing on hearing and renal function was conducted. Results:This study included 70 AS patients, of which 33(25 males, 8 females, aged 3.4-27.8 years) were followed up, resulting in a loss rate of 52.9%.The follow-up period ranged from 1.1to 15.8 years, with 16 patients followed-up for over 10 years. During the follow-up, 10 patients presenting with hearing abnormalities at the time of diagnosis of AS had progressive hearing loss, and 3 patients with new hearing abnormalities were followed up, which appeared at 5-6 years of disease course. All of which were sensorineural deafness. While only 3 patients with hearing abnormalities among 13 patients received hearing aid intervention. Of these patients,7 developed end-stage renal disease(ESRD), predominantly males (6/7). The rate of long-term hearing loss was significantly different between ESRD group and non-ESRD group(P=0.013). There was no correlation between the progression of renal disease and long-term hearing level(P>0.05). kidney biopsies from 28 patients revealed varying degrees of podocyte lesion and uneven thickness of basement membrane. The severity of podocyte lesion was correlated with the rate of long-term hearing loss(P=0.048), and there was no correlation with the severity of hearing loss(P>0.05). Among 11 cases, theCOL4A5mutationwas most common (8 out of 11), but there was no significant correlation between the mutation type and hearing phenotype(P>0.05). Conclusion:AS patients exhibit progressive hearing loss with significant heterogeneity over the long-term.. THearing loss is more likely to occur 5-6 years into the disease course. Hearing abnormalities are closely related to renal disease status, kidney tissue pathology, and gene mutations, emphasizing the need for vigilant long-term hearing follow-up and early intervention.
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Affiliation(s)
- 丽宁 郭
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 薇 刘
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 敏 陈
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 佳童 徐
- 首都医科大学附属北京儿童医院病理科Department of Pathology, Beijing Children′s Hospital, Capital Medical University
| | - 宁 马
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 晓 张
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 清川 段
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 珊珊 刘
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 晓旭 王
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 俊淞 甄
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 鑫 倪
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
| | - 杰 张
- 国家儿童医学中心 首都医科大学附属北京儿童医院耳鼻咽喉头颈外科(北京,100045)Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health, Beijing 100045, China
- 儿童耳鼻咽喉头颈外科疾病北京市重点实验室Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery
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Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome. Life (Basel) 2020; 10:life10120360. [PMID: 33352923 PMCID: PMC7766141 DOI: 10.3390/life10120360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/11/2022] Open
Abstract
Most adults with Alport syndrome (AS) suffer from progressive sensorineural hearing loss. However, little is known about the early characteristics of hearing loss in children with AS. As a part of the EARLY PRO-TECT Alport trial, this study was the first clinical trial ever to investigate hearing loss in children with AS over a timespan of up to six years Nine of 51 children (18%) had hearing impairment. Audiograms were divided into three age groups: in the 5–9-year-olds, the 4-pure tone average (4PTA) was 8.9 decibel (dB) (n = 15) in those with normal hearing and 43.8 dB (n = 2, 12%) in those with hearing impairment. Among the 10–13-year-olds, 4PTA was 4.8 dB (healthy, n = 12) and 41.4 dB (hearing impaired, n = 6.33%). For the 14–20-year-olds, the 4PTA was 7.0 dB (healthy; n = 9) and 48.2 dB (hearing impaired, n = 3.25%). On average, hearing thresholds of the hearing impaired group increased, especially at frequencies between 1–3 kHz. In conclusion, 18% of children developed hearing loss, with a maximum hearing loss in the audiograms at 1–3 kHz. The percentage of children with hearing impairment increased from 10% at baseline to 18% at end of trial as did the severity of hearing loss.
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4
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Barozzi S, Soi D, Intieri E, Giani M, Aldè M, Tonon E, Signorini L, Renieri A, Fallerini C, Perin P, Montini G, Ambrosetti U. Vestibular and audiological findings in the Alport syndrome. Am J Med Genet A 2020; 182:2345-2358. [PMID: 32820599 DOI: 10.1002/ajmg.a.61796] [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: 05/03/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 01/20/2023]
Abstract
Alport syndrome (AS) is caused by mutations in collagen IV, which is widespread in the basement membranes of many organs, including the kidneys, eyes, and ears. Whereas the effects of collagen IV changes in the cochlea are well known, no changes have been described in the posterior labyrinth. The aim of this study was to investigate both the auditory and the vestibular function of a group of individuals with AS. Seventeen patients, aged 9-52, underwent audiological tests including pure-tone and speech audiometry, immittance test and otoacoustic emissions and vestibular tests including video head impulse test, rotatory test, and vestibular evoked myogenic potentials. Hearing loss affected 25% of the males and 27.3% of the females with X-linked AS. It was sensorineural with a cochlear localization and a variable severity. 50% of the males and 45.4% of the females had a hearing impairment in the high-frequency range. Otoacoustic emissions were absent in about one-third of the individuals. A peripheral vestibular dysfunction was present in 75% of the males and 45.4% of the females, with no complaints of vertigo or dizziness. The vestibular impairment was compensated and the vestibulo-ocular reflex asymmetry was more evident in rotatory tests carried out at lower than higher speeds; a vestibular hypofunction was present in all hearing impaired ears although it was also found in subjects with normal hearing. A posterior labyrinth injury should be hypothesized in AS even when the patient does not manifest hearing disorders or evident signs of renal failure.
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Affiliation(s)
- Stefania Barozzi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniela Soi
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,ASST Nord Milano, Milan, Italy
| | - Elisabetta Intieri
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Otorinolaringoiatria ASST Valle Olona, Busto Arsizio, Italy
| | - Marisa Giani
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mirko Aldè
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Audiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Tonon
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lia Signorini
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy.,Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Paola Perin
- Dipartimento di scienze del Sistema nervoso e del comportamento, Università di Pavia, Pavia, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Giuliana Bernardo Caprotti chair of Pediatrics, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Umberto Ambrosetti
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,UOC Audiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Sung V, Downie L, Paxton GA, Liddle K, Birman CS, Chan WW, Cottier C, Harris A, Hunter M, Peadon E, Peacock K, Roddick L, Rose E, Saunders K, Amor DJ. Childhood Hearing Australasian Medical Professionals network: Consensus guidelines on investigation and clinical management of childhood hearing loss. J Paediatr Child Health 2019; 55:1013-1022. [PMID: 31524978 DOI: 10.1111/jpc.14508] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/14/2019] [Accepted: 05/12/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Valerie Sung
- Prevention Innovation, Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Lilian Downie
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Reproductive Epidemiology, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Royal Children's Hospital, Monash University, Melbourne, Victoria, Australia.,Victorian Clinical Genetics Services, Monash University, Melbourne, Victoria, Australia
| | - Georgia A Paxton
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Infection and Immunity, Clinical Paediatrics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Karen Liddle
- Child Development Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
| | - Catherine S Birman
- ENT Department, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney Cochlear Implant Centre, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Medical School, Macquarie University, Sydney, New South Wales, Australia
| | - Wei Wei Chan
- Department of Paediatrics, Gold Coast University Hospital, Gold Coast, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Carolyn Cottier
- The Hearing Support Service, Sydney Children's Hospital, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Alison Harris
- Child Development Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
| | - Matthew Hunter
- Monash Genetics, Monash Health, Monash University, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth Peadon
- Deafness Centre, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Kenneth Peacock
- Deafness Centre, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Laurence Roddick
- Department of General Paediatrics, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.,Department of Paediatric Respiratory Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.,Discipline of Paediatrics, University of Newcastle, Newcastle, New South Wales, Australia
| | - Elizabeth Rose
- Department of Otolaryngology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia.,Neurogenetics, Genetics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Kerryn Saunders
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.,Paediatric Hearing Services, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - David J Amor
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Victorian Clinical Genetics Services, Monash University, Melbourne, Victoria, Australia.,Neurodisability and Rehabilitation, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, Royal Children's Hospital, Melbourne, Victoria, Australia
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Zhang X, Zhang Y, Zhang Y, Gu H, Chen Z, Ren L, Lu X, Chen L, Wang F, Liu Y, Ding J. X-linked Alport syndrome: pathogenic variant features and further auditory genotype-phenotype correlations in males. Orphanet J Rare Dis 2018; 13:229. [PMID: 30577881 PMCID: PMC6303895 DOI: 10.1186/s13023-018-0974-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 12/07/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To analyze the clinical audiological characteristics of X-Linked Alport syndrome (XLAS) in males and their relationships with genotypes. METHODS The clinical data of 87 male patients with AS were reviewed. Hearing levels were evaluated using pure tone audiometry (PTA) testing, acoustic immittance, and otoacoustic emissions (OAE) testing. The genotypes of COL4A5 and the pathogenic variants were analyzed. The relationships between auditory phenotypes and genotypes were analyzed. RESULTS Among the 87 patients, the number of patients with normal hearing and hearing loss were 32 and 55, respectively. In all cases, the hearing loss was characterized as bilateral symmetrical sensorineural deafness. Majority of the patients had mild-to-moderate hearing loss. Hearing loss usually started in the middle frequency range and gradually affected high frequencies, at school age and gradually increased with increasing age. However, it maintained a relatively steady level of 50-60 dB HL during the teenage years. The audiometric curves included groove-type in 51 cases (92.73%). Patients were identified to have 60 different COL4A5 pathogenic variants. Of the 49 patients who were followed-up for more than 2 years, 28 cases presented a decreasing trend in the hearing level of about 5 dB per year. The degree of hearing loss was positively correlated with gene mutation type and renal function. CONCLUSIONS Hearing loss in males with XLAS is symmetrical sensorineural, and progressive with increasing age. There is a significant correlation between the degree of hearing loss and genotype, renal function, and age.
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Affiliation(s)
- Xiao Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Yanqin Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034 China
| | - Yanmei Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Hongbo Gu
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Zhe Chen
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Lei Ren
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Xingxing Lu
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Li Chen
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Fang Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034 China
| | - Yuhe Liu
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, 100034 China
| | - Jie Ding
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034 China
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7
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Bignall ONR, Dixon BP. Management of Hematuria in Children. CURRENT TREATMENT OPTIONS IN PEDIATRICS 2018; 4:333-349. [PMID: 30128264 PMCID: PMC6097192 DOI: 10.1007/s40746-018-0134-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose of Review This paper provides a review of the diagnostic evaluation of both microscopic and gross hematuria, as well as an update on the pathogenesis, clinical features, and treatment strategies for several diseases of the kidneys and urinary tract in which hematuria is a prominent finding. The goal is to provide pediatric providers with a framework through which appropriate and expeditious referral to subspecialty care may be made for definitive treatment. Recent Findings Although there has been great heterogeneity in published treatment strategies for many causes of hematuria, the Kidney Diseases Improving Global Outcomes (KDIGO) initiative has recently set forth guidelines for glomerular diseases in particular to provide evidence-based strategies for treatment. In addition, recent advances in the understanding of molecular pathogenesis and long-term clinical outcomes for other non-glomerular diseases has led to updates in treatment strategies summarized in this review. Summary As the pediatric primary care provider is often the first point of contact for children with microscopic or gross hematuria, updated knowledge as to the epidemiology and management of several of the various causes of hematuria will improve the care of children by both avoiding extraneous testing and interventions and implementing definitive care (either by expectant management and reassurance or by subspecialty referral) in a timely manner.
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Affiliation(s)
- O N Ray Bignall
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center
| | - Bradley P Dixon
- Renal Section, Department of Pediatrics, University of Colorado School of Medicine
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Chen YZ, Sun LZ, Wang HY, Jiang XY, Mo Y, Yue ZH, Chen HM, Liu T, Lin HR. [Clinical and pathological features and the misdiagnosis of childhood Alport syndrome: a retrospective analysis of 91 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:371-375. [PMID: 28407818 PMCID: PMC7389671 DOI: 10.7499/j.issn.1008-8830.2017.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To explore the clinical and pathological features and the diagnosis of childhood Alport syndrome (AS). METHODS A retrospective analysis was performed on clinical data of 91 children with AS. RESULTS Hematuria was observed in all 91 patients, of whom 86 were accompanied with proteinuria. Sixty-one children with X-Linked AS (XL-AS) had positive family history. Renal biopsy was performed on 82 children. Mild to moderate mesangial proliferation was observed in 74 cases. Small amounts of immune complexes deposits in the glomerular mesangial area were observed in 48 cases. Glomerular basement membrane (GBM) attenuation, thickening and layering were observed in 53 cases by electron microscopy (EM). In 63 cases receiving renal tissue type IV collagen α3 and α5 chain immunofluorescence detection, 58 were diagnosed with AS, including 53 cases of XL-AS and 5 cases of autosomal recessive AS. In 91 cases of AS, 58 were diagnosed as AS by renal tissue type IV collagen α3 and α5 chain immunofluorescence, 21 were diagnosed by EM, one was diagnosed by skin biopsy, and 12 were diagnosed by gene detection. Six novel mutations of COL4A5 gene were found. Forty-five cases were misdiagnosed before the diagnosis of AS. Forty-one of the 45 cases received steroids and/or immunosuppressant therapy. CONCLUSIONS The clinical manifestations and pathological changes are not specific in children with AS, resulting in a higher rate of misdiagnosis. Typical lesions of GBM under EM are only observed in a part of patients. There is a high novel mutation rate of COL4A5 in the detected AS children.
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Affiliation(s)
- Yan-Zhen Chen
- Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
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Guidelines for aetiological investigation into severe to profound bilateral permanent childhood hearing impairment. HEARING BALANCE AND COMMUNICATION 2016. [DOI: 10.1080/21695717.2016.1209000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Guidelines for aetiological investigation into mild to moderate bilateral permanent childhood hearing impairment. HEARING BALANCE AND COMMUNICATION 2016. [DOI: 10.1080/21695717.2016.1208999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Cuna V, Battaglino G, Capelli I, Sala E, Donati G, Cianciolo G, La Manna G. Hypoacusia and Chronic Renal Dysfunction: New Etiopathogenetic Prospective. Ther Apher Dial 2014; 19:111-8. [DOI: 10.1111/1744-9987.12232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Vania Cuna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Giuseppe Battaglino
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Irene Capelli
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Elisa Sala
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Gabriele Donati
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Giuseppe Cianciolo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
| | - Gaetano La Manna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES); Nephrology, Dialysis and Renal Transplant Unit; St Orsola Hospital; University of Bologna; Bologna Italy
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EGFR expression in acquired middle ear cholesteatoma in children and adults. Eur J Pediatr 2012; 171:307-10. [PMID: 21800041 DOI: 10.1007/s00431-011-1526-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 06/22/2011] [Indexed: 10/17/2022]
Abstract
Middle ear cholesteatomas are characterized by the presence of keratinized stratified squamous epithelium inside this cavity. It is considered to be more aggressive in childhood. In normal skin, the epidermal growth factor receptor (EGFR) is expressed in the cytoplasmic membrane of epithelial cells of the basal layer. In contrast, its expression in middle ear cholesteatoma extends to suprabasal layers. The objective of this study is to detect the presence of EGFR in cases of acquired cholesteatoma of the middle ear and correlate the expression of this receptor with patients' ages. In this cross-sectional study, cholesteatoma samples were collected from 50 patients (35 adults and 15 children) who underwent otological surgery, throughout 1 year of study. These samples were subjected to histological and immunohistochemical assays. Results were submitted to statistical analyses and main findings were: EGFR was present in the parabasal layers in 27 cases and EGFR expression was extended to all layers of the matrix in 17 cases. There were no statistically significant differences in what concerns age-related variances in EGFR expression. The intensity and location of EGFR expression in acquired cholesteatoma of the middle ear confirm the hyperproliferative capacity of keratinocytes.
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Weegerink N, Schraders M, Leijendeckers J, Slieker K, Huygen P, Hoefsloot L, Oostrik J, Pennings R, Simon A, Snik A, Kremer H, Kunst H. Audiometric characteristics of a Dutch family with Muckle-Wells syndrome. Hear Res 2011; 282:243-51. [DOI: 10.1016/j.heares.2011.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Revised: 07/14/2011] [Accepted: 07/18/2011] [Indexed: 01/30/2023]
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