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Hubčíková K, Rakús T, Mühlbäck A, Benetin J, Bruncvik L, Petrášová Z, Bušková J, Brunovský M. Psychosocial Impact of Huntington's Disease and Incentives to Improve Care for Affected Families in the Underserved Region of the Slovak Republic. J Pers Med 2022; 12:jpm12121941. [PMID: 36556162 PMCID: PMC9783383 DOI: 10.3390/jpm12121941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Huntington's disease (HD) is often on the margin of standard medical practice due to its low prevalence, the lack of causal treatment, and the typically long premanifest window prior to the onset of the symptoms, which contrasts with the long-lasting burden that the disease causes in affected families. METHODS To capture these socio-psychological aspects of HD and map the experiences of affected individuals, persons at risk of HD, and caregivers, we created a questionnaire using a qualitative research approach. The questionnaire containing 16 questions was conducted online for a period of three months through patient associations in Slovakia and their infrastructures. RESULTS In total, we received 30 responses. The survey results, in particular, indicate insufficient counselling by physicians with explicitly missing information about the possibility of preimplantation genetic diagnostic. There was also a necessity to improve comprehensive social and health care in the later stages of the disease, raise awareness of the disease in the general health community, and provide more information on ongoing clinical trials. CONCLUSION The psychosocial effects, as well as the burden, can be mitigated by comprehensive genetic counselling as well as reproductive and financial guidelines and subsequent therapeutic programs to actively support patients, caregivers, children, and adolescents growing up in affected families, preferably with the help of local HD community association. LIMITATIONS We have used online data collection to reach a wider HD community, but at the same time, we are aware that the quality of the data we would obtain through face-to-face interviews would be considerably better. Therefore, future studies need to be conducted to obtain more detailed information.
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Affiliation(s)
- Katarína Hubčíková
- Neuropsychiatric Department, Psychiatric Hospital of Philipp Pinel in Pezinok, 90201 Pezinok, Slovakia
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
- Correspondence: ; Tel.: +421917111575; Fax: +421336482121
| | - Tomáš Rakús
- Neuropsychiatric Department, Psychiatric Hospital of Philipp Pinel in Pezinok, 90201 Pezinok, Slovakia
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
- Department of Psychiatry, Slovac Medical University, 83303 Bratislava, Slovakia
| | - Alžbeta Mühlbäck
- Department of Neuropsychiatry, kbo-Isar-Amper-Klinikum, 84416 Taufkirchen (Vils), Germany
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, 12821 Prague, Czech Republic
- Department of Neurology, University Hospital of Ulm, 89081 Ulm, Germany
| | - Ján Benetin
- Neuropsychiatric Department, Psychiatric Hospital of Philipp Pinel in Pezinok, 90201 Pezinok, Slovakia
| | - Lucia Bruncvik
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
- Landesklinikum Hainburg, 2410 Hainburg an der Donau, Austria
| | - Zuzana Petrášová
- Neuropsychiatric Department, Psychiatric Hospital of Philipp Pinel in Pezinok, 90201 Pezinok, Slovakia
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
| | - Jitka Bušková
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
- National Institute of Mental Health, 25067 Klecany, Czech Republic
| | - Martin Brunovský
- Third Faculty of Medicine, Charles University in Prague, 10000 Prague, Czech Republic
- National Institute of Mental Health, 25067 Klecany, Czech Republic
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Singh S, Sharma N, Sachdeva M, Behl T, Zahoor I, Fuloria NK, Sekar M, Fuloria S, Subramaniyan V, Alsubayiel AM, Dailah HG, Naved T, Bhatia S, Al-Harrasi A, Aleya L. Focusing the pivotal role of nanotechnology in Huntington's disease: an insight into the recent advancements. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73809-73827. [PMID: 36100788 DOI: 10.1007/s11356-022-22830-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Neurodegeneration is the loss of neuronal capacity and structure over time which causes neurodegenerative disorders like Alzheimer, amyotrophic lateral sclerosis, Parkinson, and Huntington's disease (HD). This review is primarily concerned with HD, which was fully described by George Huntington in 1872. In developed countries, HD has become another common single-gene neurological disorder. Because of its autosomal dominant inheritance, the sickness affects both individuals and their families. Huntington disease has been recognized as a disorder that affects the complete body and brain in which the mutant huntingtin polyglutamine (polyQ) sequence is extensively increased and gets correlated to CAG trinucleotide which codes for glutamine (Q). These proteins have characteristics that produce apoptosis and dysfunction. HD is a lethal condition which needs an immediate diagnosis and treatment, and therefore, nanoparticle has come into sight out as opportunistic strategies for treatment of HD. Nanostructures have great potential to cross the blood brain barrier and also prevent breakdown of active molecule and reduces the drug toxicity. This review explains the distinguishing symptoms, genetics, and stages during the development of Huntington's disease, and also provides an overview of HD with an emphasis on its epidemiology, pathogenesis, and management. This review focuses on the latest studies on nanotechnology-related technologies, i.e., magnetic nanoparticle, solid lipid nanoparticle, and polymeric nanoparticle for Huntington's disease treatment. The pioneering patents and in-progress clinical trials related to Huntington's disease has also been summarized in this review.
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Affiliation(s)
- Sukhbir Singh
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, 133207, India
| | - Neelam Sharma
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, 133207, India.
| | - Monika Sachdeva
- Fatimah College of Health Sciences, Al Ain, United Arab Emirates
| | - Tapan Behl
- School of Health Sciences, University of Petroleum and Energy Studies, Bidholi, 248007, Dehradun, Uttarakhand, India.
| | - Ishrat Zahoor
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Neeraj Kumar Fuloria
- Faculty of Pharmacy and Centre of Excellence for Biomaterials Engineering, AIMST University, Bedong, Kedah, Malaysia
| | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Malaysia
| | - Shivkanya Fuloria
- Faculty of Pharmacy and Centre of Excellence for Biomaterials Engineering, AIMST University, Bedong, Kedah, Malaysia
| | | | - Amal M Alsubayiel
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Hamed Ghaleb Dailah
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Tanveer Naved
- Amity Institute of Pharmacy, Amity University, Noida, India
| | - Saurabh Bhatia
- School of Health Sciences, University of Petroleum and Energy Studies, Bidholi, 248007, Dehradun, Uttarakhand, India
- Natural and Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
| | - Lotfi Aleya
- Chrono-Environment Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
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Tabrizi SJ, Schobel S, Gantman EC, Mansbach A, Borowsky B, Konstantinova P, Mestre TA, Panagoulias J, Ross CA, Zauderer M, Mullin AP, Romero K, Sivakumaran S, Turner EC, Long JD, Sampaio C. A biological classification of Huntington's disease: the Integrated Staging System. Lancet Neurol 2022; 21:632-644. [PMID: 35716693 DOI: 10.1016/s1474-4422(22)00120-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/11/2022] [Accepted: 03/11/2022] [Indexed: 12/24/2022]
Abstract
The current research paradigm for Huntington's disease is based on participants with overt clinical phenotypes and does not address its pathophysiology nor the biomarker changes that can precede by decades the functional decline. We have generated a new research framework to standardise clinical research and enable interventional studies earlier in the disease course. The Huntington's Disease Integrated Staging System (HD-ISS) comprises a biological research definition and evidence-based staging centred on biological, clinical, and functional assessments. We used a formal consensus method that involved representatives from academia, industry, and non-profit organisations. The HD-ISS characterises individuals for research purposes from birth, starting at Stage 0 (ie, individuals with the Huntington's disease genetic mutation without any detectable pathological change) by using a genetic definition of Huntington's disease. Huntington's disease progression is then marked by measurable indicators of underlying pathophysiology (Stage 1), a detectable clinical phenotype (Stage 2), and then decline in function (Stage 3). Individuals can be precisely classified into stages based on thresholds of stage-specific landmark assessments. We also demonstrated the internal validity of this system. The adoption of the HD-ISS could facilitate the design of clinical trials targeting populations before clinical motor diagnosis and enable data standardisation across ongoing and future studies.
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Affiliation(s)
- Sarah J Tabrizi
- UCL Huntington's Disease Centre, Department of Neurodegenerative Diseases, UCL Queen Square Institute of Neurology, UK Dementia Research Institute, University College London, UK.
| | - Scott Schobel
- Product Development Neuroscience, F Hoffmann-La Roche, Basel, Switzerland
| | | | | | | | | | - Tiago A Mestre
- Parkinson's Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | | | - Christopher A Ross
- Division of Neurobiology, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Departments of Neurology, Neuroscience, and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Klaus Romero
- Critical Path Institute, Tucson, Arizona 85718, USA
| | | | | | - Jeffrey D Long
- Department of Psychiatry, Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Cristina Sampaio
- CHDI Management/CHDI Foundation, Princeton, NJ, USA; Clinical Pharmacology Laboratory, Faculdade de Medicina de Lisboa, University of Lisbon, Lisbon, Portugal.
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Shadfar S, Brocardo M, Atkin JD. The Complex Mechanisms by Which Neurons Die Following DNA Damage in Neurodegenerative Diseases. Int J Mol Sci 2022; 23:ijms23052484. [PMID: 35269632 PMCID: PMC8910227 DOI: 10.3390/ijms23052484] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 01/18/2023] Open
Abstract
Human cells are exposed to numerous exogenous and endogenous insults every day. Unlike other molecules, DNA cannot be replaced by resynthesis, hence damage to DNA can have major consequences for the cell. The DNA damage response contains overlapping signalling networks that repair DNA and hence maintain genomic integrity, and aberrant DNA damage responses are increasingly described in neurodegenerative diseases. Furthermore, DNA repair declines during aging, which is the biggest risk factor for these conditions. If unrepaired, the accumulation of DNA damage results in death to eliminate cells with defective genomes. This is particularly important for postmitotic neurons because they have a limited capacity to proliferate, thus they must be maintained for life. Neuronal death is thus an important process in neurodegenerative disorders. In addition, the inability of neurons to divide renders them susceptible to senescence or re-entry to the cell cycle. The field of cell death has expanded significantly in recent years, and many new mechanisms have been described in various cell types, including neurons. Several of these mechanisms are linked to DNA damage. In this review, we provide an overview of the cell death pathways induced by DNA damage that are relevant to neurons and discuss the possible involvement of these mechanisms in neurodegenerative conditions.
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Affiliation(s)
- Sina Shadfar
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Macquarie University, Sydney, NSW 2109, Australia; (S.S.); (M.B.)
| | - Mariana Brocardo
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Macquarie University, Sydney, NSW 2109, Australia; (S.S.); (M.B.)
| | - Julie D. Atkin
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Macquarie University, Sydney, NSW 2109, Australia; (S.S.); (M.B.)
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia
- Correspondence:
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Bhat A, Dalvi H, Jain H, Rangaraj N, Singh SB, Srivastava S. Perspective insights of repurposing the pleiotropic efficacy of statins in neurodegenerative disorders: An expository appraisal. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2021; 2:100012. [PMID: 34909647 PMCID: PMC8663947 DOI: 10.1016/j.crphar.2020.100012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 10/26/2022] Open
Abstract
Neurodegenerative disorders which affects a larger population pose a great clinical challenge. These disorders impact the quality of life of an individual by damaging the neurons, which are the unit cells of the brain. Clinicians are faced with the grave challenge of inhibiting the progression of these diseases as available treatment options fail to meet the clinical demand. Thus, treating the disease/disorder symptomatically is the Hobson's choice. The goal of the researchers is to introduce newer therapies in this segment and introducing a new molecule will take long years of development. Hence, drug repurposing/repositioning can be a better substitute in comparison to time consuming and expensive drug discovery and development cycle. Presently, a paradigm shift towards the re-purposing of drugs can be witnessed. Statins which have been previously approved as anti-hyperlipidemic agents are in the limelight of research for re-purposed drugs. Owing to their anti-inflammatory and antioxidant nature, statins act as neuroprotective in several brain disorders. Further they attenuate the amyloid plaques and protein aggregation which are the triggering factors in the Alzheimer's and Parkinson's respectively. In case of Huntington disease and Multiple sclerosis they help in improving the psychomotor symptoms and stimulate remyelination thus acting as neuroprotective. This article reviews the potential of statins in treating neurodegenerative disorders along with a brief discussion on the safety concerns associated with use of statins and human clinical trial data linked with re-tasking statins for neurodegenerative disorders along with the regulatory perspectives involved with the drug repositioning.
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Affiliation(s)
- Aditi Bhat
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
| | - Harshita Dalvi
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
| | - Harsha Jain
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
| | - Nagarjun Rangaraj
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
| | - Shashi Bala Singh
- Department of Pharmacology and Regulatory Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
| | - Saurabh Srivastava
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, 500037, India
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Rajan-Babu IS, Peng JJ, Chiu R, Li C, Mohajeri A, Dolzhenko E, Eberle MA, Birol I, Friedman JM. Genome-wide sequencing as a first-tier screening test for short tandem repeat expansions. Genome Med 2021; 13:126. [PMID: 34372915 PMCID: PMC8351082 DOI: 10.1186/s13073-021-00932-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/05/2021] [Indexed: 02/01/2023] Open
Abstract
Background Screening for short tandem repeat (STR) expansions in next-generation sequencing data can enable diagnosis, optimal clinical management/treatment, and accurate genetic counseling of patients with repeat expansion disorders. We aimed to develop an efficient computational workflow for reliable detection of STR expansions in next-generation sequencing data and demonstrate its clinical utility. Methods We characterized the performance of eight STR analysis methods (lobSTR, HipSTR, RepeatSeq, ExpansionHunter, TREDPARSE, GangSTR, STRetch, and exSTRa) on next-generation sequencing datasets of samples with known disease-causing full-mutation STR expansions and genomes simulated to harbor repeat expansions at selected loci and optimized their sensitivity. We then used a machine learning decision tree classifier to identify an optimal combination of methods for full-mutation detection. In Burrows-Wheeler Aligner (BWA)-aligned genomes, the ensemble approach of using ExpansionHunter, STRetch, and exSTRa performed the best (precision = 82%, recall = 100%, F1-score = 90%). We applied this pipeline to screen 301 families of children with suspected genetic disorders. Results We identified 10 individuals with full-mutations in the AR, ATXN1, ATXN8, DMPK, FXN, or HTT disease STR locus in the analyzed families. Additional candidates identified in our analysis include two probands with borderline ATXN2 expansions between the established repeat size range for reduced-penetrance and full-penetrance full-mutation and seven individuals with FMR1 CGG repeats in the intermediate/premutation repeat size range. In 67 probands with a prior negative clinical PCR test for the FMR1, FXN, or DMPK disease STR locus, or the spinocerebellar ataxia disease STR panel, our pipeline did not falsely identify aberrant expansion. We performed clinical PCR tests on seven (out of 10) full-mutation samples identified by our pipeline and confirmed the expansion status in all, showing absolute concordance between our bioinformatics and molecular findings. Conclusions We have successfully demonstrated the application of a well-optimized bioinformatics pipeline that promotes the utility of genome-wide sequencing as a first-tier screening test to detect expansions of known disease STRs. Interrogating clinical next-generation sequencing data for pathogenic STR expansions using our ensemble pipeline can improve diagnostic yield and enhance clinical outcomes for patients with repeat expansion disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-021-00932-9.
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Affiliation(s)
- Indhu-Shree Rajan-Babu
- Department of Medical Genetics, University of British Columbia and Children's & Women's Hospital, Vancouver, BC, V6H3N1, Canada. .,Department of Medical and Molecular Genetics, King's College London, Strand, London, WC2R 2LS, UK.
| | - Junran J Peng
- Department of Medical Genetics, University of British Columbia and Children's & Women's Hospital, Vancouver, BC, V6H3N1, Canada
| | - Readman Chiu
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, V5Z4S6, Canada
| | | | | | - Chenkai Li
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, V5Z4S6, Canada.,Bioinformatics Graduate Program, University of British Columbia, Vancouver, BC, V6T1Z4, Canada
| | - Arezoo Mohajeri
- Department of Medical Genetics, University of British Columbia and Children's & Women's Hospital, Vancouver, BC, V6H3N1, Canada
| | | | | | - Inanc Birol
- Department of Medical Genetics, University of British Columbia and Children's & Women's Hospital, Vancouver, BC, V6H3N1, Canada.,Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, V5Z4S6, Canada
| | - Jan M Friedman
- Department of Medical Genetics, University of British Columbia and Children's & Women's Hospital, Vancouver, BC, V6H3N1, Canada
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Bessi V, Mazzeo S, Bagnoli S, Giacomucci G, Ingannato A, Ferrari C, Padiglioni S, Franchi V, Sorbi S, Nacmias B. The Effect of CAG Repeats within the Non-Pathological Range in the HTT Gene on Cognitive Functions in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment. Diagnostics (Basel) 2021; 11:1051. [PMID: 34200421 PMCID: PMC8228729 DOI: 10.3390/diagnostics11061051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 12/27/2022] Open
Abstract
The Huntingtin gene (HTT) is within a class of genes containing a key region of CAG repeats. When expanded beyond 39 repeats, Huntington disease (HD) develops. Individuals with less than 35 repeats are not associated with HD. Increasing evidence has suggested that CAG repeats play a role in modulating brain development and brain function. However, very few studies have investigated the effect of CAG repeats in the non-pathological range on cognitive performances in non-demented individuals. In this study, we aimed to test how CAG repeats' length influences neuropsychological scores in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). We included 75 patients (46 SCD and 29 MCI). All patients underwent an extensive neuropsychological battery and analysis of HTT alleles to quantify the number of CAG repeats. Results: CAG repeat number was positively correlated with scores of tests assessing for executive function, visual-spatial ability, and memory in SCD patients, while in MCI patients, it was inversely correlated with scores of visual-spatial ability and premorbid intelligence. When we performed a multiple regression analysis, we found that these relationships still remained, also when adjusting for possible confounding factors. Interestingly, logarithmic models better described the associations between CAG repeats and neuropsychological scores. CAG repeats in the HTT gene within the non-pathological range influenced neuropsychological performances depending on global cognitive status. The logarithmic model suggested that the positive effect of CAG repeats in SCD patients decreases as the number of repeats grows.
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Affiliation(s)
- Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Camilla Ferrari
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Sonia Padiglioni
- Regional Referral Centre for Relational Criticalities, 50139 Tuscany Region, Italy;
- Unit Clinic of Organizations Careggi University Hospital, 50139 Florence, Italy
| | - Virginia Franchi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy; (S.M.); (S.B.); (G.G.); (A.I.); (C.F.); (V.F.); (S.S.); (B.N.)
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
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Huntington's disease: lessons from prion disorders. J Neurol 2021; 268:3493-3504. [PMID: 33625583 DOI: 10.1007/s00415-021-10418-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023]
Abstract
Decades of research on the prion protein and its associated diseases have caused a paradigm shift in our understanding of infectious agents. More recent years have been marked by a surge of studies supporting the application of these findings to a broad array of neurodegenerative disorders such as Alzheimer's and Parkinson's diseases. Here, we present evidence to suggest that Huntington's disease, a monogenic disorder of the central nervous system, shares features with prion disorders and that, it too, may be governed by similar mechanisms. We further posit that these similarities could suggest that, like other common neurodegenerative disorders, sporadic forms of Huntington's disease may exist.
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Despotov K, Zádori D, Veres G, Jakab K, Gárdián G, Tóth E, Kincses TZ, Vécsei L, Ajtay A, Bereczki D, Klivényi P. Genetic epidemiological characteristics of a Hungarian subpopulation of patients with Huntington's disease. BMC Neurol 2021; 21:79. [PMID: 33602179 PMCID: PMC7890867 DOI: 10.1186/s12883-021-02089-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Recent advances in therapeutic options may prevent deterioration related to Huntington’s disease (HD), even at the pre-symptomatic stage. Be that as it may, a well-characterized patient population is essential for screening and monitoring outcome. Accordingly, the aim of this study was to describe the characteristics of a Hungarian subpopulation of HD patients and mutation carriers diagnosed at the University of Szeged. Methods We conducted a search for International Classification of Diseases (ICD) code G10H0 in the local medical database for the period of 1 January 1998 to 31 December 2018. Results We identified 90 HD cases (male: 45, female: 45) and 34 asymptomatic carriers (male: 15, female: 19). The median age of onset was 45 years (range: 16–79). There were 3 cases of juvenile onset (3.3%), and 7 of late disease onset (7.8%). The median repeat length was 43 (range: 36–70) for the pathological and 19 for the non-pathological alleles (range: 9–35). 17.5% of the pathological alleles were in the decreased penetrance range, while 7% of non-pathological alleles were intermediate. Conclusions The genetic and clinical features of the population examined in the present study were in line with the previous Hungarian study, as well as with international literature. The exceptions were the higher ratio of reduced penetrance and intermediate alleles. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02089-9.
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Affiliation(s)
- Katalin Despotov
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Dénes Zádori
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Gábor Veres
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Katalin Jakab
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Gabriella Gárdián
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Eszter Tóth
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - Tamás Zsigmond Kincses
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary
| | - András Ajtay
- Department of Neurology, Semmelweis University, Budapest, Hungary.,MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
| | - Dániel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary.,MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
| | - Péter Klivényi
- Department of Neurology, University of Szeged, 6 Semmelweis Street, Szeged, 6725, Hungary.
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10
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Hong EP, MacDonald ME, Wheeler VC, Jones L, Holmans P, Orth M, Monckton DG, Long JD, Kwak S, Gusella JF, Lee JM. Huntington's Disease Pathogenesis: Two Sequential Components. J Huntingtons Dis 2021; 10:35-51. [PMID: 33579862 PMCID: PMC7990433 DOI: 10.3233/jhd-200427] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Historically, Huntington's disease (HD; OMIM #143100) has played an important role in the enormous advances in human genetics seen over the past four decades. This familial neurodegenerative disorder involves variable onset followed by consistent worsening of characteristic abnormal movements along with cognitive decline and psychiatric disturbances. HD was the first autosomal disease for which the genetic defect was assigned to a position on the human chromosomes using only genetic linkage analysis with common DNA polymorphisms. This discovery set off a multitude of similar studies in other diseases, while the HD gene, later renamed HTT, and its vicinity in chromosome 4p16.3 then acted as a proving ground for development of technologies to clone and sequence genes based upon their genomic location, with the growing momentum of such advances fueling the Human Genome Project. The identification of the HD gene has not yet led to an effective treatment, but continued human genetic analysis of genotype-phenotype relationships in large HD subject populations, first at the HTT locus and subsequently genome-wide, has provided insights into pathogenesis that divide the course of the disease into two sequential, mechanistically distinct components.
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Affiliation(s)
- Eun Pyo Hong
- Molecular Neurogenetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Medical and Population Genetics Program, the Broad Institute of M.I.T. and Harvard, Cambridge, MA, USA
| | - Marcy E MacDonald
- Molecular Neurogenetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Medical and Population Genetics Program, the Broad Institute of M.I.T. and Harvard, Cambridge, MA, USA
| | - Vanessa C Wheeler
- Molecular Neurogenetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Lesley Jones
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurology, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Peter Holmans
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurology, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Michael Orth
- Department of Neurology, University of Ulm, Germany
| | - Darren G Monckton
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jeffrey D Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.,Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Seung Kwak
- CHDI Management/CHDI Foundation, Princeton, NJ, USA
| | - James F Gusella
- Molecular Neurogenetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Medical and Population Genetics Program, the Broad Institute of M.I.T. and Harvard, Cambridge, MA, USA.,Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Jong-Min Lee
- Molecular Neurogenetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Medical and Population Genetics Program, the Broad Institute of M.I.T. and Harvard, Cambridge, MA, USA
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11
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Frequency of the loss of CAA interruption in the HTT CAG tract and implications for Huntington disease in the reduced penetrance range. Genet Med 2020; 22:2108-2113. [PMID: 32741964 PMCID: PMC7708297 DOI: 10.1038/s41436-020-0917-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022] Open
Abstract
Purpose In some Huntington disease (HD) patients, the “loss of interruption” (LOI) variant eliminates an interrupting codon in the HTT CAG-repeat tract, which causes earlier age of onset (AOO). The magnitude of this effect is uncertain, since previous studies included few LOI carriers, and the variant also causes CAG size misestimation. We developed a rapid LOI detection screen, enabling unbiased frequency estimation among manifest HD patients. Additionally, we combined published data with clinical data from newly identified patients to accurately characterize the LOI’s effect on AOO. Methods We developed a LOI detection polymerase chain reaction (PCR) assay, and screened patients to estimate the frequency of the LOI variant and its effect on AOO. Results Mean onset for LOI carriers (n = 49) is 20.4 years earlier than expected based on diagnosed CAG size. After correcting for CAG size underestimation, the variant is still associated with onset 9.5 years earlier. The LOI is present in 1.02% of symptomatic HD patients, and in 32.2% of symptomatic reduced penetrance (RP) range patients (36–39 CAGs). Conclusion The LOI causes significantly earlier onset, greater than expected by CAG length, particularly in persons with 36–39 CAG repeats. Detection of this variant has implications for HD families, especially for those in the RP range.
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12
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Sundblom J, Niemelä V, Ghazarian M, Strand AS, Bergdahl IA, Jansson JH, Söderberg S, Stattin EL. High frequency of intermediary alleles in the HTT gene in Northern Sweden - The Swedish Huntingtin Alleles and Phenotype (SHAPE) study. Sci Rep 2020; 10:9853. [PMID: 32555394 PMCID: PMC7299994 DOI: 10.1038/s41598-020-66643-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/20/2020] [Indexed: 11/08/2022] Open
Abstract
Trinucleotide (CAG) repeat expansions longer than 39 in the huntingtin (HTT) gene cause Huntington's disease (HD). The frequency of intermediate alleles (IA) with a length of 27-35 in the general population is not fully known, but studied in specific materials connected to the incidence of HD. The Swedish Huntingtin Alleles and Phenotype (SHAPE) study aims to assess the frequency of trinucleotide repeat expansions in the HTT gene in north Sweden. 8260 individuals unselected for HD from the counties of Norr- and Västerbotten in the north of Sweden were included. DNA samples were obtained and analysis of the HTT gene was performed, yielding data on HTT gene expansion length in 7379 individuals. A high frequency of intermediate alleles, 6.8%, was seen. Also, individuals with repeat numbers lower than ever previously reported (<5) were found. These results suggest a high frequency of HD in the norther parts of Sweden. Subsequent analyses may elucidate the influence of IA:s on traits other than HD.
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Affiliation(s)
- Jimmy Sundblom
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.
| | - Valter Niemelä
- Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden
| | - Maria Ghazarian
- Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden
| | - Ann-Sofi Strand
- Science for Life Laboratory (SciLifeLab), Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Jan-Håkan Jansson
- Department of Public Health and Clinical Medicine, Research Unit Skellefteå, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, Sweden
| | - Eva-Lena Stattin
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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13
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Thiels C, Stahl A, Saft C, Juckel G, Lücke T. [Huntington's disease with childhood and adolescent onset: course of disease, clinical presentation and diagnostic challenges]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2020; 88:661-667. [PMID: 32369858 DOI: 10.1055/a-1082-6605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Huntington's disease (HD) is an autosomal-dominant neurodegenerative disorder caused by a gene mutation in chromosome 4 that leads to an expansion of CAG - triplet repeats. It occurs mainly between the age of 30 and 50. Only less than 10 % of HD patients are younger than 20 years. In contrast to adult patients young HD patients show more often psychiatric and cognitive symptoms at disease onset than chorea. One third of the children with HD develops an epilepsy.We present 6 children diagnosed with HD in different stages of childhood. We describe first symptoms as well as genetic characteristics and other distinctive features.Both, the clinical presentation and the course of HD in childhood differ from HD in adults. In adolescents the clinical symptoms at onset are often psychiatric (like depression or attention deficit disorder). Choreatic movements typical for adult HD patients are missing.Due to the low prevalence of HD in childhood and the variability of clinical symptoms the process of diagnosing HD in children is difficult. Very often the diagnosis is made years after the first symptoms. Early diagnosis, however, is often important for managing social problems and problems in school.
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Affiliation(s)
- Charlotte Thiels
- Neuropädiatrie und Sozialpädiatrie, Universitätsklinik für Kinder- und Jugendmedizin der Ruhr-Universität Bochum
| | - Anna Stahl
- Universitätsklinik für Kinder- und Jugendmedizin der Ruhr-Universität Bochum
| | - Carsten Saft
- Abteilung für Neurologie der Ruhr-Universität Bochum, Huntington-Zentrum NRW, St. Josef-Hospital
| | - Georg Juckel
- LWL Klinik für Psychiatrie, Ruhr-Universität Bochum
| | - Thomas Lücke
- Neuropädiatrie und Sozialpädiatrie, Universitätsklinik für Kinder- und Jugendmedizin der Ruhr-Universität Bochum
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14
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Apolinário TA, da Silva IDS, Agostinho LDA, Paiva CLA. Investigation of intermediate CAG alleles of the HTT in the general population of Rio de Janeiro, Brazil, in comparison with a sample of Huntington disease-affected families. Mol Genet Genomic Med 2020; 8:e1181. [PMID: 32067426 PMCID: PMC7196456 DOI: 10.1002/mgg3.1181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/14/2020] [Accepted: 01/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Huntington disease (HD) (MIM: 143100) is a severe autosomal dominant neurodegenerative disease caused by the expansion of CAG trinucleotides (>35) in the HTT. OBJECTIVE To investigate the frequency of intermediate CAG alleles (IAs) in individuals residing in Rio de Janeiro city with no familial history of HD (general population, GP) in comparison with a sample of individuals from families presenting with HD who were previously investigated by our group (affected sample, AS). RESULTS The frequency of normal CAG alleles was 96.2%, while that of IAs was 3.6%, and that of reduced penetrance alleles was 0.2% in the GP (n = 470 chromosomes); 7.2% (17/235 individuals) of the GP presented an IA in heterozygosis with a normal allele. There was no statistically significant difference between the frequencies of the IAs in the GP and in the AS (p = .9). The most frequent haplotype per normal allele was (CAG)17-(CCG)7 (101/461) and per IA was (CAG)27-(CCG)7 (6/17) in the GP. These haplotypes were also the most frequent in the normal and IA chromosomes of the AS, respectively. CONCLUSION The genetic profiles of the IAs obtained from GP and AS were rather similar. It is important to investigate the frequencies of the IAs because expansions arise from a step-by-step mechanism in which, during intergenerational transmission, large normal alleles can generate IAs, which are then responsible for generating de novo HD mutations. The genetic investigation of IAs in the GP was also important because it was focused on the population of Rio de Janeiro, an understudied group. CCG7 was the most frequent CCG allele in linkage disequilibrium with normal, intermediate, and expanded CAG alleles, similar to the Western Europe population. However, a more robust investigation, in conjunction with haplogroup determination (A, B, or C), will be required to elucidate the ancestral origin of the HTT mutations in Brazilians.
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Affiliation(s)
- Thays A. Apolinário
- Programa de Pós‐Graduação em NeurologiaUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroRJBrazil
| | - Iane dos Santos da Silva
- Programa de Pós‐Graduação em Biologia Molecular e CelularUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroRJBrazil
| | - Luciana de Andrade Agostinho
- Programa de Pós‐Graduação em NeurologiaUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroRJBrazil
- Centro Universitário FAMINAS – UNIFAMINASMuriaéMGBrazil
- Fundação Cristiano Varella‐Hospital do CâncerMuriaéMGBrazil
| | - Carmen L. A. Paiva
- Programa de Pós‐Graduação em NeurologiaUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroRJBrazil
- Programa de Pós‐Graduação em Biologia Molecular e CelularUniversidade Federal do Estado do Rio de Janeiro (UNIRIO)Rio de JaneiroRJBrazil
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15
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Capiluppi E, Romano L, Rebora P, Nanetti L, Castaldo A, Gellera C, Mariotti C, Macerollo A, Cislaghi MG. Late-onset Huntington's disease with 40-42 CAG expansion. Neurol Sci 2020; 41:869-876. [PMID: 31820322 PMCID: PMC7160095 DOI: 10.1007/s10072-019-04177-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/25/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Huntington's disease (HD) is a rare autosomal dominant neurodegenerative disorder caused by a CAG expansion greater than 35 in the IT-15 gene. There is an inverse correlation between the number of pathological CAG and the age of onset. However, CAG repeats between 40 and 42 showed a wider onset variation. We aimed to investigate potential clinical differences between patients with age at onset ≥ 60 years (late onset-HD) and patients with age at onset between 30 and 59 years (common-onset HD) in a cohort of patients with the same CAG expansions (40-42). METHODS A retrospective analysis of 66 HD patients with 40-41-42 CAG expansion was performed. Patients were investigated with the Unified Huntington's Disease Rating Scale (subitems I-II-III and Total Functional Capacity, Functional Assessment and Stage of Disease). Data were analysed using χ2, Fisher's test, t test and Pearson's correlation coefficient. GENMOD analysis and Kaplan-Meier analysis were used to study the disease progression. RESULTS The age of onset ranged from 39 to 59 years in the CO subgroup, whereas the LO subgroup showed an age of onset from 60 to 73 years. No family history was reported in 31% of the late-onset in comparison with 20% in common-onset HD (p = 0.04). No difference emerged in symptoms of onset, in clinical manifestations and in progression of disease between the two groups. CONCLUSION There were no clinical differences between CO and LO subgroups with 40-42 CAG expansion. There is a need of further studies on environmental as well genetic variables modifying the age at onset.
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Affiliation(s)
| | - Luca Romano
- Department of Clinical Sciences "Luigi Sacco"- L. Sacco Hospital, University of Milan, Milan, Italy
| | - Paola Rebora
- Medical Statistics School, University of Milano-Bicocca, Milan, Italy
| | - Lorenzo Nanetti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Castaldo
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cinzia Gellera
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Caterina Mariotti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonella Macerollo
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
- School of Psychology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
| | - M Giuliana Cislaghi
- Department of Clinical Sciences "Luigi Sacco"- L. Sacco Hospital, University of Milan, Milan, Italy
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16
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Joosten IBT, Hellebrekers DMEI, de Greef BTA, Smeets HJM, de Die-Smulders CEM, Faber CG, Gerrits MM. Parental repeat length instability in myotonic dystrophy type 1 pre- and protomutations. Eur J Hum Genet 2020; 28:956-962. [PMID: 32203199 DOI: 10.1038/s41431-020-0601-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 01/03/2023] Open
Abstract
Myotonic dystrophy type 1 (DM1) is caused by a CTG trinucleotide repeat expansion on chromosome 19q13.3. While DM1 premutation (36-50 repeats) and protomutation (51-80 repeats) allele carriers are mostly asymptomatic, offspring is at risk of inheriting expanded, symptom-associated, (CTG)n repeats of n > 80. In this study we aimed to evaluate the intergenerational instability of DM1 pre- and protomutation alleles, focussing on the influence of parental gender. One hundred and forty-six parent-child pairs (34 parental premutations, 112 protomutations) were retrospectively selected from the DM1 patient cohort of the Maastricht University Medical Center+. CTG repeat size of parents and children was determined by (triplet-primed) PCR followed by fragment length analysis and Southern blot analysis. Fifty-eight out of eighty-one (71.6%) paternal transmissions led to a (CTG)n repeat of n > 80 in offspring, compared with 15 out of 65 (23.1%) maternal transmissions (p < 0.001). Repeat length instability occurred for paternal (CTG)n repeats of n ≥ 45, while maternal instability did not occur until (CTG)n repeats reached a length of n ≥ 71. Transmission of premutations caused (CTG)n repeats of n > 80 in offspring only when paternally transmitted (two cases), while protomutations caused (CTG)n repeats of n > 80 in offspring in 71 cases, of which 56 (78.9%) were paternally transmitted. In conclusion, our data show that paternally transmitted pre- and protomutations were more unstable than maternally transmitted pre- and protomutations. For genetic counseling, this implies that males with a small DMPK mutation have a higher risk of symptomatic offspring compared with females. Consequently, we suggest addressing sex-dependent factors in genetic counseling of small-sized CTG repeat carriers.
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Affiliation(s)
- Isis B T Joosten
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Debby M E I Hellebrekers
- Department of Clinical Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Bianca T A de Greef
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Hubert J M Smeets
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Genetics and Cell Biology, Clinical Genomics Unit, Maastricht University, Maastricht, The Netherlands.,School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | | | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Monique M Gerrits
- Department of Clinical Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands.
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17
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Alptekin D, Pazarcı P, Bereketoğlu MA, Erkoç MA, Ilgaz NS, Lüleyap Ü. Huntington hastalığı tanısı almış hastalarda ve ailelerinde CAG trinükleotid tekrar sayılarının fragman analizi ile tespiti. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.461390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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18
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HTT gene intermediate alleles in neurodegeneration: evidence for association with Alzheimer's disease. Neurobiol Aging 2019; 76:215.e9-215.e14. [DOI: 10.1016/j.neurobiolaging.2018.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 11/22/2022]
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19
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Chheda P, Chanekar M, Salunkhe Y, Dama T, Pais A, Pande S, Bendre R, Shah N. A Study of Triplet-Primed PCR for Identification of CAG Repeat Expansion in the HTT Gene in a Cohort of 503 Indian Cases with Huntington's Disease Symptoms. Mol Diagn Ther 2018; 22:353-359. [PMID: 29619771 DOI: 10.1007/s40291-018-0327-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Huntington's disease (HD) is an autosomal-dominant neurodegenerative disorder with an average age at onset of 40 years. It is a polyglutamine (polyQ) disorder that is caused by an increase in the number of CAG repeats in the huntingtin (HTT) gene. Genetic tests that accurately determine the number of CAG repeats are performed for confirmation of diagnosis, predictive testing of persons at genetic risk for inheriting HD, and prenatal testing. The aim of our study was to evaluate efficacy of triplet-primed polymerase chain reaction (TP-PCR) for routine diagnosis of HD in suspected cases from India. METHODS We evaluated a combination of CAG flanking PCR and triplet-primed PCR for estimation of CAG repeats in 503 cases with clinical suspicion of HD. RESULTS There were 250 cases (49.7%) that showed the presence of expanded alleles, with 241 (47.9%) being fully penetrant alleles and nine (1.8%) in the reduced penetrance category. There were seven juvenile cases with an age of onset of < 20 years, with the longest allele comprising 106 CAG repeats found in an 8-year-old male patient. The results demonstrated an inverse (R = - 0.67) relationship between CAG length and age at clinical onset. CONCLUSION Our study on pan-Indian cases is one of the largest studies reported so far in India and focuses on the most accurate and comprehensive molecular diagnostic evaluation of HD.
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Affiliation(s)
- Pratiksha Chheda
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India.
| | - Milind Chanekar
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India
| | - Yogita Salunkhe
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India
| | - Tavisha Dama
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India
| | - Anurita Pais
- Genetics Department, Metropolis Healthcare Ltd, Mumbai, 400 070, India
| | - Shailesh Pande
- Genetics Department, Metropolis Healthcare Ltd, Mumbai, 400 070, India
| | - Rajesh Bendre
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India
| | - Nilesh Shah
- Department of Molecular Pathology, Metropolis Healthcare Ltd, Commercial Building A, Unit No. 409 to 416, 4th Floor, Kohinoor City, Near Kohinoor Mall, Kirol Road, Kurla-W, Mumbai, 400 070, India
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20
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Jamali Z, Dianatpour M, Miryounesi M, Modarressi MH. A study of CAG repeat instability of HTT gene following spermatogenesis, by single sperm analysis. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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22
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Population-specific genetic modification of Huntington's disease in Venezuela. PLoS Genet 2018; 14:e1007274. [PMID: 29750799 PMCID: PMC5965898 DOI: 10.1371/journal.pgen.1007274] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/23/2018] [Accepted: 02/23/2018] [Indexed: 12/21/2022] Open
Abstract
Modifiers of Mendelian disorders can provide insights into disease mechanisms and guide therapeutic strategies. A recent genome-wide association (GWA) study discovered genetic modifiers of Huntington's disease (HD) onset in Europeans. Here, we performed whole genome sequencing and GWA analysis of a Venezuelan HD cluster whose families were crucial for the original mapping of the HD gene defect. The Venezuelan HD subjects develop motor symptoms earlier than their European counterparts, implying the potential for population-specific modifiers. The main Venezuelan HD family inherits HTT haplotype hap.03, which differs subtly at the sequence level from European HD hap.03, suggesting a different ancestral origin but not explaining the earlier age at onset in these Venezuelans. GWA analysis of the Venezuelan HD cluster suggests both population-specific and population-shared genetic modifiers. Genome-wide significant signals at 7p21.2-21.1 and suggestive association signals at 4p14 and 17q21.2 are evident only in Venezuelan HD, but genome-wide significant association signals at the established European chromosome 15 modifier locus are improved when Venezuelan HD data are included in the meta-analysis. Venezuelan-specific association signals on chromosome 7 center on SOSTDC1, which encodes a bone morphogenetic protein antagonist. The corresponding SNPs are associated with reduced expression of SOSTDC1 in non-Venezuelan tissue samples, suggesting that interaction of reduced SOSTDC1 expression with a population-specific genetic or environmental factor may be responsible for modification of HD onset in Venezuela. Detection of population-specific modification in Venezuelan HD supports the value of distinct disease populations in revealing novel aspects of a disease and population-relevant therapeutic strategies.
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23
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Kay C, Collins JA, Wright GEB, Baine F, Miedzybrodzka Z, Aminkeng F, Semaka AJ, McDonald C, Davidson M, Madore SJ, Gordon ES, Gerry NP, Cornejo-Olivas M, Squitieri F, Tishkoff S, Greenberg JL, Krause A, Hayden MR. The molecular epidemiology of Huntington disease is related to intermediate allele frequency and haplotype in the general population. Am J Med Genet B Neuropsychiatr Genet 2018; 177:346-357. [PMID: 29460498 DOI: 10.1002/ajmg.b.32618] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/21/2017] [Indexed: 01/31/2023]
Abstract
Huntington disease (HD) is the most common monogenic neurodegenerative disorder in populations of European ancestry, but occurs at lower prevalence in populations of East Asian or black African descent. New mutations for HD result from CAG repeat expansions of intermediate alleles (IAs), usually of paternal origin. The differing prevalence of HD may be related to the rate of new mutations in a population, but no comparative estimates of IA frequency or the HD new mutation rate are available. In this study, we characterize IA frequency and the CAG repeat distribution in fifteen populations of diverse ethnic origin. We estimate the HD new mutation rate in a series of populations using molecular IA expansion rates. The frequency of IAs was highest in Hispanic Americans and Northern Europeans, and lowest in black Africans and East Asians. The prevalence of HD correlated with the frequency of IAs by population and with the proportion of IAs found on the HD-associated A1 haplotype. The HD new mutation rate was estimated to be highest in populations with the highest frequency of IAs. In European ancestry populations, one in 5,372 individuals from the general population and 7.1% of individuals with an expanded CAG repeat in the HD range are estimated to have a molecular new mutation. Our data suggest that the new mutation rate for HD varies substantially between populations, and that IA frequency and haplotype are closely linked to observed epidemiological differences in the prevalence of HD across major ancestry groups in different countries.
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Affiliation(s)
- Chris Kay
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer A Collins
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Galen E B Wright
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Fiona Baine
- Division of Human Genetics, Department of Pathology, University of Cape Town, South Africa.,Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zosia Miedzybrodzka
- Medical Genetics Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Folefac Aminkeng
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Alicia J Semaka
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Cassandra McDonald
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Mark Davidson
- Medical Genetics Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Steven J Madore
- Molecular Biology Group, Coriell Institute for Medical Research, Camden, New Jersey
| | - Erynn S Gordon
- Molecular Biology Group, Coriell Institute for Medical Research, Camden, New Jersey
| | - Norman P Gerry
- Molecular Biology Group, Coriell Institute for Medical Research, Camden, New Jersey
| | - Mario Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Ferdinando Squitieri
- IRCCS Casa Sollievo della Sofferenza Hospital, Huntington and Rare Diseases Unit (CSS-Mendel Rome), San Giovanni Rotondo, Italy
| | - Sarah Tishkoff
- Department of Genetics, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacquie L Greenberg
- Division of Human Genetics, Department of Pathology, University of Cape Town, South Africa
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michael R Hayden
- Centre for Molecular Medicine Therapeutics, University of British Columbia, Vancouver, BC, Canada
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Abstract
Background: Although the typical age of onset for Huntington’s disease (HD) is in the fourth decade, between 4.4–11.5% of individuals with HD have a late onset (over 60 years of age). Diagnosis of Late onset HD (LoHD) can be missed, due to the perceived low likelihood of HD in the over 60-year-olds. Objective: To review the epidemiology, genotype and phenotype of LoHD. Methods: We systematically searched MEDLINE, EMBASE and Web of Science (inception-November 2016). Web of Science was then used to search for papers citing identified studies. Content experts were consulted for any additional studies. We included all studies reporting the clinical phenotype of LoHD for more than one participant. Results: 20 studies were identified from a potential list of 1243. Among Caucasian HD cohorts, 4.4–11.5% of individuals have LoHD, and this proportion may be increasing. Proportion of LoHD without a positive family history ranges from 3–68%. 94.4% of reported cases of LoHD had CAG repeat lengths of ≤44. Motor manifestations are the commonest initial presentation, although 29.2% presented with non-motor manifestations as the first clinical feature in one case series. Individuals with LoHD may have slower progression of illness. Cognitive impairment rather than chorea may be the major source of disability in this group. Conclusions: LoHD represents a substantial proportion of new diagnoses of HD and has some unique features. Further characterization of this population will aid clinicians in diagnosis.
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Affiliation(s)
- Sai S Chaganti
- Huntington Disease Service, Westmead Hospital, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Elizabeth A McCusker
- Huntington Disease Service, Westmead Hospital, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Clement T Loy
- Huntington Disease Service, Westmead Hospital, Sydney, Australia.,School of Public Health, The University of Sydney, Sydney, Australia.,The Garvan Institute of Medical Research, Sydney, Australia
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Abstract
Huntington's disease (HD) is an autosomal dominant progressive neurological disorder characterized by motor, cognitive, and psychiatric symptoms that typically present later on in life, although juvenile cases do exist. The identification of the disease-causing mutation, a CAG triplet repeat expansion in the HTT gene, in 1993 generated numerous investigations into the cellular and molecular pathways underlying the disorder. HD mouse models have played a prominent role in these studies, and the use of these mouse models of HD in the development and evaluation of novel therapeutic strategies is reviewed in this chapter. As new interventions and therapeutic approaches are evaluated and implemented, genetic mouse models will continue to be used with the hope of developing effective treatments for HD.
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Affiliation(s)
- Natalia Kosior
- Centre for Molecular Medicine and Therapeutics, and Department of Medical Genetics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, and Department of Medical Genetics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.
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Consequences of EPR–Proton Qubits Populating DNA. ADVANCES IN QUANTUM CHEMISTRY 2018. [DOI: 10.1016/bs.aiq.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kay C, Hayden MR, Leavitt BR. Epidemiology of Huntington disease. HANDBOOK OF CLINICAL NEUROLOGY 2017; 144:31-46. [DOI: 10.1016/b978-0-12-801893-4.00003-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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29
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Kay C, Collins JA, Miedzybrodzka Z, Madore SJ, Gordon ES, Gerry N, Davidson M, Slama RA, Hayden MR. Huntington disease reduced penetrance alleles occur at high frequency in the general population. Neurology 2016; 87:282-8. [PMID: 27335115 DOI: 10.1212/wnl.0000000000002858] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 03/16/2016] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To directly estimate the frequency and penetrance of CAG repeat alleles associated with Huntington disease (HD) in the general population. METHODS CAG repeat length was evaluated in 7,315 individuals from 3 population-based cohorts from British Columbia, the United States, and Scotland. The frequency of ≥36 CAG alleles was assessed out of a total of 14,630 alleles. The general population frequency of reduced penetrance alleles (36-39 CAG) was compared to the prevalence of patients with HD with genetically confirmed 36-39 CAG from a multisource clinical ascertainment in British Columbia, Canada. The penetrance of 36-38 CAG repeat alleles for HD was estimated for individuals ≥65 years of age and compared against previously reported clinical penetrance estimates. RESULTS A total of 18 of 7,315 individuals had ≥36 CAG, revealing that approximately 1 in 400 individuals from the general population have an expanded CAG repeat associated with HD (0.246%). Individuals with CAG 36-37 genotypes are the most common (36, 0.096%; 37, 0.082%; 38, 0.027%; 39, 0.000%; ≥40, 0.041%). General population CAG 36-38 penetrance rates are lower than penetrance rates extrapolated from clinical cohorts. CONCLUSION HD alleles with a CAG repeat length of 36-38 occur at high frequency in the general population. The infrequent diagnosis of HD at this CAG length is likely due to low penetrance. Another important contributing factor may be reduced ascertainment of HD in those of older age.
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Affiliation(s)
- Chris Kay
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Jennifer A Collins
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Zosia Miedzybrodzka
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Steven J Madore
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Erynn S Gordon
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Norman Gerry
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Mark Davidson
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Ramy A Slama
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ
| | - Michael R Hayden
- From the Centre for Molecular Medicine and Therapeutics (C.K., J.A.C., R.A.S., M.R.H.), University of British Columbia, Canada; Medical Genetics Group (Z.M., M.D.), School of Medicine and Dentistry, University of Aberdeen, UK; and Molecular Biology Group (S.J.M., E.S.G., N.G.), Coriell Institute for Medical Research, Camden, NJ.
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Bak J, Kim HJ, Kim SY, Choi YS. Neuroprotective effect of caffeic acid phenethyl ester in 3-nitropropionic acid-induced striatal neurotoxicity. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2016; 20:279-86. [PMID: 27162482 PMCID: PMC4860370 DOI: 10.4196/kjpp.2016.20.3.279] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/19/2016] [Accepted: 03/14/2016] [Indexed: 12/21/2022]
Abstract
Caffeic acid phenethyl ester (CAPE), derived from honeybee hives, is a bioactive compound with strong antioxidant activity. This study was designed to test the neuroprotective effect of CAPE in 3-nitropropionic acid (3NP)-induced striatal neurotoxicity, a chemical model of Huntington's disease (HD). Initially, to test CAPE's antioxidant activity, a 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulfonic acid (ABTS) antioxidant assay was employed, and CAPE showed a strong direct radical-scavenging eff ect. In addition, CAPE provided protection from 3NP-induced neuronal cell death in cultured striatal neurons. Based on these observations, the in vivo therapeutic potential of CAPE in 3NP-induced HD was tested. For this purpose, male C57BL/6 mice were repeatedly given 3NP to induce HD-like pathogenesis, and 30 mg/kg of CAPE or vehicle (5% dimethyl sulfoxide and 95% peanut oil) was administered daily. CAPE did not cause changes in body weight, but it reduced mortality by 29%. In addition, compared to the vehicle-treated group, robustly reduced striatal damage was observed in the CAPE-treated animals, and the 3NP-induced behavioral defi cits on the rotarod test were signifi cantly rescued after the CAPE treatment. Furthermore, immunohistochemical data showed that immunoreactivity to glial fibrillary acidic protein (GFAP) and CD45, markers for astrocyte and microglia activation, respectively, were strikingly reduced. Combined, these data unequivocally indicate that CAPE has a strong antioxidant eff ect and can be used as a potential therapeutic agent against HD.
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Affiliation(s)
- Jia Bak
- Department of Pharmaceutical Science and Technology, College of Health and Medical Science, Catholic University of Daegu, Gyeongsan 38430, Korea
| | - Hee Jung Kim
- Department of Physiology, College of Medicine, Dankook University, Cheonan 31116, Korea
| | - Seong Yun Kim
- Department of Pharmacology, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Yun-Sik Choi
- Department of Pharmaceutical Science and Technology, College of Health and Medical Science, Catholic University of Daegu, Gyeongsan 38430, Korea
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31
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Bastepe M, Xin W. Huntington Disease: Molecular Diagnostics Approach. ACTA ACUST UNITED AC 2015; 87:9.26.1-9.26.23. [DOI: 10.1002/0471142905.hg0926s87] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Murat Bastepe
- Neurogenetics DNA Diagnostic Laboratory, Department of Neurology, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts
- Genetics Training Program, Harvard Medical School Boston Massachusetts
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts
| | - Winnie Xin
- Neurogenetics DNA Diagnostic Laboratory, Department of Neurology, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts
- Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts
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Krause A, Mitchell C, Essop F, Tager S, Temlett J, Stevanin G, Ross C, Rudnicki D, Margolis R. Junctophilin 3 (JPH3) expansion mutations causing Huntington disease like 2 (HDL2) are common in South African patients with African ancestry and a Huntington disease phenotype. Am J Med Genet B Neuropsychiatr Genet 2015; 168:573-85. [PMID: 26079385 PMCID: PMC4565761 DOI: 10.1002/ajmg.b.32332] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/28/2015] [Indexed: 12/12/2022]
Abstract
Huntington disease (HD) is a progressive autosomal dominant neurodegenerative disorder, characterized by abnormal movements, cognitive decline, and psychiatric symptoms, caused by a CAG repeat expansion in the huntingtin (HTT) gene on chromosome 4p. A CAG/CTG repeat expansion in the junctophilin-3 (JPH3) gene on chromosome 16q24.2 causes a Huntington disease-like phenotype (HDL2). All patients to date with HDL2 have some African ancestry. The present study aimed to characterize the genetic basis of the Huntington disease phenotype in South Africans and to investigate the possible origin of the JPH3 mutation. In a sample of unrelated South African individuals referred for diagnostic HD testing, 62% (106/171) of white patients compared to only 36% (47/130) of black patients had an expansion in HTT. However, 15% (20/130) of black South African patients and no white patients (0/171) had an expansion in JPH3, confirming the diagnosis of Huntington disease like 2 (HDL2). Individuals with HDL2 share many clinical features with individuals with HD and are clinically indistinguishable in many cases, although the average age of onset and diagnosis in HDL2 is 5 years later than HD and individual clinical features may be more prominent. HDL2 mutations contribute significantly to the HD phenotype in South Africans with African ancestry. JPH3 haplotype studies in 31 families, mainly from South Africa and North America, provide evidence for a founder mutation and support a common African origin for all HDL2 patients. Molecular testing in individuals with an HD phenotype and African ancestry should include testing routinely for JPH3 mutations.
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Affiliation(s)
- Amanda Krause
- Division of Human Genetics, National Health Laboratory Service, Johannesburg, South Africa
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Claire Mitchell
- Division of Human Genetics, National Health Laboratory Service, Johannesburg, South Africa
| | - Fahmida Essop
- Division of Human Genetics, National Health Laboratory Service, Johannesburg, South Africa
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Susan Tager
- Department of Neurology, University of the Witwatersrand, Johannesburg, South Africa
- Donald Gordon Medical Centre, Johannesburg, South Africa
| | - James Temlett
- Department of Neurology, University of the Witwatersrand, Johannesburg, South Africa
- Department Clinical Neurology, University of Adelaide and the Royal Adelaide Hospital, Adelaide, Australia
| | - Giovanni Stevanin
- Sorbonne Universités, UPMC Univ Paris, Institut du Cerveau et de la Moelle épinière, Paris, France
- Ecole Pratique des Hautes Etudes, Paris, France
| | - Christopher Ross
- Johns Hopkins University School of Medicine, Departments of Psychiatry, Neurology, Neuroscience, and Pharmacology and Molecular Sciences and Program in Cellular and Molecular Medicine, Baltimore, Maryland
| | - Dobrila Rudnicki
- Johns Hopkins University School of Medicine, Departments of Psychiatry and Program in Cellular and Molecular Medicine, Baltimore, Maryland
| | - Russell Margolis
- Johns Hopkins University School of Medicine, Departments of Psychiatry and Neurology and Program in Cellular and Molecular Medicine, Baltimore, Maryland
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33
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Castilhos RM, Augustin MC, Santos JA, Perandones C, Saraiva-Pereira ML, Jardim LB. Genetic aspects of Huntington's disease in Latin America. A systematic review. Clin Genet 2015; 89:295-303. [PMID: 26178794 DOI: 10.1111/cge.12641] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/07/2015] [Accepted: 07/07/2015] [Indexed: 01/16/2023]
Abstract
We aimed to present a systematic review on Huntington's disease (HD) in Latin America (LA). PubMed and LILACS were searched up to March 2015, reporting confirmed HD cases in LA. Case series, cross-sectional, case-control, and prospective studies were included. From 534 communications, 47 were eligible. Population-based studies were not found; minimal prevalence of 0.5-4/100,000 was estimated for Venezuela and Mexico. Geographical isolates were well characterized in Venezuela and in Peru. CAG repeats at HTT gene varied between 7-33 and 37-112 in normal and expanded alleles, respectively. Intermediate alleles were found in 4-10% of controls. Ages at onset and the expanded CAG repeats correlated with r from - 0.55 to -0.91. While haplotype patterns of Venezuelan and Brazilian chromosomes were similar to those observed in Europeans, haplotypes from Peruvian HD patients did not match the same pattern. The limited number of papers found suggests that HD is poorly diagnosed in LA. Minimal prevalence seemed to be halfway between those of Caucasians and Asians. Range of CAG repeats was similar to those of Europeans. Haplotype studies indicate that majority of HD patients might be of Caucasian descent; an Asian origin for some Peruvian patients was proposed.
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Affiliation(s)
- R M Castilhos
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto Nacional de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil
| | - M C Augustin
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J A Santos
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C Perandones
- Parkinson's Disease and Movement Disorders Program, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - M L Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departmento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Laboratório de Identificação Humana, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - L B Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto Nacional de Genética Médica Populacional (INAGEMP), Porto Alegre, Brazil.,Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Laboratório de Identificação Humana, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Oosterloo M, Van Belzen MJ, Bijlsma EK, Roos RA. Is There Convincing Evidence that Intermediate Repeats in the HTT Gene Cause Huntington’s Disease? J Huntingtons Dis 2015; 4:141-8. [DOI: 10.3233/jhd-140120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mayke Oosterloo
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martine J. Van Belzen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Emilia K. Bijlsma
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Raymund A.C. Roos
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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35
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Schiefer J, Werner CJ, Reetz K. Clinical diagnosis and management in early Huntington's disease: a review. Degener Neurol Neuromuscul Dis 2015; 5:37-50. [PMID: 32669911 PMCID: PMC7337146 DOI: 10.2147/dnnd.s49135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/23/2015] [Indexed: 11/23/2022] Open
Abstract
This review focuses on clinical diagnosis and both pharmacological and nonpharmacological therapeutic options in early stages of the autosomal dominant inherited neurodegenerative Huntington's disease (HD). The available literature has been reviewed for motor, cognitive, and psychiatric alterations, which are the three major symptom domains of this devastating progressive disease. From a clinical point of view, one has to be aware that the HD phenotype can vary highly across individuals and during the course of the disease. Also, symptoms in juvenile HD can differ substantially from those with adult-onset of HD. Although there is no cure of HD and management is limited, motor and psychiatric symptoms often respond to pharmacotherapy, and nonpharmacological approaches as well as supportive care are essential. International treatment recommendations based on study results, critical statements, and expert opinions have been included. This review is restricted to symptomatic and supportive approaches since all attempts to establish a cure for the disease or modifying therapies have failed so far.
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Affiliation(s)
| | | | - Kathrin Reetz
- Euregional Huntington Center
- Jülich Aachen Research Alliance (JARA) – Translational Brain Medicine, Department of Neurology, RWTH Aachen University, Aachen, Germany
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36
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Uhlmann WR, Peñaherrera MS, Robinson WP, Milunsky JM, Nicholson JM, Albin RL. Biallelic mutations in huntington disease: A new case with just one affected parent, review of the literature and terminology. Am J Med Genet A 2015; 167A:1152-60. [DOI: 10.1002/ajmg.a.37009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/22/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Wendy R. Uhlmann
- Division of Molecular Medicine and Genetics; Department of Internal Medicine; University of Michigan; Ann Arbor Michigan
- Department of Human Genetics; University of Michigan; Ann Arbor Michigan
| | - Maria S. Peñaherrera
- Department of Medical Genetics; University of British Columbia; Vancouver British Columbia
- Child and Family Research Institute; Vancouver British Columbia
| | - Wendy P. Robinson
- Department of Medical Genetics; University of British Columbia; Vancouver British Columbia
- Child and Family Research Institute; Vancouver British Columbia
| | | | - Jane M. Nicholson
- Division of Molecular Medicine and Genetics; Department of Internal Medicine; University of Michigan; Ann Arbor Michigan
- Department of Obstetrics and Gynecology; University of Michigan; Ann Arbor Michigan
| | - Roger L. Albin
- Department of Neurology; University of Michigan; Ann Arbor Michigan
- VA Ann Arbor Healthcare System; Geriatrics Research, Education, and Clinical Center; Ann Arbor Michigan
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37
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Zanko A, Abrams L. Case report: concurrent Wilson disease and Huntington disease: lightning can strike twice. J Genet Couns 2014; 24:40-5. [PMID: 25378206 DOI: 10.1007/s10897-014-9789-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 10/27/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Andrea Zanko
- Division of Medical Genetics, Department of Pediatrics, University of California Medical Center, San Francisco, 94143, CA, USA,
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Sun X, Marque LO, Cordner Z, Pruitt JL, Bhat M, Li PP, Kannan G, Ladenheim EE, Moran TH, Margolis RL, Rudnicki DD. Phosphorodiamidate morpholino oligomers suppress mutant huntingtin expression and attenuate neurotoxicity. Hum Mol Genet 2014; 23:6302-17. [PMID: 25035419 DOI: 10.1093/hmg/ddu349] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Huntington's disease (HD) is a neurodegenerative disorder caused by a CAG trinucleotide repeat expansion in the huntingtin (HTT) gene. Disease pathogenesis derives, at least in part, from the long polyglutamine tract encoded by mutant HTT. Therefore, considerable effort has been dedicated to the development of therapeutic strategies that significantly reduce the expression of the mutant HTT protein. Antisense oligonucleotides (ASOs) targeted to the CAG repeat region of HTT transcripts have been of particular interest due to their potential capacity to discriminate between normal and mutant HTT transcripts. Here, we focus on phosphorodiamidate morpholino oligomers (PMOs), ASOs that are especially stable, highly soluble and non-toxic. We designed three PMOs to selectively target expanded CAG repeat tracts (CTG22, CTG25 and CTG28), and two PMOs to selectively target sequences flanking the HTT CAG repeat (HTTex1a and HTTex1b). In HD patient-derived fibroblasts with expanded alleles containing 44, 77 or 109 CAG repeats, HTTex1a and HTTex1b were effective in suppressing the expression of mutant and non-mutant transcripts. CTGn PMOs also suppressed HTT expression, with the extent of suppression and the specificity for mutant transcripts dependent on the length of the targeted CAG repeat and on the CTG repeat length and concentration of the PMO. PMO CTG25 reduced HTT-induced cytotoxicity in vitro and suppressed mutant HTT expression in vivo in the N171-82Q transgenic mouse model. Finally, CTG28 reduced mutant HTT expression and improved the phenotype of Hdh(Q7/Q150) knock-in HD mice. These data demonstrate the potential of PMOs as an approach to suppressing the expression of mutant HTT.
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Affiliation(s)
- Xin Sun
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Leonard O Marque
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Zachary Cordner
- Behavioral Neuroscience Laboratory, Department of Psychiatry and Behavioral Sciences
| | - Jennifer L Pruitt
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Manik Bhat
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Pan P Li
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Geetha Kannan
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Ellen E Ladenheim
- Behavioral Neuroscience Laboratory, Department of Psychiatry and Behavioral Sciences
| | - Timothy H Moran
- Behavioral Neuroscience Laboratory, Department of Psychiatry and Behavioral Sciences
| | - Russell L Margolis
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Department of Neurology, and Program of Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Dobrila D Rudnicki
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Program of Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Chandra A, Johri A, Beal MF. Prospects for neuroprotective therapies in prodromal Huntington's disease. Mov Disord 2014; 29:285-93. [PMID: 24573776 DOI: 10.1002/mds.25835] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/14/2014] [Accepted: 01/16/2014] [Indexed: 12/13/2022] Open
Abstract
Huntington's disease (HD) is a prototypical dominantly inherited neurodegenerative disorder characterized by progressive cognitive deterioration, psychiatric disturbances, and a movement disorder. The genetic cause of the illness is a CAG repeat expansion in the huntingtin gene, which leads to a polyglutamine expansion in the huntingtin protein. The exact mechanism by which mutant huntingtin causes HD is unknown, but it causes abnormalities in gene transcription as well as both mitochondrial dysfunction and oxidative damage. Because the penetrance of HD is complete with CAG repeats greater than 39, patients can be diagnosed well before disease onset with genetic testing. Longitudinal studies of HD patients before disease onset have shown that subtle cognitive and motor deficits occur as much as 10 years before onset, as do reductions in glucose utilization and striatal atrophy. An increase in inflammation, as shown by elevated interleukin-6, occurs approximately 15 years before onset. Detection of these abnormalities may be useful in defining an optimal time for disease intervention to try to slow or halt the degenerative process. Although reducing gene expression with small interfering RNA or short hairpin RNA is an attractive approach, other approaches targeting energy metabolism, inflammation, and oxidative damage may be more easily and rapidly moved into the clinic. The recent PREQUEL study of coenzyme Q10 in presymptomatic gene carriers showed the feasibility of carrying out clinical trials to slow or halt onset of HD. We review both the earliest detectable clinical and laboratory manifestations of HD, as well as potential neuroprotective therapies that could be utilized in presymptomatic HD.
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Affiliation(s)
- Abhishek Chandra
- Brain and Mind Research Institute, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, New York, USA
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40
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Semaka A, Hayden M. Evidence-based genetic counselling implications for Huntington disease intermediate allele predictive test results. Clin Genet 2014; 85:303-11. [DOI: 10.1111/cge.12324] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/18/2013] [Accepted: 11/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
- A. Semaka
- Centre for Molecular Medicine and Therapeutics; University of British Columbia; Vancouver British Columbia Canada
| | - M.R. Hayden
- Centre for Molecular Medicine and Therapeutics; University of British Columbia; Vancouver British Columbia Canada
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41
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Melamed O, Behar DM, Bram C, Magal N, Pras E, Reznik-Wolf H, Borochowitz ZU, Davidov B, Mor-Cohen R, Baris HN. Founder mutation for Huntington disease in Caucasus Jews. Clin Genet 2014; 87:167-72. [PMID: 24405192 DOI: 10.1111/cge.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/05/2014] [Accepted: 01/06/2014] [Indexed: 11/29/2022]
Abstract
Huntington disease (HD), an autosomal dominant disorder involving HTT, is characterized by chorea, psychiatric illness and cognitive decline. Diagnosis and age of onset depend on the degree of expansion of the trinucleotide CAG repeat within the gene. The prevalence of HD is known for Europeans but has not been studied in the Israeli population. Between 2006 and 2011 we diagnosed in our adult genetics clinic ten HD probands, nine of whom were Caucasus Jews (CJ) (Azerbaijani), and one Ashkenazi Jewish. We performed haplotype analysis to look for evidence of a founder mutation, and found that of the nine CJ, eight shared the same haplotype that was compatible with the A1 haplogroup. We calculated the coalescence age of the mutation to be between 80 and 150 years. Ninety percent of our HD patients are CJ, as are 27% of the HD patients in Israel, although the CJ comprise only 1.4% of the Israeli population. Our findings suggest a higher prevalence of HD among CJ compared to the general Israeli population and are consistent with a recent founder mutation. We recommend a higher degree of suspicion for HD in CJ with subtle clinical findings.
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Affiliation(s)
- O Melamed
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
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42
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Vázquez-Mojena Y, Laguna-Salvia L, Laffita-Mesa JM, González-Zaldívar Y, Almaguer-Mederos LE, Rodríguez-Labrada R, Almaguer-Gotay D, Zayas-Feria P, Velázquez-Pérez L. Genetic features of Huntington disease in Cuban population: Implications for phenotype, epidemiology and predictive testing. J Neurol Sci 2013; 335:101-4. [DOI: 10.1016/j.jns.2013.08.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 08/22/2013] [Accepted: 08/26/2013] [Indexed: 10/26/2022]
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Semaka A, Kay C, Doty CN, Collins JA, Tam N, Hayden MR. High frequency of intermediate alleles on Huntington disease-associated haplotypes in British Columbia's general population. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:864-71. [PMID: 24038799 DOI: 10.1002/ajmg.b.32193] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 07/11/2013] [Indexed: 11/08/2022]
Abstract
Intermediate alleles (27-35 CAG, IAs) for Huntington disease (HD) usually do not confer the disease phenotype but are prone to CAG repeat instability. Consequently, offspring are at-risk of inheriting an expanded allele in the HD range (≥36 CAG). IAs that expand into a new mutation have been hypothesized to be more susceptible to instability compared to IAs identified on the non-HD side of a family from the general population. Frequency estimates for IAs are limited and have largely been determined using clinical samples of HD or related disorders, which may result in an ascertainment bias. This study aimed to establish the frequency of IAs in a sample of a British Columbia's (B.C.) general population with no known association to HD and examine the haplotype of new mutation and general population IAs. CAG sizing was performed on 1,600 DNA samples from B.C.'s general population. Haplotypes were determined using 22 tagging SNPs across the HTT gene. 5.8% of individuals were found to have an IA, of which 60% were on HD-associated haplotypes. There was no difference in the haplotype distribution of new mutation and general population IAs. These findings suggest that IAs are relatively frequent in the general population and are often found on haplotypes associated with expanded CAG lengths. There is likely no difference in the propensity of new mutation and general population IAs to expand into the disease range given that they are both found on disease-associated haplotypes. These findings have important implications for clinical practice.
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Affiliation(s)
- Alicia Semaka
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, Canada
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Marchina E, Misasi S, Bozzato A, Ferraboli S, Agosti C, Rozzini L, Borsani G, Barlati S, Padovani A. Gene expression profile in fibroblasts of Huntington's disease patients and controls. J Neurol Sci 2013; 337:42-6. [PMID: 24296361 DOI: 10.1016/j.jns.2013.11.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 10/19/2013] [Accepted: 11/11/2013] [Indexed: 01/08/2023]
Abstract
Huntington's disease is an inherited disorder caused by expanded stretch of consecutive trinucleotides (cytosine-adenosine-guanine, CAG) within the first exon of the huntingtin (HTT) gene on chromosome 4 (p16.3). The mutated huntingtin (mHTT) gains toxic function, probably through mechanisms that involve aberrant interactions in several pathways, causing cytotoxicity. Pathophysiology of disease involves several tissues; indeed it has been shown that there is a broad toxic effect of mHTT in the peripheral tissue of patients with HD, not only in the central nervous system. In this study we compared gene expression profiles (GEP) of HD fibroblasts and matched controls using microarray technology. We used RT-PCR to test the consistency of the microarray data and we found four genes up-regulated in HD patients with respect to control individuals. The genes appear to be involved in different pathways that have been shown to be perturbed even in HD models and patients. Although our study is preliminary and has to be extended to a larger cohort of HD patients and controls, nevertheless it shows that gene expression profiles seem to be altered in the fibroblasts of HD patients. Validation of the differential expressions at the protein level is required to ascertain if this cell type can be considered a suitable model for the identification of HD biomarkers.
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Affiliation(s)
- Eleonora Marchina
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| | - Silvia Misasi
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Andrea Bozzato
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Sergio Ferraboli
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Chiara Agosti
- Division of Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luca Rozzini
- Division of Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuseppe Borsani
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Sergio Barlati
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Division of Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Affiliation(s)
- S Mahalingam
- From the George Washington University Medical Center, Department of Radiology, Washington, DC
| | - L M Levy
- From the George Washington University Medical Center, Department of Radiology, Washington, DC.
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46
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Paulsen JS, Nance M, Kim JI, Carlozzi NE, Panegyres PK, Erwin C, Goh A, McCusker E, Williams JK. A review of quality of life after predictive testing for and earlier identification of neurodegenerative diseases. Prog Neurobiol 2013; 110:2-28. [PMID: 24036231 PMCID: PMC3833259 DOI: 10.1016/j.pneurobio.2013.08.003] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 08/26/2013] [Accepted: 08/26/2013] [Indexed: 12/12/2022]
Abstract
The past decade has witnessed an explosion of evidence suggesting that many neurodegenerative diseases can be detected years, if not decades, earlier than previously thought. To date, these scientific advances have not provoked any parallel translational or clinical improvements. There is an urgency to capitalize on this momentum so earlier detection of disease can be more readily translated into improved health-related quality of life for families at risk for, or suffering with, neurodegenerative diseases. In this review, we discuss health-related quality of life (HRQOL) measurement in neurodegenerative diseases and the importance of these "patient reported outcomes" for all clinical research. Next, we address HRQOL following early identification or predictive genetic testing in some neurodegenerative diseases: Huntington disease, Alzheimer's disease, Parkinson's disease, Dementia with Lewy bodies, frontotemporal dementia, amyotrophic lateral sclerosis, prion diseases, hereditary ataxias, Dentatorubral-pallidoluysian atrophy and Wilson's disease. After a brief report of available direct-to-consumer genetic tests, we address the juxtaposition of earlier disease identification with assumed reluctance toward predictive genetic testing. Forty-one studies examining health-related outcomes following predictive genetic testing for neurodegenerative disease suggested that (a) extreme or catastrophic outcomes are rare; (b) consequences commonly include transiently increased anxiety and/or depression; (c) most participants report no regret; (d) many persons report extensive benefits to receiving genetic information; and (e) stigmatization and discrimination for genetic diseases are poorly understood and policy and laws are needed. Caution is appropriate for earlier identification of neurodegenerative diseases but findings suggest further progress is safe, feasible and likely to advance clinical care.
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Affiliation(s)
- Jane S Paulsen
- Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, IA, USA; Department of Psychology, University of Iowa, Iowa City, IA, USA.
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47
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Saft C, Leavitt BR, Epplen JT. Clinical utility gene card for: Huntington's disease. Eur J Hum Genet 2013; 22:ejhg2013206. [PMID: 24105375 DOI: 10.1038/ejhg.2013.206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Carsten Saft
- Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Jörg T Epplen
- Department of Human Genetics, Huntington Centre NRW, Ruhr-University Bochum, Germany
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48
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Semaka A, Kay C, Doty C, Collins JA, Bijlsma EK, Richards F, Goldberg YP, Hayden MR. CAG size-specific risk estimates for intermediate allele repeat instability in Huntington disease. J Med Genet 2013; 50:696-703. [PMID: 23896435 DOI: 10.1136/jmedgenet-2013-101796] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION New mutations for Huntington disease (HD) occur due to CAG repeat instability of intermediate alleles (IA). IAs have between 27 and 35 CAG repeats, a range just below the disease threshold of 36 repeats. While they usually do not confer the HD phenotype, IAs are prone to paternal germline CAG repeat instability. Consequently, they may expand into the HD range upon transmission to the next generation, producing a new mutation. Quantified risk estimates for IA repeat instability are extremely limited but needed to inform clinical practice. METHODS Using small-pool PCR of sperm DNA from Caucasian men, we examined the frequency and magnitude of CAG repeat instability across the entire range of intermediate CAG sizes. The CAG size-specific risk estimates generated are based on the largest sample size ever examined, including 30 IAs and 18 198 sperm. RESULTS Our findings demonstrate a significant risk of new mutations. While all intermediate CAG sizes demonstrated repeat expansion into the HD range, alleles with 34 and 35 CAG repeats were associated with the highest risk of a new mutation (2.4% and 21.0%, respectively). IAs with ≥33 CAG repeats showed a dramatic increase in the frequency of instability and a switch towards a preponderance of repeat expansions over contractions. CONCLUSIONS These data provide novel insights into the origins of new mutations for HD. The CAG size-specific risk estimates inform clinical practice and provide accurate risk information for persons who receive an IA predictive test result.
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Affiliation(s)
- Alicia Semaka
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
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Experiences of predictive testing in young people at risk of Huntington's disease, familial cardiomyopathy or hereditary breast and ovarian cancer. Eur J Hum Genet 2013; 22:396-401. [PMID: 23860040 DOI: 10.1038/ejhg.2013.143] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/31/2013] [Accepted: 06/06/2013] [Indexed: 11/09/2022] Open
Abstract
While debate has focused on whether testing of minors for late onset genetic disorders should be carried out if there is no medical benefit, less is known about the impact on young people (<25 years) who have had predictive testing often many years before the likely onset of symptoms. We looked at the experiences of young people who had had predictive testing for a range of conditions with variable ages at onset and options for screening and treatment. A consecutive series of 61 young people who had a predictive test aged 15-25 years at the Clinical Genetic Service, Manchester, for HD, HBOC (BrCa 1 or 2) or FCM (Hypertrophic Cardiomyopathy or Dilated Cardiomyopathy), were invited to participate. Thirty-six (36/61; 59%) agreed to participate (10 HD, 16 HBOC and 10 FCM) and telephone interviews were audiotaped, transcribed and analysed using Interpretative Phenomenological Analysis. None of the participants expressed regret at having the test at a young age. Participants saw the value of pretest counselling not in facilitating a decision, but rather as a source of information and support. Differences emerged among the three groups in parent/family involvement in the decision to be tested. Parents in FCM families were a strong influence in favour of testing, in HBOC the decision was autonomous but usually congruent with the views of parents, whereas in HD the decision was autonomous and sometimes went against the opinions of parents/grandparents. Participants from all three groups proposed more tailoring of predictive test counselling to the needs of young people.
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Cruz-Mariño T, Laffita-Mesa JM, Gonzalez-Zaldivar Y, Velazquez-Santos M, Aguilera-Rodriguez R, Estupinan-Rodriguez A, Vazquez-Mojena Y, Macleod P, Paneque M, Velazquez-Perez L. Large normal and intermediate alleles in the context of SCA2 prenatal diagnosis. J Genet Couns 2013; 23:89-96. [PMID: 23813298 DOI: 10.1007/s10897-013-9615-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 05/22/2013] [Indexed: 12/22/2022]
Abstract
In 2001 a program for predictive testing of Spinocerebellar Ataxia type 2 was developed in Cuba, based on the detection of an abnormal CAG trinucleotide repeat expansion in the ATXN2 gene. A descriptive study was designed to assess the implications of ATXN2 large normal and intermediate alleles in the context of the SCA2 Prenatal Diagnosis Program. Four clinical scenarios were selected based upon the behaviour of large normal and intermediate alleles when passing from one generation to the next, showing expansions, contractions, or stability in the CAG repeat size. In some populations, traditional Mendelian risk figures of 0 % or 50 % may not be applicable due to the high frequency of unstable large normal alleles. Couples with no family history of SCA2 may have a >0 % risk of having an affected offspring. Similarly, couples in which there is both an expanded and a large normal allele may have a recurrence risk >50 %. It is imperative that these issues be addressed with these couples during genetic counseling. These recurrence risks have to be carefully estimated in the presence of such alleles (particularly alleles ≥27 CAG repeats), carriers need to be aware of the potential risk for their descendants, and programs for prenatal diagnosis must be available for them.
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Affiliation(s)
- Tania Cruz-Mariño
- Predictive Genetics Department, Center for the Research and Rehabilitation of Hereditary Ataxias, Reparto Edecio Pérez, Carretera Vía Habana, Holguín, Cuba, 80100,
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