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Frontino G, Di Tonno R, Stancampiano MR, Arrigoni F, Rigamonti A, Morotti E, Canarutto D, Bonfanti R, Russo G, Barera G, Piemonti L. Paediatric Wolfram syndrome Type 1: should gonadal dysfunction be part of the diagnostic criteria? Front Endocrinol (Lausanne) 2023; 14:1155644. [PMID: 37383390 PMCID: PMC10294676 DOI: 10.3389/fendo.2023.1155644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023] Open
Abstract
Aims Wolfram Syndrome Spectrum Disorder (WFS1-SD), in its "classic" form, is a rare autosomal recessive disease with poor prognosis and wide phenotypic spectrum. Insulin dependent diabetes mellitus (DM), optic atrophy (OA) diabetes insipidus (DI) and sensorineural deafness (D) are the main features of WFS1-SD. Gonadal dysfunction (GD) has been described mainly in adults with variable prevalence and referred to as a minor clinical feature. This is the first case series investigating gonadal function in a small cohort of paediatric patients affected by WFS1-SD. Methods Gonadal function was investigated in eight patients (3 male and 5 female) between 3 and 16 years of age. Seven patients have been diagnosed with classic WFS1-SD and one with non-classic WFS1-SD. Gonadotropin and sex hormone levels were monitored, as well as markers of gonadal reserve (inhibin-B and anti-Mullerian hormone). Pubertal progression was assessed according to Tanner staging. Results Primary hypogonadism was diagnosed in 50% of patients (n=4), more specifically 67% (n=2) of males and 40% of females (n=2). Pubertal delay was observed in one female patient. These data confirm that gonadal dysfunction may be a frequent and underdiagnosed clinical feature in WFS1-SD. Conclusions GD may represent a frequent and earlier than previously described feature in WFS1-SD with repercussions on morbidity and quality of life. Consequently, we suggest that GD should be included amongst clinical diagnostic criteria for WFS1-SD, as has already been proposed for urinary dysfunction. Considering the heterogeneous and elusive presentation of WFS1-SD, this clinical feature may assist in an earlier diagnosis and timely follow-up and care of treatable associated diseases (i.e. insulin and sex hormone replacement) in these young patients.
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Affiliation(s)
- Giulio Frontino
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Diabetes Research Institute, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Raffaella Di Tonno
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Marianna Rita Stancampiano
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Arrigoni
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Rigamonti
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Diabetes Research Institute, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Elisa Morotti
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Daniele Canarutto
- San Raffaele Telethon Institute for Gene Therapy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Pediatric Immunohematology Unit and BMT Program, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Diabetes Research Institute, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Gianni Russo
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Graziano Barera
- Department of Pediatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
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Serbis A, Rallis D, Giapros V, Galli-Tsinopoulou A, Siomou E. Wolfram Syndrome 1: A Pediatrician's and Pediatric Endocrinologist's Perspective. Int J Mol Sci 2023; 24:ijms24043690. [PMID: 36835101 PMCID: PMC9960967 DOI: 10.3390/ijms24043690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/21/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
Wolfram syndrome 1 (WS1) is a rare autosomal recessive neurodegenerative disease caused by mutations in WFS1 and WFS2 genes that produce wolframin, a protein involved in endoplasmic reticulum calcium homeostasis and cellular apoptosis. Its main clinical features are diabetes insipidus (DI), early-onset non-autoimmune insulin-dependent diabetes mellitus (DM), gradual loss of vision due to optic atrophy (OA) and deafness (D), hence the acronym DIDMOAD. Several other features from different systems have been reported such as urinary tract, neurological, and psychiatric abnormalities. In addition, endocrine disorders that can appear during childhood and adolescence include primary gonadal atrophy and hypergonadotropic hypogonadism in males and menstrual cycle abnormalities in females. Further, anterior pituitary dysfunction with deficient GH and/or ACTH production have been described. Despite the lack of specific treatment for the disease and its poor life expectancy, early diagnosis and supportive care is important for timely identifying and adequately managing its progressive symptoms. The current narrative review focuses on the pathophysiology and the clinical features of the disease, with a special emphasis on its endocrine abnormalities that appear during childhood and adolescence. Further, therapeutic interventions that have been proven to be effective in the management of WS1 endocrine complications are discussed.
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Affiliation(s)
- Anastasios Serbis
- Department of Pediatrics, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
- Correspondence:
| | - Dimitrios Rallis
- Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
| | - Assimina Galli-Tsinopoulou
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
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Jodoin A, Marchand M, Beltrand J. Wolfram syndrome in a young woman with associated hypergonadotropic hypogonadism - A case report. J Pediatr Endocrinol Metab 2022; 35:1552-1555. [PMID: 36100371 DOI: 10.1515/jpem-2022-0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Wolfram syndrome (WFS) is a rare neurodegenerative disease. Clinical diagnosis is made when nonautoimmune insulin-dependent diabetes is found to be associated with bilateral optic atrophy in a patient early in life. Frequent associations include diabetes insipidus, diabetes mellitus, optic atrophy and deafness. Many other multisystemic associations have been described including menstrual irregularities in female and hypogonadism in male patients. CASE PRESENTATION We present a first case of WFS associated with hypergonadotropic hypogonadism in a female adolescent diagnosed with WFS both clinically and genetically. Other causes of premature ovarian insufficiency (POI) have been excluded. CONCLUSIONS This case report shows the importance of gonadal function assessment and follow-up in time for both genders.
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Affiliation(s)
- Andréanne Jodoin
- Pediatric Endocrinology, Gynecology and Diabetology Department, Necker Hospital, Paris, France.,Obstetrics and Gynecology Department, University of Montreal, Montreal, Canada
| | - Maud Marchand
- Pediatric Endocrinology, Gynecology and Diabetology Department, Necker Hospital, Paris, France
| | - Jacques Beltrand
- Pediatric Endocrinology, Gynecology and Diabetology Department, Necker Hospital, Paris, France
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Majander A, Jurkute N, Burté F, Brock K, João C, Huang H, Neveu MM, Chan CM, Duncan HJ, Kelly S, Burkitt-Wright E, Khoyratty F, Lai YT, Subash M, Chinnery PF, Bitner-Glindzicz M, Arno G, Webster AR, Moore AT, Michaelides M, Stockman A, Robson AG, Yu-Wai-Man P. WFS1-Associated Optic Neuropathy: Genotype-Phenotype Correlations and Disease Progression. Am J Ophthalmol 2022; 241:9-27. [PMID: 35469785 DOI: 10.1016/j.ajo.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the pattern of vision loss and genotype-phenotype correlations in WFS1-associated optic neuropathy (WON). DESIGN Multicenter cohort study. METHODS The study involved 37 patients with WON carrying pathogenic or candidate pathogenic WFS1 variants. Genetic and clinical data were retrieved from the medical records. Thirteen patients underwent additional comprehensive ophthalmologic assessment. Deep phenotyping involved visual electrophysiology and advanced psychophysical testing with a complementary metabolomic study. MAIN OUTCOME MEASURES WFS1 variants, functional and structural optic nerve and retinal parameters, and metabolomic profile. RESULTS Twenty-two recessive and 5 dominant WFS1 variants were identified. Four variants were novel. All WFS1 variants caused loss of macular retinal ganglion cells (RGCs) as assessed by optical coherence tomography (OCT) and visual electrophysiology. Advanced psychophysical testing indicated involvement of the major RGC subpopulations. Modeling of vision loss showed an accelerated rate of deterioration with increasing age. Dominant WFS1 variants were associated with abnormal reflectivity of the outer plexiform layer (OPL) on OCT imaging. The dominant variants tended to cause less severe vision loss compared with recessive WFS1 variants, which resulted in more variable phenotypes ranging from isolated WON to severe multisystem disease depending on the WFS1 alleles. The metabolomic profile included markers seen in other neurodegenerative diseases and type 1 diabetes mellitus. CONCLUSIONS WFS1 variants result in heterogenous phenotypes influenced by the mode of inheritance and the disease-causing alleles. Biallelic WFS1 variants cause more variable, but generally more severe, vision and RGC loss compared with heterozygous variants. Abnormal cleftlike lamination of the OPL is a distinctive OCT feature that strongly points toward dominant WON.
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Affiliation(s)
- Anna Majander
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; Department of Ophthalmology, Helsinki University Hospital, University of Helsinki (A.M.), Helsinki, Finland.
| | - Neringa Jurkute
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Florence Burté
- Biosciences Institute, International Centre for Life, Newcastle University (F.B.), Newcastle upon Tyne, United Kingdom
| | - Kristian Brock
- Cancer Research UK Clinical Trials Unit, University of Birmingham (K.B.), Birmingham, United Kingdom
| | - Catarina João
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Houbin Huang
- Hainan Hospital of the General Hospital of Chinese People's Liberation Army (H.H.), Sanya, China
| | - Magella M Neveu
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Choi Mun Chan
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Holly J Duncan
- Newcastle Eye Centre, Royal Victoria Infirmary (H.J.D.), Newcastle upon Tyne, United Kingdom
| | - Simon Kelly
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Emma Burkitt-Wright
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust (E.B.-W.), Manchester, United Kingdom; Division of Evolution and Genomic Sciences, University of Manchester, Manchester Academic Health Sciences Centre (E.B.-W.), Manchester, United Kingdom
| | - Fadil Khoyratty
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Yoon Tse Lai
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Mala Subash
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Patrick F Chinnery
- MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge (P.F.C.), Cambridge, United Kingdom
| | | | - Gavin Arno
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Andrew R Webster
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Anthony T Moore
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; Department of Ophthalmology, UCSF School of Medicine (A.T.M.), San Francisco, California, USA
| | - Michel Michaelides
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Andrew Stockman
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Anthony G Robson
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Patrick Yu-Wai-Man
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge (P.Y.-W.-M.), Cambridge, United Kingdom; and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals (P.Y.-W.-M.), Cambridge, United Kingdom
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Urinary Tract Involvement in Wolfram Syndrome: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211994. [PMID: 34831749 PMCID: PMC8624443 DOI: 10.3390/ijerph182211994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022]
Abstract
Wolfram Syndrome (WS) is a rare neurodegenerative disease with autosomal recessive inheritance and characterized by juvenile onset, non-autoimmune diabetes mellitus and later followed by optic atrophy leading to blindness, diabetes insipidus, hearing loss, and other neurological and endocrine dysfunctions. A wide spectrum of neurodegenerative abnormalities affecting the central nervous system has been described. Among these complications, neurogenic bladder and urodynamic abnormalities also deserve attention. Urinary tract dysfunctions (UTD) up to end stage renal disease are a life-threatening complication of WS patients. Notably, end stage renal disease is reported as one of the most common causes of death among WS patients. UTD have been also reported in affected adolescents. Involvement of the urinary tract occurs in about 90% of affected patients, at a median age of 20 years and with peaks at 13, 21 and 33 years. The aim of our narrative review was to provide an overview of the most important papers regarding urological impairment in Wolfram Syndrome. A comprehensive search on PubMed including Wolfram Syndrome and one or more of the following terms: chronic renal failure, bladder dysfunction, urological aspects, and urinary tract dysfunction, was done. The exclusion criteria were studies not written in English and not including urinary tract dysfunction deep evaluation and description. Studies mentioning general urologic abnormalities without deep description and/or follow-up were not considered. Due to the rarity of the condition, we considered not only papers including pediatric patients, but also papers with pediatric and adult case reports
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Ivask M, Volke V, Raasmaja A, Kõks S. High-fat diet associated sensitization to metabolic stress in Wfs1 heterozygous mice. Mol Genet Metab 2021; 134:203-211. [PMID: 34312071 DOI: 10.1016/j.ymgme.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
Wolfram syndrome is a rare autosomal recessive disorder caused by mutations in the wolframin ER transmembrane glycoprotein (WFS1) gene and characterized by diabetes mellitus, diabetes insipidus, optic atrophy and deafness. In experimental models the homozygous Wfs1 mutant mice have a full penetrance and clearly expressed phenotype, whereas heterozygous mutants have a less-pronounced phenotype between the wild-type and homozygous mutant mice. Heterozygous WFS1 mutations have been shown to be significant risk factors for diabetes and metabolic disorders in humans. In the present study we analyzed the response of heterozygous Wfs1 mice to high fat diet (HFD) by exploring potential outcomes and molecular changes induced by this challenge. The HFD treatment increased the body weight (BW) similarly both in Wfs1 wild-type (WT) and heterozygous (HZ) mice, and therefore HFD also prevented the impaired BW gain found in Wfs1 mutant mice. In Wfs1HZ mutant mice, HFD impaired the normalized insulin secretion and the expression of ER stress genes in isolated pancreatic islets. These results suggest that Wfs1HZ mice have a decreased insulin response and pronounced cellular stress response due to a higher sensitivity to HFD as hypothesized. In Wfs1HZ mice, HFD increased the expression of Ire1α and Chop in pancreas and decreased that of Ire1α and Atf4 in liver. The present study shows that HFD can disturb insulin function with an increased ER stress in Wfs1HZ mice and only one functional Wfs1 gene copy is not sufficient to compensate this challenge. In conclusion, our study indicates that quantitative Wfs1 gene deficiency is sufficient to predispose the carriers of single functional Wfs1 copy to diabetes and metabolic syndrome and makes them susceptible to the environmental challenges such as HFD.
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Affiliation(s)
- Marilin Ivask
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Vallo Volke
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Endocrinology Unit, Tartu University Hospital, Tartu, Estonia
| | - Atso Raasmaja
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland.
| | - Sulev Kõks
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, Australia
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Diabetes Mellitus Due to Wolfram Syndrome Type 1 (DIDMOAD). Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Das L, Rai A, Mavuduru R, Vaiphei K, Sharma A, Gupta V, Bhadada SK, Lodha S, Panda N, Bhansali A, Singh P, Dutta P. Wolfram syndrome: clinical and genetic profiling of a cohort from a tertiary care centre with characterization of the primary gonadal failure. Endocrine 2020; 69:420-429. [PMID: 32350710 DOI: 10.1007/s12020-020-02320-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Wolfram syndrome (WFS) is a rare, monogenic neurodegenerative syndrome characterised by insulin requiring non-autoimmune diabetes mellitus (DM) and optic atrophy which are usually the earliest and commonest manifestations. However, there are other features which are under-recognized, adding to morbidity and premature mortality in these patients. METHODS Five patients (three males, two females) with genetically confirmed WFS at a single tertiary care centre were prospectively followed up. Their symptomatology, clinical profile, genetic analysis and radiology were analyzed. Multidisciplinary approach was used for comprehensive clinical care of this cohort. Patients with primary gonadal failure were subjected to biopsy and immunohistochemistry (IHC) for wolframin was performed. RESULTS DM was the earliest presenting manifestation at 6.2 ± 1.3 years followed by optic atrophy at 10.4 ± 2.3 years, diabetes insipidus at 12 ± 2.1 years and deafness at 12.8 ± 2.1 years. All patients were autoantibody negative with low C-peptide(<0.6 ng/ml). Hypoglycemic episodes were frequent (upto 60%) but there was no instance of diabetic ketoacidosis. Optic atrophy was present alongwith proliferative diabetic retinopathy and cataract in 40%. Uncommon manifestations included neuropsychiatric features, parasuicide, cystopathy, brainstem atrophy and hypergonadotropic hypogonadism only in adult males (n = 2). Testicular biopsy revealed partly hyalinised seminiferous tubules and prominence of Leydig cells. IHC confirmed the presence of mutated wolframin, which was not significantly different from normal testis specimen on protein quantification. CONCLUSIONS WFS requires a multidisciplinary approach with special emphasis on early diagnosis and management of other endocrine and non-endocrine features so as to improve long-term outcomes. Gonadal functions need periodic assessment, especially in adult males.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, PGIMER, Chandigarh, India
| | - Ashutosh Rai
- Department of Translational and Regenerative Medicine, PGIMER, Chandigarh, India
| | | | - Kim Vaiphei
- Department of Histopathology, PGIMER, Chandigarh, India
| | | | - Vishali Gupta
- Department of Ophthalmology, PGIMER, Chandigarh, India
| | | | - Sailesh Lodha
- Department of Endocrinology, Eternal Heart Care Centre, Jaipur, India
| | - Naresh Panda
- Department of Otorhinolarygology, PGIMER, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, PGIMER, Chandigarh, India
| | | | - Pinaki Dutta
- Department of Endocrinology, PGIMER, Chandigarh, India.
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Leroux C, Grasland M, Turmel N, Le Breton F, Chesnel C, Hentzen C, Amarenco G. [Urinary disorders of Wolfram syndrome. Clinical and urodynamic analysis from 6 observations]. Prog Urol 2019; 30:205-208. [PMID: 31761518 DOI: 10.1016/j.purol.2019.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/01/2022]
Abstract
Wolfram syndrome is a neurodegenerative disorder characterized by childhood onset diabetes mellitus, optic nerve atrophy, diabetes insipidus, hearing impairment, brainstem alteration and commonly bladder and bowel dysfunction. OBJECTIVE We present here, 6 new cases of urinary dysfunction in this rare disease. RESULTS All patients had urinary retention with overactive bladder. The urodynamic assessment found overactive detrusor in 3 cases. Five out of six patients performed self-catheterization and were treated with anticholinergics or intradetrusor injection of botulinum toxin. The follow-up at 5 years found an alteration of the upper urinary tracts and a renal failure 3/6. CONCLUSION Urinary dysfunction is common in Wolfram syndrome, mainly characterized by overactive bladder and urinary retention. The urological risk is major requiring a systelmatic follow-up of these patients. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- C Leroux
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France.
| | - M Grasland
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France
| | - N Turmel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Abstract
OBJECTIVES Because the central nervous system (CNS) is the second most frequently affected organ in mitochondrial disorders (MIDs) and since paediatric MIDs are increasingly recognised, it is important to know about the morphological CNS abnormalities on imaging in these patients. This review aims at summarising and discussing current knowledge and recent advances concerning CNS imaging abnormalities in paediatric MIDs. METHODS A systematic literature review was conducted. RESULTS The most relevant CNS abnormalities in paediatric MIDs on imaging include white and grey matter lesions, stroke-like lesions as the morphological equivalent of stroke-like episodes, cerebral atrophy, calcifications, optic atrophy, and lactacidosis. Because these CNS lesions may be seen with or without clinical manifestations, it is important to screen all MID patients for cerebral involvement. Some of these lesions may remain unchanged for years whereas others may be dynamic, either in the sense of progression or regression. Typical dynamic lesions are stroke-like lesions and grey matter lesions. Clinically relevant imaging techniques for visualisation of CNS abnormalities in paediatric MIDs are computed tomography, magnetic resonance (MR) imaging, MR spectroscopy, single-photon emission computed tomography, positron-emission tomography, and angiography. CONCLUSIONS CNS imaging in paediatric MIDs is important for diagnosing and monitoring CNS involvement. It also contributes to the understanding of the underlying pathomechanisms that lead to CNS involvement in MIDs.
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Affiliation(s)
| | - Sinda Zarrouk-Mahjoub
- University of Tunis, El Manar and Genomics Platform, Pasteur Institute of Tunis, Tunisia
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11
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Increased Mitochondrial Protein Levels and Bioenergetics in the Musculus Rectus Femoris of Wfs1-Deficient Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:3175313. [PMID: 30584460 PMCID: PMC6280240 DOI: 10.1155/2018/3175313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/15/2018] [Accepted: 09/25/2018] [Indexed: 12/19/2022]
Abstract
Wfs1 deficiency leads to a progressive loss of plasma insulin concentration, which should reduce the consumption of glucose in insulin-dependent tissues, causing a variety of changes in intracellular energy metabolism. Our objective here was to assess the changes in the amount and function of mitochondrial proteins in different muscles of Wfs1-deficient mice. Mitochondrial functions were assayed by high-resolution oxygraphy of permeabilized muscle fibers; the protein amount was evaluated by liquid chromatography tandem mass spectrometry (LC/MS/MS) analysis and mRNA levels of the uncoupler proteins UCP2 and UCP3 by real-time PCR; and citrate synthase (CS) activity was determined spectrophotometrically in muscle homogenates. Compared to controls, there were no changes in proton leak and citrate synthase activity in the heart and m. soleus tissues of Wfs1-deficient mice, but significantly higher levels of both of these factors were observed in the m. rectus femoris; mitochondrial proteins and mRNA of UCP2 were also higher in the m. rectus femoris. ADP-stimulated state 3 respiration was lower in the m. soleus, remained unchanged in the heart, and was higher in the m. rectus femoris. The mitochondrial protein amount and activity are higher in Wfs1-deficient mice, as are mitochondrial proton leak and oxygen consumption in m. rectus femoris. These changes in muscle metabolism may be important for identifying the mechanisms responsible for Wolfram syndrome and diabetes.
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12
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Karzon R, Narayanan A, Chen L, Lieu JEC, Hershey T. Longitudinal hearing loss in Wolfram syndrome. Orphanet J Rare Dis 2018; 13:102. [PMID: 29945639 PMCID: PMC6020390 DOI: 10.1186/s13023-018-0852-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/20/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Wolfram syndrome (WFS) is a rare autosomal recessive disease with clinical manifestations of diabetes mellitus (DM), diabetes insipidus (DI), optic nerve atrophy (OA) and sensorineural hearing loss (SNHL). Although SNHL is a key symptom of WFS, there is limited information on its natural history using standardized measures. Such information is important for clinical care and determining its use as an outcome measure in clinical trials. METHODS Standardized audiologic measures, including pure-tone testing, tympanometry, speech perception, and the unaided Speech Intelligibility Index (SII) were assessed in patients with confirmed WFS annually. Mixed model analyses were used to examine main effects of age, time or interactions for pure tone average (PTA), high frequency average (HFA) and SII. RESULTS Forty WFS patients were evaluated between 1 and 6 times. Mean age at initial enrollment was 13.5 years (SD = 5.6). Patients were classified as having normal hearing (n = 10), mild-to-severe (n = 24) or profound SNHL (n = 6). Mean age of diagnosis for SNHL was 8.3 years (SD = 5.1) with 75% prevalence. HFA worsened over time for both ears, and SII worsened over time in the worse ear, with greater decline in both measures in younger patients. Average estimated change over 1 year for all measures was in the subclinical range and power analyses suggest that 100 patients would be needed per group (treatment vs. placebo) to detect a 60% reduction in annual change of HFA over 3 years. If trials focused on just those patients with SNHL, power estimates suggest 55 patients per group would be sufficient. CONCLUSIONS Most patients had a slow progressive SNHL emerging in late childhood. Change over time with standard audiologic tests (HFA, SII) was small and would not be detectable for at least 2 years in an individual. Relatively large sample sizes would be necessary to detect significant impact on hearing progression in a clinical trial. Hearing function should be monitored clinically in WFS to provide appropriate intervention. Because SNHL can occur very early in WFS, audiologists and otolaryngologists should be aware of and refer for later emerging symptoms.
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Affiliation(s)
- Roanne Karzon
- Saint Louis Children's Hospital, One Children's Place, St. Louis, MO, 63110, USA.,Program in Audiology and Communication Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Anagha Narayanan
- Department of Psychiatry, Washington University in St. Louis School of Medicine, 4525 Scott Avenue, Campus Box 8134, St. Louis, MO, 63110, USA
| | - Ling Chen
- Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Judith E C Lieu
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Tamara Hershey
- Department of Psychiatry, Washington University in St. Louis School of Medicine, 4525 Scott Avenue, Campus Box 8134, St. Louis, MO, 63110, USA. .,Department of Radiology, Washington University in St. Louis School of Medicine, 4525 Scott Avenue, Campus Box 8134, St. Louis, MO, 63110, USA.
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13
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Rove KO, Vricella GJ, Hershey T, Thu MH, Lugar HM, Vetter J, Marshall BA, Austin PF. Lower Urinary Tract Dysfunction and Associated Pons Volume in Patients with Wolfram Syndrome. J Urol 2018; 200:1107-1113. [PMID: 29883657 DOI: 10.1016/j.juro.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 01/23/2023]
Abstract
PURPOSE Wolfram syndrome is a neurodegenerative disorder characterized by childhood onset diabetes mellitus, optic nerve atrophy, diabetes insipidus, hearing impairment, and commonly bladder and bowel dysfunction. We hypothesized that there is an association between a smaller pons, which contains the pontine micturition center, and abnormal lower urinary tract function. MATERIALS AND METHODS Patients with genetically confirmed Wolfram syndrome attended an annual multidisciplinary research clinic. Subjects underwent noninvasive urodynamic testing and brain magnetic resonance imaging, and completed validated patient reported outcome measures. Bowel and bladder diaries were completed before visits. Age and gender corrected linear and logistic mixed effects models were used to correlate pons volume, corrected for whole brain size, to urodynamic and patient reported outcomes. RESULTS A total of 36 patients attended 142 visits between 2010 and 2016. Mean age was 16.9 years (range 7 to 30) and 64% of patients were female. Functional bladder capacity was decreased in 31% of the patients, normal in 54% and increased in 14%. Of the patients 44% and 54% had abnormal uroflowmetry and post-void residual, respectively, on at least 1 occasion. There was no increase through time in incidence of lower urinary tract dysfunction. Decreased pons volume was associated with increased post-void residual (p = 0.048) and higher PinQ (Pediatric Incontinence Questionnaire) score (p = 0.011), indicating lower quality of life and higher levels of dysfunction. CONCLUSIONS A significant number of children, adolescents and young adults with Wolfram syndrome have objective evidence of lower urinary tract dysfunction. Decreased pons volume is associated with more abnormal urinary function and lower quality of life in patients with Wolfram syndrome.
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Affiliation(s)
- Kyle O Rove
- Division of Pediatric Urology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri.
| | - Gino J Vricella
- Division of Pediatric Urology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri
| | - Tamara Hershey
- Department of Neurology and Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Muang H Thu
- Division of Pediatric Urology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri
| | - Heather M Lugar
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Joel Vetter
- Division of Pediatric Urology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri
| | - Bess A Marshall
- Departments of Pediatrics and Cell Biology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri
| | - Paul F Austin
- Scott Department of Urology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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14
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Affiliation(s)
- Deborah J Wake
- Diabetic Department, Victoria Hospital, Kirkcaldy, Fife, KY2 5AH, Scotland, UK
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15
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Identification of a novel WFS1 homozygous nonsense mutation in Jordanian children with Wolfram syndrome. Meta Gene 2016; 9:219-24. [PMID: 27617222 PMCID: PMC5006133 DOI: 10.1016/j.mgene.2016.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
Wolfram syndrome (WS) is a rare autosomal recessive neurodegenerative disorder characterized by the presentation of early onset type I diabetes mellitus and optic atrophy with later onset diabetes insipidus and deafness. WFS1 gene was identified on chromosome 4p16.1 as the gene responsible for WS disease given that most of the WS patients were found to carry mutations in this gene. This study was carried out to investigate the molecular spectrum of WFS1 gene in Jordanian families. Molecular and clinical characterization was performed on five WS patients from two unrelated Jordanian families. Our data indicated that WS patients of the first family harbored two deletion mutations (V415del and F247fs) located in exon 8 and exon 7 respectively, with a compound heterozygous pattern of inheritance; while in the second family, we identified a novel nonsense mutation (W185X) located in exon 5 in the N-terminal cytoplasmic domain with a homozygous pattern of inheritance. This mutation can be considered as loss of function mutation since the resulting truncated protein lost both the transmembrane domain and the C-terminal domain. Additionally, the W185X mutation lies within the CaM binding domain in wolframin protein which is thought to have a role in the regulation of wolframin function in response to calcium levels.
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16
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Abstract
INTRODUCTION Mitochondria, essential to multicellular life, convert food into ATP to satisfy cellular energy demands. Since different tissues have different energy requirements, mitochondrial density is high in tissues with high metabolic needs, such as the visual system, which is therefore highly susceptible to limited energy supply as a result of mitochondrial dysfunction. AREAS COVERED Vision impairment is a common feature of most mitochondrial diseases. At the same time, there is mounting evidence that mitochondrial impairment contributes to the pathogenesis of major eye diseases such as glaucoma and might also be involved in the reported vision impairment in neurodegenerative disorders such as Alzheimer's disease. EXPERT OPINION Rather than relying on symptomatic treatment, acknowledging the mitochondrial origin of visual disorders in mitochondrial, neurodegenerative and ocular diseases could lead to novel therapeutics that aim to modulate mitochondrial function in order to protect against vision loss. This approach has already shown some promising clinical results in inherited retinal disorders, which supports the idea that targeting mitochondria could also be a treatment option for other optic neuropathies.
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Affiliation(s)
- Jamuna Chhetri
- a Division of Pharmacy, School of Medicine, Faculty of Health , University of Tasmania , Hobart , Australia
| | - Nuri Gueven
- a Division of Pharmacy, School of Medicine, Faculty of Health , University of Tasmania , Hobart , Australia
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Abbasi R, Bitarafan F, Khodaeian M, Ebrahim-Habibi A, Abbasi F, Amoli MM. Molecular investigation of WFS1 gene exon 8 in Iranian patients with Wolfram syndrome. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0425-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Mozzillo E, Delvecchio M, Carella M, Grandone E, Palumbo P, Salina A, Aloi C, Buono P, Izzo A, D'Annunzio G, Vecchione G, Orrico A, Genesio R, Simonelli F, Franzese A. A novel CISD2 intragenic deletion, optic neuropathy and platelet aggregation defect in Wolfram syndrome type 2. BMC MEDICAL GENETICS 2014; 15:88. [PMID: 25056293 PMCID: PMC4121299 DOI: 10.1186/1471-2350-15-88] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/11/2014] [Indexed: 11/10/2022]
Abstract
Background Wolfram Syndrome type 2 (WFS2) is considered a phenotypic and genotypic variant of WFS, whose minimal criteria for diagnosis are diabetes mellitus and optic atrophy. The disease gene for WFS2 is CISD2. The clinical phenotype of WFS2 differs from WFS1 for the absence of diabetes insipidus and psychiatric disorders, and for the presence of bleeding upper intestinal ulcers and defective platelet aggregation. After the first report of consanguineous Jordanian patients, no further cases of WFS2 have been reported worldwide. We describe the first Caucasian patient affected by WFS2. Case presentation The proband was a 17 year-old girl. She presented diabetes mellitus, optic neuropathy, intestinal ulcers, sensorineural hearing loss, and defective platelet aggregation to ADP. Genetic testing showed a novel homozygous intragenic deletion of CISD2 in the proband. Her brother and parents carried the heterozygous mutation and were apparently healthy, although they showed subclinical defective platelet aggregation. Long runs of homozygosity analysis from SNP-array data did not show any degree of parental relationship, but the microsatellite analysis confirmed the hypothesis of a common ancestor. Conclusion Our patient does not show optic atrophy, one of the main diagnostic criteria for WFS, but optic neuropathy. Since the “asymptomatic” optic atrophy described in Jordanian patients is not completely supported, we could suppose that the ocular pathology in Jordanian patients was probably optic neuropathy and not optic atrophy. Therefore, as optic atrophy is required as main diagnostic criteria of WFS, it might be that the so-called WFS2 could not be a subtype of WFS. In addition, we found an impaired aggregation to ADP and not to collagen as previously reported, thus it is possible that different experimental conditions or inter-patient variability can explain different results in platelet aggregation. Further clinical reports are necessary to better define the clinical spectrum of this syndrome and to re-evaluate its classification.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetology, University of Naples "Federico II", Via S, Pansini 5, 80131 Naples, Italy.
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19
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Abstract
OBJECTIVES Assessment of auditory and vestibular function in Wolfram Syndrome (WS) patients, using a standardized protocol. DESIGN Prospective cohort study of 11 patients using otoscopic inspection, tympanometry, otoacoustic emissions, pure tones, speech in noise (SIN), the Speech Intelligibility Index, and rotational chair testing. RESULTS Mean SNHL diagnosis was 7.3 years with 55% prevalence. Four patients with a Speech Intelligibility Index less than 0.75 (better ear) routinely used bilateral amplification devices. Two patients with normal-hearing sensitivity exhibited abnormal SIN scores. The only patient with significant vestibular dysfunction also had a distinctive low-frequency component to her SNHL. CONCLUSIONS Hearing loss may occur earlier than previously suspected, and comprehensive testing including SIN testing may reveal deficits not apparent with pure-tone testing. Particular configurations of hearing loss may indicate a need for comprehensive vestibular assessment. Because SNHL can be the first symptom of WS, audiologists and otolaryngologists should be vigilant about referring patients with hearing loss for ophthalmologic examination.
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Bonnet Wersinger D, Benkafadar N, Jagodzinska J, Hamel C, Tanizawa Y, Lenaers G, Delettre C. Impairment of visual function and retinal ER stress activation in Wfs1-deficient mice. PLoS One 2014; 9:e97222. [PMID: 24823368 PMCID: PMC4019519 DOI: 10.1371/journal.pone.0097222] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 04/16/2014] [Indexed: 01/27/2023] Open
Abstract
Wolfram syndrome is an early onset genetic disease (1/180,000) featuring diabetes mellitus and optic neuropathy, associated to mutations in the WFS1 gene. Wfs1−/− mouse model shows pancreatic beta cell atrophy, but its visual performance has not been investigated, prompting us to study its visual function and histopathology of the retina and optic nerve. Electroretinogram and visual evoked potentials (VEPs) were performed in Wfs1−/− and Wfs1+/+ mice at 3, 6, 9 and 12 months of age. Fundi were pictured with Micron III apparatus. Retinal ganglion cell (RGC) abundance was determined from Brn3a immunolabeling of retinal sections. RGC axonal loss was quantified by electron microscopy in transversal optic nerve sections. Endoplasmic reticulum stress was assessed using immunoglobulin binding protein (BiP), protein disulfide isomerase (PDI) and inositol-requiring enzyme 1 alpha (Ire1α) markers. Electroretinograms amplitudes were slightly reduced and latencies increased with time in Wfs1−/− mice. Similarly, VEPs showed decreased N+P amplitudes and increased N-wave latency. Analysis of unfolded protein response signaling revealed an activation of endoplasmic reticulum stress in Wfs1−/− mutant mouse retinas. Altogether, progressive VEPs alterations with minimal neuronal cell loss suggest functional alteration of the action potential in the Wfs1−/− optic pathways.
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Affiliation(s)
- Delphine Bonnet Wersinger
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
| | - Nesrine Benkafadar
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
| | - Jolanta Jagodzinska
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
| | - Christian Hamel
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
- Centre Hospitalier Universitaire, Genetics of Sensory Diseases, Montpellier, France
| | - Yukio Tanizawa
- Division of Endocrinology, Metabolism, Hematological Sciences and Therapeutics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Guy Lenaers
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
| | - Cécile Delettre
- INSERM U1051, Institut des Neurosciences de Montpellier, France and Université de Montpellier I et II, Montpellier, France
- * E-mail:
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Ribière C, Kaboré F, Chaussenot A, Paquis-Flucklinger V, Lenne-Aurier K, Gaillet S, Boissier R, Karsenty G. Troubles vésicosphinctériens au cours du syndrome de Wolfram. Prog Urol 2013; 23:519-23. [DOI: 10.1016/j.purol.2013.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 03/29/2013] [Indexed: 11/26/2022]
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Xu Q, Qu H, Wei S. Clinical and molecular genetic analysis of a new mutation in children with Wolfram syndrome: a case report. Mol Med Rep 2013; 7:965-8. [PMID: 23338790 DOI: 10.3892/mmr.2013.1277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 01/08/2013] [Indexed: 11/06/2022] Open
Abstract
A 12‑year‑old Chinese girl presented with gradual vision loss and insulin‑dependent diabetes mellitus and was suspected to suffer from Wolfram syndrome (WFS). A series of clinical examinations were performed, as well as direct DNA sequencing to screen the entire coding region of the WFS1 gene in the patient's family, including her parents and a brother. Ophthalmological examination revealed counting fingers/10 cm in the right eye and hand motions/10 cm in the left eye. Ophthalmoscopical examination identified bilateral optic atrophy without any signs of diabetic retinopathy. A hearing test was performed and revealed that the hearing ability for high frequency sounds was decreased. Urinary output in 24 h was >5,000 ml. In addition, a base substitution at c.2411T>C (Leu804Pro) in exon 8 was identified which was homozygous with the patient and heterozygous with the healthy parents and the brother. In the present case, a neuroophthalmology consult performed in the early stages of the disease was crucial for early diagnosis. In addition, this case study highlights the importance of performing a hearing test as well as collecting and analyzing 24‑h urine output in patients presenting with juvenile diabetes mellitus patients and optic atrophy without any signs of diabetic retinopathy.
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Affiliation(s)
- Qianqian Xu
- Department of Ophthalmology, PLA General Hospital, Beijing 100853, PR China
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23
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Circadian rhythms and food anticipatory behavior in Wfs1-deficient mice. Biochem Biophys Res Commun 2012; 424:717-23. [PMID: 22800759 DOI: 10.1016/j.bbrc.2012.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 07/06/2012] [Indexed: 11/22/2022]
Abstract
The dorsomedial hypothalamic nucleus (DMH) has been proposed as a candidate for the neural substrate of a food-entrainable oscillator. The existence of a food-entrainable oscillator in the mammalian nervous system was inferred previously from restricted feeding-induced behavioral rhythmicity in rodents with suprachiasmatic nucleus lesions. In the present study, we have characterized the circadian rhythmicity of behavior in Wfs1-deficient mice during ad libitum and restricted feeding. Based on the expression of Wfs1 protein in the DMH it was hypothesized that Wfs1-deficient mice will display reduced or otherwise altered food anticipatory activity. Wfs1 immunoreactivity in DMH was found almost exclusively in the compact part. Restricted feeding induced c-Fos immunoreactivity primarily in the ventral and lateral aspects of DMH and it was similar in both genotypes. Wfs1-deficiency resulted in significantly lower body weight and reduced wheel-running activity. Circadian rhythmicity of behavior was normal in Wfs1-deficient mice under ad libitum feeding apart from elongated free-running period in constant light. The amount of food anticipatory activity induced by restricted feeding was not significantly different between the genotypes. Present results indicate that the effects of Wfs1-deficiency on behavioral rhythmicity are subtle suggesting that Wfs1 is not a major player in the neural networks responsible for circadian rhythmicity of behavior.
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Identification of homozygous WFS1 mutations (p.Asp211Asn, p.Gln486*) causing severe Wolfram syndrome and first report of male fertility. Eur J Hum Genet 2012; 21:347-51. [PMID: 22781099 DOI: 10.1038/ejhg.2012.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Wolfram syndrome (WFS) is a neurodegenerative genetic condition characterized by juvenile-onset of diabetes mellitus and optic atrophy. We studied clinical features and the molecular basis of severe WFS (neurodegenerative complications) in two consanguineous families from Iran. A clinical and molecular genetic investigation was performed in the affected and healthy members of two families. The clinical diagnosis of WFS was confirmed by the existence of diabetes mellitus and optic atrophy in the affected patients, who in addition had severe neurodegenerative complications. Sequencing of WFS1 was undertaken in one affected member from each family. Targeted mutations were tested in all members of relevant families. Patients had most of the reported features of WFS. Two affected males in the first family had fathered unaffected children. We identified two homozygous mutations previously reported with apparently milder phenotypes: family 1: c.631G>A (p.Asp211Asn) in exon 5, and family 2: c.1456C>T (p.Gln486*) in exon 8. Heterozygous carriers were unaffected. This is the first report of male Wolfram patients who have successfully fathered children. Surprisingly, they also had almost all the complications associated with WFS. Our report has implications for genetic counseling and family planning advice for other affected families.
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A clinical case study of a Wolfram syndrome-affected family: pattern-reversal visual evoked potentials and electroretinography analysis. Doc Ophthalmol 2012; 124:133-41. [PMID: 22311385 DOI: 10.1007/s10633-011-9308-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 12/20/2011] [Indexed: 12/18/2022]
Abstract
Wolfram syndrome (WFS), or DIDMOAD, is a rare (1/100 000 to 1/770 000), progressive neurodegenerative disorder. In its early stages, it is characterized by insulin-dependent diabetes mellitus, optic atrophy and loss of sensorineural hearing-this is followed by diabetes insipidus, progressive neurological abnormalities and other endocrine abnormalities, which occur in later years. The aim of this study was to report on the clinical and electrophysiological findings from a family with the WFS1 mutation. The five family members were subjected to a complete ophthalmic examination, which included a flash full-field electroretinogram and pattern-reversal visual evoked potentials (PVEPs) performed according to ISCEV standards. Optic atrophy was confirmed in two homozygotic patients, where P100 latencies were significantly delayed-up to 146 ms in PVEP. P100 latencies were normal in the three heterozygotic patients we examined. Curve morphology abnormalities were observed in all five patients we examined. No literature describing the morphology of PVEP in Wolfram syndrome patients was found. In flash electroretinography, scotopic and photopic responses appeared in normal morphology and value. Diabetic retinopathy was not observed in the diabetes mellitus patients.
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Aloi C, Salina A, Pasquali L, Lugani F, Perri K, Russo C, Tallone R, Ghiggeri GM, Lorini R, d'Annunzio G. Wolfram syndrome: new mutations, different phenotype. PLoS One 2012; 7:e29150. [PMID: 22238590 PMCID: PMC3251553 DOI: 10.1371/journal.pone.0029150] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 11/22/2011] [Indexed: 11/21/2022] Open
Abstract
Background Wolfram Syndrome (WS) is an autosomal recessive neurodegenerative disorder characterized by Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness identified by the acronym “DIDMOAD”. The WS gene, WFS1, encodes a transmembrane protein called Wolframin, which recent evidence suggests may serve as a novel endoplasmic reticulum calcium channel in pancreatic β-cells and neurons. WS is a rare disease, with an estimated prevalence of 1/550.000 children, with a carrier frequency of 1/354. The aim of our study was to determine the genotype of WS patients in order to establish a genotype/phenotype correlation. Methodology/Principal Findings We clinically evaluated 9 young patients from 9 unrelated families (6 males, 3 females). Basic criteria for WS clinical diagnosis were coexistence of insulin-treated diabetes mellitus and optic atrophy occurring before 15 years of age. Genetic analysis for WFS1 was performed by direct sequencing. Molecular sequencing revealed 5 heterozygous compound and 3 homozygous mutations. All of them were located in exon 8, except one in exon 4. In one proband only an heterozygous mutation (A684V) was found. Two new variants c.2663 C>A and c.1381 A>C were detected. Conclusions/Significance Our study increases the spectrum of WFS1 mutations with two novel variants. The male patient carrying the compound mutation [c.1060_1062delTTC]+[c.2663 C>A] showed the most severe phenotype: diabetes mellitus, optic atrophy (visual acuity 5/10), deafness with deep auditory bilaterally 8000 Hz, diabetes insipidus associated to reduced volume of posterior pituitary and pons. He died in bed at the age of 13 years. The other patient carrying the compound mutation [c.409_424dup16]+[c.1381 A>C] showed a less severe phenotype (DM, OA).
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Affiliation(s)
- Concetta Aloi
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Alessandro Salina
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Lorenzo Pasquali
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
- Centro de Investigacion Biomedica en Red (CIBER) de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Francesca Lugani
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
- Division of Nephrology, Department of Medicine, Columbia University, New York, New York, United States of America
- Laboratory on Pathophysiology of Uremia and Department of Nephrology, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Katia Perri
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Chiara Russo
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Ramona Tallone
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Gian Marco Ghiggeri
- Laboratory on Pathophysiology of Uremia and Department of Nephrology, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Renata Lorini
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
| | - Giuseppe d'Annunzio
- Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
- * E-mail:
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Zmyslowska A, Borowiec M, Antosik K, Szalecki M, Stefanski A, Iwaniszewska B, Jedrzejczyk M, Pietrzak I, Mlynarski W. Wolfram syndrome in the Polish population: novel mutations and genotype-phenotype correlation. Clin Endocrinol (Oxf) 2011; 75:636-41. [PMID: 21564155 DOI: 10.1111/j.1365-2265.2011.04102.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Wolfram syndrome is a rare form of diabetes mellitus associated with optic atrophy and disorders of different organs (e.g. diabetes insipidus, hearing loss, ataxia, anaemia and many others). This syndrome is caused by recessive mutations in the wolframin gene (WFS1) localized on chromosome 4p16·1. The aim of this study was to identify the causative mutations in WFS1 in a group of Polish patients with suspected Wolfram syndrome. PATIENTS AND MEASUREMENTS Nine patients with clinical symptoms consistent with Wolfram syndrome (at least diabetes mellitus and optic atrophy) and 22 first-degree relatives were examined. The molecular analysis was carried out by direct sequencing of the exons, the exon-intron junctions, and the 5' and 3' untranslated regions of WFS1. RESULTS Nine different mutations in WFS1 (five of them novel) were identified in the nine patients. Six patients were homozygous for the following mutations: V412fs, S443R, W539X, V659fs. They developed diabetes at a mean age of 5·2 years. Three patients were compound-heterozygous for the following mutations: S167fs, Q392X, Y513fs, W648X, V779G. They developed diabetes at a mean age of 6·5 years. CONCLUSIONS Mean age of diagnosis of diabetes among the Polish patients was typical for Wolfram syndrome; however, compound-heterozygous patients were slightly older at diabetes onset.
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Affiliation(s)
- A Zmyslowska
- Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Lodz, Poland
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Boutzios G, Livadas S, Marinakis E, Opie N, Economou F, Diamanti-Kandarakis E. Endocrine and metabolic aspects of the Wolfram syndrome. Endocrine 2011; 40:10-3. [PMID: 21725703 DOI: 10.1007/s12020-011-9505-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Wolfram syndrome (WS), also known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness), is a neurodegenerative disease with autosomal recessive inheritance with incomplete penetrance. DIDMOAD is a very rare disease with an estimated prevalence of 1 in 770,000 and it is believed to occur in 1 of 150 patients with juvenile-onset insulin-dependent diabetes mellitus. Additionally, WS may also present with different endocrine and metabolic abnormalities such as anterior and posterior pituitary gland dysfunction. This mini-review summarizes the variable presentation of WS and the need of screening for other metabolic and hormonal abnormalities, coexisting in this rare syndrome.
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Affiliation(s)
- Georgios Boutzios
- Third Department of Medicine, Medical School University of Athens, Sotiria Hospital Athens, Athens, Greece
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Chaussenot A, Bannwarth S, Rouzier C, Vialettes B, Mkadem SAE, Chabrol B, Cano A, Labauge P, Paquis-Flucklinger V. Neurologic features and genotype-phenotype correlation in Wolfram syndrome. Ann Neurol 2010; 69:501-8. [DOI: 10.1002/ana.22160] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 07/11/2010] [Accepted: 07/12/2010] [Indexed: 11/09/2022]
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Skarbez K, Priestley Y, Hoepf M, Koevary SB. Comprehensive Review of the Effects of Diabetes on Ocular Health. EXPERT REVIEW OF OPHTHALMOLOGY 2010; 5:557-577. [PMID: 21760834 PMCID: PMC3134329 DOI: 10.1586/eop.10.44] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Simsek T, Ozdamar Y, Simsek E, Men G. Usher syndrome associated with a variant of Dandy-Walker malformation. J Pediatr Ophthalmol Strabismus 2010; 47 Online:e1-4. [PMID: 21214164 DOI: 10.3928/01913913-20100324-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 01/23/2009] [Indexed: 11/20/2022]
Abstract
Three cases of Usher syndrome associated with a variant of Dandy-Walker malformation in three siblings from consanguineous Turkish parents are described. The siblings had retinitis pigmentosa and hearing loss. Two of the siblings also had mental retardation, which is not a constant finding in Usher syndrome. Dandy-Walker malformation might have contributed to the mental retardation in two of these patients and might be a coincidental finding with Usher syndrome.
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Affiliation(s)
- Tulay Simsek
- Ulucanlar Training and Research Eye Hospital, Ankara, Turkey
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Kumar S. Wolfram syndrome: important implications for pediatricians and pediatric endocrinologists. Pediatr Diabetes 2010; 11:28-37. [PMID: 20015125 DOI: 10.1111/j.1399-5448.2009.00518.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Sharath Kumar
- Department of Pediatrics, Amrita Institute of Medical Sciences, Cochin, Kerala, India.
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Hong J, Zhang YW, Zhang HJ, Jia HY, Zhang Y, Ding XY, Zhou DY, Chen HP, Jiang XH, Cui B, Li XY, Ning G. The novel compound heterozygous mutations, V434del and W666X, in WFS1 gene causing the Wolfram syndrome in a Chinese family. Endocrine 2009; 35:151-7. [PMID: 19160074 DOI: 10.1007/s12020-009-9145-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 09/15/2008] [Accepted: 09/23/2008] [Indexed: 10/21/2022]
Abstract
Wolfram syndrome (WFS), also known as DIDMOAD, is an infrequent cause of diabetes mellitus. WFS is an autosomal recessive neurodegenerative disease characterized by various clinical manifestations such as diabetes mellitus, optic atrophy, diabetes insipidus, deafness, neurological symptoms, renal tract abnormalities, psychiatric disorders, and gonadal disorders. The majority of patients with WFS carry the loss of function mutations in the WFS1 gene. The exons 2-8 of the WFS1 gene from one Chinese WFS patient were amplified by the polymerase chain reaction (PCR), subcloning techniques and direct sequence determination was applied to the amplified fragments. The compound heterozygous mutation of a 3-bp (GAC) deletion (V434del) and another compound heterozygous mutation (G-->N)(W666X) in exon 8 of WFS1 gene was identified in the patient. Other seventeen members of her family were investigated. Four cases with heterozygotes had been found through screening for the mutation V434del and five cases for the mutation W666X in the whole family. This is the first report of WFS with the mutation V434del and W666X in the WFS1 gene.
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Affiliation(s)
- Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Shanghai JiaoTong University School of Medicine, Shanghai, 200025, People's Republic of China
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Abstract
Wolfram syndrome (WS), an infrequent cause of diabetes mellitus, derives its name from the physician who first reported the combination of juvenile-onset diabetes mellitus and optic atrophy. Also referred to as DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness), it is an autosomal recessive neurodegenerative disease characterized by various clinical manifestations, such as diabetes mellitus, optic atrophy, diabetes insipidus, deafness, neurological symptoms, renal tract abnormalities, psychiatric manifestations and gonadal disorders. The condition is very rare with an estimated prevalence of one in 770,000 of the normal population, one out of 150 cases of juvenile-onset insulin-dependent diabetes mellitus, and with a carrier frequency of one in 354. This progressive neurodegenerative disease usually results in death before the age of 50 years and many patients lead a morbid life. The pathogenesis of the disorder although unknown is ascribed to mutation of a gene on chromosome 4p encoding a transmembrane protein of undetermined function called wolframin. This review summarizes the variable presentation of the disorder, its widespread complications, poor quality of life in affected individuals, and the problems in diagnosis and treatment of the syndrome.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Post Box 930, GPO Srinagar, J&K, India 190010.
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Ribeiro MRF, Crispim F, Vendramini MF, Moisés RS. [Wolfram syndrome: from definition to molecular bases]. ACTA ACUST UNITED AC 2007; 50:839-44. [PMID: 17160206 DOI: 10.1590/s0004-27302006000500003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 04/18/2006] [Indexed: 11/21/2022]
Abstract
Wolfram syndrome (WS) is an autosomal recessive progressive neurodegenerative disorder characterized by diabetes mellitus and optic atrophy. Diabetes insipidus and sensorineural deafness are also noted frequently, explaining the acronym DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) by which the syndrome is also referred. Additional manifestations such as atonic bladder, ataxia, nystagmus and predisposition for psychiatric illness may be present. The Wolfram syndrome gene, WFS1, was mapped to chromosome 4p16.1 by positional cloning. It encodes an 890-amino-acid polypeptide named wolframin. Although the wolframin function is still not completely known, its localization to the endoplasmic reticulum suggests it can play a role in calcium homeostasis, membrane trafficking and protein processing. Knowing the cellular function of wolframin is necessary for understanding the pathophysiology of Wolfram syndrome. This knowledge may lead to development of therapies to prevent or reduce the outcomes of WS.
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Wolfram Syndrome: Case Report and Review of the Literature. ACTA ACUST UNITED AC 2007; 33:18-20. [DOI: 10.1007/s12019-007-0007-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Revised: 11/30/1999] [Accepted: 10/31/2006] [Indexed: 11/26/2022]
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Ari S, Keklíkçí U, Caça I, Unlü K, Kayabaşi H. Wolfram syndrome. ACTA ACUST UNITED AC 2007; 39:53-5. [PMID: 17914206 DOI: 10.1007/bf02697327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Revised: 11/30/1999] [Accepted: 10/31/2006] [Indexed: 10/22/2022]
Abstract
Wolfram syndrome (WFS) is a rare diffuse neurodegenerative disorder characterized by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and a wide variety of central nervous system abnormalities. Insulin-dependent diabetes mellitus with optic nerve atrophy is sufficient criteria for the diagnosis. WFS is a devastating disease for the patients and their families. This study emphasizes the need for careful evaluation of cases having insulin-dependent diabetes mellitus and optic atrophy.
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Affiliation(s)
- Seyhmus Ari
- Department of Opthalmology, Diyarbakir State Hospital, Diyarbakir, Turkey.
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Liu Z, Sakakibara R, Uchiyama T, Yamamoto T, Ito T, Ito S, Awa Y, Odaka T, Yamaguchi T, Hattori T. Bowel dysfunction in Wolfram syndrome. Diabetes Care 2006; 29:472-3. [PMID: 16443921 DOI: 10.2337/diacare.29.02.06.dc05-2049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
AIMS To provide a clinical update on the hereditary optic neuropathies. METHODS Review of the literature. RESULTS The hereditary optic neuropathies comprise a group of disorders in which the cause of optic nerve dysfunction appears to be hereditable, based on familial expression or genetic analysis. In some hereditary optic neuropathies, optic nerve dysfunction is typically the only manifestation of the disease. In others, various neurologic and systemic abnormalities are regularly observed. CONCLUSION The most common hereditary optic neuropathies are autosomal dominant optic atrophy (Kjer's disease) and maternally inherited Leber's hereditary optic neuropathy. We review the clinical phenotypes of these and other inherited disorders with optic nerve involvement.
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MESH Headings
- Dysautonomia, Familial/complications
- Dysautonomia, Familial/genetics
- Female
- Friedreich Ataxia/complications
- Friedreich Ataxia/genetics
- Humans
- Male
- Muscular Dystrophies/complications
- Muscular Dystrophies/genetics
- Optic Atrophies, Hereditary/complications
- Optic Atrophies, Hereditary/genetics
- Optic Atrophies, Hereditary/physiopathology
- Optic Atrophy, Autosomal Dominant/complications
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/physiopathology
- Optic Atrophy, Hereditary, Leber/complications
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/physiopathology
- Pedigree
- Spinocerebellar Ataxias/complications
- Spinocerebellar Ataxias/genetics
- Vision Disorders/etiology
- Vision Disorders/genetics
- Vision Disorders/physiopathology
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Affiliation(s)
- N J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA 30022, USA.
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Abstract
PURPOSE OF REVIEW This review will update the ophthalmologist on recent developments in pediatric neuro-ophthalmology. RECENT FINDINGS Research into the genetics of congenital strabismus syndromes has brought new insights into the development of the ocular motor system. There is also new literature on childhood ocular myasthenia gravis and childhood neurosarcoidosis. The results of three different surgical treatments for congenital nystagmus are described. Reviews on cortical visual impairment, dyslexia, Aicardi syndrome, and neuronal ceroid lipofuscinosis are presented. SUMMARY Pediatric neuro-ophthalmology is a diverse and challenging field. As we strive to provide excellent care to these patients, we will use the results of basic science, genetic, and neurobiological research.
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Affiliation(s)
- Su Ann Lim
- Department of Ophthalmology, Dean A McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA
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Domènech E, Gómez-Zaera M, Nunes V. Study of the WFS1 gene and mitochondrial DNA in Spanish Wolfram syndrome families. Clin Genet 2004; 65:463-9. [PMID: 15151504 DOI: 10.1111/j.1399-0004.2004.00249.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Wolfram syndrome (WS) is an autosomal recessive neurodegenerative disorder characterized by early onset diabetes mellitus and progressive optic atrophy. Patients with WS frequently develop deafness, diabetes insipidus, renal tract abnormalities, and diverse psychiatric illnesses, among others. A gene responsible for WS was identified on 4p16.1 (WFS1). It encodes a putative 890 amino acid transmembrane protein present in a wide spectrum of tissues. A new locus for WS has been located on 4q22-24, providing evidence for the genetic heterogeneity of this syndrome. Six Spanish families with a total of seven WS patients were screened for mutations in the WFS1-coding region by direct sequencing. We found three previously undescribed mutations c.873C > A, c.1949_50delAT, and c.2206G > C, as well as the duplication c.409_424dup16, formerly published as 425ins16. Several groups had detected deletions in the mitochondrial DNA (mtDNA) of WS patients. For this reason, we also studied the presence of mtDNA rearrangements as well as Leber's hereditary optic neuropathy, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes, and A1555G point mutations in the WS families. No mtDNA abnormalities were detected.
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Affiliation(s)
- E Domènech
- Centre de Genètica Mèdica i Molecular, Institut de Recerca Oncològica (I.R.O.), Gran Via s/n Km 2.7, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
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