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Queen NJ, Huang W, Zou X, Mo X, Cao L. AAV-BDNF gene therapy ameliorates a hypothalamic neuroinflammatory signature in the Magel2-null model of Prader-Willi syndrome. Mol Ther Methods Clin Dev 2023; 31:101108. [PMID: 37766791 PMCID: PMC10520877 DOI: 10.1016/j.omtm.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Individuals with Prader-Willi syndrome (PWS) exhibit several metabolic and behavioral abnormalities associated with excessive food-seeking activity. PWS is thought to be driven in part by dysfunctional hypothalamic circuitry and blunted responses to peripheral signals of satiety. Previous work described a hypothalamic transcriptomic signature of individuals with PWS. Notably, PWS patients exhibited downregulation of genes involved in neuronal development and an upregulation of neuroinflammatory genes. Deficiencies of brain-derived neurotrophic factor (BDNF) and its receptor were identified as potential drivers of PWS phenotypes. Our group recently applied an adeno-associated viral (AAV)-BDNF gene therapy within a preclinical PWS model, Magel2-null mice, to improve metabolic and behavioral function. While this proof-of-concept project was promising, it remained unclear how AAV-BDNF was influencing the hypothalamic microenvironment and how its therapeutic effect was mediated. To investigate, we hypothalamically injected AAV-BDNF to wild type and Magel2-null mice and performed mRNA sequencing on hypothalamic tissue. Here, we report that (1) Magel2 deficiency is associated with neuroinflammation in the hypothalamus and (2) AAV-BDNF gene therapy reverses this neuroinflammation. These data newly reveal Magel2-null mice as a valid model of PWS-related neuroinflammation and furthermore suggest that AAV-BDNF may modulate obesity-related neuroinflammatory phenotypes through direct or indirect means.
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Affiliation(s)
- Nicholas J. Queen
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Wei Huang
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Xunchang Zou
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Xiaokui Mo
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Lei Cao
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
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Balestrino R, Losa M, Albano L, Barzaghi LR, Mortini P. Intranasal oxytocin as a treatment for obesity: safety and efficacy. Expert Rev Endocrinol Metab 2023; 18:295-306. [PMID: 37232186 DOI: 10.1080/17446651.2023.2216794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Known for its effect on labor and lactation and on emotional and social functions, oxytocin has recently emerged as a key modulator of feeding behavior and indeed suggested as a potential treatment for obesity. The potential positive effect of oxytocin on both metabolic and psychological-behavioral complications of hypothalamic lesions makes it a promising tool in the management of these conditions. AREAS COVERED The aim of the present review article is to provide an overview of the mechanism of action and clinical experience of the use of oxytocin in different forms of obesity. EXPERT OPINION Current evidence suggests a potential role of oxytocin in the treatment of obesity with different causes. Several challenges remain: an improved understanding of the physiological regulation, mechanisms of action of oxytocin, and interplay with other endocrine axes is fundamental to clarify its role. Further clinical trials are needed to determine the safety and efficacy of oxytocin for the treatment of different forms of obesity. Understanding the mechanism(s) of action of oxytocin on body weight regulation might also improve our understanding of obesity and reveal possible new therapeutic targets - as well as promoting advances in other fields in which oxytocin might be used.
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Affiliation(s)
- Roberta Balestrino
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele, Milano, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Losa
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele, Milano, Italy
| | - Luigi Albano
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele, Milano, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele, Milan, Italy
| | - Lina R Barzaghi
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele, Milano, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele, Milano, Italy
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Nicoară DM, Scutca AC, Mang N, Juganaru I, Munteanu AI, Vitan L, Mărginean O. Central precocious puberty in Prader-Willi syndrome: a narrative review. Front Endocrinol (Lausanne) 2023; 14:1150323. [PMID: 37251677 PMCID: PMC10214499 DOI: 10.3389/fendo.2023.1150323] [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: 01/24/2023] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Prader-Willi syndrome (PWS, OMIM176270) is a rare genetic disorder with recognizable dysmorphic features and multisystemic consequences such as endocrine, neurocognitive and metabolic ones. Although most patients with Prader-Willi syndrome exhibit hypogonadotropic hypogonadism, there is variability regarding sexual maturation, with precocious puberty occurring in rare cases. Our aim is to elaborate a thorough review of Prader-Willi patients with central precocious puberty, in order to raise awareness of such cases and to enhance our knowledge regarding the diagnosis and prompt treatment of this particular PWS patients.
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Affiliation(s)
- Delia-Maria Nicoară
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Alexandra-Cristina Scutca
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, Timisoara, Romania
| | - Niculina Mang
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Iulius Juganaru
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, Timisoara, Romania
- Research Center in Pediatrics - Disturbances of Growth and Development in Children – BELIVE, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Andrei-Ioan Munteanu
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, Timisoara, Romania
| | - Luiza Vitan
- Department of Endocrinology, Railway Hospital 2 Bucharest, Timisoara, Romania
| | - Otilia Mărginean
- Department of Pediatrics, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, Timisoara, Romania
- Research Center in Pediatrics - Disturbances of Growth and Development in Children – BELIVE, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
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Gámez S, Cobo J, Fernández-Lafitte M, Coronas R, Parra I, Oliva JC, Àlvarez A, Esteba-Castillo S, Giménez-Palop O, Corripio R, Palao DJ, Caixàs A. An Exploratory Analysis on the 2D:4D Digit Ratio and Its Relationship with Social Responsiveness in Adults with Prader-Willi Syndrome. J Clin Med 2023; 12:jcm12031155. [PMID: 36769803 PMCID: PMC9917981 DOI: 10.3390/jcm12031155] [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: 12/27/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a genetic disorder produced by a lack of expression of paternally derived genes in the 15q11-13 region. Research has generally focused on its genetic and behavioral expression, but only a few studies have examined epigenetic influences. Prenatal testosterone or the maternal testosterone-to-estradiol ratio (MaTtEr) has been suggested to play an important role in the development of the 'social brain' during pregnancy. Some studies propose the 2D:4D digit ratio of the hand as an indirect MaTtEr measure. The relationship between social performance and MaTtEr has been studied in other neurodevelopmental conditions such as Autism Spectrum Disorder (ASD), but to our best knowledge, it has never been studied in PWS. Therefore, our study aims to clarify the possible existence of a relationship between social performance-as measured using the Social Responsiveness Scale (SRS)-and MaTtEr levels using the 2D:4D ratio. We found that, as a group, PWS individuals have shorter index and ring fingers than the control group, but no significant difference in the 2D:4D ratios. The 2D:4D ratio showed a correlation only with Restricted Interests and Repetitive Behavior Subscale, where a positive correlation only for male individuals with PWS was found. Considering only PWS with previous GH treatment during childhood/adolescence (PWS-GH), index and ring fingers did not show differences in length with the control group, but the 2D:4D ratio was significantly higher in the right or dominant hand compared to controls.
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Affiliation(s)
- Sara Gámez
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
- Correspondence: (J.C.); (A.C.)
| | - Meritxell Fernández-Lafitte
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Ramón Coronas
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Isabel Parra
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
| | - Joan Carles Oliva
- Statistics Unit, Fundació Parc Taulí—(I3PT)—CERCA, 08208 Sabadell, Spain
| | - Aida Àlvarez
- Department of Mental Health, Mutua Terrassa University Hospital, 08221 Terrassa, Spain
| | - Susanna Esteba-Castillo
- Specialized Mental Health and Intellectual Disability Department, Institut d’Assistència Sanitària, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopment Group, Girona Biomedical Research Institute IDIBGI, Institut d’Assistència Sanitària, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Olga Giménez-Palop
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Raquel Corripio
- Pediatric Endocrine Department, Parc Taulí Hospital Universitari, Institutd’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Correspondence: (J.C.); (A.C.)
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Queen NJ, Zou X, Anderson JM, Huang W, Appana B, Komatineni S, Wevrick R, Cao L. Hypothalamic AAV-BDNF gene therapy improves metabolic function and behavior in the Magel2-null mouse model of Prader-Willi syndrome. Mol Ther Methods Clin Dev 2022; 27:131-148. [PMID: 36284766 PMCID: PMC9573893 DOI: 10.1016/j.omtm.2022.09.012] [Citation(s) in RCA: 4] [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: 07/08/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022]
Abstract
Individuals with Prader-Willi syndrome (PWS) display developmental delays, cognitive impairment, excessive hunger, obesity, and various behavioral abnormalities. Current PWS treatments are limited to strict supervision of food intake and growth hormone therapy, highlighting the need for new therapeutic strategies. Brain-derived neurotrophic factor (BDNF) functions downstream of hypothalamic feeding circuitry and has roles in energy homeostasis and behavior. In this preclinical study, we assessed the translational potential of hypothalamic adeno-associated virus (AAV)-BDNF gene therapy as a therapeutic for metabolic dysfunction in the Magel2-null mouse model of PWS. To facilitate clinical translation, our BDNF vector included an autoregulatory element allowing for transgene titration in response to the host's physiological needs. Hypothalamic BDNF gene transfer prevented weight gain, decreased fat mass, increased lean mass, and increased relative energy expenditure in female Magel2-null mice. Moreover, BDNF gene therapy improved glucose metabolism, insulin sensitivity, and circulating adipokine levels. Metabolic improvements were maintained through 23 weeks with no adverse behavioral effects, indicating high levels of efficacy and safety. Male Magel2-null mice also responded positively to BDNF gene therapy, displaying improved body composition, insulin sensitivity, and glucose metabolism. Together, these data suggest that regulating hypothalamic BDNF could be effective in the treatment of PWS-related metabolic abnormalities.
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Affiliation(s)
- Nicholas J. Queen
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Xunchang Zou
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Jacqueline M. Anderson
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Wei Huang
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Bhavya Appana
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Suraj Komatineni
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Rachel Wevrick
- Department of Medical Genetics, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Lei Cao
- Department of Cancer Biology & Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
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Wang J, Shen X, Yang H, Shi W, Zhu X, Gao H, Yin H, Meng F, Wu Y. Inter- and intra-observer reliability of the "Assessment of Motor Repertoire- 3 to 5 Months" based on video recordings of infants with Prader-Willi syndrome. BMC Pediatr 2022; 22:150. [PMID: 35317775 PMCID: PMC8939132 DOI: 10.1186/s12887-022-03224-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background The “Assessment of Motor Repertoire—3 to 5 Months”, which is a part of Prechtl's General Movements Assessment (GMA), has been gradually applied to infants with genetic metabolic disorders. However, there have been no studies on the application of the GMA for infants with Prader-Willi syndrome (PWS). Aims The purpose of this study was to determine the inter- and intra-observer reliability of the assessment tool in a population of infants with PWS. Study design This was a reliability and agreement study. Subjects This was a cross-sectional study with15 infants with PWS born at an average gestational age of 38 weeks. Outcome measures Standardized video recordings of 15 infants with PWS (corrected ages of 3 to 5 months) were independently assessed by three observers. Kappa and ICC statistics were applied in inter- and intra- observer reliability analyses. Results The overall reliability ICC values of the “Motor Optimality Score” (MOS) ranged from 0.84 to 0.98, and the pairwise agreement ranged between 0.86 and 0.95 for inter- observe reliability. In addition, ICC values for the MOS ranged between 0.95 and 0.98 for tester agreement in intra-observer reliability. Complete agreement reliability (100%) was achieved in the subcategories of “Fidgety Movements” and “Movement Character” for the inter- and intra-observer reliability. Moderate to high inter- and intra-observer reliability were found in the subcategories of “Repertoire of Co-Existent Other Movements”, “Quality of Other Movements” and “Posture”, with kappa values ranging between 0.63 and 1.00. Conclusion There were high levels of inter-and intra-observer agreement in the “Assessment of Motor Repertoire—3 to 5 Months” for infants with PWS. It is possible to carry out standardized quantitative assessments of the motor performance of infants with PWS.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Xiushu Shen
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China. .,Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, 201102, China.
| | - Wei Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Xiaoyun Zhu
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Herong Gao
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Huanhuan Yin
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Fanzhe Meng
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Yun Wu
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
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Che Din N, Umat C, Abdul Wahat NH, Talib AB. Mapping the evidence of multidimensional health approaches in treating individuals with Prader-Willi Syndrome: A scoping review protocol. BMJ Open 2022; 12:e047638. [PMID: 35022164 PMCID: PMC8756288 DOI: 10.1136/bmjopen-2020-047638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Prader-Willi Syndrome (PWS) is one of the rare diseases involving genetics and affects various body systems. The disease is known due to the absence of paternal genes on chromosome 15q11-q13. Multisystem complex conditions require interdisciplinary healthcare treatment. However, to the best of our knowledge, there is little evidence of an established successful model of an interdisciplinary approach in managing rare diseases like PWS. METHODS AND ANALYSIS The scoping review process follows the five-staged Arksey and O'Malley (2005) methodology framework excluding the optional consultation stage (stage 6): the definition of the research questions (step 1); the eligibility criteria and search strategy are defined (stage 2); the study selection process based on the eligibility criteria identified will follow (stage 3); a framework developed for this review will then inform the extraction and charting of data from the included studies (step 4) and results will be aggregated and summarised with criteria relevant for health professionals and policymakers (stage 5). We will search for electronic databases (MEDLINE/PubMed, Scopus, Web of Science), grey literature sources and critical studies' reference lists to determine the appropriate inclusion criteria. Three researchers will review all abstracts and full-text studies for inclusion. ETHICS AND DISSEMINATION This scoping review methodology does not require ethical approval since it aims to synthesise information from available publications. A scoping review article will be submitted for publication to a scientific journal following this protocol.
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Affiliation(s)
- Normah Che Din
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Cila Umat
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Nor Haniza Abdul Wahat
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Azhar Bin Talib
- Prader-Willi Syndrome Association (PWSA) Malaysia, Jalan Enggang, Taman Keramat, Kuala Lumpur
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Chevalère J, Camblats AM, Laurier V, Mourre F, Estival S, Postal V. The influence of emotional contexts on mental flexibility in Prader-Willi syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:133-150. [PMID: 33491829 DOI: 10.1111/jir.12817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/15/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The present study investigated the influence of emotional contexts on mental flexibility in adults with Prader-Willi syndrome (PWS) using a voluntary task-switching paradigm that was implemented with emotionally valenced pictures. The study aims were to assess whether adults with PWS have impaired switching abilities, whether the deficit is specific to PWS or linked to intellectual disabilities, and the influence of emotional contexts on performance. METHOD The task-switching performance of 30 adults with PWS was compared with that of 30 healthy adults matched on chronological age, and to that of 30 adults with intellectual disabilities but without PWS, matched on intellectual quotient level and chronological age. Indicators of switching performance were switching cost and repetition bias. Emotional contexts were operationalised with positive, neutral and negative task-irrelevant pictures. RESULTS Adults with PWS showed a large increase in switching costs compared with the two control groups, and this effect did not vary across emotional contexts. More fine-tuned examination revealed subtle performance modulations: negative contexts tended to increase the repetition bias in all three groups while positive contexts slowed down global performance in PWS. CONCLUSIONS The results confirmed previous studies, showing impaired switching abilities in PWS over and beyond the influence of intellectual level, but revealed no robust variations in switching deficits across emotional contexts.
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Affiliation(s)
- J Chevalère
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), UMR 6024, CNRS & Univ. Clermont-Auvergne, Clermont-Ferrand, France
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - A-M Camblats
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Laurier
- AP-HP Hôpital Marin, Hendaye, France
| | - F Mourre
- AP-HP Hôpital Marin, Hendaye, France
| | - S Estival
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Postal
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
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Hospital outcomes of scoliosis surgery in children with Prader-Willi Syndrome: comparison with adolescent idiopathic scoliosis. Spine Deform 2021; 9:1641-1647. [PMID: 33950464 DOI: 10.1007/s43390-021-00359-7] [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: 10/02/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the peri-operative outcomes of patients with Prader-Willi Syndrome (PWS) undergoing spinal deformity correction and compare the outcomes to patients with adolescent idiopathic scoliosis (AIS). METHODS A retrospective review of the Kid's Inpatient Database was performed from 2000 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. Cohorts were created on the basis of PWS diagnosis and adolescent idiopathic scoliosis. Statistical analysis was performed for differences in post-operative outcomes between these two patient cohorts. RESULTS Between 2000 and 2012, the number of spinal fusions performed increased by 24.6 and 32.2% in the PWS and adolescent idiopathic scoliosis populations, respectively. There was no difference between the incidence of major complications in PWS patients when compared to AIS (1.7% vs. 1.0% in idiopathic scoliosis; p = 0.362). Although there was no significant difference in the rate of overall minor complications, PWS patients were demonstrated to be more likely to experience post-operative pneumonia (p < 0.0001) and implant complications (p < 0.001). CONCLUSION Patients with scoliosis associated with PWS do not have any increased risk of major complications following spinal deformity correction when compared to patients with adolescent idiopathic scoliosis. Two important minor complications to keep in mind when surgically treating scoliosis in PWS patients include pulmonary and implant-related complications. LEVEL OF EVIDENCE Retrospective comparative study, Level III.
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Barton JR, Snook AE, Waldman SA. From leptin to lasers: the past and present of mouse models of obesity. Expert Opin Drug Discov 2021; 16:777-790. [PMID: 33472452 PMCID: PMC8243785 DOI: 10.1080/17460441.2021.1877654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
Introduction: Obesity is a prevalent condition that accounts for significant morbidity and mortality across the globe. Despite substantial effort, most obesity pharmacotherapies have proven unsafe or ineffective. The use of obese mouse models provides unique insight into the hormones and mechanisms that regulate appetite and metabolism. Paramount among these models are the 'obese' and 'diabetic' mice that revealed the powerful satiety hormone leptin, revolutionizing obesity research.Areas Covered: In this article, the authors discuss work on leptin therapy, and the clinical response to leptin in humans. The authors describe the use of modern mouse genetics to study targetable mechanisms for genetic forms of human obesity. Additionally, they describe mouse models of neuromodulation and their utility in unraveling neural circuits that govern appetite and metabolism.Expert opinion: Combining past and present models of obesity is required for the development of safe, effective, and impactful obesity therapy. Current research in obesity can benefit from repositories of genetically engineered mouse models to discover interactions between appetitive systems and circuits. Combining leptin therapy with other satiety signals comprising the gut-brain axis is a promising approach to induce significant enduring weight loss.
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Affiliation(s)
- Joshua R. Barton
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Adam E. Snook
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Scott A. Waldman
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Meade C, Martin R, McCrann A, Lyons J, Meehan J, Hoey H, Roche E. Prader-Willi Syndrome in children: Quality of life and caregiver burden. Acta Paediatr 2021; 110:1665-1670. [PMID: 33378107 DOI: 10.1111/apa.15738] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/03/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022]
Abstract
Prader-Willi syndrome is a complex condition requiring constant care and supervision of the affected child. AIM To evaluate quality of life and caregiver burden in children with Prader-Willi syndrome. METHODS All children with Prader-Willi syndrome, attending a tertiary referral centre, were invited to participate (n = 44). Quality of life was evaluated using the PedsQL questionnaire. Family impact modules and parent proxy reports evaluated the impact on the quality of life of the child and family. Additional challenges were captured using a burden questionnaire. RESULTS Nineteen children participated. Median age was 7.9 years (0.6-18.1 years). Majority were female (n = 14, 74%). Median age at diagnosis was 2.5 weeks (range birth-2 years 8 months). Growth hormone treatment was in place for the majority (n = 14, 74%). Increased weight and age were identified as significantly impacting on family functioning and relationships. Parents perceived increased weight and age to have a significant negative impact on their child's psychosocial health and social functioning. Caregivers of children >12 years reported an increased burden of care. Disruption to routines, restriction of social activities and psychological difficulties were reported as increasing caregiver burden. CONCLUSION Prader-Willi syndrome impacts significantly on quality of life for both the affected child and the family.
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Affiliation(s)
- Christina Meade
- Department of Nutrition and Dietetics National Children's Hospital Tallaght University Hospital Dublin Ireland
| | - Ruth Martin
- Department of Nutrition and Dietetics National Children's Hospital Tallaght University Hospital Dublin Ireland
| | - Ann McCrann
- Department of Paediatric Growth Diabetes and Endocrinology National Children's Hospital Tallaght University Hospital Dublin Ireland
| | - Jacqueline Lyons
- Department of Paediatric Growth Diabetes and Endocrinology National Children's Hospital Tallaght University Hospital Dublin Ireland
| | - Judith Meehan
- Discipline of Paediatrics Trinity College Dublin The University of Dublin Dublin Ireland
| | - Hilary Hoey
- Discipline of Paediatrics Trinity College Dublin The University of Dublin Dublin Ireland
| | - Edna Roche
- Department of Paediatric Growth Diabetes and Endocrinology National Children's Hospital Tallaght University Hospital Dublin Ireland
- Discipline of Paediatrics Trinity College Dublin The University of Dublin Dublin Ireland
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12
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Hypogonadism in Patients with Prader Willi Syndrome: A Narrative Review. Int J Mol Sci 2021; 22:ijms22041993. [PMID: 33671467 PMCID: PMC7922674 DOI: 10.3390/ijms22041993] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 12/20/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a multisystemic complex genetic disorder related to the lack of a functional paternal copy of chromosome 15q11-q13. Several clinical manifestations are reported, such as short stature, cognitive and behavioral disability, temperature instability, hypotonia, hypersomnia, hyperphagia, and multiple endocrine abnormalities, including growth hormone deficiency and hypogonadism. The hypogonadism in PWS is due to central and peripheral mechanisms involving the hypothalamus-pituitary-gonadal axis. The early diagnosis and management of hypogonadism in PWS are both important for physicians in order to reach a better quality of life for these patients. The aim of this study is to summarize and investigate causes and possible therapies for hypogonadism in PWS. Additional studies are further needed to clarify the role of different genes related to hypogonadism and to establish a common and evidence-based therapy.
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13
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Salles J, Lacassagne E, Eddiry S, Franchitto N, Salles JP, Tauber M. What can we learn from PWS and SNORD116 genes about the pathophysiology of addictive disorders? Mol Psychiatry 2021; 26:51-59. [PMID: 33082508 DOI: 10.1038/s41380-020-00917-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
Addictive disorders have been much investigated and many studies have underlined the role of environmental factors such as social interaction in the vulnerability to and maintenance of addictive behaviors. Research on addiction pathophysiology now suggests that certain behavioral disorders are addictive, one example being food addiction. Yet, despite the growing body of knowledge on addiction, it is still unknown why only some of the individuals exposed to a drug become addicted to it. This observation has prompted the consideration of genetic heritage, neurodevelopmental trajectories, and gene-environment interactions in addiction vulnerability. Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder in which children become addicted to food and show early social impairment. PWS is caused by the deficiency of imprinted genes located on the 15q11-q13 chromosome. Among them, the SNORD116 gene was identified as the minimal gene responsible for the PWS phenotype. Several studies have also indicated the role of the Snord116 gene in animal and cellular models to explain PWS pathophysiology and phenotype (including social impairment and food addiction). We thus present here the evidence suggesting the potential involvement of the SNORD116 gene in addictive disorders.
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Affiliation(s)
- Juliette Salles
- Université de Toulouse III, F-31000, Toulouse, France.,CHU de Toulouse, Service de psychiatrie et psychologie, psychiatrie Toulouse, F-31000, Toulouse, France.,Inserm Unité 1043, CNRS 5828, Université Paul Sabatier, Toulouse III, F-31000, Toulouse, France.,CHU de Toulouse, Institut des Handicaps Neurologiques, Psychiatriques et Sensoriels, F-31000, Toulouse, France
| | - Emmanuelle Lacassagne
- Inserm Unité 1043, CNRS 5828, Université Paul Sabatier, Toulouse III, F-31000, Toulouse, France
| | - Sanaa Eddiry
- Inserm Unité 1043, CNRS 5828, Université Paul Sabatier, Toulouse III, F-31000, Toulouse, France
| | - Nicolas Franchitto
- Université de Toulouse III, F-31000, Toulouse, France.,CHU de Toulouse, Service d'addictologie clinique, urgences réanimation médecine, F-31000, Toulouse, France
| | - Jean-Pierre Salles
- Inserm Unité 1043, CNRS 5828, Université Paul Sabatier, Toulouse III, F-31000, Toulouse, France
| | - Maithé Tauber
- Université de Toulouse III, F-31000, Toulouse, France. .,Inserm Unité 1043, CNRS 5828, Université Paul Sabatier, Toulouse III, F-31000, Toulouse, France. .,CHU de Toulouse, Institut des Handicaps Neurologiques, Psychiatriques et Sensoriels, F-31000, Toulouse, France. .,CHU de Toulouse, Centre de référence du Syndrome de Prader-Willi et autres syndromes avec troubles du comportement alimentaire, Unité d'endocrinologie, obésités, maladies osseuses, génétique et gynécologie médicale, F-31000, Toulouse, France.
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14
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Coban MA, Blackburn PR, Whitelaw ML, van Haelst MM, Atwal PS, Caulfield TR. Structural Models for the Dynamic Effects of Loss-of-Function Variants in the Human SIM1 Protein Transcriptional Activation Domain. Biomolecules 2020; 10:biom10091314. [PMID: 32932609 PMCID: PMC7563489 DOI: 10.3390/biom10091314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 02/02/2023] Open
Abstract
Single-minded homologue 1 (SIM1) is a transcription factor with numerous different physiological and developmental functions. SIM1 is a member of the class I basic helix-loop-helix-PER-ARNT-SIM (bHLH-PAS) transcription factor family, that includes several other conserved proteins, including the hypoxia-inducible factors, aryl hydrocarbon receptor, neuronal PAS proteins, and the CLOCK circadian regulator. Recent studies of HIF-a-ARNT and CLOCK-BMAL1 protein complexes have revealed the organization of their bHLH, PASA, and PASB domains and provided insight into how these heterodimeric protein complexes form; however, experimental structures for SIM1 have been lacking. Here, we describe the first full-length atomic structural model for human SIM1 with its binding partner ARNT in a heterodimeric complex and analyze several pathogenic variants utilizing state-of-the-art simulations and algorithms. Using local and global positional deviation metrics, deductions to the structural basis for the individual mutants are addressed in terms of the deleterious structural reorganizations that could alter protein function. We propose new experiments to probe these hypotheses and examine an interesting SIM1 dynamic behavior. The conformational dynamics demonstrates conformational changes on local and global regions that represent a mechanism for dysfunction in variants presented. In addition, we used our ab initio hybrid model for further prediction of variant hotspots that can be engineered to test for counter variant (restoration of wild-type function) or basic research probe.
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Affiliation(s)
- Mathew A. Coban
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Patrick R. Blackburn
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Murray L. Whitelaw
- Department of Molecular and Cellular Biology, University of Adelaide, Adelaide SA 5000, Australia;
| | - Mieke M. van Haelst
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Paldeep S. Atwal
- Center for Individualized Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
- Atwal Clinic, Jacksonville, FL 32224, USA
| | - Thomas R. Caulfield
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL 32224, USA;
- Center for Individualized Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN 55905, USA, MN, USA
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
- Correspondence: ; Tel.: +1-904-953-6072; Fax: +1-904-953-7370
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15
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Munné-Miralvés C, Brunet-Llobet L, Cahuana-Cárdenas A, Torné-Durán S, Miranda-Rius J, Rivera-Baró A. Oral disorders in children with Prader-Willi syndrome: a case control study. Orphanet J Rare Dis 2020; 15:43. [PMID: 32041633 PMCID: PMC7011482 DOI: 10.1186/s13023-020-1326-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/03/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Prader-Willi Syndrome (PWS) is a genetic disorder caused by the lack of expression of certain paternal genes located on chromosome 15q11-q13. This anomaly causes cognitive, neurological and endocrine abnormalities, among which one of the most important is hyperphagia. The aim of this study was to assess the oral health of children with PWA and to establish preventive criteria. RESULTS Thirty patients with PWS (mean age 10.2 years) and 30 age- and gender-matched controls were included in the study. Twenty-six patients with PWS(86.6%) followed dietary treatment prescribed by their endocrinologist. Individuals with PWS had a mean caries index of 53.3% and Decayed Missing Filled teeth (DMFT) index 2.5, and 53.3% had gingivitis, in the control group the respective figures were 43.3%, 0.93, and 60%. Only the DMFT index (p 0.017) presented significant differences. Regarding stimulated salivary secretion, patients with PWS presented a mean of 0.475 ml/min with a pH of 6.15, while controls presented a mean of 0.848 ml/min with a pH of 7.53; the differences between the groups were statistically significant in both cases (p 0.032 and p 0.0001 respectively). The population with PWS presented a higher plaque index (> 2) than their healthy peers, but the differences were not significant. CONCLUSION Pediatric patients with Prader-Willi syndrome have an increased risk of caries and gingivitis. The children with this syndrome have a decreased salivary flow and a more acidic salivary pH. In these patients, dental care is an essential part of their multidisciplinary medical treatment.
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Affiliation(s)
- Carla Munné-Miralvés
- Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Lluís Brunet-Llobet
- Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain.
| | - Abel Cahuana-Cárdenas
- Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Sergi Torné-Durán
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jaume Miranda-Rius
- Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Alejandro Rivera-Baró
- Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
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16
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Jehan S, Zizi F, Pandi-Perumal SR, McFarlane SI, Jean-Louis G, Myers AK. Energy imbalance: obesity, associated comorbidities, prevention, management and public health implications. ADVANCES IN OBESITY, WEIGHT MANAGEMENT & CONTROL 2020; 10:146-161. [PMID: 33305001 PMCID: PMC7725222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The prevalence of obesity has been continually increasing, as have its associated comorbidities and health care costs. Effective management of obesity and early intervention measures are necessary to overcome this global issue. The responsibility for preventing and managing this global epidemic does not lie solely on an individual, but also on the entire health care system. Policy makers-nationally and globally-must play their roles to solve the issue. In this review article, we examine methods of controlling and managing obesity through interventions, such as a low caloric diet, physical exercise, pharmacological guidance, and bariatric surgical procedures. While health care professionals should educate patients about all available treatment options for severe obesity, bariatric surgical procedures have increased in popularity and are considered very beneficial with outcomes fruitful in managing severe obesity.
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Affiliation(s)
- Shazia Jehan
- Department of Population Health, Center for Healthful Behavior Change, USA
| | - Ferdinand Zizi
- Department of Population Health, Center for Healthful Behavior Change, USA
| | | | | | | | - Alyson K Myers
- Department of Internal Medicine, Division of Endocrinology, USA
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17
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Gowda S, Seibert T, Uli N, Farrell R. Pediatric Obesity: Endocrinologic and Genetic Etiologies and Management. CURRENT CARDIOVASCULAR RISK REPORTS 2019. [DOI: 10.1007/s12170-019-0632-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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18
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Hirsch HJ, Gross-Tsur V, Sabag Y, Nice S, Genstil L, Benarroch F, Constantini N. Myokine levels after resistance exercise in young adults with Prader-Willi syndrome (PWS). Am J Med Genet A 2019; 182:115-121. [PMID: 31692257 DOI: 10.1002/ajmg.a.61391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 12/30/2022]
Abstract
Individuals with PWS require marked caloric restriction and daily exercise to prevent morbid obesity. Lower energy expenditure, hypotonia, decreased muscle mass, and cognitive impairment make exercise challenging for this population. Exercise guidelines include resistance training as an important component. Myokine responses to resistance exercise may mediate beneficial metabolic effects. We aimed to determine if young PWS adults can perform a resistance exercise program and to measure myokine responses in PWS versus age- and BMI-matched controls. Each group included 11 participants (7M/4F). Ages and BMI for PWS and controls were 30.7 ± 4.6 versus 30.1 ± 4.3 years and 28.3 ± 4.3 versus 28.2 ± 4.2 kg/m2 , respectively. Glucose, creatine kinase (CK), lactate, and myokines were measured before, after, 30, and 60 min after completing eight resistance exercises. Myokines were assayed using a multiplex myokine panel (Merck Millipore). CK was lower in PWS versus controls (62 ± 16 vs.322 ± 100 U/L, p < .04). Peak lactate was 3.7 ± 0.7 in PWS versus 7.3 ± 0.7 mmol/Lin controls (p < .001). The increase in interleukin-6 was similar in PWS and controls (41 ± 16% and 35 ± 10%, respectively). Pre- and post-exercise levels of the six myokines assayed showed no consistent differences between the PWS and control participants. PWS young adults are capable of performing resistance/strength-building exercise. The lower CK and peak lactate levels in PWS may reflect decreased muscle mass in this population. Further studies are needed to determine optimal exercise regimens and assess the role of myokines incontributing to the metabolic phenotype of PWS.
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Affiliation(s)
- Harry J Hirsch
- Multidisciplinary Prader-Willi Syndrome Clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Varda Gross-Tsur
- Multidisciplinary Prader-Willi Syndrome Clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.,The Hebrew University School of Medicine, Jerusalem, Israel
| | - Yanir Sabag
- The Hebrew University School of Medicine, Jerusalem, Israel
| | - Shachar Nice
- Heidi Rothberg Sport Medicine Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Larry Genstil
- Multidisciplinary Prader-Willi Syndrome Clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Fortu Benarroch
- Multidisciplinary Prader-Willi Syndrome Clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.,The Hebrew University School of Medicine, Jerusalem, Israel.,Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Naama Constantini
- The Hebrew University School of Medicine, Jerusalem, Israel.,Heidi Rothberg Sport Medicine Center, Shaare Zedek Medical Center, Jerusalem, Israel
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19
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Pacoricona Alfaro DL, Lemoine P, Ehlinger V, Molinas C, Diene G, Valette M, Pinto G, Coupaye M, Poitou-Bernert C, Thuilleaux D, Arnaud C, Tauber M. Causes of death in Prader-Willi syndrome: lessons from 11 years' experience of a national reference center. Orphanet J Rare Dis 2019; 14:238. [PMID: 31684997 PMCID: PMC6829836 DOI: 10.1186/s13023-019-1214-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/24/2019] [Indexed: 12/12/2022] Open
Abstract
Background In the last 20 years, substantial improvements have been made in the diagnosis, treatment and management of patients with Prader-Willi syndrome (PWS). Few data on causes of death are available since those improvements were made. Our study assessed the causes of death among French patients with PWS over the first 11 years of experience of the nationwide French Reference Center for PWS (FRC-PWS). Methods Our study relied on two sources of mortality information at national level between 2004 and 2014: The French Epidemiological Centre for the Medical Causes of Death (CépiDc) Registry and the FRC-PWS database. Causes of death were classified into seven categories: respiratory, cardiovascular, gastrointestinal, severe infection, sudden death, other causes, and unknown. Descriptive statistics were calculated separately for children (< 18 years-old) and adults (≥18 years-old). Results One hundred and four deaths were identified in France from 2004 to 2014. The median age at death was 30 years, ranging from less than 1 month to 58 years. Seventeen deaths occurred in patients under 18 years, with 70% of them in children under 2 years. Respiratory causes accounted for more than 50% of the deaths in patients with PWS in both children and adults. Both cause and age of death did not significantly differ according to gender or genetic subtype. Conclusions Patients with PWS die prematurely due to a respiratory cause in most cases at all ages. In those adult patients with data on obesity, 98% were reported to be obese.
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Affiliation(s)
| | - Perrine Lemoine
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France
| | | | - Catherine Molinas
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France.,Centre de Physiopathologie de Toulouse-Purpan, UMR 5282 CNRS, UMR 1043 Inserm, Paul Sabatier University, Toulouse, France
| | - Gwénaëlle Diene
- UMR 1027 Inserm- Paul Sabatier University, Toulouse, France.,Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Marion Valette
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France.,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France
| | - Graziella Pinto
- Pediatric Endocrinology, Diabetology and Gynecology Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Necker Children's University Hospital, Paris, France
| | - Muriel Coupaye
- French National Reference Center for Prader-Willi Syndrome, Nutrition Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Paris, France
| | - Christine Poitou-Bernert
- French National Reference Center for Prader-Willi Syndrome, Nutrition Department, Assistance-Publique Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics team, Sorbonne University, UPMC University Paris 06, Inserm, Paris, France
| | - Denise Thuilleaux
- French National Reference Center for Prader-Willi Syndrome, Prader-Willi Unit, Assistance Publique Hôpitaux de Paris (AP-HP), Marine Hendaye Hospital, Hendaye, France
| | - Catherine Arnaud
- UMR 1027 Inserm- Paul Sabatier University, Toulouse, France.,Unité de Soutien Méthodologique à la Recherche, University Hospital Center of Toulouse, Toulouse, France
| | - Maithé Tauber
- Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology Unit, Children's Hospital, University Hospital Center of Toulouse, Toulouse, France. .,French National Reference Center for Prader-Willi Syndrome, Children's Hospital, University Hospital Center of Toulouse, 330, avenue de Grande-Bretagne - TSA 40031, 31059, Toulouse cedex 9, France. .,Centre de Physiopathologie de Toulouse-Purpan, UMR 5282 CNRS, UMR 1043 Inserm, Paul Sabatier University, Toulouse, France.
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20
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Bantim YCV, Kussaba ST, de Carvalho GP, Garcia-Junior IR, Roman-Torres CVG. Oral health in patients with Prader-Willi syndrome: current perspectives. Clin Cosmet Investig Dent 2019; 11:163-170. [PMID: 31308759 PMCID: PMC6613606 DOI: 10.2147/ccide.s183981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a rare complex multisystem disorder and presents several aspects related to dentistry. The purpose of this review is to present current perspectives about oral health in patients with PWS. Delay development, hyperphagia, foamy and highly viscous saliva raise the risk of caries and contribute to tooth wear. Cariogenic foods uncontrolled consumption allows to obesity and dental problems progress worsening systemic disorders. These factors can be controlled. The success in follow-ups with caries free and oral health controlled demonstrate the importance of multidisciplinary team intervention corroborated by support at home from birth to adulthood. Thereby, current perspective on the disease is that there is possibility of proper maintenance of oral health in PWS patients. Guided care interferes positively with the overall well-being and quality of life of the individual with PWS and their family. A multidisciplinary team with a focus on teaching patients and family members will help minimize eventual problems.
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Affiliation(s)
- Yasmin Comoti Vita Bantim
- Department of Surgery an Integrated Clinic, Araçatuba School of Dentistry, São Paulo State - University Unesp, Araçatuba, SP, Brazil
| | - Sérgio Takashi Kussaba
- Department of Dentistry, Cathedral College, Boa Vista, RR, Brazil.,Department of Dentistry, University Santo Amaro, São Paulo, SP, Brazil
| | | | - Idelmo Rangel Garcia-Junior
- Department of Surgery an Integrated Clinic, Araçatuba School of Dentistry, São Paulo State - University Unesp, Araçatuba, SP, Brazil
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21
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Russo FB, Brito A, de Freitas AM, Castanha A, de Freitas BC, Beltrão-Braga PCB. The use of iPSC technology for modeling Autism Spectrum Disorders. Neurobiol Dis 2019; 130:104483. [PMID: 31129084 DOI: 10.1016/j.nbd.2019.104483] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/31/2019] [Accepted: 05/22/2019] [Indexed: 12/28/2022] Open
Abstract
Autism Spectrum Disorders (ASDs) are a group of neurodevelopmental disorders that influence social skills, involving communication, interaction, and behavior, usually with repetitive and restrictive manners. Due to the variety of genes involved in ASDs and several possible environmental factors influence, there is still no answer to what really causes syndromic and non-syndromic types of ASDs, usually affecting each individual in a unique way. However, we know that the mechanism underlying ASDs involves brain functioning. The human brain is a complex structure composed of close to 100 billion cells, which is a big challenge to study counting just with post mortem tissue investigation or genetic approaches. Therefore, human induced pluripotent stem cells (iPSC) technology has been used as a tool to produce viable cells for understanding a working brain. Taking advantage of patient-derived stem cells, researchers are now able to generate neurons, glial cells and brain organoids in vitro to model ASDs. In this review we report data from different studies showing how iPSCs have been a critical tool to study the different phenotypes of ASDs.
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Affiliation(s)
- Fabiele Baldino Russo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - Anita Brito
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | | | - Andrelissa Castanha
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - Beatriz C de Freitas
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - Patricia Cristina Baleeiro Beltrão-Braga
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil; Department of Obstetrics, School of Arts Sciences and Humanities, São Paulo, SP 03828-000, Brazil.
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22
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Morales JS, Valenzuela PL, Pareja-Galeano H, Rincón-Castanedo C, Rubin DA, Lucia A. Physical exercise and Prader-Willi syndrome: A systematic review. Clin Endocrinol (Oxf) 2019; 90:649-661. [PMID: 30788853 DOI: 10.1111/cen.13953] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this systematic review was to summarize evidence on the acute responses of individuals with Prader-Willi syndrome (PWS) to physical exercise, and on the effectiveness of long-term exercise interventions to improve the clinical manifestations of this syndrome. DESIGN/METHODS Relevant articles were identified in the electronic databases PubMed, Medline, CINAHL and SPORTDiscus (from inception to December 2018). Twenty-two studies including a total of 356 patients with PWS met all inclusion criteria and were included in the review. RESULTS Patients with PWS present with a decreased physical performance and impaired cardiorespiratory (maximal oxygen consumption, heart rate recovery after exercise) and hormonal (growth hormone release) responses to exercise. Most long-term exercise interventions have proven to decrease body mass while improving physical performance. Some benefits have also been reported in biochemical (glucose homeostasis, lipid profile) and biomechanical (gait pattern) variables, although there is controversy regarding the effects on body composition. No exercise-related adverse events have been reported in patients with PWS. CONCLUSION Physical exercise seems to be safe and effective for improving several phenotypes in PWS, notably physical fitness. However, further research is needed to confirm these results and especially to corroborate whether exercise per se or combined with dietary intervention is an effective coadjuvant treatment for reducing body mass in these patients.
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Affiliation(s)
- Javier S Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Pedro L Valenzuela
- Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain
- Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | - Helios Pareja-Galeano
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
| | | | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, California
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
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Geets E, Meuwissen MEC, Van Hul W. Clinical, molecular genetics and therapeutic aspects of syndromic obesity. Clin Genet 2018; 95:23-40. [PMID: 29700824 DOI: 10.1111/cge.13367] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 12/13/2022]
Abstract
Obesity has become a major health problem worldwide. To date, more than 25 different syndromic forms of obesity are known in which one (monogenic) or multiple (polygenic) genes are involved. This review gives an overview of these forms and focuses more in detail on 6 syndromes: Prader Willi Syndrome and Prader Willi like phenotype, Bardet Biedl Syndrome, Alström Syndrome, Wilms tumor, Aniridia, Genitourinary malformations and mental Retardation syndrome and 16p11.2 (micro)deletions. Years of research provided plenty of information on the molecular genetics of these disorders and the obesity phenotype leading to a more individualized treatment of the symptoms, however, many questions still remain unanswered. As these obesity syndromes have different signs and symptoms in common, it makes it difficult to accurately diagnose patients which may result in inappropriate treatment of the disease. Therefore, the big challenge for clinicians and scientists is to more clearly differentiate all syndromic forms of obesity to provide conclusive genetic explanations and eventually deliver accurate genetic counseling and treatment. In addition, further delineation of the (functions of the) underlying genes with the use of array- or next-generation sequencing-based technology will be helpful to unravel the mechanisms of energy metabolism in the general population.
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Affiliation(s)
- E Geets
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - M E C Meuwissen
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - W Van Hul
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
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Butler MG, Hossain W, Hassan M, Manzardo AM. Growth hormone receptor (GHR) gene polymorphism and scoliosis in Prader-Willi syndrome. Growth Horm IGF Res 2018; 39:29-33. [PMID: 29273483 PMCID: PMC6668334 DOI: 10.1016/j.ghir.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/03/2017] [Accepted: 12/01/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE A growth hormone receptor (GHR) gene polymorphism impacts sensitivity to endogenous and exogenous growth hormone (GH) to moderate growth and development. Increased sensitivity may accelerate spinal growth and contribute to scoliosis, particularly in GH-deficient and treated populations such as Prader-Willi syndrome (PWS). Therefore, we examined the relationship between GHR genotype and scoliosis (case and control) in PWS cohorts. DESIGN We utilized a case-control design in a study of 73 subjects (34M; 39F) with genetically confirmed PWS in 32 individuals previously diagnosed with moderate to severe scoliosis (mean age=16.9±10.2years; age range of 1 to 41years) and 41 adults with no evidence of scoliosis (mean age=30.8±9.7years; age range of 18 to 56years). The GHR gene polymorphism was determined using PCR specific primers to capture the two recognized GHR gene fragment sizes [i.e., full length (fl) or exon 3 deletions (d3)]. RESULTS Twenty-three (72%) of the 32 case subjects with scoliosis required surgical correction with an approximately equal balance for gender and PWS genetic subtype among cases and 41 control subjects without scoliosis. The GHR d3/d3 genotype was identified in N=2 of 8 (25%) cases with scoliosis and the d3/fl genotype was identified in N=11 of 25 (44%) cases with scoliosis but the distribution difference did not statistically differ. The GHR fl/fl genotype was correlated with a significantly faster rate and heavier weight gain among case subjects. CONCLUSION Our examination of demographic and genetic markers associated with scoliosis and surgical repair in PWS found no evidence to support differences in gender, PWS genetic subtype or GHR d3 allele distributions among the case vs control groups. Those with fl/fl alleles were heavier than those with d3/d3 or d3/fl genotypes and warrant further study with a larger sample size and possibly to include other vulnerable populations requiring growth hormone treatment.
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Affiliation(s)
- Merlin G Butler
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States.
| | - Waheeda Hossain
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Maaz Hassan
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ann M Manzardo
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States
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Chiu VJY, Tsai LP, Wei JT, Tzeng IS, Wu HC. Motor performance in Prader-Willi syndrome patients and its potential influence on caregiver's quality of life. PeerJ 2017; 5:e4097. [PMID: 29255649 PMCID: PMC5732539 DOI: 10.7717/peerj.4097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/04/2017] [Indexed: 12/21/2022] Open
Abstract
Background Prader-Willi syndrome (PWS) is a complex, multisystem genetic disorder characterized by a variety of physical, cognitive, and behavioral impairments. PWS is a unique sarcopenia model characterized by an abnormal increase in body fat mass and a decrease in muscle mass that predisposes patients to reduced physical activity, functional limitations, and disability. These manifestations may require both symptomatic and supportive management, thus negatively influencing their lifelong family caregiver’s quality of life. The aim of this study was to examine the functional motor performance of adults with PWS in Taiwan and to measure the quality of life of their primary family caregivers. Methods The functional motor tests consisted of the following: (1) 30-s sit-to-stand test, (2) timed up-and-go test, (3) hand grip and lateral pinch strength tests, and (4) Berg Balance Scale. The World Health Organization Quality of Life-short form (WHOQOL-BREF) and the Short-Form 36 Health Survey Questionnaire (SF-36) were used to evaluate health-related quality of life, and the parenting stress index was used to assess the magnitude of stress within the parent-child system. Results The participants included seven adults (two females and five males) with genetically confirmed PWS and their respective main caregivers. The mean age of the adults with PWS was 25.28 years; range 18–31 years, SD 5.10; the mean BMI was 29.2 kg/m2, SD 6.43. All adults with PWS showed lower hand grip and lateral pinch strengths, fewer sit-to-stand cycles during the 30-s chair stand test, and greater average time during the timed up-and-go test when compared to the normative data on healthy adults. Balance was negatively correlated with the caregiver’s health concepts of social functioning (rs −0.879, P = 0.009) and with role limitations due to physical problems (rs −0.899, P = 0.006) and emotional problems (rs −0.794, P = 0.033); hand grip strength was negatively correlated with bodily pain (rs −0.800, P = 0.031), as assessed using the SF-36 questionnaire. The timed up-and-go test was positively correlated with the social relationship domain (rs 0.831, P = 0.021), as assessed using the WHOQOL-BREF questionnaire. The parenting stress index showed no association with the PWS patient’s physical activities. Conclusions All adults with PWS showed decreased upper and lower limb strength and functional mobility when compared to healthy adults. Some of their motor performance might have negative effects on their primary family members in terms of social participation and physical and emotional role limitations. Future research should explore the relationship between physical performances, psychological difficulties of PWS and caregiver’s QOL.
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Affiliation(s)
- Valeria Jia-Yi Chiu
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Li-Ping Tsai
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,Department of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Jang-Ting Wei
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Hsin-Chi Wu
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,Department of Medicine, Tzu Chi University, Hualien, Taiwan
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Wu ML, Li J, Ding Y, Chen Y, Chang GY, Wang XM, Wang J, Shen YP. [Endocrine and metabolic features of female children with Prader-Willi syndrome: an analysis of 4 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:514-518. [PMID: 28506340 PMCID: PMC7389132 DOI: 10.7499/j.issn.1008-8830.2017.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/28/2017] [Indexed: 06/07/2023]
Abstract
This article reports the clinical features and endocrine and metabolic features of 4 children with Prader-Willi syndrome (PWS). All the patients were female and aged 6-12 years at diagnosis. All of them had clinical manifestations of obesity, unusual facies, developmental retardation, and intellectual disability. Genetic detection showed that 2 patients had paternal deletion of the 15q11.2-q13 region, one patient had maternal autodiploid in the 15q11.2-q13 region, and one patient had no abnormality in the 15q11.2-q13 region. All patients had varying degrees of endocrine and metabolic disorders: 2 patients had short stature, among whom one had delayed appearance of secondary sex characteristics and the other one had type 2 diabetes; one patient had insulin resistance and no mammary gland development; one patient had a body height of P3-P10 and precocious puberty. Patients with PWS have various endocrine disorders, so long-term endocrine follow-up and management is very important.
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Affiliation(s)
- Mo-Ling Wu
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
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27
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Wu ML, Li J, Ding Y, Chen Y, Chang GY, Wang XM, Wang J, Shen YP. [Endocrine and metabolic features of female children with Prader-Willi syndrome: an analysis of 4 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:514-518. [PMID: 28506340 PMCID: PMC7389132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/28/2017] [Indexed: 11/04/2023]
Abstract
This article reports the clinical features and endocrine and metabolic features of 4 children with Prader-Willi syndrome (PWS). All the patients were female and aged 6-12 years at diagnosis. All of them had clinical manifestations of obesity, unusual facies, developmental retardation, and intellectual disability. Genetic detection showed that 2 patients had paternal deletion of the 15q11.2-q13 region, one patient had maternal autodiploid in the 15q11.2-q13 region, and one patient had no abnormality in the 15q11.2-q13 region. All patients had varying degrees of endocrine and metabolic disorders: 2 patients had short stature, among whom one had delayed appearance of secondary sex characteristics and the other one had type 2 diabetes; one patient had insulin resistance and no mammary gland development; one patient had a body height of P3-P10 and precocious puberty. Patients with PWS have various endocrine disorders, so long-term endocrine follow-up and management is very important.
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Affiliation(s)
- Mo-Ling Wu
- Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
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Elhamamsy AR. Role of DNA methylation in imprinting disorders: an updated review. J Assist Reprod Genet 2017; 34:549-562. [PMID: 28281142 PMCID: PMC5427654 DOI: 10.1007/s10815-017-0895-5] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/23/2017] [Indexed: 12/20/2022] Open
Abstract
Genomic imprinting is a complex epigenetic process that contributes substantially to embryogenesis, reproduction, and gametogenesis. Only small fraction of genes within the whole genome undergoes imprinting. Imprinted genes are expressed in a monoallelic parent-of-origin-specific manner, which means that only one of the two inherited alleles is expressed either from the paternal or maternal side. Imprinted genes are typically arranged in clusters controlled by differentially methylated regions or imprinting control regions. Any defect or relaxation in imprinting process can cause loss of imprinting in the key imprinted loci. Loss of imprinting in most cases has a harmful effect on fetal development and can result in neurological, developmental, and metabolic disorders. Since DNA methylation and histone modifications play a key role in the process of imprinting. This review focuses on the role of DNA methylation in imprinting process and describes DNA methylation aberrations in different imprinting disorders.
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Affiliation(s)
- Amr Rafat Elhamamsy
- Department of Clinical Pharmacy, School of Pharmacy, Tanta University, Tanta, 31512, Gharbia, Egypt.
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29
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Abstract
Obesity is a complex, heritable trait influenced by the interplay of genetics, epigenetics, metagenomics and the environment. With the increasing access to high precision diagnostic tools for genetic investigations, numerous genes influencing the phenotype have been identified, especially in early onset severe obesity. This review summarizes the current knowledge on the known genetic causes of obesity and the available therapeutic options. Furthermore, we discuss the role and potential mechanism of epigenetic changes that may be involved as mediators of the environmental influences and that may provide future opportunities for intervention.
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Affiliation(s)
- Vidhu V Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, NY
- Harvard Medical School, Boston, MA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA
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30
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Thaker VV. GENETIC AND EPIGENETIC CAUSES OF OBESITY. ADOLESCENT MEDICINE: STATE OF THE ART REVIEWS 2017; 28:379-405. [PMID: 30416642 PMCID: PMC6226269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Obesity is a complex, heritable trait influenced by the interplay of genetics, epigenetics, metagenomics and the environment. With the increasing access to high precision diagnostic tools for genetic investigations, numerous genes influencing the phenotype have been identified, especially in early onset severe obesity. This review summarizes the current knowledge on the known genetic causes of obesity and the available therapeutic options. Furthermore, we discuss the role and potential mechanism of epigenetic changes that may be involved as mediators of the environmental influences and that may provide future opportunities for intervention.
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Affiliation(s)
- Vidhu V Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, NY
- Harvard Medical School, Boston, MA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA
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31
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Chevreul K, Berg Brigham K, Clément MC, Poitou C, Tauber M. Economic burden and health-related quality of life associated with Prader-Willi syndrome in France. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:879-890. [PMID: 27174598 DOI: 10.1111/jir.12288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND To date, there has been no published comprehensive estimation of costs related to Prader-Willi syndrome (PWS). Our objective was therefore to provide data on the economic burden and health-related quality of life associated with PWS in France in order to raise awareness of the repercussions on individuals suffering from this syndrome and on caregivers as well as on the health and social care systems. METHOD A retrospective cross-sectional study was carried out on 51 individuals recruited through the French PWS patient association. Data on their demographic characteristics and resource use were obtained from an online questionnaire, and costs were estimated by a bottom-up approach. The EQ-5D-5L health questionnaire was used to measure the health-related quality of life of individuals suffering from PWS and their caregivers. RESULTS The average annual cost of PWS was estimated at €58 890 per individual, with direct healthcare accounting for €42 299, direct non-healthcare formal costs €13 865 and direct non-healthcare informal costs €8459. The main contributors to PWS costs were hospitalisations and social services. Indirect costs resulting from loss of productivity in the labour market was €32 542 for adults suffering from PWS. Mean EQ-5D utility scores were 0.4 for individuals with PWS and 0.7 for caregivers. CONCLUSIONS Prader-Willi syndrome represents a major economic burden from a societal perspective and has a significant impact on health-related quality of life both for individuals suffering from PWS and for their caregivers in France. These results underscore the need to develop tailored policies targeted at improving care. Likewise, a larger study collecting a broader range of medical characteristics should be undertaken to achieve more precise estimations.
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Affiliation(s)
- K Chevreul
- Sorbonne Paris Cité, Univ Paris Diderot, Paris, France
- Inserm, ECEVE, Paris, France
- URC-Eco, AP-HP, Paris, France
- Univ Paris-Est Créteil, Créteil, France
| | - K Berg Brigham
- URC-Eco, AP-HP, Paris, France
- Univ Paris-Est Créteil, Créteil, France
| | | | - C Poitou
- Institute of Cardiometabolism and Nutrition, ICAN, AP-HP, Nutrition Department and French Reference Centre for Prader-Willi Syndrome, University Pierre et Marie Curie-Paris 6, Paris, France
| | - M Tauber
- Reference Centre for Prader-Willi Syndrome, Children Hospital, Department of Endocrinology, Obesity, Bone Diseases, Genetics and Gynecology, Toulouse Hospital, Toulouse, France
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Shoffstall AJ, Gaebler JA, Kreher NC, Niecko T, Douglas D, Strong TV, Miller JL, Stafford DE, Butler MG. The High Direct Medical Costs of Prader-Willi Syndrome. J Pediatr 2016; 175:137-43. [PMID: 27283463 PMCID: PMC7464637 DOI: 10.1016/j.jpeds.2016.05.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/31/2016] [Accepted: 05/06/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess medical resource utilization associated with Prader-Willi syndrome (PWS) in the US, hypothesized to be greater relative to a matched control group without PWS. STUDY DESIGN We used a retrospective case-matched control design and longitudinal US administrative claims data (MarketScan) during a 5-year enrollment period (2009-2014). Patients with PWS were identified by Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 759.81. Controls were matched on age, sex, and payer type. Outcomes included total, outpatient, inpatient and prescription costs. RESULTS After matching and application of inclusion/exclusion criteria, we identified 2030 patients with PWS (1161 commercial, 38 Medicare supplemental, and 831 Medicaid). Commercially insured patients with PWS (median age 10 years) had 8.8-times greater total annual direct medical costs than their counterparts without PWS (median age 10 years: median costs $14 907 vs $819; P < .0001; mean costs: $28 712 vs $3246). Outpatient care comprised the largest portion of medical resource utilization for enrollees with and without PWS (median $5605 vs $675; P < .0001; mean $11 032 vs $1804), followed by mean annual inpatient and medication costs, which were $10 879 vs $1015 (P < .001) and $6801 vs $428 (P < .001), respectively. Total annual direct medical costs were ∼42% greater for Medicaid-insured patients with PWS than their commercially insured counterparts, an increase partly explained by claims for Medicaid Waiver day and residential habilitation. CONCLUSION Direct medical resource utilization was considerably greater among patients with PWS than members without the condition. This study provides a first step toward quantifying the financial burden of PWS posed to individuals, families, and society.
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Affiliation(s)
| | | | | | | | | | - Theresa V Strong
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Jennifer L Miller
- Division of Pediatric Endocrinology, University of Florida College of Medicine, Gainesville, FL
| | - Diane E Stafford
- Division of Endocrinology, Harvard Medical School, Boston Children's Hospital, Boston, MA
| | - Merlin G Butler
- Division of Research and Genetics, Departments of Psychiatry & Behavioral Sciences and Pediatrics, Kansas University Medical Center, Kansas City, KS
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Basheer R, Jalal MJA, Gomez R. An unusual case of adolescent type 2 diabetes mellitus: Prader-Willi syndrome. J Family Med Prim Care 2016; 5:181-3. [PMID: 27453871 PMCID: PMC4943134 DOI: 10.4103/2249-4863.184661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder, characterized by neonatal hypotonia, developmental delay, short stature, childhood obesity, hypogonadism, and characteristic facial features. Here we report a 21-year-old male who presented with uncontrolled glycemic status. He was diagnosed to have diabetes mellitus at the age of 15 with osmotic symptoms - polyuria, polydipsia, and polyphagia. In the early period, after diagnosis, his blood sugars were reasonably controlled with oral hypoglycemic agents. However, a year back, he was switched onto insulin therapy due to secondary OHA failure. On examination, his body mass index was 36 kg/m(2). He had bilateral gynecomastia, decreased biparietal diameter, almond shaped eyes with esotropia. He had hypogonadism and also had mild cognitive impairment. He did not have any proximal myopathy or other focal neurological deficits. Hormonal evaluation showed low testosterone and inappropriately normal fluorescence in situ hybridization suggestive of central hypogonadism. With fetal and neonatal hypotonia, delayed developmental milestones, hypogonadism, and early onset diabetes, he fulfilled the clinical criteria for the diagnosis of PWS. Multidisciplinary approach of clinicians together with family and social support are essential to bring out the optimal outcome for such syndromic cases.
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Affiliation(s)
- Riyas Basheer
- Department of Family Medicine, Lakeshore Hospital and Research Centre, Ernakulam, Kerala, India
| | | | - Ramesh Gomez
- Department of Endocrinology, Lakeshore Hospital and Research Centre, Ernakulam, Kerala, India
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McVea S, Thompson AJ, Abid N, Richardson J. Thermal dysregulation in Prader-Willi syndrome: a potentially fatal complication in adolescence, not just in infancy. BMJ Case Rep 2016; 2016:bcr-2016-215344. [PMID: 27358096 DOI: 10.1136/bcr-2016-215344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 13-year-old boy with a background of Prader-Willi syndrome (PWS) was admitted to the regional paediatric intensive care unit, with community-acquired pneumonia. Despite a week of intravenous antibiotics, resolution of inflammatory markers and resolving consolidation on radiograph, he remained feverish. Fever of unknown origin investigations were negative and he was diagnosed with central thermal dysregulation secondary to hypothalamic dysfunction in PWS. Following a hyperpyrexia period, secondary rhabdomyolysis and renal failure developed. This was successfully managed with active cooling, ventilation and haemofiltration. After weaning from haemofiltration, the patient was successfully extubated to non-invasive respiratory support.
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Affiliation(s)
- Steven McVea
- Royal Belfast Hospital for Sick Children, Belfast, UK
| | | | - Noina Abid
- Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Julie Richardson
- Paediatric Intensive Care Unit, The Royal Belfast Hospital For Sick Children, Belfast, UK
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Di Lorenzo R, Sberveglieri S, Marrama D, Landi G, Ferri P. Weight control and behavior rehabilitation in a patient suffering from Prader Willi syndrome. BMC Res Notes 2016; 9:199. [PMID: 27036220 PMCID: PMC4818533 DOI: 10.1186/s13104-016-1981-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 03/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study reports a case of Prader Willi syndrome (PWS), a genomic imprinting disease related to chromosome regions 15q11.2-q13 15, which includes hypothalamic dysfunction leading to hyperphagia, obesity, shortness, sleep abnormalities. Our case is extremely severe, in comparison to other PWS cases described in literature, due to the association with severe emotional and psychiatric symptoms: oppositional behaviour, rigidity of thought, skin picking and pathological hoarding. CASE PRESENTATION We described the case of a Caucasian male patient suffering from PWS, treated in outpatient care by local Mental Health Centre and supported by Social Service, who was admitted to a residential rehabilitative facility. After a 2-year follow-up, the patient showed a global improvement in symptoms and functioning, as registered by the rating scales administered. At the end of observation period, we also reported an important improvement in weight control, reducing the risk of obesity and related diseases, therefore improving the prognosis of life. CONCLUSION This case highlights the need for long-term, individualized and multi-professional treatment in patients suffering from a complex genetic syndrome with both organic and psychological alterations, for which medical care setting and pharmacological treatments are not sufficient. Clinical observation of this case leads us to compare PWS to drug addiction and indirectly endorse the neurophysiological hypothesis that food and drugs stimulate the same brain circuits in the limbic system.
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Affiliation(s)
- Rosaria Di Lorenzo
- />Psychiatrist, SPDC, Department of Mental Health, Az-USL-Modena, Via P. Giardini, 1355 Baggiovara, 41126 Modena, Italy
| | - Sara Sberveglieri
- />Registered Nurse, School of Nursing, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
| | - Donatella Marrama
- />Psychiatrist, Outpatient Care Service, Department of Mental Health, Az-USL-Modena, Via I. Newton, 150, 41121 Modena, Italy
| | - Giulia Landi
- />Resident in Psychiatry, School of Psychiatry, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
| | - Paola Ferri
- />Nurse Researcher, School of Nursing, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
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Johnson L, Manzardo AM, Miller JL, Driscoll DJ, Butler MG. Elevated plasma oxytocin levels in children with Prader-Willi syndrome compared with healthy unrelated siblings. Am J Med Genet A 2015; 170:594-601. [PMID: 26615966 DOI: 10.1002/ajmg.a.37488] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/05/2015] [Indexed: 11/07/2022]
Abstract
Prader-Willi syndrome (PWS) is a rare genetic disorder associated with distinct abnormal behaviors including hyperphagia, profound social deficits, and obsessive-compulsive tendencies. PWS males showed reduced oxytocin receptor (OTR) gene expression and density in the hypothalamic paraventricular nucleus that may play a role in PWS psychopathology. Oxytocin is an anorexigenic neuropeptide similar to vasopressin that is associated with social cognition and obsessive-compulsive behavior. To evaluate oxytocin biology in PWS, we examined overnight fasting plasma oxytocin levels in 23 children with PWS (mean ± SD age: 8.2 ± 2.0 year) having genetic confirmation and 18 age matched healthy unrelated siblings without PWS (mean ± SD age: 8.2 ± 2.3 year) and a similar gender ratio under the same clinical assessments, specimen processing and laboratory conditions. Multiplex immune assays were carried out using the Milliplex Human Neuropeptide Magnetic panel and the Luminex system. Natural log-transformed oxytocin levels were analyzed using general linear model adjusting for diagnosis, gender, age and body mass index (BMI). Oxytocin plasma levels were significantly elevated in children with PWS (168 ± 121 pg/ml) compared with unrelated and unaffected siblings without the diagnosis of PWS (64.8 ± 83.8 pg/ml, F = 8.8, P < 0.01) and the diagnosis of PWS predicted oxytocin level (F = 9.5, P < 0.003) in controlled regression analysis with an overall model fit R(2) = 0.33 (P < 0.01). The symptoms of hyperphagia, anxiety and repetitive behaviors classically seen in PWS may be related to the disruption of oxytocin responsivity or feedback in the hypothalamic paraventricular nucleus possibly influencing vasopressin signaling. Further study is needed to characterize oxytocin function in PWS.
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Affiliation(s)
- Lisa Johnson
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
| | - Ann M Manzardo
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer L Miller
- Department of Pediatrics, University of Florida Medical Center, Gainesville, Florida
| | - Daniel J Driscoll
- Department of Pediatrics, University of Florida Medical Center, Gainesville, Florida
| | - Merlin G Butler
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
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Tvrdik T, Mason D, Dent KM, Thornton L, Hornton SN, Viskochil DH, Stevenson DA. Stress and coping in parents of children with Prader-Willi syndrome: Assessment of the impact of a structured plan of care. Am J Med Genet A 2015; 167A:974-82. [PMID: 25755074 DOI: 10.1002/ajmg.a.36971] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/29/2014] [Indexed: 01/12/2023]
Abstract
Hyperphagia, developmental delays, and maladaptive behaviors are common in Prader-Willi syndrome (PWS) likely resulting in heightened parental stress. Objectives were to evaluate stress, describe usefulness of coping behaviors, and assess the impact of a structured Plan of Care (PC) on parents with children with PWS. Parents answered Perceived Stress Scale (PSS-14), Coping Health Inventory for Parents (CHIP), and narrative/demographic surveys. The PC was introduced to a cohort of parents after completion of the PSS-14 and CHIP and re-administered 4-6 month after the introduction of the PC. Higher parental stress (n = 57) was observed compared to the general population, and associated with parent's age, number of children living at home, and child's age and residential setting. "Maintaining family integration, cooperation, and an optimistic definition of the situation" was the most useful coping pattern. Thirty-eight parents answered the PSS-14 and CHIP after the PC. Parental stress decreased after the PC (P = 0.035). Coping behaviors related to "maintaining family integration" increased after the PC (P = 0.042). Women and men preferred different coping patterns before and after the PC. In conclusion, parental stress is increased in PWS, and a PC decreased stress and increased coping behaviors related to family stability for parents with children with PWS.
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Affiliation(s)
- Tatiana Tvrdik
- Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, Utah
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Prevalence of Prader-Willi syndrome among infants with hypotonia. J Pediatr 2014; 164:1064-7. [PMID: 24582009 DOI: 10.1016/j.jpeds.2014.01.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 12/23/2013] [Accepted: 01/17/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate the prevalence of Prader-Willi syndrome (PWS) in infants with hypotonia between the ages of 0 and 2 years. STUDY DESIGN Karyotyping studies were performed in all infants with hypotonia. The study group was composed of infants with hypotonia for whom the karyotyping was found to be normal. Fluorescence in situ hybridization and methylation analysis were performed simultaneously in the study group. Molecular studies for uniparental disomy were undertaken in the patients without deletions with an abnormal methylation pattern. RESULTS Sixty-five infants with hypotonia with a mean age of 8 months were enrolled. A deletion was detected in 6 patients by fluorescence in situ hybridization analysis. Only 1 patient had no deletion but had an abnormal methylation pattern. A maternal uniparental disomy was observed in this patient. PWS was diagnosed in 10.7 % (7/65) of the infants with hypotonia. CONCLUSION The prevalence of PWS syndrome is high among infants with hypotonia. PWS should be considered by pediatricians and neonatologists in the differential diagnosis of all newborns with hypotonia. Early diagnosis of PWS is important for the management of these patients.
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Does an Association between the Idiopathic Left-Sided Varicocele and Eye Colour Exist? Adv Urol 2014; 2014:524570. [PMID: 24803926 PMCID: PMC3997988 DOI: 10.1155/2014/524570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 11/17/2022] Open
Abstract
The possible interrelation between male reproductive disorders and iris pigmentation is poorly understood. We have found a link between eye colour and the existence of adolescent varicocele. Therefore, we aimed to extend our investigation on the relationship between the eye colour and varicocele in adult men. 231 andrology outpatients from Caucasian origin were included in the study. The presence of varicocele, sperm disturbances, and the iris pigment of the patients were investigated. Left-sided varicocele was found in 93 adults. In the group of light-eyed men the prevalence of varicocele was significantly lower than among the dark-eyed men (15% versus 59.5%, P < 0.001). No associations were found between the eye colour and disturbances in semen parameters in males with varicocele (P = 0.419) and in those without varicocele (P = 0.586). The present results in adult men suggest that the prevalence of varicocele could be associated with the iris pigment. A possible genetic linkage between the eye colour and the susceptibility to some disorders like varicocele could not be excluded. However, the iris pigmentation seems not to have a direct relationship with the sperm disturbances.
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Nair A, Kishore S, Gupta R, Sharma A, Jyotsna VP. An obese young man with uncontrolled diabetes and insatiable hunger: Prader-Willi syndrome. Indian J Endocrinol Metab 2013; 17:S680-S682. [PMID: 24910837 PMCID: PMC4046591 DOI: 10.4103/2230-8210.123566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a rare cause of obesity. With the rising incidence of obesity, clinicians need to be aware of genetic causes of obesity and when to suspect them. A case of PWS, which was diagnosed in adulthood, has been discussed. This case is special because of lack of history of floppiness in infancy and predominance behavioral problems.
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Affiliation(s)
- Abilash Nair
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Shyam Kishore
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ranjan Gupta
- Department of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - A Sharma
- Department of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - V P Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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