1
|
Pluta N, von Moers A, Pechmann A, Stenzel W, Goebel HH, Atlan D, Wolf B, Nanda I, Zaum AK, Rost S. Whole-Genome Sequencing Identified New Structural Variations in the DMD Gene That Cause Duchenne Muscular Dystrophy in Two Girls. Int J Mol Sci 2023; 24:13567. [PMID: 37686372 PMCID: PMC10488134 DOI: 10.3390/ijms241713567] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Dystrophinopathies are the most common muscle diseases, especially in men. In women, on the other hand, a manifestation of Duchenne muscular dystrophy is rare due to X-chromosomal inheritance. We present two young girls with severe muscle weakness, muscular dystrophies, and creatine kinase (CK) levels exceeding 10,000 U/L. In the skeletal muscle tissues, dystrophin staining reaction showed mosaicism. The almost entirely skewed X-inactivation in both cases supported the possibility of a dystrophinopathy. Despite standard molecular diagnostics (including multiplex ligation-dependent probe amplification (MLPA) and next generation sequencing (NGS) gene panel sequencing), the genetic cause of the girls' conditions remained unknown. However, whole-genome sequencing revealed two reciprocal translocations between their X chromosomes and chromosome 5 and chromosome 19, respectively. In both cases, the breakpoints on the X chromosomes were located directly within the DMD gene (in introns 54 and 7, respectively) and were responsible for the patients' phenotypes. Additional techniques such as Sanger sequencing, conventional karyotyping and fluorescence in situ hybridization (FISH) confirmed the disruption of DMD gene in both patients through translocations. These findings underscore the importance of accurate clinical data combined with histopathological analysis in pinpointing the suspected underlying genetic disorder. Moreover, our study illustrates the viability of whole-genome sequencing as a time-saving and highly effective method for identifying genetic factors responsible for complex genetic constellations in Duchenne muscular dystrophy (DMD).
Collapse
Affiliation(s)
- Natalie Pluta
- Department of Human Genetics, University of Würzburg, 97074 Würzburg, Germany
| | - Arpad von Moers
- Department of Pediatrics and Neuropediatrics, DRK Kliniken Berlin, 14050 Berlin, Germany
| | - Astrid Pechmann
- Department of Neuropediatrics and Muscle Disorders, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Werner Stenzel
- Department of Neuropathology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, 10117 Berlin, Germany
| | - Hans-Hilmar Goebel
- Department of Neuropathology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, 10117 Berlin, Germany
| | | | - Beat Wolf
- iCoSys, University of Applied Sciences Western Switzerland, 1700 Fribourg, Switzerland
| | - Indrajit Nanda
- Department of Human Genetics, University of Würzburg, 97074 Würzburg, Germany
| | - Ann-Kathrin Zaum
- Department of Human Genetics, University of Würzburg, 97074 Würzburg, Germany
| | - Simone Rost
- Department of Human Genetics, University of Würzburg, 97074 Würzburg, Germany
- Medical Genetics Center (MGZ), 80335 Munich, Germany
| |
Collapse
|
2
|
Bakhshandeh M, Behroozi S, Ghorbani A. Next-generation sequencing approach to molecular diagnosis of Iranian patients with Duchenne/Becker muscular dystrophy: Several novel variants identified. eNeurologicalSci 2023; 30:100446. [PMID: 36845278 PMCID: PMC9945705 DOI: 10.1016/j.ensci.2023.100446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/11/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) constitute the second most prevalent muscular dystrophy, with large deletions or duplications accounting for 66% of cases. No effective treatment exists for DMD/BMD. At present, genetic diagnosis serves as the foundation for gene therapy treatments. In this study, a comprehensive molecular investigation was conducted. The subjects diagnosed with DMD/BMD were initially examined using multiplex ligation-dependent probe amplification (MLPA) technology. The negative MLPA results were analyzed further using next-generation sequencing (NGS) technology. The MLPA detected 201 deletions (65.9%) and 20 duplications (6.6%) along the dystrophin gene among the 305 Iranian patients examined. The deletion of exon 52 in the amenable skipping subgroup was associated with an earlier onset age and a more severe phenotype. Twenty-one of the small mutations found in 58 MLPA-negative patients were novel. The most prevalent variants were nonsense variants (46.5%), frameshift variants (31%), splicing variants (6.9%), missense variants (10.4%), and synonymous mutations (5.1%). Our results demonstrate that MLPA and NGS can be effective diagnostic tools for very young patients with a single exon deletion.
Collapse
Affiliation(s)
- MohammadKazem Bakhshandeh
- Hakim Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author.
| | - Samira Behroozi
- Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran
| | | |
Collapse
|
3
|
Weber FJ, Latshang TD, Blum MR, Kohler M, Wertli MM. Prognostic factors, disease course, and treatment efficacy in Duchenne muscular dystrophy: A systematic review and meta-analysis. Muscle Nerve 2022; 66:462-470. [PMID: 35860996 PMCID: PMC9804574 DOI: 10.1002/mus.27682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/10/2022] [Accepted: 07/17/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION/AIMS Prognostic factors in Duchenne muscular dystrophy (DMD) predict the disease course and may help individualize patient care. The aim was to summarize the evidence on prognostic factors that may support treatment decisions. METHODS We searched six databases for prospective studies that each included ≥50 DMD patients with a minimum follow-up of 1 y. Primary outcomes were age at loss of ambulation (LoA), pulmonary function (forced vital capacity percent of predicted, FVC%p), and heart failure. RESULTS Out of 5074 references, 59 studies were analyzed. Corticosteroid use was associated with a delayed LoA (pooled effect hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.23-0.75, I2 94%), better pulmonary function tests (higher peak FVC%, prolonged time with FVC%p > 50%, and reduced need for assisted ventilation) and delayed cardiomyopathy. Longer corticosteroid treatment was associated with later LoA (>1 y compared to <1 y; pooled HR: 0.50, 95% CI 0.27-0.90) and early treatment start (aged <5 y) may be associated with early cardiomyopathy and higher fracture risk. Genotype appeared to be an independent driver of LoA in some studies. Higher baseline physical function tests (e.g., 6-minute walk test) were associated with delayed LoA. Left ventricular dysfunction and FVC <1 L increased and the use of angiotensin-converting enzyme (ACE) inhibitors reduced the risk of heart failure and death. Fusion surgery in scoliosis may potentially preserve pulmonary function. DISCUSSION Prognostic factors that may inform clinical decisions include age at corticosteroid treatment initiation and treatment duration, ACE-inhibitor use, baseline physical function tests, pulmonary function, and cardiac dysfunction.
Collapse
Affiliation(s)
- Fabio J Weber
- Sleep Disorders Center and Pulmonary Division, University Hospital Zurich, Zurich, Switzerland
| | - Tsogyal D Latshang
- Sleep Disorders Center and Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.,Sleep Disorders Center and Pulmonary Division, Kantonsspital Graubuenden, Chur, Switzerland
| | - Manuel R Blum
- Department of General Internal Medicine, University Hospital Bern, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Malcolm Kohler
- Sleep Disorders Center and Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.,Zurich Center for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| | - Maria M Wertli
- Department of General Internal Medicine, University Hospital Bern, University of Bern, Bern, Switzerland.,Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| |
Collapse
|
4
|
Almeida-Becerril T, Rodríguez-Cruz M, Hernández-Cruz SY, Ruiz-Cruz ED, Mendoza CRS, Cárdenas-Conejo A, Escobar-Cedillo RE, Ávila-Moreno F, Aquino-Jarquin G. Natural history of circulating miRNAs in Duchenne disease: Association with muscle injury and metabolic parameters. Acta Neurol Scand 2022; 146:512-524. [PMID: 36000352 DOI: 10.1111/ane.13673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This study aimed to evaluate whether the expression of circulating dystromiRs and a group of oxidative stress-related (OS-R) miRNAs is associated with muscle injury and circulating metabolic parameters in Duchenne muscular dystrophy (DMD) patients. METHODS Twenty-four DMD patients were included in this cross-sectional study. Clinical scales to evaluate muscle injury (Vignos, GMFCS, Brooke, and Medical Research Council), enzymatic muscle injury parameters (CPK, ALT, and AST), anthropometry, metabolic indicators, physical activity, serum dystromiRs (miR-1-3p, miR-133a-3p, and miR-206), and OS-R miRNAs (miR-21-5p, miR-31-5p, miR-128-3p, and miR-144-3p) levels were measured in ambulatory and non-ambulatory DMD patients. RESULTS DystromiRs (except miR-1-3p) and miRNAs OS-R levels were lower (p-value <.05) in the non-ambulatory group than the ambulatory group. The expression of those miRNAs correlated with Vignos scale score (For instance, rho = -0.567, p-value <0.05 for miR-21-5p) and with other scales scores of muscle function and strength. CPK, AST, and ALT concentration correlated with expression of all miRNAs (For instance, rho = 0.741, p-value <.05 between miR-206 level and AST concentration). MiR-21-5p level correlated with glucose concentration (rho = -0.369, p-value = .038), and the miR-1-3p level correlated with insulin concentration (rho = 0.343, p-value = .05). CONCLUSIONS Non-ambulatory DMD patients have lower circulating dystromiRs and OS-R miRNAs levels than ambulatory DMD patients. The progressive muscle injury is associated with a decrease in the expression of those miRNAs, evidencing DMD progress. These findings add new information about the natural history of DMD.
Collapse
Affiliation(s)
- Tomas Almeida-Becerril
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund, Centro Médico Nacional Siglo XXI (CMN-SXXI), Instituto Mexicano del Seguro Social (IMSS), Mexico City (CDMX), Mexico.,Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México (UNAM), CDMX, Mexico
| | - Maricela Rodríguez-Cruz
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund, Centro Médico Nacional Siglo XXI (CMN-SXXI), Instituto Mexicano del Seguro Social (IMSS), Mexico City (CDMX), Mexico
| | - Sthephanie Yannín Hernández-Cruz
- Laboratorio de Nutrición Molecular, Unidad de Investigación Médica en Nutrición, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund, Centro Médico Nacional Siglo XXI (CMN-SXXI), Instituto Mexicano del Seguro Social (IMSS), Mexico City (CDMX), Mexico
| | - Eugenia Dolores Ruiz-Cruz
- Departamento de Genética, Unidad Médica de Alta Especialidad Hospital General "Dr. Gaudencio González Garza", Centro Médico Nacional La Raza, IMSS, CDMX, Mexico
| | - Christian Ricardo Sánchez Mendoza
- Departamento de Genética, Unidad Médica de Alta Especialidad Hospital General "Dr. Gaudencio González Garza", Centro Médico Nacional La Raza, IMSS, CDMX, Mexico
| | - Alan Cárdenas-Conejo
- Departamento de Genética Médica, Hospital de Pediatría "Dr. Silvestre Frenk Freund", CMN-Siglo XXI, IMSS, CDMX, Mexico
| | | | - Federico Ávila-Moreno
- Lung Diseases Laboratory 12, Biomedicine Research Unit (UBIMED), Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, Estado de México, Mexico
| | - Guillermo Aquino-Jarquin
- Laboratorio de Investigación en Genómica, Genética y Bioinformática, Hospital Infantil de México "Federico Gómez", CDMX, Mexico
| |
Collapse
|
5
|
Seated Outcome Measures in Children With Duchenne Muscular Dystrophy. Pediatr Phys Ther 2022; 34:375-380. [PMID: 35653235 DOI: 10.1097/pep.0000000000000916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Quantifiable motor strength measures to assess disease severity throughout the continuum of Duchenne muscular dystrophy (DMD) are needed. To study the feasibility of seated trunk strength using hand-held dynamometry (HHD) and caregiver-reported subjective functional independence measures in boys with DMD. METHODS Prospective, cross-sectional, observational study of 18 participants with DMD enrolled from pediatric muscular dystrophy clinic during routine clinical assessment. Hand-held dynamometry, seated reach distance test and Pediatric Evaluation of Disability Inventory (PEDI) were administered. RESULTS All study participants regardless of the walking status were able to complete the seated function tests demonstrating feasibility. The age of the participants correlated negatively with PEDI mobility and positively with HHD extension scores. The seated measures did not statistically correlate with PEDI mobility scores. CONCLUSIONS Seated motor strength measures and PEDI mobility scores are feasible. The PEDI mobility and HHD extension scores correlate with age. Study limitations included single-center experience and cross-sectional data. VIDEO ABSTRACT LINK https://www.dropbox.com/s/s4r0k7o6s0tfbkb/PT-Seated-Measures-And-DMD-2022.mp4?dl=0.
Collapse
|
6
|
Bora M, Yalçin A, Bulut N, Yilmaz Ö, Karaduman A, Topuz S, Alemdaroğlu-Gürbüz İ. Investigation of surface electromyography amplitude values during stair climbing task in children with Duchenne muscular dystrophy. Neurol Sci 2021; 43:2791-2801. [PMID: 34608577 DOI: 10.1007/s10072-021-05643-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aims of this study were (a) to examine the surface electromyography (sEMG) amplitude values of the lower limb muscles during stair climbing both between different functional levels of Duchenne muscular dystrophy (DMD), in comparison with healthy children, and (b) to investigate the relationships between sEMG amplitudes and physical performance. METHODS sEMG amplitudes of the lower limbs of twenty-one children with DMD between levels I and III according to the Brooke Lower Extremity Functional Classification Scale and eleven healthy peers were evaluated by using sEMG during stair climbing task. Physical performance was evaluated by 6-min walk test and ascending 4-step timed performance test. RESULTS The lower limb sEMG amplitude values of children with DMD were statistically higher than healthy children (p < 0.001). sEMG amplitudes of the right (p = 0.01) and left (p = 0.003) biceps femoris, the right (p < 0.001) and left (p = 0.001) gastrocnemius medialis, and the right vastus lateralis (p = 0.02) muscles were higher in children with levels 2-3 than those in level 1. Moderate-to-strong relations were found between the gastrocnemius medialis and biceps femoris sEMG amplitudes and physical performance assessments (p < 0.05). CONCLUSION Increased sEMG amplitude values in the lower limbs during stair climbing task are thought to be caused by the effort to compensate for progressive muscle weakness and are associated with lower physical performance in children with DMD. Further, sEMG amplitude values are determined to increase as the functional level deteriorates. CLINICAL TRIAL REGISTRATION NUMBER AND URL NCT04287582 ( https://clinicaltrials.gov/ct2/show/NCT04287582?term=merve+bora&draw=2&rank=1 ).
Collapse
Affiliation(s)
- Merve Bora
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Ali Yalçin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Numan Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Öznur Yilmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - Ayşe Karaduman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Sogutozu, 06510, Çankaya/Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey
| | - İpek Alemdaroğlu-Gürbüz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Talatpaşa Bulvarı, 06100, Altındağ/Ankara, Turkey.
| |
Collapse
|
7
|
Lasa-Fernandez H, Mosqueira-Martín L, Alzualde A, Lasa-Elgarresta J, Vallejo-Illarramendi A. A genotyping method combining primer competition PCR with HRM analysis to identify point mutations in Duchenne animal models. Sci Rep 2020; 10:17224. [PMID: 33057138 PMCID: PMC7560699 DOI: 10.1038/s41598-020-74173-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/28/2020] [Indexed: 11/09/2022] Open
Abstract
Dystrophin-null sapje zebrafish is an excellent model for better understanding the pathological mechanisms underlying Duchenne muscular dystrophy, and it has recently arisen as a powerful tool for high-throughput screening of therapeutic candidates for this disease. While dystrophic phenotype in sapje larvae can be easily detected by birefringence, zebrafish genotyping is necessary for drug screening experiments, where the potential rescue of larvae phenotype is the primary outcome. Genotyping is also desirable during colony husbandry since heterozygous progenitors need to be selected. Currently, sapje zebrafish are genotyped through techniques involving sequencing or multi-step PCR, which are often costly, tedious, or require special equipment. Here we report a simple, precise, cost-effective, and versatile PCR genotyping method based on primer competition. Genotypes can be resolved by standard agarose gel electrophoresis and high-resolution melt assay, the latter being especially useful for genotyping a large number of samples. Our approach has shown high sensitivity, specificity, and reproducibility in detecting the A/T point mutation in sapje zebrafish and the C/T mutation in the mdx mouse model of Duchenne. Hence, this method can be applied to other single nucleotide substitutions and may be further optimized to detect small insertions and deletions. Given its robust performance with crude DNA extracts, our strategy may be particularly well-suited for detecting single nucleotide variants in poor-quality samples such as ancient DNA or DNA from formalin-fixed, paraffin-embedded material.
Collapse
Affiliation(s)
- Haizpea Lasa-Fernandez
- Group of Neurosciences, Dept. Pediatrics, University of the Basque Country UPV/EHU, Hospital Universitario Donostia, Paseo Dr. Begiristain 105, 20014, San Sebastián, Spain
- Group of Neuromuscular Diseases, Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain
- CIBERNED, Instituto de Salud Carlos III, 28031, Madrid, Spain
| | - Laura Mosqueira-Martín
- Group of Neurosciences, Dept. Pediatrics, University of the Basque Country UPV/EHU, Hospital Universitario Donostia, Paseo Dr. Begiristain 105, 20014, San Sebastián, Spain
- Group of Neuromuscular Diseases, Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain
- CIBERNED, Instituto de Salud Carlos III, 28031, Madrid, Spain
| | | | - Jaione Lasa-Elgarresta
- Group of Neurosciences, Dept. Pediatrics, University of the Basque Country UPV/EHU, Hospital Universitario Donostia, Paseo Dr. Begiristain 105, 20014, San Sebastián, Spain
- Group of Neuromuscular Diseases, Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain
- CIBERNED, Instituto de Salud Carlos III, 28031, Madrid, Spain
| | - Ainara Vallejo-Illarramendi
- Group of Neurosciences, Dept. Pediatrics, University of the Basque Country UPV/EHU, Hospital Universitario Donostia, Paseo Dr. Begiristain 105, 20014, San Sebastián, Spain.
- Group of Neuromuscular Diseases, Biodonostia Health Research Institute, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain.
- CIBERNED, Instituto de Salud Carlos III, 28031, Madrid, Spain.
| |
Collapse
|
8
|
Natural History of Serum Enzyme Levels in Duchenne Muscular Dystrophy and Implications for Clinical Practice. Am J Phys Med Rehabil 2020; 99:1121-1128. [PMID: 32520799 DOI: 10.1097/phm.0000000000001500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In Duchenne muscular dystrophy, creatine kinase and transaminases are released into the circulation, indicating muscle injury. Their usefulness in monitoring muscle injury or disease progression has not yet been fully evaluated. Thus, this study examined serum creatine kinase and transaminase concentrations at different ages in patients with Duchenne muscular dystrophy and evaluated their association with muscle injury. DESIGN This is a prospective cohort study that included 110 patients with Duchenne muscular dystrophy categorized by age groups. Creatine kinase and transaminases were quantified in the serum; the Vignos scale evaluated the muscle function. RESULTS Creatine kinase and transaminase levels were higher in ambulatory than that in nonambulatory patients, which significantly decreased as age increased. Serum creatine kinase and transaminase concentrations were elevated in all ages, and those aged 3-4 yrs had the highest concentrations. Age and Vignos Scale were significantly correlated with creatine kinase and transaminase concentrations. Age, creatine kinase, and transaminases explained the 42.5% of loss of muscle function. CONCLUSIONS This study added the knowledge on the natural history of Duchenne muscular dystrophy at different ages and confirmed that creatine kinase and transaminases decrease with age and loss of muscle function, making them generally inappropriate for monitoring response to therapy, although they are useful for the clinical diagnosis.
Collapse
|
9
|
Winters KV, Reynaud O, Novikov DS, Fieremans E, Kim SG. Quantifying myofiber integrity using diffusion MRI and random permeable barrier modeling in skeletal muscle growth and Duchenne muscular dystrophy model in mice. Magn Reson Med 2018; 80:2094-2108. [PMID: 29577406 PMCID: PMC6107391 DOI: 10.1002/mrm.27188] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To measure the microstructural changes during skeletal muscle growth and progressive pathologies using the random permeable model with diffusion MRI, and compare findings to conventional imaging modalities such as three-point Dixon and T2 imaging. METHODS In vivo and ex vivo DTI experiments with multiple diffusion times (20-700 ms) were completed on wild-type (n = 22) and muscle-dystrophic mdx mice (n = 8) at various developmental time points. The DTI data were analyzed with the random permeable model framework that provides estimates of the unrestricted diffusion coefficient (D0 ), membrane surface-to-volume ratio (S/V), and membrane permeability (κ). In addition, the MRI experiments included conventional measures, such as tissue fat fractions and T2 relaxation. RESULTS During normal muscle growth between week 4 and week 13, the in vivo S/V, fractional anisotropy, and fat fraction correlated positively with age (ρ = 0.638, 0.664, and 0.686, respectively), whereas T2 correlated negatively (ρ = -0.847). In mdx mice, all DTI random permeable model parameters and fat fraction had significant positive correlation with age, whereas fractional anisotropy and T2 did not have significant correlation with age. Histological measurements of the perimeter-to-area ratio served as a proxy for the model-derived S/V in the cylindrical myofiber geometry, and had a significant correlation with the ex vivo S/V (r = 0.71) as well as the in vivo S/V (r = 0.56). CONCLUSION The present study demonstrates that DTI at multiple diffusion times with the random permeable model analysis allows for noninvasively quantifying muscle fiber microstructural changes during both normal muscle growth and disease progression. Future studies can apply our technique to evaluate current and potential treatments to muscle myopathies.
Collapse
Affiliation(s)
- Kerryanne V. Winters
- Center for Advanced Imaging Innovation and Research (CAIR), New York, NY USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY USA
| | - Olivier Reynaud
- Center for Advanced Imaging Innovation and Research (CAIR), New York, NY USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY USA
| | - Dmitry S. Novikov
- Center for Advanced Imaging Innovation and Research (CAIR), New York, NY USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY USA
| | - Els Fieremans
- Center for Advanced Imaging Innovation and Research (CAIR), New York, NY USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY USA
| | - Sungheon Gene Kim
- Center for Advanced Imaging Innovation and Research (CAIR), New York, NY USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY USA
| |
Collapse
|
10
|
Salzberg DC, Mann JR, McDermott S. Differences in Race and Ethnicity in Muscular Dystrophy Mortality Rates for Males under 40 Years of Age, 2006-2015. Neuroepidemiology 2018; 50:201-206. [PMID: 29698937 DOI: 10.1159/000488244] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/07/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND/AIMS Duchenne Muscular Dystrophy (DMD) has childhood onset, primarily affects males, and is usually fatal before the age of 40 years. Previous studies have indicated that this X-linked condition is more prevalent in whites than in blacks, but those were based on active surveillance, and limited to smaller populations and younger ages. METHODS US death data were used to calculate mortality rates by race and ethnicity, with MD as either the underlying or multiple cause of death (MCD). Poisson approximation was used for confidence intervals; chi-square was used to compare rates. RESULTS From 2006 to 2015, there were 3,256 deaths in males <40 years with MD as MCD, and 71% of these were aged 15-29 years. For whites, the average annual death rate was 0.43/100,000, which was significantly higher (p < 0.0001) that that of blacks (0.28), American Indian/Alaska Natives (0.20), and Asian/Pacific Islanders (0.21). The rate for non-Hispanic whites (0.46) was significantly higher (p < 0.0001) than the rates for Hispanic whites (0.31), Hispanic blacks (0.07), and non-Hispanic blacks (0.29). CONCLUSION Since DMD is the primary cause of deaths in young males with MD, mortality rates are a reasonable proxy for the relative difference in racial prevalence. It appears that DMD is significantly more common in white males than in males of other races.
Collapse
Affiliation(s)
- Deborah C Salzberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Joshua R Mann
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Suzanne McDermott
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
11
|
Voit A, Patel V, Pachon R, Shah V, Bakhutma M, Kohlbrenner E, McArdle JJ, Dell'Italia LJ, Mendell JR, Xie LH, Hajjar RJ, Duan D, Fraidenraich D, Babu GJ. Reducing sarcolipin expression mitigates Duchenne muscular dystrophy and associated cardiomyopathy in mice. Nat Commun 2017; 8:1068. [PMID: 29051551 PMCID: PMC5648780 DOI: 10.1038/s41467-017-01146-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 08/22/2017] [Indexed: 01/16/2023] Open
Abstract
Sarcolipin (SLN) is an inhibitor of the sarco/endoplasmic reticulum (SR) Ca2+ ATPase (SERCA) and is abnormally elevated in the muscle of Duchenne muscular dystrophy (DMD) patients and animal models. Here we show that reducing SLN levels ameliorates dystrophic pathology in the severe dystrophin/utrophin double mutant (mdx:utr -/-) mouse model of DMD. Germline inactivation of one allele of the SLN gene normalizes SLN expression, restores SERCA function, mitigates skeletal muscle and cardiac pathology, improves muscle regeneration, and extends the lifespan. To translate our findings into a therapeutic strategy, we knock down SLN expression in 1-month old mdx:utr -/- mice via adeno-associated virus (AAV) 9-mediated RNA interference. The AAV treatment markedly reduces SLN expression, attenuates muscle pathology and improves diaphragm, skeletal muscle and cardiac function. Taken together, our findings suggest that SLN reduction is a promising therapeutic approach for DMD.
Collapse
Affiliation(s)
- Antanina Voit
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Vishwendra Patel
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Ronald Pachon
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Vikas Shah
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Mohammad Bakhutma
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Erik Kohlbrenner
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Joseph J McArdle
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Louis J Dell'Italia
- Department of Medicine, University of Alabama at Birmingham, and Birmingham VA Medical Center, Birmingham, AL, 35294, USA
| | - Jerry R Mendell
- Department of Pediatrics and Department of Neurology, Ohio State University Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Lai-Hua Xie
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Roger J Hajjar
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Dongsheng Duan
- Department of Molecular Microbiology and Immunology, Neurology, Bioengineering, Biomedical Sciences, The University of Missouri, Columbia, MO, 65212, USA
| | - Diego Fraidenraich
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | - Gopal J Babu
- Department of Cell Biology and Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA.
| |
Collapse
|
12
|
Bendixen RM, Houtrow A. Parental Reflections on the Diagnostic Process for Duchenne Muscular Dystrophy: A Qualitative Study. J Pediatr Health Care 2017; 31:285-292. [PMID: 27743907 PMCID: PMC5389929 DOI: 10.1016/j.pedhc.2016.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/09/2016] [Accepted: 09/10/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Duchenne muscular dystrophy (DMD) is a rare neuromuscular disease with no known cure. We sought to update over 30 years of research reporting on the diagnostic delays in DMD. METHODS Through personal interviews, this study qualitatively explored parents' experiences regarding receipt of the DMD diagnosis and the guidance for care provided. Thematic analysis identified themes and provided answers to the research questions being addressed. RESULTS Four themes emerged: (a) Dismissive illustrates little consideration of parent concern in the diagnostic process; (b) Limited Knowledge describes misunderstandings about clinical signs, recommended screenings, and testing to achieve a diagnosis of DMD; (c) Careless Delivery reports on the manner in which the diagnosis was given; and (d) Lack of Guidance describes the follow-up that occurred after the diagnosis. CONCLUSION Despite marked medical progress over the past several decades, substantial barriers to arriving at the diagnosis of DMD and the provision of care guidance remain.
Collapse
Affiliation(s)
| | - Amy Houtrow
- University of Pittsburgh Medical Center, Pittsburgh, PA
| |
Collapse
|
13
|
Bertrand LA, Askeland EJ, Mathews KD, Erickson BA, Cooper CS. Prevalence and bother of patient-reported lower urinary tract symptoms in the muscular dystrophies. J Pediatr Urol 2016; 12:398.e1-398.e4. [PMID: 27567595 DOI: 10.1016/j.jpurol.2016.04.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/14/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Duchenne muscular dystrophy (DMD) and the less severe Becker muscular dystrophy (BMD) are characterized by progressive muscle weakness and eventual loss of ambulation, and result from mutations in the dystrophin gene. Dystrophin is essential for skeletal muscle functioning but its role in smooth muscle function is not as well established. In a retrospective review, our group previously demonstrated that roughly half of these patients have at least one documented urologic diagnosis, most commonly being lower urinary tract symptoms (LUTS) and nephrolithiasis. To better understand the frequency of LUTS and the degree to which they impact quality of life in this patient population, we performed a cross-sectional evaluation. METHODS AND MATERIALS Following IRB approval, a survey modified from multiple validated surveys was distributed to DMD and BMD patients. The survey contained questions derived from multiple validated questionnaires, including the American Urological Association Symptom Score and the Dysfunctional Voiding Symptoms Score, which assessed both the frequency of lower urinary tract symptoms (i.e. urinary urgency, frequency, enuresis, dysuria, and bowel function) as well as how bothersome patients found these symptoms. RESULTS Of the 56 respondents (mean age 15.3; range 4-33), 40 (71.4%) reported at least one LUTS, most commonly urgency (n = 31, 55%) and hesitancy of stream (n = 32, 57%) (Figure). Although the majority of the patients reported being happy with their symptoms, 16% (n = 9) expressed dissatisfaction. We did not find any correlation between LUTS and disease progression, as measured by years non-ambulatory, on chi-square analysis. CONCLUSIONS In this cross-sectional study of the frequency and degree of bother of LUTS in D/BMD patients, we found that a high percentage experience LUTS. Despite this high prevalence, the majority report that they are not especially bothered by these symptoms; however, over 16% express dissatisfaction with their current LUTS. With this patient population now living longer, this may become even more prevalent. Screening for bothersome LUTS in patients with DMD and BMD should be a part of disease management, with appropriate treatment or referral to a urologist for those bothered by their symptoms to positively impact their quality of life.
Collapse
Affiliation(s)
| | - Eric J Askeland
- Department of Urology, University of Iowa, Iowa City, IA, USA
| | | | | | | |
Collapse
|
14
|
Begam M, Abro VM, Mueller AL, Roche JA. Sodium 4-phenylbutyrate reduces myofiber damage in a mouse model of Duchenne muscular dystrophy. Appl Physiol Nutr Metab 2016; 41:1108-1111. [PMID: 27628198 DOI: 10.1139/apnm-2016-0173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We performed a placebo-controlled pre-clinical study to determine if sodium 4-phenylbutyrate (4PB) can reduce contraction-induced myofiber damage in the mdx mouse model of Duchenne muscular dystrophy (DMD). At 72 h post-eccentric contractions, 4PB significantly increased contractile torque and reduced myofiber damage and macrophage infiltration. We conclude that 4PB, which is approved by Health Canada (Pheburane) and the United States Food and Drug Administration (Buphenyl) for urea cycle disorders, might modify disease severity in patients with DMD.
Collapse
Affiliation(s)
- Morium Begam
- a Department of Health Care Sciences, Physical Therapy Program, Wayne State University, 259 Mack Ave., Rm. 4440, Detroit, MI 48201, USA
| | - Valerie M Abro
- a Department of Health Care Sciences, Physical Therapy Program, Wayne State University, 259 Mack Ave., Rm. 4440, Detroit, MI 48201, USA
| | - Amber L Mueller
- b Program in Molecular Medicine, University of Maryland School of Medicine, 685 W. Baltimore St., Rm. 580, Baltimore, MD 21201, USA
| | - Joseph A Roche
- a Department of Health Care Sciences, Physical Therapy Program, Wayne State University, 259 Mack Ave., Rm. 4440, Detroit, MI 48201, USA
| |
Collapse
|
15
|
Smith SJ, Horstick EJ, Davidson AE, Dowling J. Analysis of Zebrafish Larvae Skeletal Muscle Integrity with Evans Blue Dye. J Vis Exp 2015:53183. [PMID: 26649573 PMCID: PMC4692762 DOI: 10.3791/53183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The zebrafish model is an emerging system for the study of neuromuscular disorders. In the study of neuromuscular diseases, the integrity of the muscle membrane is a critical disease determinant. To date, numerous neuromuscular conditions display degenerating muscle fibers with abnormal membrane integrity; this is most commonly observed in muscular dystrophies. Evans Blue Dye (EBD) is a vital, cell permeable dye that is rapidly taken into degenerating, damaged, or apoptotic cells; in contrast, it is not taken up by cells with an intact membrane. EBD injection is commonly employed to ascertain muscle integrity in mouse models of neuromuscular diseases. However, such EBD experiments require muscle dissection and/or sectioning prior to analysis. In contrast, EBD uptake in zebrafish is visualized in live, intact preparations. Here, we demonstrate a simple and straightforward methodology for performing EBD injections and analysis in live zebrafish. In addition, we demonstrate a co-injection strategy to increase efficacy of EBD analysis. Overall, this video article provides an outline to perform EBD injection and characterization in zebrafish models of neuromuscular disease.
Collapse
Affiliation(s)
- Sarah J Smith
- Program in Genetics & Genome Biology, The Hospital for Sick Children; Department of Molecular Genetics, The University of Toronto
| | - Eric J Horstick
- Program in Genomics of Differentiation, Eunice Kennedy Shriver National Institute of Child Health and Human Development; Departments of Pediatrics and Neurology, University of Michigan
| | - Ann E Davidson
- Program in Genetics & Genome Biology, The Hospital for Sick Children; Department of Molecular Genetics, The University of Toronto
| | - James Dowling
- Program in Genetics & Genome Biology, The Hospital for Sick Children; Department of Molecular Genetics, The University of Toronto; Departments of Pediatrics and Neurology, University of Michigan;
| |
Collapse
|
16
|
McCullagh KJA, Perlingeiro RCR. Coaxing stem cells for skeletal muscle repair. Adv Drug Deliv Rev 2015; 84:198-207. [PMID: 25049085 PMCID: PMC4295015 DOI: 10.1016/j.addr.2014.07.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/19/2014] [Accepted: 07/07/2014] [Indexed: 02/06/2023]
Abstract
Skeletal muscle has a tremendous ability to regenerate, attributed to a well-defined population of muscle stem cells called satellite cells. However, this ability to regenerate diminishes with age and can also be dramatically affected by multiple types of muscle diseases, or injury. Extrinsic and/or intrinsic defects in the regulation of satellite cells are considered to be major determinants for the diminished regenerative capacity. Maintenance and replenishment of the satellite cell pool is one focus for muscle regenerative medicine, which will be discussed. There are other sources of progenitor cells with myogenic capacity, which may also support skeletal muscle repair. However, all of these myogenic cell populations have inherent difficulties and challenges in maintaining or coaxing their derivation for therapeutic purpose. This review will highlight recent reported attributes of these cells and new bioengineering approaches to creating a supply of myogenic stem cells or implants applicable for acute and/or chronic muscle disorders.
Collapse
Affiliation(s)
- Karl J A McCullagh
- Department of Physiology, School of Medicine and Regenerative Medicine Institute, National University of Ireland Galway, Ireland
| | - Rita C R Perlingeiro
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
| |
Collapse
|
17
|
Ayoglu B, Chaouch A, Lochmüller H, Politano L, Bertini E, Spitali P, Hiller M, Niks EH, Gualandi F, Pontén F, Bushby K, Aartsma-Rus A, Schwartz E, Le Priol Y, Straub V, Uhlén M, Cirak S, 't Hoen PAC, Muntoni F, Ferlini A, Schwenk JM, Nilsson P, Al-Khalili Szigyarto C. Affinity proteomics within rare diseases: a BIO-NMD study for blood biomarkers of muscular dystrophies. EMBO Mol Med 2015; 6:918-36. [PMID: 24920607 PMCID: PMC4119355 DOI: 10.15252/emmm.201303724] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Despite the recent progress in the broad-scaled analysis of proteins in body fluids, there is still a lack in protein profiling approaches for biomarkers of rare diseases. Scarcity of samples is the main obstacle hindering attempts to apply discovery driven protein profiling in rare diseases. We addressed this challenge by combining samples collected within the BIO-NMD consortium from four geographically dispersed clinical sites to identify protein markers associated with muscular dystrophy using an antibody bead array platform with 384 antibodies. Based on concordance in statistical significance and confirmatory results obtained from analysis of both serum and plasma, we identified eleven proteins associated with muscular dystrophy, among which four proteins were elevated in blood from muscular dystrophy patients: carbonic anhydrase III (CA3) and myosin light chain 3 (MYL3), both specifically expressed in slow-twitch muscle fibers and mitochondrial malate dehydrogenase 2 (MDH2) and electron transfer flavoprotein A (ETFA). Using age-matched sub-cohorts, 9 protein profiles correlating with disease progression and severity were identified, which hold promise for the development of new clinical tools for management of dystrophinopathies.
Collapse
Affiliation(s)
- Burcu Ayoglu
- Affinity Proteomics, SciLifeLab, School of Biotechnology KTH-Royal Institute of Technology, Stockholm, Sweden
| | - Amina Chaouch
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Hanns Lochmüller
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Luisa Politano
- Cardiomiology and Medical Genetics, Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesú Children's Hospital, Rome, Italy
| | - Pietro Spitali
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Monika Hiller
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Eric H Niks
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Francesca Gualandi
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fredrik Pontén
- SciLifeLab, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kate Bushby
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Annemieke Aartsma-Rus
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Volker Straub
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Mathias Uhlén
- Affinity Proteomics, SciLifeLab, School of Biotechnology KTH-Royal Institute of Technology, Stockholm, Sweden
| | - Sebahattin Cirak
- Research Center for Genetic Medicine, Childrens National Medical Center, Washington, DC, USA
| | - Peter A C 't Hoen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Francesco Muntoni
- The Dubowitz Neuromuscular Centre, UCL Institute of Child Health, London, UK
| | - Alessandra Ferlini
- Unit of Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Jochen M Schwenk
- Affinity Proteomics, SciLifeLab, School of Biotechnology KTH-Royal Institute of Technology, Stockholm, Sweden
| | - Peter Nilsson
- Affinity Proteomics, SciLifeLab, School of Biotechnology KTH-Royal Institute of Technology, Stockholm, Sweden
| | | |
Collapse
|
18
|
Waugh TA, Horstick E, Hur J, Jackson SW, Davidson AE, Li X, Dowling JJ. Fluoxetine prevents dystrophic changes in a zebrafish model of Duchenne muscular dystrophy. Hum Mol Genet 2014; 23:4651-62. [PMID: 24760771 PMCID: PMC4119416 DOI: 10.1093/hmg/ddu185] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is a common and relentlessly progressive muscle disease. Some interventions have been identified that modestly slow progression and prolong survival, but more meaningful therapies are lacking. The goal of this study is to identify new therapeutic pathways for DMD using a zebrafish model of the disease. To accomplish this, we performed a non-biased drug screen in sapje, a zebrafish line with a recessive nonsense mutation in dystrophin. We identified 6 positive hits (out of 640 total drugs tested) by their ability to prevent abnormal birefringence in sapje. Follow-up analyses demonstrated that fluoxetine, a selective serotonin reuptake inhibitor (SSRI), provided the most substantial benefit. Morpholino-based experimentation confirmed that modulation of the serotonin pathway alone can prevent the dystrophic phenotype, and transcriptomic analysis revealed changes in calcium homeostasis as a potential mechanism. In all, we demonstrate that monoamine agonists can prevent disease in a vertebrate model of DMD. Given the safe and widespread use of SSRIs in clinical practice, our study identifies an attractive target pathway for therapy development.
Collapse
MESH Headings
- Animals
- Base Sequence
- Birefringence
- Calcium/metabolism
- Disease Models, Animal
- Drug Evaluation, Preclinical
- Dystrophin/metabolism
- Embryo, Nonmammalian/drug effects
- Embryo, Nonmammalian/metabolism
- Evans Blue/metabolism
- Fluoxetine/pharmacology
- Fluoxetine/therapeutic use
- Gene Expression Profiling
- Gene Knockdown Techniques
- Homeostasis/drug effects
- Molecular Sequence Data
- Morpholinos/pharmacology
- Muscular Dystrophy, Animal/drug therapy
- Muscular Dystrophy, Animal/genetics
- Muscular Dystrophy, Animal/pathology
- Muscular Dystrophy, Duchenne/drug therapy
- Muscular Dystrophy, Duchenne/genetics
- Muscular Dystrophy, Duchenne/pathology
- Oligonucleotide Array Sequence Analysis
- Phenotype
- Serotonin Plasma Membrane Transport Proteins/metabolism
- Stress, Mechanical
- Survival Analysis
- Zebrafish/embryology
- Zebrafish/genetics
- Zebrafish/physiology
Collapse
Affiliation(s)
| | | | | | | | - Ann E Davidson
- Division of Neurology and Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada
| | | | - James J Dowling
- Department of Pediatrics, Department of Neurology, and Department of Neuroscience, University of Michigan, Ann Arbor, MI 48109-2200, USA Division of Neurology and Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada Department of Paediatrics, and Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
19
|
Uwineza A, Hitayezu J, Murorunkwere S, Ndinkabandi J, Kalala Malu CK, Caberg JH, Dideberg V, Bours V, Mutesa L. Genetic diagnosis of Duchenne and Becker muscular dystrophy using multiplex ligation-dependent probe amplification in Rwandan patients. J Trop Pediatr 2014; 60:112-7. [PMID: 24213305 DOI: 10.1093/tropej/fmt090] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Duchenne and Becker muscular dystrophies are the most common clinical forms of muscular dystrophies. They are genetically X-linked diseases caused by a mutation in the dystrophin (DMD) gene. A genetic diagnosis was carried out in six Rwandan patients presenting a phenotype of Duchenne and Becker muscular dystrophies and six asymptomatic female carrier relatives using multiplex ligation-dependent probe amplification (MLPA). Our results revealed deletion of the exons 48-51 in one patient, an inherited deletion of the exons 8-21 in two brothers and a de novo deletion of the exons 46-50 in the fourth patient. No copy number variation was found in two patients. Only one female carrier presented exon deletion in the DMD gene. This is the first cohort of genetic analysis in Rwandan patients affected by Duchenne and Becker muscular dystrophies. This report confirmed that MLPA assay can be easily implemented in low-income countries.
Collapse
Affiliation(s)
- Annette Uwineza
- Center for Medical Genetics, Department of Molecular Biology & Cytogenetics, Faculty of Medicine, National University of Rwanda, PO Box 30-Butare, Rwanda
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Schneider JS, Shanmugam M, Gonzalez JP, Lopez H, Gordan R, Fraidenraich D, Babu GJ. Increased sarcolipin expression and decreased sarco(endo)plasmic reticulum Ca2+ uptake in skeletal muscles of mouse models of Duchenne muscular dystrophy. J Muscle Res Cell Motil 2013; 34:349-56. [DOI: 10.1007/s10974-013-9350-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 05/27/2013] [Indexed: 02/02/2023]
|
21
|
Daack-Hirsch S, Holtzer C, Cunniff C. Parental perspectives on the diagnostic process for Duchenne and Becker muscular dystrophy. Am J Med Genet A 2013; 161A:687-95. [PMID: 23494880 DOI: 10.1002/ajmg.a.35810] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/05/2012] [Accepted: 11/14/2012] [Indexed: 11/08/2022]
Abstract
Duchenne and Becker muscular dystrophy (DBMD) are allelic, X-linked recessive, neuromuscular disorders characterized by progressive loss of muscle function. Despite technological advances in diagnostic genetic testing, the mean age at diagnosis (4.7 years) has remained unchanged for decades. The purpose of the study was to characterize parental perceptions of the diagnostic process and identify factors that influence the timeline. Data collection for this qualitative study consisted of six individual and five group interviews. Participants (N = 30) included Hispanic, non-Hispanic black, and non-Hispanic white parents whose son was diagnosed with DBMD. The "help-seeking behavior model" provided an analytical framework to analyze the data. Parents did not move through help-seeking stages unidirectionally as described in other studies. Delays existed at each stage. We identified personal, familial, social, cultural, and provider factors that impeded earlier diagnosis. These barriers prolonged movement through a stage or led families to repeat previous stages. Results should initiate debate among system administrators, patient advocates, and healthcare providers regarding which barriers may be most modifiable and which interventions may reduce the time to diagnosis and limit parental emotional distress.
Collapse
|
22
|
Abstract
PURPOSE Duchenne muscular dystrophy is a dystrophinopathy affecting males that is associated with multiple organ system complications. To our knowledge urological complications of Duchenne muscular dystrophy have been described only anecdotally to date. MATERIALS AND METHODS We reviewed the medical charts of 135 patients with Duchenne or Duchenne-Becker muscular dystrophy for demographics and disease progression, urological diagnoses, intervention and followup. RESULTS Of 135 patients 67 (50%) had at least 1 documented urological diagnosis and 38 (28%) had multiple manifestations. Lower urinary tract symptoms were the most common urological diagnosis (32% of patients). Survival analysis revealed a median age at onset of lower urinary tract symptoms of 23 years (95% CI 17.7-23.9). Intervention was required in 12 patients (9%), most commonly due to nephrolithiasis. Urological morbidity increased with Duchenne muscular dystrophy progression when stratified by clinical progression. Lower urinary tract symptoms were more common in nonambulatory patients (40.7% vs 19%, p = 0.007), those with a diagnosis of scoliosis (44% vs 19.7%, p = 0.003) and/or scoliosis spine surgery (60% vs 22%, p <0.001), and those on invasive respiratory support (53% vs 29%, p = 0.046). Likewise, nephrolithiasis was more common in nonambulatory patients (10% vs 0%, p = 0.017), those with scoliosis (12% vs 0%, p = 0.004) and/or scoliosis spine surgery (20% vs 1%, p <0.001), and those on invasive respiratory support (29% vs 3%, p <0.001). Only 28% of patients with a urological manifestation were referred to urology. CONCLUSIONS As these patients transition into adolescence and adulthood, the increased prevalence of urological manifestations warrants increased awareness and referral to urologists.
Collapse
|
23
|
Austin SB, Penfold RB, Johnson RL, Haines J, Forman S. Clinician identification of youth abusing over-the-counter products for weight control in a large U.S. integrated health system. J Eat Disord 2013; 1:40. [PMID: 24999418 PMCID: PMC4081803 DOI: 10.1186/2050-2974-1-40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/19/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Abuse of over-the-counter (OTC) products, such as diet pills and laxatives, for weight control by adolescents is well-documented and can precipitate serious medical conditions. Yet only a small percentage of youth with disordered weight control behaviors receive treatment. The objective of this study was to examine how often clinicians communicate with youth with symptoms consistent with abuse of OTC products for weight control about possible use of these products. We used electronic medical records and administrative claims for services for 53,229 12 to 17 year old patients receiving care from an integrated health system in the U.S. Northwest from August 2007 to December 2010. We examined electronic text of clinical notes to identify encounters in which the clinician noted one of 10 metabolic conditions potentially associated with abuse of OTC products (diet pills, laxatives, diuretics, ipecac, orlistat, and alli®) for weight control and then assessed whether clinicians noted communication with adolescent patients about possible use of OTC products for weight control. RESULTS We identified 130 (0.2% of sample) patients with clinical notes indicating one or more of the metabolic conditions. In clinical notes for only four (3.1%) of these patients did clinicians document suspicion or communication about possible abuse of the OTC products. All four had a previous eating disorder diagnosis. In the 12 months subsequent to the clinical encounter in which a metabolic disturbance was identified, medical notes for only three (2.3%) of the 130 patients indicated clinician suspicion or communication about possible abuse of these products or an eating disorder. CONCLUSIONS Clinicians are missing a critical window of opportunity to query adolescents when presenting with suspicious metabolic disturbances about possible abuse of OTC products for weight control. Clinicians may need more training to detect OTC product abuse, and electronic medical records should prompt more thorough enquiry.
Collapse
Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA ; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Robert B Penfold
- Group Health Research Institute, Seattle, WA, USA ; Department of Health Services Research, University of Washington, School of Public Health, Seattle, WA, USA
| | | | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada
| | - Sara Forman
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA
| |
Collapse
|
24
|
Lerman J. Perioperative management of the paediatric patient with coexisting neuromuscular disease. Br J Anaesth 2012; 107 Suppl 1:i79-89. [PMID: 22156273 DOI: 10.1093/bja/aer335] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Children with neuromuscular diseases present a wide range of clinical manifestations and clinical implications for the anaesthesiologist. Neuromuscular diseases in children affect muscle strength by either directly weakening the muscle fibrils or indirectly by a degenerative nerve supply and weak neuromuscular junction. Of the more than 200 neuromuscular disorders known, the vast majority are genetic in origin. This review focuses on four of the more common neuromuscular disorders with emphasis on their pathophysiology and clinical implications for anaesthesiologists: malignant hyperthermia, the muscular dystrophies (Duchenne's, Becker's, and Emery-Dreifuss), mitochondrial disorders, and cerebral palsy.
Collapse
Affiliation(s)
- J Lerman
- Department of Anaesthesia, Women and Children's Hospital of Buffalo, State University of New York at Buffalo, 219 Bryant St, Buffalo, NY 14222, USA.
| |
Collapse
|
25
|
|