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Klubdaeng A, Tovichien P. Clinical approach for pulmonary alveolar proteinosis in children. World J Clin Cases 2024; 12:6339-6345. [DOI: 10.12998/wjcc.v12.i30.6339] [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: 03/12/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 09/04/2024] Open
Abstract
In this editorial, we discuss the clinical implications of the article by Zhang et al. Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by excessive surfactant accumulation in the alveoli. It is classified into four categories: Primary, secondary, congenital, and unclassified forms. Primary PAP is caused by the disruption of granulocyte-macrophage colony-stimulating factor (GM-CSF) receptor signaling, which is necessary for the clearance of surfactant by alveolar macrophages. It is further divided into autoimmune PAP, caused by anti-GM-CSF antibodies blocking alveolar macrophage activation, and hereditary PAP, resulting from mutations in genes encoding GM-CSF receptors. Secondary PAP develops due to conditions affecting the number or function of alveolar macrophages, such as infections, immunodeficiency, hematological disorders, or exposure to inhaled toxins. Congenital PAP is linked to mutations in genes involved in surfactant protein production. Notably, the causes of PAP differ between children and adults. Diagnostic features include a characteristic "crazy-paving" pattern on high-resolution computed tomography, accompanied by diffuse ground-glass opacities and interlobular septal thickening. The presence of PAP can be identified by the milky appearance of bronchoalveolar lavage fluid and histological evaluation. However, these methods cannot definitively determine the cause of PAP. Whole lung lavage remains the standard treatment, often combined with specific therapies based on the underlying cause.
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Affiliation(s)
- Anuvat Klubdaeng
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Prakarn Tovichien
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Wilhelm SDP, Moresco AA, Rivero AD, Siu VM, Heinemann IU. Characterization of a novel heterozygous variant in the histidyl-tRNA synthetase gene associated with Charcot-Marie-Tooth disease type 2W. IUBMB Life 2024. [PMID: 39352000 DOI: 10.1002/iub.2918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 09/01/2024] [Indexed: 10/03/2024]
Abstract
Heterozygous pathogenic variants in the histidyl-tRNA synthetase (HARS) gene are associated with Charcot-Marie-Tooth (CMT) type 2W disease, classified as an axonal peripheral neuropathy. To date, at least 60 variants causing CMT symptoms have been identified in seven different aminoacyl-tRNA synthetases, with eight being found in the catalytic domain of HARS. The genetic data clearly show a causative role of aminoacyl-tRNA synthetases in CMT; however, the cellular mechanisms leading to pathology can vary widely and are unknown in the case of most identified variants. Here we describe a novel HARS variant, c.412T>C; p.Y138H, identified through a CMT gene panel in a patient with peripheral neuropathy. To determine the effect of p.Y138H we employed a humanized HARS yeast model and recombinant protein biochemistry, which identified a deficiency in protein dimerization and a growth defect which shows mild but significant improvement with histidine supplementation. This raises the potential for a clinical trial of histidine.
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Affiliation(s)
- Sarah D P Wilhelm
- Department of Biochemistry, The University of Western Ontario, London, Ontario, Canada
| | - Angelica A Moresco
- Division of Medical Genetics, Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
| | - Alberto D Rivero
- Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Victoria Mok Siu
- Division of Medical Genetics, Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Ilka U Heinemann
- Department of Biochemistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
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Fletcher C, Hadchouel A, Thumerelle C, Mazenq J, Fleury M, Corvol H, Jedidi N, Benhamida M, Bessaci K, Bilhouee T, Borie R, Brouard J, Cantais A, Clement A, Coutier L, Cisterne C, Cros P, Dalphin ML, Delacourt C, Deneuville E, Dubus JC, Egron C, Epaud R, Fayon M, Forgeron A, Gachelin E, Galode F, Gertini I, Giovannini-Chami L, Gourdan P, Guiddir T, Herzog A, Houdouin V, Hullo É, Jarreau PH, Labbé G, Labouret G, Ladaurade A, Le Clainche Viala L, Marguet C, Masson-Rouchaud A, Perisson C, Rames C, Reix P, Renoux MC, Roditis L, Schweitzer C, Tatopoulos A, Trioche-Eberschweiler P, Troussier F, Vigier C, Weiss L, Legendre M, Louvrier C, de Becdelievre A, Coulomb A, Sileo C, Ducou le Pointe H, Berteloot L, Delestrain C, Nathan N. Epidemiology of childhood interstitial lung disease in France: the RespiRare cohort. Thorax 2024; 79:842-852. [PMID: 38964860 DOI: 10.1136/thorax-2023-221325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 05/16/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Interstitial lung disease in children (chILD) are rare and mostly severe lung diseases. Very few epidemiological data are available in limited series of patients. The aim of this study was to assess the prevalence and incidence of chILD in France. METHODS We performed within the RespiRare network a multicentre retrospective observational study in patients with chILD from 2000 to 2022 and a prospective evaluation of chILD's incidence between February 2022 and 2023. RESULTS chILD was reported in 790 patients in 42 centres. The estimated 2022 prevalence in France was 44 /million children (95% CI 40.76 to 47.46) and the computed incidence was 4.4 /million children (95% CI 3.44 to 5.56). The median age at diagnosis was 3 months with 16.9% of familial forms. Lung biopsy and genetic analyses were performed in 23.4% and 76.9%, respectively. The most frequent chILD aetiologies in the <2 years group were surfactant metabolism disorders (16.3%) and neuroendocrine cell hyperplasia of infancy (11.8%), and in the 2-18 years group diffuse alveolar haemorrhage (12.2%), connective tissue diseases (11.4%), hypersensitivity pneumonitis (8.8%) and sarcoidosis (8.8%). The management included mainly oxygen therapy (52%), corticosteroid pulses (56%), oral corticosteroids (44%), azithromycin (27.2%), enteral nutrition (26.9%), immunosuppressants (20.3%) and hydroxychloroquine (15.9%). The 5-year survival rate was 57.3% for the patients diagnosed before 2 years and 86% between 2 and 18 years. CONCLUSION This large and systematic epidemiological study confirms a higher incidence and prevalence of chILD than previously described. In order to develop international studies, efforts are still needed to optimise the case collection and to harmonise diagnostic and management practices.
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Affiliation(s)
- Camille Fletcher
- Paediatric Pulmonology Department and Reference Center for Rare Lung Diseases, RespiRare, Sorbonne University, AP-HP, Armand Trousseau Hospital, Paris, France
- Laboratory of Childhood Genetic Diseases, UMR_S933, Sorbonne University, INSERM, Armand Trousseau Hospital, Paris, France
| | - Alice Hadchouel
- AP-HP, Service de Pneumologie Pédiatrique and Reference center for rare lung diseases RespiRare, Necker-Enfants Malades Hospital, Paris, France
- INSERM U1151 INEM, Université Paris Cité, INSERM, Paris, France
| | | | - Julie Mazenq
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases RespiRare, Aix-Marseille University, AP-HM, Marseille, France
- INRAE, C2VN, INSERM, Marseille, France
| | - Manon Fleury
- APHP, Armand Trousseau Hospital, Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases RespiRare, Sorbonne University, Paris, France
| | - Harriet Corvol
- Paediatric Pulmonology Department and Reference Center for Rare Lung Diseases, RespiRare, Sorbonne University, AP-HP, Armand Trousseau Hospital, Paris, France
- CDR Saint-Antoine, Paris, France
| | - Nouha Jedidi
- Paediatric Pulmonology Department and Reference Center for Rare Lung Diseases, RespiRare, Sorbonne University, AP-HP, Armand Trousseau Hospital, Paris, France
| | - Myriam Benhamida
- Pediatric Department, University Hospital Centre Nantes, Nantes, France
| | - Katia Bessaci
- Pediatric Pulmonology Department, University Hospital Centre Reims, Reims, France
| | - Tiphaine Bilhouee
- Pediatric Department, University Hospital Centre Nantes, Nantes, France
| | - Raphael Borie
- APHP, Bichat Hospital, Pulmonology Department A, Université Paris Cité, Paris, France
- Inserm UMR-S 1152 PHERE, INSERM, Paris, France
| | - Jacques Brouard
- Medical Pediatric Department, Inserm UMRS 1311, DYNAMICURE, UNICAEN, University Hospital Centre Caen, Caen, France
| | - Aurélie Cantais
- Pediatric Department, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Annick Clement
- Plateforme d'expertise maladies rares, AP-HP.Sorbonne University, Paris, France
| | - Laurianne Coutier
- Pediatric Pulmonology Department, University Hospital Lyon, Lyon, France
| | - Camille Cisterne
- Pediatric Pulmonology Department, Lille University Hospital, Lille, France
| | - Pierrick Cros
- Pediatric Department, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Marie-Laure Dalphin
- Pediatric Pulmonology Department, Centre Hospitalier Universitaire de Besancon, Besancon, France
| | - Christophe Delacourt
- AP-HP, Service de Pneumologie Pédiatrique and Reference center for rare lung diseases RespiRare, Necker-Enfants Malades Hospital, Paris, France
- INSERM U1151 INEM, Université Paris Cité, INSERM, Paris, France
| | - Eric Deneuville
- Pediatric Pulmonology Department, University Hospital Centre Rennes, Rennes, France
| | - Jean-Christophe Dubus
- Pediatric Pulmonology Department and Reference Center for Rare Lung Diseases RespiRare, Aix-Marseille University, AP-HM, Marseille, France
- IRD, MEPHI, IHU Méditerranée-Infection, Aix-Marseille Université, Marseille, France
| | - Carole Egron
- University Hospital Centre Clermont-Ferrand, Clermont-Ferrand, France
| | - Ralph Epaud
- Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Creteil, France
- FHU SENEC; University Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Michael Fayon
- Pediatric Pulmonology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Clinical Investigation Center (CIC 1401); Bordeaux University, Cardio-Thoracic Research Center of Bordeaux, Inserm, U1045, INSERM, Bordeaux, France
| | - Aude Forgeron
- Pediatric Pulmonology Department, Hospital Centre Le Mans, Le Mans, France
| | - Elsa Gachelin
- Pediatric Pulmonology Department, CHU Nord Réunion, Saint-Denis, France
| | - François Galode
- Pediatric Pulmonology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Isabelle Gertini
- Pediatric Pulmonology Department, Tours University hospital, Tours, France
| | - Lisa Giovannini-Chami
- Pediatric Pulmonology Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, France
| | - Pierre Gourdan
- Pediatric Pulmonology Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, France
| | - Tamazoust Guiddir
- Pediatric Pulmonology Department, AP-HP - Université Paris Saclay, Hospital Bicetre, Le Kremlin-Bicetre, France
| | - Audrey Herzog
- Pediatric Pulmonology Department, CHU de Strasbourg, Strasbourg, France
| | - Véronique Houdouin
- Pediatric Pulmonology Department, AP-HP - Paris University, Robert Debré Hospital, Paris, France
| | - Églantine Hullo
- Pediatric Pulmonology Department, University Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - Pierre-Henri Jarreau
- Néonatal intensive care unit, Cochin Hospital, Université Paris Cité, Paris, France
| | - Guillame Labbé
- University Hospital Centre Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Alice Ladaurade
- Pediatric Pulmonology Department, Centre Hospitalier Universitaire de Besancon, Besancon, France
| | | | | | | | - Caroline Perisson
- Pediatric Pulmonology Department, CHU de La Réunion Sites Sud, Saint-Pierre, Réunion
| | - Cinthia Rames
- Pediatric Department, CHU Amiens-Picardie, Amiens, France
| | - Philippe Reix
- Pediatric Pulmonology Department, University Hospital Lyon, Lyon, France
| | | | - Léa Roditis
- Pediatric Pulmonology Department, CHU Toulouse, Toulouse, France
| | | | | | | | | | - Clémentine Vigier
- Pediatric Pulmonology Department, University Hospital Centre Rennes, Rennes, France
| | - Laurence Weiss
- Pediatric Pulmonology Department, CHU de Strasbourg, Strasbourg, France
| | - Marie Legendre
- Laboratory of Childhood Genetic Diseases, UMR_S933, Sorbonne University, INSERM, Armand Trousseau Hospital, Paris, France
- APHP, Armand Trousseau Hospital, Molecular Genetics Department, Sorbonne University, Paris, France
| | - Camille Louvrier
- Laboratory of Childhood Genetic Diseases, UMR_S933, Sorbonne University, INSERM, Armand Trousseau Hospital, Paris, France
- APHP, Armand Trousseau Hospital, Molecular Genetics Department, Sorbonne University, Paris, France
| | - Alix de Becdelievre
- Molecular Genetics Department, Centre Hospitalier Universitaire Henri Mondor, Creteil, France
- INSERM U-955, Université Paris Est Creteil, INSERM, Créteil, France
| | - Aurore Coulomb
- Pathology Department, Sorbonne University, AP-HP, Armand-Trousseau Hospital, Paris, France
| | - Chiara Sileo
- APHP, Sorbonne University, Radiology Department, Armand-Trousseau Hospital, Paris, France
| | - Hubert Ducou le Pointe
- APHP, Sorbonne University, Radiology Department, Armand-Trousseau Hospital, Paris, France
| | - Laureline Berteloot
- Pediatric Radiology Department, APHP, Université Paris Cité, Necker-Enfants Malades Hospitals, Paris, France
| | - Céline Delestrain
- Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Creteil, France
- FHU SENEC; University Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Nadia Nathan
- Paediatric Pulmonology Department and Reference Center for Rare Lung Diseases, RespiRare, Sorbonne University, AP-HP, Armand Trousseau Hospital, Paris, France
- Laboratory of Childhood Genetic Diseases, UMR_S933, Sorbonne University, INSERM, Armand Trousseau Hospital, Paris, France
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Roy C, Allou N, Coulomb A, Grenet D, Borie R, Zuber B, Hamid A, Glorion M, Brun AL, Longchamps E, Hadchouel A, Brugiere O. Successful lung transplantation in genetic methionyl-tRNA synthetase-related alveolar proteinosis/lung fibrosis without recurrence under methionine supplementation: Medium-term outcome in 4 cases. Am J Transplant 2024; 24:1317-1322. [PMID: 38461880 DOI: 10.1016/j.ajt.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
Pulmonary alveolar proteinosis (PAP) results from the accumulation of lipoproteinaceous material in the alveoli and alveolar macrophages, and can be associated with pulmonary fibrosis, with a need for lung transplantation (LTx). Causes of PAP are autoimmune (90%-95%), secondary (5%), or hereditary (<1%). Patients with hereditary PAP are generally not considered for isolated LTx, due to the high probability of recurrence after LTx, and only a challenging scenario with sequential LTx followed by hematopoietic stem cell transplantation (HSCT) was reported as successful. Recently, a new genetic cause of PAP linked to mutations in the methionyl-tRNA synthetase (MARS) gene has been reported, with a highly variable clinical presentation. Because clinical correction of the defective MARS activity with methionine supplementation has been reported in nontransplanted children, we reassessed the feasibility of LTx for candidates with MARS-related PAP/fibrosis. We report 3 cases of LTx performed for MARS-related pulmonary alveolar proteinosis-pulmonary fibrosis without recurrence under methionine supplementation, whereas another fourth case transplanted without supplementation had fatal PAP recurrence. These results suggest the effectiveness of methionine in correcting defective MARS activity and also looking for this very rare diagnosis in case of unclassified PAP/fibrosis. It argues for not excluding the feasibility of isolated LTx in patients with MARS mutation.
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Affiliation(s)
- Charlotte Roy
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France; Service de Pneumologie pédiatrique, Hôpital Necker, Paris, France
| | - Nathalie Allou
- Service de Pneumologie, Hôpital CHU Felix Guyon, La Réunion
| | - Aurore Coulomb
- Service d'Anatomopathologie, Hôpital Armand Trousseau, Paris, France
| | - Dominique Grenet
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France
| | - Raphaël Borie
- Service de Pneumologie, Hôpital Bichat, Paris, France
| | | | - Abdulmonem Hamid
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France; Collège de Médecine des hôpitaux de Paris (CMHP)
| | | | | | | | - Alice Hadchouel
- Service de Pneumologie pédiatrique, Hôpital Necker, Paris, France
| | - Olivier Brugiere
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France; CEA/DRF/Institut de Biologie François Jacob/Service de Recherches en Hémato-Immunologie Hôpital St-Louis, Paris, France.
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Ward C, Beharry A, Tennakoon R, Rozik P, Wilhelm SDP, Heinemann IU, O’Donoghue P. Mechanisms and Delivery of tRNA Therapeutics. Chem Rev 2024; 124:7976-8008. [PMID: 38801719 PMCID: PMC11212642 DOI: 10.1021/acs.chemrev.4c00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/11/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024]
Abstract
Transfer ribonucleic acid (tRNA) therapeutics will provide personalized and mutation specific medicines to treat human genetic diseases for which no cures currently exist. The tRNAs are a family of adaptor molecules that interpret the nucleic acid sequences in our genes into the amino acid sequences of proteins that dictate cell function. Humans encode more than 600 tRNA genes. Interestingly, even healthy individuals contain some mutant tRNAs that make mistakes. Missense suppressor tRNAs insert the wrong amino acid in proteins, and nonsense suppressor tRNAs read through premature stop signals to generate full length proteins. Mutations that underlie many human diseases, including neurodegenerative diseases, cancers, and diverse rare genetic disorders, result from missense or nonsense mutations. Thus, specific tRNA variants can be strategically deployed as therapeutic agents to correct genetic defects. We review the mechanisms of tRNA therapeutic activity, the nature of the therapeutic window for nonsense and missense suppression as well as wild-type tRNA supplementation. We discuss the challenges and promises of delivering tRNAs as synthetic RNAs or as gene therapies. Together, tRNA medicines will provide novel treatments for common and rare genetic diseases in humans.
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Affiliation(s)
- Cian Ward
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Aruun Beharry
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Rasangi Tennakoon
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Peter Rozik
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Sarah D. P. Wilhelm
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Ilka U. Heinemann
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - Patrick O’Donoghue
- Department of Biochemistry, Department of Chemistry, The University of Western Ontario, London, Ontario N6A 5C1, Canada
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Bernardinello N, Griese M, Borie R, Spagnolo P. Emerging Treatments for Childhood Interstitial Lung Disease. Paediatr Drugs 2024; 26:19-30. [PMID: 37948041 PMCID: PMC10770003 DOI: 10.1007/s40272-023-00603-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
Childhood interstitial lung disease (chILD) is a large and heterogeneous group of disorders characterized by diffuse lung parenchymal markings on chest imaging and clinical signs such as dyspnea and hypoxemia from functional impairment. While some children already present in the neonatal period with interstitial lung disease (ILD), others develop ILD during their childhood and adolescence. A timely and accurate diagnosis is essential to gauge treatment and improve prognosis. Supportive care can reduce symptoms and positively influence patients' quality of life; however, there is no cure for many of the chILDs. Current therapeutic options include anti-inflammatory or immunosuppressive drugs. Due to the rarity of the conditions and paucity of research in this field, most treatments are empirical and based on case series, and less than a handful of small, randomized trials have been conducted thus far. A trial on hydroxychloroquine yielded good safety but a much smaller effect size than anticipated. A trial in fibrotic disease with the multitargeted tyrosine kinase inhibitor nintedanib showed similar pharmacokinetics and safety as in adults. The unmet need for the treatment of chILDs remains high. This article summarizes current treatments and explores potential therapeutic options for patients suffering from chILD.
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Affiliation(s)
- Nicol Bernardinello
- Respiratory Disease Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani n°2, 35128, Padua, Italy
| | - Matthias Griese
- Department of Pediatric Pneumology, Dr. von Hauner Children's Hospital, German Center for Lung Research (DZL), Ludwig-Maximilians University, Munich, Germany
| | - Raphaël Borie
- Université de Paris, INSERM UMR 1152, Service de Pneumologie A, Centre de compétences maladies pulmonaires rares, Hôpital Bichat-Claude Bernard, AP-HP, 75018, Paris, France
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani n°2, 35128, Padua, Italy.
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Frémond ML, Berteloot L, Hadchouel A. [Lung involvement in autoinflammatory diseases]. Rev Mal Respir 2024; 41:18-28. [PMID: 38040588 DOI: 10.1016/j.rmr.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/31/2023] [Indexed: 12/03/2023]
Abstract
Genetic autoinflammatory diseases are now a recognized and rapidly expanding group. The lung involvement historically associated with autoinflammatory diseases is inflammatory seritis, primarily seen in familial Mediterranean fever and other interleukin-1 mediated diseases. Over the last ten years, pulmonary involvement has been the core presentation of two autoinflammatory diseases associated with constitutive type I interferon activation, i.e. SAVI and COPA syndrome. Most patients with these diseases usually develop early progression to pulmonary fibrosis, which is responsible for high rates of morbidity and mortality. Other rare autoinflammatory diseases are associated with alveolar proteinosis, particularly when related to MARS mutations. Additionally, in adults, VEXAS is frequently associated with pulmonary involvement, albeit without prognosis effect. A molecular approach to autoinflammatory diseases enables not only the definition of biomarkers for diagnosis, but also the identification of targeted treatments. Examples include JAK inhibitors in SAVI and COPA syndrome, even though this therapy does not prevent progression to pulmonary fibrosis. Another illustrative example is the efficacy of methionine supplementation in alveolar proteinosis linked to MARS mutations. Overall, in autoinflammatory diseases the lung is now emerging as a possible affected organ. Continuing discovery of new autoinflammatory diseases is likely to uncover further pathologies involving the lung. Such advances are expected to lead to the development of novel therapeutic perspectives.
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Affiliation(s)
- M-L Frémond
- Unité d'immuno-hématologie et rhumatologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, centre université de Paris-Cité, 149, rue de Sèvres, 75015 Paris, France; Institut imagine, laboratoire de neurogénétique et neuroinflammation, université de Paris-Cité, 24, boulevard du Montparnasse, 75015 Paris, France.
| | - L Berteloot
- Service de radiologie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, centre université de Paris-Cité, 75015 Paris, France
| | - A Hadchouel
- Institut Necker-Enfants-Malades (INEM), Inserm, université Paris-Cité, 75015 Paris, France; Service de pneumologie et allergologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, centre université de Paris-Cité, 75015 Paris, France
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8
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Yoon I, Kim U, Choi J, Kim S. Disease association and therapeutic routes of aminoacyl-tRNA synthetases. Trends Mol Med 2024; 30:89-105. [PMID: 37949787 DOI: 10.1016/j.molmed.2023.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
Aminoacyl-tRNA synthetases (ARSs) are enzymes that catalyze the ligation of amino acids to tRNAs for translation. Beyond their traditional role in translation, ARSs have acquired regulatory functions in various biological processes (epi-translational functions). With their dual-edged activities, aberrant expression, secretion, and mutations of ARSs are associated with human diseases, including cancer, autoimmune diseases, and neurological diseases. The increasing numbers of newly unveiled activities and disease associations of ARSs have spurred interest in novel drug development, targeting disease-related catalytic and noncatalytic activities of ARSs as well as harnessing ARSs as sources for biological therapeutics. This review speculates how the translational and epi-translational activities of ARSs can be related and describes how their activities can be linked to diseases and drug discovery.
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Affiliation(s)
- Ina Yoon
- Institute for Artificial Intelligence and Biomedical Research, Medicinal Bioconvergence Research Center, College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea
| | - Uijoo Kim
- Institute for Artificial Intelligence and Biomedical Research, Medicinal Bioconvergence Research Center, College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea
| | - Jaeyoung Choi
- Institute for Artificial Intelligence and Biomedical Research, Medicinal Bioconvergence Research Center, College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea
| | - Sunghoon Kim
- Institute for Artificial Intelligence and Biomedical Research, Medicinal Bioconvergence Research Center, College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea; College of Medicine, Gangnam Severance Hospital, Yonsei University, Seoul 06273, Republic of Korea; Institute for Convergence Research and Education in Advanced Technology, Yonsei University, Incheon 21983, Republic of Korea.
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彭 文, 朱 燕, 王 来, 陆 炜, 杨 琳, 朱 丽. [A case of interstitial lung and liver disease caused by MARS1 gene mutation]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1186-1190. [PMID: 37990466 PMCID: PMC10672959 DOI: 10.7499/j.issn.1008-8830.2307050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/13/2023] [Indexed: 11/23/2023]
Abstract
The patient is a female infant, 4 months and 9 days old, who was admitted to the hospital due to recurrent fever, cough, and hepatomegaly for over a month. The patient was a healthy full-term infant with a normal birth history. At 2 months and 22 days after birth, she developed recurrent fever, cough, and respiratory distress. Chest imaging revealed diffuse bilateral lung lesions, and fiberoptic bronchoscopy showed interstitial changes in both lungs. These suggested the presence of interstitial lung disease. The patient also presented with hepatomegaly, anemia, hyperlipidemia, hypothyroidism, and malnutrition. Genetic testing indicated compound heterozygous variations in the MARS1 gene. This mutation can cause interstitial lung and liver disease, which is a severe rare disorder that typically manifests in infancy or early childhood. It is inherited in an autosomal recessive manner and characterized by early-onset respiratory insufficiency and liver disease in infants or young children. Since its first reported case in 2013, as of June 2023, only 38 related cases have been reported worldwide. This article reports the multidisciplinary diagnosis and treatment of interstitial lung and liver disease in an infant caused by MARS1 gene mutation.
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Affiliation(s)
| | | | | | - 炜 陆
- 国家儿童医学中心/复旦大学附属儿科医院内分泌遗传代谢科上海201102
| | - 琳 杨
- 国家儿童医学中心/复旦大学附属儿科医院内分泌遗传代谢科上海201102
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Querin B, Schweitzer-Chaput A, Cisternino S, Auvity S, Fauqueur AS, Negbane A, Hadchouel A, Schlatter J, Cotteret C. Pharmaceutical Oral Formulation of Methionine as a Pediatric Treatment in Inherited Metabolic Disease. Pharmaceutics 2023; 15:pharmaceutics15030957. [PMID: 36986818 PMCID: PMC10056843 DOI: 10.3390/pharmaceutics15030957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
L-Methionine (Met) is an essential alpha-amino acid playing a key role in several metabolic pathways. Rare inherited metabolic diseases such as mutations affecting the MARS1 gene encoding methionine tRNA synthetase (MetRS) can cause severe lung and liver disease before the age of two years. Oral Met therapy has been shown to restore MetRS activity and improve clinical health in children. As a sulfur-containing compound, Met has a strongly unpleasant odor and taste. The objective of this study was to develop an optimized pediatric pharmaceutical formulation of Met powder, to be reconstituted with water, to obtain a stable oral suspension. Organoleptic characteristics and physicochemical stability of the powdered Met formulation and suspension were evaluated at three storage temperatures. Met quantification was assessed by a stability-indicating chromatographic method as well as microbial stability. The use of a specific fruit flavor (e.g., strawberry) with sweeteners (e.g., sucralose) was considered acceptable. No drug loss, pH changes, microbiological growth, or visual changes were observed at 23 ± 2 °C and 4 ± 2 °C with the powder formulation for 92 days, and the reconstituted suspension for at least 45 days. The developed formulation facilitates the preparation, administration, the dose adjustment and palatability of Met treatment in children.
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Affiliation(s)
- Benjamin Querin
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
| | - Arnaud Schweitzer-Chaput
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
| | - Salvatore Cisternino
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
- Université Paris Cité, Inserm UMRS 1144, Faculté de Pharmacie, 4, Avenue de l’Observatoire, F-75006 Paris, France
- Correspondence: ; Tel.: +33-1-44-495-191
| | - Sylvain Auvity
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
- Université Paris Cité, Inserm UMRS 1144, Faculté de Pharmacie, 4, Avenue de l’Observatoire, F-75006 Paris, France
| | - Anne-Sophie Fauqueur
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
| | - Abdel Negbane
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
| | - Alice Hadchouel
- Service de Pneumologie Pédiatrique, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris, AP-HP, 149 rue de Sèvres, F-75015 Paris, France
- Institut Necker Enfants Malades (INEM), INSERM U1151, Faculté de Médecine, Université Paris Cité, 156 rue de Vaugirard, F-75015 Paris, France
| | - Joël Schlatter
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
- Service Pharmacie, Hôpital Paul Doumer, Assistance Publique des Hôpitaux de Paris, AP-HP, 1 rue de l’hôpital, F-60140 Labruyère, France
| | - Camille Cotteret
- Service Pharmacie, Hôpital Universitaire Necker—Enfants Malades, Assistance Publique des Hôpitaux de Paris (AP-HP), 149 rue de Sèvres, F-75015 Paris, France
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11
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[Interstitial lung diseases in children of genetic origin]. Rev Mal Respir 2023; 40:38-46. [PMID: 36564324 DOI: 10.1016/j.rmr.2022.11.003] [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: 03/14/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
Abstract
Interstitial lung diseases in children of genetic origin. Interstitial lung disease (ILD) in children (chILD) encompasses a heterogeneous group of rare respiratory disorders, most of which are chronic and severe. In more and more of these cases, a genetic cause has been identified. As of now, the main mutations have been localized in the genes encoding the surfactant proteins (SP)-C (SFTPC), SP-B (SFTPB), their transporter ATP-binding cassette, family 1, member 3 (ABCA3), transcription factor NK2 homeobox 1 (NKX2-1) and, more rarely, SP-A1 (SFTPA1) or SP-A2 (SFTPA2). Pediatric pulmonary alveolar proteinosis (PAP) is associated with mutations in CSF2RA, CSF2RB, and MARS; more recently, mutations in STING1 and COPA have been associated with specific auto-inflammatory disorders including ILD manifestations. The relationships between the molecular abnormalities and the phenotypic expressions generally remain poorly understood. In the coming years, it is expected that newly identified molecular defects will help to more accurately predict disease courses and to produce individualized targeted therapies.
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Bonella F, Borie R. Targeted therapy for pulmonary alveolar proteinosis: the time is now. Eur Respir J 2022; 59:59/4/2102971. [PMID: 35450922 DOI: 10.1183/13993003.02971-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Pneumology Dept, Ruhrlandklinik, University Hospital, University of Essen, European Reference Network (ERN)-LUNG, ILD Core Network, Essen, Germany
| | - Raphael Borie
- Université de Paris, Inserm, U1152, laboratoire d'excellence INFLAMEX, Paris, France.,Hôpital Bichat, APHP, Service de Pneumologie A, Centre constitutif du centre de référence des Maladies Pulmonaires Rares, FHU APOLLO, Paris, France
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O'Callaghan M, Helly F, Tarling E, Keane MP, McCarthy C. Methionine supplementation; potential for improving alveolar macrophage function through reverse cholesterol transport? Eur Respir J 2021; 59:13993003.02594-2021. [PMID: 34857611 DOI: 10.1183/13993003.02594-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/25/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Marissa O'Callaghan
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Feargal Helly
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Elizabeth Tarling
- Division of Cardiology, University of California, Los Angeles, California, USA
| | - Michael P Keane
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland .,School of Medicine, University College Dublin, Dublin, Ireland
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Hadchouel A, Delacourt C. Comment on: Methionine supplementation; potential for improving alveolar macrophage function through reverse cholesterol transport? Eur Respir J 2021; 59:13993003.02937-2021. [PMID: 34857610 DOI: 10.1183/13993003.02937-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Alice Hadchouel
- AP-HP, Hôpital Universitaire Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Centre de Référence pour les Maladies Respiratoires Rares de l'Enfant, Paris, France .,Faculté de Médecine, Université de Paris, Paris, France
| | - Christophe Delacourt
- AP-HP, Hôpital Universitaire Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Centre de Référence pour les Maladies Respiratoires Rares de l'Enfant, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
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