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Potter SN, Migliore B, Carter J, Copeland VR, Smith EC, Peay HL, Kucera KS. Age-Related Blood Levels of Creatine Kinase-MM in Newborns and Patients with Duchenne Muscular Dystrophy: Considerations for the Development of Newborn Screening Algorithms. Int J Neonatal Screen 2024; 10:41. [PMID: 38920848 PMCID: PMC11203585 DOI: 10.3390/ijns10020041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/13/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
Duchenne muscular dystrophy (DMD) is an X-linked progressive disorder and the most common type of muscular dystrophy in children. As newborn screening (NBS) for DMD undergoes evaluation for the Recommended Uniform Screening Panel and is already mandated in multiple states, refining NBS algorithms is of utmost importance. NBS for DMD involves measuring creatine kinase-MM (CK-MM) concentration-a biomarker of muscle damage-in dried blood spots. The current test is FDA-approved for samples obtained less than 72 h after birth. Separate reference ranges are needed for samples collected later than 72 h after birth. In this study, we investigated the relationship between age and CK-MM in presumed healthy newborns to inform NBS algorithm designs. In patients with DMD, CK-MM is persistently elevated in childhood and adolescence, while it may be transiently elevated for other reasons in healthy newborns. CK-MM decrease over time was demonstrated by a population sample of 20,306 presumed healthy newborns tested between 0 and 60 days of life and repeat testing of 53 newborns on two separate days. In the population sample, CK-MM concentration was highest in the second 12 h period of life (median = 318 ng/mL) when only 57.6% of newborns tested below 360 ng/mL, the lowest previously published cutoff. By 72 h of age, median CK-MM concentration was 97 ng/mL, and 96.0% of infants had concentrations below 360 ng/mL. Between 72 h and 60 days, median CK-MM concentration ranged from 32 to 37 ng/mL. Establishing age-related cutoffs is crucial for optimizing the sensitivity and specificity of NBS for DMD.
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Affiliation(s)
- Sarah Nelson Potter
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
| | - Brooke Migliore
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
| | - Javan Carter
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
| | - Veronica R. Copeland
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
| | - Edward C. Smith
- Department of Pediatrics, Duke University, Durham, NC 27710, USA;
| | - Holly L. Peay
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
| | - Katerina S. Kucera
- RTI International, Research Triangle Park, Durham, NC 22709, USA; (S.N.P.); (B.M.); (J.C.); (V.R.C.); (H.L.P.)
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Zhang Z, Hong D, Ma D, Yang P, Zhang J, Wang X, Wang Y, Meng L, Wang Y, Li Y, Sun Y, Jiang T, Xu Z. Creatine Kinase-MM/Proto-oncogene Tyrosine-Protein Kinase Receptor as a Sensitive Indicator for Duchenne Muscular Dystrophy Carriers. Mol Neurobiol 2024:10.1007/s12035-024-04235-z. [PMID: 38767836 DOI: 10.1007/s12035-024-04235-z] [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: 12/01/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024]
Abstract
Duchenne muscular dystrophy (DMD), a lethal X-linked recessive genetic disease, is characterized by progressive muscle wasting which will lead to premature death by cardiorespiratory complications in their late twenties. And 2.5-19% DMD carriers that also suffer from skeletal muscle damage or dilated cardiomyopathy when diagnosed as soon as possible is meaningful for prenatal diagnosis and advance warning for self-health. The current DMD carrier screening mainly relies on detecting serum creatine kinase activity, covering only 50-70% DMD carriers which will cause many false negatives and require the discovery of highly effective biomarker and simple detection procedure for DMD carriers. In this article, we have compiled a comprehensive summary of all documented biomarkers associated with DMD and categorized them based on their expression patterns. We specifically pinpointed novel DMD biomarkers, previously unreported in DMD carriers, and conducted further investigations to explore their potential. Compared to creatine kinase activity alone in DMD carriers, creatine kinase-MM can improve the specificity from 73 to 81%. And our investigation revealed another promising protein: proto-oncogene tyrosine-protein kinase receptor (RET). When combined with creatine kinase-MM (creatine kinase-MM/RET ratio), it significantly enhances the specificity (from 81 to 83%) and sensitivity (from 71.4 to 93%) of detecting DMD carriers in serum. Moreover, we successfully devised an efficient method for extracting RET from dried blood spots. This breakthrough allowed us to detect both creatine kinase-MM and RET using dried blood spots without compromising the detection rate.
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Affiliation(s)
- Zhilei Zhang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Dongyang Hong
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Dingyuan Ma
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Peiying Yang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Jingjing Zhang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Xin Wang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Yan Wang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Lulu Meng
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Yanyun Wang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Yahong Li
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Yun Sun
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Tao Jiang
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
| | - Zhengfeng Xu
- Center of Genetic Medicine, The affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China
- , Nanjing, China
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Kucera KS, Boyea BL, Migliore B, Potter SN, Robles VR, Kutsa O, Cope H, Okoniewski KC, Wheeler A, Rehder CW, Smith EC, Peay HL. Two years of newborn screening for Duchenne muscular dystrophy as a part of the statewide Early Check research program in North Carolina. Genet Med 2024; 26:101009. [PMID: 37864479 DOI: 10.1016/j.gim.2023.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023] Open
Abstract
PURPOSE Current and emerging treatments for Duchenne muscular dystrophy (DMD) position DMD as a candidate condition for newborn screening (NBS). In anticipation of the nomination of DMD for universal NBS, we conducted a prospective study under the Early Check voluntary NBS research program in North Carolina, United States. METHODS We performed screening for creatine kinase-MM (CK-MM), a biomarker of muscle damage, on residual routine newborn dried blood spots (DBS) from participating newborns. Total creatine kinase testing and next generation sequencing of an 86-neuromuscular gene panel that included DMD were offered to parents of newborns who screened positive. Bivariate and multivariable analyses were performed to assess effects of biological and demographic predictors on CK-MM levels in DBS. RESULTS We screened 13,354 newborns and identified 2 males with DMD. The provisional 1626 ng/mL cutoff was raised to 2032 ng/mL to improve specificity, and additional cutoffs (900 and 360 ng/mL) were implemented to improve sensitivity for older and low-birthweight newborns. CONCLUSION Population-scale screening for elevated CK-MM in DBS is a feasible approach to identify newborns with DMD. Inclusion of birthweight- and age-specific cutoffs, repeat creatine kinase testing after 72 hours of age, and DMD sequencing improve sensitivity and specificity of screening.
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Affiliation(s)
| | | | | | | | | | - Oksana Kutsa
- RTI International, Research Triangle Park, Durham, NC
| | - Heidi Cope
- RTI International, Research Triangle Park, Durham, NC
| | | | - Anne Wheeler
- RTI International, Research Triangle Park, Durham, NC
| | | | | | - Holly L Peay
- RTI International, Research Triangle Park, Durham, NC
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Tavakoli NP, Gruber D, Armstrong N, Chung WK, Maloney B, Park S, Wynn J, Koval‐Burt C, Verdade L, Tegay DH, Cohen LL, Shapiro N, Kennedy A, Noritz G, Ciafaloni E, Weinberger B, Ellington M, Schleien C, Spinazzola R, Sood S, Brower A, Lloyd‐Puryear M, Caggana M. Newborn screening for Duchenne muscular dystrophy: A two-year pilot study. Ann Clin Transl Neurol 2023; 10:1383-1396. [PMID: 37350320 PMCID: PMC10424650 DOI: 10.1002/acn3.51829] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/02/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVE Duchenne muscular dystrophy (DMD) is an X-linked disorder resulting in progressive muscle weakness and atrophy, cardiomyopathy, and in late stages, cardiorespiratory impairment, and death. As treatments for DMD have expanded, a DMD newborn screening (NBS) pilot study was conducted in New York State to evaluate the feasibility and benefit of NBS for DMD and to provide an early pre-symptomatic diagnosis. METHODS At participating hospitals, newborns were recruited to the pilot study, and consent was obtained to screen the newborn for DMD. The first-tier screen measured creatine kinase-MM (CK-MM) in dried blood spot specimens submitted for routine NBS. Newborns with elevated CK-MM were referred for genetic counseling and genetic testing. The latter included deletion/duplication analysis and next-generation sequencing (NGS) of the DMD gene followed by NGS for a panel of neuromuscular conditions if no pathogenic variants were detected in the DMD gene. RESULTS In the two-year pilot study, 36,781 newborns were screened with CK-MM. Forty-two newborns (25 male and 17 female) were screen positive and referred for genetic testing. Deletions or duplications in the DMD gene were detected in four male infants consistent with DMD or Becker muscular dystrophy. One female DMD carrier was identified. INTERPRETATION This study demonstrated that the state NBS program infrastructure and screening technologies we used are feasible to perform NBS for DMD. With an increasing number of treatment options, the clinical utility of early identification for affected newborns and their families lends support for NBS for this severe disease.
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Affiliation(s)
- Norma P. Tavakoli
- Division of GeneticsWadsworth Center, New York State Department of HealthAlbanyNew YorkUSA
- Department of Biomedical SciencesState University of New YorkAlbanyNew YorkUSA
| | - Dorota Gruber
- Department of Pediatrics, Cohen Children's Medical CenterNorthwell HealthNew Hyde ParkNew YorkUSA
- Departments of Pediatrics and CardiologyZucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | | | - Wendy K. Chung
- Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Breanne Maloney
- Division of GeneticsWadsworth Center, New York State Department of HealthAlbanyNew YorkUSA
| | - Sunju Park
- Division of GeneticsWadsworth Center, New York State Department of HealthAlbanyNew YorkUSA
| | - Julia Wynn
- Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Carrie Koval‐Burt
- Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Lorraine Verdade
- Department of Pediatrics, Cohen Children's Medical CenterNorthwell HealthNew Hyde ParkNew YorkUSA
| | - David H. Tegay
- Department of Pediatrics, Cohen Children's Medical CenterNorthwell HealthNew Hyde ParkNew YorkUSA
- IQVIADurhamNorth CarolinaUSA
| | | | | | | | | | - Emma Ciafaloni
- Pediatric Neuromuscular MedicineUniversity of RochesterRochesterNew YorkUSA
| | - Barry Weinberger
- Division of Neonatology, Cohen Children's Medical CenterNorthwell HealthNew Hyde ParkNew YorkUSA
- Department of PediatricsZucker School of Medicine of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Marty Ellington
- Department of PediatricsZucker School of Medicine of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
- Department of PediatricsLenox Hill Hospital, Northwell HealthNew YorkNew YorkUSA
| | - Charles Schleien
- Department of Pediatrics, Cohen Children's Medical CenterNorthwell HealthNew Hyde ParkNew YorkUSA
- Department of PediatricsZucker School of Medicine of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Regina Spinazzola
- Department of PediatricsZucker School of Medicine of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
- Division of Neonatal‐Perinatal Medicine at Cohen Children's Hospital/North Shore University Hospital, Northwell HealthManhassetNew YorkUSA
| | - Sunil Sood
- Department of PediatricsZucker School of Medicine of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
- South Shore University Hospital, Northwell HealthBay ShoreNew YorkUSA
| | - Amy Brower
- American College of Medical Genetics and GenomicsBethesdaMarylandUSA
| | - Michele Lloyd‐Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Institutes of HealthBethesdaMarylandUSA
| | - Michele Caggana
- Division of GeneticsWadsworth Center, New York State Department of HealthAlbanyNew YorkUSA
- Department of Biomedical SciencesState University of New YorkAlbanyNew YorkUSA
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5
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Maloney B, Park S, Sowizral M, Brackett I, Moslehi R, Chung WK, Gruber D, Brower A, Lloyd-Puryear M, Caggana M, Tavakoli NP. Factors Influencing Creatine Kinase-MM Concentrations in Newborns and Implications for Newborn Screening for Duchenne Muscular Dystrophy. Clin Biochem 2023:110614. [PMID: 37479106 DOI: 10.1016/j.clinbiochem.2023.110614] [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: 05/11/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Newborn screening for Duchenne muscular dystrophy can be performed via a first-tier creatine kinase-MM measurement followed by reflex testing to second-tier molecular analysis of the DMD gene. In order to establish appropriate cut-offs for the creatine kinase-MM screen, factors that influence creatine kinase-MM in newborns were investigated. MATERIALS AND METHODS Creatine kinase-MM data from a consented pilot study in New York State were collected over a two-year period and combined with de-identified validation data and analyzed. Univariate analysis and multiple linear regression analysis were performed. RESULTS The analysis indicated that age of newborn at specimen collection, gestational age and birth weight were significant influencers of CK-MM levels in newborns. In addition, to a lesser extent, sex, race/ethnicity and seasonal temperature also affect CK-MM levels in newborns. CONCLUSIONS To reduce false positive and false negative cases, newborn screening programs should be cognizant of factors that influence CK-MM when determining cut-offs for the assay. Variability based on age at specimen collection and birth weight are primarily observed within the first week of life. Therefore, particularly during this time period, multi-tiered cut-offs based on age of collection and lower cut-offs for premature and low birth weight babies are recommended. Other cut-off determinants may include sex, race/ethnicity and seasonal temperature.
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Affiliation(s)
- Breanne Maloney
- Division of Genetics, Wadsworth Center, New York State Department of Health, 120, New Scotland Ave., Albany, NY, 12208 USA.
| | - Sunju Park
- Division of Genetics, Wadsworth Center, New York State Department of Health, 120, New Scotland Ave., Albany, NY, 12208 USA.
| | - Mycroft Sowizral
- Wadsworth Center, New York State Department of Health, 140, New Scotland Ave., Albany, NY, 12208, USA.
| | - Isa Brackett
- Department of Epidemiology, School of Public Health, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA.
| | - Roxana Moslehi
- Department of Epidemiology and Biostatistics, and Cancer Research Center, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA.
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, 630, West 168(th) Street, New York, NY, 10032, USA.
| | - Dorota Gruber
- Department of Pediatrics, Cohen Children's Medical Center, Northwell Health, 225, Community Drive, Suite 110, Great Neck, NY, 11020, USA.
| | - Amy Brower
- American College of Medical Genetics and Genomics, 7101, Wisconsin Ave., Suite 1101, Bethesda, MD, 20814, USA.
| | - Michele Lloyd-Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (Retired), National Institutes of Health, 1, Center Drive, Bethesda, MD, 20892, USA.
| | - Michele Caggana
- Division of Genetics, Wadsworth Center, New York State Department of Health, 120, New Scotland Ave., Albany, NY, 12208 USA; Department of Biomedical Sciences, School of Public Health, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA.
| | - Norma P Tavakoli
- Division of Genetics, Wadsworth Center, New York State Department of Health, 120, New Scotland Ave., Albany, NY, 12208 USA; Department of Biomedical Sciences, School of Public Health, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA.
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Chen B, Wang Y, Hou D, Zhang Y, Zhang B, Niu Y, Ji H, Tian Y, Liu X, Kang X, Cai H, Li Z. Transcriptome-Based Identification of the Muscle Tissue-Specific Expression Gene CKM and Its Regulation of Proliferation, Apoptosis and Differentiation in Chicken Primary Myoblasts. Animals (Basel) 2023; 13:2316. [PMID: 37508090 PMCID: PMC10376263 DOI: 10.3390/ani13142316] [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: 06/14/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Skeletal muscle is an essential tissue in meat-producing animals, and meat-producing traits have been a hot topic in chicken genetic breeding research. Current research shows that creatine kinase M-type-like (CKM) is one of the most abundant proteins in skeletal muscle and plays an important role in the growth and development of skeletal muscle, but its role in the development of chicken skeletal muscle is still unclear. Via RNA sequencing (RNA-seq), we found that CKM was highly expressed in chicken breast muscle tissue. In this study, the expression profile of CKM was examined by quantitative real-time PCR (qPCR), and overexpression and RNA interference techniques were used to explore the functions of CKM in the proliferation, apoptosis and differentiation of chicken primary myoblasts (CPMs). It was shown that CKM was specifically highly expressed in breast muscle and leg muscle and was highly expressed in stage 16 embryonic muscle, while CKM inhibited proliferation, promoted the apoptosis and differentiation of CPMs and was involved in regulating chicken myogenesis. Transcriptome sequencing was used to identify genes that were differentially expressed in CPMs after CKM disruption, and bioinformatics analysis showed that CKM was involved in regulating chicken myogenesis. In summary, CKM plays an important role in skeletal muscle development during chicken growth and development.
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Affiliation(s)
- Bingjie Chen
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yanxing Wang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Dan Hou
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yushi Zhang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Bochun Zhang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yufang Niu
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Haigang Ji
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yadong Tian
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Xiaojun Liu
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Xiangtao Kang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Hanfang Cai
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Zhuanjian Li
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
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Dantonio P, Tavakoli NP, Migliore B, McCown E, Lim T, Park S, Caggana M, Kucera KS, Phan H, Street N, Petritis K, Vogt RF. Multi-Laboratory Evaluation of Prototype Dried Blood Spot Quality Control Materials for Creatine Kinase-MM Newborn Screening Assays. Int J Neonatal Screen 2023; 9:ijns9010013. [PMID: 36975851 PMCID: PMC10053407 DOI: 10.3390/ijns9010013] [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] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 03/04/2023] Open
Abstract
Pilot studies to detect newborns with Duchenne Muscular Dystrophy (DMD) by newborn bloodspot screening (NBS) have been conducted under the New York State Newborn Screening Program (NYS) and are currently in progress as part of the Early Check Program at Research Triangle Institute (RTI) International. The Newborn Screening Quality Assurance Program (NSQAP) at the U.S. Centers for Disease Control and Prevention (CDC) produced a set of seven prototype dried blood spot (DBS) reference materials spiked with varying levels of creatine kinase MM isoform (CK-MM). These DBS were evaluated over a 3-week period by CDC, NYS, and RTI, all using the same CK-MM isoform-specific fluoroimmunoassay. Results from each laboratory were highly correlated with the relative proportion of CK-MM added to each of the six spiked pools. Based on reference ranges established by NYS and RTI for their pilot studies, these contrived DBS collectively spanned the CK-MM ranges found in typical newborns and the elevated ranges associated with DMD. This set allows quality assessment over the wide range of fluctuating CK-MM levels in typical and DMD-affected newborns.
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Affiliation(s)
- Paul Dantonio
- Newborn Screening and Molecular Biology Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Norma P. Tavakoli
- Wadsworth Center, Division of Genetics, New York State Department of Health, Albany, NY 12208, USA
| | - Brooke Migliore
- RTI International, Research Triangle Park, Durham, NC 27709, USA
| | - Elizabeth McCown
- Newborn Screening and Molecular Biology Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Timothy Lim
- Newborn Screening and Molecular Biology Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Sunju Park
- Wadsworth Center, Division of Genetics, New York State Department of Health, Albany, NY 12208, USA
| | - Michele Caggana
- Wadsworth Center, Division of Genetics, New York State Department of Health, Albany, NY 12208, USA
| | | | - Han Phan
- Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA
- Rare Disease Research, Atlanta, GA 30329, USA
| | - Natalie Street
- Birth Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects & Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Konstantinos Petritis
- Newborn Screening and Molecular Biology Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Robert F. Vogt
- Newborn Screening and Molecular Biology Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
- Correspondence:
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8
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Newborn screening and genomic analysis of duchenne muscular dystrophy in Henan, China. Clin Chim Acta 2023; 539:90-96. [PMID: 36516925 DOI: 10.1016/j.cca.2022.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Duchenne Muscular Dystrophy (DMD) is a rare disorder caused by mutations in the dystrophin gene. Recent availability in treatment for DMD raised the need of early screening in our center, but newborn screening (NBS) for DMD has not been carried out in Henan Province. OBJECTIVES To determine an optimal cutoff value through the quantitative determination of the creatine kinase isoform MM (CK-MM) concentration dried blood spot (DBS) to identify male DMD, and to evaluate assess the detection rate and mutation spectrum of DMD in Henan, China. METHODS The CK-MM level in DBS was measured using with a GSP® neonatal creatine kinase -MM kit from 13,110 male newborns to establish the cut-off value for CK-MM. Multiplex ligation-dependent probe amplification (MLPA) were carried out for infants with elevated CK levels to detect DMD gene deletions/ duplications, NGS and sanger sequencing were then applied to exclude MLPA-negative samples to single-nucleotide variants. Phenotype-genotype correlations were analyzed using REVEL For novel missense mutations. RESULTS Statistical analysis of CK-MM value of the 13,110 neonates suggested that the cut-off value may be set as 472 ng/mL. 3 cases of DMD were screened among 13,110 newborns, all of whom had CK-MM levels >600 ng/mL. We detected 4 rare variants in DMD gene, including 2 exon deletions (deletion of exon 52 and deletion from exon 3 to exon 7) and 2 point variants (c.9568C>T and c.4030C>T). Two cases were all exon deletions, one case was compound heterozygous variants. CONCLUSIONS The estimated incidence of male neonatal DMD was 1:4,370 in Henan province. NBS is of great value to the early intervention and treatment of the disease, and is fundamental to support public health decision-making. The experience from this study provided a model that will allow further expansion and facilitate establishment a universal public health screening in Henan hospital systems.
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A pilot study of newborn screening for Duchenne muscular dystrophy in Guangzhou. Heliyon 2022; 8:e11071. [PMID: 36281417 PMCID: PMC9587328 DOI: 10.1016/j.heliyon.2022.e11071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background To estimate the overall situation of Duchenne muscular dystrophy (DMD) screening in newborns in Guangzhou, China. Method A total of 62553 newborns including 44268 males and 18285 females were screened for DMD by measuring muscle specific creatine kinase isoform (CK-MM) concentrations using the GSP® Neonatal CK-MM kit based on time-resolved immunofluorescence. We recalled positive cases and recollected dried blood spots (DBS) for retest of CK-MM. The newborns with retest positive result were recalled again for serum creatine kinase (CK) and multiplex ligation-dependent probe amplification (MLPA) test. Whole exon sequencing was performed when MLPA test was negative. Results Four males were diagnosed with DMD. The incidence of males was 1/11067. No DMD patient was found in female. There were significant differences of CK-MM concentration between male and female newborns. Among gestational age (GA), birth weight (BW) and age at sampling, linear regression analysis showed that CK-MM concentration was much more closely correlated with GA and age at sampling. Conclusions CK-MM concentration is affected by gender, GA, BW and age at sampling. The efficiency of DMD screening might be improved by adjusting a multitier cut-off value according to GA and age at sampling. DMD newborn screening should be male priority. A total of 62553 newborns including 44268 males and 18285 females were screened for DMD in Guangzhou. Four males were diagnosed with DMD. The incidence of males was 1/11067. No DMD patient found in female. DMD newborn screening should be male priority. The efficiency of DMD screening might be improved by adjusting a multitier cut-off value according to GA and age at sampling.
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10
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Park S, Maloney B, Caggana M, Tavakoli NP. Creatine kinase-MM concentration in dried blood spots from newborns and implications for newborn screening for Duchenne muscular dystrophy. Muscle Nerve 2022; 65:652-658. [PMID: 35307847 PMCID: PMC9322420 DOI: 10.1002/mus.27533] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022]
Abstract
Introduction/Aims Creatine kinase‐MM (CK‐MM) is a marker of skeletal muscle damage. Detection of elevated levels of CK‐MM in newborns can enable an early suspicion of the diagnosis of Duchenne muscular dystrophy (DMD) before symptom onset. Our aim was to investigate CK‐MM levels in DMD‐affected and unaffected newborns using an immunoassay that measures CK‐MM concentration in dried blood spots collected for routine newborn screening. Methods To validate the assay in our laboratory, CK‐MM measurements and newborn demographic information were collected for 8584 de‐identified specimens and 15 confirmed DMD patients. After analyzing validation data, CK‐MM normal ranges were determined based on age of newborn at specimen collection. Subsequently, the assay was used to measure CK‐MM concentration in 26 135 newborns as part of a consented pilot study to screen for DMD in New York State. Mean and median levels of CK‐MM based on age of collection, in addition to the 2.5th, 50th, 97.5th, and 99.5th percentiles, were recalculated using the validation and screening data sets. Results Median CK‐MM within 1 hour of birth was 109 ng/mL, rose to a high of 499 ng/mL at 25 hours of age, and then declined to 200 ng/mL at 2 days of life. The median continued to decline more slowly and then stabilized at approximately 40 ng/mL at 1 week of life. Discussion Because of the marked variability and elevated CK‐MM levels observed within the first days of life, it is important to set multiple CK‐MM age‐related cut‐offs when screening for DMD in newborns.
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Affiliation(s)
- Sunju Park
- Division of Genetics, Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, New York, USA
| | - Breanne Maloney
- Division of Genetics, Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, New York, USA
| | - Michele Caggana
- Division of Genetics, Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, New York, USA
| | - Norma P Tavakoli
- Division of Genetics, Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, New York, USA
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11
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Gruber D, Lloyd‐Puryear M, Armstrong N, Scavina M, Tavakoli NP, Brower AM, Caggana M, Chung WK. Newborn screening for Duchenne muscular dystrophy-early detection and diagnostic algorithm for female carriers of Duchenne muscular dystrophy. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2022; 190:197-205. [PMID: 36152336 PMCID: PMC9826042 DOI: 10.1002/ajmg.c.32000] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/24/2022] [Accepted: 08/27/2022] [Indexed: 01/11/2023]
Abstract
Duchenne muscular dystrophy (DMD) is the most common pediatric-onset form of muscular dystrophy, occurring in 1 in 5,000 live male births. DMD is a multi-system disease resulting in muscle weakness with progressive deterioration of skeletal, heart, and smooth muscle, and learning disabilities. Pathogenic/likely pathogenic (P/LP) variants in the DMD gene, which encodes dystrophin protein, cause dystrophinopathy. All males with a P/LP variant in the X-linked DMD gene are expected to be affected. Two to 20% of female heterozygotes with a P/LP variant develop symptoms of dystrophinopathy ranging from mild muscle weakness to significant disability similar to Becker muscular dystrophy. Recently, with improvements in therapies and testing methodology, there is stronger evidence supporting newborn screening (NBS) for DMD for males and females because females may also develop symptoms. A consented pilot study to screen newborns for DMD was initiated in New York State (NYS) and conducted from 2019 to 2021. The identification of female carriers and the realization of the subsequent uncertainty of providers concerning follow-up during the pilot led to the development of algorithms for screening and diagnosis of carrier females, including both NBS and cascade molecular testing of family members.
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Affiliation(s)
- Dorota Gruber
- Department of PediatricsCohen Children's Medical Center, Northwell HealthNew Hyde ParkNew YorkUSA,Departments of Pediatrics and CardiologyDonald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNew YorkUSA
| | - Michele Lloyd‐Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (Retired), National Institutes of HealthBethesdaMarylandUSA
| | - Niki Armstrong
- Parent Project Muscular DystrophyWashingtonDistrict of ColumbiaUSA
| | - Mena Scavina
- Parent Project Muscular DystrophyWashingtonDistrict of ColumbiaUSA,Nemours Children's Health, DelawareWilmingtonDelawareUSA
| | - Norma P. Tavakoli
- Division of Genetics, Wadsworth CenterNew York State Department of HealthAlbanyNew YorkUSA
| | - Amy M. Brower
- American College of Medical Genetics and GenomicsBethesdaMarylandUSA
| | - Michele Caggana
- Division of Genetics, Wadsworth CenterNew York State Department of HealthAlbanyNew YorkUSA
| | - Wendy K. Chung
- Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
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12
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Abstract
PURPOSE OF REVIEW This review highlights the key studies investigating various types of biomarkers in Duchenne muscular dystrophy (DMD). RECENT FINDINGS Several proteomic and metabolomic studies have been undertaken in both human DMD patients and animal models of DMD that have identified potential biomarkers in DMD. Although there have been a number of proteomic and metabolomic studies that have identified various potential biomarkers in DMD, more definitive studies still need to be undertaken in DMD patients to firmly correlate these biomarkers with diagnosis, disease progression, and monitoring the effects of novel treatment strategies being developed.
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Affiliation(s)
- Theo Lee-Gannon
- Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Xuan Jiang
- Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- UT Southwestern Senator Paul D. Wellstone Muscular Dystrophy Specialized Research Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Tara C Tassin
- Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- UT Southwestern Senator Paul D. Wellstone Muscular Dystrophy Specialized Research Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Pradeep P A Mammen
- Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
- Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
- UT Southwestern Senator Paul D. Wellstone Muscular Dystrophy Specialized Research Center, UT Southwestern Medical Center, Dallas, TX, 75390, USA.
- Heart Failure, Ventricular Assist Device & Heart Transplant Program, UT Southwestern Medical Center, Dallas, TX, 75390, USA.
- Hamon Center for Regenerative Science and Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA.
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13
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Improving Recruitment for a Newborn Screening Pilot Study with Adaptations in Response to the COVID-19 Pandemic. Int J Neonatal Screen 2022; 8:ijns8020023. [PMID: 35466194 PMCID: PMC9036248 DOI: 10.3390/ijns8020023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/09/2022] [Indexed: 12/07/2022] Open
Abstract
Seven months after the launch of a pilot study to screen newborns for Duchenne Muscular Dystrophy (DMD) in New York State, New York City became an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. All in-person research activities were suspended at the study enrollment institutions of Northwell Health and NewYork-Presbyterian Hospitals, and study recruitment was transitioned to 100% remote. Pre-pandemic, all recruitment was in-person with research staff visiting the postpartum patients 1-2 days after delivery to obtain consent. With the onset of pandemic, the multilingual research staff shifted to calling new mothers while they were in the hospital or shortly after discharge, and consent was collected via emailed e-consent links. With return of study staff to the hospitals, a hybrid approach was implemented with in-person recruitment for babies delivered during the weekdays and remote recruitment for babies delivered on weekends and holidays, a cohort not recruited pre-pandemic. There was a drop in the proportion of eligible babies enrolled with the transition to fully remote recruitment from 64% to 38%. In addition, the proportion of babies enrolled after being approached dropped from 91% to 55%. With hybrid recruitment, the proportion of eligible babies enrolled (70%) and approached babies enrolled (84%) returned to pre-pandemic levels. Our experience adapting our study during the COVID-19 pandemic led us to develop new recruitment strategies that we continue to utilize. The lessons learned from this pilot study can serve to help other research studies adapt novel and effective recruitment methods.
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14
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Migliore BA, Zhou L, Duparc M, Robles VR, Rehder CW, Peay HL, Kucera KS. Evaluation of the GSP Creatine Kinase-MM Assay and Assessment of CK-MM Stability in Newborn, Patient, and Contrived Dried Blood Spots for Newborn Screening for Duchenne Muscular Dystrophy. Int J Neonatal Screen 2022; 8:ijns8010012. [PMID: 35225934 PMCID: PMC8883886 DOI: 10.3390/ijns8010012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Duchenne Muscular Dystrophy (DMD) is a fatal X-linked disorder with a birth prevalence of 19.8:100,000 males worldwide. Elevated concentration of the muscle enzyme creatine kinase-MM (CK-MM) allows for presymptomatic screening of newborns using Dried Blood Spots (DBS). We evaluated imprecision and carryover of the FDA-approved PerkinElmer GSP Neonatal CK-MM kit over multiple runs, days, and operators, followed by quantification of CK-MM loss in stored newborn, contrived, and non-newborn patient DBS resulting from exposure to ambient versus low humidity (50-day trial), and high humidity and high temperature (8-day trial). Imprecision %CV was ≤14% for all verification comparisons and over 6 months of testing. On average, the mean CK-MM recovery after 50 days was >80% of initial concentration for all sample types stored in low humidity and <80% in ambient humidity. After 8 days of storage in high humidity and high temperature, the mean recovery for newborn samples was <80%. Verification results for the GSP Neonatal CK-MM assay were concordant with kit parameters and the assay performed consistently over 6 months. CK-MM degradation in ambient storage can be mitigated by reducing exposure to humidity. Assessment of DBS shipping and storage conditions is recommended prior to implementing DMD screening.
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Affiliation(s)
- Brooke A. Migliore
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
| | - Linran Zhou
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
| | - Martin Duparc
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
| | - Veronica R. Robles
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
| | | | - Holly L. Peay
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
| | - Katerina S. Kucera
- RTI International, Research Triangle Park, Durham, NC 27709, USA; (B.A.M.); (L.Z.); (M.D.); (V.R.R.); (H.L.P.)
- Correspondence: ; Tel.: +1-(919)-541-6000
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15
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Implementation of Hospital-Based Supplemental Duchenne Muscular Dystrophy Newborn Screening (sDMDNBS): A Pathway to Broadening Adoption. Int J Neonatal Screen 2021; 7:ijns7040077. [PMID: 34842620 PMCID: PMC8629008 DOI: 10.3390/ijns7040077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/29/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is not currently part of mandatory newborn screening, despite the availability of a test since 1975. In the absence of screening, a DMD diagnosis is often not established in patients until 3-6 years of age. During this time, irreversible muscle degeneration takes place, and clinicians agree that the earlier therapy is initiated, the better the long-term outcome. With recent availability of FDA-approved DMD therapies, interest has renewed for adoption by state public health programs, but such implementation is a multiyear process. To speed access to approved therapies, we implemented a unique, hospital-based program offering parents of newborns an optional, supplemental DMD newborn screen (NBS) via a two-tiered approach: utilizing a creatine kinase (CK) enzyme assay coupled with rapid targeted next-generation sequencing (tNGS) for the DMD gene (using a Whole-Exome Sequencing (WES) assay). The tNGS/WES assay integrates the ability to detect both point mutations and large deletion/duplication events. This tiered newborn screening approach allows for the opportunity to improve treatment and outcomes, avoid the diagnostic delays, and diminish healthcare disparities. To implement this screening algorithm through hospitals in a way that would ultimately be acceptable to public health laboratories, we chose an FDA-approved CK-MM immunoassay to avoid the risks of false-negative/-positive results. Because newborn CK values can be affected due to non-DMD-related causes such as birth trauma, a confirmatory repeat CK assay on a later dried blood spot (DBS) collection has been proposed. Difficulties associated with non-routine repeat DBS collection, including the tracking and recall of families, and the potential creation of parental anxiety associated with false-positive results, can be avoided with this algorithm. Whereas a DMD diagnosis is essentially ruled out by the absence of detected DMD sequence abnormalities, a subsequent CK would still be warranted to confirm resolution of the initial elevation, and thus the absence of non-DMD muscular dystrophy or other pathologies. To date, we have screened over 1500 newborns (uptake rate of ~80%) by a CK-MM assay, and reflexed DMD tNGS in 29 of those babies. We expect the experience from this screening effort will serve as a model that will allow further expansion to other hospital systems until a universal public health screening is established.
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16
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Wang Y, Xiao Y, Zheng Y, Yang L, Wang D. An anti-ADAMTS1 treatment relieved muscle dysfunction and fibrosis in dystrophic mice. Life Sci 2021; 281:119756. [PMID: 34175316 DOI: 10.1016/j.lfs.2021.119756] [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: 01/26/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 11/27/2022]
Abstract
Duchenne Muscular Dystrophy (DMD) is caused by mutations in the dystrophin gene, accompanied by aberrant extracellular matrix synthesis and muscle damage. ADAMTS1 metalloproteinase was reported increased in dystrophin-deficient mdx mouse. The aim of this study was to explore the role of ADAMTS1 in muscle function, fibrosis and damage, and respiratory function of mdx mice. 102 DMD patients and their mothers were included in this study. Multiplex ligation dependent probe amplification (MLPA) assay and Next-generation sequencing (NGS) were adopted to do genetic diagnosis. Dystrophin-deficient mdx mice were treated with anti-ADAMTS1 antibody (anti-ADAMTS1) for three weeks. The results showed that ADAMTS1 was increased in gastrocnemius muscle of mdx mice and serum of DMD patients. Anti-ADAMTS1 treatment increased Versican transcription but suppressed versican protein expression. Besides, we found anti-ADAMTS1 improved muscle strength, diaphragm and extensor digitorum longus muscles functions in mdx mice. Meanwhile, muscle fibrosis and damage were attenuated in anti-ADAMTS1 treated dystrophic mice. In summary, anti-ADAMTS1 antibody relieved muscle dysfunction and fibrosis in dystrophic mice. It is suggested that ADAMTS1 is a potential target for developing new biological therapies for DMD.
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Affiliation(s)
- Yan Wang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi 'an 710004, Shaanxi Province, China; Department of Neurology, Xi'an Children's Hospital, Xi'an 710000, Shaanxi Province, China
| | - Yanfeng Xiao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi 'an 710004, Shaanxi Province, China.
| | - Yanyan Zheng
- Department of Neurology, Xi'an Children's Hospital, Xi'an 710000, Shaanxi Province, China
| | - Le Yang
- Department of Neurology, Xi'an Children's Hospital, Xi'an 710000, Shaanxi Province, China
| | - Dong Wang
- Department of Neurology, Xi'an Children's Hospital, Xi'an 710000, Shaanxi Province, China
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17
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Moat SJ, Zelek WM, Carne E, Ponsford MJ, Bramhall K, Jones S, El-Shanawany T, Wise MP, Thomas A, George C, Fegan C, Steven R, Webb R, Weeks I, Morgan BP, Jolles S. Development of a high-throughput SARS-CoV-2 antibody testing pathway using dried blood spot specimens. Ann Clin Biochem 2021; 58:123-131. [PMID: 33269949 PMCID: PMC7844389 DOI: 10.1177/0004563220981106] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Serological assays for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have roles in seroepidemiology, convalescent plasma-testing, antibody durability and vaccine studies. Currently, SARS-CoV-2 serology is performed using serum/plasma collected by venepuncture. Dried blood spot (DBS) testing offers significant advantages as it is minimally invasive, avoids venepuncture with specimens being mailed to the laboratory. METHODS A pathway utilizing a newborn screening laboratory infrastructure was developed using an enzyme-linked immunosorbent assay to detect IgG antibodies against the receptor-binding domain of the SARS-CoV-2 spike protein in DBS specimens. Paired plasma and DBS specimens from SARS-CoV-2 antibody-positive and -negative subjects and polymerase chain reaction positive subjects were tested. DBS specimen stability, effect of blood volume and punch location were also evaluated. RESULTS DBS specimens from antibody-negative (n = 85) and -positive (n = 35) subjects and polymerase chain reaction positive subjects (n = 11) had a mean (SD; range) optical density (OD) of 0.14 (0.046; 0.03-0.27), 0.98 (0.41; 0.31-1.64) and 1.12 (0.37; 0.49-1.54), respectively. An action value OD >0.28 correctly assigned all cases. The weighted Deming regression for comparison of the DBS and the plasma assay yielded: y = 0.004041 + 1.005x, r = 0.991, Sy/x 0.171, n = 82. Extraction efficiency of antibodies from DBS specimens was >99%. DBS specimens were stable for at least 28 days at ambient room temperature and humidity. CONCLUSIONS SARS-CoV-2 IgG receptor-binding domain antibodies can be reliably detected in DBS specimens. DBS serological testing offers lower costs than either point of care or serum/plasma assays that require patient travel, phlebotomy and hospital/clinic resources; the development of a DBS assay may be particularly important for resource poor settings.
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Affiliation(s)
- Stuart J Moat
- Wales Newborn Screening Laboratory, Department of Medical Biochemistry, Immunology and Toxicology, University Hospital of Wales, Cardiff, Wales, UK
- School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Wioleta M Zelek
- Systems Immunity University Research Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Emily Carne
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Mark J Ponsford
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
- Division of Infection, Inflammation and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Kathryn Bramhall
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Sara Jones
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - Tariq El-Shanawany
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, UK
| | - Annette Thomas
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - Chloe George
- Welsh Blood Service, Ely Valley Road, Talbot Green, Pontyclun, UK
| | - Christopher Fegan
- Department of Haematology, University Hospital of Wales, Cardiff, Wales, UK
| | - Rachael Steven
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Russell Webb
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Ian Weeks
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - B Paul Morgan
- Systems Immunity University Research Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
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Abstract
Duchenne muscular dystrophy is a severe, progressive, muscle-wasting disease that leads to difficulties with movement and, eventually, to the need for assisted ventilation and premature death. The disease is caused by mutations in DMD (encoding dystrophin) that abolish the production of dystrophin in muscle. Muscles without dystrophin are more sensitive to damage, resulting in progressive loss of muscle tissue and function, in addition to cardiomyopathy. Recent studies have greatly deepened our understanding of the primary and secondary pathogenetic mechanisms. Guidelines for the multidisciplinary care for Duchenne muscular dystrophy that address obtaining a genetic diagnosis and managing the various aspects of the disease have been established. In addition, a number of therapies that aim to restore the missing dystrophin protein or address secondary pathology have received regulatory approval and many others are in clinical development.
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Affiliation(s)
- Dongsheng Duan
- Department of Molecular Microbiology and Immunology and Department of Neurology, School of Medicine; Department of Biomedical Sciences, College of Veterinary Medicine; Department of Biomedical, Biological & Chemical Engineering, College of Engineering, University of Missouri, Columbia, MO, USA
| | - Nathalie Goemans
- Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | | | - Eugenio Mercuri
- Centro Clinico Nemo, Policlinico Gemelli, Rome, Italy
- Peadiatric Neurology, Catholic University, Rome, Italy
| | - Annemieke Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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19
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Beckers P, Caberg JH, Dideberg V, Dangouloff T, den Dunnen JT, Bours V, Servais L, Boemer F. Newborn screening of duchenne muscular dystrophy specifically targeting deletions amenable to exon-skipping therapy. Sci Rep 2021; 11:3011. [PMID: 33542429 PMCID: PMC7862591 DOI: 10.1038/s41598-021-82725-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/25/2021] [Indexed: 11/08/2022] Open
Abstract
Duchenne Muscular Dystrophy (DMD) is a lethal progressive muscle-wasting disease. New treatment strategies relying on DMD gene exon-skipping therapy have recently been approved and about 30% of patients could be amenable to exon 51, 53 or 45 skipping. We evaluated the spectrum of deletions reported in DMD registries, and designed a method to screen newborns and identify DMD deletions amenable to exon 51, 53 and 45 skipping. We developed a multiplex qPCR assay identifying hemi(homo)-zygotic deletions of the flanking exons of these therapeutic targets in DMD exons (i.e. exons 44, 46, 50, 52 and 54). We conducted an evaluation of our new method in 51 male patients with a DMD phenotype, 50 female carriers of a DMD deletion and 19 controls. Studies were performed on dried blood spots with patient's consent. We analyzed qPCR amplification curves of controls, carriers, and DMD patients to discern the presence or the absence of the target exons. Analysis of the exons flanking the exon-skipping targets permitted the identification of patients that could benefit from exon-skipping. All samples were correctly genotyped, with either presence or absence of amplification of the target exon. This proof-of-concept study demonstrates that this new assay is a highly sensitive method to identify DMD patients carrying deletions that are rescuable by exon-skipping treatment. The method is easily scalable to population-based screening. This targeted screening approach could address the new management paradigm in DMD, and could help to optimize the beneficial therapeutic effect of DMD therapies by permitting pre-symptomatic care.
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Affiliation(s)
- Pablo Beckers
- Biochemical Genetics Laboratory, Human Genetic Department, CHU de Liège, Université de Liège, CHU Sart-Tilman, Domaine Universitaire du Sart-Tilman, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
| | - Jean-Hubert Caberg
- Molecular Genetics Laboratory, Human Genetic Department, CHU Sart-Tilman, University of Liege, Liège, Belgium
| | - Vinciane Dideberg
- Molecular Genetics Laboratory, Human Genetic Department, CHU Sart-Tilman, University of Liege, Liège, Belgium
| | - Tamara Dangouloff
- Division of Child Neurology, Neuromuscular Reference Center Disease, Department of Pediatrics, University Hospital Liège & University of Liège, Liège, Belgium
| | - Johan T den Dunnen
- Department of Human Genetics and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Vincent Bours
- Head of Human Genetics Department, CHU Sart-Tilman, University of Liege, Liège, Belgium
| | - Laurent Servais
- Division of Child Neurology, Neuromuscular Reference Center Disease, Department of Pediatrics, University Hospital Liège & University of Liège, Liège, Belgium
- Department of Paediatrics, MDUK Neuromuscular Center, University of Oxford, Oxford, UK
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetic Department, CHU de Liège, Université de Liège, CHU Sart-Tilman, Domaine Universitaire du Sart-Tilman, Avenue de l'Hôpital, 1, 4000, Liège, Belgium.
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Alonso-Fernández JR, López JF. Review and Proposal of Alternative Technologies for Comprehensive and Reliable Newborn Screening Using Paper Borne Urine Samples for Lysosomal Storage Disorders: Glycosphingolipid Disorders. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2021. [DOI: 10.1590/2326-4594-jiems-2020-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Grounds MD, Terrill JR, Al-Mshhdani BA, Duong MN, Radley-Crabb HG, Arthur PG. Biomarkers for Duchenne muscular dystrophy: myonecrosis, inflammation and oxidative stress. Dis Model Mech 2020; 13:13/2/dmm043638. [PMID: 32224496 PMCID: PMC7063669 DOI: 10.1242/dmm.043638] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a lethal, X-linked disease that causes severe loss of muscle mass and function in young children. Promising therapies for DMD are being developed, but the long lead times required when using clinical outcome measures are hindering progress. This progress would be facilitated by robust molecular biomarkers in biofluids, such as blood and urine, which could be used to monitor disease progression and severity, as well as to determine optimal drug dosing before a full clinical trial. Many candidate DMD biomarkers have been identified, but there have been few follow-up studies to validate them. This Review describes the promising biomarkers for dystrophic muscle that have been identified in muscle, mainly using animal models. We strongly focus on myonecrosis and the associated inflammation and oxidative stress in DMD muscle, as the lack of dystrophin causes repeated bouts of myonecrosis, which are the key events that initiate the resultant severe dystropathology. We discuss the early events of intrinsic myonecrosis, along with early regeneration in the context of histological and other measures that are used to quantify its incidence. Molecular biomarkers linked to the closely associated events of inflammation and oxidative damage are discussed, with a focus on research related to protein thiol oxidation and to neutrophils. We summarise data linked to myonecrosis in muscle, blood and urine of dystrophic animal species, and discuss the challenge of translating such biomarkers to the clinic for DMD patients, especially to enhance the success of clinical trials. Summary: This Review discusses biomarkers in blood and urine linked to myonecrosis, inflammation and oxidative stress, to enhance development of therapies for DMD, and the challenges to be overcome for clinical translation.
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Affiliation(s)
- Miranda D Grounds
- School of Human Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Jessica R Terrill
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Basma A Al-Mshhdani
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Marisa N Duong
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Hannah G Radley-Crabb
- School of Pharmacy and Biomedical Sciences, Curtin Health and Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Peter G Arthur
- School of Molecular Sciences, the University of Western Australia, Perth, WA 6009, Australia
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22
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Swiner DJ, Jackson S, Burris BJ, Badu-Tawiah AK. Applications of Mass Spectrometry for Clinical Diagnostics: The Influence of Turnaround Time. Anal Chem 2020; 92:183-202. [PMID: 31671262 PMCID: PMC7896279 DOI: 10.1021/acs.analchem.9b04901] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This critical review discusses how the need for reduced clinical turnaround times has influenced chemical instrumentation. We focus on the development of modern mass spectrometry (MS) and its application in clinical diagnosis. With increased functionality that takes advantage of novel front-end modifications and computational capabilities, MS can now be used for non-traditional clinical analyses, including applications in clinical microbiology for bacteria differentiation and in surgical operation rooms. We summarize here recent developments in the field that have enabled such capabilities, which include miniaturization for point-of-care testing, direct complex mixture analysis via ambient ionization, chemical imaging and profiling, and systems integration.
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Affiliation(s)
- Devin J. Swiner
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Sierra Jackson
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Benjamin J. Burris
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
| | - Abraham K. Badu-Tawiah
- Department of Chemistry and Biochemistry, The Ohio State University, Columbus, Ohio 43210
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23
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Timonen A, Lloyd-Puryear M, Hougaard DM, Meriö L, Mäkinen P, Laitala V, Pölönen T, Skogstrand K, Kennedy A, Airenne S, Polari H, Korpimäki T. Duchenne Muscular Dystrophy Newborn Screening: Evaluation of a New GSP ® Neonatal Creatine Kinase-MM Kit in a US and Danish Population. Int J Neonatal Screen 2019; 5:27. [PMID: 33072986 PMCID: PMC7510235 DOI: 10.3390/ijns5030027] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/31/2019] [Indexed: 11/16/2022] Open
Abstract
Duchenne muscular dystrophy (DMD/Duchenne) is a progressive X-linked disease and is the most common pediatric-onset form of muscular dystrophy, affecting approximately 1:5000 live male births. DNA testing for mutations in the dystrophin gene confirms the diagnosis of this disorder. This study involves assessment of screening newborns for DMD using an immunoassay for muscle-type (MM) creatine kinase (CK) isoform-the GSP Neonatal CK-MM kit. Comparisons were made with CK activity determination by fluorescence measurement. In addition, the study evaluated the effect of gestational age, age of infant at time of sampling and how stable the CK-MM was over time. This assay discriminates well between normal, unaffected and Duchenne affected populations and is suitable for Duchenne newborn screening.
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Affiliation(s)
- Anne Timonen
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
- Correspondence: ; Tel.: +358-40-173-7720
| | | | - David M. Hougaard
- Danish Center for Neonatal Screening, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Liisa Meriö
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
| | | | - Ville Laitala
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
| | - Tuukka Pölönen
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
| | - Kristin Skogstrand
- Danish Center for Neonatal Screening, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Annie Kennedy
- Parent Project Muscular Dystrophy, Hackensack, NJ 07601, USA
| | - Sari Airenne
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
| | - Hanna Polari
- PerkinElmer, Wallac Oy, Mustionkatu 6, 20750 Turku, Finland
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24
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Xie M, Jiang L, Dun Y, Zhang W, Liu S. Trimetazidine combined with exercise improves exercise capacity and anti-fatal stress ability through enhancing mitochondrial quality control. Life Sci 2019; 224:157-168. [PMID: 30872179 DOI: 10.1016/j.lfs.2019.03.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/04/2019] [Accepted: 03/10/2019] [Indexed: 12/15/2022]
Abstract
AIMS To explore the effects of trimetazidine combined with exercise on EC and anti-fatal stress ability, and illustrate the underlying mechanism. METHODS C57BL/6 mice were randomly assigned to four groups (n = 11 in each group): the control, exercise, trimetazidine and trimetazidine + exercise (TE) groups. Mice were accordingly given saline (ig), Aerobic exercise (AE), trimetazidine (ig), or a combination of trimetazidine (ig) and AE for five weeks. After the intervention, each group was randomly subdivided into rest and exhaustive exercise (EE) subgroups. The mice in the control-EE and TE-EE subgroups underwent fatal stress experiments. EC and anti-fatal stress ability were assessed respectively. Mitochondrial quality control (MQC) in skeletal muscle were measured at the protein level and the organelle level. KEY FINDINGS A significantly increased exhaustive swimming time was observed in exercise (39.10 ± 12.58 min vs 14.18 ± 4.37 min), trimetazidine (33.73 ± 8.45 min vs 14.18 ± 4.37 min) and TE groups (73.78 ± 18.95 min vs 14.18 ± 4.37 min) compared with that in the control group, and a synergistic effect was detected (P < 0.05). Fatal stress experiments successfully induced skeletal muscle damage, including increased creatine kinase activity, myofibrosis, and impaired antioxidative enzyme system, all those were significantly alleviated by trimetazidine supplementation combined with AE precondition (P < 0.05). Meanwhile, AE and trimetazidine alone or combined, significantly enhanced the MQC in normal mice by activating mitochondrial biogenesis, dynamics and mitophagy, and that in mice underwent fatal stress stimulus (P < 0.05). SIGNIFICANCE This study for the first time found that trimetazidine and AE have synergistic effects on improving EC. Moreover, the combination of both interventions enhances anti-fatal stress ability. Enhancing MQC may be a key mechanism of AE combined with trimetazidine that improves EC and anti-fatal stress ability.
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Affiliation(s)
- Murong Xie
- Cardiac Rehabilitation Center, Department of Rehabilitation, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Lingjun Jiang
- Cardiac Rehabilitation Center, Department of Rehabilitation, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Yaoshan Dun
- Cardiac Rehabilitation Center, Department of Rehabilitation, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Wenliang Zhang
- Cardiac Rehabilitation Center, Department of Rehabilitation, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Suixin Liu
- Cardiac Rehabilitation Center, Department of Rehabilitation, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China.
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Abstract
Titin/connectin, encoded by the TTN gene, is the largest protein in humans. It acts as a molecular spring in the sarcomere of striated muscles. Although titin is degraded in the skeletal muscles of patients with muscular dystrophies, studies of titin have been limited by its mammoth size. Mutations in the TTN gene have been detected not only in skeletal muscle diseases but in cardiac muscle diseases. TTN mutations result in a wide variety of phenotypes. Recent proteome analysis has found that titin fragments are excreted into the urine of patents with Duchenne muscular dystrophy (DMD). Enzyme-linked immunosorbent assays (ELISAs) have shown that urinary titin is a useful noninvasive biomarker for the diagnosis and screening of not only DMD, but also of neuromuscular diseases, for predicting the outcome of cardiomyopathy and for evaluating physical activities. The development of ELISA systems to measure urinary titin has opened a door to studying muscle degradation directly and noninvasively. This review provides current understanding of urinary titin and future prospects for measuring this protein.
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26
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Sato K, Tachikawa M, Watanabe M, Miyauchi E, Uchida Y, Terasaki T. Identification of Blood-Brain Barrier-Permeable Proteins Derived from a Peripheral Organ: In Vivo and in Vitro Evidence of Blood-to-Brain Transport of Creatine Kinase. Mol Pharm 2019; 16:247-257. [PMID: 30495961 DOI: 10.1021/acs.molpharmaceut.8b00975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Certain proteins, such as inflammatory cytokines, that are released from injured or diseased organs are transported from the circulating blood through the blood-brain barrier (BBB) into the brain and contribute to the pathogenesis of related central nervous system dysfunctions. However, little is known about the protein transport mechanisms involved in the central nervous system dysfunctions. The aims of the present study were to identify BBB-permeable protein(s) derived from liver and to clarify their transport characteristics at the BBB. After administration of biotin-labeled liver cytosolic protein fraction to mice in vivo, we identified 9 biotin-labeled proteins in the brain. Among them, we focused here on creatine kinase (CK). In vitro uptake studies with human brain microvessel endothelial cells (hCMEC/D3 cells) showed preferential uptake of muscle-type CK (CK-MM) compared with brain-type CK (CK-BB) at the BBB. Integration plot analysis revealed that CK-MM readily penetrated into brain parenchyma from the circulating blood across the BBB. The uptake of CK-MM by hCMEC/D3 cells was decreased at 4 °C and in the presence of clathrin- and caveolin-dependent endocytosis inhibitors. These results indicate that entry of CK into the brain is mediated by a transport system(s) at the BBB.
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Affiliation(s)
- Kazuki Sato
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
| | - Masanori Tachikawa
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
| | - Michitoshi Watanabe
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
| | - Eisuke Miyauchi
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
| | - Yasuo Uchida
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
| | - Tetsuya Terasaki
- Division of Membrane Transport and Drug Targeting, Graduate School of Pharmaceutical Sciences , Tohoku University , Sendai 980-8577 , Japan
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27
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Capillary-based chemiluminescence immunoassay for C-reactive protein with portable imaging device. Anal Bioanal Chem 2018; 410:7177-7183. [DOI: 10.1007/s00216-018-1321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/02/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
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Matsuo M, Shirakawa T, Awano H, Nishio H. Receiver operating curve analyses of urinary titin of healthy 3-y-old children may be a noninvasive screening method for Duchenne muscular dystrophy. Clin Chim Acta 2018; 486:110-114. [PMID: 30053403 DOI: 10.1016/j.cca.2018.07.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is a progressive, fatal muscle wasting disease. Early detection of DMD by mass screening may enable the early treatment of these patients. We have reported that urinary titin concentration, an indicator of severe muscle wasting, is a diagnostic biomarker for DMD. METHODS Urinary titin concentrations were measured in healthy 3-y-old children and, by comparison with concentrations in 4 DMD patients, and validated as a screening biomarker for DMD. Urine samples were obtained from 100 healthy Japanese children, 52 boys and 48 girls, and their urinary titin concentrations measured by ELISA. RESULTS The mean ± SD urinary titin concentration was 1.5 ± 2.5 nmol/l, and the mean urinary titin concentration normalized to creatinine was 2.2 ± 4.1 pmol/mg creatinine, with no differences between boys and girls. Histograms and box-and-whisker plots showed that almost all titin and normalized titin concentrations were in narrow ranges, with one outlier in common. Receiver operating characteristic curve analysis showed that titin and normalized-titin concentrations from healthy 3-y-olds were completely separate from those of 3-y-old DMD patients. CONCLUSIONS These findings indicate that urinary titin may be an excellent non-invasive biomarker to screen for DMD.
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Affiliation(s)
- Masafumi Matsuo
- Research Center for Locomotion Biology, Kobe Gakuin University, Kobe, Japan; KNC Department of Nucleic Acid Drug Discovery, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan.
| | - Taku Shirakawa
- Research Center for Locomotion Biology, Kobe Gakuin University, Kobe, Japan; KNC Department of Nucleic Acid Drug Discovery, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan.
| | - Hiroyuki Awano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hisahide Nishio
- Research Center for Locomotion Biology, Kobe Gakuin University, Kobe, Japan; Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan.
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29
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Siddiqui MK, Veluchamy A, Maroteau C, Tavendale R, Carr F, Pearson E, Colhoun H, Morris AD, George J, Doney A, Pirmohamed M, Alfirevic A, Wadelius M, Maitland van der Zee AH, Ridker PM, Chasman DI, Palmer CNA. CKM Glu83Gly Is Associated With Blunted Creatine Kinase Variation, but Not With Myalgia. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.117.001737. [PMID: 28790154 DOI: 10.1161/circgenetics.117.001737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/23/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND To test the association of a recently reported variant in the creatine kinase (CK) muscle gene, CKM Glu83Gly (rs11559024) with constitutive creatine phosphokinase (CK) levels, CK variation, and inducibility. Given the diagnostic importance of CK in determining muscle damage, we tested the association of the variant with myalgia. METHODS AND RESULTS Meta-analysis between longitudinal cohort GoDARTS (Genetics of Diabetes Audit and Research, Tayside Scotland), minor allele frequency (=0.02), and randomized clinical trial (JUPITER [Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin], minor allele frequency=0.018) was used to replicate the association with baseline CK measures. GoDARTS was used to study the relationship with CK variability. Myalgia was studied in JUPITER trial participants. Baseline and SDs of CK were on average 18% (P value=6×10-63) and 24% (P value=2×10-5) lower for carriers of the variant, respectively. The variant was not associated with myalgia (odds ratio, 0.84; 95% confidence interval, 0.52-1.38). CONCLUSIONS This study highlights that a genetic factor known to be associated with constitutive CK levels is also associated with CK variability and inducibility. This is discussed in the context of evidence to suggest that the variant has an impact on inducibility of CK by trauma through a previously reported case of a homozygous carrier. However, the lack of association between the variant and myalgia suggests that it cannot reliably be used as a biomarker for muscle symptoms.
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Affiliation(s)
- Moneeza Kalhan Siddiqui
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Abirami Veluchamy
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Cyrielle Maroteau
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Roger Tavendale
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Fiona Carr
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Ewan Pearson
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Helen Colhoun
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Andrew D Morris
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Jacob George
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Alexander Doney
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Munir Pirmohamed
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Ana Alfirevic
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Mia Wadelius
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Anke H Maitland van der Zee
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Paul M Ridker
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Daniel I Chasman
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.)
| | - Colin N A Palmer
- From the Pat McPherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (M.K.S., A.V., C.M., R.T., F.C., E.P., J.G., A.D., C.N.A.P.); Centre for Genomic and Experimental Medicine (H.C.) and Usher Institute of Population Health Sciences and Informatics (A.D.M.), University of Edinburgh, United Kingdom; Institute of Translational Medicine, University of Liverpool, United Kingdom (M.P., A.A.); Department of Medical Sciences, Clinical Pharmacology and Science of Life Laboratory, Uppsala University, Sweden (M.W.); Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, The Netherlands (A.H.M.v.d.Z.); Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands (A.H.M.v.d.Z.); Brigham and Women's Hospital and Harvard Medical School, Boston, MA (P.M.R., D.I.C.).
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Ross LF, Clarke AJ. A Historical and Current Review of Newborn Screening for Neuromuscular Disorders From Around the World: Lessons for the United States. Pediatr Neurol 2017; 77:12-22. [PMID: 29079012 DOI: 10.1016/j.pediatrneurol.2017.08.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 07/31/2017] [Accepted: 08/20/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND We aimed to review the history of newborn screening for three neuromuscular disorders (Duchenne muscular dystrophy, Pompe disease, and spinal muscular atrophy [SMA]) to determine best practices. METHODS The history of newborn screening for Duchenne muscular dystrophy began in 1975 with the measurement of creatinine kinase on newborn male blood spots from two Midwestern hospitals in the United States. Over the next 40 years, ten programs were implemented around the globe although none currently remain. The first experimental pilot program for Pompe disease began in 2005 in Taiwan. In 2013, Missouri was the first US state to implement Pompe newborn screening before its inclusion in the Recommended Uniform Screening Panel (RUSP) in 2015 by the Advisory Committee on Heritable Disorders in Newborns and Children (United States). In 2008, SMA was reviewed and rejected for inclusion in the RUSP because no treatment existed. With the approval of nusinersen in late 2016, spinal muscular atrophy is being reconsidered for the RUSP. RESULTS A condition should meet public health screening criteria to be included in the RUSP. Duchenne muscular dystrophy, Pompe, and SMA challenge traditional screening criteria: Duchenne muscular dystrophy does not present in infancy and lacks effective treatment; Pompe and SMA may not present until adulthood; and safety and efficacy of long-term intrathecal treatment for SMA is unknown. Potential reproductive benefit and improved research recruitment do not justify a public health screening program. CONCLUSIONS This review provides lessons that could benefit US public health departments as they consider expanding screening to include neuromuscular disorders like Duchenne muscular dystrophy, Pompe, and SMA.
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Affiliation(s)
- Lainie Friedman Ross
- Clinical Ethics, Departments of Pediatrics, Medicine, Surgery and the College, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago Illinois.
| | - Angus John Clarke
- Clinical Genetics, Institute of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
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Exercise Combined with Rhodiola sacra Supplementation Improves Exercise Capacity and Ameliorates Exhaustive Exercise-Induced Muscle Damage through Enhancement of Mitochondrial Quality Control. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8024857. [PMID: 29359009 PMCID: PMC5735688 DOI: 10.1155/2017/8024857] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/01/2017] [Indexed: 11/24/2022]
Abstract
Mounting evidence has firmly established that increased exercise capacity (EC) is associated with considerable improvements in the survival of patients with cardiovascular disease (CVD) and that antistress capacity is a prognostic predictor of adverse cardiovascular events in patients with CVD. Previous studies have indicated that aerobic exercise (AE) and supplementation with Rhodiola sacra (RS), a natural plant pharmaceutical, improve EC and enable resistance to stress; however, the underlying mechanism remains unclear. This study explored the ability of AE and RS, alone or combined, to improve EC and ameliorate exhaustive exercise- (EE-) induced stress and elucidate the mechanism involved. We found that AE and RS significantly increased EC in mice and ameliorated EE-induced stress damage in skeletal and cardiac muscles (SCM); furthermore, a synergistic effect was detected for the first time. To our knowledge, the present work is the first to report that AE and RS activate mitophagy, mitochondrial dynamics, and biogenesis in SCM, both in the resting state and after EE. These data indicate that AE and RS synergistically improve EC in mice and protect SCM from EE-induced stress by enhancing mitochondrial quality control, including the activation of mitophagy, mitochondrial dynamics, and biogenesis, both at rest and after EE.
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Precision newborn screening for lysosomal disorders. Genet Med 2017; 20:847-854. [PMID: 29120458 DOI: 10.1038/gim.2017.194] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/26/2017] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The implementation of newborn screening for lysosomal disorders has uncovered overall poor specificity, psychosocial harm experienced by caregivers, and costly follow-up testing of false-positive cases. We report an informatics solution proven to minimize these issues. METHODS The Kentucky Department for Public Health outsourced testing for mucopolysaccharidosis type I (MPS I) and Pompe disease, conditions recently added to the recommended uniform screening panel, plus Krabbe disease, which was added by legislative mandate. A total of 55,161 specimens were collected from infants born over 1 year starting from February 2016. Testing by tandem mass spectrometry was integrated with multivariate pattern recognition software (Collaborative Laboratory Integrated Reports), which is freely available to newborn screening programs for selection of cases for which a biochemical second-tier test is needed. RESULTS Of five presumptive positive cases, one was affected with infantile Krabbe disease, two with Pompe disease, and one with MPS I. The remaining case was a heterozygote for the latter condition. The false-positive rate was 0.0018% and the positive predictive value was 80%. CONCLUSION Postanalytical interpretive tools can drastically reduce false-positive outcomes, with preliminary evidence of no greater risk of false-negative events, still to be verified by long-term surveillance.
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Tortorelli S, Eckerman JS, Orsini JJ, Stevens C, Hart J, Hall PL, Alexander JJ, Gavrilov D, Oglesbee D, Raymond K, Matern D, Rinaldo P. Moonlighting newborn screening markers: the incidental discovery of a second-tier test for Pompe disease. Genet Med 2017; 20:840-846. [PMID: 29095812 DOI: 10.1038/gim.2017.190] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/20/2017] [Indexed: 01/14/2023] Open
Abstract
PURPOSE To describe a novel biochemical marker in dried blood spots suitable to improve the specificity of newborn screening for Pompe disease. METHODS The new marker is a ratio calculated between the creatine/creatinine (Cre/Crn) ratio as the numerator and the activity of acid α-glucosidase (GAA) as the denominator. Using Collaborative Laboratory Integrated Reports (CLIR), the new marker was incorporated in a dual scatter plot that can achieve almost complete segregation between Pompe disease and false-positive cases. RESULTS The (Cre/Crn)/GAA ratio was measured in residual dried blood spots of five Pompe cases and was found to be elevated (range 4.41-13.26; 99%ile of neonatal controls: 1.10). Verification was by analysis of 39 blinded specimens that included 10 controls, 24 samples with a definitive classification (16 Pompe, 8 false positives), and 5 with genotypes of uncertain significance. The CLIR tool showed 100% concordance of classification for the 24 known cases. Of the remaining five cases, three p.V222M homozygotes, a benign variant, were classified by CLIR as false positives; two with genotypes of unknown significance, one likely informative, were categorized as Pompe disease. CONCLUSION The CLIR tool inclusive of the new ratio could have prevented at least 12 of 13 (92%) false-positive outcomes.
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Affiliation(s)
- Silvia Tortorelli
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
| | - Jason S Eckerman
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Joseph J Orsini
- Laboratory of Human Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Colleen Stevens
- Laboratory of Human Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Jeremy Hart
- Division of Laboratory Services, Kentucky Department for Public Health, Frankfort, Kentucky, USA.,Department of Pathology & Laboratory Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Patricia L Hall
- EGL Genetics, Tucker, Georgia, USA.,Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John J Alexander
- EGL Genetics, Tucker, Georgia, USA.,Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dimitar Gavrilov
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Devin Oglesbee
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kimiyo Raymond
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Dietrich Matern
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Piero Rinaldo
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Bang HS, Seo DY, Chung YM, Kim DH, Lee SJ, Lee SR, Kwak HB, Kim TN, Kim M, Oh KM, Son YJ, Kim S, Han J. Ursolic acid supplementation decreases markers of skeletal muscle damage during resistance training in resistance-trained men: a pilot study. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2017; 21:651-656. [PMID: 29200908 PMCID: PMC5709482 DOI: 10.4196/kjpp.2017.21.6.651] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/24/2017] [Accepted: 09/07/2017] [Indexed: 12/17/2022]
Abstract
Ursolic acid (UA) supplementation was previously shown to improve skeletal muscle function in resistance-trained men. This study aimed to determine, using the same experimental paradigm, whether UA also has beneficial effects on exercise-induced skeletal muscle damage markers including the levels of cortisol, B-type natriuretic peptide (BNP), myoglobin, creatine kinase (CK), creatine kinase-myocardial band (CK-MB), and lactate dehydrogenase (LDH) in resistance-trained men. Sixteen healthy participants were randomly assigned to resistance training (RT) or RT+UA groups (n=8 per group). Participants were trained according to the RT program (60~80% of 1 repetition, 6 times/week), and the UA group was additionally given UA supplementation (450 mg/day) for 8 weeks. Blood samples were obtained before and after intervention, and cortisol, BNP, myoglobin, CK, CK-MB, and LDH levels were analyzed. Subjects who underwent RT alone showed no significant change in body composition and markers of skeletal muscle damage, whereas RT+UA group showed slightly decreased body weight and body fat percentage and slightly increased lean body mass, but without statistical significance. In addition, UA supplementation significantly decreased the BNP, CK, CK-MB, and LDH levels (p<0.05). In conclusion, UA supplementation alleviates increased skeletal muscle damage markers after RT. This finding provides evidence for a potential new therapy for resistance-trained men.
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Affiliation(s)
- Hyun Seok Bang
- Department of Physical Education, College of Health, Social Welfare and Education, Tong Myong University, Busan 48520, Korea
| | - Dae Yun Seo
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK 21 Plus Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
| | - Young Min Chung
- School of Free Major, Tong Myong University, Busan 48520, Korea
| | - Do Hyung Kim
- Department of Physical Education, Changwon National University, Changwon 51140, Korea
| | - Sam-Jun Lee
- Department of Physical Education, College of Health, Social Welfare and Education, Tong Myong University, Busan 48520, Korea
| | - Sung Ryul Lee
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK 21 Plus Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
| | - Hyo-Bum Kwak
- Department of Kinesiology, Inha University, Incheon 22212, Korea
| | - Tae Nyun Kim
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK 21 Plus Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
| | - Min Kim
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK 21 Plus Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
| | - Kyoung-Mo Oh
- Department of Sports Leisure, College of Kyungsang, Busan 47583, Korea
| | - Young Jin Son
- Department of Sports Industry, Busan University of Foreign Studies, Busan 46234, Korea
| | - Sanghyun Kim
- Department of Sports Science, College of Natural Science, Chonbuk National University, Jeonju 54896, Korea
| | - Jin Han
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, Department of Health Sciences and Technology, BK 21 Plus Team, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
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Scheuerbrandt G. Screening for Duchenne muscular dystrophy in Germany, 1977-2011: A personal story. Muscle Nerve 2017; 57:185-188. [PMID: 28981144 DOI: 10.1002/mus.25979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 09/11/2017] [Accepted: 09/26/2017] [Indexed: 11/08/2022]
Abstract
EDITOR'S NOTE This article by Dr. Günter Scheuerbrandt is a fascinating personal account and historical narrative of the birth and development of a screening program for Duchenne Muscular Dystrophy in Germany, beginning 40 years ago. As the author notes, approval of an institutional review board or ethics committee was not required for this type of scientific investigation in one's field at the time this program was begun, but we have removed all personal data from any of the materials presented in here in order to conform to current concepts of ethical publication. This article is about the screening of 528,410, mostly 4-6-week-old, boys in Germany between 1977 and 2011 for high levels of creatine kinase (CK) to identify those with Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). During these 34 years of infant screening, 147 boys with confirmed, probable, and possible DMD (incidence 1:3,600 male births) and 33 boys with confirmed, probable, and possible BMD (incidence 1:15,500 male births) were found. Research reports about DMD were sent to families and pediatricians participating in the screening, and, on request, to families and scientists everywhere. It is hoped that screening programs used as the basis for future therapies will be able to modify the natural history of boys with DMD. New dystrophin mutations will continue to occur, necessitating screening and early therapy. Abstract Submitted for Presentation at the 10th International Society for Neonatal Screening-Asia Pacific Regional Meeting, August 2017, Ulaanbataar, Mongolia. Muscle Nerve 57: 185-188, 2018.
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Al-Zaidy SA, Lloyd-Puryear M, Kennedy A, Lopez V, Mendell JR. A Roadmap to Newborn Screening for Duchenne Muscular Dystrophy. Int J Neonatal Screen 2017; 3:8. [PMID: 31588416 PMCID: PMC6777346 DOI: 10.3390/ijns3020008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is the most common childhood form of muscular dystrophy, with an estimated frequency of 1:5000 live births. The impact of the disease presents as early as infancy with significant developmental delays, and ultimately loss of ambulation and respiratory insufficiency. Glucocorticoids are the only pharmacological agents known to alter the natural progression of the disease by prolonging ambulation, reducing scoliosis, and assisted ventilation. Introduction of therapy at an early age may halt the muscle pathology in DMD. In anticipation of the potentially disease-modifying products that are reaching regulatory review, Parent Project Muscular Dystrophy (PPMD) formally initiated a national Duchenne Newborn Screening (DNBS) effort in December 2014 to build public health infrastructure for newborn screening (NBS) for Duchenne in the United States. The effort includes a formalized national Duchenne Newborn Screening Steering Committee, six related Working Groups, a Duchenne Screening Test Development Project led by PerkinElmer, a program with the American College of Medical Genetic and Genomics' Newborn Screening Translation Research Network (NBSTRN), and collaborations with other Duchenne partners and federal agencies involved in NBS. We herein review the organization and effort of the U.S. DNBS program to develop the evidence supporting the implementation of NBS for DMD.
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Affiliation(s)
- Samiah A. Al-Zaidy
- Department of Pediatrics, Divisions of Neurology and Neuromuscular at Nationwide Children’s Hospital, Columbus, 43205 OH, USA
| | | | - Annie Kennedy
- Parent Project Muscular Dystrophy, Hackensack, 07601 NJ, USA
| | - Veronica Lopez
- Mark Krueger & Associates, Inc., New York, 10175 NY, USA
| | - Jerry R. Mendell
- Department of Pediatrics, Divisions of Neurology and Neuromuscular at Nationwide Children’s Hospital, Columbus, 43205 OH, USA
- Center for Gene Therapy, Research Institute, Nationwide Children’s Hospital, Columbus, 43205 OH, USA
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