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Costa-Riquetto AD, de Santana LS, Franco PC, Jr ACS, Martio AE, Lisboa HRK, Kohara SK, Teles MG. Genetic and clinical features of neonatal and early onset diabetes mellitus in a tertiary center cohort in Brazil. Clin Genet 2023; 103:434-447. [PMID: 36510364 DOI: 10.1111/cge.14279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Neonatal diabetes mellitus (NDM) is defined as the occurrence of severe hyperglycemia in infants under 6 months old and may be permanent (PNDM) or transient (TNDM). When diabetes is diagnosed at 6-12 months of age (early onset diabetes [EOD]), the etiology may be monogenic; however, most cases consist of type 1 diabetes mellitus (T1DM). Molecular diagnosis was determined in a cohort of 35 unrelated Brazilian patients with NDM or EOD based on targeted next-generation sequencing panel and/or chromosome 6q24 abnormalities. The impact of genetic testing on treatment and follow-up was evaluated. Overall, 24 patients had NDM: with 18 (75.0%) having PNDM, 5 TNDM (20.8%) and 1 case in which this information was unknown. Eleven patients had EOD. Genetic testing was positive in 20/24 patients with NDM (83.3%) and in 18.2% of cases of EOD. The commonest causes were ATP-sensitive potassium (KATP) channel genes, and GCK and IPEX mutations (37.1%, 11.4% and 5.7%, respectively). Patients with PNDM due to KCNJ11 and ABCC8 mutations transitioned successfully to sulfonylureas in almost 60% of cases, reinforcing the benefit of performing genetic testing in NDM as early as possible. This report refers to the largest series of cases of NDM (TNDM and PNDM) and EOD in Brazil in which patients were submitted to molecular investigation and in which the clinical impact of genetic diagnosis was also evaluated.
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Affiliation(s)
- Aline Dantas Costa-Riquetto
- Grupo de Diabetes Monogênico (Monogenic Diabetes Group), Unidade de Endocrinologia Genética (LIM25), Unidade de Diabetes, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Lucas Santos de Santana
- Grupo de Diabetes Monogênico (Monogenic Diabetes Group), Unidade de Endocrinologia Genética (LIM25), Unidade de Diabetes, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Pedro Campos Franco
- Grupo de Diabetes Monogênico (Monogenic Diabetes Group), Unidade de Endocrinologia Genética (LIM25), Unidade de Diabetes, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Augusto Cezar Santomauro Jr
- Grupo de Diabetes Monogênico (Monogenic Diabetes Group), Unidade de Endocrinologia Genética (LIM25), Unidade de Diabetes, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | | | | | | | - Milena G Teles
- Grupo de Diabetes Monogênico (Monogenic Diabetes Group), Unidade de Endocrinologia Genética (LIM25), Unidade de Diabetes, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
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Silva LDSD, de Queiroz NNM, de Melo FTC, Abrahão Neto JF, Janaú LC, de Souza Neto NJK, de Lemos MN, de Oliveira MCNI, de Alcântara AL, de Moraes LV, da Silva WM, de Souza ÍJA, Said NM, de Lemos GN, Felício KM, dos Santos MC, Motta ARB, dos Reis MDSO, Lobato IJC, de Figueiredo PBB, de Souza ACCB, Piani PPF, Felício JS. Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes. Front Endocrinol (Lausanne) 2020; 11:605681. [PMID: 33329405 PMCID: PMC7711089 DOI: 10.3389/fendo.2020.605681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients. METHODS We performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30-60 ng/ml were given 4,000 IU/day for 12 weeks. RESULTS There was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively). CONCLUSION Our pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose. CLINICAL TRIAL REGISTRATION http://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.
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Affiliation(s)
| | | | | | - João Felício Abrahão Neto
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | | | | | - Manuela Nascimento de Lemos
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | | | - Angélica Leite de Alcântara
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Lorena Vilhena de Moraes
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Wanderson Maia da Silva
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Ícaro José Araújo de Souza
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Nivin Mazen Said
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | | | - Karem Miléo Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Márcia Costa dos Santos
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Ana Regina Bastos Motta
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | | | - Isabel Jane Campos Lobato
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | | | | | - Pedro Paulo Freire Piani
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - João Soares Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
- *Correspondence: João Soares Felício,
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Identification of New Inhibitors with Potential Antitumor Activity from Polypeptide Structures via Hierarchical Virtual Screening. Molecules 2019; 24:molecules24162943. [PMID: 31416180 PMCID: PMC6720962 DOI: 10.3390/molecules24162943] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 12/12/2022] Open
Abstract
Leukemias are neoplasms that affect hematopoietic cells, which are developed by genetic alterations (mutations) that lead to the loss of proliferation control mechanisms (maturation and/or cell death). The α4β1 integrin receptor is a therapeutic target for inflammation, autoimmune diseases and lymphoid tumors. This study was carried out to search through the antagonists-based virtual screening for α4β1 receptor. Initially, seventeen (17) structures were selected (based on the inhibitory activity values, IC50) and the structure with the best value was chosen as the pivot. The pharmacophoric pattern was determined from the online PharmaGist server and resulted in a model of score value equal to 97.940 with 15 pharmacophoric characteristics that were statistically evaluated via Pearson correlations, principal component analysis (PCA) and hierarchical clustering analysis (HCA). A refined model generated four pharmacophoric hypotheses totaling 1.478 structures set of Zinc_database. After, the pharmacokinetic, toxicological and biological activity predictions were realized comparing with pivot structure that resulted in five (ZINC72088291, ZINC68842860, ZINC14365931, ZINC09588345 and ZINC91247798) structures with optimal in silico predictions. Therefore, future studies are needed to confirm antitumor potential activity of molecules selected this work with in vitro and in vivo assays.
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Hellwege J, Keaton J, Giri A, Gao X, Velez Edwards DR, Edwards TL. Population Stratification in Genetic Association Studies. CURRENT PROTOCOLS IN HUMAN GENETICS 2017; 95:1.22.1-1.22.23. [PMID: 29044472 PMCID: PMC6007879 DOI: 10.1002/cphg.48] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Population stratification (PS) is a primary consideration in studies of genetic determinants of human traits. Failure to control for PS may lead to confounding, causing a study to fail for lack of significant results, or resources to be wasted following false-positive signals. Here, historical and current approaches for addressing PS when performing genetic association studies in human populations are reviewed. Methods for detecting the presence of PS, including global and local ancestry methods, are described. Also described are approaches for accounting for PS when calculating association statistics, such that measures of association are not confounded. Many traits are being examined for the first time in minority populations, which may inherently feature PS. © 2017 by John Wiley & Sons, Inc.
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Affiliation(s)
- Jacklyn Hellwege
- Vanderbilt Genetics Institute, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN 37203, USA
| | - Jacob Keaton
- Vanderbilt Genetics Institute, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN 37203, USA
| | - Ayush Giri
- Vanderbilt Genetics Institute, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN 37203, USA
| | - Xiaoyi Gao
- Department of Ophthalmology and Preventive Medicine, Keck School of Medicine, University of Southern California, Los
Angeles, CA 90033, USA
| | - Digna R. Velez Edwards
- Vanderbilt Genetics Institute, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center,
Nashville, TN 37203, USA
| | - Todd L. Edwards
- Vanderbilt Genetics Institute, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN 37203, USA
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Gomes KFB, Santos AS, Semzezem C, Correia MR, Brito LA, Ruiz MO, Fukui RT, Matioli SR, Passos-Bueno MR, Silva MERD. The influence of population stratification on genetic markers associated with type 1 diabetes. Sci Rep 2017; 7:43513. [PMID: 28262800 PMCID: PMC5338024 DOI: 10.1038/srep43513] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 01/26/2017] [Indexed: 12/17/2022] Open
Abstract
Ethnic admixtures may interfere with the definition of type 1 diabetes (T1D) risk determinants. The role of HLA, PTPN22, INS-VNTR, and CTLA4 in T1D predisposition was analyzed in Brazilian T1D patients (n = 915), with 81.7% self-reporting as white and 789 controls (65.6% white). The results were corrected for population stratification by genotyping 93 ancestry informative markers (AIMs) (BeadXpress platform). Ancestry composition and structural association were characterized using Structure 2.3 and STRAT. Ethnic diversity resulted in T1D determinants that were partially discordant from those reported in Caucasians and Africans. The greatest contributor to T1D was the HLA-DR3/DR4 genotype (OR = 16.5) in 23.9% of the patients, followed by -DR3/DR3 (OR = 8.9) in 8.7%, -DR4/DR4 (OR = 4.7) in 6.0% and -DR3/DR9 (OR = 4.9) in 2.6%. Correction by ancestry also confirmed that the DRB1*09-DQB1*0202 haplotype conferred susceptibility, whereas the DRB1*07-DQB1*0202 and DRB1*11-DQB1*0602 haplotypes were protective, which is similar to reports in African-American patients. By contrast, the DRB1*07-DQB1*0201 haplotype was protective in our population and in Europeans, despite conferring susceptibility to Africans. The DRB1*10-DQB1*0501 haplotype was only protective in the Brazilian population. Predisposition to T1D conferred by PTPN22 and INS-VNTR and protection against T1D conferred by the DRB1*16 allele were confirmed. Correcting for population structure is important to clarify the particular genetic variants that confer susceptibility/protection for T1D in populations with ethnic admixtures.
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Affiliation(s)
- Karla Fabiana Brasil Gomes
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
| | - Aritânia Sousa Santos
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
| | - Cintia Semzezem
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
| | - Márcia Regina Correia
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
| | - Luciano Abreu Brito
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências da Universidade de São Paulo. Rua do Matão, 277, 05422-970, São Paulo, São Paulo, Brazil
| | - Marcelo Ortega Ruiz
- Laboratório de Imunologia, Rua Claudio Manoel da Costa, 270, Marília, São Paulo, Brazil
| | - Rosa Tsuneshiro Fukui
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
| | - Sergio Russo Matioli
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências da Universidade de São Paulo. Rua do Matão, 277, 05422-970, São Paulo, São Paulo, Brazil
| | - Maria Rita Passos-Bueno
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências da Universidade de São Paulo. Rua do Matão, 277, 05422-970, São Paulo, São Paulo, Brazil
| | - Maria Elizabeth Rossi da Silva
- Laboratório de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455, sala 3324, 01246-903, São Paulo, São Paulo, Brazil
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CD226 rs763361 is associated with the susceptibility to type 1 diabetes and greater frequency of GAD65 autoantibody in a Brazilian cohort. Mediators Inflamm 2014; 2014:694948. [PMID: 24891767 PMCID: PMC4033476 DOI: 10.1155/2014/694948] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/10/2014] [Accepted: 04/10/2014] [Indexed: 12/04/2022] Open
Abstract
CD226 rs763361 variant increases susceptibility to type 1 diabetes (T1D) in Caucasians. There is no data about CD226 variants in the very heterogeneous Brazilian population bearing a wide degree of admixture. We investigated its association with T1D susceptibility, clinical phenotypes, and autoimmune manifestations (islet and extrapancreatic autoantibodies). Casuistry. 532 T1D patients and 594 controls in a case-control study. Initially, CD226 coding regions and boundaries were sequenced in a subset of 106 T1D patients and 102 controls. In a second step, two CD226 variants, rs763361 (exon 7) and rs727088 (3′ UTR region), involved with CD226 regulation, were genotyped in the entire cohort. C-peptide and autoantibody levels were determined. No new polymorphic variant was found. The variants rs763361 and rs727088 were in strong linkage disequilibrium. The TT genotype of rs763361 was associated with TID risk (OR = 1.503; 95% CI = 1.135–1.991; P = 0.0044), mainly in females (P = 0.0012), greater frequency of anti-GAD autoantibody (31.9% × 24.5%; OR = 1.57; CI = 1.136–2.194; P = 0.0081), and lower C-peptide levels when compared to those with TC + CC genotypes (0.41 ± 0.30 ng/dL versus 0.70 ± 0.53 ng/dL P = 0.0218). Conclusions. The rs763361 variant of CD226 gene (TT genotype) was associated with susceptibility to T1D and with the degree of aggressiveness of the disease in T1D patients from Brazil. Ancestry had no effect.
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Szaflarska-Popławska A. Coexistence of coeliac disease and type 1 diabetes. PRZEGLAD GASTROENTEROLOGICZNY 2014; 9:11-7. [PMID: 24868293 PMCID: PMC4027839 DOI: 10.5114/pg.2014.40844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 01/17/2012] [Accepted: 03/27/2012] [Indexed: 12/30/2022]
Abstract
There is a selective review of the literature concerning the coexistence of coeliac disease and type 1 diabetes mellitus. This review focuses on the principles of serological tests towards coeliac disease in patients with type 1 diabetes mellitus and metabolic control measures as a result of a gluten-free diet.
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Affiliation(s)
- Anna Szaflarska-Popławska
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
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Guelho D, Paiva I, Carvalheiro M. Diabetes mellitus – um «continuum» fisiopatológico. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.rpedm.2013.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Moreira MC, Lara GM, Linden R, Feksa LR, Tavares RG, Almeida SEDM, Berlese DB. Frequency of the anti-glutamic acid decarboxylase immunological marker in patients with diabetes duration longer than three years in southern Brazil. SAO PAULO MED J 2011; 129:130-3. [PMID: 21755246 PMCID: PMC10866313 DOI: 10.1590/s1516-31802011000300002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 06/01/2010] [Accepted: 03/21/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE The anti-GAD (glutamic acid decarboxylase) antibody is considered to be an important marker for type 1 diabetes mellitus (DM1), with frequency that varies depending on the population studied and the duration of the disease. Therefore, the aim of this study was to determine the frequency of this autoantibody in a group of patients in southern Brazil with DM1 that had been diagnosed more than three years previously. DESIGN AND SETTING Analytical cross-sectional study with a control group conducted at the Biomedicine Laboratory of Universidade Feevale. METHODS This study was conducted between June 2007 and December 2008, and 109 individuals were enrolled during this period. Fifty-eight were DM1 patients and 51 were individuals free from DM1 and without any history of diabetes, who constituted the control group. RESULTS In the DM1 group, the mean age was 27 ± 1.7 years and 50% were men. The mean fasting blood glucose in the DM1 group was 208 ± 15 mg/dl and mean HbA1c (glycosylated hemoglobin) was 8.7 ± 0.25%. In the control group, the mean fasting blood glucose and HbA1c were 82 mg/dl and 5.0% respectively. Thirty-seven individuals with DM1 (63.8%) were positive for anti-GAD, and this proportion was significantly larger than in the control group. CONCLUSIONS These results show the high prevalence of anti-GAD in the population of diabetic patients in southern Brazil, thus indicating that the antibody was still present a long time after the disease had been diagnosed.
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Affiliation(s)
| | - Gustavo Müller Lara
- MSc. Teacher responsible for the Immunology Laboratory Course for Undergraduate Biomedicine, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
| | - Rafael Linden
- PhD. Professor in the Institute of Health Sciences and Researcher in the Bioanalysis Research Group, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
| | - Luciane Rosa Feksa
- PhD. Professor in the Institute of Health Sciences and Researcher in the Bioanalysis Research Group, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
| | - Rejane Giacomelli Tavares
- PhD. Professor in the Institute of Health Sciences and Researcher in the Bioanalysis Research Group, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
| | - Sabrina Esteves de Matos Almeida
- PhD. Professor in the Institute of Health Sciences and Researcher in the Bioanalysis Research Group, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
| | - Daiane Bolzan Berlese
- PhD. Adjunct professor and Researcher in the Bioanalysis Research Group, Universidade Feevale, Novo Hamburgo, Rio Grande do Sul, Brazil.
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