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Gutiérrez LK, Moreno-Manuel AI, Jalife J. Kir2.1-Na V1.5 channelosome and its role in arrhythmias in inheritable cardiac diseases. Heart Rhythm 2024; 21:630-646. [PMID: 38244712 DOI: 10.1016/j.hrthm.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/22/2024]
Abstract
Sudden cardiac death in children and young adults is a relatively rare but tragic event whose pathophysiology is unknown at the molecular level. Evidence indicates that the main cardiac sodium channel (NaV1.5) and the strong inward rectifier potassium channel (Kir2.1) physically interact and form macromolecular complexes (channelosomes) with common partners, including adapter, scaffolding, and regulatory proteins that help them traffic together to their eventual membrane microdomains. Most important, dysfunction of either or both ion channels has direct links to hereditary human diseases. For example, certain mutations in the KCNJ2 gene encoding the Kir2.1 protein result in Andersen-Tawil syndrome type 1 and alter both inward rectifier potassium and sodium inward currents. Similarly, trafficking-deficient mutations in the gene encoding the NaV1.5 protein (SCN5A) result in Brugada syndrome and may also disturb both inward rectifier potassium and sodium inward currents. Moreover, gain-of-function mutations in KCNJ2 result in short QT syndrome type 3, which is extremely rare but highly arrhythmogenic, and can modify Kir2.1-NaV1.5 interactions in a mutation-specific way, further highlighting the relevance of channelosomes in ion channel diseases. By expressing mutant proteins that interrupt or modify Kir2.1 or NaV1.5 function in animal models and patient-specific pluripotent stem cell-derived cardiomyocytes, investigators are defining for the first time the mechanistic framework of how mutation-induced dysregulation of the Kir2.1-NaV1.5 channelosome affects cardiac excitability, resulting in arrhythmias and sudden death in different cardiac diseases.
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Affiliation(s)
- Lilian K Gutiérrez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - José Jalife
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan.
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Liu Y, Tang Y, Zhang H, Chen H, Luo Q, Liu J. Duchenne muscular dystrophy caused by a deletion (c.5021del) in exon 35 of the DMD gene: A case report and review of the literature. Heliyon 2024; 10:e28677. [PMID: 38586344 PMCID: PMC10998125 DOI: 10.1016/j.heliyon.2024.e28677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Duchenne muscular dystrophy (DMD MIM#310200) is a degenerative muscle disease caused by mutations in the dystrophin gene located on Xp21.2. The clinical features encompass muscle weakness and markedly elevated serum creatine kinase levels. An 8-year-old Chinese boy was diagnosed with Duchenne muscular dystrophy (DMD). Whole exome gene sequencing was conducted and the Sanger method was used to validate sequencing. A deletion (c.5021del) in exon 35 of the dystrophin gene was identified, which was predicted to generate a frameshift mutation and create an early termination codon (p.Leu1674CysfsTer47). It has a pathogenic effect against dystrophin in the muscle cell membrane of the patient. As such, prednisone treatment at a dose of 0.75 mg/kg.d was administered. After one month, a notable reduction in fall frequency was observed. Our new finding will expand the pathogenic mutation spectrum causing DMD.
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Affiliation(s)
- Yue Liu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Yanhui Tang
- Department of Pediatric, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hui Zhang
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Hongying Chen
- Department of Pediatric, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qing Luo
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Jinbo Liu
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, China
- Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, China
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3
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Farrar MA, Kariyawasam D, Grattan S, Bayley K, Davis M, Holland S, Waddel LB, Jones K, Lorentzos M, Ravine A, Wotton T, Wiley V. Newborn Screening for the Diagnosis and Treatment of Duchenne Muscular Dystrophy. J Neuromuscul Dis 2023; 10:15-28. [PMID: 36373292 PMCID: PMC9881031 DOI: 10.3233/jnd-221535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A pilot newborn screening (NBS) program for Duchenne muscular dystrophy (DMD) study proposes to assess the feasibility of the screening procedure, temporal course of the various steps of screening, and the public acceptability of the program. This is particularly vital to ascertain as DMD is considered a 'non-treatable' disease and thus does not fit the traditional criteria for newborn screening. However, modern perspectives of NBS for DMD are changing and point to possible net benefits for children and their families undertaking NBS for DMD. The aim of this workshop was to establish pathways for the successful implementation and evaluation of a pilot NBS for DMD program in Australia. Consensus was reached as to the rationale for, potential benefits, risks, barriers and facilitators of screening, alongside the establishment of screening protocols and clinical referral pathways.
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Affiliation(s)
- Michelle A. Farrar
- Department of Paediatric Neurology, Sydney Children’s Hospital Network, Sydney, NSW, Australia,Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, NSW, Australia
| | - Didu Kariyawasam
- Department of Paediatric Neurology, Sydney Children’s Hospital Network, Sydney, NSW, Australia,Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, NSW, Australia
| | - Sarah Grattan
- Department of Paediatric Neurology, Sydney Children’s Hospital Network, Sydney, NSW, Australia,Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, NSW, Australia
| | - Klair Bayley
- Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands, WA, Australia
| | - Mark Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia
| | - Sandra Holland
- Department of Paediatric Neurology, Sydney Children’s Hospital Network, Sydney, NSW, Australia,Discipline of Paediatrics, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, NSW, Australia
| | - Leigh B. Waddel
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia,Kids Neuroscience Centre, The Children’s Hospital at Westmead, Westmead, NSW, Australia,Discipline of Paediatrics, University of Sydney, Sydney, NSW, Australia
| | - Kristi Jones
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Michelle Lorentzos
- The T.Y. Nelson Department of Neurology and Neurosurgery, The Children’s Hospital at Westmead, Sydney, NSW, Australia,Kids Neuroscience Centre, The Children’s Hospital at Westmead, Westmead, NSW, Australia,Discipline of Paediatrics, University of Sydney, Sydney, NSW, Australia
| | - Anja Ravine
- NSW Newborn Screening Programme, Children’s Hospital Westmead, Westmead, NSW, Australia
| | - Tiffany Wotton
- NSW Newborn Screening Programme, Children’s Hospital Westmead, Westmead, NSW, Australia
| | - Veronica Wiley
- NSW Newborn Screening Programme, Children’s Hospital Westmead, Westmead, NSW, Australia
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Jimenez-Vazquez EN, Arad M, Macías Á, Vera-Pedrosa ML, Cruz FM, Gutierrez LK, Cuttitta AJ, Monteiro da Rocha A, Herron TJ, Ponce-Balbuena D, Guerrero-Serna G, Binah O, Michele DE, Jalife J. SNTA1 gene rescues ion channel function and is antiarrhythmic in cardiomyocytes derived from induced pluripotent stem cells from muscular dystrophy patients. eLife 2022; 11:e76576. [PMID: 35762211 PMCID: PMC9239678 DOI: 10.7554/elife.76576] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/07/2022] [Indexed: 01/10/2023] Open
Abstract
Background Patients with cardiomyopathy of Duchenne Muscular Dystrophy (DMD) are at risk of developing life-threatening arrhythmias, but the mechanisms are unknown. We aimed to determine the role of ion channels controlling cardiac excitability in the mechanisms of arrhythmias in DMD patients. Methods To test whether dystrophin mutations lead to defective cardiac NaV1.5-Kir2.1 channelosomes and arrhythmias, we generated iPSC-CMs from two hemizygous DMD males, a heterozygous female, and two unrelated control males. We conducted studies including confocal microscopy, protein expression analysis, patch-clamping, non-viral piggy-bac gene expression, optical mapping and contractility assays. Results Two patients had abnormal ECGs with frequent runs of ventricular tachycardia. iPSC-CMs from all DMD patients showed abnormal action potential profiles, slowed conduction velocities, and reduced sodium (INa) and inward rectifier potassium (IK1) currents. Membrane NaV1.5 and Kir2.1 protein levels were reduced in hemizygous DMD iPSC-CMs but not in heterozygous iPSC-CMs. Remarkably, transfecting just one component of the dystrophin protein complex (α1-syntrophin) in hemizygous iPSC-CMs from one patient restored channelosome function, INa and IK1 densities, and action potential profile in single cells. In addition, α1-syntrophin expression restored impulse conduction and contractility and prevented reentrant arrhythmias in hiPSC-CM monolayers. Conclusions We provide the first demonstration that iPSC-CMs reprogrammed from skin fibroblasts of DMD patients with cardiomyopathy have a dysfunction of the NaV1.5-Kir2.1 channelosome, with consequent reduction of cardiac excitability and conduction. Altogether, iPSC-CMs from patients with DMD cardiomyopathy have a NaV1.5-Kir2.1 channelosome dysfunction, which can be rescued by the scaffolding protein α1-syntrophin to restore excitability and prevent arrhythmias. Funding Supported by National Institutes of Health R01 HL122352 grant; 'la Caixa' Banking Foundation (HR18-00304); Fundación La Marató TV3: Ayudas a la investigación en enfermedades raras 2020 (LA MARATO-2020); Instituto de Salud Carlos III/FEDER/FSE; Horizon 2020 - Research and Innovation Framework Programme GA-965286 to JJ; the CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación (MCIN) and the Pro CNIC Foundation), and is a Severo Ochoa Center of Excellence (grant CEX2020-001041-S funded by MICIN/AEI/10.13039/501100011033). American Heart Association postdoctoral fellowship 19POST34380706s to JVEN. Israel Science Foundation to OB and MA [824/19]. Rappaport grant [01012020RI]; and Niedersachsen Foundation [ZN3452] to OB; US-Israel Binational Science Foundation (BSF) to OB and TH [2019039]; Dr. Bernard Lublin Donation to OB; and The Duchenne Parent Project Netherlands (DPPNL 2029771) to OB. National Institutes of Health R01 AR068428 to DM and US-Israel Binational Science Foundation Grant [2013032] to DM and OB.
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Affiliation(s)
- Eric N Jimenez-Vazquez
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
| | - Michael Arad
- Leviev Heart Center, Sheba Medical Center, Tel Hashomer, and Tel Aviv UniversityTel AvivIsrael
| | - Álvaro Macías
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | - Maria L Vera-Pedrosa
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | - Francisco Miguel Cruz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | - Lilian K Gutierrez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | - Ashley J Cuttitta
- Department of Molecular and Integrative Physiology, University of Michigan Medical SchoolAnn ArborUnited States
| | - André Monteiro da Rocha
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
| | - Todd J Herron
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
| | - Daniela Ponce-Balbuena
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
| | - Guadalupe Guerrero-Serna
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
| | - Ofer Binah
- Department of Physiology, Biophysics and Systems Biology, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of TechnologyHaifaIsrael
| | - Daniel E Michele
- Department of Molecular and Integrative Physiology, University of Michigan Medical SchoolAnn ArborUnited States
| | - José Jalife
- Department of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of MichiganAnn ArborUnited States
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)MadridSpain
- Department of Molecular and Integrative Physiology, University of Michigan Medical SchoolAnn ArborUnited States
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Cullom C, Vo V, McCabe MD. Orthotopic Heart Transplantation in Manifesting Carrier of Duchenne Muscular Dystrophy. J Cardiothorac Vasc Anesth 2021; 36:2593-2599. [PMID: 34670720 DOI: 10.1053/j.jvca.2021.09.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | - Victoria Vo
- Department of Anesthesiology, Loma Linda University, Loma Lina, CA
| | - Melissa D McCabe
- Department of Anesthesiology, Loma Linda University, Loma Lina, CA.
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Choi J, Kane T, Propst L, Spencer S, Kostialik J, Arjunan A. Not just carriers: experiences of X-linked female heterozygotes. J Assist Reprod Genet 2021; 38:2757-2767. [PMID: 34333720 PMCID: PMC8581108 DOI: 10.1007/s10815-021-02270-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To better understand the needs and experiences of the X-linked carrier community to improve future recognition, diagnosis, and treatment by bringing X-linked carrier voices together. METHODS An anonymous survey link was distributed to members of Remember the Girls, a non-profit organization for female (XX) carriers of X-linked conditions, through its website, Facebook group, Instagram, and Twitter. The survey was developed to gather data on XX carriers of numerous X-linked conditions. RESULTS One hundred and fifty individuals participated in the study. The majority (81/150) of individuals learned about their carrier status by giving birth to a son diagnosed with an X-linked condition. However, over 80% (120/145) believed that they should learn this information before the age of 18. Over 80% of participants (124/148) felt that they either have or may have symptoms attributable to their X-linked condition. Yet, only 10.1% (15/148) felt that they had sufficient access to knowledgeable healthcare providers and/or medical information. Additionally, 46.7% (70/150) of participants reported that healthcare providers did not discuss reproductive options with them. Improving carrier access to medical information, research studies, new treatments, and reproductive methods was found to be the top priority. CONCLUSION Limited information exists on X-linked carriers' risk for symptoms and there is a lack of available treatments. This study demonstrates the need for more knowledgeable healthcare providers and medical information within the X-linked carrier community.
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Affiliation(s)
- Jennifer Choi
- Northwestern University Graduate Program in Genetic Counseling, Chicago, IL, USA.
| | - Taylor Kane
- Remember the Girls Inc., Mount Laurel, NJ, USA
| | | | - Sara Spencer
- Division of Clinical Genetics, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Beneficial Role of Exercise in the Modulation of mdx Muscle Plastic Remodeling and Oxidative Stress. Antioxidants (Basel) 2021; 10:antiox10040558. [PMID: 33916762 PMCID: PMC8066278 DOI: 10.3390/antiox10040558] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is an X-linked recessive progressive lethal disorder caused by the lack of dystrophin, which determines myofibers mechanical instability, oxidative stress, inflammation, and susceptibility to contraction-induced injuries. Unfortunately, at present, there is no efficient therapy for DMD. Beyond several promising gene- and stem cells-based strategies under investigation, physical activity may represent a valid noninvasive therapeutic approach to slow down the progression of the pathology. However, ethical issues, the limited number of studies in humans and the lack of consistency of the investigated training interventions generate loss of consensus regarding their efficacy, leaving exercise prescription still questionable. By an accurate analysis of data about the effects of different protocol of exercise on muscles of mdx mice, the most widely-used pre-clinical model for DMD research, we found that low intensity exercise, especially in the form of low speed treadmill running, likely represents the most suitable exercise modality associated to beneficial effects on mdx muscle. This protocol of training reduces muscle oxidative stress, inflammation, and fibrosis process, and enhances muscle functionality, muscle regeneration, and hypertrophy. These conclusions can guide the design of appropriate studies on human, thereby providing new insights to translational therapeutic application of exercise to DMD patients.
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Kincl V, Panovský R, Pešl M, Máchal J, Juříková L, Haberlová J, Masárová L. Echocardiographic signs of subclinical cardiac function impairment in Duchenne dystrophy gene carriers. Sci Rep 2020; 10:20794. [PMID: 33247228 PMCID: PMC7695725 DOI: 10.1038/s41598-020-77882-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022] Open
Abstract
To assess subclinical cardiac function impairment in Duchenne dystrophy (DMD) female carriers. Forty-four female subjects proved as DMD carriers underwent echocardiographic examination including tissue Doppler imaging (TDI) of mitral and tricuspid annulus. Seventeen age-matched healthy female subjects served as controls. A significant differences in peak systolic annular velocity (Sa) between carriers and controls were found for lateral and septal part of the mitral annulus and for tricuspid annulus (0.09 vs. 0.11 m/s, p < 0.001, 0.08 vs. 0.09 m/s, p < 0.01 and 0.13 vs. 0.14 m/s, p = 0.02 respectively). There was also difference in early diastolic velocity (Ea) of the septal part of the mitral annulus (0.11 vs. 0.13 m/s, p = 0.03). The subclinical deterioration of systolic function is presented even in asymptomatic DMD female carriers.
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Affiliation(s)
- Vladimír Kincl
- Department of Internal Medicine/Cardiology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic. .,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
| | - Roman Panovský
- Department of Internal Medicine/Cardiology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Martin Pešl
- Department of Internal Medicine/Cardiology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Máchal
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Juříková
- Department of Pediatric Neurology, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Jana Haberlová
- Department of Pediatric Neurology, Second Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Lucia Masárová
- Department of Internal Medicine/Cardiology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
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Preuße C, von Moers A, Kölbel H, Pehl D, Goebel HH, Schara U, Stenzel W. Inflammation-induced fibrosis in skeletal muscle of female carriers of Duchenne muscular dystrophy. Neuromuscul Disord 2019; 29:487-496. [DOI: 10.1016/j.nmd.2019.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/04/2019] [Accepted: 05/03/2019] [Indexed: 02/06/2023]
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Brignol TN, Ventura DF. What is the Ocular phenotype associated with a dystrophin deletion of exons 12-29? Intractable Rare Dis Res 2018; 7:295-296. [PMID: 30560026 PMCID: PMC6290837 DOI: 10.5582/irdr.2018.01120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a result of a X-linked recessive inherited mutation of the DMD gene which contains 79 exons. This rare disease is passed on by the mother who is called a carrier. Primarily it affects boys, but in rare cases it can affect girls. Dystrophin protein is mostly located in skeletal and cardiac muscles, which explains muscular and cardiac manifestations in symptomatic female DMD-carriers. Dystrophin is also present in extramuscular tissues. Some dystrophin isoforms are exclusively or predominantly expressed in the brain or the retina. It has been reported that DMD patients and DMD-carriers present normal visual acuity, but abnormal electroretinographic findings. As symptomatic female DMD are very rare, ophthalmic screening of the female patient with deletions of exons 12- 29 is valuable. Studying the functional relationship between ocular symptoms and related different deletions of exons dystrophin gene may further elucidate the pathophysiology in DMD.
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Affiliation(s)
- Tuy Nga Brignol
- Medical Affairs Department, The French Muscular Dystrophy Association (AFM-Telethon), Evry, France
- Address correspondence to:Dr. Tuy Nga Brignol, Medical Affairs Department, The French Muscular Dystrophy Association (AFM-Telethon), 1, rue de l’Internationale, Evry 9100, France. E-mail:
| | - Dora Fix Ventura
- Department of Experimental Psychology, Institute of Psychology, Universidade de São Paulo, Av. Prof. Mello Moraes 1721, Cidade Universitária, São Paulo, SP, CEP 05508-030, Brazil
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