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von Steinbuechel N, Zeldovich M, Timmermann D, Krenz U, Koerte IK, Bonfert MV, Berweck S, Kieslich M, Henrich M, Brockmann K, Buchheim A, Roediger M, Lendt M, Auer C, Neu A, Kaiser A, Driemeyer J, Greving S, Wartemann U, Pinggera D, Thomé C, Suss J, Muehlan H, Cunitz K. Final Validation of the Quality of Life after Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire. Children (Basel) 2024; 11:438. [PMID: 38671655 PMCID: PMC11049366 DOI: 10.3390/children11040438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Until recently, no disease-specific health-related quality of life (HRQoL) questionnaire existed for pediatric traumatic brain injuries (TBIs). In this revalidation study, the psychometric properties and the validity of the 35-item QOLIBRI-KID/ADO questionnaire in its final German version were examined in 300 children and adolescents. It is the first self-reported TBI-specific tool for measuring pediatric HRQoL in individuals aged between 8 and 17 years. The six-factor model fits the data adequately. The questionnaire's internal consistency was excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability, and the measure's construct validity was supported by the overlap between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. The discriminant validity tests showed that older children and girls reported a significantly lower HRQoL than comparison groups, and this was also true of children who were anxious or depressed, or who suffered from post-concussion symptoms, replicating the results of the questionnaire's first developmental study. Our results suggest that the QOLIBRI-KID/ADO is a reliable and valid multidimensional tool that can be used together with the adult version in clinical contexts and research to measure disease-specific HRQoL after pediatric TBI throughout a person's life. This may help improve care, treatment, daily functioning, and HRQoL after TBI.
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Affiliation(s)
- Nicole von Steinbuechel
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
| | - Marina Zeldovich
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Dagmar Timmermann
- Department of Psychosomatic Medicine and Psychotherapy, Division of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany;
| | - Ugne Krenz
- University Medical Center Goettingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; (U.K.); (S.G.)
| | - Inga K. Koerte
- cBRAIN/Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilian University Hospital, LMU University, Nussbaumstrasse 5, 80336 Munich, Germany;
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Mass General Brigham, 55 Fruit Street, Boston, MA 02114, USA
| | - Michaela V. Bonfert
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, Dr. Von Hauner Children’s Hospital, LMU University Hospital, Haydnstr. 5, 80336 Munich, Germany;
| | - Steffen Berweck
- Specialist Center for Paediatric Neurology, Neurorehabilitation and Epileptology, Schoen Klinik, Krankenhausstraße 20, 83569 Vogtareuth, Germany;
| | - Matthias Kieslich
- Department of Paediatric Neurology, Hospital of Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (M.K.); (M.H.)
| | - Marlene Henrich
- Department of Paediatric Neurology, Hospital of Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (M.K.); (M.H.)
| | - Knut Brockmann
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University Medical Center, Robert-Koch-Str. 40, 37075 Göttingen, Germany;
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
| | - Maike Roediger
- Department of Pediatrics and Adolescent Medicine, General Pediatrics, Intensive Care Medicine and Neonatology & Department of Pediatric Cardiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany;
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Strümper Straße 111, 40670 Meerbusch, Germany;
| | - Christian Auer
- Johannes Kepler University Linz, Altenberger Straße 69, 4020 Linz, Austria;
- Department of Neurosurgery, Kepler Univesity Hospital GmbH, Wagner-Jauregg-Weg 15, 4020 Linz, Austria
| | - Axel Neu
- Department of Neurology and Neuropediatry, VAMED Klinik Geesthacht GmbH, Johannes-Ritter-Straße 100, 21502 Geesthacht, Germany; (A.N.); (A.K.)
| | - Alexander Kaiser
- Department of Neurology and Neuropediatry, VAMED Klinik Geesthacht GmbH, Johannes-Ritter-Straße 100, 21502 Geesthacht, Germany; (A.N.); (A.K.)
| | - Joenna Driemeyer
- Department of Pediatrics, University of Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Sven Greving
- University Medical Center Goettingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; (U.K.); (S.G.)
| | - Ulrike Wartemann
- Department of Neuropediatrics, VAMED Klinik Hohenstücken GmbH, Brahmsstraße 38, 14772 Brandenburg an der Havel, Germany;
| | - Daniel Pinggera
- Department of Neurosurgery, Tirol Kliniken GmbH, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (D.P.); (C.T.)
| | - Claudius Thomé
- Department of Neurosurgery, Tirol Kliniken GmbH, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (D.P.); (C.T.)
| | - Joachim Suss
- Department of Pediatric Surgery, Wilhelmstift Catholic Children’s Hospital, Liliencronstraße 130, 22149 Hamburg, Germany;
| | - Holger Muehlan
- Department of Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany;
| | - Katrin Cunitz
- Institute of Psychology, University of Innsbruck, Universitaetsstr. 5-7, 6020 Innsbruck, Austria; (N.v.S.); (M.Z.); (A.B.)
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
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Worthmann A, Ridder J, Piel SYL, Evangelakos I, Musfeldt M, Voß H, O'Farrell M, Fischer AW, Adak S, Sundd M, Siffeti H, Haumann F, Kloth K, Bierhals T, Heine M, Pertzborn P, Pauly M, Scholz JJ, Kundu S, Fuh MM, Neu A, Tödter K, Hempel M, Knippschild U, Semenkovich CF, Schlüter H, Heeren J, Scheja L, Kubisch C, Schlein C. Fatty acid synthesis suppresses dietary polyunsaturated fatty acid use. Nat Commun 2024; 15:45. [PMID: 38167725 PMCID: PMC10762034 DOI: 10.1038/s41467-023-44364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
Dietary polyunsaturated fatty acids (PUFA) are increasingly recognized for their health benefits, whereas a high production of endogenous fatty acids - a process called de novo lipogenesis (DNL) - is closely linked to metabolic diseases. Determinants of PUFA incorporation into complex lipids are insufficiently understood and may influence the onset and progression of metabolic diseases. Here we show that fatty acid synthase (FASN), the key enzyme of DNL, critically determines the use of dietary PUFA in mice and humans. Moreover, the combination of FASN inhibition and PUFA-supplementation decreases liver triacylglycerols (TAG) in mice fed with high-fat diet. Mechanistically, FASN inhibition causes higher PUFA uptake via the lysophosphatidylcholine transporter MFSD2A, and a diacylglycerol O-acyltransferase 2 (DGAT2)-dependent incorporation of PUFA into TAG. Overall, the outcome of PUFA supplementation may depend on the degree of endogenous DNL and combining PUFA supplementation and FASN inhibition might be a promising approach to target metabolic disease.
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Affiliation(s)
- Anna Worthmann
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julius Ridder
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sharlaine Y L Piel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ioannis Evangelakos
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Melina Musfeldt
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah Voß
- Section / Core Facility Mass Spectrometry and Proteomics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie O'Farrell
- Sagimet Biosciences Inc., 155 Bovet Rd., San Mateo, CA, 94402, USA
| | - Alexander W Fischer
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Molecular Metabolism, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - Sangeeta Adak
- Division of Endocrinology, Metabolism & Lipid Research, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Monica Sundd
- National Institute of Immunology, New Delhi, India
| | - Hasibullah Siffeti
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Friederike Haumann
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katja Kloth
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tatjana Bierhals
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Heine
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Pertzborn
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mira Pauly
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia-Josefine Scholz
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Suman Kundu
- Department of Biochemistry, University of Delhi South Campus, New Delhi 110021 and Department of Biological Sciences, Birla Institute of Technology and Science Pilani, K K Birla Goa Campus, Goa, 403726, India
| | - Marceline M Fuh
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Neu
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Tödter
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Uwe Knippschild
- Department of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany
| | - Clay F Semenkovich
- Division of Endocrinology, Metabolism & Lipid Research, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Hartmut Schlüter
- Section / Core Facility Mass Spectrometry and Proteomics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joerg Heeren
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ludger Scheja
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Schlein
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Baach F, Meyer B, Oh J, Lezius S, Böger R, Schwedhelm E, Choe CU, Neu A. Developmental dynamics of homoarginine, ADMA and SDMA plasma levels from birth to adolescence. Amino Acids 2023; 55:1381-1388. [PMID: 37648945 PMCID: PMC10689515 DOI: 10.1007/s00726-023-03318-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
Guanidino compounds such as dimethylarginines (SDMA, ADMA) and L-homoarginine ((L-)hArg) can interfere with bioavailability and function of the main NO-donor L-arginine (L-Arg). High ADMA and SDMA but low L-hArg concentrations have been associated with cardio- and cerebrovascular events and mortality in adults. The role of guanidino compounds in paediatric patients remains less clear. We, therefore, compared guanidino compound levels in plasma samples of 57 individuals with chronic kidney disease (CKD) and 141 individuals without CKD from the age of 0 to 17 years, including patients with different comorbidities by correlation and regression analyses. We found highest hArg, SDMA and ADMA concentrations in neonates (Kruskal-Wallis, p < 0.001 for all). From the age of 1 year on, hArg levels increased, whereas SDMA und ADMA levels further decreased in children. SDMA and ADMA are higher in children with CKD independent of GFR (mean factor 1.92 and 1.38, respectively, p < 0.001 for both), and SDMA is strongly correlated with creatinine concentration in children with CKD (Spearman's rho 0.74, p < 0.001). We provide guanidino compound levels in a large sample covering all paediatric age groups for the first time. Our data can be used to assess the role of guanidino compounds such as hArg in disease states, i.e. cerebro- and cardiovascular disorders in childhood and adolescence.
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Affiliation(s)
- Florence Baach
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Boglarka Meyer
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Jun Oh
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Susanne Lezius
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK E.V.), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, Klinikum Itzehoe, Robert-Koch-Strasse 2, 25524, Itzehoe, Germany
| | - Axel Neu
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
- VAMED Klinik Geesthacht, Johannes-Ritter-Strasse 100, 21502, Geesthacht, Germany.
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Baechle C, Eckert A, Kamrath C, Neu A, Manuwald U, Thiele-Schmitz S, Weidler O, Knauer-Fischer S, Rosenbauer J, Holl RW. Incidence and presentation of new-onset type 1 diabetes in children and adolescents from Germany during the COVID-19 pandemic 2020 and 2021: Current data from the DPV Registry. Diabetes Res Clin Pract 2023; 197:110559. [PMID: 36758641 DOI: 10.1016/j.diabres.2023.110559] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
AIMS To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed when compared to long-standing trends. METHODS Our study is based on diabetes manifestation data of the 0.5-<18-year-old children/adolescents from the German multicenter Diabetes Prospective Follow-up Registry. Based on long-term pre-pandemic trends from 2011 to 2019, we estimated adjusted incidence rate ratios (IRR) for T1D and DKA, and prevalence rate ratios (PRR) regarding autoantibody status with 95 % confidence intervals (CI) for the years 2020 and 2021 (observed versus predicted rates), using multivariable negative binomial or beta-binomial regression, respectively. RESULTS We analyzed data of 30,840 children and adolescents with new-onset T1D. The observed incidences were significantly higher than the predicted incidences (IRR2020 1.13 [1.08-1.19]; IRR2021 1.20 [1.15-1.26]). The prevalence of autoantibody-negative diabetes did not change (PRR2020 0.91 [0.75-1.10]; PRR2021 1.03 [0.86-1.24]). The incidence of DKA during the pandemic was higher than predicted (IRR2020 1.34 [1.23-1.46]; IRR2021 1.37 [1.26-1.49]). CONCLUSIONS An increase in the incidences of T1D and DKA, but not of autoantibody-negative diabetes was observed during both pandemic years. Further monitoring and efforts for DKA prevention at onset are necessary.
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Affiliation(s)
- C Baechle
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - A Eckert
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, D-89081 Ulm, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - C Kamrath
- Justus Liebig University, Center of Child and Adolescent Medicine, Division of Paediatric Endocrinology and Diabetology, Feulgenstraße 10-12, D-35392 Giessen, Germany.
| | - A Neu
- University Hospital Tübingen, Clinic for Paediatrics and Youth Medicine, Hoppe-Seyler-Straße 1, D-72076 Tübingen, Germany.
| | - U Manuwald
- Technische Universität Dresden, Faculty of Medicine "Carl Gustav Carus", Institute and Policlinic of Occupational and Social Medicine, Health Sciences/Public Health, Fetscherstraße 74, D-01307 Dresden, Germany.
| | - S Thiele-Schmitz
- St. Louise Women's and Children's Hospital, Diabetes Center for Children and Adolescents, Husener Straße 81, D-33098 Paderborn, Germany.
| | - O Weidler
- Elbe Kliniken Stade - Buxtehude, Bremervörder Straße 111, D-21682 Stade, Germany.
| | - S Knauer-Fischer
- University Hospital Mannheim, Clinic for Pediatric and Adolescent Medicine, Division of Endocrinology and Diabetology, Theodor-Kutzer-Ufer 1, D-368167 Mannheim, Germany.
| | - J Rosenbauer
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - R W Holl
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, D-89081 Ulm, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
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Svensson J, Ibfelt EH, Carstensen B, Neu A, Cinek O, Skrivarhaug T, Rami-Merhar B, Feltbower RG, Castell C, Konrad D, Gillespie K, Jarosz-Chobot P, Marčiulionytė D, Rosenbauer J, Bratina N, Ionescu-Tirgoviste C, Gorus F, Kocova M, de Beaufort C, Patterson CC. Age-period-cohort modelling of type 1 diabetes incidence rates among children included in the EURODIAB 25-year follow-up study. Acta Diabetol 2023; 60:73-82. [PMID: 36205797 DOI: 10.1007/s00592-022-01977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
AIMS Specific patterns in incidence may reveal environmental explanations for type 1 diabetes incidence. We aimed to study type 1 diabetes incidence in European childhood populations to assess whether an increase could be attributed to either period or cohort effects. METHODS Nineteen EURODIAB centres provided single year incidence data for ages 0-14 in the 25-year period 1989-2013. Case counts and person years were classified by age, period and cohort (APC) in 1-year classes. APC Poisson regression models of rates were fitted using restricted cubic splines for age, period and cohort per centre and sex. Joint models were fitted for all centres and sexes, to find a parsimonious model. RESULTS A total of 57,487 cases were included. In ten and seven of the 19 centres the APC models showed evidence of nonlinear cohort effects or period effects, respectively, in one or both sexes and indications of sex-specific age effects. Models showed a positive linear increase ranging from approximately 0.6 to 6.6%/year. Centres with low incidence rates showed the highest overall increase. A final joint model showed incidence peak at age 11.6 and 12.6 for girls and boys, respectively, and the rate-ratio was according to sex below 1 in ages 5-12. CONCLUSION There was reasonable evidence for similar age-specific type 1 diabetes incidence rates across the EURODIAB population and peaks at a younger age for girls than boys. Cohort effects showed nonlinearity but varied between centres and the model did not contribute convincingly to identification of environmental causes of the increase.
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Affiliation(s)
- J Svensson
- Diabetes Technology Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - E H Ibfelt
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - B Carstensen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - A Neu
- University Children´S Hospital, Tübingen, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - T Skrivarhaug
- Division of Adolescent and Paediatric Medicine, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - B Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R G Feltbower
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - C Castell
- Department of Health, Government of Catalonia, Barcelona, Spain
| | - D Konrad
- Division of Paediatric Endocrinology and Diabetology and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - K Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - P Jarosz-Chobot
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - D Marčiulionytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Rosenbauer
- German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - N Bratina
- Diabetes & Metabolic Diseases, Department of Endocrinology, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- National Institute of Diabetes Nutrition and Metabolic Diseases, NC Paulescu, Bucharest, Romania
| | - F Gorus
- Diabetes Research Center, Brussels Free University - Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, North Macedonia
| | - C de Beaufort
- Department of Paediatric Diabetes and Endocrinology, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Breakspear S, Frueh P, Neu A, Noecker B, Popescu C, Uellner Q. Learning from hair moisture sorption and hysteresis. Int J Cosmet Sci 2022; 44:555-568. [PMID: 35892223 DOI: 10.1111/ics.12806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The process of moisture sorption and desorption by human hair was analysed for extracting hints on the hair structure. METHODS The isotherms of moisture sorption and desorption by hair were recorded for untreated and chemically treated (permed and bleached) hair. Data of swelling were also considered. RESULTS By examining the swelling and moisture sorption of keratin fibres, it is possible to conclude that hysteresis is quite improbably caused by capillary condensation. The mobility of the protein chains and the strength of the bonds binding water molecules to the active sites inside the matrix are proposed as causes instead. The concept of "breaking symmetry", derived from moisture sorption-desorption data, and the method of evaluating this parameter, is proposed as a way of characterizing the chemical treatment of hair. The results show that bleaching produces a larger breaking of symmetry than perming, and this is suggested to be due to new hydrogen bonds, created as a result of the chemical treatment, replacing the original disulfide bonds, which are of different strength compared to the bonds of untreated hair. The quantitative sorption data matched well to the model of grains of matrix enveloped in layers of water molecules at increasing relative humidity, up to 100 %. The analysis suggested that, aside from the glass transition event occurring at around 60-70 % relative humidity, there is another, less examined, transition occurring at around 30 % relative humidity, assigned to the opening of the hair inner structure, and accommodation of more water molecules. Both transitions are reflected by corresponding changes in the fibre mechanical behaviour. CONCLUSION The moisture sorption-desorption by hair was shown not only to allow a quantitative differentiation among various cosmetic treatments of the hair, but also to provide valuable information on the structure of the fibre.
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Affiliation(s)
| | - P Frueh
- KAO Germany GmbH, Darmstadt, Germany.,KAO Corporation, Tokyo, Japan
| | - A Neu
- KAO Germany GmbH, Darmstadt, Germany
| | - B Noecker
- KAO Germany GmbH, Darmstadt, Germany
| | - C Popescu
- KAO Germany GmbH, Darmstadt, Germany
| | - Q Uellner
- KAO Germany GmbH, Darmstadt, Germany
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Stute F, Hauck PA, Woitschach R, Neu A, Kozlik-Feldmann R, Mir TS. Channelopathies in Pediatric Patients: Is It a Multidisciplinary Challenge? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F. Stute
- Universitäres Herz- und Gefäßzentrum UKE, Hamburg, France
| | - P. A. Hauck
- Department of Pediatric Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
| | - R. Woitschach
- Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg, Deutschland
| | - A. Neu
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | | | - T. S. Mir
- Department of Pediatric Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
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8
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Kloth K, Neu A, Rau I, Hülsemann W, Kutsche K, Volk AE. Severe congenital contractural arachnodactyly caused by biallelic pathogenic variants in FBN2. Eur J Med Genet 2021; 64:104161. [PMID: 33571691 DOI: 10.1016/j.ejmg.2021.104161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/17/2021] [Accepted: 02/04/2021] [Indexed: 11/26/2022]
Abstract
Fibrillin-2, encoded by FBN2, plays an important role in the early process of elastic fiber assembly. To date, heterozygous pathogenic variants in FBN2 have been shown to cause congenital contractural arachnodactyly (CCA; Beals-Hecht syndrome). Classical CCA is characterized by long and slender fingers and toes, ear deformities, joint contractures at birth, clubfeet, muscular hypoplasia and often tall stature. In individuals with a severe CCA form, different cardiovascular or gastrointestinal anomalies have been described. Here, we report on a 15-year-old girl with a severe form of CCA and novel biallelic variants in FBN2. The girl inherited the missense variant c.3563G > T/p.(Gly1188Val) from her unaffected father and the nonsense variant c.6831C > A/p.(Cys2277*) from her healthy mother. We could detect only a small amount of FBN2 transcripts harboring the nonsense variant in leukocyte-derived mRNA from the patient and mother suggesting nonsense-mediated mRNA decay. As the father did not show any clinical signs of CCA we hypothesize the missense variant c.3563G > T to be a hypomorphic allele. Taken together, our data suggests that severe CCA can be inherited in an autosomal-recessive manner by compound heterozygosity of a hypomorphic and a null allele of the FBN2 gene.
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Affiliation(s)
- Katja Kloth
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Axel Neu
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Isabella Rau
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Hülsemann
- Department of Handsurgery, Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Kerstin Kutsche
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander E Volk
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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9
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Neu A, Hornig S, Sasani A, Isbrandt D, Gerloff C, Tsikas D, Schwedhelm E, Choe CU. Creatine, guanidinoacetate and homoarginine in statin-induced myopathy. Amino Acids 2020; 52:1067-1069. [PMID: 32594255 PMCID: PMC7406479 DOI: 10.1007/s00726-020-02865-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/20/2020] [Indexed: 11/05/2022]
Abstract
Our study evaluated the effect of creatine and homoarginine in AGAT- and GAMT-deficient mice after simvastatin exposure. Balestrino and Adriano suggest that guanidinoacetate might explain the difference between AGAT- and GAMT-deficient mice in simvastatin-induced myopathy. We agree with Balestrino and Adriano that our data shows that (1) creatine possesses a protective potential to ameliorate statin-induced myopathy in humans and mice and (2) homoarginine did not reveal a beneficial effect in statin-induced myopathy. Third, we agree that guanidinoacetate can be phosphorylated and partially compensate for phosphocreatine. In our study, simvastatin-induced damage showed a trend to be less pronounced in GAMT-deficient mice compared with wildtype mice. Therefore, (phospo) guanidinoacetate cannot completely explain the milder phenotype of GAMT-deficient mice, but we agree that it might contribute to ameliorate statin-induced myopathy in GAMT-deficient mice compared with AGAT-deficient mice. Finally, we agree with Balestino and Adriano that AGAT metabolites should further be evaluated as potential treatments in statin-induced myopathy.
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Affiliation(s)
- Axel Neu
- Experimental Neuropediatrics, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sönke Hornig
- Experimental Neuropediatrics, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ali Sasani
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Dirk Isbrandt
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,University of Cologne, Cologne, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Dimitris Tsikas
- Core Unit Proteomics, Hannover Medical School, Institute of Toxicology, Hannover, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
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10
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Wagner M, Lévy J, Jung-Klawitter S, Bakhtiari S, Monteiro F, Maroofian R, Bierhals T, Hempel M, Elmaleh-Bergès M, Kitajima JP, Kim CA, Salomao JG, Amor DJ, Cooper MS, Perrin L, Pipiras E, Neu A, Doosti M, Karimiani EG, Toosi MB, Houlden H, Jin SC, Si YC, Rodan LH, Venselaar H, Kruer MC, Kok F, Hoffmann GF, Strom TM, Wortmann SB, Tabet AC, Opladen T. Loss of TNR causes a nonprogressive neurodevelopmental disorder with spasticity and transient opisthotonus. Genet Med 2020; 22:1061-1068. [PMID: 32099069 DOI: 10.1038/s41436-020-0768-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE TNR, encoding Tenascin-R, is an extracellular matrix glycoprotein involved in neurite outgrowth and neural cell adhesion, proliferation and migration, axonal guidance, myelination, and synaptic plasticity. Tenascin-R is exclusively expressed in the central nervous system with highest expression after birth. The protein is crucial in the formation of perineuronal nets that ensheath interneurons. However, the role of Tenascin-R in human pathology is largely unknown. We aimed to establish TNR as a human disease gene and unravel the associated clinical spectrum. METHODS Exome sequencing and an online matchmaking tool were used to identify patients with biallelic variants in TNR. RESULTS We identified 13 individuals from 8 unrelated families with biallelic variants in TNR sharing a phenotype consisting of spastic para- or tetraparesis, axial muscular hypotonia, developmental delay, and transient opisthotonus. Four homozygous loss-of-function and four different missense variants were identified. CONCLUSION We establish TNR as a disease gene for an autosomal recessive nonprogressive neurodevelopmental disorder with spasticity and transient opisthotonus and highlight the role of central nervous system extracellular matrix proteins in the pathogenicity of spastic disorders.
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Affiliation(s)
- Matias Wagner
- Institute of Human Genetics, Faculty of Medicine, Technical University München, Munich, Germany. .,Institute of Human Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg, Germany. .,Institut für Neurogenomik, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg, Germany.
| | - Jonathan Lévy
- Genetics Department, AP-HP, Robert-Debré University Hospital, Paris, France
| | - Sabine Jung-Klawitter
- Division of Neuropediatrics and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany
| | - Somayeh Bakhtiari
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA.,Departments of Child Health, Neurology, Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Reza Maroofian
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - Tatjana Bierhals
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Chong A Kim
- Genetic Unit, Instituto da Criança-HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Julia G Salomao
- Genetic Unit, Instituto da Criança-HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - David J Amor
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Monica S Cooper
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Laurence Perrin
- Genetics Department, AP-HP, Robert-Debré University Hospital, Paris, France
| | - Eva Pipiras
- Department of Cytogenetics, Jean-Verdier Hospital, Paris 13 University, Embryology and Histology, AP-HP, Bondy, France
| | - Axel Neu
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mohammad Doosti
- Department of Genetics, Next Generation Genetic Polyclinic, Mashhad, Iran
| | - Ehsan G Karimiani
- Genetics Research Centre, Molecular and Clinical Sciences Institute, St. George's, University, London, UK
| | - Mehran B Toosi
- Department of Pediatric Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Henry Houlden
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - Sheng Chih Jin
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
| | | | - Lance H Rodan
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
| | - Hanka Venselaar
- Centre for Molecular and Biomolecular Informatics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Michael C Kruer
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA.,Departments of Child Health, Neurology, Cellular & Molecular Medicine and Program in Genetics, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Fernando Kok
- Mendelics Genomic Analysis, São Paulo, São Paulo, Brazil
| | - Georg F Hoffmann
- Division of Neuropediatrics and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany
| | - Tim M Strom
- Institute of Human Genetics, Faculty of Medicine, Technical University München, Munich, Germany
| | - Saskia B Wortmann
- Institute of Human Genetics, Faculty of Medicine, Technical University München, Munich, Germany.,Institute of Human Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg, Germany.,University Childrens Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Anne-Claude Tabet
- Genetics Department, AP-HP, Robert-Debré University Hospital, Paris, France.,Neuroscience Department, Human Genetics and Cognitive Function Unit, Pasteur Institute, Paris, France
| | - Thomas Opladen
- Division of Neuropediatrics and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany.
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11
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Sasani A, Hornig S, Grzybowski R, Cordts K, Hanff E, Tsikas D, Böger R, Gerloff C, Isbrandt D, Neu A, Schwedhelm E, Choe CU. Muscle phenotype of AGAT- and GAMT-deficient mice after simvastatin exposure. Amino Acids 2019; 52:73-85. [DOI: 10.1007/s00726-019-02812-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
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12
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Storm Van's Gravesande K, Calabrese P, Blaschek A, Rostásy K, Huppke P, Rothe L, Mall V, Kessler J, Kalbe E, Dornfeld E, Elpers C, Lohmann H, Weddige A, Hagspiel S, Kirschner J, Brehm M, Blank C, Schubert J, Schimmel M, Pacheè S, Mohrbach M, Karenfort M, Kamp G, Lücke T, Neumann H, Lutz S, Gierse A, Sievers S, Schiffmann H, de Soye I, Trollmann R, Candova A, Rosner M, Neu A, Romer G, Seidel U, John R, Hofmann C, Schulz, Kinder S, Bertolatus A, Scheidtmann K, Lasogga R, Leiz S, Alber M, Kranz J, Bajer-Kornek B, Seidl R, Novak A. The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
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Affiliation(s)
- K Storm Van's Gravesande
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
| | - P Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland
| | - A Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
| | - K Rostásy
- Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Dr. Friedrich Steiner Str. 5, 5711 Datteln, Germany
| | - P Huppke
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany
| | - L Rothe
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - V Mall
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany
| | - J Kessler
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - E Kalbe
- Department of Medical Psychology ǀ, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
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13
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Schneeberger PE, Bierhals T, Neu A, Hempel M, Kutsche K. de novo MEPCE nonsense variant associated with a neurodevelopmental disorder causes disintegration of 7SK snRNP and enhanced RNA polymerase II activation. Sci Rep 2019; 9:12516. [PMID: 31467394 PMCID: PMC6715695 DOI: 10.1038/s41598-019-49032-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/19/2019] [Indexed: 02/06/2023] Open
Abstract
In eukaryotes, the elongation phase of transcription by RNA polymerase II (RNAP II) is regulated by the transcription elongation factor b (P-TEFb), composed of Cyclin-T1 and cyclin-dependent kinase 9. The release of RNAP II is mediated by phosphorylation through P-TEFb that in turn is under control by the inhibitory 7SK small nuclear ribonucleoprotein (snRNP) complex. The 7SK snRNP consists of the 7SK non-coding RNA and the proteins MEPCE, LARP7, and HEXIM1/2. Biallelic LARP7 loss-of-function variants underlie Alazami syndrome characterized by growth retardation and intellectual disability. We report a boy with global developmental delay and seizures carrying the de novo MEPCE nonsense variant c.1552 C > T/p.(Arg518*). mRNA and protein analyses identified nonsense-mediated mRNA decay to underlie the decreased amount of MEPCE in patient fibroblasts followed by LARP7 and 7SK snRNA downregulation and HEXIM1 upregulation. Reduced binding of HEXIM1 to Cyclin-T1, hyperphosphorylation of the RNAP II C-terminal domain, and upregulated expression of ID2, ID3, MRPL11 and snRNAs U1, U2 and U4 in patient cells are suggestive of enhanced activation of P-TEFb. Flavopiridol treatment and ectopic MEPCE protein expression in patient fibroblasts rescued increased expression of six RNAP II-sensitive genes and suggested a possible repressive effect of MEPCE on P-TEFb-dependent transcription of specific genes.
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Affiliation(s)
- Pauline E Schneeberger
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tatjana Bierhals
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Neu
- Childrens Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kerstin Kutsche
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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14
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Kloth K, Synofzik M, Kernstock C, Schimpf-Linzenbold S, Schuettauf F, Neu A, Wissinger B, Weisschuh N. Novel likely pathogenic variants in TMEM126A identified in non-syndromic autosomal recessive optic atrophy: two case reports. BMC Med Genet 2019; 20:62. [PMID: 30961538 PMCID: PMC6454730 DOI: 10.1186/s12881-019-0795-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/29/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Reports on autosomal recessive optic atrophy (arOA) are sparse and so far, only one gene has been specifically associated with non-syndromic arOA, namely TMEM126A. To date, all reports of pathogenic TMEM126A variants are from affected individuals of Maghrebian origin, who all carry an identical nonsense variant. Here we report two novel variants in the TMEM126A gene from non-Maghreb individuals, both found in affected individuals with an arOA phenotype. CASE PRESENTATION We report three affected individuals from two families. The proband of family A, a 24-year-old Turkish woman, was diagnosed with visual loss in early childhood but a diagnosis of optic atrophy was only made at 14 years. A diagnostic gene panel revealed a splice donor variant (c.86 + 2 T > C) in homozygous state in the TMEM126A gene. Analysis of this variant based on RNA from whole blood revealed a single aberrant transcript lacking exon 2, presumably representing a functional null allele. Two siblings from family B, a 16-year old Iraqi girl and her 14-year old brother, were diagnosed with optic atrophy in early childhood. A missense variant p.(S36 L) in the TMEM126A gene was identified in homozygous state in a gene panel-based diagnostic setting in both siblings. This missense variant is ultra rare in the general population, affects a highly evolutionarily conserved amino acid and segregates with the disease within the family. The three probands reported in this study had a relatively mild clinical course without any evidence of a syndromic (e.g. neurological) comorbidity, which is in line with previous studies. CONCLUSIONS We provide additional evidence for the implication of biallelic pathogenic TMEM126A variants in arOA. Our findings extend both the mutational spectrum and geographic presence of TMEM126A in arOA. Screening of the entire gene should be considered in affected individuals presenting with features resembling arOA and also from non-Maghrebian descent.
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Affiliation(s)
- Katja Kloth
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Christoph Kernstock
- Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | | | - Frank Schuettauf
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Neu
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Wissinger
- Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Nicole Weisschuh
- Center for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany.
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15
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Abstract
Patients with chronic diseases manifesting in childhood, such as type 1 diabetes, need to make an optimal transition from pediatric to adult medical care. This or transitionis a challenge for patients and their treatment teams, since metabolic control is often unstable at this time of life. Additional factors like the social environment, as well as concomitant diseases, also need to be taken into account and often represent hurdles to optimal therapy. Transition is an important process to guarantee good self-management of diabetes therapy and good outcomes in the long term. This review provides an overview and recommendations on the topic of transition in diabetes.
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Affiliation(s)
- B Gallwitz
- Medizinische Klinik IV, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland.
| | - A Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen, Tübingen, Deutschland
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16
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Stockebrand M, Sasani A, Das D, Hornig S, Hermans-Borgmeyer I, Lake HA, Isbrandt D, Lygate CA, Heerschap A, Neu A, Choe CU. A Mouse Model of Creatine Transporter Deficiency Reveals Impaired Motor Function and Muscle Energy Metabolism. Front Physiol 2018; 9:773. [PMID: 30013483 PMCID: PMC6036259 DOI: 10.3389/fphys.2018.00773] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/04/2018] [Indexed: 11/22/2022] Open
Abstract
Creatine serves as fast energy buffer in organs of high-energy demand such as brain and skeletal muscle. L-Arginine:glycine amidinotransferase (AGAT) and guanidinoacetate N-methyltransferase are responsible for endogenous creatine synthesis. Subsequent uptake into target organs like skeletal muscle, heart and brain is mediated by the creatine transporter (CT1, SLC6A8). Creatine deficiency syndromes are caused by defects of endogenous creatine synthesis or transport and are mainly characterized by intellectual disability, behavioral abnormalities, poorly developed muscle mass, and in some cases also muscle weakness. CT1-deficiency is estimated to be among the most common causes of X-linked intellectual disability and therefore the brain phenotype was the main focus of recent research. Unfortunately, very limited data concerning muscle creatine levels and functions are available from patients with CT1 deficiency. Furthermore, different CT1-deficient mouse models yielded conflicting results and detailed analyses of their muscular phenotype are lacking. Here, we report the generation of a novel CT1-deficient mouse model and characterized the effects of creatine depletion in skeletal muscle. HPLC-analysis showed strongly reduced total creatine levels in skeletal muscle and heart. MR-spectroscopy revealed an almost complete absence of phosphocreatine in skeletal muscle. Increased AGAT expression in skeletal muscle was not sufficient to compensate for insufficient creatine transport. CT1-deficient mice displayed profound impairment of skeletal muscle function and morphology (i.e., reduced strength, reduced endurance, and muscle atrophy). Furthermore, severely altered energy homeostasis was evident on magnetic resonance spectroscopy. Strongly reduced phosphocreatine resulted in decreased ATP/Pi levels despite an increased inorganic phosphate to ATP flux. Concerning glucose metabolism, we show increased glucose transporter type 4 expression in muscle and improved glucose clearance in CT1-deficient mice. These metabolic changes were associated with activation of AMP-activated protein kinase – a central regulator of energy homeostasis. In summary, creatine transporter deficiency resulted in a severe muscle weakness and atrophy despite different compensatory mechanisms.
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Affiliation(s)
- Malte Stockebrand
- German Center for Neurodegenerative Diseases, Bonn, Germany.,Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany
| | - Ali Sasani
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Experimental Neuropediatrics, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Devashish Das
- Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
| | - Sönke Hornig
- Experimental Neuropediatrics, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Irm Hermans-Borgmeyer
- Transgenic Mouse Unit, Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah A Lake
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Dirk Isbrandt
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Craig A Lygate
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom.,Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Arend Heerschap
- Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
| | - Axel Neu
- Experimental Neuropediatrics, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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17
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Neu A, Feldhahn L, Ehehalt S, Ziegler J, Rothe U, Rosenbauer J, Holl RW. No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany. Pediatr Diabetes 2018; 19:637-639. [PMID: 29235225 DOI: 10.1111/pedi.12622] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/04/2017] [Accepted: 11/16/2017] [Indexed: 01/13/2023] Open
Abstract
Objective of this study was to analyze prevalence changes in type 2 diabetes (T2D) among children and adolescents over the last 10 years. We performed a cross-sectional survey in Baden-Württemberg (BW), Germany, by using a written questionnaire and comparing these results with T2D prevalence data from the same area retrieved in 2004/2005. In 2016, 50 patients with T2D under 20 years of age were registered in BW, Germany, which corresponds to a prevalence rate of 2.42 per 100 000 (95% confidence interval [CI]: 1.75-3.09). The prevalence rate found in the same geographic area 10 years prior was 2.30 per 100 000 (95% CI: 1.70-2.90). Overall, 70% of T2D patients of this age group were treated by adult diabetologists. Concisely the prevalence of T2D in children and adolescents is still low in South Germany, remaining practically unchanged over the past decade.
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Affiliation(s)
- A Neu
- University Children's Hospital Tübingen, Tübingen, Germany
| | - L Feldhahn
- Children's Hospital Böblingen, Böblingen, Germany
| | - S Ehehalt
- Department of Pediatrics, Public Health Department Stuttgart, Stuttgart, Germany
| | - J Ziegler
- University Children's Hospital Tübingen, Tübingen, Germany
| | - U Rothe
- Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany
| | - J Rosenbauer
- German Diabetes Centre and Leibniz Institute for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - R W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University Ulm, Ulm, Germany
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18
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Schönhoff M, Weineck G, Hoppe J, Hornig S, Cordts K, Atzler D, Gerloff C, Böger R, Neu A, Schwedhelm E, Choe CU. Cognitive performance of 20 healthy humans supplemented with L-homoarginine for 4 weeks. J Clin Neurosci 2018; 50:237-241. [DOI: 10.1016/j.jocn.2018.01.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 01/08/2018] [Indexed: 12/29/2022]
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19
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Glasgow RIC, Thompson K, Barbosa IA, He L, Alston CL, Deshpande C, Simpson MA, Morris AAM, Neu A, Löbel U, Hall J, Prokisch H, Haack TB, Hempel M, McFarland R, Taylor RW. Novel GFM2 variants associated with early-onset neurological presentations of mitochondrial disease and impaired expression of OXPHOS subunits. Neurogenetics 2017; 18:227-235. [PMID: 29075935 PMCID: PMC5705740 DOI: 10.1007/s10048-017-0526-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 10/03/2017] [Indexed: 11/29/2022]
Abstract
Mitochondrial diseases are characterised by clinical, molecular and functional heterogeneity, reflecting their bi-genomic control. The nuclear gene GFM2 encodes mtEFG2, a protein with an essential role during the termination stage of mitochondrial translation. We present here two unrelated patients harbouring different and previously unreported compound heterozygous (c.569G>A, p.(Arg190Gln); c.636delA, p.(Glu213Argfs*3)) and homozygous (c.275A>C, p.(Tyr92Ser)) recessive variants in GFM2 identified by whole exome sequencing (WES) together with histochemical and biochemical findings to support the diagnoses of pathological GFM2 variants in each case. Both patients presented similarly in early childhood with global developmental delay, raised CSF lactate and abnormalities on cranial MRI. Sanger sequencing of familial samples confirmed the segregation of bi-allelic GFM2 variants with disease, while investigations into steady-state mitochondrial protein levels revealed respiratory chain subunit defects and loss of mtEFG2 protein in muscle. These data demonstrate the effects of defective mtEFG2 function, caused by previously unreported variants, confirming pathogenicity and expanding the clinical phenotypes associated with GFM2 variants.
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Affiliation(s)
- Ruth I C Glasgow
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Kyle Thompson
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Inês A Barbosa
- Department of Medical and Molecular Genetics, King's College London School of Medicine, London, UK
| | - Langping He
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Charlotte L Alston
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Charu Deshpande
- Department of Medical and Molecular Genetics, King's College London School of Medicine, London, UK
| | - Michael A Simpson
- Department of Medical and Molecular Genetics, King's College London School of Medicine, London, UK
| | - Andrew A M Morris
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
- Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - Axel Neu
- University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Löbel
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julie Hall
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München, Oberschleißheim, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Tobias B Haack
- Institute of Human Genetics, Technische Universität München, Munich, Germany
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert McFarland
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
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20
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Rolvien T, Butscheidt S, Jeschke A, Neu A, Denecke J, Kubisch C, Meisler MH, Pueschel K, Barvencik F, Yorgan T, Oheim R, Schinke T, Amling M. Severe bone loss and multiple fractures in SCN8A-related epileptic encephalopathy. Bone 2017; 103:136-143. [PMID: 28676440 DOI: 10.1016/j.bone.2017.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/20/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
Abstract
Mutations in the SCN8A gene encoding the neuronal voltage-gated sodium channel Nav1.6 are known to be associated with epileptic encephalopathy type 13. We identified a novel de novo SCN8A mutation (p.Phe360Ala, c.1078_1079delTTinsGC, Exon 9) in a 6-year-old girl with epileptic encephalopathy accompanied by severe juvenile osteoporosis and multiple skeletal fractures, similar to three previous case reports. Skeletal assessment using dual energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT) and serum analyses revealed a combined trabecular and cortical bone loss syndrome with elevated bone resorption. Likewise, when we analyzed the skeletal phenotype of 2week-old Scn8a-deficient mice we observed reduced trabecular and cortical bone mass, as well as increased osteoclast indices by histomorphometric quantification. Based on this cumulative evidence the patient was treated with neridronate (2mg/kg body weight administered every 3months), which fully prevented additional skeletal fractures for the next 25months. Taken together, our data provide evidence for a negative impact of SCN8A mutations on bone mass, which can be positively influenced by anti-resorptive treatment.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany; Department of Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Sebastian Butscheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Anke Jeschke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Axel Neu
- Department of Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jonas Denecke
- Department of Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Kubisch
- Department of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miriam H Meisler
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Klaus Pueschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Barvencik
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Timur Yorgan
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Ralf Oheim
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany.
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21
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Rosenbauer J, Stahl-Pehe A, Neu A, Rothe U, Reuter HM, Siegel E, Badenhoop K, Seufert J, Holl RW. Prävalenz des Typ-1-Diabetes bei Erwachsenen in Deutschland – Schätzung auf der Basis von bundesweitem DPV-Register und NRW-Diabetesregister. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Rosenbauer
- Deutsches Diabetes-Zentrum, Leibniz-Institut an der Heinrich-Heine-Universität Düsseldorf, Institut für Biometrie und Epidemiologie, Düsseldorf, Germany
| | - A Stahl-Pehe
- Deutsches Diabetes-Zentrum, Leibniz-Institut an der Heinrich-Heine-Universität Düsseldorf, Institut für Biometrie und Epidemiologie, Düsseldorf, Germany
| | - A Neu
- Universitäts-Klinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - U Rothe
- Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Gesundheitswissenschaften/Public Health, Dresden, Germany
| | - HM Reuter
- Ambulantes Medizinisches Zentrum Jena, Diabetologische Schwerpunktpraxis, Jena, Germany
| | - E Siegel
- St. Josefkrankenhaus Heidelberg, Innere Medizin – Gastroenterologie, Diabetologie und Ernährungsmedizin, Heidelberg, Germany
| | - K Badenhoop
- Universitätsklinikum der Goethe-Universität Frankfurt, Medizinische Klinik 1 – SP Diabetologie und Endokrinologie, Frankfurt, Germany
| | - J Seufert
- Universitätsklinikum Freiburg, Klinik für Innere Medizin II – Abteilung Endokrinologie und Diabetologie, Freiburg, Germany
| | - RW Holl
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
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22
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Schweizer R, Herrlich S, Lösch-Binder M, Glökler M, Heimgärtner M, Liebrich F, Messner K, Muckenhaupt T, Schneider A, Ziegler J, Neu A. Der Proteinfaktor: Verhinderung des Blutzuckeranstiegs nach Fett-Protein-reicher Mahlzeit (FPRM) durch zusätzliche Insulingabe. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Schweizer
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - S Herrlich
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Lösch-Binder
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Glökler
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Heimgärtner
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - F Liebrich
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - K Messner
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - T Muckenhaupt
- Klinikum am Steinenberg Reutlingen, Klinik für Kinder- und Jugendmedizin, Reutlingen, Germany
| | - A Schneider
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - J Ziegler
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - A Neu
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
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23
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-111213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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Kim JH, Shinde D, Reijnders M, Hauser N, Belmonte R, Wilson G, Bosch D, Bubulya P, Shashi V, Petrovski S, Stone J, Park E, Veltman J, Sinnema M, Stumpel C, Draaisma J, Nicolai J, Yntema H, Lindstrom K, de Vries B, Jewett T, Santoro S, Vogt J, Bachman K, Seeley A, Krokosky A, Turner C, Rohena L, Hempel M, Kortüm F, Lessel D, Neu A, Strom T, Wieczorek D, Bramswig N, Laccone F, Behunova J, Rehder H, Gordon C, Rio M, Romana S, Tang S, El-Khechen D, Cho M, McWalter K, Douglas G, Baskin B, Begtrup A, Funari T, Schoch K, Stegmann A, Stevens S, Zhang DE, Traver D, Yao X, MacArthur D, Brunner H, Mancini G, Myers R, Owen L, Lim ST, Stachura D, Vissers L, Ahn EY, Vissers LELM, Ahn EYE. De Novo Mutations in SON Disrupt RNA Splicing of Genes Essential for Brain Development and Metabolism, Causing an Intellectual-Disability Syndrome. Am J Hum Genet 2016; 99:711-719. [PMID: 27545680 PMCID: PMC5011044 DOI: 10.1016/j.ajhg.2016.06.029] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/24/2016] [Indexed: 12/01/2022] Open
Abstract
The overall understanding of the molecular etiologies of intellectual disability (ID) and developmental delay (DD) is increasing as next-generation sequencing technologies identify genetic variants in individuals with such disorders. However, detailed analyses conclusively confirming these variants, as well as the underlying molecular mechanisms explaining the diseases, are often lacking. Here, we report on an ID syndrome caused by de novo heterozygous loss-of-function (LoF) mutations in SON. The syndrome is characterized by ID and/or DD, malformations of the cerebral cortex, epilepsy, vision problems, musculoskeletal abnormalities, and congenital malformations. Knockdown of son in zebrafish resulted in severe malformation of the spine, brain, and eyes. Importantly, analyses of RNA from affected individuals revealed that genes critical for neuronal migration and cortex organization (TUBG1, FLNA, PNKP, WDR62, PSMD3, and HDAC6) and metabolism (PCK2, PFKL, IDH2, ACY1, and ADA) are significantly downregulated because of the accumulation of mis-spliced transcripts resulting from erroneous SON-mediated RNA splicing. Our data highlight SON as a master regulator governing neurodevelopment and demonstrate the importance of SON-mediated RNA splicing in human development.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lisenka E L M Vissers
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6500 HB Nijmegen, the Netherlands.
| | - Eun-Young Erin Ahn
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; Department of Biochemistry and Molecular Biology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA.
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25
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter – AWMF-Registernummer 057–016. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-100779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universität Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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26
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Kržišnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Soltész G, Dahlquist GG. Seasonal variation in month of diagnosis in children with type 1 diabetes registered in 23 European centers during 1989-2008: little short-term influence of sunshine hours or average temperature. Pediatr Diabetes 2015; 16:573-80. [PMID: 25316271 DOI: 10.1111/pedi.12227] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The month of diagnosis in childhood type 1 diabetes shows seasonal variation. OBJECTIVE We describe the pattern and investigate if year-to-year irregularities are associated with meteorological factors using data from 50 000 children diagnosed under the age of 15 yr in 23 population-based European registries during 1989-2008. METHODS Tests for seasonal variation in monthly counts aggregated over the 20 yr period were performed. Time series regression was used to investigate if sunshine hour and average temperature data were predictive of the 240 monthly diagnosis counts after taking account of seasonality and long term trends. RESULTS Significant sinusoidal pattern was evident in all but two small centers with peaks in November to February and relative amplitudes ranging from ± 11 to ± 38% (median ± 17%). However, most centers showed significant departures from a sinusoidal pattern. Pooling results over centers, there was significant seasonal variation in each age-group at diagnosis, with least seasonal variation in those under 5 yr. Boys showed greater seasonal variation than girls, particularly those aged 10-14 yr. There were no differences in seasonal pattern between four 5-yr sub-periods. Departures from the sinusoidal trend in monthly diagnoses in the period were significantly associated with deviations from the norm in average temperature (0.8% reduction in diagnoses per 1 °C excess) but not with sunshine hours. CONCLUSIONS Seasonality was consistently apparent throughout the period in all age-groups and both sexes, but girls and the under 5 s showed less marked variation. Neither sunshine hour nor average temperature data contributed in any substantial way to explaining departures from the sinusoidal pattern.
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Affiliation(s)
- C C Patterson
- Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Belfast, UK
| | - E Gyürüs
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - A Neu
- Pediatric Endocrinology & Diabetes, University Children's Hospital, Tübingen, Germany
| | - E Schober
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R C Parslow
- Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
| | - G Joner
- Department of Pediatrics, Ullevål University Hospital, Oslo, Norway
| | - J Svensson
- Department of Paediatrics, Herlev University Hospital, Copenhagen, Denmark
| | - C Castell
- Public Health Agency, Department of Health, Government of Catalonia, Barcelona, Spain
| | - P J Bingley
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - E Schoenle
- Department of Endocrinology and Diabetology, University Children's Hospital, Zurich, Switzerland
| | - P Jarosz-Chobot
- Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland
| | - B Urbonaité
- Institute of Endocrinology, Lithuanian University of Health Science, Kaunas, Lithuania
| | - U Rothe
- Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany
| | - C Kržišnik
- Department of Pediatrics, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- Nutrition and Metabolic Diseases Clinic, N Paulescu Institute of Diabetes and Metabolic Diseases, Bucharest, Romania
| | - I Weets
- Diabetes Research Center, Brussels Free University, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, Macedonia
| | - G Stipancic
- Department of Paediatrics, University Hospital Sestre Milosrdnice, Zagreb, Croatia
| | - M Samardzic
- Department of Endocrinology and Diabetes, University Children's Hospital, Podgorica, Montenegro
| | - C E de Beaufort
- Department of Paediatric Diabetes and Endocrinology, Centre Hospitalier de Luxembourg, Luxembourg
| | - A Green
- Odense Patient data Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - G Soltész
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - G G Dahlquist
- Department of Clinical Science, University of Umeå, Umeå, Sweden
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Marguet SL, Le-Schulte VTQ, Merseburg A, Neu A, Eichler R, Jakovcevski I, Ivanov A, Hanganu-Opatz IL, Bernard C, Morellini F, Isbrandt D. Treatment during a vulnerable developmental period rescues a genetic epilepsy. Nat Med 2015; 21:1436-44. [PMID: 26594844 DOI: 10.1038/nm.3987] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/09/2015] [Indexed: 12/14/2022]
Abstract
The nervous system is vulnerable to perturbations during specific developmental periods. Insults during such susceptible time windows can have long-term consequences, including the development of neurological diseases such as epilepsy. Here we report that a pharmacological intervention timed during a vulnerable neonatal period of cortical development prevents pathology in a genetic epilepsy model. By using mice with dysfunctional Kv7 voltage-gated K(+) channels, which are mutated in human neonatal epilepsy syndromes, we demonstrate the safety and efficacy of the sodium-potassium-chloride cotransporter NKCC1 antagonist bumetanide, which was administered during the first two postnatal weeks. In Kv7 current-deficient mice, which normally display epilepsy, hyperactivity and stereotypies as adults, transient bumetanide treatment normalized neonatal in vivo cortical network and hippocampal neuronal activity, prevented structural damage in the hippocampus and restored wild-type adult behavioral phenotypes. Furthermore, bumetanide treatment did not adversely affect control mice. These results suggest that in individuals with disease susceptibility, timing prophylactically safe interventions to specific windows during development may prevent or arrest disease progression.
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Affiliation(s)
- Stephan Lawrence Marguet
- Experimental Neurophysiology, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany.,Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Andrea Merseburg
- Experimental Neurophysiology, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany.,Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Neu
- Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ronny Eichler
- Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Igor Jakovcevski
- Experimental Neurophysiology, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany
| | - Anton Ivanov
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Neurosciences des Systèmes (INS), Unité Mixte de Recherche (UMR) S1106, Marseille, France
| | - Ileana Livia Hanganu-Opatz
- Developmental Neurophysiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christophe Bernard
- Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Neurosciences des Systèmes (INS), Unité Mixte de Recherche (UMR) S1106, Marseille, France
| | - Fabio Morellini
- Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Behavioral Biology Unit, Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Isbrandt
- Experimental Neurophysiology, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany.,Experimental Neuropediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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28
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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29
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Neu A, Lange K, Barrett T, Cameron F, Dorchy H, Hoey H, Jarosz-Chobot P, Mortensen HB, Robert JJ, Robertson K, de Beaufort C. Classifying insulin regimens--difficulties and proposal for comprehensive new definitions. Pediatr Diabetes 2015; 16:402-6. [PMID: 25865149 DOI: 10.1111/pedi.12275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 11/29/2022] Open
Abstract
Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.
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Affiliation(s)
- A Neu
- Children's Hospital, University Hospital Tuebingen, Germany
| | - K Lange
- Department of Medical Psychology OE5430, Hannover Medical School, Germany
| | - T Barrett
- Institute of Child Health, University of Birmingham, UK
| | - F Cameron
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia
| | - H Dorchy
- Clinique de Diabetologie, Hopital Universitaire des Enfants, Brussels, Belgium
| | - H Hoey
- Department of Paediatrics, University of Dublin, Trinity College, Ireland
| | - P Jarosz-Chobot
- Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland
| | - H B Mortensen
- Faculty of Health Science, University of Copenhagen, Denmark
| | - J-J Robert
- Department of Diabetes in Children and Adolescents, Hôpital Necker - Enfants Malades, Paris, France
| | - K Robertson
- Department of Paediatrics, DCRTD, Kuwait.,Department of Diabetes, Royal Hospital for Sick Children, Glasgow, UK
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30
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Stockebrand M, Hornig S, Neu A, Atzler D, Cordts K, Böger RH, Isbrandt D, Schwedhelm E, Choe CU. Homoarginine supplementation improves blood glucose in diet-induced obese mice. Amino Acids 2015; 47:1921-9. [DOI: 10.1007/s00726-015-2022-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
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31
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Skoda E, Keifenheim K, Holl R, Rapps N, Neu A, Junne F, Teufel M. Komorbidität von Essstörungen und Diabetes mellitus Typ 1: Genese, Prävalenz und Interventionsmöglichkeiten. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1399311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- E. Skoda
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - K. Keifenheim
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - R. Holl
- Universität Ulm, Institut für Epidemiologie und medizinische Biometrie
| | - N. Rapps
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - A. Neu
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin
| | - F. Junne
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - M. Teufel
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
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32
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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33
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnosis, Therapy and Control of Diabetes Mellitus in Children and Adolescents. Exp Clin Endocrinol Diabetes 2014; 122:425-34. [DOI: 10.1055/s-0034-1366384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | - B. Karges
- Sektion Endokrinologie und Diabetologie, RWTH Aachen
| | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Podeswik
- Bundesverband Bunter Kreis e. V., Institut für Sozialmedizin in der Pädiatrie, Augsburg
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Schweizer R, Herrlich S, Lösch-Binder M, Braun R, Behret F, Schneider A, Neu A. Anstieg des Blutzuckers nach fett- und proteinreichen Mahlzeiten: Die Tübinger Grill Studie, eine Pilotstudie bei Jugendlichen mit Typ 1 Diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1350564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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36
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Choe CU, Nabuurs C, Stockebrand MC, Neu A, Nunes P, Morellini F, Sauter K, Schillemeit S, Hermans-Borgmeyer I, Marescau B, Heerschap A, Isbrandt D. L-arginine:glycine amidinotransferase deficiency protects from metabolic syndrome. Hum Mol Genet 2013. [DOI: 10.1093/hmg/ddt320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
AMP-activated protein kinase (AMPK) is a key sensor and regulator of energy homeostasis. Previously, we demonstrated that intracellular energy depletion by L-arginine:glycine amidinotransferase (AGAT) deficiency resulted in AMPK activation and protected from metabolic syndrome. In the present study, we show tissue-specific leptin dependence of AMPK activation by energy depletion. We investigated leptin-dependent AMPK regulation in AGAT- and leptin-deficient (d/d ob/ob) mice. Like ob/ob mice, but unlike d/d mice, d/d ob/ob mice were obese and glucose intolerant. Therefore, leptin is a prerequisite for resistance to metabolic syndrome in AGAT-deficient mice. Quantitative Western blots revealed a 4-fold increase in AMPK activation in skeletal muscle of d/d ob/ob mice (P<0.001). However, AMPK activation was absent in white adipose tissue (WAT) and liver. Compared with blood glucose levels in ob/ob mice, fasting levels were still reduced and therefore did not show leptin dependence (wild-type, 79.4±3.9 mg/dl; d/d, 68.4±3.2 mg/dl; P<0.05). In ob/ob mice and wild-type mice, 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside (AICAR), in combination with leptin, augmented glucose tolerance compared with AICAR alone, whereas no improvement was found under conditions of high-fat-diet feeding. These findings reveal a previously unknown synergistic AMPK activation by leptin and intracellular energy depletion, suggesting that AMPK activation can be therapeutically effective in metabolic syndrome only if leptin sensitivity is preserved.
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Affiliation(s)
- Malte Stockebrand
- 1Experimental Neuropediatrics, Center for Molecular Neurobiology and Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Falkenried 94, 20251 Hamburg, Germany.
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Rajab JM, Schweizer R, Liebrich F, Braun R, Kranz J, Serra E, Lösch-Binder M, Neu A. Geringe Alltagsbelastung bei heranwachsenden Patienten durch Typ 1 Diabetes. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Choe CU, Nabuurs C, Stockebrand MC, Neu A, Nunes P, Morellini F, Sauter K, Schillemeit S, Hermans-Borgmeyer I, Marescau B, Heerschap A, Isbrandt D. L-arginine:glycine amidinotransferase deficiency protects from metabolic syndrome. Hum Mol Genet 2012; 22:110-23. [PMID: 23026748 DOI: 10.1093/hmg/dds407] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Phosphorylated creatine (Cr) serves as an energy buffer for ATP replenishment in organs with highly fluctuating energy demand. The central role of Cr in the brain and muscle is emphasized by severe neurometabolic disorders caused by Cr deficiency. Common symptoms of inborn errors of creatine synthesis or distribution include mental retardation and muscular weakness. Human mutations in l-arginine:glycine amidinotransferase (AGAT), the first enzyme of Cr synthesis, lead to severely reduced Cr and guanidinoacetate (GuA) levels. Here, we report the generation and metabolic characterization of AGAT-deficient mice that are devoid of Cr and its precursor GuA. AGAT-deficient mice exhibited decreased fat deposition, attenuated gluconeogenesis, reduced cholesterol levels and enhanced glucose tolerance. Furthermore, Cr deficiency completely protected from the development of metabolic syndrome caused by diet-induced obesity. Biochemical analyses revealed the chronic Cr-dependent activation of AMP-activated protein kinase (AMPK), which stimulates catabolic pathways in metabolically relevant tissues such as the brain, skeletal muscle, adipose tissue and liver, suggesting a mechanism underlying the metabolic phenotype. In summary, our results show marked metabolic effects of Cr deficiency via the chronic activation of AMPK in a first animal model of AGAT deficiency. In addition to insights into metabolic changes in Cr deficiency syndromes, our genetic model reveals a novel mechanism as a potential treatment option for obesity and type 2 diabetes mellitus.
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Affiliation(s)
- Chi-un Choe
- Experimental Neuropediatrics, Center for Molecular Neurobiology and Department of Pediatrics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Krzisnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Dahlquist GG, Soltész G. Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase. Diabetologia 2012; 55:2142-7. [PMID: 22638547 DOI: 10.1007/s00125-012-2571-8] [Citation(s) in RCA: 310] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 04/02/2012] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. METHODS All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. RESULTS Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. CONCLUSIONS/INTERPRETATION The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.
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Affiliation(s)
- C C Patterson
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science Block B, Grosvenor Road, Belfast, BT12 6BJ, UK.
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Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost any organ system, including the kidneys. Using a large national dataset, our goal was to compare the morbidity as measured by hospitalization and mortality rates between hemodialysis patients with end-stage renal disease (ESRD) secondary to SLE to those with ESRD due to other causes. METHODS The risk of hospitalization was calculated by Poisson regression with clustering for repeated measures using the United States Renal Data System (USRDS) Hospitalization Analytic File in strata of pediatric and adult patients. Cox proportional hazard ratio was used to assess the mortality risk in hospitalized patients. Subjects were censored at transplantation or end of follow-up. RESULTS Adult patients with ESRD secondary to SLE were hospitalized more frequently than other adults (incidence rate ratio (IRR): 1.43, 95% confidence interval (CI): 1.15-1.77) and had a higher risk of death (hazard ratio (HR): 1.89, 95% CI: 1.66-2.5). Mortality was higher in hospitalized pediatric patients with SLE compared to pediatric patients with other causes of ESRD (HR: 2.01, 95% CI: 1.75-2.31) and adults with SLE (HR: 2.05, 95% CI: 1.79-2.34). CONCLUSION Our study demonstrates that there is a trend toward increased hospitalization rates in pediatric and adult patients with SLE. Among these hospitalized patients with SLE, there is an increased risk of death due to cardiovascular disease.
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Affiliation(s)
- S Sule
- Johns Hopkins University, Maryland, USA.
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Ehehalt S, Neu A, Michaelis D, Heinke P, Willasch AM, Dietz K. Incidence of type 1 diabetes in childhood before and after the reunification of Germany--an analysis of epidemiological data, 1960-2006. Exp Clin Endocrinol Diabetes 2012; 120:441-4. [PMID: 22576256 DOI: 10.1055/s-0032-1309045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the impact of rapidly changing environmental factors on the incidence of type 1 diabetes mellitus (T1D). METHOD We compared the frequency of T1D in children before and after the reunification of Germany by means of the registries of the German Democratic Republic (GDR, 1960-1989) and of Baden-Wuerttemberg (BW, 1987-2006). The number of cases of diabetes onset in East Germany after the reunification was predicted by a mathematical model. The observed incidence rate in the Eastern part of Germany after the reunification was taken from the literature 1. RESULTS In Germany, the incidence rate of T1D in children aged 0-14 was 7.2/100 000/year (95%-CI 6.9-7.5, GDR, 1980-1987), and 10.4/100 000/year (95%-CI 9.5-11.4, BW, 1987-1994). For the whole observation period (1960-2006), the observed incidence rates y could be described by the square of a linear function [GDR: y=(1.86 + 0.040 * (year - 1960))²; r²=0.85; BW: y=(3.03 + 0.085 * (year - 1987))², r²=0.89]. The mean rise in incidence before the reunification was less than half the mean rise after the reunification (mean slope: BW 0.085, 95%-CI 0.080-0.090 vs. GDR 0.040, 95% CI 0.036-0.044). The observed incidence for East Germany after 1989 was higher than the prediction on the basis of the GDR -registry (GDR 12.3/100 000/year vs. Saxony 15.7/100 000/year, 95%-CI 14.2-17.3, n=412; 1999-2003). CONCLUSION We conclude that the basis for the disease progress is a genetic predisposition. Environmental factors may modify changes in incidence of type 1 diabetes but do not determine the overall risk.
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Affiliation(s)
- S Ehehalt
- Paediatric Endocrinology and Diabetes, University Children's Hospital Tuebingen, Germany
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Ehehalt S, Dietz K, Neu A. Prognose der Häufigkeitsentwicklung des Typ-1-Diabetes – Daten zur Prävalenz im Kindes- und Jugendalter aus Baden-Württemberg. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Karges B, Neu A, Hofer SE, Rosenbauer J, Kiess W, Rütschle H, Dost A, Kentrup H, Holl RW. [Frequency and influencing factors of ketoacidosis at diabetes onset in children and adolescents--a long-term study between 1995 and 2009]. Klin Padiatr 2011; 223:70-3. [PMID: 21271502 DOI: 10.1055/s-0030-1269884] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Diabetic ketoacidosis (DKA) is a frequent acute complication at onset of type 1 diabetes. It is assumed that increased public awareness about diabetes symptoms may reduce DKA rate at diabetes onset. To investigate the time-dependent trend in DKA prevalence we analysed the frequency and determinants of DKA at disease onset over 15 years in pediatric patients. PATIENTS AND METHODS The prevalence of DKA at disease onset was analysed in individuals aged ≤18 years treated for the first time from 1995-2009 within 7 days after diagnosis in pediatric centers. Simple and multiple logistic regression analysis was performed to investigate influencing factors on DKA prevalence. Change of the probability of ketoacidosis over years were modelled in the logistic regression as linear trend. RESULTS 16 562 individuals from 170 institutions were studied with a mean age of 9.2 ± 4.2 years. DKA (pH <7.3) was present in 20.8% of patients without a significant trend between 1995 and 2009 (p=0.222). DKA prevalence was higher in children ≤5 years (26.3%) and in the age group 10-15 years (21.7%) than in individuals aged 5-10 years (16.4%) and 15-18 years (16.9%, p<0.001). Girls had DKA more often than boys (21.2% vs. 19.3%, p=0.002). DKA frequency was increased in individuals with migration background (26.5% vs. 19.2%, p<0.001). CONCLUSIONS DKA prevalence at diabetes onset was constant at about 21% during the last 15 years. Very young children, pubertal adolescents, girls and individuals with migration background are at higher risk for DKA at diagnosis. To prevent DKA earlier diagnosis of type 1 diabetes is warranted especially in these patient groups.
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Affiliation(s)
- B Karges
- Sektion Endokrinologie und Diabetologie, Universitätsklinikum Aachen, RWTH Aachen.
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1262636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Neu A, Eiselt M, Paul M, Sauter K, Stallmeyer B, Isbrandt D, Schulze-Bahr E. A homozygous SCN5A mutation in a severe, recessive type of cardiac conduction disease. Hum Mutat 2010; 31:E1609-21. [DOI: 10.1002/humu.21302] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Blohm M, Lehmberg K, Hillebrand G, Neu A, Ridderbusch I, Schneppenheim R, Singer D. Unterarmgangrän und Hirninfarkt bei „normaler“ Gerinnung: Homozygoter Antithrombin III – Mangel Typ II (Budapest). Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gocz A, Neu A, Lange K. Struktur und Qualität der pädiatrischen Diabetesversorgung 1998–2008 in Deutschland: Zentralisierung und steigende Qualifizierung bei unzureichender Finanzierung. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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