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Galderisi A, Kariyawasam D, Stoupa A, Quoc AN, Pinto G, Viaud M, Brabant S, Beltrand J, Polak M, Samara-Boustani D. Glucose pattern in children with classical congenital adrenal hyperplasia: evidence from continuous glucose monitoring. Eur J Endocrinol 2024; 190:L7. [PMID: 38668689 DOI: 10.1093/ejendo/lvae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 05/04/2024]
Affiliation(s)
- Alfonso Galderisi
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Department of Pediatrics, Pediatric Endocrinology, Yale University, New Haven, CT, United States
| | - Dulanjalee Kariyawasam
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Atanasia Stoupa
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Adrien Nguyen Quoc
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
| | - Graziella Pinto
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
| | - Magali Viaud
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
| | - Séverine Brabant
- Department of Functional Explorations, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris, France
| | - Jacques Beltrand
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Michel Polak
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Dinane Samara-Boustani
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
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Morin A, Allodji R, Kariyawasam D, Touraine P, Puget S, Beccaria K, De Carli E, Kieffer V, Rivollet S, Abbou S, Fayech C, Souchard V, Dufour C, De Vathaire F, Bolle S, Grill J, Fresneau B. Very long-term outcomes of pediatric patients treated for optic pathway gliomas: A longitudinal cohort study. Neuro Oncol 2024:noae045. [PMID: 38465768 DOI: 10.1093/neuonc/noae045] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Optic pathway gliomas (OPG) represent 5% of childhood brain tumors. Successive relapses lead to multiple treatments exposing to late complications. METHODS We included patients treated at Gustave Roussy (GR) between 01.1980 and 12.2015 for OPG, before 18 years-old and alive at 5 years from diagnosis. Mortality and physical health conditions data were extracted from medical data files and updated thanks to the GR long-term follow-up program and French national mortality registry for patients included in the French Childhood Cancer Survivor Study. RESULTS We included 182 5y-OPG-childhood survivors in the analysis (sex-ratio M/F 0.8, 35% with NF1). With a median follow-up of 17.2y (range=5-41), we registered 82 relapses, 9 second malignancies and 15 deaths as first events after 5 years, resulting in 20-y conditional overall survival (C-OS) and late events-free survival (LEFS) of 79.9% (95%CI=71-86) and 43.5% (95%CI=36-51) respectively. NF1 (Hazard ratio HR=3, 95%CI=1.4-6.8), hypothalamic involvement (HR=3.2, 95%CI=1.4-7.3), and radiotherapy (HR=2.8, 95%CI=1.1-6.7) were significantly associated with C-OS in multivariable analyses. Ninety-five percent of 5y-OPG survivors suffered from any health condition, especially visual acuity "<1/10" (n=109), pituitary deficiency (n=106) and neurocognitive impairment (n=89). NF1 (HR 2.1) was associated with precocious puberty. With a median time post diagnosis of 4.2 years, 33 cerebrovascular events were observed in 21 patients. CONCLUSION Late relapses, second malignancies and cerebrovascular diseases are severe late events resulting in premature mortality. Morbidity is high and needing after-cancer care to improve quality of life. Risk factors could be considered to better stratify long-term follow-up.
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Affiliation(s)
- Alice Morin
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Rodrigue Allodji
- Radiation Epidemiology Group, INSERM Unit 1018, Villejuif, F-94805, France
- Paris-Saclay University, Villejuif, F-94805, France
- Gustave Roussy, Villejuif, F-94805, France
| | - Dulanjalee Kariyawasam
- Necker-Enfants Malades University Hospital, Paris cite University, Department of Pediatric Endocrinology, Diabetology and Gynaecology, Paris, F-75015, France
| | - Philippe Touraine
- Pitie-Salpetriere hospital, Sorbonne University, Department of endocrinology and reproductive medicine, Paris, F-75013, France
| | - Stéphanie Puget
- Necker-Enfants Malades University Hospital, Paris cite University, Neuro-surgery department, Paris, F-75015, France
| | - Kevin Beccaria
- Necker-Enfants Malades University Hospital, Paris cite University, Neuro-surgery department, Paris, F-75015, France
| | - Emilie De Carli
- Angers University Hospital, Department of Children and Adolescents Onco-hematology, Angers, F- 49933, France
| | - Virginie Kieffer
- Saint-Maurice hospital, Monitoring and Integration Center for children with acquired brain damage, Saint-Maurice, F-94410, France
| | - Sophie Rivollet
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Samuel Abbou
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Chiraz Fayech
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Vincent Souchard
- Radiation Epidemiology Group, INSERM Unit 1018, Villejuif, F-94805, France
- Paris-Saclay University, Villejuif, F-94805, France
- Gustave Roussy, Villejuif, F-94805, France
| | - Christelle Dufour
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Florent De Vathaire
- Radiation Epidemiology Group, INSERM Unit 1018, Villejuif, F-94805, France
- Paris-Saclay University, Villejuif, F-94805, France
- Gustave Roussy, Villejuif, F-94805, France
| | - Stéphanie Bolle
- Gustave Roussy, Paris-Saclay University , Radiation Oncology Department, Villejuif, F-94805, France
| | - Jacques Grill
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Brice Fresneau
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
- Radiation Epidemiology Group, INSERM Unit 1018, Villejuif, F-94805, France
- Paris-Saclay University, Villejuif, F-94805, France
- Gustave Roussy, Villejuif, F-94805, France
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Benhamou PY, Adenis A, Tourki Y, Pou S, Madrolle S, Franc S, Kariyawasam D, Beltrand J, Klonoff DC, Charpentier G. Efficacy of a Hybrid Closed-Loop Solution in Patients With Excessive Time in Hypoglycaemia: A Post Hoc Analysis of Trials With DBLG1 System. J Diabetes Sci Technol 2024; 18:372-379. [PMID: 36172702 PMCID: PMC10973855 DOI: 10.1177/19322968221128565] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Automated insulin delivery is an efficient treatment for patients with type 1 diabetes. Little is known on its impact on patients with excessive time in hypoglycaemia. METHODS We performed a post hoc analysis of three randomized control trials that used the DBLG1 (Diabeloop Generation 1) hybrid closed-loop solution. Patients whose time below 70 mg/dL during baseline, open-loop phase exceeded 5% were selected. The outcomes were the differences between the closed-loop and the open-loop phases in time in various ranges and Glycemia Risk Index (GRI). RESULTS We identified 45 patients exhibiting ≥5% of time below 70 mg/dL during the open-loop phase. Under closed-loop, the time in hypoglycaemia (54 to <70 mg/dL) dropped from 7.9% (SD 2.4) to 3.2% (SD 1.6) (difference -4.7% [-5.3; -4.1], P < 10-4). The time below 54 mg/dL decreased from 1.9% (SD 1.3) to 0.8% (SD 0.7) (difference -0.9% [-1.4; -0.8], P < 10-4). The time in range (TIR 70-180 mg/dL) improved from 63.3 (SD 9.5) to 68.2% (SD 8.2) (difference 5.1% [2.9; 7.0], P < 10-4). The GRI improved from 51.2 (SD 12.4) to 38.0 (SD 10.9) (difference 13.2 [10.4; 16.0], P < 10-4). CONCLUSION DBLG1 decreased time in hypoglycaemia by more than 50% even in patients with excessive time in hypoglycaemia at baseline, while also improving both TIR and GRI, under real-life conditions. The improvement in GRI (13.2%) exceeded that of the improvement in TIR (5.1%) indicating that in this data set, GRI was more sensitive than TIR to the improvement in glycaemia achieved with closed-loop. These results support the safety and efficacy of this treatment.
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Affiliation(s)
- Pierre-Yves Benhamou
- Department of Endocrinology, Grenoble University Hospita, INSERM U1055, Laboratory of Fundamental and Applied Bioenergetics, Grenoble Alpes University, Grenoble, France
- Department of Endocrinology, Univ. Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes
| | | | | | | | | | - Sylvia Franc
- Center for Study and Research for Improvement of the Treatment of Diabetes, Bioparc-Genopole Evry-Corbeil, Evry, France
- Department of Diabetes and Endocrinology, Sud-Francilien Hospital, Corbeil, France
| | - Dulanjalee Kariyawasam
- Department of Paediatric Endocrinology, Diabetology and Gynaecology, Necker-Enfants Malades University Hospital, Assistance Publique des Hôpitaux de Paris-Centre, Paris, France
- Paris Cite University, Paris, France
| | - Jacques Beltrand
- Department of Paediatric Endocrinology, Diabetology and Gynaecology, Necker-Enfants Malades University Hospital, Assistance Publique des Hôpitaux de Paris-Centre, Paris, France
- Paris Cite University, Paris, France
| | - David C. Klonoff
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
| | - Guillaume Charpentier
- Center for Study and Research for Improvement of the Treatment of Diabetes, Bioparc-Genopole Evry-Corbeil, Evry, France
- Department of Diabetes and Endocrinology, Sud-Francilien Hospital, Corbeil, France
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Galderisi A, Kariyawasam D, Stoupa A, Quoc AN, Pinto G, Viaud M, Brabant S, Beltrand J, Polak M, Samara-Boustani D. Glucose pattern in children with classical congenital adrenal hyperplasia: evidence from continuous glucose monitoring. Eur J Endocrinol 2023; 189:K19-K24. [PMID: 37952170 DOI: 10.1093/ejendo/lvad147] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/01/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND While the risk for hypoglycemia during acute illness is well described in children with classical congenital adrenal hyperplasia (CAH), there is little evidence for the prevalence of asymptomatic hypoglycemia and the daily glucose patterns in CAH. Herein, we explored the daytime glucose profile of children with classical CAH. METHODS We conducted an observational study in 11 children (6 female; age 3.1 years [1.4, 5.1]; body mass index 17.3 kg/m2 [15.6, 17.9]) with a genetic diagnosis of classical CAH receiving hydrocortisone and fludrocortisone replacement therapy. Participants underwent 2 14-day continuous glucose monitoring (CGM) sessions and an inpatient 24 h series cortisol and adrenocorticotropic hormone (ACTH) measures. Data were analyzed for 3 daytime lags (7 Am-4 Pm, 4 Pm-10pm, 10 Pm-7 Am) corresponding to the hydrocortisone dosing period with cortisol and ACTH measured before the hydrocortisone dose. RESULTS Eleven participants completed at least 1 CGM session, and 7 out of 11 underwent both the CGM session and the cortisol/ACTH serial measures. In the whole cohort, the percentage of time of sensor glucose values <70 mg/dL was higher during the 10 Pm-7 Am and the 7 Am-4 Pm time slots than in the late afternoon period (17% [7, 54] and 15% [6.8, 24] vs 2% [1.1, 16.7] during the periods 7 Am-4 Pm and 4 Pm-10 Pm, respectively [P = .006 and P = .003]). Nighttime hypoglycemia was mostly spent below the 65 mg/dL (10.9% [4.1, 34]). The glycemic pattern paralleled the nadir of daily cortisol at 7 Am (10.3±4.4 μg/dL). A greater percentage of time in hypoglycemia was associated with lower cortisol concentration at 7 Am and 10 Pm (P < .001 and P = .005). CONCLUSIONS Continuous glucose monitoring demonstrated a disrupted daily glucose pattern in children with CAH, paralleled by a lower cortisol concentration. CLINICALTRIALS.GOV REGISTRATION NCT04322435.
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Affiliation(s)
- Alfonso Galderisi
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Department of Pediatrics, Pediatric Endocrinology, Yale University, New Haven, CT, United States
| | - Dulanjalee Kariyawasam
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Athanasia Stoupa
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Adrien Nguyen Quoc
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
| | - Graziella Pinto
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
| | - Magali Viaud
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
| | - Severine Brabant
- Department of Functional Explorations, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris, France
| | - Jacques Beltrand
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Michel Polak
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, Paris, France
| | - Dinane Samara-Boustani
- Department of Paediatric Endocrinology, Diabetology, and Gynaecology, Necker-Enfants Malades University Hospital, Centre de Référence des Maladies endocriniennes Rares de la Croissance et du Développement (filière FIRENDO), AP-HP Centre, Paris, France
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Benhamou PY, Adenis A, Lablanche S, Franc S, Amadou C, Penfornis A, Kariyawasam D, Beltrand J, Charpentier G. First Generation of a Modular Interoperable Closed-Loop System for Automated Insulin Delivery in Patients With Type 1 Diabetes: Lessons From Trials and Real-Life Data. J Diabetes Sci Technol 2023; 17:1433-1439. [PMID: 37449762 PMCID: PMC10658690 DOI: 10.1177/19322968231186976] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 07/18/2023]
Abstract
BACKGROUND DBLG1 (Diabeloop Generation 1) stands as one of the five commercially available closed-loop solution worldwide for patients with type 1 diabetes as of 2023. Our aim was to provide an overview of all data obtained with this system regarding outcomes and populations, with an emphasis on interoperability. METHODS This report includes all available sources of data (three randomized control trials and five surveys on real-life data). Collection ran from March 3, 2017 to April 30, 2022. RESULTS We gathered data from 6859 adult patients treated with closed-loop from three to 12 months. Overall, all sources of data showed that time in range (TIR) 70 to 180 mg/dL, starting from 47.4% to 56.6%, improved from 12.2 to 17.3 percentage points. Time in hypoglycemia was reduced by 48% in average (range: 26%-70%) and reached a level of 1.3% in the largest and most recent cohort. In patients with excessive time in hypoglycemia at baseline (≥5%), closed-loop allowed a reduction in time below range (TBR) by 59%. The comparison of days with declared physical activity versus days without physical activity did not show differences in TBR. The improvement in TIR observed with three different pump systems (Vicentra Kaleido, n = 117; Sooil Dana-I, n = 84; and Roche Insight, n = 6684) ranged from 15.4 to 17.3 percentage points. DISCUSSION These data obtained in different European countries were consistent throughout all reports, showing that this closed-loop system is efficient (high improvement in TIR), safe (remarkably low level of TBR), and interoperable (three pump settings so far).
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Affiliation(s)
- Pierre-Yves Benhamou
- Department of Endocrinology, Grenoble
University Hospital, Grenoble Alpes University, INSERM U1055, Laboratory of
Fundamental and Applied Bioenergetics, Grenoble, France
- Endocrinology, Centre Hospitalier
Universitaire Grenoble Alpes, Grenoble Alpes University, Grenoble, France
| | | | - Sandrine Lablanche
- Department of Endocrinology, Grenoble
University Hospital, Grenoble Alpes University, INSERM U1055, Laboratory of
Fundamental and Applied Bioenergetics, Grenoble, France
| | - Sylvia Franc
- Center for Study and Research for
Improvement of the Treatment of Diabetes, Bioparc-Genopole Evry-Corbeil, Evry,
France
- Department of Diabetes and
Endocrinology, Sud-Francilien Hospital, Corbeil-Essonnes, France
- Department of Endocrinology,
Diabetology & Metabolic Diseases, Sud-Francilien Hospital, Paris-Saclay
University, Corbeil-Essonnes, France
| | - Coralie Amadou
- Department of Endocrinology,
Diabetology & Metabolic Diseases, Sud-Francilien Hospital, Paris-Saclay
University, Corbeil-Essonnes, France
| | - Alfred Penfornis
- Department of Endocrinology,
Diabetology & Metabolic Diseases, Sud-Francilien Hospital, Paris-Saclay
University, Corbeil-Essonnes, France
| | - Dulanjalee Kariyawasam
- Paediatric Endocrinology, Diabetology,
Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance
Publique des Hôpitaux de Paris-Centre, Paris, France
- Paris Cite University, Paris,
France
| | - Jacques Beltrand
- Paediatric Endocrinology, Diabetology,
Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance
Publique des Hôpitaux de Paris-Centre, Paris, France
- Paris Cite University, Paris,
France
| | - Guillaume Charpentier
- Center for Study and Research for
Improvement of the Treatment of Diabetes, Bioparc-Genopole Evry-Corbeil, Evry,
France
- Department of Diabetes and
Endocrinology, Sud-Francilien Hospital, Corbeil-Essonnes, France
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Didier-Mathon H, Stoupa A, Kariyawasam D, Yde S, Cochant-Priollet B, Groussin L, Sébag F, Cagnard N, Nitschke P, Luton D, Polak M, Carré A. Borealin/CDCA8 deficiency alters thyroid development and results in papillary tumor-like structures. Front Endocrinol (Lausanne) 2023; 14:1286747. [PMID: 37964961 PMCID: PMC10641986 DOI: 10.3389/fendo.2023.1286747] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
Background BOREALIN/CDCA8 mutations are associated with congenital hypothyroidism and thyroid dysgenesis. Borealin is involved in mitosis as part of the Chromosomal Passenger Complex. Although BOREALIN mutations decrease thyrocyte adhesion and migration, little is known about the specific role of Borealin in the thyroid. Methods We characterized thyroid development and function in Borealin-deficient (Borealin +/-) mice using histology, transcriptomic analysis, and quantitative PCR. Results Thyroid development was impaired with a hyperplastic anlage on embryonic day E9.5 followed by thyroid hypoplasia from E11.5 onward. Adult Borealin +/- mice exhibited euthyroid goiter and defect in thyroid hormone synthesis. Borealin +/- aged mice had disorganized follicles and papillary-like structures in thyroids due to ERK pathway activation and a strong increase of Braf-like genes described by The Cancer Genome Atlas (TCGA) network of papillary thyroid carcinoma. Moreover, Borealin +/- thyroids exhibited structural and transcriptomic similarities with papillary thyroid carcinoma tissue from a human patient harboring a BOREALIN mutation, suggesting a role in thyroid tumor susceptibility. Conclusion These findings demonstrate Borealin involvement in critical steps of thyroid structural development and function throughout life. They support a role for Borealin in thyroid dysgenesis with congenital hypothyroidism. Close monitoring for thyroid cancer seems warranted in patients carrying BOREALIN mutations.
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Affiliation(s)
- Hortense Didier-Mathon
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
| | - Athanasia Stoupa
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
- IMAGINE Institute Affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hopitaux de Paris (AP-HP), Paris, France
| | - Dulanjalee Kariyawasam
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
- IMAGINE Institute Affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hopitaux de Paris (AP-HP), Paris, France
| | - Sonny Yde
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
| | - Beatrix Cochant-Priollet
- Université Paris Cité, Faculté de Médecine, Paris, France
- Department of Pathology, Cochin Hospital, Assistance Publique Hopitaux de Paris (AP-HP) Centre, Paris, France
| | - Lionel Groussin
- Department of Endocrinology, Université Paris Cité, Cochin Hospital, Assistance Publique Hopitaux de Paris (AP-HP) Centre, Paris, France
| | - Frédéric Sébag
- Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Nicolas Cagnard
- Bioinformatics Platform, Institut Imagine, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France
| | - Patrick Nitschke
- Bioinformatics Platform, Institut Imagine, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France
| | - Dominique Luton
- Département de Gynécologie Obstétrique, Hôpital Bicêtre, Assistance Publique Hopitaux de Paris (AP-HP) Le Kremlin Bicêtre France, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Michel Polak
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
- IMAGINE Institute Affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hopitaux de Paris (AP-HP), Paris, France
- Centre de référence des maladies endocriniennes rares de la croissance et du développement, Necker-Enfants Malades University Hospital, Paris, France
- Centre régional de dépistage néonatal (CRDN) Ile de France, Paris, France
| | - Aurore Carré
- Université Paris Cité, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin, Paris, France
- IMAGINE Institute Affiliate, Paris, France
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Mericq V, Iñiguez G, Pinto G, Gonzalez-Briceño LG, Samara-Boustani D, Thalassinos C, Flechtner I, Stoupa A, Beltrand J, Besançon A, Brabant S, Ghazal K, Leban M, Touraine P, Cavada G, Polak M, Kariyawasam D. Identifying patient-related predictors of permanent growth hormone deficiency. Front Endocrinol (Lausanne) 2023; 14:1270845. [PMID: 37881494 PMCID: PMC10597646 DOI: 10.3389/fendo.2023.1270845] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Objective Isolated childhood growth hormone deficiency (GHD) can persist into adulthood, and re-testing at the transition period is needed to determine whether continued growth hormone therapy is indicated. Here, our objective was to identify predictors of permanent GHD. Design Retrospective single-centre study of patients with childhood-onset GHD who were re-tested after adult height attainment. Methods Auxological, clinical, laboratory, and MRI data throughout follow-up were collected. Results We included 101 patients. At GH treatment initiation, age was 8.1 ± 0.4 years, height -2.25 ± 0.8, and BMI -0.27 ± 0.1 SDS. The 29 (28.7%) patients with persistent GHD had lower height SDS (-2.57 ± 0.1 vs. -2.11 ± 0.1, p<0.001) and mean GH peaks (8.4 ± 1.0 vs.13.2 ± 0.5 mIU/L, p<0.001) at GHD diagnosis; at adult height, they had lower IGF1 (232 ± 19.9 vs. 331 ± 9.1 ng/mL, p<0.001) and higher BMI SDS (-0.15 ± 0.27 vs. -0.73 ± 0.13, p<0.005). By multivariate analysis, the best predictive model included height and BMI SDS, both GH peaks, and MRI findings at diagnosis. Patients with height at diagnosis <-3 SDS had a 7.7 (95% IC 1.4-43.1, p=0.02) fold higher risk of persistent GHD after adjustment on BMI SDS. An abnormal pituitary region by MRI was the strongest single predictor (7.2 times, 95% CI 2.7-19.8) and after multivariate analysis adjustment for GH peaks and height SDS at diagnosis, the risk increased to 10.6 (1.8 - 61.3) times. Conclusions Height <-3 SDS at GHD diagnosis and pituitary MRI abnormalities should lead to a high index of suspicion for persistent GHD.
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Affiliation(s)
- Veronica Mericq
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
| | - German Iñiguez
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile
| | - Graziella Pinto
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laura G. Gonzalez-Briceño
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Dinane Samara-Boustani
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Caroline Thalassinos
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Flechtner
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Athanasia Stoupa
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut Imagine, Paris, France
| | - Jacques Beltrand
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Paris, France
| | - Alix Besançon
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Séverine Brabant
- Functional Exploration Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Khaldoun Ghazal
- Functional Exploration Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Monique Leban
- Functional Exploration Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Touraine
- Endocrinology Department, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Gabriel Cavada
- Public Health Department, Faculty of medicine, University of Chile, Santiago, Chile
| | - Michel Polak
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut Imagine, Paris, France
- Université Paris Cité, Paris, France
| | - Dulanjalee Kariyawasam
- Paediatric Endocrinology, Diabetology, and Gynaecology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut Imagine, Paris, France
- Université Paris Cité, Paris, France
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8
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Rosimont M, Kariyawasam D, Samara-Boustani D, Giani E, Beltrand J, Bolle S, Fresneau B, Puget S, Sainte-Rose C, Alapetite C, Pinto G, Touraine P, Piketty ML, Brabant S, Abbou S, Aerts I, Beccaria K, Bourgeois M, Roujeau T, Blauwblomme T, Rocco FD, Thalassinos C, Rigaud C, James S, Busiah K, Simon A, Bourdeaut F, Lemelle L, Guerrini-Rousseau L, Orbach D, Doz F, Dufour C, Grill J, Polak M, Briceño LG. Assessment of Puberty and Hypothalamic-Pituitary-Gonadal Axis Function After Childhood Brain Tumor Treatment. J Clin Endocrinol Metab 2023; 108:e823-e831. [PMID: 36810692 DOI: 10.1210/clinem/dgad097] [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: 07/11/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT Endocrine complications are common in pediatric brain tumor patients. OBJECTIVE To describe hypothalamic-pituitary-gonadal axis (HPGA) function in patients treated in childhood for a primary brain tumor more than 5 years earlier, in order to identify risk factors for HPGA impairment. METHODS We retrospectively included 204 patients diagnosed with a primary brain tumor before 18 years of age and monitored at the pediatric endocrinology unit of the Necker Enfants-Malades University Hospital (Paris, France) between January 2010 and December 2015. Patients with pituitary adenoma or untreated glioma were excluded. RESULTS Among patients with suprasellar glioma not treated by radiotherapy, the prevalence of advanced puberty was 65% overall and 70% when the diagnosis occurred before 5 years of age. Medulloblastoma chemotherapy caused gonadal toxicity in 70% of all patients and in 87.5% of those younger than 5 years at diagnosis. In the group with craniopharyngioma, 70% of patients had hypogonadotropic hypogonadism, which was consistently accompanied by growth hormone deficiency. CONCLUSION Tumor type, location, and treatment were the risk main factors for HPGA impairment. Awareness that onset can be delayed is essential to guide information of parents and patients, patient monitoring, and timely hormone replacement therapy.
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Affiliation(s)
- Manon Rosimont
- Endocrino-diabéto-pédiatrie, Centre hospitalier chrétien du Montlégia, 4000 Liège, Belgium
| | - Dulanjalee Kariyawasam
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
| | - Dinane Samara-Boustani
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
| | - Elisa Giani
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
| | - Jacques Beltrand
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
- Université Paris Cité, 75006 Paris, France
| | - Stephanie Bolle
- Département de radiothérapie-oncologie, Institut Gustave Roussy, 94805 Villejuif, France
| | - Brice Fresneau
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Stephanie Puget
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | - Christian Sainte-Rose
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | - Claire Alapetite
- Radiation Oncology Department and Proton Centre, Institut Curie, 75005 Paris, France
| | - Graziella Pinto
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
| | - Philippe Touraine
- Université Paris Cité, 75006 Paris, France
- Service Endocrinologie et Médecine de la Reproduction, Hôpital Universitaire La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne Université, 75005 Paris, France
| | - Marie-Liesse Piketty
- Explorations Fonctionnelles, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75013 Paris, France
| | - Séverine Brabant
- Explorations Fonctionnelles, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75013 Paris, France
| | - Samuel Abbou
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Isabelle Aerts
- SIREDO Oncology Centre (Care, Innovation and research for children and AYA with cancer), Institut Curie, 75015 Paris, France
| | - Kevin Beccaria
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | - Marie Bourgeois
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | - Thomas Roujeau
- Unité de Neurochirurgie pédiatrique, Hôpital Gui de Chauliac, 34295 Montpellier, France
| | - Thomas Blauwblomme
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | | | - Caroline Thalassinos
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
| | - Charlotte Rigaud
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Syril James
- Service de Neurochirurgie, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), 75015 Paris, France
| | - Kanetee Busiah
- Pediatric Endocrinology, Diabetology and Obesity, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
| | - Albane Simon
- Endocrinologie Pédiatrique, Centre Hospitalier de Versailles, 78157 Le Chesnay, France
| | - Franck Bourdeaut
- SIREDO Oncology Centre (Care, Innovation and research for children and AYA with cancer), Institut Curie, 75015 Paris, France
| | - Lauriane Lemelle
- SIREDO Oncology Centre (Care, Innovation and research for children and AYA with cancer), Institut Curie, 75015 Paris, France
| | - Léa Guerrini-Rousseau
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and research for children and AYA with cancer), Institut Curie, 75015 Paris, France
- PSL Research University, 75006 Paris, France
| | - François Doz
- Université Paris Cité, 75006 Paris, France
- SIREDO Oncology Centre (Care, Innovation and research for children and AYA with cancer), Institut Curie, 75015 Paris, France
| | - Christelle Dufour
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Jacques Grill
- Département de Cancérologie de l'Enfant et de l'Adolescent, Institut Gustave Roussy, 94805 Villejuif, France
| | - Michel Polak
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
- Université Paris Cité, 75006 Paris, France
| | - Laura González Briceño
- Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Institut IMAGINE (affiliate), 75015 Paris, France
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9
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Nguyen Quoc A, Beccaria K, González Briceño L, Pinto G, Samara-Boustani D, Stoupa A, Beltrand J, Besançon A, Thalassinos C, Puget S, Blauwblomme T, Alapetite C, Bolle S, Doz F, Grill J, Dufour C, Bourdeaut F, Abbou S, Guerrini-Rousseau L, Leruste A, Brabant S, Cavadias I, Viaud M, Boddaert N, Polak M, Kariyawasam D. GH and Childhood-onset Craniopharyngioma: When to Initiate GH Replacement Therapy? J Clin Endocrinol Metab 2023; 108:1929-1936. [PMID: 36794424 DOI: 10.1210/clinem/dgad079] [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: 09/08/2022] [Revised: 12/31/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
CONTEXT Craniopharyngioma is a benign brain tumor with frequent local recurrence or progression after treatment. GH replacement therapy (GHRT) is prescribed in children with GH deficiency resulting from childhood-onset craniopharyngioma. OBJECTIVE To evaluate whether a shorter delay of GHRT initiation after childhood-onset craniopharyngioma completion therapy increased the risk of a new event (progression or recurrence). METHODS Retrospective, observational, monocenter study. We compared a cohort of 71 childhood-onset patients with craniopharyngiomas treated with recombinant human GH (rhGH). Twenty-seven patients were treated with rhGH at least 12 months after craniopharyngioma treatment (>12-month group) and 44 patients before 12 months (<12-month group), among which 29 patients were treated between 6 and 12 months (6-12 month group). The main outcome was the risk of tumor new event (progression of residual tumor or tumor recurrence after complete resection) after primary treatment in the >12-month group and in the <12 month or in the 6- to 12-month group patients. RESULTS In the >12-month group, the 2- and 5-year event-free survivals were respectively 81.5% (95% CI, 61.1-91.9) and 69.4% (95% CI, 47.9-83.4) compared with 72.2% (95% CI, 56.3-83.1) and 69.8% (95% CI, 53.8-81.2) in the <12-month group. The 2- and 5-year event-free survivals were the same in the 6- to 12-month group (72.4%; 95% CI, 52.4-85.1). By log-rank test, the event-free survival was not different between groups (P = .98 and P = .91).The median time for event was not statistically different.In univariate and multivariate analysis, the risk of craniopharyngioma new event was not associated with the GHRT time delay after craniopharyngioma treatment. CONCLUSIONS No association was found between GHRT time delay after childhood-onset craniopharyngioma treatment and an increased risk of recurrence or tumor progression, suggesting GH replacement therapy can be initiated 6 months after last treatment for craniopharyngiomas.
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Affiliation(s)
- Adrien Nguyen Quoc
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
| | - Kévin Beccaria
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Department of Pediatric Neurosurgery, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Laura González Briceño
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Graziella Pinto
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Dinane Samara-Boustani
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Athanasia Stoupa
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
- Cochin Institute, INSERM U1016, 75014 Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, 75015 Paris, France
| | - Jacques Beltrand
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Cochin Institute, INSERM U1016, 75014 Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, 75015 Paris, France
| | - Alix Besançon
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Caroline Thalassinos
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Stéphanie Puget
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Department of Pediatric Neurosurgery, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Thomas Blauwblomme
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Department of Pediatric Neurosurgery, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Claire Alapetite
- Radiation Oncology Department, Curie Institute, 75005 Paris, France
- Radiation Department, Proton Center, 94800 Orsay, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy institute, 94800 Villejuif, France
- ICPO (Institut Curie - Centre de Protonthérapie d'Orsay), 94800 Orsay, France
| | - François Doz
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- SIREDO Center (Care, Innovation, Research in, Children, Adolescent and Young Adults Oncology), Curie Institute, 75005 Paris, France
| | - Jacques Grill
- Child and Adolescent Cancer Department, Gustave Roussy institute, 94800 Villejuif, France
| | - Christelle Dufour
- Child and Adolescent Cancer Department, Gustave Roussy institute, 94800 Villejuif, France
| | - Franck Bourdeaut
- SIREDO Center (Care, Innovation, Research in, Children, Adolescent and Young Adults Oncology), Curie Institute, 75005 Paris, France
| | - Samuel Abbou
- Child and Adolescent Cancer Department, Gustave Roussy institute, 94800 Villejuif, France
| | - Léa Guerrini-Rousseau
- Child and Adolescent Cancer Department, Gustave Roussy institute, 94800 Villejuif, France
| | - Amaury Leruste
- SIREDO Center (Care, Innovation, Research in, Children, Adolescent and Young Adults Oncology), Curie Institute, 75005 Paris, France
| | - Séverine Brabant
- Department of Functional Explorations, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Iphigénie Cavadias
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Magali Viaud
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Nathalie Boddaert
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Department of Paediatric Radiology, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
| | - Michel Polak
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Cochin Institute, INSERM U1016, 75014 Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, 75015 Paris, France
| | - Dulanjalee Kariyawasam
- Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, 75015 Paris, France
- Faculty of medicine, Université Paris Cité, 75006 Paris, France
- Cochin Institute, INSERM U1016, 75014 Paris, France
- IMAGINE Institute Affiliate, INSERM U1163, 75015 Paris, France
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Abstract
Congenital hypothyroidism (CH) is the most frequent neonatal endocrine disorder and the most common preventable cause of development delay and growth failure if diagnosed and treated early. The thyroid is the first endocrine gland to develop during embryonic life and to be recognizable in humans. Thyroid development and maturation can be divided into 2 phases: a first phase of embryogenesis and a second phase of folliculogenesis and differentiation with thyroid hormone production at the final steps. Regulation of the thyroid function requires normal development of the hypothalamic-pituitary-thyroid axis, which occurs during the embryonic and neonatal period. Defects in any of steps of thyroid development, differentiation, and regulation lead to permanent CH. Newborn screening programs, established in only one-third of countries worldwide, detect CH and are cost-effective and highly sensitive and specific. During the last decade, epidemiology of CH has changed with increased frequency of thyroid in situ in primary CH. Advances in molecular testing have expanded knowledge and understanding of thyroid development and function. However, a molecular cause is identified in only 5% of CH due to thyroid dysgenesis. The purpose of this article is to describe the clinical approach to the child with CH, focusing on diagnostic work-up and future challenges on optimizing thyroid replacement therapy and regenerative medicine. The review is written from the perspective of the case of 2 girls referred for CH after newborn screening and diagnosed with thyroid ectopy. The genetic work-up revealed novel mutations in TUBB1 gene, associated with large platelets and abnormal platelet physiology.
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Affiliation(s)
- Athanasia Stoupa
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
- Université Paris Cité, CNRS, U1016 INSERM, Cochin Institute and U1163 INSERM, Imagine Institute affiliate, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
- Université Paris Cité, CNRS, U1016 INSERM, Cochin Institute and U1163 INSERM, Imagine Institute affiliate, Paris, France
| | - Adrien Nguyen Quoc
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
- Université Paris Cité, CNRS, U1016 INSERM, Cochin Institute and U1163 INSERM, Imagine Institute affiliate, Paris, France
- Centre de référence des maladies endocriniennes rares de la croissance et du développement, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Centre régional de dépistage néonatal (CRDN), Ile-de-France, Fédération parisienne pour le dépistage et la prévention des handicaps de l'enfant (FPDPHE), Paris, France
| | - Aurore Carré
- Université Paris Cité, CNRS, U1016 INSERM, Cochin Institute and U1163 INSERM, Imagine Institute affiliate, Paris, France
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de Gouveia Buff Passone C, Giani E, Vaivre-Douret L, Kariyawasam D, Berdugo M, Garcin L, Beltrand J, Bernardo WM, Polak M. Sulfonylurea for improving neurological features in neonatal diabetes: A systematic review and meta-analyses. Pediatr Diabetes 2022; 23:675-692. [PMID: 35657808 DOI: 10.1111/pedi.13376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/09/2022] [Revised: 05/19/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In monogenic diabetes due to KCNJ11 and ABCC8 mutations that impair KATP- channel function, sulfonylureas improve long-term glycemic control. Although KATP channels are extensively expressed in the brain, the effect of sulfonylureas on neurological function has varied widely. We evaluated published evidence about potential effects of sulfonylureas on neurological features, especially epilepsy, cognition, motor function and muscular tone, visuo-motor integration, and attention deficits in children and adults with KCNJ11 and ABCC8-related neonatal-onset diabetes mellitus. RESEARCH DESIGN AND METHODS We conducted a systematic review and meta-analyses of the literature (PROSPERO, CRD42021254782), including individual-patient data, according to PRISMA, using RevMan software. We also graded the level of evidence. RESULTS We selected 34 of 776 publications. The evaluation of global neurological function before and after sulfonylurea (glibenclamide) treatment in 114 patients yielded a risk difference (RD) of 58% (95%CI, 43%-74%; I2 = 54%) overall and 73% (95%CI, 32%-113%; I2 = 0%) in the subgroup younger than 4 years; the level of evidence was moderate and high, respectively. EEG studies of epilepsy showed a RD of 56% (95%CI, 23%-89%; I2 = 34%) in patients with KCNJ11 mutations, with a high quality of evidence. For hypotonia and motor function, the RDs were 90% (95%CI, 69%-111%; I2 = 0%) and 73% (95%CI, 35%-111%; I2 = 0%), respectively, with a high level of evidence. CONCLUSIONS Glibenclamide significantly improved neurological abnormalities in patients with neonatal-onset diabetes due to KCNJ11 or ABCC8 mutations. Hypotonia was the symptom that responded best. Earlier treatment initiation was associated with greater benefits.
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Affiliation(s)
- Caroline de Gouveia Buff Passone
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France.,Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France.,Pediatric Endocrinology Department, University of Sao Paulo, Sao Paulo, Brazil
| | - Elisa Giani
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France.,Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Laurence Vaivre-Douret
- Faculty of Health, Department of Medicine Paris Descartes, Université de Paris, and Institut Universitaire de France (IUF), Paris, France.,National Institute of Health and Medical Research (INSERM UMR 1018-CESP), Faculty of Medicine, University of Paris-Saclay, UVSQ, Villejuif, France.,Imagine Institute, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France.,Imagine Institute, Paris, France
| | - Marianne Berdugo
- Physiopathology of Ocular Diseases: Therapeutic Innovations, Sorbonne-Université and Université de Paris, Inserm UMRS 1138, Paris, France
| | - Laure Garcin
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France
| | - Jacques Beltrand
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France.,Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France.,Imagine Institute, Paris, France
| | | | - Michel Polak
- Pediatric Endocrinology, Gynaecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Paris, France.,Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France.,Imagine Institute, Paris, France
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Stoupa A, Kariyawasam D, Polak M, Carré A. Genetics of congenital hypothyroidism: Modern concepts. Pediatr Investig 2022; 6:123-134. [PMID: 35774517 PMCID: PMC9218988 DOI: 10.1002/ped4.12324] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/09/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Congenital hypothyroidism (CH) is the most common neonatal endocrine disorder and one of the most common preventable causes of intellectual disability in the world. CH may be due to developmental or functional thyroid defects (primary or peripheral CH) or be hypothalamic‐pituitary in origin (central CH). In most cases, primary CH is caused by a developmental malformation of the gland (thyroid dysgenesis, TD) or by a defect in thyroid hormones synthesis (dyshormonogenesis, DH). TD represents about 65% of CH and a genetic cause is currently identified in fewer than 5% of patients. The remaining 35% are cases of DH and are explained with certainty at the molecular level in more than 50% of cases. The etiology of CH is mostly unknown and may include contributions from individual and environmental factors. In recent years, the detailed phenotypic description of patients, high‐throughput sequencing technologies, and the use of animal models have made it possible to discover new genes involved in the development or function of the thyroid gland. This paper reviews all the genetic causes of CH. The modes by which CH is transmitted will also be discussed, including a new oligogenic model. CH is no longer simply a dominant disease for cases of CH due to TD and recessive for cases of CH due to DH, but a far more complex disorder.
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Affiliation(s)
- Athanasia Stoupa
- Department of Paediatric Endocrinology Gynaecology and Diabetology Ile de France Regional Neonatal Screening Centre (CRDN) Necker Enfants‐Malades University Hospital Paris France
- Institut IMAGINE INSERM U1163 Paris France
- Institut Cochin INSERM U1016 Paris France
- Centre des maladies endocriniennes rares de la croissance et du dévelopement Paris France
| | - Dulanjalee Kariyawasam
- Department of Paediatric Endocrinology Gynaecology and Diabetology Ile de France Regional Neonatal Screening Centre (CRDN) Necker Enfants‐Malades University Hospital Paris France
- Institut IMAGINE INSERM U1163 Paris France
- Institut Cochin INSERM U1016 Paris France
- Centre des maladies endocriniennes rares de la croissance et du dévelopement Paris France
| | - Michel Polak
- Department of Paediatric Endocrinology Gynaecology and Diabetology Ile de France Regional Neonatal Screening Centre (CRDN) Necker Enfants‐Malades University Hospital Paris France
- Institut IMAGINE INSERM U1163 Paris France
- Institut Cochin INSERM U1016 Paris France
- Centre des maladies endocriniennes rares de la croissance et du dévelopement Paris France
- Université de Paris Cité Paris France
| | - Aurore Carré
- Institut IMAGINE INSERM U1163 Paris France
- Institut Cochin INSERM U1016 Paris France
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González Briceño LG, Kariyawasam D, Samara-Boustani D, Giani E, Beltrand J, Bolle S, Fresneau B, Puget S, Sainte-Rose C, Alapetite C, Pinto G, Piketty ML, Brabant S, Abbou S, Aerts I, Beccaria K, Bourgeois M, Roujeau T, Blauwblomme T, Di Rocco F, Thalassinos C, Pauwels C, Rigaud C, James S, Busiah K, Simon A, Bourdeaut F, Lemelle L, Guerrini-Rousseau L, Orbach D, Touraine P, Doz F, Dufour C, Grill J, Polak M. High Prevalence of Early Endocrine Disorders After Childhood Brain Tumors in a Large Cohort. J Clin Endocrinol Metab 2022; 107:e2156-e2166. [PMID: 34918112 DOI: 10.1210/clinem/dgab893] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 07/27/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Endocrine complications are common in pediatric brain tumor patients. OBJECTIVE We aimed to describe the endocrine follow-up of patients with primary brain tumors. METHODS This is a noninterventional observational study based on data collection from medical records of 221 patients followed at a Pediatric Endocrinology Department. RESULTS Median age at diagnosis was 6.7 years (range, 0-15.9), median follow-up 6.7 years (0.3-26.6), 48.9% female. Main tumor types were medulloblastoma (37.6%), craniopharyngioma (29.0%), and glioma (20.4%). By anatomic location, 48% were suprasellar (SS) and 52% non-suprasellar (NSS). Growth hormone deficiency (GHD) prevalence was similar in both groups (SS: 83.0%, NSS: 76.5%; P = 0.338), appearing at median 1.8 years (-0.8 to 12.4) after diagnosis; postradiotherapy GHD appeared median 1.6 years after radiotherapy (0.2-10.7). Hypothyroidism was more prevalent in SS (76.4%), than NSS (33.9%) (P < 0.001), as well as ACTH deficiency (SS: 69.8%, NSS: 6.1%; P < 0.001). Early puberty was similar in SS (16%) and NSS (12.2%). Hypogonadotropic hypogonadism was predominant in SS (63.1%) vs NSS (1.3%), P < 0.001, and postchemotherapy gonadal toxicity in NSS (29.6%) vs SS (2.8%), P < 0.001. Adult height was lower for NSS compared to target height (-1.0 SD, P < 0.0001) and to SS patients (P < 0.0001). Thyroid nodules were found in 13/45 patients (28.8%), including 4 cancers (4.8-11.5 years after radiotherapy). Last follow-up visit BMI was higher in both groups (P = 0.0001), and obesity incidence was higher for SS (46.2%) than NSS (17.4%). CONCLUSION We found a high incidence of early-onset endocrine disorders. An endocrine consultation and nutritional evaluation should be mandatory for all patients with a brain tumor, especially when the tumor is suprasellar or after hypothalamus/pituitary irradiation.
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Affiliation(s)
- Laura Gabriela González Briceño
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
- ESPE Fellowship - European Society for Paediatric Endocrinology
| | - Dulanjalee Kariyawasam
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Dinane Samara-Boustani
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Elisa Giani
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Jacques Beltrand
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
- Université de Paris, 75006 Paris, France
| | - Stéphanie Bolle
- Institut Gustave Roussy, Département de radiothérapie-oncologie, 94805 Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
| | - Stéphanie Puget
- Université de Paris, 75006 Paris, France
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | - Christian Sainte-Rose
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | - Claire Alapetite
- Institut Curie, Radiation Oncology Department and Proton Center, 75005 Paris, France
| | - Graziella Pinto
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Marie-Liesse Piketty
- Hôpital Necker-Enfants Malades, Explorations Fonctionnelles, 75015 Paris, France
| | - Séverine Brabant
- Hôpital Necker-Enfants Malades, Explorations Fonctionnelles, 75015 Paris, France
| | - Samuel Abbou
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
| | - Isabelle Aerts
- Institut Curie, SIREDO Oncology Center (Care, Innovation and research for children and AYA with cancer), 75005 Paris, France
| | - Kevin Beccaria
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | - Marie Bourgeois
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | - Thomas Roujeau
- Hôpital Montpellier, Hôpital Gui de Chauliac, Unité de Neurochirurgie pédiatrique, 34295 Montpellier, France
| | - Thomas Blauwblomme
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | | | - Caroline Thalassinos
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Christian Pauwels
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
| | - Charlotte Rigaud
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
| | - Syril James
- Hôpital Universitaire Necker-Enfants Malades - APHP, Service Neurochirurgie, 75015 Paris, France
| | - Kanetee Busiah
- Lausanne University Hospital, Pediatric Endocrinology, Diabetology and Obesity Unit, Lausanne University, 1011 Lausanne, Switzerland
| | - Albane Simon
- Hôpital André Mignot - Centre Hospitalier de Versailles, Endocrinologie Pédiatrique, 78157 Le Chesnay, France
| | - Franck Bourdeaut
- Institut Curie, SIREDO Oncology Center (Care, Innovation and research for children and AYA with cancer), 75005 Paris, France
| | - Lauriane Lemelle
- Institut Curie, SIREDO Oncology Center (Care, Innovation and research for children and AYA with cancer), 75005 Paris, France
| | - Léa Guerrini-Rousseau
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
- Team "Genomics and Oncogenesis of Pediatric Brain Tumors", INSERM U981, Gustave Roussy, University Paris Saclay, 94805 Villejuif, France
| | - Daniel Orbach
- Institut Curie, SIREDO Oncology Center (Care, Innovation and research for children and AYA with cancer), 75005 Paris, France
- PSL Research University, 75006 Paris, France
| | - Philippe Touraine
- Hôpital Universitaire La Pitié-Salpêtrière - APHP, Service Endocrinologie et médecine de la reproduction, Sorbonne Université Médecine, 75013 Paris, France
| | - François Doz
- Université de Paris, 75006 Paris, France
- Institut Curie, SIREDO Oncology Center (Care, Innovation and research for children and AYA with cancer), 75005 Paris, France
| | - Christelle Dufour
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
- Team "Genomics and Oncogenesis of Pediatric Brain Tumors", INSERM U981, Gustave Roussy, University Paris Saclay, 94805 Villejuif, France
| | - Jacques Grill
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric and Adolescent Oncology, 94805 Villejuif, France
- Team "Genomics and Oncogenesis of Pediatric Brain Tumors", INSERM U981, Gustave Roussy, University Paris Saclay, 94805 Villejuif, France
| | - Michel Polak
- Hôpital Universitaire Necker-Enfants Malades - Assistance Publique Hôpitaux de Paris (APHP), Service d'Endocrinologie, gynécologie et diabétologie pédiatrique, Institut IMAGINE (affiliate), 75015 Paris, France
- Université de Paris, 75006 Paris, France
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Abstract
Congenital hypothyroidism (CH) is the most frequent neonatal endocrine disorder. CH is due to thyroid development or thyroid function defects (primary) or may be of hypothalamic-pituitary origin (central). Primary CH is caused essentially by abnormal thyroid gland morphogenesis (thyroid dysgenesis, TD) or defective thyroid hormone synthesis (dyshormonogenesis, DH). DH accounts for about 35% of CH and a genetic cause is identified in 50% of patients. However, TD accounts for about 65% of CH, and a genetic cause is identified in less than 5% of patients. The pathogenesis of CH is largely unknown and may include the contribution of individual and environmental factors. During the last years, detailed phenotypic description of patients, next-generation sequence technologies and use of animal models allowed the discovery of novel candidate genes in thyroid development and function. We provide an overview of recent genetic causes of primary and central CH. In addition, mode of inheritance and the oligogenic model of CH are discussed.
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Affiliation(s)
- Athanasia Stoupa
- Service d'endocrinologie, gynécologie et diabétologie pédiatriques, Centre régional de dépistage néonatal (CRDN) Île-de-France, Hôpital universitaire Necker-Enfants-malades, AP-HP Paris, France - Affilié Institut IMAGINE, Inserm U1163, Paris, France - Inserm U1016, Institut Cochin, Paris, France - Centre des maladies endocriniennes rares de la croissance et du développement, Paris, France
| | - Dulanjalee Kariyawasam
- Service d'endocrinologie, gynécologie et diabétologie pédiatriques, Centre régional de dépistage néonatal (CRDN) Île-de-France, Hôpital universitaire Necker-Enfants-malades, AP-HP Paris, France - Affilié Institut IMAGINE, Inserm U1163, Paris, France - Inserm U1016, Institut Cochin, Paris, France - Centre des maladies endocriniennes rares de la croissance et du développement, Paris, France
| | - Michel Polak
- Service d'endocrinologie, gynécologie et diabétologie pédiatriques, Centre régional de dépistage néonatal (CRDN) Île-de-France, Hôpital universitaire Necker-Enfants-malades, AP-HP Paris, France - Affilié Institut IMAGINE, Inserm U1163, Paris, France - Inserm U1016, Institut Cochin, Paris, France - Centre des maladies endocriniennes rares de la croissance et du développement, Paris, France - Université de Paris, Paris, France
| | - Aurore Carré
- Affilié Institut IMAGINE, Inserm U1163, Paris, France - Inserm U1016, Institut Cochin, Paris, France
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Abstract
CONTEXT Early treatment is essential to avoid the cardiac complication of neonatal hyperthyroidism (NH). Our results have direct implications for clinical care. OBJECTIVE NH can cause potentially fatal neonatal thyrotoxicosis. Here, we have evaluated the feasibility of neonatal hyperthyroidism screening using the thyroid-stimulating hormone value in dried blood collected routinely on filter paper on the third postnatal day of life for congenital hypothyroidism screening. METHODS Retrospective case-control study. Cases were identified using data from our previously published study of 280 000 infants born in 10 maternity units in France in 2007-2014. Controls were identified among the 1 362 564 infants born in the Ile-de-France region during the same period. RESULTS A screening thyroid-stimulating hormone level below 0.18 mIU/L on the third postnatal day had 71% (95% CI 44-90%) sensitivity, 99% (95% CI 99-100%) specificity, 81% (95% CI 74-86%) positive predictive value, and 98% (95% CI 97-99%) negative predictive value for detecting severe NH. By univariate regression analysis, the screening thyroid-stimulating hormone value was the strongest predictor of NH (P < .00001), with an area under the receiver-operating characteristics curve of 0.98 (95% CI 0.95-1.0). Expected frequencies were not significantly different from observed frequencies (Hosmer-Lemeshow test, P = .99). CONCLUSION The screening thyroid-stimulating hormone test can be used to detect severe NH, the optimal cut-off being 0.18 mIU/L. The additional cost compared with screening for congenital hypothyroidism would be small. Infants with neonatal hyperthyroidism would benefit from an earlier diagnosis with treatment initiation at the presymptomatic stage in many cases, ensuring optimal outcomes.
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Affiliation(s)
- Maïa Banigé
- Department of Neonatal Pediatrics and Intensive Care, Hôpital Universitaire Cochin-Port Royal, Assistance Publique Hôpitaux de Paris, (AP-HP), Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Department, Hôpital Universitaire Necker-Enfants Malades, AP-HP, INSERM U1016, IMAGINE Institute, Paris, France
| | - Valerie Gauthereau
- Fédération Parisienne pour le dépistage et la prévention des handicaps de l'enfant, Paris, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, Hôpital Universitaire Bichat-Claude Bernard, AP-HP, Université de Paris, IMAGINE Institute, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology and Diabetology Department, Centre Régional de Dépistage Néonatal (CRDN), Hôpital Universitaire Necker-Enfants Malades, AP-HP, Université de Paris, INSERM U1016, Centre for Rare Endocrine Diseases affecting Growth and Development, IMAGINE Institute, Paris, France
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Kariyawasam D, Morin C, Casteels K, Le Tallec C, Sfez A, Godot C, Huneker E, Garrec N, Benhamou PY, Polak M, Charpentier G, Franc S, Beltrand J. Hybrid closed-loop insulin delivery versus sensor-augmented pump therapy in children aged 6–12 years: a randomised, controlled, cross-over, non-inferiority trial. Lancet Digit Health 2022; 4:e158-e168. [DOI: 10.1016/s2589-7500(21)00271-5] [Citation(s) in RCA: 4] [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: 04/14/2021] [Revised: 10/22/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
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Passone CDGB, Vermillac G, Staels W, Besancon A, Kariyawasam D, Godot C, Lambe C, Talbotec C, Girard M, Chardot C, Berteloot L, Hachem T, Lapillonne A, Poidvin A, Storey C, Neve M, Stan C, Dugelay E, Fauret-Amsellem AL, Capri Y, Cavé H, Ybarra M, Chandra V, Scharfmann R, Bismuth E, Polak M, Carel JC, Pigneur B, Beltrand J. Mitchell-Riley Syndrome: Improving Clinical Outcomes and Searching for Functional Impact of RFX-6 Mutations. Front Endocrinol (Lausanne) 2022; 13:802351. [PMID: 35813646 PMCID: PMC9257252 DOI: 10.3389/fendo.2022.802351] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS/HYPOTHESIS Caused by biallelic mutations of the gene encoding the transcription factor RFX6, the rare Mitchell-Riley syndrome (MRS) comprises neonatal diabetes, pancreatic hypoplasia, gallbladder agenesis or hypoplasia, duodenal atresia, and severe chronic diarrhea. So far, sixteen cases have been reported, all with a poor prognosis. This study discusses the multidisciplinary intensive clinical management of 4 new cases of MRS that survived over the first 2 years of life. Moreover, it demonstrates how the mutations impair the RFX6 function. METHODS Clinical records were analyzed and described in detail. The functional impact of two RFX6R181W and RFX6V506G variants was assessed by measuring their ability to transactivate insulin transcription and genes that encode the L-type calcium channels required for normal pancreatic beta-cell function. RESULTS All four patients were small for gestational age (SGA) and prenatally diagnosed with duodenal atresia. They presented with neonatal diabetes early in life and were treated with intravenous insulin therapy before switching to subcutaneous insulin pump therapy. All patients faced recurrent hypoglycemic episodes, exacerbated when parenteral nutrition (PN) was disconnected. A sensor-augmented insulin pump therapy with a predictive low-glucose suspension system was installed with good results. One patient had a homozygous c.1517T>G (p.Val506Gly) mutation, two patients had a homozygous p.Arg181Trp mutation, and one patient presented with new compound heterozygosity. The RFX6V506G and RFX6R181W mutations failed to transactivate the expression of insulin and genes that encode L-type calcium channel subunits required for normal pancreatic beta-cell function. CONCLUSIONS/INTERPRETATION Multidisciplinary and intensive disease management improved the clinical outcomes in four patients with MRS, including adjustment of parenteral/oral nutrition progression and advanced diabetes technologies. A better understanding of RFX6 function, in both intestine and pancreas cells, may break ground in new therapies, particularly regarding the use of drugs that modulate the enteroendocrine system.
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Affiliation(s)
- Caroline de Gouveia Buff Passone
- Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
- *Correspondence: Caroline de Gouveia Buff Passone, ; orcid.org/0000-0003-2639-352X
| | - Gaëlle Vermillac
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Willem Staels
- Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France
- Beta Cell Neogenesis (BENE) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Division of Pediatric Endocrinology, Department of Pediatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Alix Besancon
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
- Imagine Institute, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Cécile Godot
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Cécile Lambe
- Pediatric Gastroentherology Hepatology and Nutrition Unit, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Cécile Talbotec
- Pediatric Gastroentherology Hepatology and Nutrition Unit, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
- INSERM UMR S 1139, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - Muriel Girard
- Hepatology Unit, Hôpital Universitaire Necker Enfants Malades, Université de Paris, Inserm U1151, Centre de Référence Maladie rares Atresie des voies biliaires et cholestases génétiques et Filière de soin Filfoie, Paris, France
| | - Christophe Chardot
- Pediatric Surgery Department, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Laureline Berteloot
- Pediatric Radiology Department, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France/INSERM U1163, Institut Imagine, Paris, France
| | - Taymme Hachem
- Neonatal Intensive Care Unit, Hôpital Universitaire Necker Enfants Malades, EHU 7328 Université Paris Descartes, Paris, France
| | - Alexandre Lapillonne
- Neonatal Intensive Care Unit, Hôpital Universitaire Necker Enfants Malades, EHU 7328 Université Paris Descartes, Paris, France
| | - Amélie Poidvin
- Université Paris Cité, Hôpital Universitaire Robert-Debré, Service d’Endocrinologie Diabétologie Pédiatrique et CRMR Prisis, Paris, France
| | - Caroline Storey
- Université Paris Cité, Hôpital Universitaire Robert-Debré, Service d’Endocrinologie Diabétologie Pédiatrique et CRMR Prisis, Paris, France
| | - Mathieu Neve
- Pediatric Department Hôpital d’Enfants de Margency Croix-Rouge française, Margency, France
| | - Cosmina Stan
- Pediatric Department Hôpital d’Enfants de Margency Croix-Rouge française, Margency, France
| | - Emmanuelle Dugelay
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Universitaire Robert-Debré, Paris, France
| | | | - Yline Capri
- Genetic Department, Hopital Universitaire Robert Debré, Paris, France
| | - Hélène Cavé
- Genetic Department, Hopital Universitaire Robert Debré, Paris, France
| | - Marina Ybarra
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, QC, Canada
| | - Vikash Chandra
- Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France
- Biomedicum Stem Cell Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Raphaël Scharfmann
- Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France
| | - Elise Bismuth
- Université Paris Cité, Hôpital Universitaire Robert-Debré, Service d’Endocrinologie Diabétologie Pédiatrique et CRMR Prisis, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Jean Claude Carel
- Université Paris Cité, Hôpital Universitaire Robert-Debré, Service d’Endocrinologie Diabétologie Pédiatrique et CRMR Prisis, Paris, France
| | - Bénédicte Pigneur
- Pediatric Gastroentherology Hepatology and Nutrition Unit, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Jacques Beltrand
- Department of Endocrinology, Metabolism and Diabetes, Inserm U1016, Cochin Institute, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Pathologies Gynécologiques Rares et des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
- Imagine Institute, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, Paris, France
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18
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Pereira V, Torrejon J, Kariyawasam D, Berlanga P, Guerrini-Rousseau L, Ayrault O, Varlet P, Tauziède-Espariat A, Puget S, Bolle S, Beccaria K, Blauwblomme T, Brugières L, Grill J, Geoerger B, Dufour C, Abbou S. Clinical and molecular analysis of smoothened inhibitors in Sonic Hedgehog medulloblastoma. Neurooncol Adv 2021; 3:vdab097. [PMID: 34409296 PMCID: PMC8367281 DOI: 10.1093/noajnl/vdab097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 12/21/2022] Open
Abstract
Background Smoothened inhibitors (SMOi) have shown activity in Sonic Hedgehog (SHH) medulloblastoma, however this therapeutic class was not developed in children due to severe effects reported on growth. We hereby report long-term follow-up of young patients treated with SMOi for recurrent medulloblastoma. Methods Clinical data on response and toxicity from patients treated with vismodegib or sonidegib from 2011 to 2019 for a SHH medulloblastoma were retrospectively reviewed. Methylation analysis and whole exome sequencing were performed whenever possible. Results All patients with a somatic PTCH1 mutation responded to SMOi (6/8), including 2 prolonged complete responses. One patient was free of disease 8.2 years after treatment. SMOi was challenged again for 3 patients. Two of them had a response, one with SMOi alone, the other one in combination with temozolomide despite previous progression under monotherapy. SMO resistance mutations were found in patients from biopsy at relapse. Combination with temozolomide or surgery plus radiotherapy was associated with very long disease control in 2 patients. The most severe adverse events were myalgia and growth plate fusion with metaphyseal sclerosis. Normal growth velocity was recovered for 1 patient although her final height was below estimated target height. Conclusions Targeting SMO in mutated PTCH1 is an interesting strategy for long-term responses. Combination of SMOi with chemotherapy or surgery and local radiotherapy is an appealing strategy to prevent early resistance and diminish SMOi exposure, especially in young patients. Inhibition of SHH pathway causes growth and development impairment but partial recovery of the growth velocity is possible.
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Affiliation(s)
- Victor Pereira
- Department of Pediatric Haematology and Oncology, Besançon University Hospital, Besançon, France.,Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France
| | - Jacob Torrejon
- Curie University Institute, CNRS UMR 3347, INSERM U1021, Orsay, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Diabetology and Gynecology Department, Necker Enfant-Malades University Hospital, AP-HP, Paris, France.,Imagine Institute, Inserm U1163, Paris, France.,Cochin Institute, Inserm U1016, Paris, France
| | - Pablo Berlanga
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France
| | - Léa Guerrini-Rousseau
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France.,INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, Villejuif, France
| | - Olivier Ayrault
- Curie University Institute, CNRS UMR 3347, INSERM U1021, Orsay, France
| | - Pascale Varlet
- Department of Neuropathology, Saint-anne Hospital, Paris, France
| | | | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker Enfants-Malades University Hospital, AP-HP, Paris, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France
| | - Kevin Beccaria
- Department of Pediatric Neurosurgery, Necker Enfants-Malades University Hospital, AP-HP, Paris, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Necker Enfants-Malades University Hospital, AP-HP, Paris, France
| | - Laurence Brugières
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France
| | - Jacques Grill
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France.,INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, Villejuif, France
| | - Birgit Geoerger
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France
| | - Christelle Dufour
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France.,INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, Villejuif, France
| | - Samuel Abbou
- Department of Pediatric and Adolescents Oncology, Gustave Roussy Cancer Institute, Paris Saclay University, Villejuif, France.,INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, Villejuif, France
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19
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Abstract
Congenital Adrenal Hyperplasia (CAH) is a genetic disorder, mostly (95%) due to CYP21A2 mutations. Its incidence in France is 1/15,000 to 1/16,000 births. The screening of newborns in France is effective since 1996, by using a 17-hydroxyprogesterone dosage on a dried blood spot. This screening allowed, as in other countries, a decrease in mortality and in morbidity by earlier management of adrenal crisis usually symptomatic from the 2nd week after birth. The French Newborn Screening has for now adopted the two-tier screens on the same dried blood spot, using a fluoroimmunoassay on both screens. This approach provides a high sensitivity, but has also a low positive predictive value. New strategies including the LC-MS/MS method can be considered in the future.
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Affiliation(s)
- Dulanjalee Kariyawasam
- Service d'endocrinologie, diabétologie, gynécologie pédiatriques, Hôpital universitaire Necker-Enfants malades, AP-HP-Centre, 149 rue de Sèvres, 75015 Paris, France
| | - Thao Nguyen-Khoa
- Centre régional de dépistage néonatal - Île-de-France, AP-HP, 149 rue de Sèvres, 75015 Paris, France
| | - Laura Gonzalez Briceño
- Service d'endocrinologie, diabétologie, gynécologie pédiatriques, Hôpital universitaire Necker-Enfants malades, AP-HP-Centre, 149 rue de Sèvres, 75015 Paris, France. - Centre régional de dépistage néonatal - Île-de-France, AP-HP, 149 rue de Sèvres, 75015 Paris, France
| | - Michel Polak
- Service d'endocrinologie, diabétologie, gynécologie pédiatriques, Hôpital universitaire Necker-Enfants malades, AP-HP-Centre, 149 rue de Sèvres, 75015 Paris, France. - Centre régional de dépistage néonatal - Île-de-France, AP-HP, 149 rue de Sèvres, 75015 Paris, France. - Université de Paris, Paris, France
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20
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Kariyawasam D, Peries M, Foissac F, Eymard-Duvernay S, Tylleskär T, Singata-Madliki M, Kankasa C, Meda N, Tumwine J, Mwiya M, Engebretsen I, Flück CE, Hartmann MF, Wudy SA, Hirt D, Treluyer JM, Molès JP, Blanche S, Van De Perre P, Polak M, Nagot N. Lopinavir-Ritonavir Impairs Adrenal Function in Infants. Clin Infect Dis 2021; 71:1030-1039. [PMID: 31633158 DOI: 10.1093/cid/ciz888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/10/2019] [Accepted: 09/05/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Perinatal treatment with lopinavir boosted by ritonavir (LPV/r) is associated with steroidogenic abnormalities. Long-term effects in infants have not been studied. METHODS Adrenal-hormone profiles were compared at weeks 6 and 26 between human immunodeficiency virus (HIV)-1-exposed but uninfected infants randomly assigned at 7 days of life to prophylaxis with LPV/r or lamivudine (3TC) to prevent transmission during breastfeeding. LPV/r in vitro effect on steroidogenesis was assessed in H295R cells. RESULTS At week 6, 159 frozen plasma samples from Burkina Faso and South Africa were assessed (LPV/r group: n = 92; 3TC group: n = 67) and at week 26, 95 samples from Burkina Faso (LPV/r group: n = 47; 3TC group: n = 48). At week 6, LPV/r-treated infants had a higher median dehydroepiandrosterone (DHEA) level than infants from the 3TC arm: 3.91 versus 1.48 ng/mL (P < .001). Higher DHEA levels (>5 ng/mL) at week 6 were associated with higher 17-OH-pregnenolone (7.78 vs 3.71 ng/mL, P = .0004) and lower testosterone (0.05 vs 1.34 ng/mL, P = .009) levels in LPV/r-exposed children. There was a significant correlation between the DHEA and LPV/r AUC levels (ρ = 0.40, P = .019) and Ctrough (ρ = 0.40, P = .017). At week 26, DHEA levels remained higher in the LPV/r arm: 0.45 versus 0.13 ng/mL (P = .002). Lopinavir, but not ritonavir, inhibited CYP17A1 and CYP21A2 activity in H295R cells. CONCLUSIONS Lopinavir was associated with dose-dependent adrenal dysfunction in infants. The impact of long-term exposure and potential clinical consequences require evaluation. CLINICAL TRIALS REGISTRATION NCT00640263.
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Affiliation(s)
- Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology, and Diabetology Unit, Hopital Universitaire Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris (AP-HP), Paris, France.,INSERM U1016, Faculte de Medecine, Universite Paris Descartes, Sorbonne Paris Cite, Paris, France.,IMAGINE Institute, Paris, France
| | - Marianne Peries
- Pathogenesis and Control of Chronic Infections, INSERM U1058, Universite de Montpellier, Etablissement Francais du Sang, Montpellier, France
| | - Frantz Foissac
- Service de Pharmacologie Clinique, Hopital Cochin, AP-HP, Groupe Hospitalier Paris Centre, France.,Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France
| | - Sabrina Eymard-Duvernay
- Pathogenesis and Control of Chronic Infections, INSERM U1058, Universite de Montpellier, Etablissement Francais du Sang, Montpellier, France
| | | | - Mandisa Singata-Madliki
- Effective Care Research Unit, University of Fort Hare, Cecilia Makiwane Hospital, East London, South Africa
| | - Chipepo Kankasa
- University of Zambia, School of Medicine, Department of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
| | - Nicolas Meda
- Center of International Research for Health, Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - James Tumwine
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mwiya Mwiya
- University of Zambia, School of Medicine, Department of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
| | | | - Christa E Flück
- Pediatric Endocrinology, Diabetology, and Metabolism, Department of Pediatrics and Department of BioMedical Research, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland
| | - Michaela F Hartmann
- Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany
| | - Stefan A Wudy
- Steroid Research and Mass Spectrometry Unit, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany
| | - Deborah Hirt
- Service de Pharmacologie Clinique, Hopital Cochin, AP-HP, Groupe Hospitalier Paris Centre, France.,Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France
| | - Jean Marc Treluyer
- Service de Pharmacologie Clinique, Hopital Cochin, AP-HP, Groupe Hospitalier Paris Centre, France.,Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France
| | - Jean-Pierre Molès
- Pathogenesis and Control of Chronic Infections, INSERM U1058, Universite de Montpellier, Etablissement Francais du Sang, Montpellier, France
| | - Stéphane Blanche
- Pediatric Immunology-Hematology and Rheumatology Unit, Hopital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Philippe Van De Perre
- Service de Pharmacologie Clinique, Hopital Cochin, AP-HP, Groupe Hospitalier Paris Centre, France.,Centre Hospitalo-Universitaire (CHU) de Montpellier, Montpellier, France
| | - Michel Polak
- Pediatric Endocrinology, Gynecology, and Diabetology Unit, Hopital Universitaire Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris (AP-HP), Paris, France.,INSERM U1016, Faculte de Medecine, Universite Paris Descartes, Sorbonne Paris Cite, Paris, France.,IMAGINE Institute, Paris, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, INSERM U1058, Universite de Montpellier, Etablissement Francais du Sang, Montpellier, France.,Centre Hospitalo-Universitaire (CHU) de Montpellier, Montpellier, France
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21
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Sermet-Gaudelus I, Temmam S, Huon C, Behillil S, Gajdos V, Bigot T, Lurier T, Chrétien D, Backovic M, Delaunay-Moisan A, Donati F, Albert M, Foucaud E, Mesplées B, Benoist G, Faye A, Duval-Arnould M, Cretolle C, Charbit M, Aubart M, Auriau J, Lorrot M, Kariyawasam D, Fertitta L, Orliaguet G, Pigneur B, Bader-Meunier B, Briand C, Enouf V, Toubiana J, Guilleminot T, van der Werf S, Leruez-Ville M, Eloit M. Prior infection by seasonal coronaviruses, as assessed by serology, does not prevent SARS-CoV-2 infection and disease in children, France, April to June 2020. Euro Surveill 2021; 26:2001782. [PMID: 33797390 PMCID: PMC8017906 DOI: 10.2807/1560-7917.es.2021.26.13.2001782] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/07/2021] [Indexed: 01/10/2023] Open
Abstract
BackgroundChildren have a low rate of COVID-19 and secondary severe multisystem inflammatory syndrome (MIS) but present a high prevalence of symptomatic seasonal coronavirus infections.AimWe tested if prior infections by seasonal coronaviruses (HCoV) NL63, HKU1, 229E or OC43 as assessed by serology, provide cross-protective immunity against SARS-CoV-2 infection.MethodsWe set a cross-sectional observational multicentric study in pauci- or asymptomatic children hospitalised in Paris during the first wave for reasons other than COVID (hospitalised children (HOS), n = 739) plus children presenting with MIS (n = 36). SARS-CoV-2 antibodies directed against the nucleoprotein (N) and S1 and S2 domains of the spike (S) proteins were monitored by an in-house luciferase immunoprecipitation system assay. We randomly selected 69 SARS-CoV-2-seropositive patients (including 15 with MIS) and 115 matched SARS-CoV-2-seronegative patients (controls (CTL)). We measured antibodies against SARS-CoV-2 and HCoV as evidence for prior corresponding infections and assessed if SARS-CoV-2 prevalence of infection and levels of antibody responses were shaped by prior seasonal coronavirus infections.ResultsPrevalence of HCoV infections were similar in HOS, MIS and CTL groups. Antibody levels against HCoV were not significantly different in the three groups and were not related to the level of SARS-CoV-2 antibodies in the HOS and MIS groups. SARS-CoV-2 antibody profiles were different between HOS and MIS children.ConclusionPrior infection by seasonal coronaviruses, as assessed by serology, does not interfere with SARS-CoV-2 infection and related MIS in children.
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Affiliation(s)
- Isabelle Sermet-Gaudelus
- Institut Necker Enfants Malades, INSERM U 1171, Paris, France
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- These authors contributed equally to the work
| | - Sarah Temmam
- These authors contributed equally to the work
- Pathogen Discovery Laboratory, Department of Virology, Institut Pasteur, Paris, France
| | - Christèle Huon
- Pathogen Discovery Laboratory, Department of Virology, Institut Pasteur, Paris, France
| | - Sylvie Behillil
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
- National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Vincent Gajdos
- Hôpital Antoine Beclere, Clamart, France
- Centre for Research in Epidemiology and Population Health, INSERM UMR1018, Villejuif, France
| | - Thomas Bigot
- Hub de Bioinformatique et Biostatistique - Département Biologie Computationnelle, Institut Pasteur, USR 3756 CNRS, Paris, France
- Pathogen Discovery Laboratory, Department of Virology, Institut Pasteur, Paris, France
| | - Thibaut Lurier
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, Saint-Genès-Champanelle, France
- Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, Marcy l'Etoile, France
- Université de Lyon, INRAE, VetAgro Sup, Usc 1233 UR RS2GP, Marcy l'Etoile, France
| | - Delphine Chrétien
- Pathogen Discovery Laboratory, Department of Virology, Institut Pasteur, Paris, France
| | - Marija Backovic
- Unité de Virologie Structurale, Institut Pasteur, Département de Virologie, CNRS, UMR3569, Paris, France
| | - Agnès Delaunay-Moisan
- Université Paris-Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC), Gif-sur-Yvette, France
| | - Flora Donati
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
- National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Mélanie Albert
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
- National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | | | | | | | | | | | - Célia Cretolle
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marina Charbit
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Mélodie Aubart
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Johanne Auriau
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | | | - Laura Fertitta
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Gilles Orliaguet
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Bénédicte Pigneur
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | | | - Vincent Enouf
- Plateforme de microbiologie mutualisée (P2M), Pasteur International Bioresources Network (PIBnet), Institut Pasteur, Paris, France
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
- National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Julie Toubiana
- Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
- Unité Biodiversité et Epidemiologie des Bacteries Pathogènes, Institut Pasteur, Paris, France
- Université de Paris, Paris, France
| | | | - Sylvie van der Werf
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
- National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | | | - Marc Eloit
- Ecole Nationale Vétérinaire d'Alfort, Maisons Alfort, France
- Pathogen Discovery Laboratory, Department of Virology, Institut Pasteur, Paris, France
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22
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Stoupa A, Kariyawasam D, Muzza M, de Filippis T, Fugazzola L, Polak M, Persani L, Carré A. New genetics in congenital hypothyroidism. Endocrine 2021; 71:696-705. [PMID: 33650047 DOI: 10.1007/s12020-021-02646-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 11/02/2020] [Accepted: 01/21/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Congenital hypothyroidism (CH) is the most frequent neonatal endocrine disorder and one of the most common preventable forms of mental retardation worldwide. CH is due to thyroid development or thyroid function defects (primary) or may be of hypothalamic-pituitary origin (central). Primary CH is caused essentially by abnormal thyroid gland morphogenesis (thyroid dysgenesis, TD) or defective thyroid hormone synthesis (dyshormonogenesis, DH). TD accounts for about 65% of CH, however a genetic cause is identified in less than 5% of patients. PURPOSE The pathogenesis of CH is largely unknown and may include the contribution of individual and environmental factors. During the last years, detailed phenotypic description of patients, next-generation sequence technologies and use of animal models allowed the discovery of novel candidate genes in thyroid development, function and pathways. RESULTS AND CONCLUSION We provide an overview of recent genetic causes of primary and central CH. In addition, mode of inheritance and the oligogenic model of CH are discussed.
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Affiliation(s)
- Athanasia Stoupa
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Necker Children's University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- IMAGINE Institute affiliate, INSERM U1163, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Necker Children's University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- IMAGINE Institute affiliate, INSERM U1163, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
| | - Marina Muzza
- Lab of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy
| | - Tiziana de Filippis
- Lab of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy
| | - Laura Fugazzola
- Lab of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20100, Milan, Italy
| | - Michel Polak
- Pediatric Endocrinology, Gynecology, and Diabetology Department, Necker Children's University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- IMAGINE Institute affiliate, INSERM U1163, Paris, France
- Cochin Institute, INSERM U1016, Paris, France
- RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
- Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Luca Persani
- Lab of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149, Milan, Italy
- Department of Biotechnology and Translational Medicine, University of Milan, 20100, Milan, Italy
| | - Aurore Carré
- IMAGINE Institute affiliate, INSERM U1163, Paris, France.
- Cochin Institute, INSERM U1016, Paris, France.
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Flechtner I, Viaud M, Kariyawasam D, Perrissin-Fabert M, Bidet M, Bachelot A, Touraine P, Labrune P, de Lonlay P, Polak M. Puberty and fertility in classic galactosemia. Endocr Connect 2021; 10:240-247. [PMID: 33491660 PMCID: PMC7983486 DOI: 10.1530/ec-21-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 11/21/2022]
Abstract
Classic galactosemia is a rare inborn error of galactose metabolism with a birth prevalence of about 1/30,000-60,000. Long-term complications occurring despite dietary treatment consist of premature ovarian insufficiency (POI) and neurodevelopmental impairments. We performed with the French Reference Centers for Rare Diseases a multisite collaborative questionnaire survey for classic galactosemic patients. Its primary objective was to assess their puberty, pregnancy, gonadotropic axis, and pelvic morphology by ultrasound. The secondary objective was to determine predictive factors for pregnancy without oocyte donation. Completed questionnaires from 103 patients, 56 females (median age, 19 years (3-52 years)) and 47 males (median age, 19 years (3-45 years)), were analyzed. Among the 43 females older than 13 years old, mean age for breast development first stage was 13.8 years; spontaneous menarche occurred in 21/31 females at a mean age of 14.6 years. In these 21 women, 62% had spaniomenorrhea and 7/17 older than 30 years had amenorrhea. All age-groups confounded, FSH was above reference range for 65.7% of the patients, anti-Müllerian hormone and inhibin B were undetectable, and the ovaries were small with few or no follicles detected. Among the 5 females who sought to conceive, 4 had pregnancies. Among the 47 males, 1 had cryptorchidism, all have normal testicular function and none had a desire to conceive children. Thus, spontaneous puberty and POI are both common in this population. Spontaneous menarche seems to be the best predictive factor for successful spontaneous pregnancy.
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Affiliation(s)
- Isabelle Flechtner
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
| | - Magali Viaud
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
| | - Dulanjalee Kariyawasam
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
| | - Marie Perrissin-Fabert
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
| | - Maud Bidet
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
| | - Anne Bachelot
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Endocrinology and Reproductive Medicine, AP-HPIE3M, Hôpital Pitié-Salpêtrière, ICAN, Paris, France
| | - Philippe Touraine
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Endocrinology and Reproductive Medicine, AP-HPIE3M, Hôpital Pitié-Salpêtrière, ICAN, Paris, France
| | - Philippe Labrune
- Department of Pediatrics, APHP, Centre de Référence des Maladies héréditaires du Métabolisme Hépatique, Hopital Antoine Béclère and Paris Sud University, Clamart, France
| | - Pascale de Lonlay
- Reference Center of Inherited Metabolic Diseases, Université de Paris, Necker Enfants Malades, University Hospital, Paris, France
- Centre for Rare Gynecological Disorders, Hospital Universitaire Necker-Enfants Malades, Paediatric Endocrinology, Gynaecology and Diabetology, AP-HP, Université de Paris, Paris, France
| | - Michel Polak
- Center for Rare Gynecological Disorders, Centre des Pathologies Gynécologiques Rares, Paris, France
- Department of Paediatric Endocrinology, Gynaecology, and Diabetology, AP-HP, Necker-Enfants Malades University Hospital, IMAGINE Institute affiliate, Paris, France
- Centre for Rare Gynecological Disorders, Hospital Universitaire Necker-Enfants Malades, Paediatric Endocrinology, Gynaecology and Diabetology, AP-HP, Université de Paris, Paris, France
- Correspondence should be addressed to M Polak:
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24
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Stoupa A, Al Hage Chehade G, Kariyawasam D, Tohier C, Bole-Feysot C, Nitschke P, Thibault H, Jullie ML, Polak M, Carré A. First case of fetal goitrous hypothyroidism due to SLC5A5/NIS mutations. Eur J Endocrinol 2020; 183:K1-K5. [PMID: 32805706 DOI: 10.1530/eje-20-0255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 03/20/2020] [Accepted: 08/17/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Among patients with congenital hypothyroidism, 35% have dyshormonogenesis (DH) with thyroid gland in situ with or without goiter. The majority of DH cases are due to mutations in genes involved in thyroid hormone production as TG, TPO, SLC5A5/NIS, SLC26A4/PDS, IYD/DEHAL1, DUOX2, and DUOXA2, and are usually inherited on an autosomal recessive basis. Most previously reported cases of fetal hypothyroidism and goiter were related to TG or TPO mutations and recently DUOXA2. PATIENT In a male patient with antenatal goiter treated with intraamniotic levothyroxine injections, whose long-term follow-up is described in detail, two novel NIS mutations were detected. Mutations of NIS were located in exon 1 (c.52G>A, p.G18R) and exon 13 (c.1546C>T, p.R516X), each mutation was inherited from parents, who are healthy carriers. The p.G18R mutation affecting the first transmembrane domain of the protein can be responsible for deficient iodide uptake. However, the second is a nonsense mutation leading probably to mRNA degradation. In addition, the patient has undergone a thyroidectomy and we have studied the thyroid tissue. The thyroid histology showed heterogeneity with large follicles, epithelial hyperplasia and many areas of fibrosis. Immunohistochemistry with NIS specific antibody showed NIS staining at the basolateral plasma membrane of the thyrocytes. CONCLUSIONS We report the first case of fetal goitrous hypothyroidism due to two novel NIS mutations with access to thyroid tissue of the patient, specific histology studies and long-term follow-up. This case expands our knowledge and provides further insights on molecular causes of fetal goiter in humans.
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Affiliation(s)
- Athanasia Stoupa
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Ghada Al Hage Chehade
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Celine Tohier
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Bole-Feysot
- Genomics Platform, INSERM UMR 1163, Imagine Institute, Paris Descartes Sorbonne Paris Cite University, Paris, France
| | - Patrick Nitschke
- Bioinformatics Platform, IMAGINE Institute, Paris Descartes University, Paris, France
| | | | | | - Michel Polak
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Necker-Enfants Malades University Hospital, Paris, France
- Centre régional de dépistage néonatal (CRDN) Ile de France, Paris, France
| | - Aurore Carré
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
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25
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Borges KS, Pignatti E, Leng S, Kariyawasam D, Ruiz-Babot G, Ramalho FS, Taketo MM, Carlone DL, Breault DT. Wnt/β-catenin activation cooperates with loss of p53 to cause adrenocortical carcinoma in mice. Oncogene 2020; 39:5282-5291. [PMID: 32561853 PMCID: PMC7378041 DOI: 10.1038/s41388-020-1358-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 02/29/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 12/23/2022]
Abstract
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options. The lack of mouse models that recapitulate the genetics of ACC has hampered progress in the field. We analyzed The Cancer Genome Atlas (TCGA) dataset for ACC and found that patients harboring alterations in both p53/Rb and Wnt/β-catenin signaling pathways show a worse prognosis compared with patients that harbored alterations in only one. To model this, we utilized the Cyp11b2(AS)Cre mouse line to generate mice with adrenocortical-specific Wnt/β-catenin activation, Trp53 deletion, or the combination of both. Mice with targeted Wnt/β-catenin activation or Trp53 deletion showed no changes associated with tumor formation. In contrast, alterations in both pathways led to ACC with pulmonary metastases. Similar to ACCs in humans, these tumors produced increased levels of corticosterone and aldosterone and showed a high proliferation index. Gene expression analysis revealed that mouse tumors exhibited downregulation of Star and Cyp11b1 and upregulation of Ezh2, similar to ACC patients with a poor prognosis. Altogether, these data show that altering both Wnt/β-catenin and p53/Rb signaling is sufficient to drive ACC in mouse. This autochthonous model of ACC represents a new tool to investigate the biology of ACC and to identify new treatment strategies.
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Affiliation(s)
- Kleiton Silva Borges
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA.,Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Emanuele Pignatti
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Sining Leng
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Division of Medical Sciences, Harvard Medical School, Boston, MA, 02115, USA
| | - Dulanjalee Kariyawasam
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Gerard Ruiz-Babot
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
| | - Fernando Silva Ramalho
- Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Makoto Mark Taketo
- Division of Experimental Therapeutics, Graduate School of Medicine, Kyoto University, Kyoto, 606-8506, Japan
| | - Diana L Carlone
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA.,Harvard Stem Cell Institute, Cambridge, MA, 02138, USA
| | - David T Breault
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, 02115, USA. .,Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA. .,Harvard Stem Cell Institute, Cambridge, MA, 02138, USA.
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26
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Stoupa A, Al Hage Chehade G, Chaabane R, Kariyawasam D, Szinnai G, Hanein S, Bole-Feysot C, Fourrage C, Nitschke P, Thalassinos C, Pinto G, Mnif M, Baron S, De Kerdanet M, Reynaud R, Barat P, Hachicha M, Belguith N, Polak M, Carré A. High Diagnostic Yield of Targeted Next-Generation Sequencing in a Cohort of Patients With Congenital Hypothyroidism Due to Dyshormonogenesis. Front Endocrinol (Lausanne) 2020; 11:545339. [PMID: 33692749 PMCID: PMC7937947 DOI: 10.3389/fendo.2020.545339] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To elucidate the molecular cause in a well-characterized cohort of patients with Congenital Hypothyroidism (CH) and Dyshormonogenesis (DH) by using targeted next-generation sequencing (TNGS). STUDY DESIGN We studied 19 well-characterized patients diagnosed with CH and DH by targeted NGS including genes involved in thyroid hormone production. The pathogenicity of novel mutations was assessed based on in silico prediction tool results, functional studies when possible, variant location in important protein domains, and a review of the recent literature. RESULTS TNGS with variant prioritization and detailed assessment identified likely disease-causing mutations in 10 patients (53%). Monogenic defects most often involved TG, followed by DUOXA2, DUOX2, and NIS and were usually homozygous or compound heterozygous. Our review shows the importance of the detailed phenotypic description of patients and accurate analysis of variants to provide a molecular diagnosis. CONCLUSIONS In a clinically well-characterized cohort, TNGS had a diagnostic yield of 53%, in accordance with previous studies using a similar strategy. TG mutations were the most common genetic defect. TNGS identified gene mutations causing DH, thereby providing a rapid and cost-effective genetic diagnosis in patients with CH due to DH.
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Affiliation(s)
- Athanasia Stoupa
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Ghada Al Hage Chehade
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Rim Chaabane
- Laboratory of Human Molecular Genetics, Medicine School, University of Sfax, Sfax, Tunisia
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Gabor Szinnai
- Pediatric Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
- Pediatric Endocrinology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Sylvain Hanein
- INSERM U1163, IMAGINE Institute, Translational Genetics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Bole-Feysot
- Genomics Platform, INSERM UMR 1163, Paris Descartes Sorbonne Paris Cite University, Imagine Institute, Paris, France
| | - Cécile Fourrage
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Patrick Nitschke
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Caroline Thalassinos
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Graziella Pinto
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Mouna Mnif
- Endocrinology Department, CHU Hedi Chaker, Sfax, Tunisia
| | - Sabine Baron
- Pediatrics Department, CHU Nantes, Nantes, France
| | | | | | - Pascal Barat
- CHU de Bordeaux, Pediatric Endocrinology, Bordeaux, France
| | | | - Neila Belguith
- Laboratory of Human Molecular Genetics, Medicine School, University of Sfax, Sfax, Tunisia
- Medical Genetics Department, CHU Hedi Chaker, Sfax, Tunisia
| | - Michel Polak
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Necker-Enfants Malades University Hospital, Paris, France
- Centre Régional de Dépistage Néonatal (CRDN) Ile de France, Paris, France
- *Correspondence: Michel Polak, ; Aurore Carré,
| | - Aurore Carré
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- *Correspondence: Michel Polak, ; Aurore Carré,
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27
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Stoupa A, Adam F, Kariyawasam D, Strassel C, Gawade S, Szinnai G, Kauskot A, Lasne D, Janke C, Natarajan K, Schmitt A, Bole-Feysot C, Nitschke P, Léger J, Jabot-Hanin F, Tores F, Michel A, Munnich A, Besmond C, Scharfmann R, Lanza F, Borgel D, Polak M, Carré A. TUBB1 mutations cause thyroid dysgenesis associated with abnormal platelet physiology. EMBO Mol Med 2019; 10:emmm.201809569. [PMID: 30446499 PMCID: PMC6284387 DOI: 10.15252/emmm.201809569] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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] [Indexed: 12/11/2022] Open
Abstract
The genetic causes of congenital hypothyroidism due to thyroid dysgenesis (TD) remain largely unknown. We identified three novel TUBB1 gene mutations that co‐segregated with TD in three distinct families leading to 1.1% of TUBB1 mutations in TD study cohort. TUBB1 (Tubulin, Beta 1 Class VI) encodes for a member of the β‐tubulin protein family. TUBB1 gene is expressed in the developing and adult thyroid in humans and mice. All three TUBB1 mutations lead to non‐functional α/β‐tubulin dimers that cannot be incorporated into microtubules. In mice, Tubb1 knock‐out disrupted microtubule integrity by preventing β1‐tubulin incorporation and impaired thyroid migration and thyroid hormone secretion. In addition, TUBB1 mutations caused the formation of macroplatelets and hyperaggregation of human platelets after stimulation by low doses of agonists. Our data highlight unexpected roles for β1‐tubulin in thyroid development and in platelet physiology. Finally, these findings expand the spectrum of the rare paediatric diseases related to mutations in tubulin‐coding genes and provide new insights into the genetic background and mechanisms involved in congenital hypothyroidism and thyroid dysgenesis.
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Affiliation(s)
- Athanasia Stoupa
- INSERM U1016, Faculté de Médecine, Cochin Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute Affiliate, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Frédéric Adam
- INSERM UMR_S1176, Paris-Sud University, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Dulanjalee Kariyawasam
- RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Catherine Strassel
- INSERM, EFS Grand Est, BPPS UMR-S 1255, FMTS, Université de Strasbourg, Strasbourg, France
| | - Sanjay Gawade
- Department of Biomedicine, Pediatric Immunology, University of Basel, Basel, Switzerland
| | - Gabor Szinnai
- Department of Biomedicine, Pediatric Immunology, University of Basel, Basel, Switzerland.,Pediatric Endocrinology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexandre Kauskot
- INSERM UMR_S1176, Paris-Sud University, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Dominique Lasne
- INSERM UMR_S1176, Paris-Sud University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Necker Children's Hospital, Biological Hematology Service, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Carsten Janke
- Institut Curie, CNRS UMR3348, PSL Research University, Orsay, France.,Institut Curie, CNRS UMR3348, Université Paris Sud, Université Paris-Saclay, Orsay, France
| | - Kathiresan Natarajan
- Institut Curie, CNRS UMR3348, PSL Research University, Orsay, France.,Institut Curie, CNRS UMR3348, Université Paris Sud, Université Paris-Saclay, Orsay, France
| | - Alain Schmitt
- INSERM U1016, Faculté de Médecine, Cochin Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Bole-Feysot
- Genomic Platform, INSERM UMR 1163, IMAGINE Institute, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Patrick Nitschke
- Bioinformatics Platform, IMAGINE Institute, Paris Descartes University, Paris, France
| | - Juliane Léger
- RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France.,Pediatric Endocrinology Unit, Hôpital Universitaire Robert Debré, AP-HP, Paris, France.,Paris Diderot University, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1141, DHU Protect, Paris, France
| | - Fabienne Jabot-Hanin
- Bioinformatics Platform, IMAGINE Institute, Paris Descartes University, Paris, France
| | - Frédéric Tores
- Bioinformatics Platform, IMAGINE Institute, Paris Descartes University, Paris, France
| | - Anita Michel
- INSERM, EFS Grand Est, BPPS UMR-S 1255, FMTS, Université de Strasbourg, Strasbourg, France
| | - Arnold Munnich
- INSERM U1163, IMAGINE Institute, Translational Genetics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Claude Besmond
- INSERM U1163, IMAGINE Institute, Translational Genetics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Raphaël Scharfmann
- INSERM U1016, Faculté de Médecine, Cochin Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - François Lanza
- INSERM, EFS Grand Est, BPPS UMR-S 1255, FMTS, Université de Strasbourg, Strasbourg, France
| | - Delphine Borgel
- INSERM UMR_S1176, Paris-Sud University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Necker Children's Hospital, Biological Hematology Service, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Michel Polak
- INSERM U1016, Faculté de Médecine, Cochin Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute Affiliate, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,Fédération Parisienne pour le Dépistage et la Prévention des Handicaps de l'Enfant (FPDPHE), Paris, France
| | - Aurore Carré
- INSERM U1016, Faculté de Médecine, Cochin Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France .,IMAGINE Institute Affiliate, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
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28
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Schreiber A, Bellon N, Talbotec C, Diana JS, Kariyawasam D, Picard C, Bodemer C. L’importance du dermatologue dans les manifestations précoces de la polyendocrinopathie auto-immune de type 1 (APECED). Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.409] [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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Garcin L, Kariyawasam D, Busiah K, Fauret-Amsellem AL, Le Bourgeois F, Vaivre-Douret L, Cavé H, Polak M, Beltrand J. Successful off-label sulfonylurea treatment of neonatal diabetes mellitus due to chromosome 6 abnormalities. Pediatr Diabetes 2018; 19:663-669. [PMID: 29504184 DOI: 10.1111/pedi.12635] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 08/17/2017] [Revised: 11/22/2017] [Accepted: 12/11/2017] [Indexed: 11/28/2022] Open
Abstract
Chromosome 6 abnormalities such as paternal uniparental isodisomy, paternal 6q24 duplication, and maternal DMR (differentially methylated region) hypomethylation are a common cause of transient neonatal diabetes mellitus (TNDM). Oral sulfonylurea (SU) is used off-label to treat permanent neonatal diabetes mellitus owing to potassium channel mutation but has not been evaluated in TNDM. Our objective was to evaluate the efficacy and safety of SU therapy in chromosome 6-related TNDM. Description of 3 case reports and literature review was the subject of the study. SU therapy was successful in 2 patients (initiated during neonatal life in 1 patient and during relapse in the other) but failed in the other despite the use of high dosage. The literature review identified 11 cases of patients with chromosome 6-related TNDM treated with SU, including 4 treated before remission and 7 after the relapse. SU therapy was consistently effective, although 4 patients treated after the relapse required multiple oral medications. None of the patients needed associated insulin therapy. No side effects of SU or complications of diabetes were reported. SU seems effective and safe in chromosome 6-related TNDM treatment when used to treat the initial episode of diabetes or the relapse. It improves patients' and families' quality of life. SU is available only as oral tablets. A pediatric dosage form would facilitate the treatment of neonates and infants.
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Affiliation(s)
- Laure Garcin
- Service Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Dulanjalee Kariyawasam
- Service Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades Paris, Assistance Publique-Hôpitaux de Paris, France.,Faculté de Médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Inserm U1016, Institut Cochin, Paris, France
| | - Kanetee Busiah
- Service Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Anne-Laure Fauret-Amsellem
- Département de Génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Paris, France
| | - Fleur Le Bourgeois
- Service de Réanimation et Surveillance Continues de Pédiatrie, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Paris, France
| | - Laurence Vaivre-Douret
- Faculté de Médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,UMR 1018 INSERM-CESP, Universités Paris Sud-Paris Saclay UVSQ et Paris Descartes SPC, Paris, France.,Service de Pédiatrie, Hôpitaux Universitaires Paris Centre Port-Royal Cochin, Assistance Publique-Hôpitaux de Paris, et Hôpital Universitaire Necker Enfants Malades, Paris, France.,Institut Universitaire de France, Paris, France
| | - Hélène Cavé
- Département de Génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Paris, France.,Faculté de Médecine Paris-Diderot, Université Sorbonne-Paris-Cité, Paris, France
| | - Michel Polak
- Service Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades Paris, Assistance Publique-Hôpitaux de Paris, France.,Faculté de Médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Inserm U1016, Institut Cochin, Paris, France.,Institut Imagine, Paris Descartes-Université Sorbonne Paris Cité, Paris, France
| | - Jacques Beltrand
- Service Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Universitaire Necker Enfants Malades Paris, Assistance Publique-Hôpitaux de Paris, France.,Faculté de Médecine Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Inserm U1016, Institut Cochin, Paris, France.,Institut Imagine, Paris Descartes-Université Sorbonne Paris Cité, Paris, France
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Carré A, Stoupa A, Kariyawasam D, Gueriouz M, Ramond C, Monus T, Léger J, Gaujoux S, Sebag F, Glaser N, Zenaty D, Nitschke P, Bole-Feysot C, Hubert L, Lyonnet S, Scharfmann R, Munnich A, Besmond C, Taylor W, Polak M. Mutations in BOREALIN cause thyroid dysgenesis. Hum Mol Genet 2017; 26:599-610. [PMID: 28025328 DOI: 10.1093/hmg/ddw419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 12/31/2022] Open
Abstract
Congenital hypothyroidism is the most common neonatal endocrine disorder and is primarily caused by developmental abnormalities otherwise known as thyroid dysgenesis (TD). We performed whole exome sequencing (WES) in a consanguineous family with TD and subsequently sequenced a cohort of 134 probands with TD to identify genetic factors predisposing to the disease. We identified the novel missense mutations p.S148F, p.R114Q and p.L177W in the BOREALIN gene in TD-affected families. Borealin is a major component of the Chromosomal Passenger Complex (CPC) with well-known functions in mitosis. Further analysis of the missense mutations showed no apparent effects on mitosis. In contrast, expression of the mutants in human thyrocytes resulted in defects in adhesion and migration with corresponding changes in gene expression suggesting others functions for this mitotic protein. These results were well correlated with the same gene expression pattern analysed in the thyroid tissue of the patient with BOREALIN-p.R114W. These studies open new avenues in the genetics of TD in humans.
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Affiliation(s)
- Aurore Carré
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute affiliate, Paris, France
| | - Athanasia Stoupa
- IMAGINE Institute affiliate, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Dulanjalee Kariyawasam
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | | | - Cyrille Ramond
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Taylor Monus
- Department of Biological Sciences, University of Toledo, Toledo, Ohio, USA
| | - Juliane Léger
- Pediatric Endocrinology Unit, Hôpital Universitaire Robert Debré, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
| | - Sébastien Gaujoux
- Department of Digestive and Endocrine Surgery, Cochin Hospital, AP-HP, Université Paris Descartes, Paris, France
| | - Frédéric Sebag
- Department of General, Endocrine and Metabolic Surgery, Hopital de la Conception, Marseille, France
| | - Nicolas Glaser
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Delphine Zenaty
- Pediatric Endocrinology Unit, Hôpital Universitaire Robert Debré, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
| | - Patrick Nitschke
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Christine Bole-Feysot
- Genomic Platform, INSERM UMR 1163, Paris Descartes Sorbonne Paris Cite University, Imagine Institute, Paris, France
| | - Laurence Hubert
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Stanislas Lyonnet
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Raphaël Scharfmann
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Arnold Munnich
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Claude Besmond
- INSERM U1163, IMAGINE Institute, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - William Taylor
- Department of Biological Sciences, University of Toledo, Toledo, Ohio, USA
| | - Michel Polak
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,IMAGINE Institute affiliate, Paris, France.,Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,RARE Disorder Center: Centre des Maladies Endocriniennes Rares de la Croissance
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Welfringer-Morin A, Bekel L, Bodemer C, Kariyawasam D, Hadj-Rabia S. Psoriasis et lépréchaunisme : rôle du traitement substitutif par IGF1. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.356] [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: 11/26/2022]
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Abstract
Thyroid dysgenesis (TD) is the most common cause of congenital hypothyroidism in iodine-sufficient regions and includes a spectrum of developmental anomalies. The genetic components of TD are complex. Although a sporadic disease, advances in developmental biology have revealed monogenetic forms of TD. Inheritance is not based on a simple Mendelian pattern and additional genetic elements might contribute to the phenotypic spectrum. This article summarizes the key steps of normal thyroid development and provides an update on responsible genes and underlying mechanisms of TD. Up-to-date technologies in genetics and biology will allow us to advance in our knowledge of TD.
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Affiliation(s)
- Athanasia Stoupa
- Pediatric Endocrinology, Diabetology and Gynecology Department, Necker Enfants-Malades University Hospital, Assistance Publique Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France; Imagine Institute, Inserm U1163, 24 boulevard du Montparnasse, 75015, Paris, France
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Diabetology and Gynecology Department, Necker Enfants-Malades University Hospital, Assistance Publique Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France; Imagine Institute, Inserm U1163, 24 boulevard du Montparnasse, 75015, Paris, France; Cochin Institute, Inserm U1016, 22 rue Mechain, 75014, Paris, France
| | - Aurore Carré
- Imagine Institute, Inserm U1163, 24 boulevard du Montparnasse, 75015, Paris, France; Cochin Institute, Inserm U1016, 22 rue Mechain, 75014, Paris, France
| | - Michel Polak
- Pediatric Endocrinology, Diabetology and Gynecology Department, Necker Enfants-Malades University Hospital, Assistance Publique Hôpitaux de Paris, 149 rue de Sèvres, 75015, Paris, France; Imagine Institute, Inserm U1163, 24 boulevard du Montparnasse, 75015, Paris, France; Cochin Institute, Inserm U1016, 22 rue Mechain, 75014, Paris, France; Paris Descartes University, Sorbonne Paris Cité, 12 rue de l'École de Médecine, 75006, Paris, France.
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Kariyawasam D, Carré A, Luton D, Polak M. Down syndrome and nonautoimmune hypothyroidisms in neonates and infants. Horm Res Paediatr 2015; 83:126-31. [PMID: 25592247 DOI: 10.1159/000370004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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] [Received: 09/05/2014] [Accepted: 11/14/2014] [Indexed: 11/19/2022] Open
Abstract
Down syndrome is characterized by a high prevalence of thyroid dysfunction during childhood. In this paper, we review the different kinds of thyroid dysfunction that occur excluding those of autoimmune origin: congenital hypothyroidism (elevated plasma TSH with low plasma T4 occurring at birth usually detected by neonatal screening), subclinical hypothyroidism (elevated plasma TSH with plasma T4 in the normal range, which can be congenital or acquired) and acquired primary hypothyroidism (elevated plasma TSH and low plasma T4 occurring after birth). These dysfunctions, while not due to autoimmunity, are of thyroidal origin. However, the mechanisms leading to these different thyroidal abnormalities have not been clearly defined; in particular, it is difficult to determine whether the different types of dysfunction have a common cause, or if the causes are distinct. Treatment is prescribed according to the type of thyroidal abnormality.
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Kariyawasam D, Rachdi L, Carré A, Martin M, Houlier M, Janel N, Delabar JM, Scharfmann R, Polak M. DYRK1A BAC transgenic mouse: a new model of thyroid dysgenesis in Down syndrome. Endocrinology 2015; 156:1171-80. [PMID: 25490145 DOI: 10.1210/en.2014-1329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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] [Indexed: 01/17/2023]
Abstract
The most common thyroid abnormality among Down syndrome (DS) children corresponds to a mildly elevated TSH, with T4 decreased or in the normal range and thyroid hypoplasia, from the neonatal period onward, which aggravate their mental impairment. Transgenic Dyrk1A mice, obtained by bacterial artificial chromosome engineering (mBACTgDyrk1A), have 3 copies of the Dyrk1A gene. The objective is to determine whether this transgenic Dyrk1A (Dyrk1A(+/++)) mouse is an adequate murine model for the study of thyroid dysgenesis in DS. Embryonic thyroid development from embryonic day 13.5 (E13.5) to E17.5 was analyzed in wild-type (WT) and Dyrk1A(+/++) mice by immunofluorescence with anti-Nkx2-1, anti-thyroglobulin, and anti-T4 antibodies, markers of early thyroid development, hormonogenesis, and final differentiation, respectively. The expression of transcription factors Nkx2-1, Pax8, and Foxe1 involved in thyroidogenesis were studied by quantitative RT-PCR at the same embryonic stages. We then compared the adult phenotype at 8 to 12 weeks in Dyrk1A(+/++) and WT mice for T4 and TSH levels, thyroidal weight, and histological analysis. Regarding thyroidal development, at E15.5, Dyrk1A(+/++) thyroid lobes are double the size of WT thyroids (P = .01), but the thyroglobulin stained surface in Dyrk1A(+/++) thyroids is less than a third as large at E17.5 (P = .04) and their differentiated follicular surface half the size (P = .004). We also observed a significant increase in Nkx2-1, Foxe1, and Pax8 RNA levels in E13.5 and E17.5 Dyrk1A(+/++) embryonic thyroids. Dyrk1A(+/++) young adult mice have significantly lower plasma T4 (2.4 ng/mL versus WT, 3.7 ng/mL; P = 0.019) and nonsignificantly higher plasma TSH (114 mUI/L versus WT, 73mUI/L; P = .09). In addition, their thyroids are significantly heavier (P = .04) and exhibit large disorganized regions. Dyrk1A overexpression directly leads to thyroidal embryogenetic, functional and morphological impairment. The young adult thyroid phenotype is probably a result of embryogenetic impairment. The Dyrk1A(+/++) mouse can be considered a suitable study model for thyroid dysgenesis in DS.
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Affiliation(s)
- Dulanjalee Kariyawasam
- Inserm U1016 (D.K., L.R., A.C., M.H., R.S., M.P.), 75014 Paris France; Imagine Institute (D.K., A.C., M.P.), Paris, France; Pediatric Endocrinology, Gynaecology and Diabetology Unit (D.K., M.P.), Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; Diabetes and Obesity Research Laboratory (M.M.), Institut d'Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain; Unité de Biologie Fonctionnelle et Adaptative (N.J., J.-M.D.), Centre National de Recherche Scientifique 4413, Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; and Université Paris Descartes-Sorbonne Paris Cité (M.P.), 75006 Paris, France
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Kariyawasam D, Simon A, Laborde K, Parat S, Souchon PF, Frange P, Blanche S, Polak M. Adrenal enzyme impairment in neonates and adolescents treated with ritonavir and protease inhibitors for HIV exposure or infection. Horm Res Paediatr 2015; 81:226-31. [PMID: 24577112 DOI: 10.1159/000356916] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Received: 07/04/2013] [Accepted: 10/11/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human deficiency virus (HIV) protease inhibitors (PIs) are widely used drugs whose effects are pharmacologically enhanced by ritonavir, a potent cytochrome P450 inhibitor. We reported previously that prophylactic postnatal ritonavir-PI therapy in HIV-exposed neonates was associated with increases in plasma 17-hydroxyprogesterone (17-OHP) and dehydroepiandrosterone sulfate (DHEA-S). AIMS To further investigate adrenal function in neonates and adolescents given ritonavir-PI. METHODS Adrenal function was assessed prospectively in 3 HIV-exposed neonates given short-term prophylactic treatment and 3 HIV-infected adolescents given long-term treatment. Plasma cortisol, 17-OHP, 17-OH-pregnenolone, DHEA-S, and androstenedione were measured before and after ACTH administration. RESULTS None of the patients had clinical signs of adrenal dysfunction. The only neonate exposed to ritonavir-PI in utero had up to 3-fold increases in plasma 17-OHP. Increases in 17-OH-pregnenolone of up to 3.1-fold were noted in 4 of the 6 patients, and all 6 patients had elevations in DHEA-S (up to 20.4-fold increase) and/or DHEA (up to 4.7-fold) and/or androstenedione (up to 5.2-fold). All these parameters improved after treatment completion. CONCLUSION Neonates and adolescents given ritonavir-PI exhibit a similar adrenal dysfunction profile consistent with an impact on multiple adrenal enzymes. These abnormalities require evaluation, given the potentially long exposure times.
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Affiliation(s)
- D Kariyawasam
- Pediatric Endocrinology Gynecology and Diabetology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP) and IMAGINE Institute affiliate, Paris, France
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Rachdi L, Kariyawasam D, Aïello V, Herault Y, Janel N, Delabar JM, Polak M, Scharfmann R. Dyrk1A induces pancreatic β cell mass expansion and improves glucose tolerance. Cell Cycle 2014; 13:2221-9. [PMID: 24870561 PMCID: PMC4111677 DOI: 10.4161/cc.29250] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/15/2014] [Accepted: 05/15/2014] [Indexed: 01/27/2023] Open
Abstract
Type 2 diabetes is caused by a limited capacity of insulin-producing pancreatic β cells to increase their mass and function in response to insulin resistance. The signaling pathways that positively regulate functional β cell mass have not been fully elucidated. DYRK1A (also called minibrain/MNB) is a member of the dual-specificity tyrosine phosphorylation-regulated kinase (DYRK) family. A significant amount of data implicates DYRK1A in brain growth and Down syndrome, and recent data indicate that Dyrk1A haploinsufficient mice have a low functional β cell mass. Here we ask whether Dyrk1A upregulation could be a way to increase functional β cell mass. We used mice overexpressing Dyrk1A under the control of its own regulatory sequences (mBACTgDyrk1A). These mice exhibit decreased glucose levels and hyperinsulinemia in the fasting state. Improved glucose tolerance is observed in these mice as early as 4 weeks of age. Upregulation of Dyrk1A in β cells induces expansion of β cell mass through increased proliferation and cell size. Importantly, mBACTgDyrk1A mice are protected against high-fat-diet-induced β cell failure through increase in β cell mass and insulin sensitivity. These studies show the crucial role of the DYRK1A pathway in the regulation of β cell mass and carbohydrate metabolism in vivo. Activating the DYRK1A pathway could thus represent an innovative way to increase functional β cell mass.
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Affiliation(s)
- Latif Rachdi
- INSERM U1016; Institut Cochin; Faculté de Médecine Cochin; Université Paris Descartes; Paris, France
| | - Dulanjalee Kariyawasam
- INSERM U1016; Institut Cochin; Faculté de Médecine Cochin; Université Paris Descartes; Paris, France
- Hôpital Universitaire Necker Enfants Malades; Endocrinologie Gynécologie Diabétologie Pédiatriques; IMAGINE Institute; Paris, France
| | - Virginie Aïello
- INSERM U1016; Institut Cochin; Faculté de Médecine Cochin; Université Paris Descartes; Paris, France
| | - Yann Herault
- Institut de Génétique et de Biologie Moléculaire et Cellulaire; Translational Medicine and Neuroscience Program; IGBMC; CNRS; INSERM; Université de Strasbourg; UMR7104, UMR964, and Institut Clinique de la Souris; ICS; GIE CERBM; Illkirch, France
| | - Nathalie Janel
- Sorbonne Paris Cité; Unité de Biologie Fonctionnelle et Adaptative (BFA); CNRS UMR 8251; Paris Diderot University; Paris, France
| | - Jean-Maurice Delabar
- Sorbonne Paris Cité; Unité de Biologie Fonctionnelle et Adaptative (BFA); CNRS UMR 8251; Paris Diderot University; Paris, France
| | - Michel Polak
- INSERM U1016; Institut Cochin; Faculté de Médecine Cochin; Université Paris Descartes; Paris, France
- Hôpital Universitaire Necker Enfants Malades; Endocrinologie Gynécologie Diabétologie Pédiatriques; IMAGINE Institute; Paris, France
| | - Raphaël Scharfmann
- INSERM U1016; Institut Cochin; Faculté de Médecine Cochin; Université Paris Descartes; Paris, France
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Rachdi L, Kariyawasam D, Guez F, Aïello V, Arbonés ML, Janel N, Delabar JM, Polak M, Scharfmann R. Dyrk1a haploinsufficiency induces diabetes in mice through decreased pancreatic beta cell mass. Diabetologia 2014; 57:960-9. [PMID: 24477974 DOI: 10.1007/s00125-014-3174-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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: 07/31/2013] [Accepted: 01/06/2014] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS Growth factors and nutrients are important regulators of pancreatic beta cell mass and function. However, the signalling pathways by which these factors modulate these processes have not yet been fully elucidated. DYRK1A (also named minibrain/MNB) is a member of the dual-specificity tyrosine phosphorylation-regulated kinase (DYRK) family that has been conserved across evolution. A significant amount of data implicates DYRK1A in brain growth and function, as well as in neurodegenerative processes in Alzheimer's disease and Down's syndrome. We investigated here whether DYRK1A would be an attractive candidate for beta cell growth modulation. METHODS To study the role of DYRK1A in beta cell growth, we used Dyrk1a-deficient mice. RESULTS We show that DYRK1A is expressed in pancreatic islets and provide evidence that changes in Dyrk1a gene dosage in mice strongly modulate glycaemia and circulating insulin levels. Specifically, Dyrk1a-haploinsufficient mice show severe glucose intolerance, reduced beta cell mass and decreased beta cell proliferation. CONCLUSIONS/INTERPRETATION Taken together, our data indicate that DYRK1A is a critical kinase for beta cell growth as Dyrk1a-haploinsufficient mice show a diabetic profile.
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Affiliation(s)
- Latif Rachdi
- INSERM U1016, Institut Cochin, Faculté de Médecine Cochin, Université Paris Descartes, 24 Rue du Faubourg St Jacques, 75014, Paris, France,
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Carré A, Hamza RT, Kariyawasam D, Guillot L, Teissier R, Tron E, Castanet M, Dupuy C, El Kholy M, Polak M. A novel FOXE1 mutation (R73S) in Bamforth-Lazarus syndrome causing increased thyroidal gene expression. Thyroid 2014; 24:649-54. [PMID: 24219130 PMCID: PMC3993030 DOI: 10.1089/thy.2013.0417] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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] [Indexed: 11/12/2022]
Abstract
BACKGROUND Homozygous loss-of-function mutations in the FOXE1 gene have been reported in several patients with partial or complete Bamforth-Lazarus syndrome: congenital hypothyroidism (CH) with thyroid dysgenesis (usually athyreosis), cleft palate, spiky hair, with or without choanal atresia, and bifid epiglottis. Here, our objective was to evaluate potential functional consequences of a FOXE1 mutation in a patient with a similar clinical phenotype. METHODS FOXE1 was sequenced in eight patients with thyroid dysgenesis and cleft palate. Transient transfection was performed in HEK293 cells using the thyroglobulin (TG) and thyroid peroxidase (TPO) promoters in luciferase reporter plasmids to assess the functional impact of the FOXE1 mutations. Primary human thyrocytes transfected with wild type and mutant FOXE1 served to assess the impact of the mutation on endogenous TG and TPO expression. RESULTS We identified and characterized the function of a new homozygous FOXE1 missense mutation (p.R73S) in a boy with a typical phenotype (athyreosis, cleft palate, and partial choanal atresia). This new mutation located within the forkhead domain was inherited from the heterozygous healthy consanguineous parents. In vitro functional studies in HEK293 cells showed that this mutant gene enhanced the activity of the TG and TPO gene promoters (1.5-fold and 1.7-fold respectively vs. wild type FOXE1; p<0.05), unlike the five mutations previously reported in Bamforth-Lazarus syndrome. The gain-of-function effect of the FOXE1-p.R73S mutant gene was confirmed by an increase in endogenous TG production in primary human thyrocytes. CONCLUSION We identified a new homozygous FOXE1 mutation responsible for enhanced expression of the TG and TPO genes in a boy whose phenotype is similar to that reported previously in patients with loss-of-function FOXE1 mutations. This finding further delineates the role for FOXE1 in both thyroid and palate development, and shows that enhanced gene activity should be considered among the mechanisms underlying Bamforth-Lazarus syndrome.
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Affiliation(s)
- Aurore Carré
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Laboratory of Genetic Stability and Oncogenesis, (UMR8200), National Center for Scientic Research (CNRS), Université Paris-Sud, Institut Gustave Roussy, Villejuif, France
- IMAGINE affiliate, Hôpital Necker—Enfants Malades, Paris, France
| | - Rasha T. Hamza
- Pediatrics Department, Ain Shams University, Cairo, Egypt
| | - Dulanjalee Kariyawasam
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Loïc Guillot
- Saint-Antonie Research Center (INSERM UMRS 938), Saint-Antonie Hospital, Université Pierre-et-Marie-Curie, Paris, France
| | - Raphaël Teissier
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Elodie Tron
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Mireille Castanet
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Pediatrics Department, Hôpital Charles Nicolle, Centre Hospitalier Universitaire Hôpitaux de Rouen, Université de Rouen, Rouen, France
- Pediatric Endocrine Unit, Center for Rare Endocrine Diseases of Growth, Hôpital Necker—Enfants Malades, Paris, France
| | - Corinne Dupuy
- Laboratory of Genetic Stability and Oncogenesis, (UMR8200), National Center for Scientic Research (CNRS), Université Paris-Sud, Institut Gustave Roussy, Villejuif, France
| | | | - Michel Polak
- Research Center for Growth and Signaling (INSERM U845), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE affiliate, Hôpital Necker—Enfants Malades, Paris, France
- Pediatric Endocrine Unit, Center for Rare Endocrine Diseases of Growth, Hôpital Necker—Enfants Malades, Paris, France
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Abstract
Satellite units have the benefit of being local to patients and easily accessible. The main hospital where the dietitians are based is some distance away from the satellite unit. This has traditionally made it more difficult for the dietitians to assess satellite unit patients other than at set times when all the patients are assessed and advised in one visit. The aim of the telemedicine unit was to make dietary assessment of satellite unit patients easier by reducing travel time and to be more accessible to patients at times when visits by the dietitian were not scheduled. Telemedicine units were linked from the main hospital to the satellite unit. Fourteen patients were assessed and advised via this method and of these patients 8 patients were seen for help with their hyperphosphataemia. Phosphate levels on referral were 2.46 +/- 0.47mmols/l and by the following month after review by the dietitian had decreased to 2.06 +/- 0.43mmols/l (p=0.01) and 1.96 +/- 0.16mmols/l by month 6 (p=0.02). This small study shows that the telemedicine unit is an effective way to assess patients and communicate information. Travel time has been saved and patients have had the benefit of receiving dietary information soon after their raised phosphate result rather than having to wait for the next scheduled visit by the dietitian.
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Affiliation(s)
- D Kariyawasam
- Department of Dietetics, King's College Hospital, London, UK.
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40
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Winkley K, Sallis H, Kariyawasam D, Leelarathna LH, Chalder T, Edmonds ME, Stahl D, Ismail K. Five-year follow-up of a cohort of people with their first diabetic foot ulcer: the persistent effect of depression on mortality. Diabetologia 2012; 55:303-10. [PMID: 22057196 DOI: 10.1007/s00125-011-2359-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/29/2011] [Indexed: 12/30/2022]
Abstract
AIMS/HYPOTHESIS Depressive disorders are associated with mortality within 18 months of presentation of diabetic foot ulcers (DFU). The main aim of this study was to determine whether depressive disorder is still associated with increased mortality in people with their first foot ulcer at 5 years. METHODS This is a 5-year follow-up of a cohort of 253 patients presenting with their first DFU. At baseline, the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) 2.1 was used to define those who met DSM-IV (Diagnostic and Statistical Manual 4th edition) criteria for depressive disorder. Cox regression analysis controlled for potential covariates: age, sex, marital status, socioeconomic status, smoking, mean HbA(1c), diabetes complications and ulcer severity. The main outcome was mortality at 5 years. RESULTS The prevalence of DSM-IV depressive disorder at baseline was 32.2% (n = 82). There were 92 (36.4%) deaths over the 5 years of follow-up. In the Cox regression (n = 246), after adjusting for covariates, baseline DSM-IV depressive disorder was significantly associated with a twofold increased risk of mortality for any depressive episode (HR 2.09, 95% CI 1.34, 3.25), minor (HR 1.93, 95% CI 1.00, 3.74) or major depressive disorders (HR 2.18, 95% CI 1.31, 3.65), compared with patients who were not depressed. CONCLUSIONS/INTERPRETATION Depression is associated with a persistent twofold increased risk of mortality in people with their first DFU at 5 years.
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Affiliation(s)
- K Winkley
- Department of Psychological Medicine, King's College London & Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Road, London SE5 8AZ, UK.
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41
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Simon A, Warszawski J, Kariyawasam D, Le Chenadec J, Benhammou V, Czernichow P, Foissac F, Laborde K, Tréluyer JM, Firtion G, Layouni I, Munzer M, Bavoux F, Polak M, Blanche S. Association of prenatal and postnatal exposure to lopinavir-ritonavir and adrenal dysfunction among uninfected infants of HIV-infected mothers. JAMA 2011; 306:70-8. [PMID: 21730243 DOI: 10.1001/jama.2011.915] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [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] [Indexed: 11/14/2022]
Abstract
CONTEXT Lopinavir-ritonavir is a human immunodeficiency virus 1 (HIV-1) protease inhibitor boosted by ritonavir, a cytochrome p450 inhibitor. A warning about its tolerance in premature newborns was recently released, and transient elevation of 17-hydroxyprogesterone (17OHP) was noted in 2 newborns treated with lopinavir-ritonavir in France. OBJECTIVE To evaluate adrenal function in newborns postnatally treated with lopinavir-ritonavir. DESIGN, SETTING, AND PARTICIPANTS Retrospective cross-sectional analysis of the database from the national screening for congenital adrenal hyperplasia (CAH) and the French Perinatal Cohort. Comparison of HIV-1-uninfected newborns postnatally treated with lopinavir-ritonavir and controls treated with standard zidovudine. MAIN OUTCOME MEASURES Plasma 17OHP and dehydroepiandrosterone-sulfate (DHEA-S) concentrations during the first week of treatment. Clinical and biological symptoms compatible with adrenal deficiency. RESULTS Of 50 HIV-1-uninfected newborns who received lopinavir-ritonavir at birth for a median of 30 days (interquartile range [IQR], 25-33), 7 (14%) had elevated 17OHP levels greater than 16.5 ng/mL for term infants (>23.1 ng/mL for preterm) on days 1 to 6 vs 0 of 108 controls having elevated levels. The median 17OHP concentration for 42 term newborns treated with lopinavir-ritonavir was 9.9 ng/mL (IQR, 3.9-14.1 ng/mL) vs 3.7 ng/mL (IQR, 2.6-5.3 ng/mL) for 93 term controls (P < .001). The difference observed in median 17OHP values between treated newborns and controls was higher in children also exposed in utero (11.5 ng/mL vs 3.7 ng/mL; P < .001) than not exposed in utero (6.9 ng/mL vs 3.3 ng/mL; P = .03). The median DHEA-S concentration among 18 term newborns treated with lopinavir-ritonavir was 9242 ng/mL (IQR, 1347-25,986 ng/mL) compared with 484 ng/mL (IQR, 218-1308 ng/mL) among 17 term controls (P < .001). The 17OHP and DHEA-S concentrations were positively correlated (r = 0.53; P = .001). All term newborns treated with lopinavir-ritonavir were asymptomatic, although 3 premature newborns experienced life-threatening symptoms compatible with adrenal insufficiency, including hyponatremia and hyperkalemia with, in 1 case, cardiogenic shock. All symptoms resolved following completion of the lopinavir-ritonavir treatment. CONCLUSION Among newborn children of HIV-1-infected mothers exposed in utero to lopinavir-ritonavir, postnatal treatment with a lopinavir-ritonavir-based regimen, compared with a zidovudine-based regimen, was associated with transient adrenal dysfunction.
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Affiliation(s)
- Albane Simon
- Unité d’Endocrinologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
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