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Araujo Junior AEP, de Azevedo GBL, Moliterno LAM, Tavares RH, Cardoso JV, de Souza GR, Guimarães JAM, Defino HLA, Perini JA. Association of polymorphism in leptin receptor gene with susceptibility of adolescent idiopathic scoliosis. Eur Spine J 2024; 33:646-654. [PMID: 37801129 DOI: 10.1007/s00586-023-07955-3] [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] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/03/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Abnormal leptin bioavailability has play key roles in the etiology of adolescent idiopathic scoliosis (AIS). Both leptin and its receptor levels may be modulated by the presence of genetic polymorphisms. This study aimed to evaluate the role of polymorphisms in the leptin (LEP) and its main receptor (LEPR) genes in the AIS susceptibility in girls. METHODS A retrospective case-control study was conducted with 189 AIS and 240 controls. LEP rs2167270 and LEPR rs2767485 polymorphisms were genotyped using a TaqMan validated assay. Associations were evaluated by odds ratios (OR) and 95% confidence intervals (CI). RESULTS The AIS group showed a predominance of girls under 18 years old (n = 140, 74.1%), 148 (78.3%) had low or normal BMI, 111 (58.7%) had Cobb ≥ 45º and 130 (68.7%) were skeletally mature. Minor allele frequencies of rs2167270 and rs2767485 were 35.7% and 18.3%, for AIS and 35.6% and 25.4% for controls, respectively. LEPR rs2767485 T and TC + TT were associated with higher risk of AIS (OR = 1.53; 95% CI = 1.09-2.13 and OR = 1.84; 95% CI = 1.69-2.01, respectively), since CC genotype was only present in the control group. In addition, the LEP rs2167270 GA + AA was more frequent in low weight group (BMI ≤ 24.9) of girls with AIS. There was no significant association between LEP rs2167270 and AIS susceptibility, and LEPR rs2767485 and BMI. CONCLUSION The LEPR rs2767485 was associated with the genetic susceptibility of AIS and LEP rs2167270 with low BMI. These data can contribute to the identification of genetic biomarkers to improve the diagnosis and treatment.
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Affiliation(s)
- Antonio Eulalio Pedrosa Araujo Junior
- Spine Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ, Brazil
- Department of Orthopedics and Traumatology Surgery, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Gustavo Borges Laurindo de Azevedo
- Spine Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ, Brazil
- Department of Orthopedics and Traumatology Surgery, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Luis Antonio Medeiros Moliterno
- Spine Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ, Brazil
- Department of Orthopedics and Traumatology Surgery, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Renato Henriques Tavares
- Spine Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ, Brazil
| | - Jessica Vilarinho Cardoso
- Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Av. Manuel Caldeira de Alvarenga, 1.203, Rio de Janeiro, 23070-200, Brazil
| | - Giuliana Rodrigues de Souza
- Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Av. Manuel Caldeira de Alvarenga, 1.203, Rio de Janeiro, 23070-200, Brazil
- Research Division, INTO, Rio de Janeiro, RJ, Brazil
| | | | - Helton Luiz Aparecido Defino
- Department of Orthopedics and Traumatology Surgery, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jamila Alessandra Perini
- Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Av. Manuel Caldeira de Alvarenga, 1.203, Rio de Janeiro, 23070-200, Brazil.
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de Azevedo GBL, Perini JA, Araújo Junior AEP, Moliterno LAM, Andrande RM, Guimarães JAM, Defino HLA. Association of FBN1 polymorphism with susceptibility of adolescent idiopathic scoliosis: a case-control study. BMC Musculoskelet Disord 2022; 23:430. [PMID: 35526034 PMCID: PMC9077855 DOI: 10.1186/s12891-022-05370-1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibrillin-1 (FBN1) is an extracellular matrix glycoprotein essential to the structural component of microfibrils and FBN1 gene polymorphisms can be associated with adolescent idiopathic scoliosis (AIS) susceptibility. This study aimed to evaluate the potential role of the FBN1 rs12916536 polymorphism in AIS development or severity and the variation in Cobb angle in relation to patient's characteristics. METHODS DNA from 563 subjects (185 AIS patients and 378 controls) were genotyped using a validated TaqMan allelic discrimination assay. A multivariate logistic regression model evaluated the association between polymorphism and AIS, using the adjusted odds ratios (OR) with their respective 95% confidence intervals (95% CI). A linear regression analysis evaluated the variation in Cobb angle according to the patient's age and body mass index (BMI). RESULTS Among the AIS group there was a predominance of females (12:1), low or normal BMI (90%), 58% had a Cobb angle greater than 45° and 74% were skeletally mature. Age was a risk factor (4-fold) for curve progression higher than BMI (P < 0.001). The allelic frequency of the rs12916536 G > A polymorphism was 40% in controls and 31% in AIS cases; and this difference was statistically significant (P = 0.004). FBN1 rs12916536 GA + AA genotypes were associated with a lower risk of AIS susceptibility (OR = 0.58 and 95% CI = 0.35-0.98), after adjustment for age, sex and BMI. However, no significant differences were detected in polymorphism distribution with the severity of the disease (Cobb < 45° or ≥ 45°). CONCLUSION Age was a risk factor for progression of the scoliotic curve and FBN1 rs12916536 polymorphism a protective factor for AIS susceptibility.
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Affiliation(s)
- Gustavo Borges Laurindo de Azevedo
- Spine Surgery Center, National Institute of Traumatology and Orthopaedics (INTO), Rio de Janeiro, RJ, Brazil.,Departments of Orthopaedic and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, de São Paulo, Brazil
| | - Jamila Alessandra Perini
- Research Division, National Institute of Traumatology and Orthopaedics (INTO), Avenida Brasil, 500, Rio de Janeiro, RJ, zip code 20940-070, Brazil. .,Research Laboratory of Pharmaceutical Sciences (LAPESF), State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
| | - Antônio Eulálio Pedrosa Araújo Junior
- Spine Surgery Center, National Institute of Traumatology and Orthopaedics (INTO), Rio de Janeiro, RJ, Brazil.,Departments of Orthopaedic and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, de São Paulo, Brazil
| | - Luis Antonio Medeiros Moliterno
- Spine Surgery Center, National Institute of Traumatology and Orthopaedics (INTO), Rio de Janeiro, RJ, Brazil.,Departments of Orthopaedic and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, de São Paulo, Brazil
| | - Rodrigo Mantelatto Andrande
- Departments of Orthopaedic and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, de São Paulo, Brazil
| | - João Antonio Matheus Guimarães
- Research Division, National Institute of Traumatology and Orthopaedics (INTO), Avenida Brasil, 500, Rio de Janeiro, RJ, zip code 20940-070, Brazil
| | - Helton Luiz Aparecido Defino
- Departments of Orthopaedic and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo, de São Paulo, Brazil
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Aires AS, Silva LECTD, Barros AGCD, Azevedo GBLD, Naves CD. MODERN TECHNIQUES OF CERVICAL INSTRUMENTATION IN IMMATURE SKELETON: VIABILITY ASSESSMENT. Coluna/Columna 2017. [DOI: 10.1590/s1808-185120171604179210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: This study describes the use of materials for modern cervical instrumentation, evaluating its viability in children and adolescents, and the techniques used in different cases. The efficacy of the techniques was analyzed through improvement of pain, maintenance of cervical range of motion, recovery of craniocervical stability, bone consolidation, and spinal stenosis in the postoperative follow-up. Method: Retrospective study of the clinical and radiological parameters of 27 patients aged two to 16 years with cervical spine diseases. Results: Two patients had chronic dislocation in C1-C2, one had congenital axis spondylolisthesis, two had congenital dislocation in C1-C2, three had tumors, one had kyphosis after laminectomy, one had post-infection kyphosis, one had fracture, 11 were syndromic with instabilities, and five had congenital cervical scoliosis. As to surgical approaches, two patients were transorally operated, three by anterior approach, 15 by posterior approach, two by anterior and posterior approaches, and five were treated in three stages (anterior, posterior and anterior approaches). Regarding the technique of cervical stabilization, seven patients were treated by Goel-Harms technique, two received Goel’s facet distraction, and three, Wright translaminar screws. There were complications in four cases. Two patients in the instrumentation of C1 lateral mass due to poor positioning, one with cerebrospinal fluid fistula and one with surgical wound infection. Conclusion: Modern cervical instrumentation in pediatric patients is a safe and effective technique for the treatment of cervical instability.
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Teixeira da Silva LEC, de Barros AGC, de Azevedo GBL. Management of severe and rigid idiopathic scoliosis. Eur J Orthop Surg Traumatol 2015; 25 Suppl 1:S7-12. [PMID: 26033753 PMCID: PMC4488473 DOI: 10.1007/s00590-015-1650-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/13/2015] [Indexed: 11/25/2022]
Abstract
Frequently, severe idiopathic scoliosis patients are first seen in a spine centre after years of deformity evolution, presenting with large curves, severe rib hump, shoulder and trunk imbalance and cardiorespiratory complications related to neglected scoliosis. Severe rigid idiopathic scoliosis has <25% of correction on bending films and major curve over 90°. Adequate mobilization of this type of deformity is necessary to achieve maximal correction, often requiring more extensive surgical intervention, with care taken to avoid clinical and neurological complications. Halo traction, internal temporary distraction, releases, osteotomies and apical vertebral resection are often used in combination to achieve optimal results. Indications must be tailored by surgeons considering resources, deformity characteristics and patient's profile. Vertebral resection procedures may have potential neurological and clinical risks and should be one of the last treatment options performed by experienced surgical team. Neuromonitoring is essential during these procedures.
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