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Cruz H, Ferreira AM, Costa E, Barbot J, Freitas MI. Marked acanthocytosis in the setting of Klippel-Trenaunay syndrome: A case report. Int J Lab Hematol 2018; 41:e10-e12. [PMID: 30113765 DOI: 10.1111/ijlh.12913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Hugo Cruz
- Laboratory Haematology Service, Department of Pathology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Maria Ferreira
- Paediatrics Service, Department of Medicine, Centro Hospitalar Entre o Douro e Vouga, Porto, Portugal
| | - Emília Costa
- Paediatric Haematology Service, Department of Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - José Barbot
- Paediatric Haematology Service, Department of Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria Inês Freitas
- Laboratory Haematology Service, Department of Pathology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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Parizot I, Cailbault I, Winance M, Barbot J. Inégalités dans les parcours d’indemnisation des victimes d’accidents médicaux. Une enquête au sein du dispositif français de règlement amiable. Rev Epidemiol Sante Publique 2017; 65:99-108. [DOI: 10.1016/j.respe.2016.12.027] [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] [Received: 11/20/2015] [Revised: 11/30/2016] [Accepted: 12/25/2016] [Indexed: 10/20/2022] Open
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Sousa R, Gonçalves C, Guerra IC, Costa E, Fernandes A, do Bom Sucesso M, Azevedo J, Rodriguez A, Rius R, Seabra C, Ferreira F, Ribeiro L, Ferrão A, Castedo S, Cleto E, Coutinho J, Carvalho F, Barbot J, Porto B. Increased red cell distribution width in Fanconi anemia: a novel marker of stress erythropoiesis. Orphanet J Rare Dis 2016; 11:102. [PMID: 27456001 PMCID: PMC4960735 DOI: 10.1186/s13023-016-0485-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 07/12/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Red cell distribution width (RDW), a classical parameter used in the differential diagnosis of anemia, has recently been recognized as a marker of chronic inflammation and high levels of oxidative stress (OS). Fanconi anemia (FA) is a genetic disorder associated to redox imbalance and dysfunctional response to OS. Clinically, it is characterized by progressive bone marrow failure, which remains the primary cause of morbidity and mortality. Macrocytosis and increased fetal hemoglobin, two indicators of bone marrow stress erythropoiesis, are generally the first hematological manifestations to appear in FA. However, the significance of RDW and its possible relation to stress erythropoiesis have never been explored in FA. In the present study we analyzed routine complete blood counts from 34 FA patients and evaluated RDW, correlating with the hematological parameters most consistently associated with the FA phenotype. RESULTS We showed, for the first time, that RDW is significantly increased in FA. We also showed that increased RDW is correlated with thrombocytopenia, neutropenia and, most importantly, highly correlated with anemia. Analyzing sequential hemograms from 3 FA patients with different clinical outcomes, during 10 years follow-up, we confirmed a consistent association between increased RDW and decreased hemoglobin, which supports the postulated importance of RDW in the evaluation of hematological disease progression. CONCLUSIONS This study shows, for the first time, that RDW is significantly increased in FA, and this increment is correlated with neutropenia, thrombocytopenia, and highly correlated with anemia. According to the present results, it is suggested that increased RDW can be a novel marker of stress erythropoiesis in FA.
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Affiliation(s)
- Rosa Sousa
- Laboratory of Cytogenetics, Abel Salazar Institute for Biomedical Sciences, University of Porto (ICBAS, UP), Porto, Portugal
| | - Cristina Gonçalves
- Clinical Hematology Service, Hospital Center of Porto (CHP), Porto, Portugal
| | | | - Emília Costa
- Pediatric Hematology Unity, Hospital Center of Porto (CHP), Porto, Portugal
| | - Ana Fernandes
- Pediatric Hematology-Oncology Unity, Hospital Center of S. João, Porto (CHSJ), Porto, Portugal
| | - Maria do Bom Sucesso
- Pediatric Hematology-Oncology Unity, Hospital Center of S. João, Porto (CHSJ), Porto, Portugal
| | - Joana Azevedo
- Hematology Service, Hospital and University Center of Coimbra (CHUC), Porto, Portugal
| | - Alfredo Rodriguez
- Laboratory of Cytogenetics, National Institute of Pediatrics, Ciudad de Mexico (INP), Mexico City, Mexico
| | - Rocio Rius
- Laboratory of Cytogenetics, National Institute of Pediatrics, Ciudad de Mexico (INP), Mexico City, Mexico
| | - Carlos Seabra
- Clinical Pathology Service, Infante D. Pedro Hospital, Aveiro (CHBV), Aveiro, Portugal
| | - Fátima Ferreira
- Hematology Service, Hospital Center of S. João, Porto (CHSJ), Porto, Portugal
| | - Letícia Ribeiro
- Hematology Service, Hospital and University Center of Coimbra (CHUC), Porto, Portugal
| | - Anabela Ferrão
- Pediatric Service, Hospital Center of Lisboa Norte (CHLN), Lisbon, Portugal
| | - Sérgio Castedo
- Medical Genetics and Prenatal Diagnosis Prof Doctor Sérgio Castedo, Porto (GDPN), Porto, Portugal
| | - Esmeralda Cleto
- Pediatric Hematology Unity, Hospital Center of Porto (CHP), Porto, Portugal
| | - Jorge Coutinho
- Clinical Hematology Service, Hospital Center of Porto (CHP), Porto, Portugal
| | - Félix Carvalho
- UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - José Barbot
- Pediatric Hematology Unity, Hospital Center of Porto (CHP), Porto, Portugal
| | - Beatriz Porto
- Laboratory of Cytogenetics, Abel Salazar Institute for Biomedical Sciences, University of Porto (ICBAS, UP), Porto, Portugal
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Belo H, Silva G, Cardoso BA, Porto B, Minguillon J, Barbot J, Coutinho J, Casado JA, Benedito M, Saturnino H, Costa E, Bueren JA, Surralles J, Almeida A. Epigenetic Alterations in Fanconi Anaemia: Role in Pathophysiology and Therapeutic Potential. PLoS One 2015; 10:e0139740. [PMID: 26466379 PMCID: PMC4605638 DOI: 10.1371/journal.pone.0139740] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/15/2015] [Indexed: 01/23/2023] Open
Abstract
Fanconi anaemia (FA) is an inherited disorder characterized by chromosomal instability. The phenotype is variable, which raises the possibility that it may be affected by other factors, such as epigenetic modifications. These play an important role in oncogenesis and may be pharmacologically manipulated. Our aim was to explore whether the epigenetic profiles in FA differ from non-FA individuals and whether these could be manipulated to alter the disease phenotype. We compared expression of epigenetic genes and DNA methylation profile of tumour suppressor genes between FA and normal samples. FA samples exhibited decreased expression levels of genes involved in epigenetic regulation and hypomethylation in the promoter regions of tumour suppressor genes. Treatment of FA cells with histone deacetylase inhibitor Vorinostat increased the expression of DNM3Tβ and reduced the levels of CIITA and HDAC9, PAK1, USP16, all involved in different aspects of epigenetic and immune regulation. Given the ability of Vorinostat to modulate epigenetic genes in FA patients, we investigated its functional effects on the FA phenotype. This was assessed by incubating FA cells with Vorinostat and quantifying chromosomal breaks induced by DNA cross-linking agents. Treatment of FA cells with Vorinostat resulted in a significant reduction of aberrant cells (81% on average). Our results suggest that epigenetic mechanisms may play a role in oncogenesis in FA. Epigenetic agents may be helpful in improving the phenotype of FA patients, potentially reducing tumour incidence in this population.
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Affiliation(s)
- Hélio Belo
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisboa, Portugal
- CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Gabriela Silva
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisboa, Portugal
- CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Bruno A. Cardoso
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisboa, Portugal
- CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Beatriz Porto
- Laboratório de Citogenética do Instituto de Ciências Biomédicas de Abel Salazar, Porto, Portugal
| | - Jordi Minguillon
- Center for Biomedical Network Research on Rare Diseases (CIBERER) and Department of Genetics and Microbiology, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - José Barbot
- Unidade de Hematologia Pediátrica do Centro Hospitalar do Porto, Porto, Portugal
| | - Jorge Coutinho
- Unidade de Hematologia Pediátrica do Centro Hospitalar do Porto, Porto, Portugal
| | - Jose A. Casado
- Hematopoiesis and Gene Therapy Division, CIEMAT, Madrid, Spain
| | - Manuela Benedito
- Serviço de hematologia do Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Hema Saturnino
- Serviço de hematologia do Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Emília Costa
- Unidade de Hematologia Pediátrica do Centro Hospitalar do Porto, Porto, Portugal
| | - Juan A. Bueren
- Unidade de Hematologia Pediátrica do Centro Hospitalar do Porto, Porto, Portugal
| | - Jordi Surralles
- Center for Biomedical Network Research on Rare Diseases (CIBERER) and Department of Genetics and Microbiology, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Antonio Almeida
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisboa, Portugal
- CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
- * E-mail:
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Teixeira C, Barbot J, Freitas MI. Reference values for reticulocyte parameters and hypochromic RBC in healthy children. Int J Lab Hematol 2015; 37:626-30. [DOI: 10.1111/ijlh.12374] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Affiliation(s)
- C. Teixeira
- Department of Pathology; Laboratory Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
| | - J. Barbot
- Department of Medicine; Pediatric Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
| | - M. I. Freitas
- Department of Pathology; Laboratory Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
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Affiliation(s)
- Cláudia Teixeira
- Laboratory Haematology Unit, Department of Pathology, Centro Hospitalar do Porto, Porto, Portugal.
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Aguiar E, Freitas MI, Barbot J. Different haematological picture of congenital sideroblastic anaemia in a hemizygote and a heterozygote. Br J Haematol 2014; 166:469. [PMID: 24862439 DOI: 10.1111/bjh.12952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eliana Aguiar
- Clinical Haematology Department, Centro Hospitalar São João, Oporto, Portugal.
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Affiliation(s)
- J Amorim
- Paediatric Haematology Department, Centro Hospitalar do Porto, Porto, Portugal.
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Sousa R, Ponte F, Teixeira S, Andrade L, Gonçalves C, Barbot J, Coutinho J, Carvalho F, Porto B. Fosfomycin increases chromosome instability in lymphocytes from Fanconi Anemia patients. Mutation Research/Genetic Toxicology and Environmental Mutagenesis 2013; 754:58-62. [PMID: 23624100 DOI: 10.1016/j.mrgentox.2013.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/12/2013] [Accepted: 04/18/2013] [Indexed: 11/25/2022]
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Coutinho M, Costa E, Monteiro T, Silva G, Costa H, Guedes A, Freitas I, Barbot J. Infantile pyknocytosis: an under-recognized form of neonatal hemolytic anemia? ACTA ACUST UNITED AC 2013; 18:27-9. [PMID: 23253864 DOI: 10.1532/lh96.12005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infantile pyknocytosis (IP) is an under-recognized hematological entity of newborns that can cause a severe neonatal hemolytic anemia. A careful, prompt, and accurate peripheral blood smear examination is essential to establish the diagnosis. Here we describe the clinical features and histological parameters of 1 case of IP. Spontaneous resolution usually occurs by 4 to 6 months, but red blood cell transfusion may be needed if the anemia is severe.
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Affiliation(s)
- Maria Coutinho
- Pediatric Hematology Unit, Centro Hospitalar do Porto, Porto, Portugal.
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Bento C, Oliveira AC, Neves J, Gameiro M, Cunha E, Coucelo M, Costa RM, Barbot J, Costa E, Fernández-Lago C, Ribeiro ML. Hb Iberia [α104(G11)Cys → Arg,TGC>CGC (α2) (HBA2:c.313T>C)], a new α-thalassemic hemoglobin variant found in the Iberian Peninsula: report of six cases. Hemoglobin 2013. [PMID: 23181747 DOI: 10.3109/03630269.2012.742911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report a new structural defect of the α2-globin chain presenting with moderate microcytic hypochromic anemia, in six individuals from three unrelated families, living in Portugal and Spain. α-Globin gene deletions were ruled out by gap-polymerase chain reaction (gap-PCR) and multiplex ligation-dependent probe amplification (MLPA). Direct sequencing of the α2-globin gene revealed a substitution of codon 104 [α104(G11)Cys→Arg, TGC>CGC (α2) (HBA2:c.313T>C)]. This new variant, not detectable by high performance liquid chromatography (HPLC) or electrophoresis, was called Hb Iberia, as it was observed for the first time in families from the Iberian Peninsula. Although the mutant allele is transcribed, as indicated by the balanced mRNA α/β ratio, the abnormal α2 chain could not form a stable tetramer as the cysteine and arginine residues, located at the α1β1 contact, differ in size, charge and hydrophobicity. Hb Iberia is the third mutation described at codon 104 on the α-globin genes, namely, Hb Sallanches (α2, TGC>TAC) and Hb Oegstgeest (α1, TGC>AGC), also characterized as unstable hemoglobins (Hbs), present on an α-thalassemic phenotype.
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Affiliation(s)
- Celeste Bento
- Centro Hospitalar e Universitário de Coimbra, Serviço de Hematologia, Coimbra, Portugal.
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Affiliation(s)
- Filipe Santos
- Department of Laboratorial Haematology, Centro Hospitalar do Porto, Oporto, Portugal.
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Pellegrino RM, Coutinho M, D'Ascola D, Lopes AM, Palmieri A, Carnuccio F, Costa M, Zecchina G, Saglio G, Costa E, Barbot J, Porto G, Pinto JP, Roetto A. Two novel mutations in the tmprss6 gene associated with iron-refractory iron-deficiency anaemia (irida) and partial expression in the heterozygous form. Br J Haematol 2012; 158:668-72. [PMID: 22765023 DOI: 10.1111/j.1365-2141.2012.09198.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Ponte F, Sousa R, Fernandes AP, Gonçalves C, Barbot J, Carvalho F, Porto B. Improvement of genetic stability in lymphocytes from Fanconi anemia patients through the combined effect of α-lipoic acid and N-acetylcysteine. Orphanet J Rare Dis 2012; 7:28. [PMID: 22591656 PMCID: PMC3407801 DOI: 10.1186/1750-1172-7-28] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 02/08/2012] [Accepted: 05/16/2012] [Indexed: 02/07/2023] Open
Abstract
Fanconi Anemia (FA) is a rare genetic disorder, characterized by progressive bone marrow failure and increased predisposition to cancer. Despite being highly heterogeneous, all FA patients are hypersensitive to alkylating agents, in particular to 1,2:3,4-diepoxybutane (DEB), and to oxidative damage. Recent studies point to defective mitochondria in FA cells, which is closely related with increased production of reactive oxygen species (ROS) and concomitant depletion of antioxidant defenses, of which glutathione is a well-known biomarker.The objective of the present work is to evaluate the putative protective effect of α-lipoic acid (α-LA), a mitochondrial protective agent, and N-acetylcysteine (NAC), a direct antioxidant and a known precursor for glutathione synthesis, in spontaneous and DEB-induced chromosome instability (CI) in lymphocyte cultures from FA patients.For that purpose, lymphocyte cultures from 15 FA patients and 24 healthy controls were pre-treated with 20 μM α-LA, 500 μM NAC and α-LA plus NAC at the same concentrations, and some of them were exposed to DEB (0.05 μg/ml). A hundred metaphases per treatment were scored to estimate the relative frequency of spontaneous and DEB-induced chromosome breakage.The obtained results revealed that a cocktail of α-LA and NAC can drastically improve the genetic stability in FA lymphocytes in vitro, decreasing CI by 60% and 80% in cultures from FA patients and FA mosaic/chimera patients, respectively. These results suggest that the studied cocktail can be used as a prophylactic approach to delay progressive clinical symptoms in FA patients caused by CI, which can culminate in the delay of the progressive bone marrow failure and early cancer development.
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Affiliation(s)
- Filipa Ponte
- Chemistry and Technology Network (REQUIMTE), Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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Silva G, Braga A, Leitão B, Mesquita A, Reis A, Duarte C, Barbot J, Silva ES. Adams-Oliver syndrome and portal hypertension: fortuitous association or common mechanism? Am J Med Genet A 2012; 158A:648-51. [PMID: 22307742 DOI: 10.1002/ajmg.a.34435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 10/04/2011] [Indexed: 11/07/2022]
Abstract
Adams-Oliver syndrome (AOS) is a rare condition defined by combination of cutis aplasia and transverse limb abnormalities. Some authors have described a possible association between this syndrome and portal hypertension (PH) due to hepatoportal sclerosis (HPS). We present a boy with AOS who developed a progressive splenomegaly and hypersplenism at the age of 2 months, and was admitted for acute gastrointestinal bleeding (GI) at the age of 9 months. Subsequently, we documented an extrahepatic portal vein obstruction and esophageal varices. After several episodes of cataclysmic upper GI bleeding a mesentero-portal shunt (MPS) was performed at 10 months. The shunt thrombosed, and after three failed attempts of thrombectomy, it was removed. One month later a splenorenal shunt was performed, and this closed spontaneously by 3 years. The patient suffered from ischemic stroke after placing the first shunt, and has spastic diplegia, left frontal lobe epilepsy, hyperactivity and attention deficit disorder, and severe psychomotor delay. At 11 years and he presented with chronic liver failure and hyperammonemia and coagulopathy. We hypothesize that there may be an early embryonic vascular abnormality (vascular disruption) that may explain these vascular phenomena.
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Affiliation(s)
- Gisela Silva
- Pediatric Service of Centro Hospitalar do Porto, Porto, Portugal.
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Rocha S, Costa E, Rocha-Pereira P, Ferreira F, Cleto E, Barbot J, Quintanilha A, Belo L, Santos-Silva A. Erythropoiesis versus inflammation in Hereditary Spherocytosis clinical outcome. Clin Biochem 2011; 44:1137-1143. [PMID: 21704613 DOI: 10.1016/j.clinbiochem.2011.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 05/30/2011] [Accepted: 06/05/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aimed to evaluate the relationship between erythropoiesis and inflammation, in Hereditary Spherocytosis (HS) clinical outcome. DESIGN AND METHODS We studied 26 controls and 82 HS patients presenting mild (n = 49) and severer (n = 33) HS forms. We evaluated plasma levels of EPO, sTfR, ferritin, iron, folic acid, vitamin B12, TNF-α, IFN-γ, elastase and lactoferrin; leukocyte and reticulocyte counts and RPI were determined. RESULTS All HS patients showed significantly higher EPO, sTfR, reticulocytes and RPI but only mild HS presented normal hemoglobin levels; the positive significant correlations between EPO and sTfR, reticulocytes and RPI observed in mild HS were not observed in severer HS patients. HS patients presented with higher levels of neutrophils, TNF-α, IFN-γ, elastase, lactoferrin and ferritin. CONCLUSIONS Our data show HS as a disease linked to enhanced erythropoiesis that is disturbed in the more severe forms, to which inflammation may contribute, at least in part.
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Affiliation(s)
- Susana Rocha
- Faculdade de Farmácia, Universidade do Porto, Rua Aníbal Cunha, 164, 4050-047, Porto, Portugal; Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
| | - Elísio Costa
- Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Campus da Asprela, Rua Dr. António Bernardino Almeida, 4200-072, Porto, Portugal.
| | - Petronila Rocha-Pereira
- Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; Centro de Investigação em Ciências da Saúde (CICS), Universidade da Beira Interior, Av. Infante D. Henrique, 6201-506, Covilhã, Portugal.
| | - Fátima Ferreira
- Serviço de Hematologia Clínica, Hospital S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Esmeralda Cleto
- Sector de Hematologia Pediátrica, Centro Hospitalar do Porto (CHP) - Hospital Santo António, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - José Barbot
- Serviço de Hematologia, Centro Hospitalar do Porto (CHP) - Hospital Maria Pia, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - Alexandre Quintanilha
- Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003, Porto, Portugal.
| | - Luís Belo
- Faculdade de Farmácia, Universidade do Porto, Rua Aníbal Cunha, 164, 4050-047, Porto, Portugal; Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
| | - Alice Santos-Silva
- Faculdade de Farmácia, Universidade do Porto, Rua Aníbal Cunha, 164, 4050-047, Porto, Portugal; Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal.
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Porto B, Sousa R, Ponte F, Torgal A, Campilho F, Campos A, Gonçalves C, Barbot J. [Fanconi anemia: cytogenetic diagnosis of 40 cases]. ACTA MEDICA PORT 2011; 24:405-412. [PMID: 22015027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 08/09/2010] [Indexed: 05/31/2023]
Abstract
Fanconi Anemia (FA) is a rare recessive disorder clinically characterized by progressive bone marrow failure, diverse congenital malformations and increased predisposition to cancer. Given the late onset of anemia, relatively to other cytopenias, and the high variability in the phenotype, a correct clinical diagnosis is difficult, and may be delayed or even missed. This fact may be prejudicial to patients, due to the need of avoiding exposure to toxic agents, programming the transplantation of hematopoietic progenitor cells and screening of neoplasia associated with the disease. Given the high genetic variability (thirteen complementation groups have been identified, each with genes presenting several different mutations), a rapid molecular diagnosis is not possible. However, there is an urgent need for a timely and correct diagnosis, due to the early evolution of the disease towards malignancy and to the early need of finding compatible donors for future hematopoietic stem cell transplantation. Fortunately, the hypersensitivity of FA cells to the clastogenic (chromosome breaking) effect of DNA cross-linking agents, in particular to diepoxybutane (DEB), provides a unique marker for the diagnosis. At present, cytogenetic analysis for detection of DEB-induced chromosome instability is the gold-standard test for the diagnosis of FA. In the present work we present the results from the DEB induced chromosome instability studies performed in the Laboratory of Cytogenetics of ICBAS between 1992 and 2009. Blood samples from 222 patients were obtained from different hospitals mainly from the north and centre of Portugal. This population includes not only patients with clinical suspicion of FA, but also patients presented with thrombocytopenia, pancitopenia or aplastic anemia, for confirmation/exclusion of FA. Two samples of amniotic fluid were also obtained for pre-natal diagnosis. A total of 34 FA patients were diagnosed. Cytogenetic studies were also performed in blood samples from AF relatives, which allowed the diagnosis of 6 new cases, 5 of them corresponding to asymptomatic individuals. In the total population of FA patients studied, 25% belong to the gypsy ethnic group. Periodic cytogenetic studies were also performed in blood samples from AF patients post transplantation, which confirmed the elimination of the original hematopoietic DEB sensitive cells.
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Affiliation(s)
- Beatriz Porto
- Laboratório de Citogenética, Instituto de Ciências Biomédicas Abel Salazar, Porto
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Castella M, Pujol R, Callén E, Trujillo JP, Casado JA, Gille H, Lach FP, Auerbach AD, Schindler D, Benítez J, Porto B, Ferro T, Muñoz A, Sevilla J, Madero L, Cela E, Beléndez C, de Heredia CD, Olivé T, de Toledo JS, Badell I, Torrent M, Estella J, Dasí A, Rodríguez-Villa A, Gómez P, Barbot J, Tapia M, Molinés A, Figuera A, Bueren JA, Surrallés J. Origin, functional role, and clinical impact of Fanconi anemia FANCA mutations. Blood 2011; 117:3759-69. [PMID: 21273304 PMCID: PMC3083295 DOI: 10.1182/blood-2010-08-299917] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 12/30/2010] [Indexed: 12/17/2022] Open
Abstract
Fanconi anemia is characterized by congenital abnormalities, bone marrow failure, and cancer predisposition. To investigate the origin, functional role, and clinical impact of FANCA mutations, we determined a FANCA mutational spectrum with 130 pathogenic alleles. Some of these mutations were further characterized for their distribution in populations, mode of emergence, or functional consequences at cellular and clinical level. The world most frequent FANCA mutation is not the result of a mutational "hot-spot" but results from worldwide dissemination of an ancestral Indo-European mutation. We provide molecular evidence that total absence of FANCA in humans does not reduce embryonic viability, as the observed frequency of mutation carriers in the Gypsy population equals the expected by Hardy-Weinberg equilibrium. We also prove that long distance Alu-Alu recombination can cause Fanconi anemia by originating large interstitial deletions involving FANCA and 2 adjacent genes. Finally, we show that all missense mutations studied lead to an altered FANCA protein that is unable to relocate to the nucleus and activate the FA/BRCA pathway. This may explain the observed lack of correlation between type of FANCA mutation and cellular phenotype or clinical severity in terms of age of onset of hematologic disease or number of malformations.
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Affiliation(s)
- Maria Castella
- Genome Instability and DNA Repair Group, Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Campus de Bellaterra s/n, Barcelona, Spain
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19
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Rocha S, Costa E, Rocha-Pereira P, Ferreira F, Cleto E, Barbot J, Quintanilha A, Belo L, Santos-Silva A. Complementary markers for the clinical severity classification of hereditary spherocytosis in unsplenectomized patients. Blood Cells Mol Dis 2010; 46:166-70. [PMID: 21138793 DOI: 10.1016/j.bcmd.2010.11.001] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 10/22/2010] [Accepted: 10/25/2010] [Indexed: 11/16/2022]
Abstract
Hereditary spherocytosis (HS) is usually classified as mild, moderate or severe using conventional features, namely, hemoglobin (Hb) concentration, reticulocyte count and bilirubin levels, which do not always contribute to an adequate clinical classification. The aim of our study was to establish the importance of some laboratory routine parameters, as markers of HS clinical outcome, by studying a control group (n=26) and unsplenectomized HS patients (n=82) presenting mild, moderate or severe HS. We performed a basic hematologic study and evaluated the reticulocyte count, bilirubin, erythropoietin (EPO) and soluble transferrin receptor (sTfR) levels; the osmotic fragility (OFT) and criohemolysis tests (CHT); the ratios Hb/MCHC (mean cell hemoglobin concentration), Hb/RDW (red cell distribution width) and MCHC/RDW, were calculated. Hb changed significantly in accordance with HS severity, but not reticulocytes or bilirubin. We found that MCHC, RDW, EPO, sTfR, OFT, CHT and the calculated ratios were significantly changed in patients, and, therefore, were valuable as complementary diagnostic tools for HS. Moreover, RDW, Hb/MCHC, Hb/RDW and MCHC/RDW changed significantly with worsening of HS; thus, they are also good markers for the clinical outcome of HS. In conclusion, we propose the use of these routine parameters as useful to complement the analysis of HS severity.
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Affiliation(s)
- Susana Rocha
- Serviço de Bioquímica, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
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20
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Porto B, Sousa R, Malheiro I, Gaspar J, Rueff J, Gonçalves C, Barbot J. Normal red blood cells partially decrease diepoxybutane-induced chromosome breakage in cultured lymphocytes from Fanconi anaemia patients. Cell Prolif 2010; 43:573-8. [PMID: 21039995 DOI: 10.1111/j.1365-2184.2010.00706.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Fanconi anaemia (FA) is a cancer-prone chromosome instability syndrome characterized by hypersensitivity to DNA cross-linking agents, such as diepoxybutane (DEB). Previous studies have shown that normal red blood cells (RBC) can protect cultured lymphocytes against chromosomal breaks induced by DEB. The present study was designed to analyse influence of RBCs from normal individuals on frequency of DEB-induced chromosome breaks in lymphocyte cultures from FA patients. MATERIALS AND METHODS A comparative study was performed between DEB-induced chromosome breaks in cultures of FA lymphocytes with either autologous or heterologous RBCs. A further comparative study was carried out between whole blood cultures from FA patients performed on two occasions, before and 1 week after transfusion of RBCs. RESULTS It was observed that normal RBCs compared to FA RBCs, partially reduced chromosome breaks in cultured FA lymphocytes. A significant reduction in DEB-induced breaks was also observed in FA cultured lymphocytes obtained 1 week after transfusion of RBCs, in comparison to those observed in the same patients before RBC transfusion. CONCLUSIONS This study shows that DEB-induced chromosome instability in FA lymphocytes is partially reduced by normal RBCs. This effect may have some clinical relevance in vivo, whenever FA patients receive a RBC transfusion.
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Affiliation(s)
- B Porto
- Laboratory of Cytogenetics, ICBAS-Institute of Biomedical Sciences Abel Salazar, UP, Porto, Portugal.
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Rocha S, Costa E, Rocha-Pereira P, Ferreira F, Cleto E, Barbot J, Quintanilha A, Belo L, Santos-Silva A. Erythrocyte membrane protein destabilization versus clinical outcome in 160 Portuguese Hereditary Spherocytosis patients. Br J Haematol 2010; 149:785-94. [DOI: 10.1111/j.1365-2141.2010.08166.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pereira JC, Barbot J, Ribeiro ML. Novel human pathological mutations. Gene symbol: ALAS2. Disease: sideroblastic anaemia. Hum Genet 2009; 126:333. [PMID: 19693999] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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23
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José Vale M, José Dinis M, Bini-Antunes M, Porto B, Barbot J, Coutinho MB. Audiologic abnormalities of Fanconi anaemia. Acta Otolaryngol 2009; 128:992-6. [DOI: 10.1080/00016480701793750] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Pinto TJ, Barbot J. 443. Spinal Anesthesia With 3mg of Bupivacaine and 15μg of Fentanyl for Knee Artroscopy. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00065] [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: 11/03/2022]
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25
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Coimbra P, Senra J, Barbot J. 132. Anaesthetic Management of Burn Injury in a Two Years Old Child. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00448] [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: 11/03/2022]
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26
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Rocha S, Vitorino RM, Lemos-Amado FM, Castro EB, Rocha-Pereira P, Barbot J, Cleto E, Ferreira F, Quintanilha A, Belo L, Santos-Silva A. Presence of cytosolic peroxiredoxin 2 in the erythrocyte membrane of patients with hereditary spherocytosis. Blood Cells Mol Dis 2008; 41:5-9. [DOI: 10.1016/j.bcmd.2008.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 02/14/2008] [Accepted: 02/19/2008] [Indexed: 11/26/2022]
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27
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Ferreira H, Costa E, Vieira E, Barbot J, Dos Santos R. Single nucleotide polymorphisms in the apo(a) kringle IV type 8 domain are not associated with atherothrombotic serum lipoprotein (a) concentration, in a Portuguese paediatric population. Int J Lab Hematol 2008; 30:240-3. [PMID: 18479303 DOI: 10.1111/j.1751-553x.2007.00932.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Lipoprotein (a) (Lp[a]) is a complex of apolipoprotein (a) (apo[a]) and low-density lipoprotein (LDL), associated with atherothrombotic disease. Most of the interindividual variations in plasma levels of Lp(a) can be attributed to sequence differences linked to the apo(a) gene locus. The aim of this study was to investigate a possible link between single nucleotide polymorphisms (SNPs) in the apo(a) kringle (K) IV type 8 domain and atherothrombotic serum Lp(a) concentrations. Direct sequencing of the two exons and flanking intronic sequences of the apo(a) K IV type 8 domain was performed in a group of 97 paediatric patients, 51 with serum Lp(a) concentration above and 46 with concentration below 30 mg/dl,. We found three SNPs, two in exon 1 (c.66A>C and c.133G>A) and one in intron 1 (c.160+1G>A). The c.66A>C polymorphism was the most common with a heterozygosity frequency of 15.46%. The c.133G>A and c.160+1G>A polymorphisms were found at a frequency of 5.15% and 1.03%, respectively. No statistically significant difference was found in the genotype distribution between the two groups of patients. Our results suggest that these SNPs in the apo(a) K IV 8 domain are not directly associated with atherothrombotic serum Lp(a) concentration in our population.
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Affiliation(s)
- H Ferreira
- Serviço de Pediatria do Hospital de Crianças Maria Pia, Maria Pia, Portugal
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28
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Costa E, Vieira E, Martins M, Saraiva J, Cancela E, Costa M, Bauerle R, Freitas T, Carvalho JR, Santos-Silva E, Barbot J, Dos Santos R. Analysis of the UDP-glucuronosyltransferase gene in Portuguese patients with a clinical diagnosis of Gilbert and Crigler-Najjar syndromes. Blood Cells Mol Dis 2005; 36:91-7. [PMID: 16269258 DOI: 10.1016/j.bcmd.2005.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Revised: 09/02/2005] [Accepted: 09/02/2005] [Indexed: 10/25/2022]
Abstract
We describe the molecular study in a cohort of 120 Portuguese patients with the clinical diagnosis of Gilbert syndrome and in one with the diagnosis of Crigler-Najjar syndrome type II, as well as a prenatal diagnosis of Crigler-Najjar syndrome type I. Among the 120 unrelated patients with Gilbert syndrome, 110 were homozygous for the [TA]7 allele ([TA]7/[TA]7), and one patient was a compound heterozygote for two different insertions ([TA]7/[TA]8). The remaining 9 patients were heterozygous for the TA insertion ([TA]6/[TA]7). Additional studies in these 9 patients revealed heterozygosity for the c.674T>G, c.488_491dupACCT and c.923G>A mutations, in 1, 1 and 4 patients, respectively. The patient with Crigler-Najjar syndrome type II was a compound heterozygote for [TA]7 and the c.923G>A mutation. The undocumented polymorphisms c.-1126C>T and c.997-82T>C were also detected in the course of this study. Prenatal diagnosis in a family with a boy previously diagnosed as Crigler-Najjar syndrome type I and homozygosity for the c.923G>A mutation revealed that the fetus was unaffected. Homozygosity for the [TA] insertion was found to be the most frequent cause of GS in our population. Identification of further mutations in the UGT1A1 gene was also seen to contribute significantly towards diagnosis.
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Affiliation(s)
- Elísio Costa
- Escola Superior de Saúde, Instituto Politécnico de Bragança, Avenida D. Afonso V, 5300-121 Bragança, Portugal.
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29
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Rocha S, Costa E, Catarino C, Belo L, Castro EMB, Barbot J, Quintanilha A, Santos-Silva A. Erythropoietin levels in the different clinical forms of hereditary spherocytosis. Br J Haematol 2005; 131:534-42. [PMID: 16281946 DOI: 10.1111/j.1365-2141.2005.05802.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Erythropoietin (EPO), the main growth factor responsible for the regulation of red blood cell production, may be overproduced when blood loss or haemolysis occurs. Patients with mild hereditary spherocytosis (HS) are able to maintain normal haemoglobin concentration, whereas typical and severe HS patients develop an anaemic state. Splenectomy usually reverses anaemia. We aimed to clarify the role of EPO in the response to enhanced spherocyte destruction, and to look for a linkage with the broad clinical spectra of HS. EPO levels, reticulocyte count and production index (RPI), other parameters used to classify HS and the protein deficiencies underlying HS were evaluated in previously diagnosed unsplenectomised (n = 24) and splenectomised (n = 10) patients presenting mild, typical or severe HS. A significant increase in EPO was observed in all unsplenectomised HS patients. In the mild form, a significant correlation of EPO with reticulocyte count and RPI was observed; however, this correlation disappeared in typical HS patients. Splenectomised HS patients presented a correction in EPO levels in all forms of HS, although the reticulocyte count and RPI sustained slightly higher values. Our data show HS as a disease linked to an overproduction of EPO, according to the severity of the disease; however, a disturbance in erythropoiesis seems to occur in typical HS. Moreover, splenectomy leads to a correction in the EPO levels.
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Affiliation(s)
- S Rocha
- Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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30
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Lima RM, Costa E, Rocha C, Vieira E, dos Santos R, Barbot J, Rocha H. Molecular characterization of a Portuguese patient with Shwachman-Diamond syndrome. J Pediatr Gastroenterol Nutr 2005; 41:115-6. [PMID: 15990640 DOI: 10.1097/01.mpg.0000155184.61625.fc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Rosa M Lima
- Serviço de Pediatria, Hospital Central Especializado de Crianças Maria Pia, Porto, Portugal
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31
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Rocha S, Rebelo I, Costa E, Catarino C, Belo L, Castro EMB, Cabeda JM, Barbot J, Quintanilha A, Santos-Silva A. Protein deficiency balance as a predictor of clinical outcome in hereditary spherocytosis. Eur J Haematol 2005; 74:374-80. [PMID: 15813910 DOI: 10.1111/j.1600-0609.2004.00385.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vertical and horizontal interactions between membrane constituents account for integrity, strength and deformability of the erythrocyte. Disruption of vertical interactions caused by membrane protein deficiencies in hereditary spherocytosis (HS), favor membrane vesiculation with development of spherocytic cells. Our aim was to evaluate the hematological and clinical presentation of HS according to the type and amount of protein deficiency. We studied 81 Portuguese individuals, 71 belonging to 21 families plus 10 unrelated subjects, and found that 51 of them were HS patients. Patients were classified as presenting mild, typical or severe HS, according to laboratory results and clinical follow-up. We performed screening tests and the standardized electrophoretic membrane protein analysis to identify and quantify protein deficiencies. We found band 3 and ankyrin deficiencies as the major causes for HS. The ratios between the value of the primary and/or secondary protein deficiencies showed significantly different values according to the severity of HS, and a significant inverse correlation with the severity of HS was observed. In mild HS, the ratios between protein deficiencies reflected equivalent protein deficiencies, while an unbalance was observed in typical HS, which was enhanced in severe HS. Our data suggest that the relative quantification of each major membrane protein and of the ratios between the values of protein deficiencies may be helpful in providing additional data about the clinical outcome of HS.
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Affiliation(s)
- S Rocha
- Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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Neves J, Costa E, Branca R, Carrilho I, Barbot J, Barbot C. [The identification of multiple thrombophilic risk factors in an infant with cerebrovascular accident]. Rev Neurol 2005; 40:479-81. [PMID: 15861329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Neonatal stroke (NNS) incidence appears to be increasing over the last years. This is believed to be a consequence of diagnostic accuracy rather than a real amplification of this entity. Nowadays, NNS incidence is estimated to be 1:4000 full newborns. CASE REPORT Child with left middle cerebral artery territory infarction in which several thromboembolic risk factors were documented both in the child (neonatal sepsis and factor V Leiden) and his mother (lupus anticoagulant, pre-eclampsy and factor V Leiden). CONCLUSIONS This case supports the increasing evidence in recent reports that association of multiple prothrombotic risk factors (maternal and foetal) is present in NNS genesis. This way the authors agree that wide prothrombotic study may be of crucial interest in identifying subjacent thrombophilic disease, even when an exogenous risk factor is present.
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Affiliation(s)
- J Neves
- Servicio de Hematología, Hospital de Crianças Maria Pia, 4050-111 Porto, Portugal
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33
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Neves J, Costa E, Branca R, Carrilho I, Barbot J, Barbot MC. Múltiples factores de riesgo trombofílicos identificados en un lactante con accidente vascular cerebral. Rev Neurol 2005. [DOI: 10.33588/rn.4008.2004070] [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: 11/24/2022]
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34
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Costa E, Antunes MB, Faria S, Vieira E, Branca R, Barbot J, Dos Santos R. Determination of neutrophil Fcgamma receptor IIIb antigens (HNA-1a, HNA-1b and HNA-1c) by fluorescence-primed allele-specific polymerase chain reaction. Clin Lab Haematol 2004; 26:319-21. [PMID: 15485460 DOI: 10.1111/j.1365-2257.2004.00633.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We evaluate a technique for genotyping HNA-1a, -1b and -1c antigens, resorting to fluorescence-primed allele-specific polymerase chain reaction (FPAS-PCR), and determine the frequency of the different genotypes in a normal Portuguese population. Our results indicate that the FPAS-PCR system is a reliable and simple tool for genotyping the neutrophil Fcgamma receptor IIIB antigens. The HNA-1a, -1b and -1c gene frequencies of 42.98, 84.21 and 6.14%, respectively, found in this study are similar to those reported for other white populations.
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Affiliation(s)
- E Costa
- Serviço de Hematologia, do Hospital de Crianças Maria Pia, Porto, Portugal.
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35
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Branca R, Costa E, Rocha S, Coelho H, Quintanilha A, Cabeda JM, Santos-Silva A, Barbot J. Coexistence of congenital red cell pyruvate kinase and band 3 deficiency. ACTA ACUST UNITED AC 2004; 26:297-300. [PMID: 15279669 DOI: 10.1111/j.1365-2257.2004.00617.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The authors report the case of a 9-year-old Caucasian girl, born in northern Portugal, with chronic nonspherocytic haemolytic anaemia and without family history of anaemia. The aethiological study of this anaemia revealed pyruvate kinase deficiency (PKD), because of two previously described mutations (426Arg-->Trp and 510Arg-->Gln). Since the blood smear revealed features not fully compatible with PKD diagnosis, additional tests were performed for the propositus and her parents, namely red blood cell membrane protein analysis. A decrease in proteins band 3 (15%) and 4.2 (18%) was found in the propositus. Her father presented only a decrease in band 3 (11%). Coexistence of PKD and erythrocyte membrane proteins deficiency in the same patient is very uncommon. Our findings suggest that a careful blood smear observation may lead to the identification of a combined deficiency in erythrocyte membrane proteins and enzymopathies.
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MESH Headings
- Anemia, Hemolytic, Congenital/etiology
- Anemia, Hemolytic, Congenital/genetics
- Anemia, Hemolytic, Congenital/metabolism
- Anion Exchange Protein 1, Erythrocyte/deficiency
- Anion Exchange Protein 1, Erythrocyte/genetics
- Anion Exchange Protein 1, Erythrocyte/metabolism
- Child
- DNA Mutational Analysis
- Erythrocytes/enzymology
- Erythrocytes/metabolism
- Exons
- Family Health
- Female
- Hematologic Tests
- Heterozygote
- Humans
- Point Mutation
- Pyruvate Kinase/deficiency
- Pyruvate Kinase/genetics
- Pyruvate Kinase/metabolism
- Pyruvate Metabolism, Inborn Errors/complications
- Pyruvate Metabolism, Inborn Errors/genetics
- Pyruvate Metabolism, Inborn Errors/metabolism
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Affiliation(s)
- R Branca
- Serviço de Hematologia, Hospital de Crianças Maria Pia, Porto, Portugal.
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36
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Coelho H, Costa E, Vieira E, Branca R, dos Santos R, Barbot J. A new case of (TA)8 allele in the UGT1A1 gene promoter in a Caucasian girl with Gilbert syndrome. Pediatr Hematol Oncol 2004; 21:371-4. [PMID: 15205079 DOI: 10.1080/08880010490457033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 10/26/2022]
Abstract
The authors describe a 5-year-old Caucasian girl, referred to their hospital for evaluation of an unconjugated hyperbilirubinemia (57.9 micromol/L) detected from blood analysis during an episode of fever. The molecular analysis of the TATA-box region of the UGT1A1 gene revealed that the patient was a compound heterozygote for two insertions, one TA and the other TATA [(TA)(7)/(TA)(8)]. This is the first case of (TA)8 allele found in a Portuguese Caucasian patient and the third found in the literature.
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Affiliation(s)
- Henrique Coelho
- Serviço de Hematologia, Hospital de Crianças Maria Pia, Porto, Portugal
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Mangavel C, Rossignol N, Perronnet A, Barbot J, Popineau Y, Guéguen J. Properties and Microstructure of Thermo-Pressed Wheat Gluten Films: a Comparison with Cast Films. Biomacromolecules 2004; 5:1596-601. [PMID: 15244483 DOI: 10.1021/bm049855k] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Wheat gluten films were prepared by thermo-pressing, and their mechanical properties were compared to those of cast films. The stress-strain relationship was established for films with various amounts of glycerol. Both relationships were quite different, revealing a different network organization. Thermo-pressed films presented higher stress values than cast films, but the effect of the glycerol amount was similar in both cases, an increase of the glycerol amount leading to a decrease of both films stress. The glycerol influence on the strain at break of thermo-pressed films was very limited, with strain values reaching a maximum around 200%. The role of disulfide bridges on themomoulded films mechanical properties was investigated, and it was shown that some rearrangements and a significative protein insolubilization occurred during the process. The effective flow porosity of the protein network for thermo-pressed films was estimated by water capillary rise measurements to about 7%. Scanning electron microscopy was used to obtain some information about the microstructure of both cast and thermo-pressed films.
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Affiliation(s)
- C Mangavel
- Institut National de la Recherche Agronomique, Unité de Recherche sur les Protéines Végétales et leurs Interactions, Rue de la Géraudière, BP 71627, 44316 Nantes Cedex 03, France.
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Ferreira H, Costa E, Vieira E, Leão A, Magalhães R, Gomes JL, Barbot J, dos Santos R. Pentanucleotide repeat (TTTTA)n polymorphism in the 5' control region of the apoliprotein (A) gene and atherothrombotic serum lipoprotein (A) concentration, in a pediatric population. Haematologica 2003; 88:ELT07. [PMID: 12651289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
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39
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Mangavel C, Barbot J, Guéguen J, Popineau Y. Molecular determinants of the influence of hydrophilic plasticizers on the mechanical properties of cast wheat gluten films. J Agric Food Chem 2003; 51:1447-1452. [PMID: 12590496 DOI: 10.1021/jf0257704] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The influence of a set of hydrophilic plasticizers varying in their chain length (ethyleneglycol and longer molecules) on the tensile strength and elongation at break of cast gluten films was studied. When considered on a molar basis (moles of plasticizer per mole of amino acid), the effect of the different plasticizers depended on their respective molecular weights for plasticizer/amino acid ratios in the range from 0.10 to 0.40. However, above a ratio of 0.40-0.50 mol/mol of amino acid, these differences were abolished and both stress and strain reached a plateau value, with all plasticizers studied. In fact, when a homologous series of molecules was considered, the ability for plasticizer to decrease stress and increase strain was closely related to the number of hydrogen bonds the molecule was able to share with the protein network. Ethyleneglycol's efficiency was, however, lower than expected from its hydrogen-bonding potential; a comparison with other diols demonstrated that this was due to the small size of this molecule. The particular effect of glycerol concentration on the films' mechanical properties suggested that other molecular features of the plasticizer, such as the number and position of hydroxide groups in the molecule, were involved in the plasticization mechanism.
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Affiliation(s)
- C Mangavel
- Institut National de la Recherche Agronomique, Unité de Recherche sur les Protéines Végétales et leurs Interactions, Rue de la Géraudière, B.P. 71627, 44316 Nantes Cedex 03, France.
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40
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Barreirinho S, Ferro A, Santos M, Costa EL, Pinto-Basto J, Sousa A, Sequeiros J, Maciel P, Barbot C, Barbot J. Inherited and acquired risk factors and their combined effects in pediatric stroke. Pediatr Neurol 2003; 28:134-8. [PMID: 12699865 DOI: 10.1016/s0887-8994(02)00506-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [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: 11/29/2022]
Abstract
The aim of this study was to identify hereditary and acquired risk-factors as they are related to the occurrence of stroke in children. We identified 21 children with stroke. A search of the Factor V Leiden mutation, the Factor II G20210A variant, and the thermolabile variant of methylenetetrahydrofolate reductase was performed in patients and in a control group (n = 115). We identified risk factors of acquired and/or hereditary nature for stroke in 19 of 21 children. Eleven children had three or more risk factors, seven had two risk factors, and one child had only one risk factor. We found three carriers (14.3%) of the Factor V Leiden mutation, two carriers (9.5%) of the Factor II G20210A variant, eleven (52.4%) thermolabile variant of methylenetetrahydrofolate reductase heterozygote carriers, and one (4.8%) homozygotes for this variant. Frequencies of the Factor V Leiden mutation and the Factor II variant were higher in patients than in controls, suggesting that these variants are associated with an increased risk of stroke in childhood. Homozygosity for the thermolabile variant of methylenetetrahydrofolate reductase was equally frequent amongst patients and controls. Our study confirms that stroke in children is commonly associated with a combination of multiple risk factors, both genetic and acquired, and that the Factor V Leiden mutation and the Factor II G20210A variant are predisposing factors for this situation.
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41
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Costa E, Pinto R, Vieira E, Polo S, Sarmento AM, Oliveira I, Pimenta R, Dos Santos R, Barbot J. [Influence of Gilbert's syndrome on serum bilirubin levels and gallstone formation in children with chronic hemolytic disease]. An Esp Pediatr 2002; 57:529-33. [PMID: 12466075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
To determine whether Gilbert's syndrome increases the risk of gallstone formation in children with chronic hemolytic disease, we studied 44 children with this diagnosis. Gallstones were detected by abdominal ultrasonography. This took place annually in scheduled examinations or in the context of acute abdominal pain. In all patients, the mean values of hemoglobin, reticulocyte and serum bilirubin in the chronic phase were recorded. In addition, TA insertion in the A(TA)nTATAA motif within the promoter region of the enzyme uridine-diphosphate-glucuronyl transferase (UGT1A1) was screened, since this is typically associated with GS.We found 10 (22.7 %) homozygotes for the mutated allele TA*7/TA*7, 12 (27.3 %) TA*6/TA*6 heterozygotes and 22 (50 %) homozygotes for the wild-type allele TA*6/TA*6. No statistically significant differences were found in the values of hemoglobin (Kruskal-Wallis test 2.496; p > 0.05) or in reticulocyte count (Kruskal-Wallis test 1.696; p > 0,05) between the three groups of patients, suggesting a similar degree of hemolysis. Patients with the UGT1A1 TA*7/TA*7 genotype showed higher mean serum bilirubin levels than did patients who were homozygous for the wild-type allele (Mann-Whitney test 35.5; p < 0.05). None of the patients with the TA*6/TA*6 genotype developed gallstones, whereas this complication was found in 2 of 12 (16.6 %) heterozygotes and 6 of 10 (60 %) homozygotes for the allele with TA insertion. In this latter group, 4 patients presented acute pancreatitis as a consequence of gallstone formation.The association between increased bilirubin load due to chronic hemolytic disease and diminished hepatic conjugation leads to raised serum bilirubin levels and consequently to an increased risk of gallstone formation. Therefore, we recommend screening for Gilbert's syndrome in children in the initial phases of chronic hemolytic diseases.
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Affiliation(s)
- E Costa
- Serviço de Hematologia. Hospital de Crianças Maria Pia. Porto. Portugal
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42
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Costa E, Vieira E, Cleto E, Cabeda JM, Pinho L, Coimbra E, Dos Santos R, Barbot J. [Glucose-6-phosphate dehydrogenase deficiency, neonatal hyperbilirubinemia and Gilbert syndrome]. ACTA MEDICA PORT 2002; 15:409-12. [PMID: 12680285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The aim of this work was to evaluate the influence of abnormal UDP-glucoronosyltransferase-1 (UGT1A1) gene variant, on the incidence and severity of neonatal hyperbilirubinemia, in glucose-6-phosphate dehydrogenase (G6PD) deficient newborns. The A(TA)nTAA region in the promoter of the UGT1A1 gene was analysed in 20 children with G6PD deficiency. Fourteen of these children had the African type variant (G6PDA-) and 6 had different variants (G6PDNara, G6PDGuadalajara, G6PDDurham, G6PDTomah, G6PDAveiro e G6PDNashville) related to chronic nonspherocytic haemolytic anaemia (CNSHA). The existence of a positive history of neonatal hyperbilirubinemia, as well as its severity was registered. The incidence of neonatal hyperbilirubinemia was increased in this group of children (90%) and was not associated with abnormal alleles of the UGT1A1 gene. It was not possible to assess the influence of abnormal alleles in the severity of the neonatal hyperbilirubinemia. However, these abnormal alleles did not account for the severity of jaundice in children who presented variants related to CNSHA, since 5 were treated with an exchange transfusion and none presented abnormal alleles.
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Affiliation(s)
- Elísio Costa
- Serviço de Hematologia, Hospital Maria Pia, Serviços de Hematologia Clínica e Pediátrica, Hospital Geral de Santo António, Unidade de Genética Molecular, Instituto de Genética Doutor Jacinto de Magalhães, Porto
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Costa E, Vieira E, Santos-Silva E, Barbot J, dos Santos R. TATA-Box polymorphism in the uridine diphosphate glucuronosyl transferase gene in Portuguese patients with clinical diagnosis of Gilbert Syndrome. Haematologica 2002; 87:ELT21. [PMID: 11940506] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Affiliation(s)
- Elísio Costa
- Serviço de Hematologia, Hospital de Crianças Maria Pia, Rua da Boavista, 827, 4050-111 Porto, Portugal.
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Costa E, Vasconcelos J, Santos E, Laranjeira A, Castro e Melo J, Barbot J. Neutrophil dysfunction in a case of glucose-6-phosphate dehydrogenase deficiency. J Pediatr Hematol Oncol 2002; 24:164-5. [PMID: 11990707 DOI: 10.1097/00043426-200202000-00023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Costa E, Pinto R, Vieira E, Polo S, Sarmento A, Oliveira I, Pimenta R, dos Santos R, Barbot J. Influencia del síndrome de Gilbert en los valores de bilirrubina sérica y presencia de litiasis vesicular en pacientes con hemólisis crónica congénita. An Pediatr (Barc) 2002. [DOI: 10.1016/s1695-4033(02)78711-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Carrilho I, Costa E, Barreirinho MS, Santos M, Barbot C, Barbot J. Prothrombotic study in full term neonates with arterial stroke. Haematologica 2001; 86:E16. [PMID: 11524266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Barbot J, Costa E, Guerra M, Barreirinho MS, Isvarlal P, Robles R, Gerritsen HE, Lämmle B, Furlan M. Ten years of prophylactic treatment with fresh-frozen plasma in a child with chronic relapsing thrombotic thrombocytopenic purpura as a result of a congenital deficiency of von Willebrand factor-cleaving protease. Br J Haematol 2001; 113:649-51. [PMID: 11380451 DOI: 10.1046/j.1365-2141.2001.02808.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report the results of 10 years of prophylactic fresh-frozen plasma (FFP) infusion therapy in a 14-year-old girl with chronic relapsing thrombotic thrombocytopenic purpura (TTP), in whom a severe congenital von Willebrand factor (VWF)-cleaving protease deficiency has been documented. Severe haemolytic crises triggered by infections were prevented and her present renal and neurological functions have been preserved. Sequential measurements of protease activity and platelet count after FFP infusion led us to conclude tentatively that 5% may be sufficient to degrade very large and adhesive VWF multimers.
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Affiliation(s)
- J Barbot
- Serviço de Hematologia do Hospital de Crianças Maria Pia, Porto, Portugal.
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Mangavel C, Barbot J, Popineau Y, Guéguen J. Evolution of wheat gliadins conformation during film formation: a fourier transform infrared study. J Agric Food Chem 2001; 49:867-72. [PMID: 11262042 DOI: 10.1021/jf0009899] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The secondary structures of wheat gliadins (a major storage protein fraction from gluten) in film-forming solutions and their evolution during film formation were investigated by Fourier transform infrared spectroscopy. In the film-forming solution, wheat gliadins presented a mixture of different secondary structures, with an important contribution of beta-turns induced by proline residues. The presence of plasticizer did not have any influence on protein secondary structure in the film-forming solution. The evolution of protein conformation was followed during drying; the major feature of this evolution was a clear growing of the infrared band at 1622 cm(-1), characteristic of intermolecular hydrogen-bonded beta-sheets. This revealed the formation of protein aggregates during film drying. The influence of the drying temperature on film properties and gliadin secondary structures was also investigated. Higher drying temperatures induced an increase of both the tensile strength of the films and the amount of beta-sheets aggregates. Although the appearance of heat-induced disulfide bridge cross-links has already been described, there is clear evidence that hydrogen-bonded beta-sheets aggregates are also induced by thermal treatment. It was not possible, however, to determine whether there is a direct relationship between the occurrence of these aggregates and the increase of the tensile strength of the films.
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Affiliation(s)
- C Mangavel
- Institut National de la Recherche Agronomique, Unité de Biochimie et Technologie des Protéines, Rue de la Géraudière, BP 71627, 44316 Nantes Cedex 03, France.
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do Sameiro Faria M, Mota C, Barbot J, Alvares S, Jardim H, Vilarinho A, Pereira E. Haemolytic uraemic syndrome, cardiomyopathy, cutaneous vasculopathy and anti-phospholipid activity. Nephrol Dial Transplant 2000; 15:1891-2. [PMID: 11071991 DOI: 10.1093/ndt/15.11.1891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Films were prepared at neutral pH from deamidated gluten by casting with or without enzymatic treatment by transglutaminase in the presence of various concentrations of diamines added to the film-forming solution. Variation in the glycerol/deamidated gluten ratio from 0.2 to 0.5 had a major effect on the film mechanical properties, which is characteristic of a plasticizing effect. A ratio of 0.35, producing a tensile strength of 1.14 +/- 0.12 MPa and an elongation at break of 376 +/- 62%, was chosen for most of the enzymatic modifications. The action of transglutaminase with or without the addition of external diamines induced a simultaneous increase in tensile strength and elongation at break of the films but tended to decrease the contact angle between the film surface and a water droplet. The presence of diamines in the film solution affected the elongation at break more than the tensile strength of the films. These diamines, able to react at their two extremities, probably acted as spacers between gluten proteins. The decrease in solubility was related to the formation of high molecular weight polymers in the film. The film properties were unaffected by the type of diamine added as secondary substrate in the transglutaminase reaction.
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Affiliation(s)
- C Larré
- Institut National de la Recherche Agronomique, Unité de Biochimie et Technologie des Protéines, B.P. 71627, 44316 Nantes Cedex 3, France.
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