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Gjefsen E, Gervin K, Bråten LCH, Goll GL, Aass HCD, Schistad EI, Wigemyr M, Pedersen LM, Skouen JS, Vigeland MD, Selmer KK, Storheim K, Zwart JA. Longitudinal changes of serum cytokines in patients with chronic low back pain and Modic changes. Osteoarthritis Cartilage 2023; 31:543-547. [PMID: 36640896 DOI: 10.1016/j.joca.2023.01.001] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/10/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To explore serum cytokine levels over time in patients with chronic low back pain (cLBP) and Modic changes (MCs), difference in change between treatment groups in the Antibiotics in Modic Changes (AIM) study and associations between change in cytokines and low back pain. METHODS Serum concentrations of 39 cytokines were measured at baseline and 1 year from 73 participants in the AIM study; 30 randomized to placebo, 43 to Amoxicillin. Low back pain intensity was measured by numeric rating scale. Change in cytokine levels over time were assessed by paired t-tests. Difference in change in cytokine levels between treatment groups and associations between changes in LBP and cytokine levels were assessed by linear regression models. Networks of cytokine changes in each treatment groups were explored by Pearson's correlations. RESULTS Five cytokines changed from baseline to 1 year, (mean change, log transformed values with CI) C-X-C motif chemokine ligand (CXCL) 10 (IP-10) (0.11 (0.01-0.20)), CXCL13 (0.61 (0.00-0.12)), C-C motif chemokine ligand (CCL)26 (0.05 (0.01-0.1)), granulocyte macrophage-colony stimulating factor (GM-CSF) (-0.12 (-0.23 to 0.00)) and CXCL11 (0.12 (0.03-0.22)). Treatment group only influenced change in CCL21 (β 0.07 (0.01-0.12)), and IL-6 (β -0.17 (-0.30 to -0.03)). Change in CXCL13 (β 2.43 (0.49-4.38)), CCL27 (β 3.07 (0.46-5.69)), IL-8 (β 1.83 (0.08-3.58)) and CCL19 (β 3.10 (0.86-5.43)) were associated with change in LBP. The correlation networks of cytokine changes demonstrate small differences between treatment groups. CONCLUSIONS Cytokine levels are relatively stable over time in our sample, with little difference between treatment groups. Some cytokines may be associated with LBP intensity. The differences between the correlation networks suggest that long-term Amoxicillin-treatment may have longstanding effects to be further explored.
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Affiliation(s)
- E Gjefsen
- Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital HF, Ulleval, Bygg 37b, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Faculty of Medicine, University of Oslo, Norway.
| | - K Gervin
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.
| | - L C H Bråten
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.
| | - G L Goll
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
| | - H C D Aass
- Department of Medical Biochemistry, Oslo University Hospital, Norway.
| | - E I Schistad
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Norway.
| | - M Wigemyr
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.
| | - L M Pedersen
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway; Department of Physiotherapy, Oslo Metropolitan University, Norway.
| | - J S Skouen
- The Outpatient Spine Clinic, Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway.
| | - M D Vigeland
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
| | - K K Selmer
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.
| | - K Storheim
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway; Department of Physiotherapy, Oslo Metropolitan University, Norway.
| | - J A Zwart
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
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Rydning SL, Dudesek A, Rimmele F, Funke C, Krüger S, Biskup S, Vigeland MD, Hjorthaug HS, Sejersted Y, Tallaksen C, Selmer KK, Kamm C. A novel heterozygous variant inERLIN2causes autosomal dominant pure hereditary spastic paraplegia. Eur J Neurol 2018. [DOI: 10.1111/ene.13625] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- S. L. Rydning
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Department of Neurology; Oslo University Hospital; Oslo Norway
| | - A. Dudesek
- Department of Neurology; University of Rostock; Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE); Rostock; Germany Germany
| | - F. Rimmele
- Department of Neurology; University of Rostock; Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE); Rostock; Germany Germany
| | - C. Funke
- CeGaT GmbH; Center for Genomics and Transcriptomics; Tübingen Germany
| | - S. Krüger
- CeGaT GmbH; Center for Genomics and Transcriptomics; Tübingen Germany
| | - S. Biskup
- CeGaT GmbH; Center for Genomics and Transcriptomics; Tübingen Germany
- Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE); University of Tübingen; Tübingen Germany
| | - M. D. Vigeland
- Department of Medical Genetics; Oslo University Hospital; Oslo Norway
| | - H. S. Hjorthaug
- Department of Medical Genetics; Oslo University Hospital; Oslo Norway
| | - Y. Sejersted
- Department of Medical Genetics; Oslo University Hospital; Oslo Norway
| | - C. Tallaksen
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Department of Neurology; Oslo University Hospital; Oslo Norway
| | - K. K. Selmer
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
- Department of Medical Genetics; Oslo University Hospital; Oslo Norway
| | - C. Kamm
- Department of Neurology; University of Rostock; Rostock Germany
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Cockerell I, Guenin M, Heimdal K, Bjørnvold M, Selmer KK, Rouvière O. Renal manifestations of tuberous sclerosis complex: patients' and parents' knowledge and routines for renal follow-up - a questionnaire study. BMC Nephrol 2018; 19:39. [PMID: 29439672 PMCID: PMC5812037 DOI: 10.1186/s12882-018-0835-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 01/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Renal angiomyolipomas (AMLs) are a major clinical feature in patients with tuberous sclerosis complex (TSC). Spontaneous bleeding can be life threatening, and appropriate information and proper surveillance and management are important to limit morbidity and mortality. Because TSC is a rare disease, patients are at risk of suboptimal medical management. Our aim was to investigate patients' and parents' knowledge about renal angiomyolipomas (AMLs) in Tuberous Sclerosis Complex (TSC) and to identify current routines for renal follow-up. METHODS A questionnaire survey was initiated by the French Reference Centre on TSC. It was distributed in France through university hospitals and the patients' association (2009-2011), and to patients registered by the Norwegian National Centre for Rare Epilepsy-Related Disorders (2013-2014). Contingency tables with Chi-Square test for independence (with Yates Continuity Correction) and Pearson-Chi-Square value were used for correlation statistics. RESULTS We included 357 patients (France, n=257; Norway n=100). Most participants knew that TSC is associated with AMLs. However, 42 % did not know about the risk of AMLrelated bleeding, and 37 % had been informed about the risk of bleeding only after the age of 15 years. Furthermore, 14 % did not know whether they themselves or their child had AMLs. Patients had less knowledge than parents. Medical consultations and patient associations were the main sources of information. Among 30 % of patients, renal imaging was not received at all, or not conducted every 1-3 years, as recommended by current guidelines. Regular imaging was more frequent in patients with AMLs < 15 years, than in patients with AMLs ≥ 15 years. Ultrasound was the most frequently used imaging modality. CONCLUSIONS Knowledge of renal AML in TSC patients and their parents was lower than expected, and follow-up by renal imaging was suboptimal for a substantial proportion of patients. Patients and parents should be informed about the risk and symptoms of renal bleeding, at the latest when the patient is 15 years. Monitoring the growth of AMLs should be standardized to comply with guidelines. Transition between adolescence and adulthood is a high-risk period and ensuring appropriate follow-up at this time is particularly important.
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Affiliation(s)
- I Cockerell
- Department of Rare Disorders and Disabilities, Oslo University Hospital, National Centre for Rare Epilepsy-Related Disorders, Pb 4950, Nydalen, 0424, Oslo, Norway.
| | - M Guenin
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France
| | - K Heimdal
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - M Bjørnvold
- National Centre for Epilepsy, Division for Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - K K Selmer
- Department of Rare Disorders and Disabilities, Oslo University Hospital, National Centre for Rare Epilepsy-Related Disorders, Pb 4950, Nydalen, 0424, Oslo, Norway.,Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - O Rouvière
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France
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Mero IL, Mørk HH, Sheng Y, Blomhoff A, Opheim GL, Erichsen A, Vigeland MD, Selmer KK. Homozygous KIDINS220 loss-of-function variants in fetuses with cerebral ventriculomegaly and limb contractures. Hum Mol Genet 2018; 26:3792-3796. [PMID: 28934391 DOI: 10.1093/hmg/ddx263] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/03/2017] [Indexed: 12/30/2022] Open
Abstract
Heterozygous mutations in KIDINS220 were recently suggested a cause of spastic paraplegia, intellectual disability, nystagmus and obesity. All patients carried terminal nonsense de novo mutations that seemed to escape nonsense-mediated mRNA decay. The mechanism for pathogenicity is yet unexplained, as it seems that heterozygous loss-of-function variants of KIDINS220 are generally well tolerated. We present a consanguineous couple who experienced four pregnancy terminations due to repeated findings in the fetuses comprising enlarged cerebral ventricles and limb contractures. Exome sequencing in two of the aborted fetuses revealed a shared homozygous frameshift variant in exon 24 in KIDINS220. Sanger sequencing of the variant in available family members showed complete segregation with the affection status, resulting in a LOD score of 2.5 under an autozygous inheritance model. mRNA studies revealed destruction of the original splice site, resulting in an out-of-frame transcript and introduction of a premature termination codon in exon 25. Premature termination codons in this position are likely to cause activation of nonsense-mediated mRNA decay and result in complete absence of KIDINS220 protein in individuals homozygous for the variant. The phenotype of the presented fetuses overlaps with findings in functional studies of knockout Kidins220 mice embryos that are non-viable with enlarged cerebral ventricles. The human fetuses also exhibit several similarities to the milder phenotype described in patients with heterozygous KIDINS220 mutations. We hence propose that the identified homozygous loss-of-function variant in KIDINS220 causes the phenotype in the presented fetuses, and that this represents a hitherto undescribed severe autosomal recessive neurodevelopmental disorder.
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Affiliation(s)
- I-L Mero
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - H H Mørk
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Y Sheng
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,Department of Medical Genetics, University of Oslo, Oslo, Norway
| | - A Blomhoff
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | | | - Aa Erichsen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - M D Vigeland
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,Department of Medical Genetics, University of Oslo, Oslo, Norway
| | - K K Selmer
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,Department of Medical Genetics, University of Oslo, Oslo, Norway
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Rydning SL, Wedding IM, Koht J, Chawla M, Øye AM, Sheng Y, Vigeland MD, Selmer KK, Tallaksen CME. A founder mutation p.H701P identified as a major cause of SPG7 in Norway. Eur J Neurol 2016; 23:763-71. [PMID: 26756429 DOI: 10.1111/ene.12937] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 09/09/2015] [Accepted: 11/04/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE SPG7 is one of the most common forms of autosomal recessive hereditary spastic paraplegia. The phenotype has been shown to be heterogeneous, varying from a complex spastic ataxia to pure spastic paraplegia or pure ataxia. The aim of this study was to clinically and genetically characterize patients with SPG7 in Norway. METHODS Six Norwegian families with a clinical diagnosis of hereditary spastic paraplegia were diagnosed with SPG7 through Sanger sequencing and whole-exome sequencing. Haplotypes were established to identify a possible founder mutation. All patients were thoroughly examined and the clinical and molecular findings are described. RESULTS The core phenotype was spastic paraparesis with ataxia, bladder disturbances and progressive external ophthalmoplegia. The variant p.H701P was identified in homozygous state in one family and in compound heterozygous state in three families. Haplotype analysis of seven surrounding single nucleotide polymorphisms supports that this variant resides on a founder haplotype. Four of the families were compound heterozygous for the previously well-described p.A510V variant. CONCLUSION SPG7 is a common subgroup of hereditary spinocerebellar disorders in Norway. The broad phenotype in the Norwegian SPG7 population illustrates the challenges with the traditional dichotomous classification of hereditary spinocerebellar disorders into hereditary spastic paraplegia or hereditary ataxia. A Norwegian founder mutation p.H701P was identified in four out of six families, making it a major cause of SPG7 in Norway.
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Affiliation(s)
- S L Rydning
- Department of Neurology, Oslo University Hospital, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
| | - I M Wedding
- Department of Neurology, Oslo University Hospital, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
| | - J Koht
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Norway
| | - M Chawla
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - A-M Øye
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Norway
| | - Y Sheng
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Norway
| | - M D Vigeland
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Norway
| | - K K Selmer
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Norway
| | - C M E Tallaksen
- Department of Neurology, Oslo University Hospital, Norway.,Institute of Clinical Medicine, University of Oslo, Norway
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Kverneland M, Taubøll E, Selmer KK, Iversen PO, Nakken KO. Modified Atkins diet may reduce serum concentrations of antiepileptic drugs. Acta Neurol Scand 2015; 131:187-90. [PMID: 25312999 DOI: 10.1111/ane.12330] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Modified Atkins diet is a treatment option for patients with pharmacoresistant epilepsy that is not suitable for surgery. In the last few years, we have tried dietary treatment added to antiepileptic drugs (AEDs) in adult patients with severe epilepsy. AIM OF THE STUDY To examine a possible pharmacokinetic interaction between the modified Atkins diet and AEDs. METHODS In four patients, AED serum concentrations were measured before onset and after 4 and 12 weeks on the diet. The patients used combinations of two or three AEDs, including carbamazepine, clobazam, lamotrigine, nitrazepam, oxcarbazepine, valproate, zonisamide, and topiramate. The patients did not change the type or dose of their AEDs during the diet period. RESULTS After 12 weeks on the diet, the average serum concentrations of the respective AEDs were reduced by 35% (range 6-46%) compared to prediet values. CONCLUSIONS Modified Atkins diet used as add-on therapy to AEDs in four patients with drug resistant seizures caused a considerable decrease in AED serum concentrations. In individual patients, this could be of clinical relevance, and we recommend that AED serum concentrations should be closely monitored when offering this diet to adults with epilepsy.
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Affiliation(s)
- M. Kverneland
- Department of Refractory Epilepsy-SSE; Oslo University Hospital; Sandvika Norway
| | - E. Taubøll
- Department of Neurology; Oslo University Hospital and University of Oslo; Oslo Norway
| | - K. K. Selmer
- Department of Medical Genetics; Oslo University Hospital and University of Oslo; Oslo Norway
| | - P. O. Iversen
- Department of Nutrition; University of Oslo; Oslo Norway
- Haematology; Oslo University Hospital; Oslo Norway
| | - K. O. Nakken
- Department of Refractory Epilepsy-SSE; Oslo University Hospital; Sandvika Norway
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Abstract
Different SCN1A mutations are known to cause a variety of phenotypes, such as generalized epilepsy with febrile seizures plus (GEFS+), Dravet syndrome and familial hemiplegic migraine (FHM). In Dravet syndrome, most mutations are de novo and familial cases are rare. In this study, Dravet syndrome is observed in two maternal half sisters. They have healthy fathers and their common mother has never experienced seizures, but has a lifelong history of migraine. Direct sequencing of DNA extracted from blood revealed a heterozygous SCN1A nonsense mutation c.3985C>T in the sisters, but not in the mother. The mutation induces a premature stop codon and probably leads to a non-functional protein. Further examination of the mother's DNA showed that she has a mosaicism of the mutation. This report of parental SCN1A nonsense mutation mosaicism in familial Dravet syndrome suggests that mosaicism might be more common than previously suspected and emphasizes the importance of taking mosaicism into account in genetic counselling of Dravet syndrome and SCN1A mutations. Furthermore, whether the migraine of the mother could be influenced by her SCN1A mutation mosaicism is not known, but increased awareness of migraine in future studies of SCN1A related epilepsies could clarify this intriguing link between migraine and epilepsy.
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Affiliation(s)
- K K Selmer
- Department of Medical Genetics, Oslo University Hospital, Ullevaal Hospital, Oslo, Norway.
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Selmer KK, Egeland T, Solaas MH, Nakken KO, Kjeldsen MJ, Friis ML, Brandal K, Corey LA, Undlien DE. Comment. Acta Neurol Scand 2008. [DOI: 10.1111/j.1600-0404.2008.01061.x] [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: 11/28/2022]
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Selmer KK, Egeland T, Solaas MH, Nakken KO, Kjeldsen MJ, Friis ML, Brandal K, Corey LA, Undlien DE. Genetic screening of Scandinavian families with febrile seizures and epilepsy or GEFS+. Acta Neurol Scand 2008; 117:289-92. [PMID: 17927801 DOI: 10.1111/j.1600-0404.2007.00941.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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] [Indexed: 01/04/2023]
Abstract
BACKGROUND Mutations in the three genes SCN1A, SCN1B and GABRG2, all encoding subunits of ion channels, have been known to cause generalized epilepsy with febrile seizures plus (GEFS+) in families of different origin. OBJECTIVE To study the occurrence of mutations in these genes in families with GEFS+ or a GEFS+ resembling phenotype of Scandinavian origin. MATERIAL AND METHODS We performed linkage analysis in 19 Scandinavian families with a history of febrile seizures (FS) and epilepsy or GEFS+. Where linkage could not be excluded, the genes of interest were sequenced. RESULTS We identified only one mutation in SCN1A, which seems to be a rare variant with no functional consequence. CONCLUSION This suggests that mutations in these three genes are not a prevalent cause of familial cases of FS and epilepsy or GEFS+ in Scandinavia.
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Affiliation(s)
- K K Selmer
- Institute of Medical Genetics, Faculty Division Ullevål University Hospital, University of Oslo, Oslo, Norway.
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