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Donath H, Wölke S, Knop V, Heß U, Duecker RP, Trischler J, Poynard T, Schubert R, Zielen S. Liver Assessment in Patients with Ataxia-Telangiectasia: Transient Elastography Detects Early Stages of Steatosis and Fibrosis. Can J Gastroenterol Hepatol 2023; 2023:2877350. [PMID: 36941982 PMCID: PMC10024628 DOI: 10.1155/2023/2877350] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 03/13/2023] Open
Abstract
Background Ataxia-telangiectasia (A-T) is a rare autosomal-recessive multisystem disorder characterized by pronounced cerebellar ataxia, telangiectasia, cancer predisposition, and altered body composition. Liver diseases with steatosis, fibrosis, and hepatocellular carcinoma are frequent findings in older patients but sensitive noninvasive diagnostic tools are lacking. Objectives To determine the sensitivity of transient elastography (TE) as a screening tool for early hepatic tissue changes and serum biomarkers for liver disease. Methods Thirty-one A-T patients aged 2 to 25 years were examined prospectively from 2016-2018 by TE. In addition, we evaluated the diagnostic performance of liver biomarkers for steatosis and necroinflammatory activity (SteatoTest and ActiTest, Biopredictive, Paris) compared to TE. For calculation and comparison, patients were divided into two groups (<12, >12 years of age). Results TE revealed steatosis in 2/21 (10%) younger patients compared to 9/10 (90%) older patients. Fibrosis was present in 3/10 (30%) older patients as assessed by TE. We found a significant correlation of steatosis with SteatoTest, alpha-fetoprotein (AFP), HbA1c, and triglycerides. Liver stiffness correlated significantly with SteatoTest, ActiTest, HbA1c, and triglycerides. Conclusion Liver disease is a common finding in older A-T patients. TE is an objective measure to detect early stages of steatosis and fibrosis. SteatoTest and ActiTest are a good diagnostic assessment for steatosis and necroinflammatory activity in patients with A-T and confirmed the TE results.
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Affiliation(s)
- H. Donath
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - S. Wölke
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - V. Knop
- 2Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - U. Heß
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - R. P. Duecker
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - J. Trischler
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - T. Poynard
- 3Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Hepatology Department, Frankfurt, Germany
| | - R. Schubert
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - S. Zielen
- 1Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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De Bernardi N, Duecker RP, Zielen S, Schubert R, Eickmeier O. Epigenetische Regulation der Resolution der Inflammation bei
Cystischer Fibrose. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- N De Bernardi
- Universitätsklinikum Frankfurt, Klinik für Kinder- und
Jugendmedizin, Abteilung für Allergologie, Pneumologie und Cystische
Fibrose, Frankfurt am Main, Germany
| | - RP Duecker
- Universitätsklinikum Frankfurt, Klinik für Kinder- und
Jugendmedizin, Abteilung für Allergologie, Pneumologie und Cystische
Fibrose, Frankfurt am Main, Germany
| | - S Zielen
- Universitätsklinikum Frankfurt, Klinik für Kinder- und
Jugendmedizin, Abteilung für Allergologie, Pneumologie und Cystische
Fibrose, Frankfurt am Main, Germany
| | - R Schubert
- Universitätsklinikum Frankfurt, Klinik für Kinder- und
Jugendmedizin, Abteilung für Allergologie, Pneumologie und Cystische
Fibrose, Frankfurt am Main, Germany
| | - O Eickmeier
- Universitätsklinikum Frankfurt, Klinik für Kinder- und
Jugendmedizin, Abteilung für Allergologie, Pneumologie und Cystische
Fibrose, Frankfurt am Main, Germany
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Donath H, Woelke S, Schubert R, Kieslich M, Theis M, Auburger G, Duecker RP, Zielen S. Neurofilament Light Chain Is a Biomarker of Neurodegeneration in Ataxia Telangiectasia. Cerebellum 2021; 21:39-47. [PMID: 33893614 PMCID: PMC8885493 DOI: 10.1007/s12311-021-01257-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
Ataxia telangiectasia (A-T) is a progressive and life-limiting disease associated with cerebellar ataxia due to progressive cerebellar degeneration. In addition to ataxia, which is described in detail, the presence of chorea, dystonia, oculomotor apraxia, athetosis, parkinsonism, and myoclonia are typical manifestations of the disease. The study aimed to evaluate the specificity and sensitivity of neurofilament light chain (NfL) as a biomarker of neurodegeneration in relation to SARA score. In this prospective trial, one visit of 42 A-T patients aged 1.3–25.6 years (mean 11.6 ± 7.3 years) was performed, in which NfL was determined from serum by ELISA. Additionally, a neurological examination of the patients was performed. Blood was collected from 19 healthy volunteers ≥ 12 years of age. We found significantly increased levels of NfL in patients with A-T compared to healthy controls (21.5 ± 3.6 pg/mL vs. 9.3 ± 0.49 pg/mL, p ≤ 0.01). There was a significant correlation of NfL with age, AFP, and SARA. NfL is a new potential progression biomarker in blood for neurodegeneration in A-T which increases with age.
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Affiliation(s)
- H Donath
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany.
| | - S Woelke
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - R Schubert
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - M Kieslich
- Division of Pediatric Neurology, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - M Theis
- Division of Pediatric Neurology, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - G Auburger
- Experimental Neurology, Medical School, Goethe University, Frankfurt, Germany
| | - R P Duecker
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - S Zielen
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
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Pietzner J, Merscher BM, Baer PC, Duecker RP, Eickmeier O, Fußbroich D, Bader P, Del Turco D, Henschler R, Zielen S, Schubert R. Low-dose irradiation prior to bone marrow transplantation results in ATM activation and increased lethality in Atm-deficient mice. Bone Marrow Transplant 2016; 51:619. [PMID: 27050750 DOI: 10.1038/bmt.2016.22] [Citation(s) in RCA: 3] [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: 11/09/2022]
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Pietzner J, Baer PC, Duecker RP, Merscher MB, Satzger-Prodinger C, Bechmann I, Wietelmann A, Del Turco D, Doering C, Kuci S, Bader P, Schirmer S, Zielen S, Schubert R. Bone marrow transplantation improves the outcome of Atm-deficient mice through the migration of ATM-competent cells. Hum Mol Genet 2012; 22:493-507. [DOI: 10.1093/hmg/dds448] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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