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Mei-Zahav M, Stafler P, Senderowitz H, Bentur L, Livnat G, Shteinberg M, Orenstein N, Bazak L, Prais D, Levine H, Gur M, Khazanov N, Simhaev L, Eliyahu H, Cohen M, Wilschanski M, Blau H, Mussaffi H. The Q359K/T360K mutation causes cystic fibrosis in Georgian Jews. J Cyst Fibros 2018; 17:e41-e45. [PMID: 30033373 DOI: 10.1016/j.jcf.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Q359K/T360K mutation, described in Jewish CF patients of Georgian decent, is of questionable clinical significance. METHODS Clinical records of patients with the Q359K/T360K mutation from three CF centers were studied for phenotypic expression and putative mechanism of dysfunction. Computer models of mutant CFTR were constructed. RESULTS Nine patients (4 homozygous) of Georgian Jewish origin were included. Age at diagnosis was 9.4 (0.25-38.2) years, median (range). Sweat chloride was 106 ± 13 meq/L, mean ± SD. Nasal Potential Difference performed in three, was abnormal. All had pulmonary symptoms since early childhood and bronchiectasis. Median FEV1 was 88 (40-121)%. Five had chronic mucoid P. aeruginosa. Homozygous patients were pancreatic insufficient. Enzyme supplementation was initiated at 3.8 (1-14.7) years, median (range). Structural models hint at possible interference of this mutation with transmembrane chloride transport. CONCLUSION In our cohort, the Q359K/T360K mutation resulted in a severe CF phenotype, although with residual early CFTR function. The CFTR2 database should consider defining this mutation as CF-causing.
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Affiliation(s)
- M Mei-Zahav
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - P Stafler
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Senderowitz
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
| | - L Bentur
- Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam health Care Campus, Israel; Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel
| | - G Livnat
- Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Cystic Fibrosis Center, Carmel Hospital, Israel
| | - M Shteinberg
- Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Cystic Fibrosis Center, Carmel Hospital, Israel
| | - N Orenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - L Bazak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - D Prais
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Levine
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Gur
- Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam health Care Campus, Israel
| | - N Khazanov
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
| | - L Simhaev
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
| | - H Eliyahu
- Electrophysiology Laboratory, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - M Cohen
- Electrophysiology Laboratory, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - M Wilschanski
- Electrophysiology Laboratory, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - H Blau
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Mussaffi
- Kathy and Lee Graub Cystic Fibrosis Center and Pulmonary Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Dropiyvsky-Goldstein H, Yaakov Y, Blau H, Efrati O, Bentur L, Livnat G, Picard E, Aviram M, Machlin R, Wilschanski M. WS15.5 Electrophysiological tests in CF diagnosis: nasal potential difference is more predictive than sweat test – single center study. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30247-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Shteinberg M, Lulu AB, Blumenfeld Z, Gur M, Bentur L, Mussaffi H, Blau H, Sarouk I, Efrati O, Cohen-Cymberknoh M, Kerem E, Aviram M, Pickard E, Livnat G. 223 Infertility among women with cystic fibrosis: prevalence and risk factors. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
BACKGROUND Cystic fibrosis (CF) is characterized by altered exocrine secretions; however, no comprehensive compositional profile of CF serous and mucous saliva secretions has been published. DESIGN We analyzed salivary flow rate and composition, and oxidative stress-related parameters, comparing CF patients with non-CF bronchiectasis patients and the healthy controls. RESULTS Median salivary magnesium concentration and lactate dehydrogenase activity were significantly lower in CF patients than in the healthy controls. Salivary total protein concentration was 45% higher in CF patients than in non-CF bronchiectasis patients. CF patients showed 8% lower levels of peroxidase compared with non-CF bronchiectasis. Salivary total antioxidant status, superoxide dismutase and uric acid values in the CF group were higher by 15%, 35% and 31%, respectively, than in both control groups. CONCLUSIONS Cystic fibrosis patients demonstrated altered salivary profile, especially in antioxidant enzymatic and molecular activity, possibly resulting from the oral cavity's ongoing inflammatory and oxidative process. Free radical mechanisms may be involved in CF pathogenesis.
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Affiliation(s)
- G Livnat
- Pediatric Pulmonary Unit, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel
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Bornstein J, Livnat G, Stolar Z, Abramovici H. Pure versus complicated vulvar vestibulitis: a randomized trial of fluconazole treatment. Gynecol Obstet Invest 2001; 50:194-7. [PMID: 11014954 DOI: 10.1159/000010309] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the effectiveness of a 6-month treatment consisting of a weekly oral dose of 150 mg fluconazole for women with vestibulitis, and to explore the causes of treatment failure. METHODS Forty women with vestibulitis were randomized to either of two treatment groups. One group received a 6-month low oxalate diet with calcium citrate complement, as a placebo, and the second group the same diet and calcium citrate with the addition of a weekly oral tablet of 150 mg fluconazole. The women were examined 3 months after completing treatment, for response to therapy. RESULTS The addition of intensive 6-month fluconazole treatment did not lead to an outcome better than that attained by maintaining a low oxalate diet with calcium citrate supplementation. The satisfactory response rate was 15 and 30%, respectively. The presence of 'complicated vestibulitis', candidiasis concomitant with vestibulitis, decreases the satisfactory response rate regardless of the type of treatment administered (odds ratio 19.9, 95% CI 1.6, 250). CONCLUSION Prolonged oral fluconazole is an ineffective treatment of vestibulitis, whether pure or complicated by concomitant vulvovaginal candidiasis. The coexistence of candidiasis and vestibulitis - complicated vestibulitis - might represent a subset of vestibulitis that is resistant to the currently available medical therapy.
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Affiliation(s)
- J Bornstein
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
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