1
|
Saghafi S, Zandieh F, Fazlollahi MR, Glocker C, Frede N, Buchta M, Yang L, Mahmoudi AH, Houshmand M, Pourpak Z, Grimbacher B, Moin M. Confirmation of Hyperimmunoglobulin E Syndrome in Two Patients with an Ocular Problem: Detection of Two New DOCK8 Mutations. Iran J Allergy Asthma Immunol 2022; 21:355-363. [PMID: 35822685 DOI: 10.18502/ijaai.v21i3.9809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 03/06/2022] [Indexed: 06/15/2023]
Abstract
Early diagnosis of primary immunodeficiencies is crucial for timely treatment and preventing unwanted complications. Next-generation sequencing (NGS) and detailed clinical and immunological evaluation can help early detect such disorders. This study aimed to confirm the diagnosis of two cases of autosomal recessive hyper-immunoglobulin E (IgE) syndrome (AR-HIES), presenting with irreversible eye involvement. Two unrelated patients with suspected AR-HIES were referred to the Immunology, Asthma and Allergy Research Institute (IAARI), Tehran, Iran. Immunological screening tests were performed for AR-HIES, which showed elevated serum IgE levels, eosinophilia, and low T-lymphocyte responses. NGS was performed, and the results were confirmed by Sanger sequencing. Sequence analysis showed a mutation in intron 17 of the dedicator of cytokinesis 8 (DOCK8) gene in the first patient, and a homozygous three base-pair deletion in exon 45 of DOCK8 in the second patient. This is the first time such mutations are reported and these variants are predicted to be damaging. Both patients suffered from persistent viral infections along with cytomegalovirus (CMV) retinitis. Suspicion of these two novel DOCK8 mutations can benefit patients presenting with recalcitrant ophthalmic viral involvements and relevant immunological test results. This would lead to earlier referrals for immunologic and genetic confirmation and thus, a more timely intervention with hematopoietic stem cell transplantation (HSCT).
Collapse
Affiliation(s)
- Shiva Saghafi
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fariborz Zandieh
- Department of Asthma, Allergy, and Immunology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Fazlollahi
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Cristina Glocker
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany AND Institute of Human Genetics, Medical Center, Faculty of Medicine, University of Freiburg, Germany.
| | - Natalie Frede
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany.
| | - Mary Buchta
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany.
| | - Linlin Yang
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany.
| | | | - Massoud Houshmand
- Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran.
| | - Zahra Pourpak
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bodo Grimbacher
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany AND DZIF- German Center for Infection Research, Satellite Center Freiburg, Freiburg, Germany AND CIBSS-Centre for Integrative Biological Signaling Studies, Albert Ludwig University, Freiburg, Germany AND RESIST-Cluster of Excellence 2155 to Hanover Medical School, Satellite Center Freiburg, Freiburg, Germany.
| | - Mostafa Moin
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Frede N, Rojas-Restrepo J, Caballero Garcia de Oteyza A, Buchta M, Hübscher K, Gámez-Díaz L, Proietti M, Saghafi S, Chavoshzadeh Z, Soler-Palacin P, Galal N, Adeli M, Aldave-Becerra JC, Al-Ddafari MS, Ardenyz Ö, Atkinson TP, Kut FB, Çelmeli F, Rees H, Kilic SS, Kirovski I, Klein C, Kobbe R, Korganow AS, Lilic D, Lunt P, Makwana N, Metin A, Özgür TT, Karakas AA, Seneviratne S, Sherkat R, Sousa AB, Unal E, Patiroglu T, Wahn V, von Bernuth H, Whiteford M, Doffinger R, Jouhadi Z, Grimbacher B. Genetic Analysis of a Cohort of 275 Patients with Hyper-IgE Syndromes and/or Chronic Mucocutaneous Candidiasis. J Clin Immunol 2021; 41:1804-1838. [PMID: 34390440 PMCID: PMC8604890 DOI: 10.1007/s10875-021-01086-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 06/05/2021] [Indexed: 01/24/2023]
Abstract
Hyper-IgE syndromes and chronic mucocutaneous candidiasis constitute rare primary immunodeficiency syndromes with an overlapping clinical phenotype. In recent years, a growing number of underlying genetic defects have been identified. To characterize the underlying genetic defects in a large international cohort of 275 patients, of whom 211 had been clinically diagnosed with hyper-IgE syndrome and 64 with chronic mucocutaneous candidiasis, targeted panel sequencing was performed, relying on Agilent HaloPlex and Illumina MiSeq technologies. The targeted panel sequencing approach allowed us to identify 87 (32 novel and 55 previously described) mutations in 78 patients, which generated a diagnostic success rate of 28.4%. Specifically, mutations in DOCK8 (26 patients), STAT3 (21), STAT1 (15), CARD9 (6), AIRE (3), IL17RA (2), SPINK5 (3), ZNF341 (2), CARMIL2/RLTPR (1), IL12RB1 (1), and WAS (1) have been detected. The most common clinical findings in this cohort were elevated IgE (81.5%), eczema (71.7%), and eosinophilia (62.9%). Regarding infections, 54.7% of patients had a history of radiologically proven pneumonia, and 28.3% have had other serious infections. History of fungal infection was noted in 53% of cases and skin abscesses in 52.9%. Skeletal or dental abnormalities were observed in 46.2% of patients with a characteristic face being the most commonly reported feature (23.1%), followed by retained primary teeth in 18.9% of patients. Targeted panel sequencing provides a cost-effective first-line genetic screening method which allows for the identification of mutations also in patients with atypical clinical presentations and should be routinely implemented in referral centers.
Collapse
Affiliation(s)
- Natalie Frede
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Rheumatology and Clinical Immunology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jessica Rojas-Restrepo
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andrés Caballero Garcia de Oteyza
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mary Buchta
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katrin Hübscher
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Laura Gámez-Díaz
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michele Proietti
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Shiva Saghafi
- Immunology Asthma and Allergy Research Institute Tehran University of Medical Sciences , Tehran, Iran
| | - Zahra Chavoshzadeh
- Pediatric Infectious Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pere Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall D'Hebron, Barcelona, Catalonia, Spain
| | - Nermeen Galal
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mehdi Adeli
- Sidra Medicine, Weill Cornell Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Moudjahed Saleh Al-Ddafari
- Laboratory of Applied Molecular Biology and Immunology, University of Abou-Bekr Belkaïd, Tlemcen, Algeria
| | - Ömür Ardenyz
- Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - T Prescott Atkinson
- Division of Pediatric Allergy & Immunology, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Fulya Bektas Kut
- Departmant of Pediatrics, Division of Pediatric Immunology and Allergy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Fatih Çelmeli
- Antalya Education and Research Hospital Department of Pediatric Immunology and Allergy, Antalya, Turkey
| | - Helen Rees
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sara S Kilic
- Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Ilija Kirovski
- Medical Faculty Skopje, 50 Divizija BB, 1000, Skopje, Macedonia
| | - Christoph Klein
- Department of Pediatrics, Dr. Von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Robin Kobbe
- First Department of Medicine, Division of Infectious Diseases, University Medical Center , Hamburg-Eppendorf, Germany
| | | | - Desa Lilic
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
| | - Peter Lunt
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - Niten Makwana
- Department of Pediatrics, Sandwell and West, Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Ayse Metin
- Department of Pediatric Allergy and Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Tuba Turul Özgür
- Department of Pediatrics, Division of Immunology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Ayse Akman Karakas
- Department of Dermatology and Venerology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Suranjith Seneviratne
- Institute of Immunity and Transplantation, Royal Free Hospital and University College London, London, UK
| | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ana Berta Sousa
- Serviço de Genética, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, and Laboratório de Imunologia Básica, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Ekrem Unal
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38010, Melikgazi, Kayseri, Turkey.,Deparment of Molecular Biology and Genetics, Gevher Nesibe Genom and Stem Cell Institution, GENKOK Genome and Stem Cell Center, Erciyes University, 38010, Melikgazi, Kayseri, Turkey
| | - Turkan Patiroglu
- Department of Pediatrics, Division of Pediatric Immunology, Faculty of Medicine, Erciyes University, 38010, Melikgazi, Kayseri, Turkey
| | - Volker Wahn
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Immunology, Labor Berlin GmbH, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health (BIH), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Margo Whiteford
- Department of Clinical Genetics, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - Rainer Doffinger
- Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge, UK
| | - Zineb Jouhadi
- Department of Pediatric Infectious Diseases, Children's Hospital CHU Ibn Rochd, University Hassan 2, Casablanca, Morocco
| | - Bodo Grimbacher
- Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. .,Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. .,German Center for Infection Research (DZIF), Satellite Center Freiburg, Freiburg, Germany. .,CIBSS - Centre for Integrative Biological Signalling Studies, Albert-Ludwigs University, Freiburg, Germany. .,RESIST - Cluster of Excellence 2155 to Hanover Medical School, Satellite Center Freiburg, Freiburg, Germany. .,CCI-Center for Chronic Immunodeficiency, Universitätsklinikum Freiburg, Breisacher Straße 115, 79106, Freiburg, Germany.
| |
Collapse
|
3
|
Petersen BS, August D, Abt R, Alddafari M, Atarod L, Baris S, Bhavsar H, Brinkert F, Buchta M, Bulashevska A, Chee R, Cordeiro AI, Dara N, Dückers G, Elmarsafy A, Frede N, Galal N, Gerner P, Glocker EO, Goldacker S, Hammermann J, Hasselblatt P, Havlicekova Z, Hübscher K, Jesenak M, Karaca NE, Karakoc-Aydiner E, Kharaghani MM, Kilic SS, Kiykim A, Klein C, Klemann C, Kobbe R, Kotlarz D, Laass MW, Leahy TR, Mesdaghi M, Mitton S, Neves JF, Öztürk B, Pereira LF, Rohr J, Restrepo JLR, Ruzaike G, Saleh N, Seneviratne S, Senol E, Speckmann C, Tegtmeyer D, Thankam P, van der Werff Ten Bosch J, von Bernuth H, Zeissig S, Zeissig Y, Franke A, Grimbacher B. Targeted Gene Panel Sequencing for Early-onset Inflammatory Bowel Disease and Chronic Diarrhea. Inflamm Bowel Dis 2017; 23:2109-2120. [PMID: 28930861 DOI: 10.1097/mib.0000000000001235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Indexed: 12/23/2022]
Abstract
BACKGROUND In contrast to adult-onset inflammatory bowel disease (IBD), where many genetic loci have been shown to be involved in complex disease etiology, early-onset IBD (eoIBD) and associated syndromes can sometimes present as monogenic conditions. As a result, the clinical phenotype and ideal disease management in these patients often differ from those in adult-onset IBD. However, due to high costs and the complexity of data analysis, high-throughput screening for genetic causes has not yet become a standard part of the diagnostic work-up of eoIBD patients. METHODS We selected 28 genes of interest associated with monogenic IBD and performed targeted panel sequencing in 71 patients diagnosed with eoIBD or early-onset chronic diarrhea to detect causative variants. We compared these results to whole-exome sequencing (WES) data available for 25 of these patients. RESULTS Target coverage was significantly higher in the targeted gene panel approach compared with WES, whereas the cost of the panel was considerably lower (approximately 25% of WES). Disease-causing variants affecting protein function were identified in 5 patients (7%), located in genes of the IL10 signaling pathway (3), WAS (1), and DKC1 (1). The functional effects of 8 candidate variants in 5 additional patients (7%) are under further investigation. WES did not identify additional causative mutations in 25 patients. CONCLUSIONS Targeted gene panel sequencing is a fast and effective screening method for monogenic causes of eoIBD that should be routinely established in national referral centers.
Collapse
Affiliation(s)
- Britt-Sabina Petersen
- 1Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany; 2Center for Chronic Immunodeficiency (CCI), DZIF Satellite Center, Medical Center, Faculty of Medicine, Germany; 3Paediatric Gastroenterology, Klinikum Nürnberg, Nuremberg, Germany; 4Laboratory of Applied Molecular Biology and Immunology, University of Abou-Bekr Belkaïd, Tlemcen, Algeria; 5Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; 6Clinic of Pediatric Allergy and Immunology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey; 7Department of Gastroenterology and Clinical Nutrition, Birmingham Children's Hospital, Birmingham, United Kingdom; 8Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 9Department of Immunology, Royal Free Hospital, London, United Kingdom; 10Primary Immunodeficiencies Unit, Hospital Dona Estefania, Pediatric University Hospital, and CEDOC, Chronic Diseases Research Center, NOVA Medical School, Lisbon, Portugal; 11Department of Pediatric Gasteroentrology and Hepatology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 12Helios Kliniken, Childrens Hospital, Krefeld, Germany; 13Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 14Paediatric Gastroenterology/Hepatology, University of Freiburg, Freiburg, Germany; 15Institute of Medical Microbiology and Hygiene, University of Freiburg, Freiburg, Germany; 16Department of Pediatrics, University Medical Center Dresden, Technische Universität Dresden, Dresden, Germany; 17Department of Medicine II, University Hospital and Medical Faculty, University Freiburg, Freiburg, Germany; 18Department of Paediatrics, Centre for Diagnosis and Treatment of Primary Immunodeficiencies, Jessenius Faculty of Medicine, Commenius University in Bratislava, Martin, Slovakia; 19Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey; 20Department of Allergy and Clinical Immunology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 21Pediatric Immunology Division, Uludag University Medical Faculty, Department of Pediatrics, Bursa, Turkey; 22Dr. von Hauner Children's Hospital, Department of Pediatrics, Ludwig-Maximilians-Universität Munich, Munich, Germany; 23Center for Chronic Immunodeficiency (CCI), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; 24Center for Pediatrics, Department of Pediatric Hematology and Oncology, University Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; 25Department of Paediatric Immunology and Infectious Diseases, Our Lady's Children's Hospital, Dublin, Ireland; 26Department of Immunology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 27Department of Paediatric Gastroenterology, St. George's Healthcare NHS Trust and University of London, London, United Kingdom; 28Department of Gastroenterology and Clinical Nutrition, Marmara University Medical Faculty, Istanbul, Turkey; 29Service of Clinical Laboratory, Division of Immunology, San Pedro De Alcántara Hospital, Cáceres, Spain; 30Bone Marrow Failure Group, Division of Pediatric Hematology and Oncology, University of Freiburg, Germany; 31Children's Hospital, University of Bonn, Germany; 32University College London Institute of Immunity and Transplantation, Royal Free Campus, London, United Kingdom; 33Department of Paediatrics, St. George's Hospital, University of London, London, United Kingdom; 34Department of Pediatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium; 35Pediatric Pneumology and Immunology, Department of Immunology, Charité University Medicine Labor Berlin Charité Vivantes GmbH, Berlin, Germany; 36Department of Medicine I, University Medical Center Dresden, Technische Universität Dresden, Dresden, Germany; 37Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany; and 38Institute of Laboratory Medicine, Brandenburg Hospital, Brandenburg Medical School, Brandenburg/Havel, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Schepp J, Proietti M, Frede N, Buchta M, Hübscher K, Rojas Restrepo J, Goldacker S, Warnatz K, Pachlopnik Schmid J, Duppenthaler A, Lougaris V, Uriarte I, Kelly S, Hershfield M, Grimbacher B. Screening of 181 Patients With Antibody Deficiency for Deficiency of Adenosine Deaminase 2 Sheds New Light on the Disease in Adulthood. Arthritis Rheumatol 2017; 69:1689-1700. [DOI: 10.1002/art.40147] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 05/04/2017] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Ignacio Uriarte
- Child & Mother Hospital Vitorio Tetamanti; Mar del Plata Argentina
| | - Susan Kelly
- Duke University School of Medicine; Durham North Carolina
| | | | - Bodo Grimbacher
- University of Freiburg, Freiburg, Germany, and Royal Free Hospital, University College London; London UK
| |
Collapse
|
5
|
Li J, Jørgensen SF, Maggadottir SM, Bakay M, Warnatz K, Glessner J, Pandey R, Salzer U, Schmidt RE, Perez E, Resnick E, Goldacker S, Buchta M, Witte T, Padyukov L, Videm V, Folseraas T, Atschekzei F, Elder JT, Nair RP, Winkelmann J, Gieger C, Nöthen MM, Büning C, Brand S, Sullivan KE, Orange JS, Fevang B, Schreiber S, Lieb W, Aukrust P, Chapel H, Cunningham-Rundles C, Franke A, Karlsen TH, Grimbacher B, Hakonarson H, Hammarström L, Ellinghaus E. Association of CLEC16A with human common variable immunodeficiency disorder and role in murine B cells. Nat Commun 2015; 6:6804. [PMID: 25891430 PMCID: PMC4444044 DOI: 10.1038/ncomms7804] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 03/03/2015] [Indexed: 02/06/2023] Open
Abstract
Common variable immunodeficiency disorder (CVID) is the most common symptomatic primary immunodeficiency in adults, characterized by B-cell abnormalities and inadequate antibody response. CVID patients have considerable autoimmune comorbidity and we therefore hypothesized that genetic susceptibility to CVID may overlap with autoimmune disorders. Here, in the largest genetic study performed in CVID to date, we compare 778 CVID cases with 10,999 controls across 123,127 single-nucleotide polymorphisms (SNPs) on the Immunochip. We identify the first non-HLA genome-wide significant risk locus at CLEC16A (rs17806056, P=2.0 × 10(-9)) and confirm the previously reported human leukocyte antigen (HLA) associations on chromosome 6p21 (rs1049225, P=4.8 × 10(-16)). Clec16a knockdown (KD) mice showed reduced number of B cells and elevated IgM levels compared with controls, suggesting that CLEC16A may be involved in immune regulatory pathways of relevance to CVID. In conclusion, the CLEC16A associations in CVID represent the first robust evidence of non-HLA associations in this immunodeficiency condition.
Collapse
Affiliation(s)
- Jin Li
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Silje F. Jørgensen
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - S. Melkorka Maggadottir
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
- Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Marina Bakay
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Klaus Warnatz
- Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg and, University of Freiburg, Freiburg, Germany
| | - Joseph Glessner
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Rahul Pandey
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Ulrich Salzer
- Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg and, University of Freiburg, Freiburg, Germany
| | - Reinhold E. Schmidt
- Clinic for Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
| | - Elena Perez
- Division of Pediatric Allergy and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Elena Resnick
- Institute of Immunology and Department of Medicine, Mount Sinai School of Medicine, New York, USA
| | - Sigune Goldacker
- Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg and, University of Freiburg, Freiburg, Germany
| | - Mary Buchta
- Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg and, University of Freiburg, Freiburg, Germany
| | - Torsten Witte
- Clinic for Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
| | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Vibeke Videm
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology. Trondheim, Norway
| | - Trine Folseraas
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Division of Cancer, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Faranaz Atschekzei
- Clinic for Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
| | - James T. Elder
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Rajan P. Nair
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Juliane Winkelmann
- Institute of Human Genetics, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
- Department of Neurology, MRI, Technische Universität München, Munich, Germany
- Synery Munich Cluster for Systems Neurology
- Stanford University, Department of Neurology and Neurosciences and Center for Sleep Sciences and Medicine, USA
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - Carsten Büning
- Department of Hepatology and Gastroenterology, Charité, Campus Mitte, Berlin, Germany
| | - Stephan Brand
- Department of Medicine II–Grosshadern, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Kathleen E. Sullivan
- Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jordan S. Orange
- Section of Immunology, Allergy, and Rheumatology, Department of Pediatric Medicine, Texas Children’s Hospital, Houston, TX, USA
| | - Børre Fevang
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious diseases, Oslo University Hospital Rikshospitalet, Norway
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology and Biobank popgen, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Pål Aukrust
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious diseases, Oslo University Hospital Rikshospitalet, Norway
| | - Helen Chapel
- Department of Clinical Immunology, Nuffield Department of Medicine, University of Oxford, UK
| | | | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Germany
| | - Tom H. Karlsen
- K.G. Jebsen Inflammation Research Centre, Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Division of Cancer, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bodo Grimbacher
- Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg and, University of Freiburg, Freiburg, Germany
| | - Hakon Hakonarson
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, USA
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lennart Hammarström
- Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Eva Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Germany
| |
Collapse
|
6
|
Stepensky P, Keller B, Buchta M, Kienzler AK, Elpeleg O, Somech R, Cohen S, Shachar I, Miosge LA, Schlesier M, Fuchs I, Enders A, Eibel H, Grimbacher B, Warnatz K. Deficiency of caspase recruitment domain family, member 11 (CARD11), causes profound combined immunodeficiency in human subjects. J Allergy Clin Immunol 2013; 131:477-85.e1. [PMID: 23374270 DOI: 10.1016/j.jaci.2012.11.050] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 11/26/2012] [Accepted: 11/29/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Profound combined immunodeficiency can present with normal numbers of T and B cells, and therefore the functional defect of the cellular and humoral immune response is often not recognized until the first severe clinical manifestation. Here we report a patient of consanguineous descent presenting at 13 months of age with hypogammaglobulinemia, Pneumocystis jirovecii pneumonia, and a suggestive family history. OBJECTIVE We sought to identify the genetic alteration in a patient with combined immunodeficiency and characterize human caspase recruitment domain family, member 11 (CARD11), deficiency. METHODS Molecular, immunologic, and functional assays were performed. RESULTS The immunologic characterization revealed only subtle changes in the T-cell and natural killer cell compartment, whereas B-cell differentiation, although normal in number, was distinctively blocked at the transitional stage. Genetic evaluation revealed a homozygous deletion of exon 21 in CARD11 as the underlying defect. This deletion abrogated protein expression and activation of the canonical nuclear factor κB (NF-κB) pathway in lymphocytes after antigen receptor or phorbol 12-myristate 13-acetate stimulation, whereas CD40 signaling in B cells was preserved. The abrogated activation of the canonical NF-κB pathway was associated with severely impaired upregulation of inducible T-cell costimulator, OX40, cytokine production, proliferation of T cells, and B cell-activating factor receptor expression on B cells. CONCLUSION Thus in patients with CARD11 deficiency, the combination of impaired activation and especially upregulation of inducible T-cell costimulator on T cells, together with severely disturbed peripheral B-cell differentiation, apparently leads to a defective T-cell/B-cell cooperation and probably germinal center formation and clinically results in severe immunodeficiency. This report discloses the crucial and nonredundant role of canonical NF-κB activation and specifically CARD11 in the antigen-specific immune response in human subjects.
Collapse
Affiliation(s)
- Polina Stepensky
- Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Warnatz K, Baerbel K, Buchta M, Kienzler AK, Elpeleg O, Somech R, Cohen S, Shachar I, Miosge L, Schlesier M, Fuchs I, Enders A, Eibel H, Grimbacher B, Stapansky P. Human CARD11 deficiency causes profound combined immunodeficiency (P3325). The Journal of Immunology 2013. [DOI: 10.4049/jimmunol.190.supp.175.10] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Patients with primary immunodeficiency present an excellent opportunity to understand the role of specific molecules in the human immune system. Recently we had the chance to investigate a young girl with a complete CARD11 deficiency due to a homozygous deletion of exon 21. Clinically the child presented with increased susceptibility to respiratory tract infections at 6 months, before she was diagnosed at 13 months with Pneumocystis jirovecii revealing her combined immunodeficiency. The immunological characterization showed severe hypogammaglobulinemia, but normal T-, B- and NK-cell numbers. While there were only subtle changes in the T cell compartment, B-cell differentiation was blocked at the transitional stage. In the absence of CARD11 protein expression activation of the canonical NF-κB pathway after antigen receptor or PMA stimulation was abrogated, while CD40 signaling in B cells was preserved. CARD11 deficient T cells were severely impaired in the up-regulation of ICOS, OX40, cytokine production and proliferation after TCR stimulation. On B cells BAFF receptor expression was reduced and after activation ICAM1 and CD25 were not induced while CD86 induction was comparable to control cells. Immunoglobulin production was intact after anti-IL-21/CD40L stimulation, demonstrating that plasma cell differentiation was not dependent on intact CARD11. Thus CARD11 plays a crucial, non-redundant role in the antigen specific immune response in humans.
Collapse
Affiliation(s)
- Klaus Warnatz
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Keller Baerbel
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Mary Buchta
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Anne-Kathrin Kienzler
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Orly Elpeleg
- 3Monique and Jacques Roboh Department of Genetic Research, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Raz Somech
- 4Edmond and Lily Safra Children's Hospital, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Cohen
- 5Immunology Department, Weizmann Institute of Science, Rehovot, Israel
| | - Idit Shachar
- 5Immunology Department, Weizmann Institute of Science, Rehovot, Israel
| | - Lisa Miosge
- 6Department of Immunology, The John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Michael Schlesier
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Ilka Fuchs
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Anselm Enders
- 7Ramaciotti Immunization Genomics Laboratory, Department of Immunology, The John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Hermann Eibel
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Bodo Grimbacher
- 1Centre of Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Polina Stapansky
- 2Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| |
Collapse
|
8
|
Kiesswetter E, Schäper M, Buchta M, Schaller KH, Rossbach B, Kraus T, Letzel S. Longitudinal study on potential neurotoxic effects of aluminium: II. Assessment of exposure and neurobehavioral performance of Al welders in the automobile industry over 4 years. Int Arch Occup Environ Health 2010; 82:1191-210. [DOI: 10.1007/s00420-009-0414-9] [Citation(s) in RCA: 20] [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] [Received: 09/25/2008] [Accepted: 03/03/2009] [Indexed: 10/21/2022]
|
9
|
Cascón A, Landa I, López-Jiménez E, Díez-Hernández A, Buchta M, Montero-Conde C, Leskelä S, Leandro-García LJ, Letón R, Rodríguez-Antona C, Eng C, Neumann HPH, Robledo M. Molecular characterisation of a common SDHB deletion in paraganglioma patients. J Med Genet 2007; 45:233-8. [PMID: 18057081 DOI: 10.1136/jmg.2007.054965] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hereditary susceptibility to familial paraganglioma syndromes is mainly due to mutations in one of six genes, including three of the four genes encoding the subunits of the mitochondrial succinate dehydrogenase complex II. Although prevalence, penetrance and clinical characteristics of patients carrying point mutations affecting the genes encoding succinate dehydrogenase have been well studied, little is known regarding these clinical features in patients with gross deletions. Recently, we found two unrelated Spanish families carrying the previously reported SDHB exon 1 deletion, and suggested that this chromosomal region could be a hotspot deletion area. METHODS We present the molecular characterisation of this apparently prevalent mutation in three new families, and discuss whether this recurrent mutation is due either to the presence of a founder effect or to a hotspot. RESULTS The breakpoint analysis showed that all Iberian Peninsular families described harbour the same exon 1 deletion, and that a different breakpoint junction segregates in an affected French pedigree. CONCLUSIONS After haplotyping the SDHB region, we concluded that the deletion detected in Iberian Peninsular people is probably due to a founder effect. Regarding the clinical characteristics of patients with this alteration, it seems that the presence of gross deletions rather than point mutations is more likely related to abdominal presentations and younger age at onset. Moreover, we found for the first time a patient with neuroblastoma and a germline SDHB deletion, but it seems that this paediatric neoplasia in a pheochromocytoma family is not a key component of this disease.
Collapse
|
10
|
Kiesswetter E, Schäper M, Buchta M, Schaller KH, Rossbach B, Scherhag H, Zschiesche W, Letzel S. Longitudinal study on potential neurotoxic effects of aluminium: I. Assessment of exposure and neurobehavioural performance of Al welders in the train and truck construction industry over 4 years. Int Arch Occup Environ Health 2007; 81:41-67. [PMID: 17522885 DOI: 10.1007/s00420-007-0191-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [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: 08/10/2006] [Accepted: 03/01/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Previous cross sectional studies on potential neurotoxic effects of long-term aluminium exposures by aluminium welders lack clear interpretable results for methodological reasons. The present longitudinal study examined on the one hand the reliability and representativity of Al-biomonitoring as indicator of individual long-term exposure and on the other hand the long-term changes of neurobehavioural performance in Al welders in relation to Al exposure and neurobehavioural performance changes of a non-exposed control group. METHODS The longitudinal study compared repeatedly measured exposure data and neurobehavioural data of 20, initially 44, male Al welders in the train and truck construction industry with data of a control group of similar age on the basis of three investigations over a period of 4 years. The repeated measurements of exposure included total dust in air as well as Al in pre- and post-shift plasma and urine samples. Neurobehavioural methods comprised symptoms, verbal intelligence, logic thinking, psychomotor behaviour, memory, and attention. Computer-aided tests from the Motor Performance Series (MLS) and the European Neurobehavioural Evaluation System (EURO-NES) were used. The characteristics of the biomonitoring data and the relationship to neurobehavioural data were examined with methods of correlation and regression analysis. The courses of neurobehavioural changes were analysed with multivariate covariance-analytical methods (MANCOVA) considering the covariates age, indicators of 'a priori' intelligence differences (education or 'premorbid' intelligence), and alcohol consumption (carbohydrate-deficient transferrin in plasma, CDT). RESULTS The mean total dust load during welding, near to the routinely worn ventilated helmets, was in the range of 5-8 mg/m(3). The biomonitoring data of the welders (pre-shift: 88-140 microg Al/g creatinine in urine; 13-16 microg Al/l plasma) showed a high long-term stability but also sensitivity to acute shift dependent exposure changes. The Al welders who had been working in this profession at an average of 15 years showed no significantly increased symptom levels compared with the control group. Explorative regression and covariance analyses revealed neither a correlation between biomonitoring and performance variables nor a significant difference between Al-exposed and controls in the performance courses during the 4 years period. Explorative modelling indicated that the structure of neurobehavioural outcomes could be determined by possible indicators of intellectual 'a priori' (premorbid) differences between subjects but not by their exposure information. CONCLUSIONS Compared to studies in the literature this study is characterized by relatively high and non-confounded Al exposure of the welders, a repeated-measurement design, and multivariate analyses. However, the long-term stable interindividual differences of internal Al exposure were not related to interindividual differences in neurobehavioural performances. Additionally, the lack of processual changes of neurobehavioural performances during the observation phase and the insignificant group differences do not make it very probable that degenerative processes caused by Al had happened before study onset or stopped just at this time point.
Collapse
Affiliation(s)
- E Kiesswetter
- Institute for Occupational Physiology, University of Dortmund, Ardeystr. 67, 44139 Dortmund, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Jegorov A, Buchta M, Sedmera P, Kuzma M, Havlicek V. Accurate product ion mass spectra of galanthamine derivatives. J Mass Spectrom 2006; 41:544-8. [PMID: 16541391 DOI: 10.1002/jms.1015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
|
12
|
Buchta M, Jegorov A, Hušák M, Cejka J, Kratochvíl B, Kuzma B, Sedmera P. Crystal structure of taxuspinanane A acetonitrile solvate, C47H59NO14 · CH3CN. Z KRIST-NEW CRYST ST 2006. [DOI: 10.1524/ncrs.2006.221.14.97] [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]
|
13
|
Buchta M, Jegorov A, Hušák M, Čejka J, Kratochvíl B, Kuzma M, Sedmera P. Crystal structure of taxuspinanane A acetonitrile solvate, C47H59NO14 · CH3CN. Z KRIST-NEW CRYST ST 2006. [DOI: 10.1524/ncrs.2006.221.1.97] [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: 11/24/2022]
Abstract
Abstract C49H62N2O14, orthorhombic, P212121 (no. 19), a = 9.46370(3)Å, b = 12.29468(3) Å, c = 40.46176(4) Å, V = 4707.9 Å3, Z = 4, Rgt(F) = 0.102, wRref(F) = 0.099, T = 150 K.
Collapse
Affiliation(s)
- M. Buchta
- 1IVAX Pharmaceuticals, Research and Development, Ostravská 29, 747 70 Opava, Czech Republic
| | - A. Jegorov
- 2IVAX Pharmaceuticals, Research and Development, Branišovská 31, 370 05 České Budějovice, Czech Republic
| | - M. Hušák
- 3Prague Institute of Chemical Technology, Department of Solid State Chemistry, Technická 5, 166 28 Prague 6, Czech Republic
| | - J. Čejka
- 3Prague Institute of Chemical Technology, Department of Solid State Chemistry, Technická 5, 166 28 Prague 6, Czech Republic
| | - B. Kratochvíl
- 3Prague Institute of Chemical Technology, Department of Solid State Chemistry, Technická 5, 166 28 Prague 6, Czech Republic
| | - M. Kuzma
- 4Academy of Sciences of the Czech Republic, Institute of Microbiology, Vídeňská 1083, 142 20 Prague 4, Czech Republic
| | - P. Sedmera
- 4Academy of Sciences of the Czech Republic, Institute of Microbiology, Vídeňská 1083, 142 20 Prague 4, Czech Republic
| |
Collapse
|
14
|
Schiavi F, Boedeker CC, Bausch B, Peçzkowska M, Gomez CF, Strassburg T, Pawlu C, Buchta M, Salzmann M, Hoffmann MM, Berlis A, Brink I, Cybulla M, Muresan M, Walter MA, Forrer F, Välimäki M, Kawecki A, Szutkowski Z, Schipper J, Walz MK, Pigny P, Bauters C, Willet-Brozick JE, Baysal BE, Januszewicz A, Eng C, Opocher G, Neumann HPH. Predictors and prevalence of paraganglioma syndrome associated with mutations of the SDHC gene. JAMA 2005; 294:2057-63. [PMID: 16249420 DOI: 10.1001/jama.294.16.2057] [Citation(s) in RCA: 233] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Paraganglioma syndrome includes inherited head and neck paragangliomas (HNPs) and adrenal or extra-adrenal pheochromocytomas and are classified according to the susceptibility genes SDHB, SDHC, and SDHD. In contrast with those with germline mutations of the SDHB and SDHD genes, clinical and genetic data on patients with mutations of SDHC are scarce. OBJECTIVE To determine the prevalence and clinical characteristics of SDHC mutation carriers compared with patients with SDHB and SDHD mutations and with sporadic cases. DESIGN, SETTING, AND PATIENTS Genetic screening for SDHC mutations in an international HNP registry of 121 unrelated index cases and in 371 sporadic cases from a pheochromocytoma registry, conducted January 1, 2001, until December 31, 2004. Identified index cases and affected relatives were clinically evaluated. MAIN OUTCOME MEASURES Prevalence of and clinical findings for SDHC mutation-associated HNPs vs those with SDHB and SDHD mutations. RESULTS The prevalence of SDHC carriers was 4% in HNP but 0% in pheochromocytoma index cases. None of the SDHC mutation carriers had signs of pheochromocytoma. We compared HNPs in 22 SDHC mutation carriers with the HNPs of SDHB (n = 15) and SDHD (n = 42) mutation carriers and with 90 patients with sporadic HNPs. Location, number of tumors, malignancy, and age were different: more carotid body tumors were found in SDHC (13/22 [59%]) than in sporadic HNPs (29/90 [32%], P = .03), as well as fewer instances of multiple tumors in SDHC (2/22) than in SDHD (24/42; P<.001), 0 malignant tumors in SDHC vs 6/15 in SDHB (P = .002), and younger age at diagnosis in SDHC than in sporadic HNPs (45 vs 52 years; P = .03). CONCLUSIONS Patients with HNP, but not those with pheochromocytoma, harbor SDHC mutations in addition to those in SDHB and SDHD. In total, more than one quarter of HNP patients carry a mutation in 1 of these 3 genes. Head and neck paragangliomas associated with SDHC mutations are virtually exclusively benign and seldom multifocal. Analysis for germline mutations of SDHC is recommended in apparently sporadic HNP to identify risk of inheritance.
Collapse
|
15
|
Neumann HPH, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C. Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. JAMA 2004; 292:943-51. [PMID: 15328326 DOI: 10.1001/jama.292.8.943] [Citation(s) in RCA: 656] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
CONTEXT Germline mutations of the genes encoding succinate dehydrogenase subunits B (SDHB) and D (SDHD) predispose to paraganglioma syndromes type 4 (PGL-4) and type 1 (PGL-1), respectively. In both syndromes, pheochromocytomas as well as head and neck paragangliomas occur; however, details for individual risks and other clinical characteristics are unknown. OBJECTIVE To determine the differences in clinical features in carriers of SDHB mutations and SDHD mutations. DESIGN, SETTING, AND PATIENTS Population-based genetic screening for SDHB and SDHD germline mutations in 417 unrelated patients with adrenal or extra-adrenal abdominal or thoracic pheochromocytomas (n = 334) or head and neck paragangliomas (n = 83), but without syndromic features, from 2 registries based in Germany and central Poland, conducted from April 1, 2000, until May 15, 2004. MAIN OUTCOME MEASURES Demographic and clinical findings with respect to gene mutation in SDHB vs SDHD compared with nonmutation carriers. RESULTS A total of 49 (12%) of 417 registrants carried SDHB or SDHD mutations. In addition, 28 SDHB and 23 SDHD mutation carriers were newly detected among relatives of these carriers. Comparison of 53 SDHB and 47 SDHD total mutation carriers showed similar ages at diagnosis but differences in penetrance and of tumor manifestations. Head and neck paragangliomas (10/32 vs 27/34, respectively, P<.001) and multifocal (9/32 vs 25/34, respectively, P<.001) tumors were more frequent in carriers of SDHD mutations. In contrast, SDHB mutation carriers have an increased frequency of malignant disease (11/32 vs 0/34, P<.001). Renal cell cancer was observed in 2 SDHB mutation carriers and papillary thyroid cancer in 1 SDHB mutation carrier and 1 SDHD mutation carrier. CONCLUSIONS In contrast with SDHD mutation carriers (PGL-1) who have more frequent multifocal paragangliomas, SDHB mutation carriers (PGL-4) are more likely to develop malignant disease and possibly extraparaganglial neoplasias, including renal cell and thyroid carcinomas. Appropriate and timely clinical screening is recommended in all patients with PGL-1 and PGL-4.
Collapse
Affiliation(s)
- Hartmut P H Neumann
- Department of Nephrology and Hypertension, Albert-Ludwigs-University, Freiburg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Vanharanta S, Buchta M, McWhinney SR, Virta SK, Peçzkowska M, Morrison CD, Lehtonen R, Januszewicz A, Järvinen H, Juhola M, Mecklin JP, Pukkala E, Herva R, Kiuru M, Nupponen NN, Aaltonen LA, Neumann HPH, Eng C. Early-onset renal cell carcinoma as a novel extraparaganglial component of SDHB-associated heritable paraganglioma. Am J Hum Genet 2004; 74:153-9. [PMID: 14685938 PMCID: PMC1181902 DOI: 10.1086/381054] [Citation(s) in RCA: 290] [Impact Index Per Article: 14.5] [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: 08/20/2003] [Accepted: 10/08/2003] [Indexed: 01/22/2023] Open
Abstract
Hereditary paraganglioma syndrome has recently been shown to be caused by germline heterozygous mutations in three (SDHB, SDHC, and SDHD) of the four genes that encode mitochondrial succinate dehydrogenase. Extraparaganglial component neoplasias have never been previously documented. In a population-based registry of symptomatic presentations of phaeochromocytoma/paraganglioma comprising 352 registrants, among whom 16 unrelated registrants were SDHB mutation positive, one family with germline SDHB mutation c.847-50delTCTC had two members with renal cell carcinoma (RCC), of solid histology, at ages 24 and 26 years. Both also had paraganglioma. A registry of early-onset RCCs revealed a family comprising a son with clear-cell RCC and his mother with a cardiac tumor, both with the germline SDHB R27X mutation. The cardiac tumor proved to be a paraganglioma. All RCCs showed loss of the remaining wild-type allele. Our observations suggest that germline SDHB mutations can predispose to early-onset kidney cancers in addition to paragangliomas and carry implications for medical surveillance.
Collapse
Affiliation(s)
- Sakari Vanharanta
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Mary Buchta
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Sarah R. McWhinney
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Sanna K. Virta
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Mariola Peçzkowska
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Carl D. Morrison
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Rainer Lehtonen
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Andrzej Januszewicz
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Heikki Järvinen
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Matti Juhola
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Jukka-Pekka Mecklin
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Eero Pukkala
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Riitta Herva
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Maija Kiuru
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Nina N. Nupponen
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Lauri A. Aaltonen
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Hartmut P. H. Neumann
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Charis Eng
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Second Department of Surgery, Helsinki University Central Hospital, and Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu, Helsinki; Departments of Pathology and Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland; Department of Pathology, Oulu University Hospital, Oulu, Finland; Division of Nephrology and Hypertension, Albert Ludwigs-University of Freiburg, Freiburg, Germany; Institute of Cardiology, Warsaw; Clinical Cancer Genetics and Human Cancer Genetics Programs, Comprehensive Cancer Center, Department of Molecular Genetics, Division of Human Genetics, Department of Internal Medicine, and Department of Pathology, The Ohio State University, Columbus; and Cancer Research UK Human Cancer Genetics Research Group, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
17
|
Buchta M, Kiesswetter E, Otto A, Schaller KH, Seeber A, Hilla W, Windorfer K, Stork J, Kuhlmann A, Gefeller O, Letzel S. Longitudinal study examining the neurotoxicity of occupational exposure to aluminium-containing welding fumes. Int Arch Occup Environ Health 2003; 76:539-48. [PMID: 12838425 DOI: 10.1007/s00420-003-0450-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [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: 09/13/2002] [Accepted: 04/16/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The neurotoxicity of occupational exposure to aluminium (Al)-containing welding fumes has been discussed with controversial results. The aim of the longitudinal study was to examine a group of Al welders for significant central nervous changes in comparison with a non-exposed cohort. METHODS A group of 98 Al welders (mean age 37 years) in the car-body construction industry, with a median of 6 years of occupational exposure to Al welding fumes, and an education-matched, gender-matched, age-matched control group of 50 car-production workers (mean age 36 years) at the same plant, were included in this longitudinal study. Two cross-sectional studies were done in 1999 and 2001. In the second cross-sectional study 97 welders and 50 controls could be examined. The examination programme consisted, for example, of a standardised anamnesis, focussing on occupational history, education, illnesses, medication, accidents and current alcohol consumption, a physical examination that included neurological status, and the assessment of Al concentration in plasma and urine. The neurobehavioral methods included a symptom questionnaire, modified Q16, and computerised and non-computerised tests: psychomotor performance (steadiness, line tracing, aiming, tapping), verbal intelligence (WST), simple reaction time, digit span, block design (HAWIE), symbol-digit substitution, digit span, switching attention (European neurobehavioral evaluation system, EURO-NES), and standard progressive matrices. The data were analysed by multivariate analysis of covariance (MANCOVA) for repeated measurements with covariates age, education, and carbohydrate-deficient transferrin in plasma (CDT). RESULTS. The median Al urine concentration (mean preshift/postshift) was 52.4 microg/g creatinine (2001) and 57.6 microg/g creatinine (1999). Median respirable air dust was 0.67 mg/m(3) (2001) and 0.47 mg/m(3) (1999). Welders and controls did not report significantly more symptoms in the modified Q16. Furthermore, no significant differences in psychomotor performance and other neurobehavioral tasks, except for reaction time, were seen between welders and non-welders. Regression analyses reveal a significant relationship between reaction time and Al excretion in urine that was confounded by other factors. CONCLUSIONS At present the outcome for reaction time has to be interpreted as a single result. However, as the modified Q16 questionnaire and the rest of the psychomotor performance showed no significant changes, the next cross-sectional study, in 2003, will provide further information on which a final conclusion can be based.
Collapse
Affiliation(s)
- M Buchta
- Institute for Occupational, Social, and Environmental Medicine, University of Mainz, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Brand P, Letzel S, Buchta M, Scheuch G, Windorfer K, Hilla W, Smith HJ, Kraus T. Can aerosol-derived airway morphometry detect early, asymptomatical lung emphysema? J Aerosol Med 2003; 16:143-51. [PMID: 12823908 DOI: 10.1089/089426803321919906] [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] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The aerosol-derived airway morphometry technique (ADAM) can be used to assess non-invasively peripheral airspace dimensions. It has been shown that this technique can identify permanent peripheral airspace enlargement in patients with lung emphysema, but it is yet unknown if early stages of emphysema can be detected. In this study, 89 aluminum welders were investigated. Although all (except two subjects) showed normal spirometry, in 29% of the subjects visual signs of early emphysema were observed with high-resolution computed tomography (HRCT) in a previous study. Using the ADAM technique, 28% of the subjects showed increased peripheral airspace dimensions. However, both groups with positive findings overlapped only in about half of the cases. Peripheral airspace dimensions correlated significantly with the mean lung density calculated from the HRCT scans, and lung density was significantly decreased in the group with increased airspace dimensions. The poor overlap of the positive findings observed with both techniques can be explained if it is considered that the visual HRCT technique and ADAM focus on different aspects of emphysematous changes in the lungs. Whereas visual HRCT is a powerful tool to identify focal changes in lung density but cannot detect mild homogeneous emphysema, ADAM delivers a measure for homogeneously distributed emphysema but cannot detect focal emphysema or regions with emphysema which are badly ventilated. Since ADAM is easy to perform, non-invasive, and can be repeatedly applied to human subjects without radiological concerns, this technique might become a useful tool for the detection and monitoring of lung emphysema in occupational medicine, epidemiology, and pharmaceutics.
Collapse
Affiliation(s)
- P Brand
- GSF Research Center for Environment and Health, Institute for Inhalation Biology, Clinical Research Group: Aerosols in Medicine, Gauting, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
NMR studies showed that 11-demethylcyclosporin A (cyclosporin E) and 11-demethylcyclosporin B exist as single species both in polar and nonpolar solvents. They adopt the same conformation that was found in the solid state.
Collapse
Affiliation(s)
- P Sedmera
- Institute of Microbiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
| | | | | | | |
Collapse
|
20
|
Strejc P, Gross R, Buchta M. [Polychlorinated biphenyls in human subepicardial fat]. Soud Lek 1997; 42:2-4. [PMID: 9221513] [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: 02/04/2023]
Abstract
A considerable relation between myocardial fatty infiltration (lipomatosis) and ischemic lesion of myocardium was proved by authors else where. This time, polychlorinated biphenyls (PCB) wee studied in subepicardial fat as well as in subcutaneous fat in thorax and abdomen of deceased person after sudden and violent death. For the time being, most published results concerned the abdominal subcutaneous fat. All the published results showed high concentrations of PCB were proved in subcutaneous fat tissue from thorax and abdominal area and specially in subepicardial fat. Topical relation of PCB deposits and heart muscle was direct in all analyzed case because of fatty infiltration of myocardium. Obviously, a direct toxic effect of PCB on myocardium can take place in stress lypolysis e.g. associated with heart infarct (in some animals hydropericardium and impairment of parenchymatous organs were observed) and prognosis of patients with ischemic lesion can get worser.
Collapse
Affiliation(s)
- P Strejc
- Ustav soudního lékarství 1. LF UK, Praha
| | | | | |
Collapse
|