Creatine transporter-deficient rat model shows motor dysfunction, cerebellar alterations, and muscle creatine deficiency without muscle atrophy

Creatine (Cr) is a nitrogenous organic acid and plays roles such as fast phosphate energy buffer to replenish ATP, osmolyte, antioxidant, neuromodulator, and as a compound with anabolic and ergogenic properties in muscle. Cr is taken from the diet or endogenously synthetized by the enzymes arginine:glycine amidinotransferase and guanidinoacetate methyltransferase, and specifically taken up by the transporter SLC6A8. Loss-of-function mutations in the genes encoding for the enzymes or the transporter cause creatine deficiency syndromes (CDS). CDS are characterized by brain Cr deficiency, intellectual disability with severe speech delay, behavioral troubles, epilepsy, and motor dysfunction. Among CDS, the X-linked Cr transporter deficiency (CTD) is the most prevalent with no efficient treatment so far. Different animal models of CTD show reduced brain Cr levels, cognitive deficiencies, and together they cover other traits similar to those of patients. However, motor function was poorly explored in CTD models, and some controversies in the phenotype exist in comparison with CTD patients. Our recently described Slc6a8^Y389C knock-in rat model of CTD showed mild impaired motor function, morphological alterations in cerebellum, reduced muscular mass, Cr deficiency, and increased guanidinoacetate content in muscle, although no consistent signs of muscle atrophy. Our results indicate that such motor dysfunction co-occurred with both nervous and muscle dysfunctions, suggesting that muscle strength and performance as well as neuronal connectivity might be affected by this Cr deficiency in muscle and brain.

Trichinosis: a prospective controlled study of patients ten years after acute infection

The existence of chronic trichinosis as a disease entity is still a matter of debate. For 10 years after an outbreak of infection with Trichinella spiralis, we conducted a prospective controlled study of the patients involved. At the termination of this investigation, we undertook clinical, biochemical, serological, immunologic, neuroradiological, radiological, and psychological studies of 128 originally infected persons and 16 controls. The categories of symptoms most often documented in persons who had been infected were muscular (90%), ocular (59%), neurological (52%), and psychological (52%). Impaired muscle strength (56%), conjunctivitis (55%), and impaired coordination (32%) were the clinical manifestations most frequently encountered. Thirty-eight percent of the 128 originally infected patients still had IgG antibodies to T. spiralis after 10 years. Magnetic resonance imaging of the brain revealed no abnormalities. No calcifications of residual larvae were detected by mammography or muscle biopsy. The level of performance in psychometric tests was lower in the originally infected population than in the general population. Although patients who had had trichinosis differed significantly from controls in terms of a variety of parameters even after 10 years, we found insufficient evidence on which to conclude that chronic trichinosis exists as a distinct entity.

[Crohn's disease-- 10 years' experience at a city hospital]

Between 1977 and 1986, 92 patients with Crohn's disease (53 females and 39 males, average age 32 years at diagnosis) were admitted for a total of 158 hospital stays at the St. Claraspital, Basel. In 71 cases the diagnosis was based on one or more of radiologic and endoscopic evaluation and/or operative findings. In 4 cases diagnosis was based solely on clinical findings and in the remaining 17 the original diagnostic workup could not be evaluated retrospectively. 65% of cases were histologically proven, while the rest of the patients were either not biopsied or biopsy yielded inconclusive results. Crohn's disease was located simultaneously in the small and large bowels in 41 patients, in the small bowel only in 23 (25%) and in the large bowel only in 20 (22%). The remaining localizations were either proximal GI tract or anal region only. Surgery was performed a total of 65 times in 44 of the 92 patients (48%), the most frequent procedures being ileocecal resection and surgical treatment of perianal fistulas and abscesses. Accordingly, the main indications for surgery were perianal complications (37%) and stenotic bowel lesions (29%). The resection rate was higher in ileal (35%) than in colorectal (25%) involvement. The 3 rectal amputations eventually necessary were all in patients with anorectal involvement.