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Ślęczkowska M, Almomani R, Marchi M, Salvi E, de Greef BTA, Sopacua M, Hoeijmakers JGJ, Lindsey P, Waxman SG, Lauria G, Faber CG, Smeets HJM, Gerrits MM. Peripheral Ion Channel Genes Screening in Painful Small Fiber Neuropathy. Int J Mol Sci 2022; 23:ijms232214095. [PMID: 36430572 PMCID: PMC9696564 DOI: 10.3390/ijms232214095] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Abstract
Neuropathic pain is a characteristic feature of small fiber neuropathy (SFN), which in 18% of the cases is caused by genetic variants in voltage-gated sodium ion channels. In this study, we assessed the role of fifteen other ion channels in neuropathic pain. Patients with SFN (n = 414) were analyzed for ANO1, ANO3, HCN1, KCNA2, KCNA4, KCNK18, KCNN1, KCNQ3, KCNQ5, KCNS1, TRPA1, TRPM8, TRPV1, TRPV3 and TRPV4 variants by single-molecule molecular inversion probes-next-generation sequencing. These patients did not have genetic variants in SCN3A, SCN7A-SCN11A and SCN1B-SCN4B. In twenty patients (20/414, 4.8%), a potentially pathogenic heterozygous variant was identified in an ion-channel gene (ICG). Variants were present in seven genes, for two patients (0.5%) in ANO3, one (0.2%) in KCNK18, two (0.5%) in KCNQ3, seven (1.7%) in TRPA1, three (0.7%) in TRPM8, three (0.7%) in TRPV1 and two (0.5%) in TRPV3. Variants in the TRP genes were the most frequent (n = 15, 3.6%), partly in patients with high mean maximal pain scores VAS = 9.65 ± 0.7 (n = 4). Patients with ICG variants reported more severe pain compared to patients without such variants (VAS = 9.36 ± 0.72 vs. VAS = 7.47 ± 2.37). This cohort study identified ICG variants in neuropathic pain in SFN, complementing previous findings of ICG variants in diabetic neuropathy. These data show that ICG variants are central in neuropathic pain of different etiologies and provides promising gene candidates for future research.
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Affiliation(s)
- Milena Ślęczkowska
- Department of Toxicogenomics, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Rowida Almomani
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Margherita Marchi
- Neuroalgology Unit, IRCCS Foundation “Carlo Besta” Neurological Institute, 20133 Milan, Italy
| | - Erika Salvi
- Neuroalgology Unit, IRCCS Foundation “Carlo Besta” Neurological Institute, 20133 Milan, Italy
| | - Bianca T A de Greef
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Maurice Sopacua
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Janneke G J Hoeijmakers
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Patrick Lindsey
- Department of Toxicogenomics, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Stephen G Waxman
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA
- Center for Neuroscience and Regeneration Research, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Giuseppe Lauria
- Neuroalgology Unit, IRCCS Foundation “Carlo Besta” Neurological Institute, 20133 Milan, Italy
| | - Catharina G Faber
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
- Correspondence:
| | - Hubert J M Smeets
- Department of Toxicogenomics, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands
| | - Monique M Gerrits
- Department of Clinical Genetics, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands
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Haroutounian S, Todorovic MS, Leinders M, Campagnolo M, Gewandter JS, Dworkin RH, Freeman R. Diagnostic criteria for idiopathic small fiber neuropathy: A systematic review. Muscle Nerve 2020; 63:170-177. [PMID: 32989823 DOI: 10.1002/mus.27070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 02/28/2020] [Revised: 09/05/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
Idiopathic small fiber neuropathy (iSFN) lacks broadly accepted diagnostic criteria, which hinders its timely diagnosis and treatment. A systematic literature review was performed to assess the published screening and diagnostic criteria for iSFN, excluding studies where SFN was of well-established etiology. Eighty-four clinical studies and seven guideline/review publications were included in this systematic review. Substantial heterogeneity existed in iSFN diagnostic criteria. The most common set of criteria to diagnose iSFN [presence of any symptoms of iSFN, absence of large fiber involvement, and reduced intraepidermal nerve fiber density (IENFD)] was used in only 14% of studies. Mandatory individual criteria to confirm iSFN included any sensory symptoms (60% of studies), pain (19% of studies), small fiber signs (20% of studies), absence of large fiber signs (62% of studies), reduced IENFD (38% of studies), and autonomic symptoms (1% of studies). This review highlights a clear need for standardized, evidence-based guidelines for diagnosing iSFN.
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Affiliation(s)
- Simon Haroutounian
- Washington University Pain Center and Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Marko S Todorovic
- Washington University Pain Center and Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Mathias Leinders
- Washington University Pain Center and Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Marta Campagnolo
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer S Gewandter
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Robert H Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine, Rochester, New York, USA
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Descamps E, Henry J, Labeyrie C, Adams D, Ghaidaa AN, Vandendries C, Adam C, Aiello D, Mariette X, Seror R. Small fiber neuropathy in Sjögren syndrome: Comparison with other small fiber neuropathies. Muscle Nerve 2020; 61:515-520. [PMID: 32012291 DOI: 10.1002/mus.26824] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 01/19/2020] [Accepted: 01/28/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION We compared histological and clinical profiles of primary Sjögren syndrome (pSS) small fiber neuropathy (SFN; pSS-SFN) with idiopathic SFN (i-SFN) and hereditary transthyretin amyloidosis SFN (hATTR-SFN) and described the evolution of pSS-SFN. METHODS All patients with pSS-SFN, i-SFN, and hATTR-SFN confirmed by reduced intraepidermal nerve fiber density on skin biopsy were retrospectively included, and their characteristics were compared. To analyze prognosis of pSS-SFN, patients prospectively underwent a second evaluation. RESULTS Fifteen pSS-SFN, 17 hATTR-SFN, and 11 i-SFN were included. Time to diagnosis SFN was longer in pSS-SFN and i-SFN than in hATTR-SFN. Painful and non-length-dependent patterns were more frequent in pSS-SFN than in hATTR-SFN. Twelve (80%) patients with pSS-SFN had a non-length-dependent pattern. Ten patients with pSS were reassessed after 3.1 years (1.7-4.7); none developed large fiber neuropathy linked to pSS. DISCUSSION Primary Sjögren syndrome SFN is characterized by a more frequent non-length-dependent pattern compared with i-SFN and hATTR-SFN. Primary Sjögren syndrome SFN did not evolve through large fiber neuropathy.
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Affiliation(s)
- Elise Descamps
- Department of Rheumatology; National Reference Center for Sjögren Syndrome and Rare Autoimmune Diseases, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, AP-HP, Le Kremlin Bicêtre, France
| | - Julien Henry
- Department of Rheumatology; National Reference Center for Sjögren Syndrome and Rare Autoimmune Diseases, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, AP-HP, Le Kremlin Bicêtre, France
| | - Céline Labeyrie
- Department of Neurology; National Reference Center for Amyloidosis Neuropathies and Other Rare Peripheral Neuropathies, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France
| | - David Adams
- Department of Neurology; National Reference Center for Amyloidosis Neuropathies and Other Rare Peripheral Neuropathies, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France
| | - Adebs Nasser Ghaidaa
- Department of Neuroradiology, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France
| | | | - Clovis Adam
- Department of Anatomopathology, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France
| | - David Aiello
- Department of Neurology; National Reference Center for Amyloidosis Neuropathies and Other Rare Peripheral Neuropathies, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology; National Reference Center for Sjögren Syndrome and Rare Autoimmune Diseases, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, AP-HP, Le Kremlin Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology; National Reference Center for Sjögren Syndrome and Rare Autoimmune Diseases, Université Paris-Saclay; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, AP-HP, Le Kremlin Bicêtre, France
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