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1.
Vaccimonitor (La Habana, Print) ; 28(1)ene.-abr. 2019. tab, graf
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-1094616

ABSTRACT

Con la finalidad de evaluar la patogenia en cepas de Salmonella Typhimurium con mutaciones en los genes invG/invE de la Isla de Patogenicidad de Salmonella 1 (SPI-1) y de los genes ssaJ/ssaK en la SPI-2, se evaluaron los modelos asa intestinal ligada de ratón asociado a la observación de los tejidos por microscopía electrónica de transmisión (MET) y la producción de salmonelosis sistémica en ratón. Para ello, se utilizaron seis cepas de Salmonella: S. Typhimurium SL-1344 (cepa control) y sus derivadas mutantes: ∆invEG S. Typhimurium SL-1344 (mutante en SPI-1) y ∆ssaJK S. Typhimurium SL-1344 (mutante en SPI-2), S. Typhimurium (cepa clínica) y sus derivadas mutantes: ∆invEG S. Typhimurium y ∆ssaJK S. Typhimurium. Los resultados de MET permitieron verificar las alteraciones morfológicas del epitelio intestinal en el ratón infectado con cepas de Salmonella cuyos genes de patogenicidad estaban intactos. Fue comprobada la pérdida del poder invasivo solo en las cepas mutadas en la SPI-1. A través del modelo de salmonelosis sistémica en ratón se pudo comprobar la pérdida de la capacidad de diseminación en ambas mutantes. En conclusión los modelos permitieron verificar la importancia que tienen los genes invG/invE de la SPI-1 y ssaJ/ssaK de la SPI-2 en la patogenia de la salmonelosis, utilizando como modelo experimental de infección ratones BALB/c. Se sugieren estos modelos in vivo para evaluar mutantes de genes implicados en la patogenia de Salmonella, ya que representan una herramienta importante para la comprensión de la interacción Salmonella-hospedero(AU)


With the aim of evaluate the pathogenesis in Salmonella Typhimurium strains with mutations in genes invG/invE of Salmonella Pathogenicity Island 1 (SPI-1) and genes ssaJ/ssaK in the SPI-2 models were evaluated ligated intestinal loop associated mouse tissues by observation by transmission electron microscopy (TEM) and the production of mouse systemic salmonellosis. For this, we used six Salmonella strains: S. Typhimurium SL-1344 (control strain) and its derived mutants: ΔinvEG S. Typhimurium SL-1344 (mutant in SPI-1) and ΔssaJK S. Typhimurium SL-1344 (mutant in SPI-2), S. Typhimurium (clinical isolate) and its derived mutants: ΔinvEG S.Typhimurium and ΔssaJK S. Typhimurium. TEM results allowed us to verify the morphological alterations of the intestinal epithelium in mice infected with Salmonella strains whose pathogenicity genes were intact. It was proven invasive power loss only in strains mutated in the SPI-1. Through systemic salmonellosis model mouse we noted the loss of the ability to spread in both mutants. In conclusion, the models allowed us to verify the importance of the invG/invE genes of SPI-1 and ssaJ/ssaK of SPI-2 in the pathogenesis of salmonellosis, using BALB/c mice as an experimental model of infection. These in vivo models are suggested to evaluate mutants of genes involved in the pathogenesis of Salmonella, since they represent an important tool for the understanding of the Salmonella-host interaction(AU)


Subject(s)
Animals , Mice , Salmonella typhimurium/pathogenicity , Genomic Islands/genetics , Microscopy, Electron, Transmission/methods , Mutation/genetics
2.
Salud(i)ciencia (Impresa) ; 23(4): 332-338, mar. 2019. tab, graf
Article in Spanish | LILACS (Americas), BINACIS | ID: biblio-1010189

ABSTRACT

Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world. The disease has\r\na highly variable clinical course, ranging from very indolent cases to patients with aggressive and rapidly\r\nprogressing outcome. Genetic studies are useful tools in analyzing this pathology, and have been incorporated in international risk classifications. The analysis of genomic rearrangements and the mutational status of immunoglobulin heavy chain variable have allowed risk groups of high prognostic value to be established. More recently, next generation sequencing studies have identified novel somatic mutations that could explain the wide clinical variability of this pathology. Among them, the analysis of NOTCH1 (neurogenic locus notch homolog protein 1) gene mutations are of interest, as deregulation is associated with tumorigenesis. NOTCH11 mutations are mostly located at exon 34 (80% of cases) and 3´UTR (untranslated region). They produce premature stop codons that produce a constitutively active and stable NOTCH1 protein. NOTCH1 mutations are associated with adverse prognosis and refractoriness to treatment. The aim of this study was to analyze NOTCH1 mutations in CLL patients by ASO-PCR and sequencing. Our results found 4.4% of cases with NOTCH1 mutated values concordant with international observations (5%-10%). Including them in the genetic status of CLL patients allows the characterization of risk groups, an aspect of great importance in clinical practice and therapeutic decisions, to be refined.


La leucemia linfocítica crónica (LLC) es la leucemia más frecuente en adultos de Occidente. Presenta\r\nun curso clínico altamente variable, con pacientes que requieren tratamiento inmediato y otros con un curso indolente de la enfermedad. Los estudios genéticos constituyen herramientas de suma utilidad en esta enfermedad, encontrándose incorporados a las clasificaciones de riesgo internacionales. El análisis de los rearreglos genómicos y del estado mutacional de los genes IGHV (immunoglobulin heavy chain variable region) ha hecho factible establecer grupos de riesgo de alto valor pronóstico. Más recientemente, estudios de secuenciación de última generación permitieron la detección de mutaciones\r\nsomáticas previamente desconocidas en esta afección, que podrían explicar la amplia variabilidad clínica\r\nobservada en la LLC. Entre ellas, resultan de interés las observadas en el gen NOTCH1 (neurogenic locus notch homolog protein 1), cuya desregulación se asocia con el desarrollo tumoral. Estas mutaciones se acumulan en mayor medida en el exón 34 (80% de los casos) y en la región 3´UTR (untraslated region), lo que genera codones de terminación prematuros que originan una proteína NOTCH1 constitutivamente activa y más estable, los cuales se asocian con pronóstico adverso y refractariedad al tratamiento. Nuestro objetivo fue evaluar mutaciones de NOTCH1 en nuestros pacientes mediante ASO-PCR y secuenciación. Se detectaron mutaciones en el 4.4% de los casos, valor concordante con los datos internacionales (5% a 10%). Su inclusión en la caracterización genética de los pacientes con LLC permitirá refinar la categorización de los grupos de riesgo, aspecto de suma importancia tanto en el seguimiento clínico como en la toma de decisiones terapéuticas.


Subject(s)
Humans , Leukemia, Lymphocytic, Chronic, B-Cell , Cytogenetics , Receptor, Notch1 , Mutation/genetics
3.
Rev. Asoc. Méd. Argent ; 132(1): 7-19, Mar. 2019. ilus, tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1009926

ABSTRACT

Se presenta el caso clínico de un lactante fallecido a los siete meses de edad con cuadro intersticial persistente. Objetivos: describir detalladamente el camino diagnóstico; alertar sobre posibles confusiones en recién nacidos con diagnósticos más frecuentes; detallar los hallazgos clínicos, radiológicos y de anatomía patológica (consultas en el exterior). Metodología: sumatoria de estudios complejos para descartar causas más frecuentes de patología intersticial en el lactante; consultas radiológicas, de anatomía patológica y genética en el exterior del país. Resultado: con diagnóstico de PAP (proteinosis alveolar pulmonar) se encontró una duplicación de material genético a nivel de cromosoma X, correspondiente al gen CSF2RA (colony stimulating factor 2-subunidad a). Este gen codifica al receptor CSF2 cuya citoquina controla la producción, diferenciación y función de granulocitos/macrófagos. (AU)


A clinical case of a deceased seven month old infant presenting persistent interstitial lung compromise is presented. Objectives. Detailed description of the diagnostic pathway used; to alert about possible confusion with other ­ more frequent ­ pathologies in the new borninfant age; to present clinical, radiological, genetic and pathology findings (consultations abroad). Methodology. A complete description of complex studies to rule out other more frequent pathologies is presented together with radiological, pathological and genetic results from consultations abroad. Results. A diagnosis of PAP (pulmonary alveolar proteinosis) was confirmed with duplication of genetic material at CSF2RA gene (colony stimulating factor 2-subunit a). This gene codifies the CSF2 receptor whose cytokine controls production, differentiation and function of granulocytes/macrophages. (AU)


Subject(s)
Humans , Male , Infant, Newborn , Infant , Lung Diseases, Interstitial/diagnosis , Lung Diseases/diagnosis , Lung Diseases/genetics , Lung Diseases/pathology , Lung Diseases/diagnostic imaging , Sex Chromosome Aberrations , Pulmonary Surfactants , Tomography, X-Ray Computed , Follow-Up Studies , Genetic Techniques , Lung Diseases, Interstitial/genetics , Diagnosis, Differential , Lung/pathology , Mutation/genetics
4.
Appl. cancer res ; 39: 1-7, 2019. ilustr.
Article in English | LILACS (Americas), Inca | ID: biblio-1023627

ABSTRACT

Background: Mutations in the RAS/RAF pathway predict resistance to anti-epidermal growth factor receptor antibodies in colorectal cancer (CRC), and may be targets for future therapies. This study investigates concordance of BRAF, HRAS, KRAS, NRAS and PIK3CA mutation status in primary CRC with matched liver (n = 274), lung (n = 114) or combined liver and lung metastases (n = 14). Methods: Next generation sequencing was performed on DNA from formalin-fixed paraffin embedded CRC and matched liver and/or lung metastases, for recurrent mutations in BRAF, HRAS, KRAS, NRAS and PIK3CA and using the single-molecule molecular inversion probe method. Results: Paired sequencing results on all five genes were reached in 249 of the 402 cases (62%). The obtained number of unique reads was not always sufficient to confidently call the absence or presence of mutations for all regions of interest. The mutational status of matched pairs was highly concordant; 91.1% concordance for all five genes, 95.5% for KRAS, 99.1% for NRAS. Lung metastases more often harboured RAS mutations compared to liver metastases (71% vs. 48%, p < 0.001). Conclusions: In this large series of CRC we show that both primary tumors and corresponding metastases can be used to determine the mutational status for targeted therapy, given the high concordance rates. Next generation sequencing including a single molecule tags is feasible, however in combination with archival formalin-fixed paraffin embedded material is limited by coverage depth.


Subject(s)
Humans , Colorectal Neoplasms/genetics , ras Proteins/genetics , Proto-Oncogene Proteins B-raf/genetics , Liver Neoplasms/genetics , Lung Neoplasms/genetics , Base Sequence , Colorectal Neoplasms/pathology , High-Throughput Nucleotide Sequencing , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Mutation/genetics
5.
São Paulo; s.n; 2019. 247 p. ilus, tab, quadros.
Thesis in Portuguese | LILACS (Americas), Inca | ID: biblio-1007843

ABSTRACT

O hepatoblastoma, câncer de fígado mais comum na infância, é um tumor embrionário que se supõe surgir da interrupção da diferenciação hepática durante a embriogênese. O genoma deste tipo tumoral carrega poucas alterações somáticas, principalmente aneuploidias cromossômicas e mutações em CTNNB1. Essa relativa escassez de mutações somáticas representa um desafio à estratificação de risco dos pacientes e ao desenvolvimento de terapias direcionadas. Neste trabalho, investigamos por sequenciamento de exoma o espectro de mutações somáticas em um grupo de 10 hepatoblastomas, pareados com suas respectivas amostras germinativas, incluindo um caso de tumor congênito. Os dados genômicos revelaram que os hepatoblastomas tem número reduzido de mutações somáticas codificadoras não-sinônimas (média de ~6 variantes/tumor, com exclusão do caso congênito), totalizando 94 mutações (92 diferentes) nos 10 tumores, mapeadas em 87 genes. Apenas três genes apresentaram mutações detectadas em mais de uma amostra, CTNNB1, CX3CL1 e CEP164. As mutações foram validadas pelo sequenciamento de um painel composto pelos genes identificados no exoma, também utilizado para investigar estes genes em um grupo adicional de 12 tumores; apenas mutações em CTNNB1 foram detectadas neste grupo adicional. Mutações somáticas em CTNNB1 foram detectadas em ~54% do grupo estudado (22 hepatoblastomas): sete variantes patogênicas do tipo nucleotídeo único (SNV) ou indel foram identificadas em oito hepatoblastomas (~36%), uma delas nunca previamente descrita (A21_S33del); deleções intragênicas foram detectadas por sequenciamento Sanger em quatro outros tumores (~18%). A proteína ß-catenina foi avaliada por imunohistoquímica, apresentando translocação para o núcleo, o que indica ativação da via WNT; esse resultado também foi observado em tumores nos quais mutações em CTNNB1 não foram detectadas. O principal achado do estudo do exoma de hepatoblastomas foi a identificação de uma mutação somática recorrente no éxon 3 do gene CX3CL1 (A235G), observada em dois diferentes tumores. A análise de expressão gênica e proteica de CX3CL1 e de seu receptor CX3CR1 revelou aumento de expressão de CX3CL1 em hepatoblastomas; este resultado foi replicado em duas coortes independentes. O detalhamento da análise evidenciou um padrão bimodal: (a) linfócitos infiltrados em regiões tumorais de inflamação pós-quimioterapia eram negativos para essas proteínas, que deveriam estar expressas neste tipo celular em condições normais, enquanto as células tumorais as expressavam; (b) nas áreas de necrose tumoral pós-quimioterapia, houve detecção das proteínas CX3CL1/CX3CR1 nos linfócitos, mas não nas células tumorais. Em conjunto, estes resultados sugerem que a ativação da via CX3CL1/CX3CR1 ocorre em parte dos hepatoblastomas, independentemente da detecção de mutações, o que parece ser um achado relevante, potencialmente relacionado a inflamação e/ou resistência à quimioterapia. Adicionalmente, três assinaturas mutacionais foram detectadas nos hepatoblastomas, duas delas com predomínio das assinaturas do COSMIC, HB-S1 (COSMIC 1 e 6, presentes em todos os tipos de câncer) e HB-S2, com similaridades à assinatura COSMIC 29, relacionada apenas a carcinoma oral de células escamosas (gengivo-bucal) associado ao hábito de mascar tabaco; uma nova assinatura mutacional foi observada em um subconjunto de hepatoblastomas (HB-S3), com padrão inespecífico de pequeno aumento de mutações C>A. As assinaturas mutacionais já relatadas para câncer de fígado não foram evidentes nestes hepatoblastomas, sugerindo um processo mutacional diferente em sua origem. Por fim, análise de mutações germinativas no caso de hepatoblastoma congênito levou à identificação de variantes germinativas em genes de predisposição a câncer (BRCA1 e FAH), levantando a questão do papel da predisposição genética no desenvolvimento destes tumores embrionários (AU)


Hepatoblastoma, the most common liver cancer in infancy, is an embryonal tumor supposed to arise from differentiation impairment during embryogenesis. Hepatoblastomas genomes carry few somatic changes, mainly chromosomal aneuploidies and mutations in the CTNNB1 gene. This relative paucity of somatic mutations poses a challenge to risk stratification and development of targeted therapies. In this work, we investigated the burden of somatic mutations in a cohort of 10 hepatoblastomas paired with their respective germline samples, including a case of congenital tumor. Data revealed a low number of non-synonymous somatic coding mutations (mean of ~6 variants/tumor), totalizing 94 mutations in the 10 tumors, mapped in 87 genes; only three genes exhibited mutations detected in more than one sample, CTNNB1, CX3CL1 and CEP164. Target sequencing was used for validation and screening of the mutated genes in an additional group of 12 tumors; only CTNNB1 mutations were detected in this additional group. CTNNB1 mutations were detected in ~54% of the cohort (22 hepatoblastomas): seven single nucleotide variant or indel mutations were identified in eight hepatoblastomas (~36%), including the A21_S33del mutation, not previously reported; intragenic deletions were detected by Sanger sequencing in 4 tumors (~18%). The ß-catenin protein was evaluated by immunohistochemistry, presenting translocation to the nucleus, indicating activation of the WNT pathway; this result was also observed in tumors without CTNNB1 mutations. The main finding of the exome study was the identification of a recurrent somatic mutation in the exon 3 of the CX3CL1 gene (A235G) in two different hepatoblastomas. Gene expression and protein analysis of CX3CL1 and its receptor CX3CR1 revealed increased expression of CX3CL1 in hepatoblastomas, a result that was replicated in two independent cohorts. A bimodal pattern of expression was observed: (a) lymphocytes infiltrated in tumor regions of inflammation post-chemotherapy were negative for these proteins, which should be expressed in this cell type under normal conditions, while the tumor cells expressed them; (b) in areas of tumor necrosis after chemotherapy, CX3CL1/CX3CR1 proteins were detected in lymphocytes, but not in tumor cells. Taken together, these results suggest that activation of the CX3CL1/CX3CR1 pathway occurs in part of the hepatoblastomas, regardless of mutation detection, potentially related to inflammation and/or resistance to chemotherapy. Additionally, three mutational signatures were detected, two of them with a predominance of signatures of COSMIC, HB-S1 (COSMIC 1 and 6, present in all types of cancer) and HB-S2 (COSMIC 29 signature, related only to oral cell carcinoma gingival-buccal associated with the habit of chewing tobacco). A new mutational signature was observed in a subset of hepatoblastomas (HB-S3), with a non-specific pattern of small increase in C>A mutations. Mutational signatures already reported for liver cancer were not evident in these hepatoblastomas, suggesting a different mutational process. Finally, an exploration of germline mutations in the congenital hepatoblastoma led to the identification of variants in genes of cancer predisposition (BRCA1 and FAH), raising the question of the role of genetic predisposition in the development of these embryonal tumors (AU)


Subject(s)
Humans , Male , Female , Syndrome , Hepatoblastoma , Carcinoma, Embryonal , Genomics , Chemokine CX3CL1 , Wnt Signaling Pathway , Whole Exome Sequencing , Liver Neoplasms/physiopathology , Liver Neoplasms/genetics , Mutation/genetics
6.
An. bras. dermatol ; 93(6): 913-915, Nov.-Dec. 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1038285

ABSTRACT

Abstract: The growth factor receptor c-kit (CD117) is expressed in immature T-cells and in some advanced forms of mycosis fungoides. c-kit gene mutation results in unrestricted neoplastic proliferation. We aimed to detect by PCR the most frequent exon mutations in seventeen plaque-stage MF patients, in their perilesional skin and in healthy skin donors. We secondarily evaluated CD117 expression by immunohistochemistry in plaque-stage and tumor-stage MF. We detected no mutation in c-kit gene and low CD117 expression was confirmed on atypical cells in one patient. Complete c-kit exon and intron sequences should be assessed and more sensitive sequencing method could be also applied.


Subject(s)
Humans , Male , Female , Aged , Exons/genetics , Mycosis Fungoides/genetics , Proto-Oncogene Proteins c-kit/genetics , Mutation/genetics , Immunohistochemistry , Case-Control Studies , Gene Expression , Polymerase Chain Reaction , Prospective Studies
7.
J. bras. pneumol ; 44(6): 498-504, Nov.-Dec. 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-984605

ABSTRACT

ABSTRACT Objectives: To characterize the main identified mutations on cystic fibrosis transmembrane conductance regulator (CFTR) in a group of children and adolescents at a cystic fibrosis center and its association with the clinical and laboratorial characteristics. Method: Descriptive cross-sectional study including patients with cystic fibrosis who had two alleles identified with CFTR mutation. Clinical, anthropometrical, laboratorial and pulmonary function (spirometry) data were collected from patients' records in charts and described with the results of the sample genotyping. Results: 42 patients with cystic fibrosis were included in the study. The most frequent mutation was F508del, covering 60 alleles (71.4%). The second most common mutation was G542X (six alleles, 7.1%), followed by N1303K and R1162X mutations (both with four alleles each). Three patients (7.14%) presented type III and IV mutations, and 22 patients (52.38%) presented homozygous mutation for F508del. Thirty three patients (78.6%) suffered of pancreatic insufficiency, 26.2% presented meconium ileus, and 16.7%, nutritional deficit. Of the patients in the study, 59.52% would be potential candidates for the use of CFTR-modulating drugs. Conclusions: The mutations of CFTR identified more frequently were F508del and G542X. These are type II and I mutations, respectively. Along with type III, they present a more severe cystic fibrosis phenotype. More than half of the sample (52.38%) presented homozygous mutation for F508del, that is, patients who could be treated with Lumacaftor/Ivacaftor. Approximately 7% of the patients (7.14%) presented type III and IV mutations, therefore becoming candidates for the treatment with Ivacaftor.


RESUMO Objetivos: Caracterizar as principais mutações identificadas no cystic fibrosis transmembrane conductance regulator (CFTR) em um grupo de crianças e adolescentes de um centro multidisciplinar de tratamento de fibrose cística e sua associação com características clínicas e laboratoriais. Método: Estudo transversal descritivo que incluiu pacientes com fibrose cística que possuíam dois alelos identificados com mutação no CFTR. Dados clínicos, antropométricos, laboratoriais e de função pulmonar (espirometria) foram coletados de registros em prontuários e descritos com os resultados de genotipagem da amostra. Resultados: Foram incluídos 42 pacientes com fibrose cística. A mutação mais frequente foi a F508del, abrangendo 60 alelos (71,4%). A segunda mutação mais comum foi a G542X (seis alelos, 7,1%), seguida das mutações N1303K e R1162X (ambas com quatro alelos cada uma). Três pacientes (7,14%) apresentaram mutações de classes III e IV, e 22 pacientes (52,38%), homozigose para F508del. Trinta e três pacientes (78,6%) tinham insuficiência pancreática, 11 (26,2%) apresentaram íleo meconial e sete (16,7%) déficit nutricional. Dos pacientes do estudo, 59,52% seriam potenciais candidatos ao uso de fármacos moduladores de CFTR. Conclusões: As mutações do CFTR identificadas com mais frequência foram F508del e G542X, as quais são mutações pertencentes às classes II e I, respectivamente, e que, juntamente à classe III, conferem um fenótipo de fibrose cística com mais gravidade. Mais da metade (52,38%) da amostra apresentava F508del em homozigose, população candidata ao novo tratamento com Lumacaftor/Ivacaftor. Aproximadamente 7% dos pacientes apresentavam mutações de classes III e IV, sendo candidatos ao tratamento com Ivacaftor.


Subject(s)
Humans , Male , Female , Child , Adolescent , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Cystic Fibrosis/genetics , Mutation/genetics , Phenotype , Cross-Sectional Studies
8.
J. bras. pneumol ; 44(5): 383-389, Sept.-Oct. 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-975940

ABSTRACT

ABSTRACT Objective: The clinical, functional, radiological and genotypic descriptions of patients with an alpha-1 antitrypsin (A1AT) gene mutation in a referral center for COPD in Brazil. Methods: A cross-sectional study of patients with an A1AT gene mutation compatible with deficiency. We evaluated the A1AT dosage and genotypic, demographic, clinical, tomographic, and functional characteristics of these patients. Results: Among the 43 patients suspected of A1AT deficiency (A1ATD), the disease was confirmed by genotyping in 27 of them. The A1AT median dosage was 45 mg/dL, and 4 patients (15%) had a normal dosage. Median age was 54, 63% of the patients were male, and the respiratory symptoms started at the age of 40. The median FEV1 was 1.37L (43% predicted). Tomographic emphysema was found in 77.8% of the individuals. The emphysema was panlobular in 76% of them and 48% had lower lobe predominance. The frequency of bronchiectasis was 52% and the frequency of bronchial thickening was 81.5%. The most common genotype was Pi*ZZ in 40.7% of participants. The other genotypes found were: Pi*SZ (18.5%), PiM1Z (14.8%), Pi*M1S (7.4%), Pi*M2Z (3.7%), Pi*M1I (3.7%), Pi*ZMnichinan (3.7%), Pi*M3Plowell (3.7%), and Pi*SF (3.7%). We did not find any significant difference in age, smoking load, FEV1, or the presence of bronchiectasis between the groups with a normal and a reduced A1AT dosage, neither for 1 nor 2-allele mutation for A1ATD. Conclusions: Our patients presented a high frequency of emphysema, bronchiectasis and bronchial thickening, and early-beginning respiratory symptoms. The most frequent genotype was Pi*ZZ. Heterozygous genotypes and normal levels of A1AT also manifested significant lung disease.


RESUMO Objetivo: Caracterização clínica, funcional, radiológica e genotípica dos pacientes portadores de mutações do gene da alfa-1 antitripsina (A1AT) em um centro de referência em doença pulmonar obstrutiva crônica (DPOC) no Brasil. Métodos: Estudo transversal de pacientes com mutação no gene da A1AT compatível com deficiência. Foram avaliadas características genotípicas, demográficas, clínicas, tomográficas, de função pulmonar, e dosagem de A1AT. Resultados: De 43 pacientes suspeitos para deficiência de alfa-1 antitripsina (DA1AT), a doença foi confirmada por genotipagem em 27. A mediana da dosagem de A1AT foi de 45 mg/dL, e 4 pacientes (15%) apresentavam dosagens normais. A idade mediana foi de 54 anos, 63% dos participantes eram do sexo masculino e a idade do início dos sintomas prevalente foi aos 40 anos. A mediana do volume expiratório forçado no primeiro segundo (VEF1) foi de 1,37 L (43% do previsto). Enfisema tomográfico foi encontrado em 77,8% dos indivíduos, sendo panlobular em 76% e de predomínio em lobos inferiores em 48%. A frequência de bronquiectasias foi de 52%, e a de espessamento brônquico, de 81,5%. O genótipo mais encontrado foi Pi*ZZ (40,7%). Os demais genótipos foram: Pi*SZ (18,5%), Pi*M1Z (14,8%), Pi*M1S (7,4%), Pi*M2Z (3,7%), Pi*M1I (3,7%), Pi*ZMnichinan (3,7%), Pi*M3Plowell (3,7%) e Pi*SF (3,7%). Não encontramos diferença significativa para idade, carga tabágica, VEF1 e presença de bronquiectasias entre os grupos com dosagem de A1AT normal versus alterada, nem entre 1 alelo versus 2 alelos com mutação para DA1AT. Conclusões: Nossos pacientes apresentaram alta frequência de enfisema, bronquiectasias e espessamento brônquico, com início precoce dos sintomas respiratórios. O genótipo mais frequente foi Pi*ZZ, embora genótipos heterozigotos e níveis normais de A1AT também tenham se manifestado com doença pulmonar significativa.


Subject(s)
Humans , Male , Female , Middle Aged , alpha 1-Antitrypsin/genetics , Mutation/genetics , Phenotype , Respiratory Function Tests , Tomography, X-Ray Computed , Cross-Sectional Studies , alpha 1-Antitrypsin Deficiency/diagnosis , alpha 1-Antitrypsin Deficiency/genetics , Genotype
9.
J. pediatr. (Rio J.) ; 94(5): 504-510, Sept.-Oct. 2018. tab
Article in English | LILACS (Americas) | ID: biblio-975994

ABSTRACT

Abstract Objectives: The aims of the study were to determine the frequency of hepatobiliary disease in patients with cystic fibrosis and to describe the sociodemographic, clinical, and laboratory profile of these patients. Methods: This was a retrospective, descriptive, and analytical study of 55 patients diagnosed with cystic fibrosis, aged between 3 months and 21 years, followed-up from January 2008 to June 2016 in a referral center. Medical records were consulted and sociodemographic, clinical and laboratory data, including hepatobiliary alterations, imaging studies, genetic studies, liver biopsies, and upper digestive endoscopies were registered. Results: Hepatobiliary disease was diagnosed in 16.4% of the patients and occurred as an initial manifestation of cystic fibrosis in 55.6% of these cases. The diagnosis of hepatopathy occurred before or concomitantly with the diagnosis of cystic fibrosis in 88.9% of the children. All patients with hepatobiliary disease were considered non-white, with a predominance of females (77.8%) and median (IQR) of 54 (27-91) months. Compared with the group without hepatobiliary disease, children with liver disease had a higher frequency of severe mutations identified in the CFTR gene (77.8% vs. 39.6%, p = 0.033) and severe pancreatic insufficiency (88.9% vs. 31.6%, p = 0.007). Conclusion: The frequency of hepatobiliary disease was high, with a very early diagnosis of the disease and its complications in the studied series. A statistical association was observed between the occurrence of hepatobiliary disease and the presence of pancreatic insufficiency and severe mutations in the CFTR gene. It is emphasized that cystic fibrosis is an important differential diagnosis of liver diseases in childhood.


Resumo Objetivos: Os objetivos do estudo foram determinar a frequência da doença hepatobiliar em pacientes com fibrose cística e descrever o perfil sociodemográfico, clínico e laboratorial destes. Métodos: Estudo retrospectivo, descritivo e analítico de 55 pacientes com diagnóstico de fibrose cística, entre três meses e 21 anos, acompanhados de janeiro de 2008 a junho de 2016 em um centro de referência. Foi realizada consulta aos prontuários médicos, registrando-se os dados sociodemográficos, clínicos e laboratoriais, incluindo-se alterações hepatobiliares, exames de imagem, estudos genéticos, biópsias hepáticas e endoscopias digestivas altas. Resultados: A doença hepatobiliar foi diagnosticada em 16,4% dos pacientes e ocorreu como manifestação inicial da fibrose cística em 55,6% destes casos. O diagnóstico da hepatopatia ocorreu antes ou concomitante ao diagnóstico da fibrose cística em 88,9% das crianças. Todos os pacientes com doença hepatobiliar foram considerados não brancos, havendo predominância do sexo feminino (77,8%) e mediana (I.I.Q) de idade de 54 (27-91) meses. Em comparação com o grupo sem doença hepatobiliar, as crianças com hepatopatia tiveram maior frequência de mutações graves no gene CFTR identificadas (77,8% vs 39,6%; p = 0,033) e de insuficiência pancreática grave (88,9% vs 31,6%; p = 0,007). Conclusão: A frequência de doença hepatobiliar foi elevada, observando-se um diagnóstico muito precoce da mesma e de suas complicações na casuística estudada. Houve associação estatística entre a ocorrência de doença hepatobiliar e a presença de insuficiência pancreática e de mutações graves do gene CFTR. Enfatiza-se que a fibrose cística represente um importante diagnóstico diferencial de hepatopatias na infância.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Exocrine Pancreatic Insufficiency/etiology , Cystic Fibrosis/complications , Liver Diseases/etiology , Mutation/genetics , Exocrine Pancreatic Insufficiency/genetics , Socioeconomic Factors , Retrospective Studies , Cystic Fibrosis/genetics , Genotype , Liver Diseases/genetics
10.
Yonsei Medical Journal ; : 13-19, 2018.
Article in English | WPRIM (Western Pacific) | ID: wprim-742510

ABSTRACT

PURPOSE: This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). MATERIALS AND METHODS: A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. RESULTS: Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6−12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7−11.3 months) (p < 0.001). CONCLUSION: The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed.


Subject(s)
Adenocarcinoma/genetics , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Animals , Base Sequence , Disease-Free Survival , Female , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Middle Aged , Mutation/genetics , Mutation Rate , Real-Time Polymerase Chain Reaction/methods , ErbB Receptors/genetics , Sequence Analysis, DNA/methods , Treatment Outcome
11.
Braz. j. med. biol. res ; 51(3): e6560, 2018. graf
Article in English | LILACS (Americas) | ID: biblio-889037

ABSTRACT

Autosomal dominant tubulointerstitial kidney disease (ADTKD) is characterized by autosomal dominant inheritance, progressive chronic kidney disease, and a bland urinary sediment. ADTKD is most commonly caused by mutations in the UMOD gene encoding uromodulin (ADTKD-UMOD). We herein report the first confirmed case of a multi-generational Brazilian family with ADTKD-UMOD, caused by a novel heterozygous mutation (c.163G>A, GGC→AGC, p.Gly55Ser) in the UMOD gene. Of 41 family members, 22 underwent genetic analysis, with 11 individuals found to have this mutation. Three affected individuals underwent hemodialysis, one peritoneal dialysis, and one patient received a kidney transplant from a family member later found to be genetically affected. Several younger individuals affected with the mutation were also identified. Clinical characteristics included a bland urinary sediment in all tested individuals and a kidney biopsy in one individual showing tubulointerstitial fibrosis. Unlike most other reported families with ADTKD-UMOD, neither gout nor hyperuricemia was found in affected individuals. In summary, we report a novel UMOD mutation in a Brazilian family with 11 affected members, and we discuss the importance of performing genetic testing in families with inherited kidney disease of unknown cause.


Subject(s)
Humans , Female , Middle Aged , Polycystic Kidney, Autosomal Dominant/genetics , Uromodulin/genetics , Mutation/genetics , Pedigree , Biopsy , Polycystic Kidney, Autosomal Dominant/pathology , Genotype
12.
Yonsei Medical Journal ; : 337-340, 2018.
Article in English | WPRIM (Western Pacific) | ID: wprim-713189

ABSTRACT

Facioscapulohumeral muscular dystrophy type 1 (FSHD1) is caused by contraction of the D4Z4 repeat array. Recent studies revealed that the FAT1 expression is associated with disease activity of FSHD, and the FAT1 alterations result in myopathy with a FSHD-like phenotype. We describe a 59-year-old woman with both contracted D4Z4 repeat units and a FAT1 mutation. Shoulder girdle muscle weakness developed at the age of 56 years, and was followed by proximal leg weakness. When we examined her at 59 years of age, she displayed asymmetric and predominant weakness of facial and proximal muscles. Muscle biopsy showed increased variation in fiber size and multifocal degenerating fibers with lymphocytic infiltration. Southern blot analysis revealed 8 D4Z4 repeat units, and targeted sequencing of modifier genes demonstrated the c.10331 A>G variant in the FAT1 gene. This FAT1 variant has previously been reported as pathogenic variant in a patient with FSHD-like phenotype. Our study is the first report of a FAT1 mutation in a FSHD1 patient, and suggests that FAT1 alterations might work as a genetic modifier.


Subject(s)
Cadherins/genetics , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Muscles/pathology , Muscular Dystrophy, Facioscapulohumeral/diagnostic imaging , Mutation/genetics , Phenotype
13.
Actual. osteol ; 13(3): 233-242, Sept - DIc. 2017. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-1117496

ABSTRACT

La displasia fibrosa ósea es un trastorno no hereditario del desarrollo esquelético caracterizado por una proliferación anormal de fibroblastos y diferenciación deficiente de osteoblastos que conduce a un reemplazo del tejido óseo esponjoso por tejido conectivo fibroso. Es producida por una mutación somática activadora del gen GNAS1 que induce una activación y proliferación de células mesenquimales indiferenciadas con formación de tejido fibroso y trabéculas óseas anómalas. Existen formas monostóticas, poliostóticas y craneofaciales con diversos grados de dolor, deformidades y fracturas óseas, aunque muchos casos son asintomáticos. En ocasiones se producen quistes óseos aneurismáticos, hemorragias, compromisos neurológicos y raramente osteosarcomas. Algunos casos se asocian a síndrome de McCune-Albright, síndrome de Mazabraud y a osteomalacia por hipofosfatemia por pérdida tubular renal inducida por el FGF23 producido por el tejido displásico. Los hallazgos en las radiografías convencionales son característicos, aunque variables y de carácter evolutivo. La gammagrafía ósea es la técnica de imagen con mayor sensibilidad para determinar la extensión de la enfermedad. El diagnóstico diferencial incluye múltiples lesiones óseas de características similares y en raras ocasiones se requiere biopsia ósea o estudio genético para confirmarlo. No existe un consenso unánime acerca del abordaje terapéutico de estos pacientes, razón por la cual es necesario un enfoque multidisciplinario. La conducta puede ser expectante o quirúrgica según el tipo de lesiones y es importante el manejo del dolor y de las endocrinopatías asociadas. La mayor experiencia publicada se refiere al uso de bifosfonatos y, más recientemente, denosumab. Los tratamientos actuales son insuficientes para modificar el curso de la enfermedad y es necesario el desarrollo de nuevas moléculas que actúen específicamente en el gen GNAS1 o sobre las células mesenquimales afectadas. (AU)


Fibrous dysplasia of bone is a noninherited developmental anomaly of bone characterized by abnormal proliferation of fibroblasts and differentiation of osteoblasts that cause a replacement of trabeculous bone by fibrous connective tissue. It is caused by a somatic mutation in the GNAS1 gene, which induces an undifferentiated mesenquimal cells activation and proliferation with formation of fibrous tissue and abnormal osseous trabeculae. There are monostotic, polyostotic and craniofacial variants with different grades of bone pain, deformities and fractures, although many cases remain asymptomatic. Aneurysmal bone cysts, bleeding, neurological compromise and infrequently osteosarcoma are possible complications. Some cases are associated to McCune-Albright syndrome, Mazabraud syndrome or hypophosphatemia and osteomalacia due to to renal tubular loss induced by FGF23 produced by dysplastic tissue. The findings on conventional radiography are characteristic although variable and evlolve with time. Bone scintigraphy is the most sensitive technique to evaluate the extent of disease. Differential diagnosis include several osseous lesions of similar appearance and, in some cases, bone biopsy or genetic testing may be necessary. Today, there is no consensus regarding the therapeutic approach for these patients and it is necessary a multidisciplinary medical team. Watchful waiting or surgical interventions can be indicated, depending on the type of bone lesions. Bone pain and associated endocrinopathies management are very important. Most published experience refers to the use of bisphosphonates and, more recently, denosumab. Current treatments are insufficient to modify the natural curse of the disease and therefore, new molecules with specific action on GNAS1 gene or affected mesenchymal cells are necessary. (AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Fibrous Dysplasia of Bone/etiology , Fibrous Dysplasia of Bone/drug therapy , Osteogenesis/genetics , Osteomalacia/complications , Congenital Abnormalities , Vitamin D/therapeutic use , Osteosarcoma/etiology , Calcium/therapeutic use , Hypophosphatemia/blood , Bone Cysts, Aneurysmal/etiology , Diagnosis, Differential , Diphosphonates/administration & dosage , Diphosphonates/adverse effects , Fractures, Bone/pathology , Mesenchymal Stem Cells/pathology , Pain Management , Fibrous Dysplasia, Monostotic/etiology , Fibrous Dysplasia of Bone/genetics , Fibrous Dysplasia of Bone/blood , Fibrous Dysplasia of Bone/diagnostic imaging , Fibrous Dysplasia, Polyostotic/etiology , Fibrous Dysplasia, Polyostotic/diagnostic imaging , Craniofacial Fibrous Dysplasia/etiology , Mutation/genetics
14.
Mem. Inst. Oswaldo Cruz ; 112(11): 793-795, Nov. 2017. graf
Article in English | LILACS (Americas) | ID: biblio-894847

ABSTRACT

A recent study showed that infectivity of Zika virus (ZIKV) Asian genotype was enhanced by an alanine-to-valine amino acid substitution at residue 188 of the NS1 protein, but the precise time and location of origin of this mutation were not formally estimated. Here, we applied a Bayesian coalescent-based framework to estimate the age and location of the ancestral viral strain carrying the A188V substitution. Our results support that the ancestral ZIKV strain carrying the A188V substitution arose in Southeastern Asia at the early 2000s and circulated in that region for some time (5-10 years) before being disseminated to Southern Pacific islands and the Americas.


Subject(s)
Humans , Proteins/genetics , Bayes Theorem , Viral Nonstructural Proteins/genetics , Zika Virus/genetics , Mutation/genetics , Phylogeny , Asia , Genotype
15.
Mem. Inst. Oswaldo Cruz ; 112(11): 775-778, Nov. 2017. tab
Article in English | LILACS (Americas) | ID: biblio-894846

ABSTRACT

BACKGROUND Mycobacterium abscessus complex (MABC) includes species with high resistance rates among mycobacterial pathogens. In fact, MABC infections may not respond to clarithromycin treatment, which has historically been very effective against MABC infection. Molecular markers have been proposed to detect both acquired (rrl polymorphisms) and inducible (erm(41) polymorphisms) clarithromycin resistance in MABC isolates. OBJECTIVES This study aimed to evaluate the susceptibility profile and molecular markers of clarithromycin resistance in MABC. METHODS The clarithromycin susceptibility profile was determined by broth microdilution with reads on days 3, 5, 7 and 14. Mutations in the rrl and erm(41) genes were evaluated by polymerase chain reaction (PCR) using specific primers, followed by sequencing. FINDINGS A total of 14 M. abscessus subsp. abscessus isolates and 28 M. abscessus subsp. massiliense isolates were evaluated, and clarithromycin resistance was observed in all isolates for up to three days of incubation. None of the 42 isolates exhibited a point mutation in the rrl gene, while all the isolates had a T28 polymorphism in the erm(41) gene. Moreover, all 28 M. abscessus subsp. massiliense isolates had a deletion in the erm(41) gene. MAIN CONCLUSIONS While all the MABC isolates exhibited acquired clarithromycin resistance, no isolates exhibited a point mutation in the rrl gene in this study. The M. abscessus subsp. massiliense isolates demonstrated clarithromycin resistance, which is an uncommon phenotype. The molecular data for the rrl and erm(41) genes were not consistent with the phenotypic test results of clarithromycin susceptibility, indicating a lack of correlation between molecular clarithromycin resistance markers for both acquired and inducible resistance.


Subject(s)
Humans , Clarithromycin/pharmacology , Drug Resistance, Bacterial/drug effects , Drug Resistance, Bacterial/genetics , Anti-Bacterial Agents/pharmacology , Mutation/genetics , Mycobacterium/drug effects , Mycobacterium/genetics , Microbial Sensitivity Tests , Genes, Bacterial
16.
Mem. Inst. Oswaldo Cruz ; 112(6): 411-418, June 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-841806

ABSTRACT

BACKGROUND The high mutation rate of the human immunodeficiency virus (HIV) has created a public health challenge because the use of antiretroviral drugs can generate selective pressure that drives resistance in these viruses. OBJECTIVE The aim of this work was to characterise the molecular and epidemiological profile of HIV in Bahia, Brazil. METHODS DNA sequences from regions of HIV gag, pol, and env genes were obtained from previous studies performed in this area between 2002 and 2012. Their genotype and drug-resistance mutations were identified using bioinformatics tools. Clinical and epidemiological data were analysed. FINDINGS Among 263 individuals (46.4% male), 97.5% were asymptomatic and 49.1% were receiving treatment. Most of the individuals were 31 to 40 years old (36.9%) and infected through heterosexual contact (40.7%). The predominant genotype was B (68.1%) followed by BF recombinants (18.6%). Among the individuals infected with either F or BF genotypes, 68.4% were women and 76.8% were infected through heterosexual transmission. The prevalence of associated mutations conferring antiretroviral resistance was 14.2%, with 3.8% of all mutations conferring resistance to protease inhibitors, 9.43% to nucleoside reverse transcriptase inhibitors, and 8.5% to non-nucleoside reverse transcriptase inhibitors. Drug resistance was higher in individuals receiving treatment (26.1%) than in the drug-naïve (4.3%) individuals. MAIN CONCLUSIONS This study will contribute to the understanding and monitoring of HIV epidemic in this Brazilian region.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , HIV Infections/genetics , HIV Infections/virology , HIV-1/immunology , Sequence Analysis, DNA , Drug Resistance, Viral/genetics , Brazil/epidemiology , Risk Factors , HIV-1 , Mutation/genetics
17.
An. bras. dermatol ; 92(3): 329-333, May-June 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-886952

ABSTRACT

Abstract Background: Familial progressive hyper- and hypopigmentation (FPHH) is a rare genodermatosis that is characterized by diffuse hyper- and hypopigmented spots on the skin and mucous membranes. It is caused by a pathogenic mutation of the KITLG gene. Objectives: To investigate the clinical features and mutation of the KITLG gene in a Chinese family with FPHH. Methods: Histopathological and immunohistochemical analysis of lesions from the proband was performed. The KITLG gene was screened for the presence of mutations. Results: A Chinese family containing 14 individuals with FPHH was described, and the proband was a 5-year-old girl showing diffuse hyper- and hypopigmented lesions on her extremities and trunk. Histopathological and immunohistochemical staining for S100 and HMB45 of skin biopsy specimens from the hyperpigmented areas showed a striking increase in melanin throughout the epidermis, especially in the basal cell layer, and staining of hypopigmented area specimens displayed lower levels of melanin in the epidermis. Mutation analysis of the KITLG gene was performed, but no mutation was found. Study limitations: The new pathogenic gene was not found. Conclusion: A family with FPHH was described. Analysis revealed that its members did not have any mutations of the KITLG gene, which provided evidence for genetic heterogeneity of this genodermatosis.


Subject(s)
Humans , Male , Female , Child, Preschool , Hypopigmentation/genetics , Hyperpigmentation/genetics , Genetic Heterogeneity , Mutation/genetics , Pedigree , Immunohistochemistry , Hypopigmentation/pathology , Hyperpigmentation/pathology , Asian Continental Ancestry Group
18.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 35(1): 90-94, Abril 2017. tab, ilus
Article in Spanish | LILACS (Americas) | ID: biblio-999154

ABSTRACT

El Síndrome de Apert llamado también acrocefalosin-dactilia tipo I, está caracterizado por craneosinostosis, sindactilia simétrica en las cuatro extremidades, retardo mental, alteraciones cutáneas y maxilofaciales; está ocasionado por una mutación en el gen receptor 2 del factor de crecimiento fibroblástico FGFR2 expresándo-se en forma autosómico dominante (AD).Caso Clínico: Se presenta caso de recién nacido masculino, Capurro de 38 semanas aproximadamente, con las características fenotípicas clásicas de este síndro-me: como es la acrocefalia y la sindactilia en manos y pies.


Apert syndrome also called acrocephalosyndactyly Type I is characterized by craniosynostosis , symmetric syndactyly in all four limbs , mental retardation , skin and maxillofacial disorders ; It is caused by a mutation in the gene receptor 2 fibrobroblástico growth factor expres-sing FGFR2 autosomal dominant (AD ) .Case report: as is the acrocephaly and syndactyly in the hands and feet of newborn male case, Capurro of 38 weeks approximately, with classical phenotypic characteristics of this syndrome is presented as is the acro-cephaly and syndactyly in hands and feet.


Subject(s)
Humans , Male , Infant, Newborn , Acrocephalosyndactylia , Syndactyly , Craniosynostoses , Skin Manifestations , Diagnostic Imaging , Maxillofacial Abnormalities , Intellectual Disability , Mutation/genetics
19.
An. bras. dermatol ; 92(5,supl.1): 154-158, 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-887085

ABSTRACT

Abstract Inherited Palmoplantar Keratodermas are rare disorders of genodermatosis that are conventionally regarded as autosomal dominant in inheritance with extensive clinical and genetic heterogeneity. This is the first report of a unique autosomal recessive Inherited Palmoplantar keratoderma -sensorineural hearing loss syndrome which has not been reported before in 3 siblings of a large consanguineous family. The patients presented unique clinical features that were different from other known Inherited Palmoplantar Keratodermas -hearing loss syndromes. Mutations in GJB2 or GJB6 and the mitochondrial A7445G mutation, known to be the major causes of diverse Inherited Palmoplantar Keratodermas -hearing loss syndromes were not detected by Sanger sequencing. Moreover, the pathogenic mutation could not be identified using whole exome sequencing. Other known Inherited Palmoplantar keratoderma syndromes were excluded based on both clinical criteria and genetic analysis.


Subject(s)
Humans , Male , Child , Adolescent , Keratoderma, Palmoplantar/genetics , Keratoderma, Palmoplantar/pathology , Hearing Loss, Sensorineural/genetics , Hearing Loss, Sensorineural/pathology , Mutation/genetics , Syndrome , Biopsy , Siblings , Whole Exome Sequencing
20.
Braz. J. Pharm. Sci. (Online) ; 53(2): e16105, 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-839491

ABSTRACT

ABSTRACT When the FLT3 gene is mutated, it originates a modified receptor with structural changes, which give survival advantage and malignant hematopoietic cell proliferation. Thus, the presence of mutations in this gene is considered an unfavorable prognostic factor. A total of 85 consecutive samples of newly diagnosed untreated patients with AL were included in the study after they provided their informed consent. FLT3 gene mutations were detected by PCR. For the pediatric group, a positive correlation was observed between WBC count and the presence of FLT3-ITD in patients with AML and ALL. Furthermore, children with AML who had the FLT3-ITD mutation showed a tendency to express CD34 in blast cells. In the adult group, the AML patients with FLT3-ITD who expressed CD34 in blast cells had a tendency to worse progression. The present data indicate no association between the prognostic factors evaluated and FLT3 gene mutations in adult with AL. Yet, the presence of FLT3-ITD mutation was significantly related with WBC count in the pediatric group. These findings demonstrate that FLT3 gene mutations can be considered as independent poor prognostic factors.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Patients/statistics & numerical data , Leukemia/pathology , Adult , Genes/genetics , Mutation/genetics , Prognosis , Child , Polymerase Chain Reaction/instrumentation
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