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1.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781304

RESUMO

OBJECTIVE@#To explore the genetic basis of a pedigree affected with hereditary spherocytosis.@*METHODS@#Peripheral blood samples were collected from 17 members of the pedigree. Genomic DNA of the proband was subjected to next generation sequencing. Candidate variant was validated by co-segregation analysis. pCAS2(c.5798+1G) and pCAS2(c.5798+1A) plasmids were constructed by homologous recombination and transfected into 293T cells. Reverse transcription PCR, TA cloning and Sanger sequencing were used to analyze the effect of candidate variant on splicing. Meanwhile, peripheral blood RNAs were extracted to analyze the effect of candidate variant on splicing in vivo.@*RESULTS@#The proband was found to carry a c.5798+1G>A variant of the SPTB gene. The variant has co-segregated with the phenotype in the pedigree. In vitro and in vivo splicing experiments confirmed that the mutation has significantly affected the splicing, resulting in shift of reading frame and produced a premature termination codon.@*CONCLUSION@#The novel c.5798+1G>A variant of the SPTB gene probably underlies the pathogenesis of hereditary spherocytosis in this pedigree.


Assuntos
Códon sem Sentido , Genética , Variação Genética , Células HEK293 , Humanos , Mutação , Genética , Linhagem , Plasmídeos , Processamento de RNA , Espectrina , Genética , Esferocitose Hereditária , Genética , Transfecção
2.
Acta Physiologica Sinica ; (6): 327-335, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-777182

RESUMO

Nonsense-mediated mRNA decay (NMD) is originally identified as a widespread mRNA surveillance machinery in degrading 'aberrant' mRNA species with premature termination codons (PTCs) rapidly, which protects the cells from the accumulation of truncated proteins. Recent studies show that NMD can also regulate the degradation of normal gene transcripts, which execute important cellular and physiological functions. Therefore, NMD is considered as a highly conserved post-transcriptional regulatory mechanism in eukaryotes. NMD modulates 3% to 20% of the transcriptome from yeast to human directly or indirectly, which is essential for various physiological processes, such as cell homeostasis, stress response, proliferation, and differentiation. NMD can regulate the level of transcripts that involves in development, and single knockout of most NMD factors has an embryonic lethal effect. NMD plays an important role in the self-renewal, differentiation of embryonic stem cells and is critical during embryonic development. In this review, we summarized the latest advances in the roles and mechanisms of NMD in embryonic development, in order to provide new ideas for the research on embryonic development and the treatment of embryonic development related diseases.


Assuntos
Códon sem Sentido , Desenvolvimento Embrionário , Humanos , Degradação do RNAm Mediada por Códon sem Sentido , RNA Mensageiro , Transcriptoma
3.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-787389

RESUMO

Cleidocranial dysplasia (CCD) is an autosomal-dominant disease characterized by the delayed closure of cranial sutures, defects in clavicle formation, supernumerary teeth, and delayed tooth eruption. Defects in the Runt-related transcription factor 2 (RUNX2), a master regulator of bone formation, have been identified in CCD patients. The aim of this study was to identify the molecular genetic causes in a CCD family with delayed tooth eruption.The 23-year-old female proband and her mother underwent clinical and radiographic examinations, and all coding exons of the RUNX2 were sequenced. Mutational analysis revealed a single nucleotide deletion mutation (NM_001024630.4 : c.357delC) in exon 3 in the proband and her mother. The single C deletion would result in a frameshift in translation and introduce a premature stop codon [p.(Asn120Thrfs*24)]. This would result in the impaired function of RUNX2 protein, which may be the cause of delayed eruption of permanent teeth in the family.


Assuntos
Clavícula , Displasia Cleidocraniana , Codificação Clínica , Códon sem Sentido , Subunidade alfa 1 de Fator de Ligação ao Core , Suturas Cranianas , Éxons , Feminino , Humanos , Biologia Molecular , Mães , Osteogênese , Deleção de Sequência , Dente , Erupção Dentária , Dente Supranumerário , Fatores de Transcrição , Adulto Jovem
4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763180

RESUMO

PURPOSE: Partner and localizer of BRCA2 (PALB2) is a breast cancer susceptibility gene that plays an important role in DNA repair. This is the first study assessing the prevalence of PALB2 mutations in early-onset and familial breast/ovarian cancer patients from Pakistan. MATERIALS AND METHODS: PALB2 mutation screening was performed in 370 Pakistani patients with early-onset and familial breast/ovarian cancer, who were negative for BRCA1, BRCA2, TP53, CHEK2, and RAD51C mutations, using denaturing high-performance liquid chromatography analysis. Mutations were confirmed by DNA sequencing. Novel PALB2 alterations were analyzed for their potential effect on protein function or splicing using various in silico prediction tools. Three-hundred and seventy-two healthy controls were screened for the presence of the identified (potentially) functional mutations. RESULTS: A novel nonsense mutation, p.Y743*, was identified in one familial breast cancer patient (1/127, 0.8%). Besides, four in silico-predicted potentially functional mutations including three missense mutations and one 5' untranslated region mutation were identified: p.D498Y, novel p.G644R, novel p.E744K, and novel c.-134_-133delTCinsGGGT. The mutations p.Y743* and p.D498Y were identified in two familial patients diagnosed with unilateral or synchronous bilateral breast cancer at the ages of 29 and 39, respectively. The other mutations were identified in an early-onset (≤ 30 years of age) breast cancer patient each. All five mutations were absent in 372 healthy controls suggesting that they are disease associated. CONCLUSION: Our findings show that PALB2 mutations account for a small proportion of early-onset and hereditary breast/ovarian cancer cases in Pakistan.


Assuntos
Regiões 5' não Traduzidas , Neoplasias da Mama , Cromatografia Líquida , Códon sem Sentido , Simulação por Computador , Reparo do DNA , Mutação em Linhagem Germinativa , Humanos , Programas de Rastreamento , Mutação de Sentido Incorreto , Paquistão , Prevalência , Análise de Sequência de DNA
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763043

RESUMO

Human cytochrome P450 2C9 is a highly polymorphic enzyme that is required for drug and xenobiotic metabolism. Here, we studied eleven P450 2C9 genetic variants—including three novel variants F69S, L310V, and Q324X—that were clinically identified in Korean patients. P450 2C9 variant enzymes were expressed in Escherichia coli and their bicistronic membrane fractions were prepared The CO-binding spectra were obtained for nine enzyme variants, indicating P450 holoenzymes, but not for the M02 (L90P) variant. The M11 (Q324X) variant could not be expressed due to an early nonsense mutation. LC-MS/MS analysis was performed to measure the catalytic activities of the P450 2C9 variants, using diclofenac as a substrate. Steady-state kinetic analysis revealed that the catalytic efficiency of all nine P450 2C9 variants was lower than that of the wild type P450 2C9 enzyme. The M05 (R150L) and M06 (P279T) variants showed high k(cat) values; however, their K(m) values were also high. As the M01 (F69S), M03 (R124Q), M04 (R125H), M08 (I359L), M09 (I359T), and M10 (A477T) variants exhibited higher K(m) and lower k(cat) values than that of the wild type enzyme, their catalytic efficiency decreased by approximately 50-fold compared to the wild type enzyme. Furthermore, the novel variant M07 (L310V) showed lower k(cat) and K(m) values than the wild type enzyme, which resulted in its decreased (80%) catalytic efficiency. The X-ray crystal structure of P450 2C9 revealed the presence of mutations in the residues surrounding the substrate-binding cavity. Functional characterization of these genetic variants can help understand the pharmacogenetic outcomes.


Assuntos
Códon sem Sentido , Sistema Enzimático do Citocromo P-450 , Citocromos , Diclofenaco , Escherichia coli , Holoenzimas , Humanos , Membranas , Metabolismo , Farmacogenética
7.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-719030

RESUMO

X-linked hypophosphatemic rickets is caused by loss-of-function mutations in PHEX, which encodes a phosphate-regulating endopeptidase homolog. We report a 26-year-old man with X-linked hypophosphatemic rickets who showed decreased serum phosphate accompanied by bilateral genu valgum and short stature. He had received medical treatment with vitamin D (alfacalcidol) and phosphate from the age of 3 to 20 years. He underwent surgery due to valgus deformity at the age of 14 and 15. Targeted gene panel sequencing for Mendelian genes identified a nonsense mutation in PHEX (c.589C>T; p.Gln197Ter) and a mosaic pattern where only 38% of sequence reads showed the variant allele. This mutation was not found in his mother, who had a normal phenotype. This is a case of a sporadic nonsense mutation in PHEX and up to date, this is the first case of a mosaic mutation in PHEX in Korea.


Assuntos
Adulto , Alelos , Códon sem Sentido , Anormalidades Congênitas , Raquitismo Hipofosfatêmico Familiar , Geno Valgo , Humanos , Coreia (Geográfico) , Mães , Fenótipo , Raquitismo Hipofosfatêmico , Vitamina D
8.
Laboratory Animal Research ; : 264-269, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-718841

RESUMO

Cell cycle dysfunction can cause severe diseases, including neurodegenerative disease and cancer. Mutations in cyclin-dependent kinase inhibitors controlling the G1 phase of the cell cycle are prevalent in various cancers. Mice lacking the tumor suppressors p16(Ink4a) (Cdkn2a, cyclin-dependent kinase inhibitor 2a), p19(Arf) (an alternative reading frame product of Cdkn2a,), and p27(Kip1) (Cdkn1b, cyclin-dependent kinase inhibitor 1b) result in malignant progression of epithelial cancers, sarcomas, and melanomas, respectively. Here, we generated knockout mouse models for each of these three cyclin-dependent kinase inhibitors using engineered nucleases. The p16(Ink4a) and p19(Arf) knockout mice were generated via transcription activator-like effector nucleases (TALENs), and p27(Kip1) knockout mice via clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9 (CRISPR/Cas9). These gene editing technologies were targeted to the first exon of each gene, to induce frameshifts producing premature termination codons. Unlike preexisting embryonic stem cell-based knockout mice, our mouse models are free from selectable markers or other external gene insertions, permitting more precise study of cell cycle-related diseases without confounding influences of foreign DNA.


Assuntos
Animais , Ciclo Celular , Códon sem Sentido , Inibidor p16 de Quinase Dependente de Ciclina , DNA , Éxons , Fase G1 , Genoma , Melanoma , Camundongos , Camundongos Knockout , Mutagênese Insercional , Doenças Neurodegenerativas , Fosfotransferases , Fases de Leitura , Sarcoma
9.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-718157

RESUMO

OBJECTIVE: We performed small-scale mutation and large genomic rearrangement (LGR) analysis of BRCA1/2 in ovarian cancer patients to determine the prevalence and the characteristics of the mutations. METHODS: All ovarian cancer patients who visited a single institution between September 2015 and April 2017 were included. Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), and long-range polymerase chain reaction (PCR) were performed to comprehensively study BRCA1/2. The genetic risk models BRCAPRO, Myriad, and BOADICEA were used to evaluate the mutation analysis. RESULTS: In total, 131 patients were enrolled. Of the 131 patients, Sanger sequencing identified 16 different BRCA1/2 small-scale mutations in 20 patients (15.3%). Two novel nonsense mutations were detected in 2 patients with a serous borderline tumor and a large-cell neuroendocrine carcinoma. MLPA analysis of BRCA1/2 in Sanger-negative patients revealed 2 LGRs. The LGRs accounted for 14.3% of all identified BRCA1 mutations, and the prevalence of LGRs identified in this study was 1.8% in 111 Sanger-negative patients. The genetic risk models showed statistically significant differences between mutation carriers and non-carriers. The 2 patients with LGRs had at least one blood relative with breast or ovarian cancer. CONCLUSION: Twenty-two (16.8%) of the unselected ovarian cancer patients had BRCA1/2 mutations that were detected through comprehensive BRCA1/2 genetic testing. Ovarian cancer patients with Sanger-negative results should be considered for LGR detection if they have one blood relative with breast or ovarian cancer. The detection of more BRCA1/2 mutations in patients is important for efforts to provide targeted therapy to ovarian cancer patients.


Assuntos
Mama , Carcinoma Neuroendócrino , Códon sem Sentido , Feminino , Testes Genéticos , Humanos , Coreia (Geográfico) , Reação em Cadeia da Polimerase Multiplex , Neoplasias Ovarianas , Ovário , Reação em Cadeia da Polimerase , Prevalência
10.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-72416

RESUMO

Diagnosis of the urea cycle disorder (USD) carbamoyl-phosphate synthetase 1 (CPS1) deficiency (CPS1D) based on only the measurements of biochemical intermediary metabolites is not sufficient to properly exclude other UCDs with similar symptoms. We report the first Korean CPS1D patient using whole exome sequencing (WES). A four-day-old female neonate presented with respiratory failure due to severe metabolic encephalopathy with hyperammonemia (1,690 µmol/L; reference range, 11.2-48.2 µmol/L). Plasma amino acid analysis revealed markedly elevated levels of alanine (2,923 µmol/L; reference range, 131-710 µmol/L) and glutamine (5,777 µmol/L; reference range, 376-709 µmol/L), whereas that of citrulline was decreased (2 µmol/L; reference range, 10-45 µmol/L). WES revealed compound heterozygous pathogenic variants in the CPS1 gene: one novel nonsense pathogenic variant of c.580C>T (p.Gln194*) and one known pathogenic frameshift pathogenic variant of c.1547delG (p.Gly516Alafs*5), which was previously reported in Japanese patients with CPS1D. We successfully applied WES to molecularly diagnose the first Korean patient with CPS1D in a clinical setting. This result supports the clinical applicability of WES for cost-effective molecular diagnosis of UCDs.


Assuntos
Sequência de Bases , Carbamoil-Fosfato Sintase (Amônia)/química , Doença da Deficiência da Carbamoil-Fosfato Sintase I/diagnóstico , Códon sem Sentido , Éxons , Feminino , Mutação da Fase de Leitura , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Recém-Nascido , República da Coreia , Análise de Sequência de DNA , Distúrbios Congênitos do Ciclo da Ureia/diagnóstico
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-57449

RESUMO

BACKGROUND: Molecular techniques are fundamental for establishing an accurate diagnosis and therapeutic approach of glycogen storage diseases (GSDs). We aimed to evaluate SLC37A4 mutation spectrum in Korean GSD Ib patients. METHODS: Nine Korean patients from eight unrelated families with GSD Ib were included. SLC37A4 mutations were detected in all patients with direct sequencing using a PCR method and/or whole-exome sequencing. A comprehensive review of previously reported SLC37A4 mutations was also conducted. RESULTS: Nine different pathogenic SLC37A4 mutations were identified in the nine patients with GSD Ib. Among them, four novel mutations were identified: c.148G>A (pGly50Arg), c.320G>A (p.Trp107*), c.412T>C (p.Trp138Arg), and c.818G>A (p.Gly273Asp). The most common mutation type was missense mutations (66.7%, 6/9), followed by nonsense mutations (22.2%, 2/9) and small deletion mutations (11.1%, 1/9). The most common mutation identified in the Korean population was c.443C>T (p.Ala148Val), which comprised 39.9% (7/18) of all tested alleles. This mutation has not been reported in GSD Ib patients in other ethnic populations. CONCLUSIONS: This study expands knowledge of the SLC37A4 mutation spectrum in Korean patients with GSD Ib.


Assuntos
Alelos , Códon sem Sentido , Diagnóstico , Doença de Depósito de Glicogênio , Glicogênio , Humanos , Métodos , Mutação de Sentido Incorreto , Reação em Cadeia da Polimerase , Deleção de Sequência
12.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-129038

RESUMO

PURPOSE: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the Bruton's tyrosine kinase (Btk) gene. The aim of this study was to investigate the clinical manifestations, molecular features, and treatment status of XLA in Korean patients at Seoul National University Children's Hospital. METHODS: Fourteen Korean boys with XLA showing serum agammaglobulinemia, non-detectable to less than 2% of peripheral B-cells, and mutation of the Btk gene were enrolled. We observed the clinical features, laboratory findings, status of treatment, and complications in these XLA patients. RESULTS: All XLA patients had a history of recurrent bacterial infections before diagnosis, and 20% of them had a neutropenia. Of the XLA patients 35.7% had a family history of XLA and 75% of their mothers were carriers. Btk gene analysis showed variable gene mutations in Xq22 including 9 amino acid substitutions, 3 frameshifts, 1 premature stop codon, and 1 splice defect. After intravenous immunoglobulin replacement therapy, infection episodes decreased, but complications such as bronchiectasis and chronic sinusitis remained. CONCLUSIONS: In patients less than 4 years of age with recurrent infection, analysis of serum gamma globulin levels and the Btk gene are recommended for the early diagnosis of XLA and for the appropriate prevention of recurrent infection.


Assuntos
Agamaglobulinemia , Substituição de Aminoácidos , Linfócitos B , Infecções Bacterianas , Bronquiectasia , Códon sem Sentido , Diagnóstico , Diagnóstico Precoce , gama-Globulinas , Humanos , Imunoglobulinas , Imunoglobulinas Intravenosas , Mães , Neutropenia , Proteínas Tirosina Quinases , Seul , Sinusite
13.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-129023

RESUMO

PURPOSE: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the Bruton's tyrosine kinase (Btk) gene. The aim of this study was to investigate the clinical manifestations, molecular features, and treatment status of XLA in Korean patients at Seoul National University Children's Hospital. METHODS: Fourteen Korean boys with XLA showing serum agammaglobulinemia, non-detectable to less than 2% of peripheral B-cells, and mutation of the Btk gene were enrolled. We observed the clinical features, laboratory findings, status of treatment, and complications in these XLA patients. RESULTS: All XLA patients had a history of recurrent bacterial infections before diagnosis, and 20% of them had a neutropenia. Of the XLA patients 35.7% had a family history of XLA and 75% of their mothers were carriers. Btk gene analysis showed variable gene mutations in Xq22 including 9 amino acid substitutions, 3 frameshifts, 1 premature stop codon, and 1 splice defect. After intravenous immunoglobulin replacement therapy, infection episodes decreased, but complications such as bronchiectasis and chronic sinusitis remained. CONCLUSIONS: In patients less than 4 years of age with recurrent infection, analysis of serum gamma globulin levels and the Btk gene are recommended for the early diagnosis of XLA and for the appropriate prevention of recurrent infection.


Assuntos
Agamaglobulinemia , Substituição de Aminoácidos , Linfócitos B , Infecções Bacterianas , Bronquiectasia , Códon sem Sentido , Diagnóstico , Diagnóstico Precoce , gama-Globulinas , Humanos , Imunoglobulinas , Imunoglobulinas Intravenosas , Mães , Neutropenia , Proteínas Tirosina Quinases , Seul , Sinusite
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-139841

RESUMO

Birt-Hogg-Dubé syndrome (BHDS) is a rare disease with autosomal dominant inheritance that manifests through skin tumors, pulmonary cystic lesions, and renal tumors. A mutation of FLCN located on chromosome 17p11.2, which encodes a tumor-suppressor protein (folliculin), is responsible for the development of BHDS. We report the case of a patient presenting with spontaneous pneumothorax, in whom a familial genetic study revealed a novel nonsense mutation: p.(Arg379*) in FLCN.


Assuntos
Síndrome de Birt-Hogg-Dubé , Códon sem Sentido , Estrona , Humanos , Pneumotórax , Doenças Raras , Pele , Cirurgia Torácica Vídeoassistida , Toracoscopia , Testamentos
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-139840

RESUMO

Birt-Hogg-Dubé syndrome (BHDS) is a rare disease with autosomal dominant inheritance that manifests through skin tumors, pulmonary cystic lesions, and renal tumors. A mutation of FLCN located on chromosome 17p11.2, which encodes a tumor-suppressor protein (folliculin), is responsible for the development of BHDS. We report the case of a patient presenting with spontaneous pneumothorax, in whom a familial genetic study revealed a novel nonsense mutation: p.(Arg379*) in FLCN.


Assuntos
Síndrome de Birt-Hogg-Dubé , Códon sem Sentido , Estrona , Humanos , Pneumotórax , Doenças Raras , Pele , Cirurgia Torácica Vídeoassistida , Toracoscopia , Testamentos
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-197566

RESUMO

Trimethylaminuria (TMAuria), known as “fish odor syndrome,” is a congenital metabolic disorder characterized by an odor resembling that of rotting fish. This odor is caused by the secretion of trimethylamine (TMA) in the breath, sweat, and body secretions and the excretion of TMA along with urine. TMAuria is an autosomal recessive disorder caused by mutations in flavin-containing monooxygenase 3 (FMO3). Most TMAuria cases are caused by missense mutations, but nonsense mutations have also been reported in these cases. Here, we describe the identification of a novel FMO3 gene mutation in a patient with TMAuria and her family. A 3-year-old girl presented with a strong corporal odor after ingesting fish. Genomic DNA sequence analysis revealed that she had compound heterozygous FMO3 mutations; One mutation was the missense mutation p.Val158Ile in exon 3, and the other was a novel nonsense mutation, p.Ser364X, in exon 7 of the FMO3 gene. Familial genetic analyses showed that the p.Val158Ile mutation was derived from the same allele in the father, and the p.Ser364X mutation was derived from the mother. This is the first description of the p.Ser364X mutation, and the first report of a Korean patient with TMAuria caused by novel compound heterozygous mutations.


Assuntos
Alelos , Pré-Escolar , Códon sem Sentido , Éxons , Pai , Feminino , Humanos , Coreia (Geográfico) , Mães , Mutação de Sentido Incorreto , Odorantes , Análise de Sequência de DNA , Suor
18.
Braz. j. microbiol ; 47(1): 177-180, Jan.-Mar. 2016. tab
Artigo em Inglês | LILACS (Américas) | ID: lil-775102

RESUMO

Abstract We report the first description of a rare catalase-negative strain of Staphylococcus aureus in Chile. This new variant was isolated from blood and synovial tissue samples of a pediatric patient. Sequencing analysis revealed that this catalase-negative strain is related to ST10 strain, which has earlier been described in relation to S. aureus carriers. Interestingly, sequence analysis of the catalase gene katA revealed presence of a novel nonsense mutation that causes premature translational truncation of the C-terminus of the enzyme leading to a loss of 222 amino acids. Our study suggests that loss of catalase activity in this rare catalase-negative Chilean strain is due to this novel nonsense mutation in the katA gene, which truncates the enzyme to just 283 amino acids.


Assuntos
Pré-Escolar , Humanos , Códon sem Sentido , Catalase/genética , Catalase/metabolismo , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/enzimologia , Staphylococcus aureus/genética , Artrite/microbiologia , Bacteriemia/microbiologia , Chile , DNA Bacteriano/química , DNA Bacteriano/genética , Genótipo , Análise de Sequência de DNA
19.
Lima; s.n; mar. 2016.
Não convencional em Espanhol | LILACS (Américas), BRISA | ID: biblio-847559

RESUMO

INTRODUCCIÓN: Antecedentes: El Instituto de Evaluación de Tecnologías en Salud e Investigación ha recibido la solicitud de evaluar el uso de Ataluren para su uso en Pacientes ambulantes mayores de 5 años con diagnóstico de distrofia muscular de Duchenne debida a una mutación sin sentido en el gen de la distrofina dentro del sistema de EsSalud, indicación actualmente no contemplada en el petitorio de medicamentos. Esta acción sigue lo estipulado en la Directiva N° 002-IETSI-ESSALUD-2015 y el objetivo final es determinar el estado del arte sobre la eficacia y seguridad de ataluren. Tecnología Sanitaria de Interés: Ataluren: La PTC124 (3-(5-(2-fluorofeni)-1, 2,4-oxadiazol-3-y1)-ácido benzoico), también conocida como Ataluren (TranslarnaTM) es una molécula pequeña de oxadiazol cuyo mecanismo de acción consiste en cominuar la traducción de ARNm sobre los codones de terminación prematuros causados por la mutación sin sentido, permitiendo la síntesis de distrofina completa y funcional. METODOLOGIA: Estrategia de Busqueda: Se realizó una búsqueda de la literatura con respecto a la eficacia y seguridad de Ataluren para el tratamiento de la DMD en las bases de datos de MEDLINE, EMBASE, CENTRAL, DARE y TRIPDATABASE. Se hizo una búsqueda adicional en www.clinicaltrials.gov, para poder identificar ensayos clínicos aún en elaboración o que no hayan sido publicados. Adicionalmente, se hizo una búsqueda dentro de la información generada por las principales instituciones internacionales oncológicas y agencias de tecnologías sanitarias que realizan revisiones sistemáticas (RS), evaluación de tecnologías sanitarias (ETS) y guías de práctica clínica (GPC). RESULTADOS:Sinopses de la Evidencia: Se realizó la búsqueda bibliográfica y de evidencia científica que sustente el uso de ataluren en DMD según la pregunta PICO establecida. Para el presente documento se seleccionó el siguiente cuerpo de evidencia que es resumido a continuación: Guías Clínicas: Se identificó una única guía práctica realizada en Colombia que hizo mención a este tratamiento. Evaluaciones de tecnología sanitaria: Se identificó una ETS del Reino Unido. Revisiones sistemáticas: No se identificaron revisiones sistemáticas. Estudios de calidad de vida: No se identificaron estudios que evaluaran calidad de vida. Ensayos clínicos: Se identificaron dos ECAs correspondientes a las fases 2a y fase 2 b. Ensayos clínicos en curso: se identificó el registro correspondiente a un estudio de fase III pendiente de publicar sus resultados. CONCLUSIONES: se evidencia que ataluren es un medicamento aún en estudio que no ha demostrado al momento ser diferente a placebo en el tratamiento de la DMD con mutación sin sentido. De hecho, la evidencia disponible que el ataluren no es mejor que el placebo en mejorar indicadores clínicos importantes en el manejo de esta enfermedad, como la DC6M, considerada como desenlace principal en enfermedades raras con compromiso neuromuscular. Ataluren tampoco mostró ser diferente al placebo en mejorar la calidad de vida de los pacientes, ni disminuye los tiempos para realizar tareas motoras como subir o bajar escalones, correr o caminar 10 metros y levantarse desde la posición supina. El Instituto de Evaluación de Tecnología en Salud e investigación ­ IETSI, no aprueba el uso de ataluren para el tratamiento de la DMD con mutación sin sentido del gen de la distrofina.


Assuntos
Humanos , Códon sem Sentido , Proteínas Associadas à Distrofina/deficiência , Distrofia Muscular de Duchenne/tratamento farmacológico , Oxidiazóis/administração & dosagem , Peru , Avaliação da Tecnologia Biomédica , Resultado do Tratamento
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-632805

RESUMO

A 2.4 kg baby boy born via Caesarian section at 35 weeks had the first onset of hypoglycemia at 2 hours of life. The infant required a glucose load of 30 mg/kg/min. Insulin level was 19.6 pmol/L (normal value 17.8-173.0) in the absence of ketosis. He was resistant to oral diazoxide but responded to octreotide infusion. The boy was found to be heterozygous for an ABCC8 nonsense mutation, p.R934*. We present our experience on the use of subcutaneous octreotide for 2 years for the treatment of diazoxide resistant congenital hyperinsulinism (CHI).


Assuntos
Masculino , Lactente , Códon sem Sentido , Hiperinsulinismo Congênito , Diazóxido , Glucose , Lactente , Insulinas , Cetose , Octreotida , Parto , Gravidez , Mutação
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