osteochondrodysplasias

骨软骨发育不良
  • 文章类型: Journal Article
    低于平均人口或假定的家族目标身高超过2SD的生长迟缓被归类为身材矮小,可能是许多疾病的临床表现。近年来,使用最新的分子遗传分析方法可以更好地了解身材矮小的遗传形式的发病机理。最近发现的这种病理机制之一是RPL13基因的单等位基因突变,导致Isidor-Toutain型脊柱表皮干发育不良(SEDM)的发展。这种形式的特征性表型特征是正常出生长度,出生后早期生长不足,桔梗,股骨近端骨phy改变,Coxavara,Genuvarum.这项研究介绍了俄罗斯联邦首例由RPL13基因突变引起的SEMD患者的临床和放射学特征。
    Growth retardation for more than 2 SD below the average population or presumed familial target height is classified as a short stature and may be a clinical manifestation of a large number of disorders. The use of the latest methods of molecular genetic analysis in recent years has allowed for a better understanding of the pathogenesis of inherited forms of a short stature. One of the recently discovered mechanisms of this pathology was monoallelic mutations in RPL13 gene, leading to the development of Isidor-Toutain type spondyloepimetaphyseal dysplasia (SEDM). Characteristic phenotypic features for this form are normal birth length, early postnatal growth deficiency, platyspondyly, proximal femoral epiphyseal changes, coxa vara, genu varum. This study presents the clinical and radiological characteristics of the first patient in the Russian -Federation with SEMD caused by a mutation in RPL13 gene.
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  • 文章类型: Journal Article
    方法:一名患有双侧Madelung畸形的32岁女性患者,表现为radious腕骨和桡尺远侧关节的严重疼痛和关节炎。在最后的后续行动中,左手腕17个月右手腕12个月,她有出色的功能效果,没有疼痛。运动范围为30°的屈曲和30°的伸展,完全前倾。
    结论:关于成人这种畸形的抢救程序的文献很少。我们展示了尺骨远端切除和放射性肩关节固定术的治疗方法。此程序可能适用于Madelung畸形,近端腕骨和远端尺尺关节关节炎。
    METHODS: A 32-year-old woman with bilateral Madelung deformity presented with severe pain and arthritis of the radiocarpal and distal radioulnar joints. At final follow-up, 17 months for the left and 12 months for the right wrist, she had excellent functional results with no pain. Range of motion was 30° of flexion and 30° of extension with full pronosupination.
    CONCLUSIONS: There is paucity in the literature regarding salvage procedures in adults with this deformity. We demonstrate treatment with distal ulna excision and an radioscapholunate arthrodesis. This procedure may be indicated in Madelung deformity and proximal radiocarpal and distal radioulnar joint arthritis.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    Stüve-Wiedemann综合征(SWS),一种罕见的常染色体隐性疾病,以尺寸小巧为特征,细长骨头的曲率,弯曲的手指,体温升高的事件,呼吸窘迫或屏气,以及喂养方面的挑战,尤其是导致婴儿死亡。SWS是白血病抑制因子受体基因中潜在错义突变的结果,反映为蛋白质水平的许多氨基酸突变。在计算机工具和技术中使用Pred_MutHTP进行突变筛选,I-Mutant2.0,PANTHER.db,PolyPhen,将突变归类为有害/不稳定,结合实验数据分析,P136A和S279P作为“效应”引起的突变出现。预先存在的知识表明,SWS进展是构象改变和功能失调的LIFR,无法与LIF结合并进一步形成LIF/LIFR/gp130信号传导复合物。为了获得对所述突变对野生型蛋白质的影响的功能见解,一个全原子,明确,溶剂分子动力学模拟是按照对接方法进行的。因此,提到RMSD,RMSF,蛋白质动态网络分析,能量景观地块和域运动分析,揭示了未结合的LIFR_WT像往常一样更倾向于LIF结合,而突变体表现出相当大的结构域封闭以抑制LIF结合。我们通过MM/GBSA进行了结合亲和力分析,并在LIFR-LIF对接后进行了解离常数估计,发现与与SWS相关的柔性突变复合物相比,WT_复合物整体上更稳定和紧凑。我们的研究为了解LIFR突变的分子水平含义提供了途径,这为治疗干预开辟了途径。
    Stüve-Wiedemann syndrome (SWS), a rare autosomal recessive disorder, characterized by diminutive size, curvature of the elongated bones, bent fingers, episodes of heightened body temperature, respiratory distress or periods of breath-holding, and challenges with feeding, especially causes fatality in infants. SWS is an outcome of potential missense mutations in the leukemia inhibitory factor receptor gene reflected as numerous amino acid mutations at protein level. Employing in silico tools and techniques like mutational screening with Pred_MutHTP, I-Mutant2.0, PANTHER.db, PolyPhen, to classify mutations as deleterious/destabilizing, in conjunction with experimental data analysis, P136A and S279P emerged as \'effect\'-causing mutations. Pre-existing knowledge suggests, SWS progression is effectuated conformationally altered and dysfunctional LIFR, unable to bind to LIF and further form the LIF/LIFR/gp130 signalling complex. To gain functional insights into the effect of the said mutations on the wild type protein, an all-atom, explicit, solvent molecular dynamics simulation was performed following docking approaches. Consequently, referring to the RMSD, RMSF, protein dynamic network analysis, energy landscape plots and domain motion analysis, it was revealed that unbound LIFR_WT was more prone to LIF binding as usual whereas the mutants exhibited considerable domain closure to inhibit LIF binding. We conducted binding affinity analysis via MM/GBSA and dissociation constant estimation after LIFR-LIF docking and found the WT_complex to be more stable and compact as a whole when compared to the flexible mutant complexes thus being associated with SWS. Our study offers a route for understanding molecular level implications upon LIFR mutations which opens an avenue for therapeutic interventions.
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  • 文章类型: Journal Article
    背景:多发性骨phy发育不良-4(MED-4,MIM226900)是一种罕见的常染色体隐性疾病,其特征是身高不成比例和下肢早发性骨关节炎。MED-4由SLC26A2基因中的纯合或复合杂合致病变体引起。然而,软骨细胞的致病机制尚不清楚.这项研究旨在鉴定MED-4家族中的致病变体,并探索人类原代软骨细胞中这种情况的分子病因。
    方法:记录临床数据,收集外周血样本进行分析。进行全外显子组测序(WES)和生物信息学分析以确定致病变体。构建野生型SLC26A2和相应的突变表达质粒并转染到人原代软骨细胞中。采用免疫印迹法和免疫荧光法检测SLC26A2蛋白在软骨细胞中的表达及亚细胞分布。通过细胞计数试剂盒-8(CCK-8)测定来测量这些变体对软骨细胞活力和凋亡的影响。随后通过定量实时聚合酶链反应(qRT-PCR)分析与软骨稳态相关的基因的表达。
    结果:我们鉴定了两个复合杂合变体c.1020_1022delTGT(p。Val341del)和c.1262T>C(p。Ile421Thr)在SLC26A2基因的患者中。突变体SLC26A2Val341del和SLC26A2Ile421Thr蛋白分布在相对较少的细胞中,仅在细胞核内观察到。具有SLC26A2变体组的软骨细胞的活力与野生型(WT)组相似。然而,SLC26A2Val341del和SLC26A2Ile421Thr的蛋白表达较SLC26A2WT降低。基质金属肽酶13(MMP13)的表达水平,X型胶原α-1链(COL10A1),变异组的Runt相关转录因子2(RUNX2)显著降低。然而,变体组的聚集蛋白聚糖(ACAN)表达高于WT组.
    结论:总体而言,我们的数据表明,SLC26A2中的变体p.Val341del和p.Ile421Thr可引起MED-4,这两种变体可促进软骨细胞增殖,同时抑制软骨细胞分化.
    BACKGROUND: Multiple epiphyseal dysplasia-4 (MED-4, MIM 226900) is a rare autosomal recessive disease characterized by disproportionate height and early onset osteoarthritis of the lower limbs. MED-4 is caused by homozygous or compound heterozygous pathogenic variants in the SLC26A2 gene. However, the underlying pathogenic mechanisms in chondrocytes remains unknown. This study aimed to identify the pathogenic variants within a MED-4 family and explore the molecular etiology of this condition in human primary chondrocyte cells.
    METHODS: Clinical data were recorded and peripheral blood samples were collected for analysis. Whole exome sequencing (WES) and bioinformatic analyses were performed to determine causative variants. Wild-type SLC26A2 and corresponding mutant expression plasmids were constructed and transfected into human primary chondrocytes. The expression and subcellular distribution of SLC26A2 protein in chondrocytes were detected by immunoblotting and immunofluorescence. Effects of these variants on chondrocytes viability and apoptosis were measured by Cell Counting Kit-8 (CCK-8) assay. Expression of genes related to cartilage homeostasis was subsequently analyzed by quantitative real-time polymerase chain reaction (qRT-PCR).
    RESULTS: We identified two compound heterozygous variants c.1020_1022delTGT(p.Val341del) and c.1262 T > C(p.Ile421Thr) in the SLC26A2 gene in the patients. Mutant SLC26A2Val341del and SLC26A2Ile421Thr proteins were distributed in relatively few cells and were observed only within the nucleus. The viability of chondrocytes with the SLC26A2 variant group was similar to the wild-type (WT) group. However, the protein expressions of SLC26A2Val341del and SLC26A2Ile421Thr were decreased compared with SLC26A2WT. Expression levels of matrix metallopeptidase 13 (MMP13), α-1 chain of type X collagen (COL10A1), and Runt-related transcription factor 2 (RUNX2) were significantly decreased in the variant group. However, aggrecan (ACAN) expression was higher in the variant group than the WT group.
    CONCLUSIONS: Overall, our data demonstrate that the variants p.Val341del and p.Ile421Thr in SLC26A2 cause MED-4 and that these two variants promote chondrocyte proliferation while inhibiting chondrocyte differentiation.
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  • 文章类型: English Abstract
    目的:分析1例多发性骨phy发育不良(MED)家系的遗传变异和分子致病机制。
    方法:选择2020年9月13日在首都医科大学附属北京积水潭医院发表的MED家系作为研究对象。收集家系的临床数据。从谱系成员中抽取外周血样品用于提取基因组DNA。对谱系进行全外显子组测序(WES)。通过Sanger测序验证候选变体。构建野生型和突变型SLC26A2表达质粒并转染到人原代软骨细胞中。通过免疫荧光和CCK8测定确定变体对蛋白质定位和细胞增殖的影响。
    结果:WES和Sanger测序显示先证者含有SLC26A2基因的复合杂合变体,包括父系衍生的c.484G>T(p.Val162Leu)错义变体和母系衍生的c.485_486delTG(p。Val162Glyfs*12)移码变体。SLC26A2WT及其突变体SLC26A2Val162Leu和SLC26A2Val162Glyfs*12表达质粒分布在人原代软骨细胞的细胞核和细胞质中。与SLC26A2WT相比,SLC26A2Val162Leu和SLC26A2Val162Glyfs*12的表达降低,伴随着人原代软骨细胞的增殖减少。
    结论:SLC26A2基因的c.484G>T和c.485_486delTG复合杂合变体可能会影响人原代软骨细胞的增殖,并为该家系MED的发病机理奠定了基础。
    OBJECTIVE: To analyze the genetic variant and molecular pathogenesis in a Chinese pedigree affected with Multiple epiphyseal dysplasia (MED).
    METHODS: A MED pedigree which had presented at the Beijing Jishuitan Hospital Affiliated to Capital Medical University on September 13, 2020 was selected as the study subject. Clinical data of the pedigree were collected. Peripheral blood samples were drawn from pedigree members for the extraction of genomic DNA. Whole exome sequencing (WES) was carried out for the pedigree. Candidate variant was verified by Sanger sequencing. Wild type and mutant SLC26A2 expression plasmids were constructed and transfected into human primary chondrocytes. The effect of the variants on the protein localization and cell proliferation was determined by immunofluorescence and CCK8 assays.
    RESULTS: WES and Sanger sequencing revealed that the proband has harbored compound heterozygous variants of the SLC26A2 gene, including a paternally derived c.484G>T (p.Val162Leu) missense variant and a maternally derived c.485_486delTG (p.Val162Glyfs*12) frameshifting variant. The SLC26A2WT and its mutant SLC26A2Val162Leu and SLC26A2Val162Glyfs*12 expression plasmids were distributed in the nuclei and cytoplasm of human primary chondrocytes. Compared with SLC26A2WT, the expressions of SLC26A2Val162Leu and SLC26A2Val162Glyfs*12 were decreased, along with reduced proliferation of human primary chondrocytes.
    CONCLUSIONS: The c.484G>T and c.485_486delTG compound heterozygous variants of the SLC26A2 gene may affect the proliferation of human primary chondrocytes and underlay the pathogenesis of MED in this pedigree.
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  • 文章类型: Journal Article
    背景:髓系细胞上表达的触发受体2蛋白(TREM2)在各种生物学过程中起着至关重要的作用,包括破骨细胞分化,和疾病相关的小胶质细胞(DAM)激活来调节神经炎症,和大脑中的吞噬作用。TREM2的遗传变异与神经退行性疾病有关,例如Nasu-hakola病(NHD),以骨病变为特征,神经精神疾病,和早发性痴呆.
    方法:我们研究了3名疑似NHD的兄弟姐妹。对先证者进行全外显子组测序以确定可能的遗传原因,并通过Sanger测序以验证另外两个受影响的兄弟姐妹中已识别的变体。一个健康的妹妹,还有父母.
    结果:我们在TREM2中鉴定了新的纯合缺失(c.549del;p.(Leu184Serfs*5))。我们的文献综述揭示了16个TREM2突变导致早发性痴呆和骨病变。
    结论:这些发现,除了先前的研究,阐明TREM2相关疾病的临床谱,帮助准确的诊断和病人护理。这些知识对于理解TREM2依赖性DAM及其参与神经发育障碍的发病机理至关重要,这可以帮助开发靶向治疗并改善受TREM2影响的个体的结果。
    BACKGROUND: The Triggering Receptor Expressed on Myeloid Cells 2 protein (TREM2) plays a crucial role in various biological processes, including osteoclast differentiation, and disease-associated microglia (DAM) activation to regulate neuroinflammation, and phagocytosis in the brain. Genetic variations in TREM2 are implicated in neurodegenerative disorders, such as Nasu-hakola disease (NHD), characterized by bone lesions, neuropsychiatric disorders, and early-onset dementia.
    METHODS: We studied 3 siblings with suspected NHD. Whole-exome sequencing was conducted on the proband to identify the possible genetic cause(s) and by Sanger sequencing to validate the identified variants in the two other affected siblings, a healthy sister, and the parents.
    RESULTS: We identified a novel homozygous deletion (c.549del; p.(Leu184Serfs*5)) in TREM2. Our literature review reveals 16 TREM2 mutations causing early-onset dementia and bone lesions.
    CONCLUSIONS: These findings, alongside previous research, elucidate the clinical spectrum of TREM2-related diseases, aiding accurate diagnosis and patient care. This knowledge is vital for understanding TREM2-dependent DAM and its involvement in the pathogenesis of neurodevelopmental disorders which can help to develop targeted therapies and improve outcomes for TREM2-affected individuals.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    软骨-毛发发育不全综合征(CHH)是一种常染色体隐性遗传疾病,通常与n.72A>G(以前称为n.70A>G和n.71A>G)有关,全球最常见的RMRP变体。已经描述了该基因中的130多种致病变体与CHH相关,据报道,芬兰和日本人口中有创始人的改变。我们先前在巴西CHH患者中的研究显示,与其他人群相比,n.197C>T变体(前n.195C>T和n.196C>T)的患病率很高。这项研究的目的是研究在一系列CHH巴西患者中RMRP基因中n.197C>T变体的可能的创始人效应。我们选择了9号染色体内的四个TAGSNP,并对先证者及其父母进行了基因分型(先前描述的23例患者和9例新颖患者)。鉴定了n.197C>T变异携带者的常见单倍型。患者的特征还包括46个常染色体祖先信息标记(AIM)。欧洲血统是最普遍的(58%),其次是非洲(24%)和美洲原住民(18%)。我们的结果加强了巴西n.197C>T变体的基础效应的假设,并表明RMRP基因中的该变体起源于9号染色体上的单个事件,可能是欧洲起源。
    Cartilage-hair hypoplasia syndrome (CHH) is an autosomal recessive disorder frequently linked to n.72A>G (previously known as n.70A>G and n.71A>G), the most common RMRP variant worldwide. More than 130 pathogenic variants in this gene have already been described associated with CHH, and founder alterations were reported in the Finnish and Japanese populations. Our previous study in Brazilian CHH patients showed a high prevalence of n.197C>T variant (former n.195C>T and n.196C>T) when compared to other populations. The aim of this study was to investigate a possible founder effect of the n.197C>T variant in the RMRP gene in a series of CHH Brazilian patients. We have selected four TAG SNPs within chromosome 9 and genotyped the probands and their parents (23 patients previously described and nine novel). A common haplotype to the n.197C>T variant carriers was identified. Patients were also characterized for 46 autosomal Ancestry Informative Markers (AIMs). European ancestry was the most prevalent (58%), followed by African (24%) and Native American (18%). Our results strengthen the hypothesis of a founder effect for the n.197C>T variant in Brazil and indicate that this variant in the RMRP gene originated from a single event on chromosome 9 with a possible European origin.
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  • 文章类型: Journal Article
    鉴于气管骨软骨症(TO)的罕见性,基层医院的许多年轻医生无法根据支气管镜检查结果识别TO.
    建立人工智能(AI)模型,用于通过使用支气管镜图像将TO与其他多结节气道疾病区分开来。
    我们通过使用EfficientNet比较2010年1月至2022年10月接受支气管镜检查的患者的影像学数据来设计研究。收集2019年10月至2022年10月安徽省胸科医院21例TO患者的支气管镜图像进行外部验证。
    多结节气道病变患者的支气管镜图像(包括TO,淀粉样变性,肿瘤,和炎症),并且在广州医科大学附属第一医院没有气道病变。这些图像被随机(4:1)分为基于不同疾病的训练和验证组,并通过卷积神经网络(CNN)用于深度学习。
    我们招募了201例多结节性气道疾病患者(38、15、75和73例TO患者,淀粉样变性,肿瘤,和炎症,分别)和213无任何气道病变。为了找到用于深度学习的多结节病变图像,我们使用了2183张支气管镜图像的多结节病变(包括TO,淀粉样变性,肿瘤,和炎症),并将它们与没有任何气道病变的图像进行比较(1733)。多结节病变识别的准确率为98.9%。Further,基于多结节病变支气管镜图像的TO检测准确率为89.2%.关于外部验证(使用来自21名TO患者的图像),所有患者均可诊断为TO;准确率为89.8%.
    我们建立了一个AI模型,可以将TO与其他多结节性气道疾病(主要是淀粉样变性,肿瘤,和炎症)通过使用支气管镜图像。该模型可以帮助年轻医生识别这种罕见的气道疾病。
    UNASSIGNED: Given the rarity of tracheobronchopathia osteochondroplastica (TO), many young doctors in primary hospitals are unable to identify TO based on bronchoscopy findings.
    UNASSIGNED: To build an artificial intelligence (AI) model for differentiating TO from other multinodular airway diseases by using bronchoscopic images.
    UNASSIGNED: We designed the study by comparing the imaging data of patients undergoing bronchoscopy from January 2010 to October 2022 by using EfficientNet. Bronchoscopic images of 21 patients with TO at Anhui Chest Hospital from October 2019 to October 2022 were collected for external validation.
    UNASSIGNED: Bronchoscopic images of patients with multinodular airway lesions (including TO, amyloidosis, tumors, and inflammation) and without airway lesions in the First Affiliated Hospital of Guangzhou Medical University were collected. The images were randomized (4:1) into training and validation groups based on different diseases and utilized for deep learning by convolutional neural networks (CNNs).
    UNASSIGNED: We enrolled 201 patients with multinodular airway disease (38, 15, 75, and 73 patients with TO, amyloidosis, tumors, and inflammation, respectively) and 213 without any airway lesions. To find multinodular lesion images for deep learning, we utilized 2183 bronchoscopic images of multinodular lesions (including TO, amyloidosis, tumor, and inflammation) and compared them with images without any airway lesions (1733). The accuracy of multinodular lesion identification was 98.9%. Further, the accuracy of TO detection based on the bronchoscopic images of multinodular lesions was 89.2%. Regarding external validation (using images from 21 patients with TO), all patients could be diagnosed with TO; the accuracy was 89.8%.
    UNASSIGNED: We built an AI model that could differentiate TO from other multinodular airway diseases (mainly amyloidosis, tumors, and inflammation) by using bronchoscopic images. The model could help young physicians identify this rare airway disease.
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