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Propionic acidemia and methylmalonic aciduria: A portrait of the first 3 years—Admissions and complications 丙酸血症和甲基丙二酸尿:前3年的住院和并发症
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-09 DOI: 10.1016/j.ymgme.2025.109289
Kimberly A. Chapman , Nicholas Ah Mew , Nina Mickle , Danielle Starin , Erin MacLeod

Background

Propionic acidemia (PA) and methylmalonic acidemia (MMA) are organic acidurias that can present with metabolic acidosis and hyperammonemia, often leading to frequent hospital admission. While recent studies have provided guidelines for management and diagnosis of these conditions, there is a lack of research detailing the frequency and reasons for hospital admission in the first three years of life.

Methods

As part of a quality improvement project, data were extracted from medical records of all patients with PA and MMA (born between 2000 and 2024) who were seen at Children's National Hospital (CNH) during their first three years of life, time of data pull, or up to point of liver transplant. We collected data on the number of individuals with PA or MMA in our patient population, the age at which they first presented, and the reason for their hospital admission.

Results

Our cohort included 11 individuals with MMA, all of whom had MMUT mutations, representing a total of 12 different variants. Additionally, 15 individuals with PA were reported. Of these, 2 individuals with PA did not undergo genetic testing, 5 had 7 separate variants in PCCA gene, and 8 had 10 different variants in PCCB gene. The mean number of hospitalizations for metabolic decompensation was 4.45 ± 6.6 for the MMA cohort and 8.7 ± 6.7 for the PA cohort, with no statistically significant difference between the groups. The MMA cohort experienced a total of 49 admissions, 16 (33 %) of which occurred in the first year of life. In the PA cohort, there were 130 total admissions, with 56 (43 %) occurring in the first year. The most frequent reason for admission in both groups was vomiting.

Discussion/Conclusions

Individuals with PA and MMA are frequently hospitalized (accounting for 5–6 % of their first three years of life) which likely impacts development and overall health. Data such as those presented in this study are crucial for improving our understanding of disease progression in these rare conditions. This information can help guide future research, support the development of the clinical guidelines, and provide healthcare providers with valuable insights to better educate families on risks and expectations. Using these data, we have altered our counseling at the time of diagnosis to better prepare families for their child's course.
背景:丙酸血症(PA)和甲基丙二酸血症(MMA)是有机酸血症,可表现为代谢性酸中毒和高氨血症,常导致频繁住院。虽然最近的研究为这些疾病的管理和诊断提供了指导方针,但缺乏详细说明三岁前住院的频率和原因的研究。方法:作为质量改进项目的一部分,从儿童国家医院(CNH)就诊的所有PA和MMA患者(2000年至2024年出生)在其生命的前三年,数据提取时间或直到肝移植点的医疗记录中提取数据。我们收集了患者群体中患有PA或MMA的个体数量、首次出现的年龄以及入院原因的数据。结果:我们的队列包括11名MMA患者,他们都有MMUT突变,总共代表12种不同的变体。此外,还报告了15例PA患者。其中2例PA患者未进行基因检测,5例有7个不同的PCCA基因变异,8例有10个不同的PCCB基因变异。MMA组因代谢失代偿住院的平均次数为4.45±6.6次,PA组为8.7±6.7次,两组间差异无统计学意义。MMA队列共经历了49例入院,其中16例(33%)发生在生命的第一年。在PA队列中,总共有130人入学,其中56人(43%)发生在第一年。两组患者最常见的入院原因均为呕吐。讨论/结论:患有PA和MMA的个体经常住院(占其生命前3年的5- 6%),这可能影响发育和整体健康。这项研究中提出的数据对于提高我们对这些罕见疾病进展的理解至关重要。这些信息可以帮助指导未来的研究,支持临床指南的开发,并为医疗保健提供者提供有价值的见解,以便更好地教育家庭了解风险和期望。利用这些数据,我们改变了诊断时的咨询方式,让家庭更好地为孩子的病程做好准备。
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引用次数: 0
MEHMO syndrome: Review and proposed classification as an eIF2-related neuroendocrinopathy MEHMO综合征:回顾并建议分类为eif2相关神经内分泌病
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-03 DOI: 10.1016/j.ymgme.2025.109287
An N. Dang Do , Fatemeh Navid , Sara K. Young-Baird
MEHMO syndrome (OMIM#300148) is a rare, X-linked, multisystemic condition that predominantly involves endocrinologic and neurologic dysfunctions. Initial naming of the syndrome emphasizes the presentation of Mental disability, Epileptic seizures, Hypogonadism/Hypogenitalism, Microcephaly, and Obesity. This review provides a synthesis of the genetics, genotypes, and phenotypes of publicly available information on EIF2S3 and MEHMO syndrome. Identification and confirmation of variants in the gene EIF2S3 as the genetic underpinning of the syndrome's pathophysiology and reports of additional cases suggest a consideration for a re-definition of the acronym and a re-classification of the condition along with others as eIF2-related neuroendocrinopathies. This would allow for more standardized and encompassing characterization of the group of eIF2-related disorders, that in turn would support and continue to spur further research progress in basic pathophysiology, disease diagnosis and monitoring, and biomarker and therapeutic discoveries.
MEHMO综合征(OMIM#300148)是一种罕见的x连锁多系统疾病,主要涉及内分泌和神经功能障碍。该综合征的最初命名强调精神残疾、癫痫发作、性腺功能减退/性腺功能减退、小头畸形和肥胖的表现。这篇综述综合了EIF2S3和MEHMO综合征的遗传学、基因型和表型的公开信息。EIF2S3基因变异的鉴定和确认是该综合征病理生理的遗传基础,以及其他病例的报告表明,需要考虑重新定义首字母缩略词,并将该疾病与其他疾病一起重新分类为eif2相关神经内分泌疾病。这将允许对eif2相关疾病组进行更标准化和更全面的表征,这反过来将支持并继续推动基础病理生理学、疾病诊断和监测、生物标志物和治疗发现方面的进一步研究进展。
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引用次数: 0
Identification of variants of the MTR gene in patients with the cblG inborn error of cobalamin metabolism diagnosed by somatic cell complementation analysis 体细胞互补分析诊断先天性钴胺素代谢错误cblG患者MTR基因变异的鉴定
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-03 DOI: 10.1016/j.ymgme.2025.109280
David Watkins , Caitlin Zacharias , Kyana Arbabian-Urquilla , Krithika Ragupathi , Brian M. Gilfix , Daniel Jimenez , Natascia Anastasio , Jean-Baptiste Rivière , David S. Rosenblatt

Purpose

The cblG inborn error of vitamin B12 metabolism is associated with pathogenic variants in the MTR gene, which encodes methionine synthase. Approximately 50 patients with the disorder have been reported, and 54 potentially causal MTR variants published.

Methods

We performed next generation sequencing and copy number variant analysis of MTR on genomic DNA from 29 cblG patients, including 7 patients that had been previously sequenced with incomplete results. All patients had been diagnosed using somatic cell complementation analysis.

Results

We identified two potential causal variants in each of the patients analyzed, although parental phasing was not done. 39 different variants were identified, including 24 not previously described in the published literature. The most common identified causal variant was c.3518C > T, p.P1173L (8 alleles). The previously identified deep intronic variants c.340-166 A > T and c.609 + 1088G > A were also seen frequently (6 alleles each). Among the newly identified variants, the most common were c.2020C > T p.Arg674Cys (3 alleles) and c.1325C > A, p.Ala442Glu (2 alleles).

Conclusion

Identification of pathogenic or likely pathogenic variants was enhanced by knowledge of complementation status which has become less frequent as somatic cell testing becomes less readily available.
目的cblG先天性维生素B12代谢错误与编码蛋氨酸合成酶的MTR基因致病性变异有关。大约有50例患者报道了这种疾病,并发表了54例潜在的因果MTR变异。方法对29例cblG患者的基因组DNA进行下一代测序和MTR拷贝数变异分析,其中7例患者先前测序结果不完整。所有患者均采用体细胞互补分析进行诊断。结果我们在分析的每个患者中确定了两个潜在的因果变异,尽管没有进行亲代分期。发现了39种不同的变异,包括24种以前未在发表文献中描述的变异。最常见的致病变异为c.3518C >; T, p.P1173L(8个等位基因)。先前发现的深层内含子变异c.340-166 A >; T和c.609 + 1088G >; A也经常出现(每个等位基因6个)。在新发现的变异中,最常见的是c.2020C > T . p.a arg674cys(3个等位基因)和c.1325C >; A, p.a ala442glu(2个等位基因)。结论随着体细胞检测技术的发展,对互补状态的了解减少了对致病性或可能致病性变异的识别。
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引用次数: 0
“Nobody listened to us for years”: Parents' experiences of provider communication in the diagnostic odyssey “多年来没有人听我们的”:父母在诊断过程中与医生沟通的经历。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-03 DOI: 10.1016/j.ymgme.2025.109283
Michelle M. Nguyen , Sevil Mahfoozi , Devon Bonner , Daphne O. Martschenko , Alisha Giri , Charis Tang , Undiagnosed Diseases Network, Jonathan A. Bernstein , Matthew T. Wheeler , Meghan C. Halley

Background

Well-recognized challenges in rare disease diagnosis include limited awareness of rare diseases among healthcare providers and barriers to accessing genetic testing. Less well understood are the ways in which communication between parents of undiagnosed children and providers may impact access to diagnosis, as well as quality of care broadly. We sought to characterize key dynamics of communication between parents of undiagnosed children and healthcare providers during the diagnostic odyssey.

Methods

Parents of undiagnosed children undergoing genomic sequencing were recruited from clinical and research settings and Facebook groups. Participants completed up to three sequential, in-depth interviews. Data were analyzed inductively to identify key themes.

Results

Parents (n = 36) identified three key dimensions of their experiences communicating with providers during the diagnostic odyssey, including examples of both effective and challenging communication related to: 1) providers' availability and responsiveness; 2) trust and validation of their concerns by providers; and 3) communication across multiple providers. Parents also described employing divergent strategies, such as increased persistence and advocacy, or minimized communication and resignation, in response to challenges.

Conclusions

Our study identified ways in which parent-provider communication can facilitate or hinder access to diagnosis and care for children with undiagnosed diseases. However, communication challenges were not universal, suggesting opportunities for intervention. Additional research is needed to identify interventions to improve parent-provider interactions during the diagnostic odyssey and to systematically evaluate the impact on time to diagnosis, access to care and patient health outcomes.
背景:罕见病诊断中公认的挑战包括医疗保健提供者对罕见病的认识有限以及获得基因检测的障碍。未确诊儿童的父母与提供者之间的沟通可能影响获得诊断的途径以及广泛的护理质量,但人们对这一点了解较少。我们试图描述在诊断过程中未确诊儿童的父母和医疗保健提供者之间沟通的关键动态。方法:从临床和研究机构以及Facebook群组中招募未确诊儿童的父母进行基因组测序。参与者完成了多达三次连续的深度访谈。对数据进行归纳分析,以确定关键主题。结果:家长(n = 36)确定了他们在诊断过程中与提供者沟通的三个关键维度,包括有效和具有挑战性的沟通的例子:1)提供者的可用性和响应性;2)提供者对其关注的信任和验证;3)跨多个提供者的通信。家长们还描述了采用不同的策略来应对挑战,比如增加坚持和倡导,或者减少沟通和放弃。结论:我们的研究确定了父母-提供者沟通可以促进或阻碍未确诊疾病儿童获得诊断和护理的方式。然而,沟通挑战并非普遍存在,这意味着干预的机会。需要进一步的研究来确定干预措施,以改善诊断过程中父母与提供者之间的互动,并系统地评估对诊断时间、获得护理和患者健康结果的影响。
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引用次数: 0
Mild pancreatic fibrosis with preserved exocrine function and increased visceral adipose tissue in m.3243A>G carriers: A magnetic resonance imaging study m.3243A>G携带者轻度胰腺纤维化,外分泌功能保留,内脏脂肪组织增加:磁共振成像研究
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-02 DOI: 10.1016/j.ymgme.2025.109282
Simone Rask Nielsen , Mimoza Gjela , Malene Pontoppidan Stoico , Asbjørn Mohr Drewes , Søren Schou Olesen , Kurt Højlund , Inge Søkilde Pedersen , Christina Brock , Jens Brøndum Frøkjær , Anja Lisbeth Frederiksen

Background

Carriers of the mitochondrial variant m.3243A>G have a high risk of diabetes mellitus and frequently report gastrointestinal symptoms, suggesting a dual endocrine and exocrine pancreas dysfunction. Whether changes in pancreatic morphology, abdominal or ectopic fat distribution contribute to these conditions, remains unknown.

Methods

Twelve m.3243A>G carriers with diabetes, 11 carriers without diabetes, and 23 healthy controls underwent abdominal magnetic resonance imaging (MRI). T1 relaxation time and magnetic resonance elastography (MRE) stiffness estimated pancreatic fibrosis. Pancreas volume was assessed by MRI and combined with faecal elastase measurements to evaluate exocrine pancreatic function. The ectopic fat content of muscle and the pancreas was estimated using proton density fat fraction, alongside abdominal fat measurements of cross-sectional areas (CSA) of visceral and subcutaneous adipose tissue. The homeostasis model assessment 2 (HOMA2) was used to estimate insulin resistance (HOMA2-IR).

Results

Compared to healthy controls, carriers with diabetes had an increased median [IQR] T1 relaxation time (909 ms [868–1085] vs. 823 ms [785–852], p < 0.001) and MRE stiffness (1.32 kPa [1.24–1.43] vs. 1.23 kPa [1.12–1.28], p = 0.03). There was no difference in pancreas volume or evidence of exocrine pancreatic dysfunction evaluated by faecal elastase. Visceral adipose tissue CSA median [IQR] was increased in m.3243A>G carriers compared to controls (61.0 cm2 [26.4–100.9] vs. 27.9 cm2 [17.2–65.0], p = 0.03) and correlated positively with HOMA2-IR (rs = 0.7, p < 0.001).

Conclusion

Increased T1 relaxation time and MRE stiffness indicate mild pancreatic fibrosis in m.3243A>G carriers with diabetes, without further evidence of exocrine insufficiency. Visceral fat was increased in m.3243A>G carriers and associated with insulin resistance, implying metabolic dysregulation.
线粒体变异m.3243A>;G的携带者患糖尿病的风险高,且经常报告胃肠道症状,提示胰腺内分泌和外分泌双重功能障碍。胰腺形态、腹部或异位脂肪分布的改变是否会导致这些疾病,目前尚不清楚。方法对12例糖尿病m.3243A>;G携带者、11例非糖尿病携带者和23例健康对照者进行腹部磁共振成像(MRI)检查。T1松弛时间和磁共振弹性成像(MRE)刚度估计胰腺纤维化。通过MRI评估胰腺体积,并结合粪便弹性酶测量来评估外分泌胰腺功能。肌肉和胰腺的异位脂肪含量是用质子密度脂肪分数来估计的,同时腹部脂肪测量内脏和皮下脂肪组织的横截面积(CSA)。使用稳态模型评估2 (HOMA2)来评估胰岛素抵抗(HOMA2- ir)。结果与健康对照组相比,糖尿病患者T1舒张时间中位数(909 ms[868-1085]比823 ms [785-852], p < 0.001)和MRE僵硬度(1.32 kPa[1.24-1.43]比1.23 kPa [1.12-1.28], p = 0.03)增加。通过粪便弹性蛋白酶评估胰腺体积或外分泌胰腺功能障碍的证据没有差异。与对照组相比,m.3243A>;G携带者的内脏脂肪组织CSA中位数[IQR]升高(61.0 cm2[26.4-100.9]对27.9 cm2 [17.2-65.0], p = 0.03),并与HOMA2-IR呈正相关(rs = 0.7, p < 0.001)。结论T1松弛时间和MRE僵硬度增加提示m.3243A>;G型糖尿病患者有轻度胰腺纤维化,无外分泌功能不全的进一步证据。m.3243A>;G携带者内脏脂肪增加,并与胰岛素抵抗相关,暗示代谢失调。
{"title":"Mild pancreatic fibrosis with preserved exocrine function and increased visceral adipose tissue in m.3243A>G carriers: A magnetic resonance imaging study","authors":"Simone Rask Nielsen ,&nbsp;Mimoza Gjela ,&nbsp;Malene Pontoppidan Stoico ,&nbsp;Asbjørn Mohr Drewes ,&nbsp;Søren Schou Olesen ,&nbsp;Kurt Højlund ,&nbsp;Inge Søkilde Pedersen ,&nbsp;Christina Brock ,&nbsp;Jens Brøndum Frøkjær ,&nbsp;Anja Lisbeth Frederiksen","doi":"10.1016/j.ymgme.2025.109282","DOIUrl":"10.1016/j.ymgme.2025.109282","url":null,"abstract":"<div><h3>Background</h3><div>Carriers of the mitochondrial variant m.3243A&gt;G have a high risk of diabetes mellitus and frequently report gastrointestinal symptoms, suggesting a dual endocrine and exocrine pancreas dysfunction. Whether changes in pancreatic morphology, abdominal or ectopic fat distribution contribute to these conditions, remains unknown.</div></div><div><h3>Methods</h3><div>Twelve m.3243A&gt;G carriers with diabetes, 11 carriers without diabetes, and 23 healthy controls underwent abdominal magnetic resonance imaging (MRI). T1 relaxation time and magnetic resonance elastography (MRE) stiffness estimated pancreatic fibrosis. Pancreas volume was assessed by MRI and combined with faecal elastase measurements to evaluate exocrine pancreatic function. The ectopic fat content of muscle and the pancreas was estimated using proton density fat fraction, alongside abdominal fat measurements of cross-sectional areas (CSA) of visceral and subcutaneous adipose tissue. The homeostasis model assessment 2 (HOMA2) was used to estimate insulin resistance (HOMA2-IR).</div></div><div><h3>Results</h3><div>Compared to healthy controls, carriers with diabetes had an increased median [IQR] T1 relaxation time (909 ms [868–1085] vs. 823 ms [785–852], <em>p</em> &lt; 0.001) and MRE stiffness (1.32 kPa [1.24–1.43] vs. 1.23 kPa [1.12–1.28], <em>p</em> = 0.03). There was no difference in pancreas volume or evidence of exocrine pancreatic dysfunction evaluated by faecal elastase. Visceral adipose tissue CSA median [IQR] was increased in m.3243A&gt;G carriers compared to controls (61.0 cm<sup>2</sup> [26.4–100.9] vs. 27.9 cm<sup>2</sup> [17.2–65.0], <em>p</em> = 0.03) and correlated positively with HOMA2-IR (r<sub>s</sub> = 0.7, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Increased T1 relaxation time and MRE stiffness indicate mild pancreatic fibrosis in m.3243A&gt;G carriers with diabetes, without further evidence of exocrine insufficiency. Visceral fat was increased in m.3243A&gt;G carriers and associated with insulin resistance, implying metabolic dysregulation.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 4","pages":"Article 109282"},"PeriodicalIF":3.5,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical characteristics and real-world outcomes in patients with mucopolysaccharidosis II over 18 years: final report of the Hunter Outcome Survey 18岁以上II型粘多糖病患者的临床特征和实际结果:Hunter结果调查的最终报告
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-02 DOI: 10.1016/j.ymgme.2025.109284
Joseph Muenzer , Jaco Botha , Hernan Amartino , Roberto Giugliani , Paul Harmatz , Christoph Kampmann , Bianca Link , Shuan-Pei Lin , David Molter , Julian Raiman , Maurizio Scarpa , Anna Tylki-Szymańska , Siddharth Jain , David A.H. Whiteman , Barbara K. Burton

Background

Mucopolysaccharidosis II (MPS II) is a rare, progressive, X-linked lysosomal storage disease. Enzyme replacement therapy (ERT) with intravenous (IV) idursulfase has been approved for the treatment of patients with MPS II since 2005. The Hunter Outcome Survey (HOS; NCT03292887) was established as a condition of approval to monitor the long-term safety and effectiveness of idursulfase. Here, we report the final results from HOS.

Methods

HOS was a multicenter, long-term, observational registry that enrolled patients with a biochemically and/or genetically confirmed diagnosis of MPS II who were untreated or treated with idursulfase and/or bone marrow transplant. Patients were enrolled prospectively (alive at enrollment) and retrospectively (deceased at enrollment). For prospectively enrolled patients, it was requested that data from routine examinations were recorded after each follow-up visit and/or a minimum of every 6 months. The safety population (SP) included patients who received at least one dose of idursulfase and were alive at HOS entry. The treatment outcomes population (TOP) included patients who received at least one dose of idursulfase and were alive at HOS entry, excluding patients who received a bone marrow transplant, patients for whom an informed consent form could not be generated by the center, and patients with a missing date of birth. Safety and effectiveness endpoints were analyzed with descriptive statistics.

Results

In total, 1332 patients were enrolled in HOS. For patients in the SP (N = 1014), the median (10th percentile, 90th percentile) age at initiation of ERT with idursulfase was 5.7 (1.6, 18.1) years, ranging from 0.0 to 65.5 years. In the TOP (N = 989), a consistent and sustained decline in urinary glycosaminoglycan levels, trends of sustained improvements in walking capacity and left ventricular mass index, and reductions in liver and spleen size were observed. Treated patients also demonstrated a median increase in survival time of approximately 10 years and a 57.9 % lower risk of death compared with an unmatched cohort of untreated patients. In the SP, 691 patients (68.1 %) experienced at least one adverse event and 269 (26.5 %) experienced at least one infusion-related reaction (IRR); most were mild or moderate in severity. There was no relationship observed between anti-drug antibody status and IRR rates.

Conclusion

Data from HOS, collected for over 18 years, represent the largest dataset of patients with MPS II to date. The effectiveness and safety profile of idursulfase support its use for the long-term treatment of patients with MPS II.
背景:粘多糖病II (MPS II)是一种罕见的进行性x连锁溶酶体积存病。自2005年以来,静脉注射(IV)伊杜硫酶的酶替代疗法(ERT)已被批准用于治疗MPS II患者。Hunter结局调查(HOS; NCT03292887)是作为监测idursulase长期安全性和有效性的批准条件而建立的。在此,我们报告居屋计划的最终结果。方法:HOS是一项多中心、长期、观察性登记,纳入未经治疗或接受伊杜硫酶和/或骨髓移植治疗的经生化和/或遗传学确诊的MPS II患者。前瞻性(入组时存活)和回顾性(入组时死亡)纳入患者。对于预期入组的患者,要求在每次随访和/或至少每6个月记录一次常规检查的数据。安全人群(SP)包括接受至少一剂伊杜硫酶治疗且在HOS进入时存活的患者。治疗结果人群(TOP)包括接受至少一剂idursulase治疗且在HOS进入时存活的患者,不包括接受骨髓移植的患者、中心无法生成知情同意书的患者和出生日期缺失的患者。安全性和有效性终点用描述性统计进行分析。结果:共有1332例患者入组。对于SP患者(N = 1014),使用idursulase开始ERT时的中位年龄(第10百分位数,第90百分位数)为5.7(1.6,18.1)岁,范围为0.0至65.5岁。在TOP (N = 989)中,观察到尿糖胺聚糖水平持续下降,行走能力和左心室质量指数持续改善的趋势,以及肝脏和脾脏大小的减小。与未接受治疗的患者相比,接受治疗的患者的生存时间中位数增加了约10年,死亡风险降低了57.9%。在SP中,691名患者(68.1%)经历了至少一次不良事件,269名患者(26.5%)经历了至少一次输液相关反应(IRR);大多数是轻度或中度的严重程度。抗药物抗体状态与IRR率无相关性。结论:HOS收集了超过18年的数据,是迄今为止MPS II患者最大的数据集。伊杜硫酶的有效性和安全性支持其用于MPS II患者的长期治疗。
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引用次数: 0
Correlation of Plasma Lyso-GL1 Levels with Clinical Phenotype and Treatment Decisions in Patients with Gaucher Disease 血浆溶酶gl1水平与戈谢病患者临床表型和治疗决策的相关性
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-02 DOI: 10.1016/j.ymgme.2025.109286
Chloe Cheung , Luca Fierro , Catherine McDonough , Chanan Stauffer , Rachel Kaplan , Louise Bier , Chunli Yu , Rachel Evard , Jaya Ganesh , Manisha Balwani
In Gaucher disease (GD), clinical management is complicated by heterogeneity and the lack of standardized guidelines for treatment initiation. As patients are being identified pre-symptomatically or as mildly affected through carrier and newborn screening programs, timing of treatment is an increasingly important issue. This study evaluated the utility of plasma lyso-GL1 as an objective biomarker to inform treatment decisions. Retrospective data were analyzed from 240 GD patients with lyso-GL1 levels measured primarily at a single laboratory between June 2018 and September 2023. The study population included both adult (n = 194, 80.8 %) and pediatric (n = 46, 19.2 %) patients predominantly diagnosed with type 1 GD (n = 234, 97.5 %) and self-identified as Jewish (82.1 %). Among 25 patients who initiated GD-specific treatment during the study period with available pre-treatment lyso-GL1 data, the median age at treatment initiation was 33 years. In this group, the median baseline lyso-GL1 was 91.6 ng/mL, which declined to 19.5 ng/mL following treatment with a median follow-up of 2.9 years. In contrast, untreated patients had a median baseline lyso-GL1 of 14.2 ng/mL, which increased to 17.0 ng/mL over a similar follow-up period. Logistic regression and receiver operating characteristic analysis identified a lyso-GL1 threshold of 78.9 ng/mL that effectively discriminated treatment status in GD1 patients, with an area under the curve of 0.865, sensitivity of 73 %, and specificity of 96 %. The predictive performance of this identified threshold was comparable to that reported in a previous study, underscoring the reproducibility and potential utility of lyso-GL1 as a reliable and objective biomarker to guide treatment initiation in Gaucher disease.
戈谢病(GD)的临床管理由于异质性和缺乏标准的治疗起始指南而变得复杂。随着患者通过携带者和新生儿筛查计划被识别为症状前或轻度影响,治疗时机日益成为重要问题。本研究评估了血浆溶酶gl1作为客观生物标志物的效用,以告知治疗决策。回顾性分析了240例GD患者的lyso-GL1水平,这些患者主要在2018年6月至2023年9月期间在一个实验室测量。研究人群包括主要诊断为1型GD的成人(n = 194, 80.8%)和儿科(n = 46, 19.2%)患者(n = 234, 97.5%),自我认定为犹太人(82.1%)。在研究期间开始gd特异性治疗的25例患者中,有可用的治疗前lyso-GL1数据,治疗开始时的中位年龄为33岁。在该组中,中位基线lyso-GL1为91.6 ng/mL,在治疗后下降到19.5 ng/mL,中位随访时间为2.9年。相比之下,未经治疗的患者的中位基线lyso-GL1为14.2 ng/mL,在类似的随访期间增加到17.0 ng/mL。Logistic回归和受试者工作特征分析发现,lyso-GL1阈值为78.9 ng/mL,曲线下面积为0.865,灵敏度为73%,特异性为96%,可有效判别GD1患者的治疗状况。这一鉴定阈值的预测性能与之前的研究报告相当,强调了lyso-GL1作为可靠和客观的生物标志物指导戈谢病治疗起始的可重复性和潜在效用。
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引用次数: 0
Commentary on the article “Progressive activation of the astrocyte A1 phenotype underlies microglia-astroglia crosstalk and contributes to neuroinflammation in neuronopathic MPS” 对文章“星形胶质细胞A1表型的进行性激活是小胶质细胞-星形胶质细胞串扰的基础,并有助于神经性MPS的神经炎症”的评论。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-01 DOI: 10.1016/j.ymgme.2025.109281
Yuxuan Gao, Weili Wang, Jiapeng Leng
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引用次数: 0
Accumulation of complex I assembly intermediates in a novel presentation of RTN4IP1-related disorder with developmental delay, ataxia and dyskinesia 复合物I组装中间体在rtn4ip1相关的发育迟缓、共济失调和运动障碍的新表现中的积累
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-01 DOI: 10.1016/j.ymgme.2025.109266
Liene Thys , Diane Beysen , Katrien Janssens , Anna C. Jansen , Naig Gueguen , Morgane LeMao , Fanny Fontaine , Stéphane Allouche , Guy Lenaers , Marije Meuwissen

Background

Biallelic variants in RTN4IP1 (OPA10) are associated with a wide phenotypic spectrum including optic atrophy with or without ataxia, impaired intellectual development and seizures (OMIM 616732). Brain imaging ranges from normal to white matter changes and cerebral atrophy. Earlier literature has reported a combined complex I and IV deficiency in RTN4IP1 cases.

Results

We report on three siblings, compound heterozygous for novel RTN4IP1 variants who presented with a movement disorder with pronounced dyskinesia along with developmental delay, optic atrophy and ataxia. Furthermore, atypical brain MRI findings with symmetrical bilateral substantia nigra abnormalities were observed in two of them. Blue native polyacrylamide gel electrophoresis performed on fibroblasts of two patients revealed a defect in the complex I assembly process.

Conclusion

Thus, we expand the clinical spectrum of RTN4IP1-associated disease with movement disorder, substantia nigra abnormalities and complex I assembly defects.
背景:RTN4IP1 (OPA10)的双等位基因变异与广泛的表型谱相关,包括伴或不伴共济失调的视神经萎缩、智力发育受损和癫痫发作(OMIM 616732)。脑成像范围从正常到白质改变和脑萎缩。早期文献报道了RTN4IP1病例中复合物I和IV的联合缺乏。结果:我们报告了三个兄弟姐妹,新型RTN4IP1变异的复合杂合,他们表现为运动障碍,伴有明显的运动障碍,发育迟缓,视神经萎缩和共济失调。此外,其中两例脑MRI表现不典型,伴有对称的双侧黑质异常。对两名患者的成纤维细胞进行的蓝色天然聚丙烯酰胺凝胶电泳显示复合物I组装过程中存在缺陷。结论:因此,我们扩大了rtn4ip1相关疾病的临床范围,包括运动障碍、黑质异常和复合物I组装缺陷。
{"title":"Accumulation of complex I assembly intermediates in a novel presentation of RTN4IP1-related disorder with developmental delay, ataxia and dyskinesia","authors":"Liene Thys ,&nbsp;Diane Beysen ,&nbsp;Katrien Janssens ,&nbsp;Anna C. Jansen ,&nbsp;Naig Gueguen ,&nbsp;Morgane LeMao ,&nbsp;Fanny Fontaine ,&nbsp;Stéphane Allouche ,&nbsp;Guy Lenaers ,&nbsp;Marije Meuwissen","doi":"10.1016/j.ymgme.2025.109266","DOIUrl":"10.1016/j.ymgme.2025.109266","url":null,"abstract":"<div><h3>Background</h3><div>Biallelic variants in <em>RTN4IP1</em> (<em>OPA10</em>) are associated with a wide phenotypic spectrum including optic atrophy with or without ataxia, impaired intellectual development and seizures (OMIM <span><span>616732</span><svg><path></path></svg></span>). Brain imaging ranges from normal to white matter changes and cerebral atrophy. Earlier literature has reported a combined complex I and IV deficiency in <em>RTN4IP1</em> cases.</div></div><div><h3>Results</h3><div>We report on three siblings, compound heterozygous for novel <em>RTN4IP1</em> variants who presented with a movement disorder with pronounced dyskinesia along with developmental delay, optic atrophy and ataxia. Furthermore, atypical brain MRI findings with symmetrical bilateral substantia nigra abnormalities were observed in two of them. Blue native polyacrylamide gel electrophoresis performed on fibroblasts of two patients revealed a defect in the complex I assembly process.</div></div><div><h3>Conclusion</h3><div>Thus, we expand the clinical spectrum of <em>RTN4IP1</em>-associated disease with movement disorder, <em>substantia nigra</em> abnormalities and complex I assembly defects.</div></div>","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109266"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to “Incidence and prevalence of phosphomannomutase 2-congenital disorder of glycosylation: Past, present, and future [Molecular Genetics and Metabolism 146 (2025) 109188]” “先天性糖基化失调的发生率和患病率:过去,现在和未来[分子遗传学和代谢146(2025)109188]”的勘误表。
IF 3.5 2区 生物学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-11-01 DOI: 10.1016/j.ymgme.2025.109252
Andrew C. Edmondson , Tomas Honzik , Christina Lam , Katrin Ounap , Peter McWilliams , Eva Morava
{"title":"Corrigendum to “Incidence and prevalence of phosphomannomutase 2-congenital disorder of glycosylation: Past, present, and future [Molecular Genetics and Metabolism 146 (2025) 109188]”","authors":"Andrew C. Edmondson ,&nbsp;Tomas Honzik ,&nbsp;Christina Lam ,&nbsp;Katrin Ounap ,&nbsp;Peter McWilliams ,&nbsp;Eva Morava","doi":"10.1016/j.ymgme.2025.109252","DOIUrl":"10.1016/j.ymgme.2025.109252","url":null,"abstract":"","PeriodicalId":18937,"journal":{"name":"Molecular genetics and metabolism","volume":"146 3","pages":"Article 109252"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Molecular genetics and metabolism
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