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Biomedical subjects

G Neri

Publications and source records attributed to G Neri.

At least 55 records · Page 3Linked to original sources

Premature termination mutations in exon 3 of the SMN1 gene are associated with exon skipping and a relatively mild SMA phenotype.

Autosomal recessive spinal muscular atrophy (SMA) is a common motor neuron disease caused by absence or mutation in the survival motor neuron (SMN1) gene. SNM1 and a nearly identical copy, SMN2, encode identical proteins, but SMN2 only produces a little full length protein due to alternative splicing. The level of functional SMN protein and the number of SMN2 genes correlate with the clinical phenotype ranging from severe to very mild. Here, we report on premature termination mutations in SMN1 exon 3 (425del5 and W102X) which induce skipping of the mutated exon. The novel nonsense mutation W102X was detected in two patients with a relatively mild phenotype who had only two copies of the SMN2 gene, a number that has previously been found associated with the severe form of SMA. We show that the shortened transcripts are translated into predicted in frame protein isoforms. Aminoglycoside treatment suppressed the nonsense mutation in cultured cells and abolished exon skipping. Fibroblasts from both patients show a high number of nuclear structures containing SMN protein (gems). These findings suggest that the protein isoform lacking the exon 3 encoded region contributes to the formation of the nuclear protein complex which may account for the milder clinical phenotype.

Adult↗

XLMR genes: update 2000.

This is the sixth edition of the catalogue of XLMR genes, ie X-linked genes whose malfunctioning causes mental retardation. The cloning era is not yet concluded, actually much remains to be done to account for the 202 XLMR conditions listed in this update. Many of these may eventually prove to be due to mutations in the same gene but the present number of 33 cloned genes falls surely short of the actual total count. It is now clear that even small families or individual patients with cytogenetic rearrangements can be instrumental in pinning down the remaining genes. DNA chip technology will hopefully allow (re)screening large numbers of patients for mutations in candidate genes or testing the expression levels of many candidate genes in informative families. Slowly, our knowledge of the structure and functioning of the proteins encoded by these genes is beginning to cast some light on the biological pathways required for the normal development of intelligence. Correlations between the molecular defects and the phenotypic manifestations are also being established. In order to facilitate the exchange of existing information and to allow its timely update, we prepared the first edition of the XLMR database (available at http://homepages.go.com/~xlmr/home.htm) and invite all colleagues, expert in the field, to contribute with their experience.

Chromosome Mapping↗

Endothelin-1[1-31] acts as a selective ETA-receptor agonist in the rat adrenal cortex.

Endothelin-1 (ET-1) is a 21-amino acid residue (ET-1[1-21]) hypertensive peptide, which together with its receptor subtypes A and B (ETA and ETB) is expressed in the rat adrenal cortex, where it stimulates steroid-hormone (aldosterone and corticosterone) secretion through the ETB receptor and the growth (proliferative activity) of the zona glomerulosa (ZG) through the ETA receptor. ET-1[1-21] is generated from bigET-1 by the endothelin-converting enzyme (ECE-1). However, recent evidence indicates the existence of an alternative chymase-mediated biosynthetic pathway leading to the production of an ET-1[1-31] peptide, which was found to reproduce the ETA receptor-mediated vascular effects of ET-1[1-21]. We found that ET-1[1-21], but not ET-1[1-31], concentration-dependently raised steroid secretion from dispersed rat adrenocortical cells, its effect being blocked by the ETB-receptor selective antagonist BQ-788. Both ET-1s concentration-dependently increased the number of "S-phase" cells (as detected by the 5-bromo-2'-deoxyuridine immunocytochemical method) in capsule-ZG strips within a 240 min incubation. The ZG proliferogenic action of both ET-1s was blocked by the ETA-receptor antagonist BQ-123, and ET-1[1-31] was found to be significantly more potent than ET-1[1-21]. Autoradiography showed that in the rat adrenal ET-1[1-21] displaced the binding of selective ligands to both ETA ([125I]PD-151242) and ETB receptors ([125I]BQ-3020), while ET-1[1-31] eliminates only the binding to ETA receptors. Collectively, our findings provide strong evidence that ET-1[1-31] acts in the rat adrenal glands as a selective ETA-receptor agonist, mainly involved in the stimulation of ZG proliferative activity.

Adrenal Cortex↗

Buffering action of endogenous nitric oxide on the adrenocortical secretagogue effect of endothelins in the rat.

The secretagogue effect of endothelins (ETs) on the rat adrenal cortex is mediated by the ETB receptor. ETB receptors are coupled with nitric oxide (NO) synthase (NOS), and NO is known to inhibit steroid-hormone secretion from adrenal cortex. We investigated whether ETB-mediated NO production interferes with the stimulatory action of ETs on rat adrenal cortex. The selective agonist of ETB receptor BQ-3020 concentration-dependently increased aldosterone secretion from dispersed zona glomerulosa (ZG) cells and corticosterone secretion from dispersed zona fasciculata-reticularis (ZF/R) cells, and the NOS inhibitor NG-nitro-L-arginine methylester (L-NAME) potentiated the effect of BQ-3020 in a concentration-dependent manner. The guanylate cyclase inhibitor Ly-83583, at a concentration suppressing guanylin- and L-arginine-induced cyclic-GMP release from dispersed adrenocortical cells, did not affect the secretory response of ZG and ZF/R cells to BQ-3020. ET-1, an agonist of both ETA and ETB receptors, stimulated the release of both aldosterone and corticosterone by in situ perfused rat adrenal gland. This effect was potentiated by L-NAME and unaffected by Ly-83583. Collectively, our findings allow us to suggest that endogenous NO exerts in vivo and in vitro a cyclic-GMP-independent buffering action on the ETB receptor-mediated adrenocortical secretagogue action of ETs.

Adrenal Cortex↗

Myocardial perfusion and metabolic changes induced by biventricular pacing in dilated cardiomyopathy and left bundle branch block: description of a case evaluated by positron emission tomography.

The effects of biventricular pacing on myocardial wall function are well known, but, at the moment, its real effects on myocardial metabolism are unclear. In patients affected by left bundle branch block, at positron emission tomography a septal defect of the uptake of 18F-fluorodeoxyglucose (FDG) was referred. There were no alterations in myocardial perfusion, suggesting possible metabolic damage. In this paper we report the case of a patient affected by dilated cardiomyopathy and left bundle branch block treated with a biventricular device. Biventricular pacing resolved both the wall motion alterations as well as the defect in FDG uptake present in the septal area. On the contrary, during biventricular pacing there were no modifications in myocardial perfusion as compared to basal evaluation.

Aged↗

[Efficacy and safety of ambulatory electric cardioversion of atrial fibrillation with monophasic and biphasic shock].

BACKGROUND: The aim of this study was to evaluate the safety and efficacy of ambulatory external cardioversion (EC) by means of monophasic and biphasic shock in patients with persistent atrial fibrillation (AF). METHODS: One hundred and twenty-seven consecutive patients with AF were submitted to EC, preceded by short general anesthesia with propofol, after pretreatment with oral anticoagulants for at least 3 weeks and, if not contraindicated, with amiodarone. In 87 of these patients we used monophasic shock and in 40 patients we used biphasic shock. Our protocol provided for up to 3 shocks delivered at an energy level ranging between 200 and 360 J for monophasic and from 70 to 175 J for biphasic shock. The patients were discharged after 4 hours of ECG monitoring and following a determination of serum CK-MB at the fourth hour. RESULTS: The mean age of the patients submitted to EC with monophasic and biphasic shock (65 +/- 9 vs 67 +/- 7 years) and the duration of AF (34 +/- 22 vs 32 +/- 25 days) were similar. The efficacy of EC with monophasic shock was 85% and the mean energy delivered was 266 +/- 81.5 J. The efficacy of the EC with biphasic shock was 98% and the mean energy delivered was 127 +/- 40 J. The difference between the percentage of efficacy and the number of joules delivered was statistically significant (p < 0.05). The mean value of the CK-MB after 4 hours following delivery of the shock was not significantly different: 2.5 ng/ml for monophasic vs 1.7 ng/ml for biphasic shock (p = NS). CONCLUSIONS: In our patients, ambulatory EC of persistent AF is safe and feasible; biphasic shock is more efficacious and requires less energy with respect to monophasic shock.

Age Factors↗

[Experimental therapy: reactivation of the FMR1 gene involved in fragile X syndrome].

Fragile X syndrome represents the most common inherited cause of mental retardation worldwide. Fragile X belongs to a large group of more than 200 mental retardation conditions caused by mutations in X-linked genes (XLMR), that have a collective frequency of up to 1 in 1000 males. Fragile X syndrome is also unique because it was the first genetic condition caused--in the overwhelming majority of cases--by the expansion of an unstable CGG repeat, becoming the prototype of a growing list of inherited disorders due to the instability of trinucleotide repeats. Ten years after the cloning of the FMR1 gene involved in fragile X syndrome, we still don't know all the molecular players that allow the destabilization of the CGG repeat located close to the gene's CpG island. However, the finding of a founder effect in fragile X syndrome indicates that only few of the unstable repeats eventually reached the pathological range. The line of research was aimed at understanding what happens after the fragile X mutation has reached a pathological size. What we showed with our 'reactivation' experiments is that the size of the CGG expansion per se does not cause the silencing of the FMR1 gene: it's the methylation that is added to the expansion that leads to the transcriptional block. Thus, by studying the 'reactivation' of fragile X full mutations, we try to learn more about their 'inactivation' and--hopefully--about possible ways of preventing or 'reverting' their inactivation in fragile X children.

Child↗

[L-acetylcarnitine treatment on fragile X patients hyperactive behaviour].

Hyperactivity is a significant problem for almost all young males affected by fragile X syndrome (FXS), the most common inherited disease causing mental retardation. Therapeutical approaches are actually based on Central Nervous System (CNS) stimulants lacking a well defined rationale and efficacy while they further decrease the patient's limited attention span. A pilot study on 17 fragile X male treated with L-acetylcarnitine (LAC) over one year, showed a significant reduction of their hyperactivity behaviour tested by the Conners Abbreviated Parent-Teacher Questionnaire. LAC use in FXS patients derives from the hypothesis that the biochemical and physiological properties this substance has may preserve brain activity. LAC is a small, hydrosoluble molecule that easily diffuses in the extracellular space and enters any cell in the nervous system through specific transporters. Different cerebral areas use this molecule differently to metabolize glucose and lipids to provide for ATP and neurotrasmitters synthesis. The acetyl group LAC carriers represents a key metabolic signaling element possibly mediating its effect in the CNS. The exogenous administration of LAC may affect brain activity in FXS by: I) modulation of fuel partitioning for energy production, which at the mithocondrial level is associated with the Kreb's cycle metabolic role in neurotransmitter synthesis; II) remodelling of lipid membrane in terms of LAC actively determining the production of polyunsaturated fatty acids; III) preferential effect on the attention component of the cholinergic system which relies on its peculiar modality of communication in the CNS. Based on the above premises an explorative, double-blind, placebo controlled, multicenter study is ongoing. A total population of 160 children from nine European centers will be enrolled. The objective of this study is to determine the effect of LAC on the hyperactive behaviour of FXS children as evaluated by the administration of the Conners Abbreviated Parent Questionnaire.

Acetylcarnitine↗

Genotype-phenotype correlations and clinical diagnostic criteria in Wolf-Hirschhorn syndrome.

We report on a clinical-genetic study of 16 Wolf-Hirschhorn syndrome (WHS) patients. Hemizygosity of 4p16.3 was detected by conventional prometaphase chromosome analysis (11 patients) or by molecular probes on apparently normal chromosomes (4 patients). One patient had normal chromosomes without a detectable molecular deletion within the WHS "critical region." In each deleted patient, the deletion was demonstrated to be terminal by fluorescence in situ hybridization (FISH). The proximal breakpoint of the rearrangement was established by prometaphase chromosome analysis in cases with a visible deletion. It was within the 4p16.1 band in six patients, apparently coincident with the distal half of this band in five patients. The extent of each of the four submicroscopic deletions was established by FISH analyses with a set of overlapping cosmid clones spanning the 4p16.3 region. We found ample variations in both the size of the deletions and the position of the respective breakpoints. The precise definition of the cytogenetic defect permitted an analysis of the genotype-phenotype correlations in WHS, leading to the proposal of a set of minimal diagnostic criteria, which in turn may facilitate the selection of critical patients in the search for the gene(s) responsible for this disorder. We observed that genotype-phenotype correlations in WHS mostly depend on the size of the deletion, a deletion of <3.5 Mb resulting in a mild phenotype, in which malformations are absent. The absence of a detectable molecular deletion is still consistent with a WHS diagnosis. Based on these observations a "minimal" WHS phenotype was inferred, the clinical manifestations of which are restricted to the typical facial appearance, mild mental and growth retardation, and congenital hypotonia.

Abnormalities, Multiple↗

Effects of irbesartan and bosentan on the blood pressure and adrenal zona glomerulosa function in heterozygous transgenic TGR[mREN2]27 rats.

The role of angiotensin-II (Ang-II) and endothelin-1 (ET-1) in the development of hypertension and zona glomerulosa (ZG) hyperfunction in the transgenic rat strain TGR[mREN2]27 (TGR) has been investigated. Male heterozygous TGR were given per os for 4 weeks the Ang-II ATI receptor antagonist irbesartan (50 mg/kg x day) or the mixed ETA/ETB receptor antagonist bosentan (100 mg/kg x day). A group of TGR received a placebo gavage. Irbesartan lowered blood pressure (BP), while bosentan was ineffective. Conversely, both antagonists decreased plasma aldosterone concentration, the volume of ZG and its parenchymal cells, and in vitro aldosterone secretion by capsule-ZG preparations. Collectively, our results allow us to conclude that (i) only Ang-II is involved in the genesis of hypertension in TGR, while both endogenous Ang-II and ET-1 play a role in the genesis of ZG hyperfunction; and (ii) hyperaldosteronism does not contribute significantly to the development of hypertension in TGR.

Animals↗

Sixty years of X-linked mental retardation: a historical footnote.

X-linked mental retardation (XLMR) is a most exciting field of modern medical genetics. It made spectacular advances over the last twenty years, after the advent of molecular genetics. The discovery of the FMR1 gene unraveled the cause of the most common form of heritable mental retardation and provided the prototype of dynamic mutations. New genes continue to be mapped to the X chromosome and more and more are being cloned and characterized, clarifying the nosology of XLMR and, more importantly, adding to our understanding of the mechanisms of intellectual development, normal and abnormal. Looking back to a more or less recent past may provide clues for future discoveries.

Chromosome Mapping↗

Effects of simvastatin and pravastatin on gonadal function in male hypercholesterolemic patients.

Inhibition of cholesterol biosynthesis by hydroxymethyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors could, in theory, adversely affect male gonadal function because cholesterol is a precursor of steroid hormones. The objective of this randomized double-blind trial was to compare the effects of simvastatin, pravastatin, and placebo on gonadal testosterone production and spermatogenesis. After a 6-week placebo and lipid-lowering diet run-in period, 159 male patients aged 21 to 55 years with type IIa or IIb hypercholesterolemia, low-density lipoprotein (LDL) cholesterol between 145 and 240 mg/dL, and normal basal levels of testosterone were randomly assigned to treatment with simvastatin 20 mg (n = 40), simvastatin 40 mg (n = 41), pravastatin 40 mg (n = 39), or placebo (n = 39) once daily. After 24 weeks of treatment, mean total cholesterol levels were decreased 24% to 27% and mean LDL cholesterol was decreased 30% to 34% in the 3 active-treatment groups (P < .001 for all comparisons to placebo). At 24 weeks, there were no statistically significant differences between the placebo group and any of the active-treatment groups for the change from baseline in testosterone, human chorionic gonadotropin (hCG)stimulated testosterone, free testosterone index, follicle-stimulating hormone (FSH), luteinizing hormone (LH), or sex hormone-binding globulin (SHBG). Moreover, there were no statistically significant differences at week 12 or week 24 for the change from baseline in sperm concentration, ejaculate volume, or sperm motility for any active treatment relative to placebo. Both simvastatin and pravastatin were well tolerated. In summary, we found no evidence for clinically meaningful effects of simvastatin or pravastatin on gonadal testosterone production, testosterone reserve, or multiple parameters of semen quality.

Adult↗