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Biomedical subjects

Michel Broyer

Publications and source records attributed to Michel Broyer.

23 records · Page 2Linked to original sources

Does growth hormone treatment affect the risk of post-transplant renal cancer?

According to the analysis of the Collaborative Transplant Study (CTS), the incidence of renal carcinoma in patients with renal transplantation as well as with heart transplantation is significantly increased at any given patient age. The cumulative incidence 10 years after kidney transplantation is 185 per 100,000 patients in children below the age of 19 years at the time of transplantation. Age and immunosuppressive treatment seem to be the major risk factors. The majority of cancers develop within the native kidneys. Chronic transplant nephropathy and accelerated senescence may be further risk factors for the development of cancer within a kidney transplant. Growth hormone (GH) treatment could not be identified as an additional risk factor.

Carcinoma, Renal Cell↗

Electric susceptibility of unsolvated glycine-based peptides.

The DC electric susceptibilities of unsolvated glycine-based peptides, WGn (W = tryptophan and G = glycine) with n = 1-5, have been measured by deflection of a molecular beam in an electric field. These are the first electric deflection measurements performed on peptides. At 300 K the susceptibilities are in the range of 200-400 A(3). By far the largest contribution to the susceptibilities is from the permanent dipole moment of the peptides. The results indicate that the peptides do not have rigid conformations with fixed dipoles. Instead the dipole is averaged as the peptides explore their energy landscape. For a given WGn peptide, all molecules have almost the same average dipole, which suggests that they all explore a similar energy landscape on the microsecond time scale of the measurement. The measured susceptibilities are in good overall agreement with values calculated from the average dipole moment deduced from Monte Carlo simulations.

Electrochemistry↗

Intralysosomal cystine accumulation in mice lacking cystinosin, the protein defective in cystinosis.

Cystinosis is an autosomal recessive disorder characterized by an accumulation of intralysosomal cystine. The causative gene, CTNS, encodes cystinosin, a seven-transmembrane-domain protein, which we recently showed to be a lysosomal cystine transporter. The most severe and frequent form of cystinosis, the infantile form, appears around 6 to 12 months, with a proximal tubulopathy (de Toni-Debré-Fanconi syndrome) and ocular damage. End-stage renal failure is reached by 10 years of age. Accumulation of cystine in all tissues eventually leads to multisystemic disease. Treatment with cysteamine, which reduces the concentration of intracellular cystine, delays disease progression but has undesirable side effects. We report the first Ctns knockout mouse model generated using a promoter trap approach. We replaced the last four Ctns exons by an internal ribosome entry site-betagal-neo cassette and showed that the truncated protein was mislocalized and nonfunctional. Ctns(-/-) mice accumulated cystine in all organs tested, and cystine crystals, pathognomonic of cystinosis, were observed. Ctns(-/-) mice developed ocular changes similar to those observed in affected individuals, bone defects and behavioral anomalies. Interestingly, Ctns(-/-) mice did not develop signs of a proximal tubulopathy, or renal failure. A preliminary therapeutic trial using an oral administration of cysteamine was carried out and demonstrated the efficiency of this treatment for cystine clearance in Ctns(-/-) mice. This animal model will prove an invaluable and unique tool for testing emerging therapeutics for cystinosis.

Alleles↗

Characterization of a putative founder mutation that accounts for the high incidence of cystinosis in Brittany.

Cystinosis is an autosomal recessive disorder, characterized by an accumulation of intralysosomal cystine, with an incidence of 1 in 100,000 to 200,000 live births. A higher incidence of cystinosis, 1 in 26,000 live births, has been reported in the western French province of Brittany. PCR amplification and sequencing has identified a 27-bp deletion starting 3 bp before the end of exon 8 and continuing into intron 8, 898-900+24del27, which has only been detected in families from this region. Reverse transcription-PCR amplification of RNA from an affected individual has shown that this mutation is indeed a splice-site mutation and results in the production of aberrant transcripts. These transcripts are predicted to either severely truncate cystinosin or alter its topology, thus accounting for the severe phenotype of these individuals. The mutation 898-900+24del27 has been identified in 7 of 18 alleles studied. This mutation is likely to be a founder mutation and would account for the higher incidence of cystinosis in Brittany.(1)

Adolescent↗

Evolution of ocular manifestations in nephropathic cystinosis: a long-term study of a population treated with cysteamine.

BACKGROUND: Nephropathic cystinosis is characterized by an accumulation of cystine crystals within most body tissues. Renal transplantation and oral cysteamine have improved the general prognosis of the disease, and ocular manifestations are now the most common complication. This long-term follow-up study describes the sequence of ocular manifestations in patients with nephropathic cystinosis treated with oral and topical cysteamine. METHODS: Data were recorded for all patients with cystinosis examined between 1980 and 2000. For each patient, photophobia and visual acuity were evaluated and slit-lamp and fundus examinations were performed. For some patients, an electroretinogram was also performed. RESULTS: Twenty-nine patients were observed during this period. They received oral and topical cysteamine. Photophobia and loss of visual acuity generally began by 10 years of age but were severe only after 15 years of age. Peripheral corneal epithelial infiltration appeared in the first few years of life. Infiltration evolved toward the depth and center of the cornea during the second decade of life. Retinopathy was present in 51.7% of the patients, with 3 cases of maculopathy and 3 cases of flattening on electroretinogram. CONCLUSIONS: Photophobia and corneal infiltration, although generally severe after 15 years of age, could be treated with topical cysteamine and corneal transplantation. Retinal infiltration, previously described as frequent and potentially blinding, is currently observed in only half of these patients, with mild visual impairment. This could be related to the treatment with oral cysteamine reaching the retinal vascularization.

Administration, Oral↗