Metabolic Diseases: a differential diagnosis of primary progressive multiple sclerosis

Objectives: The overall aim of our research project is to develop a Next Generation Sequencing strategy to identify metabolic disorders in 104 patients with a presumptive diagnosis of primary progressive MS.We would like to thank to MERCK, SA and NORTE2020 (NORTE-01-0246-FEDER-000014) for funding this Project.N/

Metabolic Diseases Masquerading As Primary Progressive Multiple Sclerosis

Objectives: The overall aim of our research project is to develop a Next Generation Sequencing strategy to identify metabolic disorders in patients with a presumptive diagnosis of primary progressive MS.This Research Project is support by MERCK, SAinfo:eu-repo/semantics/draf

Validation of a UV-spectrophotometric analytical method for determination of LPSF/AC04 from inclusion complex and liposomes

The aim of this study was to develop and validate a UV spectrophotometric method for determination of LPSF/AC04 from inclusion complex and encapsulated into liposomes. The validation parameters were determined according to the International Conference on Harmonisation (ICH) and National Health Surveillance Agency (ANVISA) guidelines. LPSF/AC04 was determined at 250 nm in methanol by a UV spectrophotometric method, exhibiting linearity in the range from 0.3 to 2 µg.mL−1 (Absorbance=0.18068 x [LPSF/AC04 µg.mL-1] + 0.00348), (r2=0.9995). The limits of detection and quantification were 0.047µg.mL−1 and 0.143µg.mL−1, respectively. The method was accurate, precise, reproducible and robust since all the samples analyzed had coefficient of variation of less than 5% and no statistically significant difference between theoretical and practical concentrations was detected. Thus, a rapid, simple, low cost and sensitive spectrophotometric method was developed and validated for determining the content of inclusion complex and liposomes containing LPSF/AC04.O objetivo deste estudo foi desenvolver e validar um método espectrofotométrico para determinação do LPSF/AC04 em complexo de inclusão e encapsulado em lipossomas. Os parâmetros de validação foram determinados de acordo com o International Conference on Harmonisation (ICH) e Agência Nacional de Vigilância Sanitária (ANVISA). OLPSF/AC04 foi determinado a 250 nm em metanol pelo método espectrofotométrico UV, que apresenta linearidade na faixa de 0,3 a 2 µg/mL (Absorbância = 0,18068 x [LPSF/AC04 µg/mL] + 0,00348), (r2 = 0,9995). Os limites de detecção e quantificação foi 0,047 µg/mL e 0,143 µg/mL, respectivamente. O método foi exato, preciso, reprodutível e robusto e todas as amostras analisadas apresentaram coeficiente de variação menor que 5% e não houve diferença estatisticamente significante entre a concentração teórica e a prática. Assim, um método espectrofotométrico rápido, simples, sensível e de baixo custo foi desenvolvido e validado para determinar o conteúdo do LPSF/AC04 em complexos de inclusão e encapsulados em lipossomas

Mutational spectrum of cystinosis in Portugal, 1998-2017

Artigo original publicado em inglês: Ferreira F, Leal I, Sousa D, et al. CTNS Molecular Genetics Profile in a Portuguese Cystinosis Population. Open J Genet. 2018 Dec 18;8(4):91-100. doi:10.4236/ojgen.2018.84008A cistinose é uma doença metabólica multisistémica, autossómica recessiva caracterizada por uma acumulação de cistina em diferentes órgãos e tecidos devido a uma deficiência no transporte de cistina para o exterior dos lisossomas. O gene responsável pela doença, CTNS, está localizado no cromossoma 17 e codifica para uma proteína de membrana lisossomal, a cistinosina. Neste trabalho foram estudados doentes não relacionados provenientes das consultas de adultos e pediatria de diferentes hospitais de Portugal continental e ilhas, que apresentavam proteinuria não-nefrótica, hipercalciúria, hipocaliemia, hiperaminoacidúria, glicosúria e hipofosfatemia, sugestivo de síndroma de Fanconi e queixas oculares. Bioquimicamente, a cistina intraleucocitária foi quantificada, tendo-se igualmente efetuado a caracterização molecular do gene CTNS, inicialmente apenas direcionado para a pesquisa da deleção de 57-kb, seguida da sequenciação de todos os exões codificantes do gene CTNS. Desde 1998 a 2017, 21 doentes cistinóticos foram bioquimicamente caracterizados. Entretanto, 4 destes doentes faleceram e dos restantes 17, apenas 11 foram estudados para o gene CTNS. Verificouse que 5 destes 11 doentes foram homozigóticos para a deleção de 57-kb (10/22; 45,5%), e outros 5 foram compostos heterozigóticos para esta mutação (15/22; 68,2%). As outras mutações identificadas foram: p.Q128X (c.721 C>T; 2/22), p.S139F (c.755 C>T; 4/22) e c.18-21delGACT (p.T7FfsX7; 1/22). Todos estes 17 doentes cistinóticos estão em tratamento, sendo que 84% são adultos, 16% são crianças jovens e 54,5% são transplantados renais. Este estudo efetuado ao longo de vários anos, reflete a experiência no diagnóstico e monitorização dos doentes cistinóticos. Além disso, a caracterização das mutações encontradas no gene CTNS, ressalta a importância para um screening inicial da deleção de 57-kb e permite um futuro aconselhamento genético aos casais de risco.Cystinosis is a multisystemic autosomal recessive deficiency of the lysossomal membrane transporter protein (cystinosin) caused by mutations in CTNS gene. This study summarizes the Portuguese experience in the diagnosis and management of patients with this rare disease over the past few years and reports recurrent mutations in the CTNS gene. Unrelated patients from different pediatric and adult hospitals all over Portugal with non-nephrotic proteinuria, hypercalciuria, hypokalemia impaired proximal reabsorption of amino acids, glycosuria and hypophosphatemia, suggestive of a Fanconi syndrome and ocular problems were studied. Intraleukocyte cystine levels were determined and molecular analysis performed, to determine the presence of the 57-kb deletion in CTNS, followed by direct sequencing of the coding exons of CTNS. From 1998 to 2017, 21 cystinotic patients were biochemically diagnosed. From the remaining 17 (4 deceased), 11 were studied for CTNS gene. Five out of 11 patients were homozygous for the 57-kb deletion (10/22; 45.5%), and other 5 were compound heterozygous for this variant (15/22; 68.2%). The other mutations found were p.Q128X (c.721 C>T; 2/22), p.S139F (c.755 C>T; 4/22) and c.18-21delGACT (p.T7FfsX7; 1/22). All of these 17 cystinotic patients are in treatment. Approximately 84% are adults, 16% are young children, and 54.5% are kidney transplant recipient. The authors would like to emphasize the importance of first screening for the 57-kb deletion since it is very common in our population. This genetic study is the first in Portugal and it could be the basis for future genetic counseling in cistinotic patients.info:eu-repo/semantics/publishedVersio

CTNS Molecular Genetics Profile in a Portuguese Cystinosis Population

Background: Cystinosis is a multisystemic autosomal recessive deficiency of the lysosomal membrane transporter protein (cystinosin) caused by mutations in CTNS gene. Objective : This study summarizes the Portuguese experience in the diagnosis and management of patients with this rare disease over the past few years and reports recurrent mutations in the CTNS gene . Methods : Unrelated patients from different pediatric and adult hospitals all over Portugal with non-nephrotic proteinuria, hypercalciuria, hypokalemia impaired proximal reabsorption of amino acids, glycosuria and hypophosphatemia, suggestive of a Fanconi syndrome and ocular problems, were studied. Intra-leukocyte cystine levels were determined and molecular analysis was performed, to determine the presence or absence of the 57-kb deletion in CTNS , followed by direct sequencing of the coding exons of CTNS . Results : From 1998 to 2017, twenty-one cystinotic patients were biochemically diagnosed. From the remaining seventeen (four deceased), eleven were studied for CTNS gene. Five out of eleven patients were homozygous for the 57-kb deletion (10/22; 45.5%), and other five were compound heterozygous for this variant (15/22; 68.2%). The other mutations found were p.Q128X (c.721 C>T; 2/22), p.S139F (c.755 C>T; 4/22) and c.18-21delGACT (p.T7FfsX7; 1/22). All of these seventeen cystinotic patients are in treatment. Approximately 84% are adults, 16% are young children, and 54.5% are kidney transplant recipient. Conclusions: The authors would like to emphasize the importance of first screening for the 57-kb deletion since it is very common in our population. This genetic study is the first in our country and it could be the basis for future genetic counseling in Portuguese population.info:eu-repo/semantics/publishedVersio

Positional Ocular Flutter Associated With Middle Cerebellar Peduncle Demyelination

Ocular flutter (OF) consists of back-to-back horizontal saccadic intrusions lacking an intersaccadic interval. OF usually occurs spontaneously, as continuous or intermittent bursts (1). Spontaneous OF has been associated with brainstem and cerebellar lesions and is presumed to reflect an intrinsic membrane receptor malfunction of the pontine saccadic burst neurons (SBN), omnipause neurons, and/or cerebellar vermis/fastigial nucleus complex leading to SBN increased firing (1). Rarely, OF may be precipitated exclusively by head position, having been described in one patient with undetermined degenerative ataxia and one other with Krabbe disease (2,3). In both cases, a focal parenchymal strategic lesion was not found, and the putative mechanism was not detailed. We describe a patient with a right middle cerebellar peduncle (MCP) demyelinating lesion associated with positional OF

GenEye24: Novel Rapid Screening Test for the Top-3 Leber's Hereditary Optic Neuropathy Pathogenic Sequence Variants

Leber's Hereditary Optic Neuropathy (LHON) has been mainly (90-95%) associated to one of three variants: m.3460G>A, m.11778G>A, m.14484T>C. Herein, a screening method was developed for its detection, supporting clinical/therapeutics decision. It relies on real-time PCR with High-Resolution Melting (HRM) analysis. Variant classification is made using HRM Software and quality controls. Ninety-four samples were analyzed. All samples were correctly assigned: 58 wild-type, 35 positive for m.11778G>A, 6 positive for m.14484T>C, 2 positive for m.3460G>A. Results presented sensitivity=1, specificity=1, Positive Predictive Value=1 and Negative Predictive Value=1. A new Real-Time PCR/HRM screening method cost-efficient, simple, robust and quick, detecting LHON's top-3 is described.This work was financed by the European Regional Development Fund (ERDF), through the Centro 2020 Regional Operational Programme under project CENTRO-01-0145-FEDER-000012-N2323 (HealthyAging2020) and through the COMPETE 2020 – Operational Programme for Competitiveness and Internationalisation and Portuguese national funds via FCT – Fundação para a Ciência e a Tecnologia, under projects POCI-01-0145-FEDER-007440 (Strategic Project), UID/NEU/04539/2019, Pest-C/SAU/LA0001/2013e2014 and doctoral grant SFRH/BD/86622/2012. The LBioMiT was financed by Santhera Pharmaceuticals, allowing the implementation of the project “Providing free of charge complete genetic tests to Portuguese patients with a clinical and instrumental diagnosis of Optic Nerve Atrophy” (PI Professor Manuela Grazina)