64 research outputs found
Special aspects of development of business in the knowledge-based economy
The article deals with the questions of development of the theory of business in the knowledge-based economy or information economy and substantiates the new direction of research of questions, connected with the category "business", from positions of the information components influencing it. Β© IDOSI Publications, 2013
Formation of larynx topographic-anatomic relations with neck organs and structures in the intermediate fetal period of ontogenesis
Objectivesto present topographic and anatomic characteristics of the larynx relationship with neck organs and structures in the intermediate fetal period of human ontogenesis.
Material and methods.The study included 85 organocomplexes of the fetuses neck of both sexes, from the 14th to the 27th week of development. The study material was divided into 2 age periods: the first group fetuses aged 1420 weeks; the second group 2127 weeks. The classical morphological techniques were used: (macromicroscopic preparation, modified method of saw cuts according to N.I. Pirogov, histotopographic method).
Results.Larynx syntopy with thyroid gland, cervical esophagus, thymus, submandibular glands was described in detail. Larynx skeletotopy with incisurae jugularis sterni, cervical vertebrae, hyoid bone, mandible was described quantitatively.
Conclusion.The data, obtained as a result of the study, supplement the data on the topographic anatomy of larynx and some neck organs and structures in the prenatal period of human ontogenesis. The revealed formation features of larynx and other neck organs and structures topography can be used in the study of intravital anatomy
Production of polyclonal antibodies and development of fluorescence polarization immunoassay for sulfanilamide
N-sulfanil-4-aminobutyric acid (SAB), which mimics common parts of the sulfonamides' structure, was synthesized and used to produce antibodies to sulfanilamide. Rabbit polyclonal antibodies have been raised using SAB conjugates with ovalbumin (OVA) or soybean trypsin inhibitor (STI). The immunogen based on SAB-STI could yield higher affinity anitbodies against sulfanilamide. The same SAB derivative was used for synthesis of a fluorescein-labeled tracer with fluorescein-thiocarbamyl ethylendiamine. A fluorescence polarization immunoassay (FPIA) for sulfanilamide was developed. The limits of detection sulfanilamide were 0.07, 0.10, and 0.07 ΞΌg mL -1 for water, diluted milk, and precipitated milk samples, respectively. The developed FPIA exhibited sensitivities below the respective maximal residue limits (MRLs) for individual sulfonamides (0.1 ΞΌg mL -1). The coefficients of variation of results for milk samples were lower than 5%. Total time for simple sample pretreatment and measurement is about 10 min for one sample. High cross-reactivity with sulfaguanidine (96%), sulfamethoxypyridazine (75%), and sulfachloropyridazine (28%), which have planar structures, could be suitable for simultaneous detection of these sulfa drugs in milk and developed fluorescence polarization immunoassay could be classified as a group-selective assay. Copyright Β© Taylor & Francis, Inc
ΠΠ»ΠΎΠΊ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π²ΠΎΠ·Π±ΡΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΠΎ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΌΡ Π½Π΅ΡΠ²Ρ ΠΊΠ°ΠΊ ΡΠ»Π΅ΠΊΡΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π½ΠΎΠΌΠ΅Π½: ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
Evaluation and interpretation of electrophysiological phenomena often plays an important role in the diagnosis of neuromuscular diseases. Motor nerve conduction block is a reduction of either amplitude or area of the compound motor action potential elicited by proximal to distal motor nerve stimulation. Today, the value of conduction block in the diagnosis of demyelinating and axonal neuropathies, as well as the diagnostic criteria for these disorders, are still under discussion.Objective of the review of the literature is to highlight the value of conduction block as an electrophysiological phenomenon in the light of clinical manifestations. There is no consensus in the literature which motor response parameters should be used as partial conduction block criteria. The diversity of pathogenic forms in which conduction block can be registered does not allow to consider the phenomenon as a sign of only demyelinating lesions, and the term conduction block should be considered as a pure electrophysiological phenomenon. Different pathophysiological mechanisms of conduction block formation should be studied separately within each nosology. Conduction block detection does not allow to specify a particular diagnosis, however, in conjunction with clinical and anamnestic data, it may be the main argument in the diagnosis of a number of peripheral nerves diseases.ΠΠ»ΠΎΠΊ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ β ΡΠ»Π΅ΠΊΡΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π½ΠΎΠΌΠ΅Π½ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ Π°ΠΌΠΏΠ»ΠΈΡΡΠ΄Ρ ΠΈΠ»ΠΈ ΠΏΠ»ΠΎΡΠ°Π΄ΠΈ ΠΌΠΎΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΠΏΡΠΈ ΡΡΠΈΠΌΡΠ»ΡΡΠΈΠΈ Π² ΠΏΡΠΎΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠ΅ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π΄ΠΈΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ°. Π‘Π΅Π³ΠΎΠ΄Π½Ρ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ°Π΅ΡΡΡ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ Π΄Π΅ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
ΠΈ Π°ΠΊΡΠΎΠ½Π°Π»ΡΠ½ΡΡ
Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ, ΠΏΡΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΡΠ΅Π³ΠΈΡΡΡΠΈΡΡΠ΅ΡΡΡ ΡΡΠΎΡ ΡΠ΅Π½ΠΎΠΌΠ΅Π½.Π¦Π΅Π»Ρ ΠΎΠ±Π·ΠΎΡΠ° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ β ΠΎΡΠ²Π΅ΡΠΈΡΡ ΡΠ΅ΠΌΡ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠΎ Π½Π΅ΡΠ²Ρ ΠΊΠ°ΠΊ ΡΠ»Π΅ΠΊΡΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅Π½ΠΎΠΌΠ΅Π½Π° Π² ΡΠ²Π΅ΡΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ, Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π΅Π³ΠΎ ΡΠΎΠ»ΠΈ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΡΡΠ΄Π° Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π΅ΡΠ²ΠΎΠ². Π Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ Π½Π΅Ρ Π΅Π΄ΠΈΠ½ΠΎΠ³ΠΎ ΠΌΠ½Π΅Π½ΠΈΡ, ΠΊΠ°ΠΊΠΈΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ ΠΌΠΎΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΡΠ»Π΅Π΄ΡΠ΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΡΠ°ΡΡΠΈΡΠ½ΠΎΠ³ΠΎ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ. Π Π°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·ΠΈΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΠΌ, ΠΏΡΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΠΌΠΎΠΆΠ½ΠΎ ΠΎΠ±Π½Π°ΡΡΠΆΠΈΡΡ Π±Π»ΠΎΠΊ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ, Π½Π΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ ΡΡΠΎΡ ΡΠ΅Π½ΠΎΠΌΠ΅Π½ ΠΊΠ°ΠΊ ΠΏΡΠΈΠ·Π½Π°ΠΊ ΠΈΡΠΊΠ»ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π΄Π΅ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΈΠ·ΠΈΡΡΡΡΠ΅Π³ΠΎ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ Π½Π΅ΡΠ²ΠΎΠ². ΠΠ±ΡΠΈΠ΅ ΠΈ ΡΠ°ΡΡΠ½ΡΠ΅ ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΡΠΈ ΡΠ°Π·Π½ΡΡ
Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡΡ
Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΈΠ·ΡΡΠ°ΡΡ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΊΠ°ΠΆΠ΄ΠΎΠΉ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΡ. ΠΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ Π½Π΅ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΡΠ΄ΠΈΡΡ ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π΅, ΡΠ΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ Π² ΡΠΎΠ²ΠΎΠΊΡΠΏΠ½ΠΎΡΡΠΈ Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΈ Π°Π½Π°ΠΌΠ½Π΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π΄Π°Π½Π½ΡΠΌΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΠ΅ Π±Π»ΠΎΠΊΠ° ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ Π°ΡΠ³ΡΠΌΠ΅Π½ΡΠΎΠΌ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΡΡΠ΄Π° Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π΅ΡΠ²ΠΎΠ²
Phosphorylation of H,K-ATPase Ξ±-subunit in microsomes from rabbit gastric mucosa by cAMP-dependent protein kinase
A 100-kDa protein that is a main component of the microsomal fraction from rabbit gastric mucosa is phosphorylated by cAMP-dependent protein kinase (PKA) in the presence of 0.2% Triton X-100. Microsomes from rabbit gastric mucosa possess activity of H,K-ATPase but not activity of Na,K-ATPase. Incubation of microsomes with 5 ΞΌM fluo
Serotonin limits generation of chromaffin cells during adrenal organ development
Adrenal glands are the major organs releasing catecholamines and regulating our stress response. The mechanisms balancing generation of adrenergic chromaffin cells and protecting against neuroblastoma tumors are still enigmatic. Here we revealed that serotonin (5HT) controls the numbers of chromaffin cells by acting upon their immediate progenitor "bridge" cells via 5-hydroxytryptamine receptor 3A (HTR3A), and the aggressive HTR3Ahigh human neuroblastoma cell lines reduce proliferation in response to HTR3A-specific agonists. In embryos (in vivo), the physiological increase of 5HT caused a prolongation of the cell cycle in "bridge" progenitors leading to a smaller chromaffin population and changing the balance of hormones and behavioral patterns in adulthood. These behavioral effects and smaller adrenals were mirrored in the progeny of pregnant female mice subjected to experimental stress, suggesting a maternal-fetal link that controls developmental adaptations. Finally, these results corresponded to a size-distribution of adrenals found in wild rodents with different coping strategies
Clinical and genetic characteristics of CharcotβMarieβTooth disease type 4D (type Lom) in Russia
Introduction. CharcotβMarieβTooth disease type 4D is a hereditary demyelinating neuropathy, that occurs with the high frequency in patients of Roma origin. It is characterized by early onset at the age of 2β10 years and hearing impairment, manifested by the 3rd decade of life.Aim of the study. To describe the clinical and genetic characteristics of CharcotβMarieβTooth disease type 4D in Russian patients of Roma origin.Materials and methods. For 14 probands from unrelated families of Roma origin with a clinical diagnosis of CharcotβMarieβTooth disease, genetic tests for the pathogenic variants c. 442C>T in the NDRG1 gene and c. 3325C>T in the SH3TC2 gene was carried out. For 8 patients with CharcotβMarieβTooth disease type 4D, detailed clinical and electrophysiological examination was performed.Results. In 11 families of Roma origin, the c. 442C>T pathogenic variant in the NDRG1 gene in a homozygous state was detected, which accounted for 79 % all observed Roma patients with CharcotβMarieβTooth disease. There are 12 of the 14 tested families live in the European part of Russia, 7 of them are from nearby regions. The average age of onset was 3.3 years. The first symptom in 7 of 8 patients was gait disturbances. At the time of examination (age range 6β19 years), all patients showed marked hypotrophy and weakness of the feet, lower leg, hands muscles, feet deformities, reduction or loss of tendon reflexes.Discussion. Due to the detection of only one pathogenic variant in most Russian patients of Roma origin with CharcotβMarieβTooth disease, the knowledge of the ethnicity of a proband with early myelinopathy can significantly simplify the confirmation of the diagnosis on the molecular level
ΠΠ½Π°Π»ΠΈΠ· Π΄Π°Π½Π½ΡΡ ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ, ΡΠΊΠ°Π·Π°Π½Π½ΡΡ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ , ΡΠ°Π·ΠΌΠ΅ΡΠ΅Π½Π½ΡΡ Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ΅ΡΡΡΡΠ΅ ΠΠΈΠ½Π·Π΄ΡΠ°Π²Π° Π ΠΎΡΡΠΈΠΈ Β«Π ΡΠ±ΡΠΈΠΊΠ°ΡΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉΒ»
One of the key elements of medical care is the assessment of the patientβs condition, which allows making a diagnosis and evaluating theΒ patientβs health status, the severity of the diseaseΒ and the prognosis of its outcome. To date, medical professionals use various methods ofΒ assessing the patientβs condition; these methods are listed in βClinical RecommendationsβΒ posted in the information resource of the MinistryΒ of Healthcare of Russia.Objective: to analyze and systemize the many methods of clinical evaluation, e. g. scores, indices, questionnaires andΒ other approaches that appear in the clinical guidelines.Methods. We analyzed the clinical guidelines developed by professional non-profitΒ medicalΒ organizations and posted on the information resource of the Ministry of Healthcare of the Russian Federation under the βClinicalΒ Recommendationsβ category. A list of clinical assessment methodsΒ derived from these guidelines was composed and potential problems inΒ their implementation by medical organizations were identified.Results. The unified list of clinical assessments presented in the guidelinesΒ includes 175 clinicalΒ assessment methods. The most common methods of clinical evaluation were the VAS pain scoreΒ (in 23 clinicalΒ guidelines), the Glasgow coma scale (in 11 clinical guidelines), and the ECOG scaleΒ (in 10 clinical guidelines).Conclusion. The methods ofΒ clinical evaluation, indicated in the Minzdrav information resourceΒ are narrowly specialized; they are used and interpreted by a physician.Β Some importantΒ information about these methods and their validation is missing, which necessitates furtherΒ efforts by the medical communityΒ to improve and update these methods.ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΊΠ»ΡΡΠ΅Π²ΡΡ
ΡΠ»Π΅ΠΌΠ΅Π½ΡΠΎΠ² ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΒ Π΄ΠΈΠ°Π³Π½ΠΎΠ·, ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ Π·Π΄ΠΎΡΠΎΠ²ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π²Β Π½Π°ΡΡΠΎΡΡΠΈΠΉ ΠΌΠΎΠΌΠ΅Π½Ρ, ΡΡΠ΅ΠΏΠ΅Π½Ρ ΡΡΠΆΠ΅ΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ (ΠΈ Π΅Π³ΠΎΒ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ) ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ· Π΅Π³ΠΎΒ ΡΠ΅ΡΠ΅Π½ΠΈΡ. ΠΠ° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½ΡΒ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΌΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠ°ΠΌΠΈ ΡΠ°Π·Π½ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡΒ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΡΡΡΒ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΎΡΠ΅Π½ΠΊΠΈΒ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΠ½ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Β ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
(ΠΠ ) ΠΏΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ,Β ΡΠ°Π·ΠΌΠ΅ΡΠ΅Π½Π½ΡΡ
Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ΅ΡΡΡΡΠ΅ ΠΠΈΠ½Π·Π΄ΡΠ°Π²Π° Π ΠΎΡΡΠΈΠΈ Β«Π ΡΠ±ΡΠΈΠΊΠ°ΡΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉΒ».Π¦Π΅Π»Ρ β ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΠ·Π°ΡΠΈΡ Π΄Π°Π½Π½ΡΡ
ΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΡ
Π² ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
ΡΠΊΠ°Π»Π°Ρ
, ΠΈΠ½Π΄Π΅ΠΊΡΠ°Ρ
, ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ°Ρ
ΠΈ Π΄ΡΡΠ³ΠΈΡ
Β ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°Ρ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ, ΡΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠΌΠΈΒ Π½Π΅ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΌΠΈ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡΠΌΠΈ ΠΈ ΡΠ°Π·ΠΌΠ΅ΡΠ΅Π½Π½ΡΡ
Β Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ΅ΡΡΡΡΠ΅ ΠΠΈΠ½ΠΈΡΡΠ΅ΡΡΡΠ²Π° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡΒ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ Β«Π ΡΠ±ΡΠΈΠΊΠ°ΡΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉΒ», Π² ΡΠ°ΡΡΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ.Β Π‘ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ ΠΏΠ΅ΡΠ΅ΡΠ΅Π½Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ, ΡΠΊΠ°Π·Π°Π½Π½ΡΡ
Π² ΠΠ , Π²ΡΡΠ²Π»Π΅Π½Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΡΡΡΡΠ²ΠΈΡ ΠΏΡΠΈ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΌΠΈ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ Π΅Π΄ΠΈΠ½ΡΠΉ ΠΏΠ΅ΡΠ΅ΡΠ΅Π½Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ,Β Π²ΠΊΠ»ΡΡΠ°ΡΡΠΈΠΉ Π² ΡΠ΅Π±Ρ 175 ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ,Β ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π² ΠΠ . ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌΠΈ Π² ΠΠ Β ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°ΠΌΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ ΡΠΊΠ°Π»Π° Π±ΠΎΠ»ΠΈ VASΒ (ΡΠΏΠΎΠΌΠΈΠ½Π°Π΅ΡΡΡ Π² 23 ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
), ΡΠΊΠ°Π»Π° ΠΊΠΎΠΌΡ ΠΏΠΎΒ Glasgow (ΡΠΏΠΎΠΌΠΈΠ½Π°Π΅ΡΡΡ Π² 11 ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
), ΡΠΊΠ°Π»Π° ECOG (ΡΠΏΠΎΠΌΠΈΠ½Π°Π΅ΡΡΡ Π² 10 ΠΠ ).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ, ΡΠΊΠ°Π·Π°Π½Π½ΡΠ΅ Π² ΠΠ , Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌ ΡΠ²Π»ΡΡΡΡΡΒ ΡΠ·ΠΊΠΎΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌΠΈ, ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ ΠΈΒ ΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡΡΡ Π²ΡΠ°ΡΠΎΠΌ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ΠΌ Π²ΠΎ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΠΠ Β Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡΡ
ΡΠ²Π΅Π΄Π΅Π½ΠΈΠΉ ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°Ρ
ΠΈ Π΄Π°Π½Π½ΡΡ
ΠΎΠ± ΠΈΡ
Π²Π°Π»ΠΈΠ΄Π°ΡΠΈΠΈΒ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠ΅Π½ΠΈΠ΅ ΡΠ°Π±ΠΎΡ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΡΠΎΠΎΠ±ΡΠ΅ΡΡΠ²Π° ΠΏΠΎ Π°ΠΊΡΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈΒ Π΄Π°Π½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ
ΠΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π¨Π°ΡΠΊΠΎβΠΠ°ΡΠΈβΠ’ΡΡΠ° ΡΠΈΠΏΠ° 4D (ΡΠΈΠΏΠ° Lom) Π² Π ΠΎΡΡΠΈΠΈ
Introduction. CharcotβMarieβTooth disease type 4D is a hereditary demyelinating neuropathy, that occurs with the high frequency in patients of Roma origin. It is characterized by early onset at the age of 2β10 years and hearing impairment, manifested by the 3rd decade of life.Aim of the study. To describe the clinical and genetic characteristics of CharcotβMarieβTooth disease type 4D in Russian patients of Roma origin.Materials and methods. For 14 probands from unrelated families of Roma origin with a clinical diagnosis of CharcotβMarieβTooth disease, genetic tests for the pathogenic variants c. 442C>T in the NDRG1 gene and c. 3325C>T in the SH3TC2 gene was carried out. For 8 patients with CharcotβMarieβTooth disease type 4D, detailed clinical and electrophysiological examination was performed.Results. In 11 families of Roma origin, the c. 442C>T pathogenic variant in the NDRG1 gene in a homozygous state was detected, which accounted for 79 % all observed Roma patients with CharcotβMarieβTooth disease. There are 12 of the 14 tested families live in the European part of Russia, 7 of them are from nearby regions. The average age of onset was 3.3 years. The first symptom in 7 of 8 patients was gait disturbances. At the time of examination (age range 6β19 years), all patients showed marked hypotrophy and weakness of the feet, lower leg, hands muscles, feet deformities, reduction or loss of tendon reflexes.Discussion. Due to the detection of only one pathogenic variant in most Russian patients of Roma origin with CharcotβMarieβTooth disease, the knowledge of the ethnicity of a proband with early myelinopathy can significantly simplify the confirmation of the diagnosis on the molecular level.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠΎΠ»Π΅Π·Π½Ρ Π¨Π°ΡΠΊΠΎβΠΠ°ΡΠΈβΠ’ΡΡΠ° ΡΠΈΠΏΠ° 4D β Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½Π°Ρ Π΄Π΅ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΈΠ·ΠΈΡΡΡΡΠ°Ρ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡ, Π²ΡΡΡΠ΅ΡΠ°ΡΡΠ°ΡΡΡ Ρ Π½Π°ΠΈΠ±ΠΎΠ»ΡΡΠ΅ΠΉ ΡΠ°ΡΡΠΎΡΠΎΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ³Π°Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠ°ΡΡΡ ΡΠ°Π½Π½ΠΈΠΌ Π΄Π΅Π±ΡΡΠΎΠΌ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 2β10 Π»Π΅Ρ ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ»ΡΡ
Π°, ΠΏΡΠΎΡΠ²Π»ΡΡΡΠΈΠΌΡΡ ΠΊ 3-ΠΉ Π΄Π΅ΠΊΠ°Π΄Π΅ ΠΆΠΈΠ·Π½ΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΎΠΏΠΈΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π¨Π°ΡΠΊΠΎβΠΠ°ΡΠΈβΠ’ΡΡΠ° ΡΠΈΠΏΠ° 4D Ρ ΡΠΎΡΡΠΈΠΉΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ³Π°Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ±Π°Π½Π΄Π°ΠΌ ΠΈΠ· 14 Π½Π΅ΡΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΡΡ
ΡΠ΅ΠΌΠ΅ΠΉ ΡΡΠ³Π°Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Β«Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΌΠΎΡΠΎΡΠ½ΠΎ-ΡΠ΅Π½ΡΠΎΡΠ½Π°Ρ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡΒ» ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΏΠΎΠΈΡΠΊ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΡΡ
Π²Π°ΡΠΈΠ°Π½ΡΠΎΠ² c. 442C>T Π² Π³Π΅Π½Π΅ NDRG1 ΠΈ Ρ. 3325C>T Π² Π³Π΅Π½Π΅ SH3TC2. Π£ 8 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π±ΠΎΠ»Π΅Π·Π½ΡΡ Π¨Π°ΡΠΊΠΎβΠΠ°ΡΠΈβΠ’ΡΡΠ° ΡΠΈΠΏΠ° 4D ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ°, Ρ 3 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β Π°Π½Π°Π»ΠΈΠ· ΡΠ»Π΅ΠΊΡΡΠΎΠ½Π΅ΠΉΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄Π°Π½Π½ΡΡ
.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π 11 ΡΠ΅ΠΌΡΡΡ
ΡΡΠ³Π°Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΡΠΉ Π²Π°ΡΠΈΠ°Π½Ρ c. 442C>T Π² Π³Π΅Π½Π΅ NDRG1 Π² Π³ΠΎΠΌΠΎΠ·ΠΈΠ³ΠΎΡΠ½ΠΎΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ, ΡΡΠΎ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 79 % Π²ΡΠ΅Ρ
ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΡΡΠ³Π°Π½ Ρ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΌΠΎΡΠΎΡΠ½ΠΎ-ΡΠ΅Π½ΡΠΎΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ. ΠΠ· 14 ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΡΠ΅ΠΌΠ΅ΠΉ 12 ΠΏΡΠΎΠΆΠΈΠ²Π°ΡΡ Π² Π΅Π²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΎΠΉ ΡΠ°ΡΡΠΈ Π ΠΎΡΡΠΈΠΈ, 7 ΠΈΠ· Π½ΠΈΡ
β Π² Π±Π»ΠΈΠ·ΠΊΠΎΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Π½ΡΡ
ΡΡΠ±ΡΠ΅ΠΊΡΠ°Ρ
Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ. ΠΠΎΠ·ΡΠ°ΡΡ Π΄Π΅Π±ΡΡΠ° Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ» Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ 3,3 Π³ΠΎΠ΄Π°. Π£ 7 ΠΈΠ· 8 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² 1-ΠΌ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠΌ Π±ΡΠ»ΠΎ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡ
ΠΎΠ΄ΠΊΠΈ. ΠΠ° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΡΠΌΠΎΡΡΠ° (Π²ΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡ 6 Π΄ΠΎ 19 Π»Π΅Ρ) Ρ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½Ρ Π²ΡΡΠ°ΠΆΠ΅Π½Π½Π°Ρ Π³ΠΈΠΏΠΎΡΡΠΎΡΠΈΡ ΠΈ ΡΠ»Π°Π±ΠΎΡΡΡ ΠΌΡΡΡ ΡΡΠΎΠΏ, Π³ΠΎΠ»Π΅Π½Π΅ΠΉ, ΠΊΠΈΡΡΠ΅ΠΉ, Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΡ ΡΡΠΎΠΏ, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΈΠ»ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΡΡ
ΠΎΠΆΠΈΠ»ΡΠ½ΡΡ
ΡΠ΅ΡΠ»Π΅ΠΊΡΠΎΠ² Ρ Π½ΠΎΠ³.ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. Π£ΡΠΈΡΡΠ²Π°Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈ ΡΠΎΠ³ΠΎ ΠΆΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ Π²Π°ΡΠΈΠ°Π½ΡΠ° Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ³Π°Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ Ρ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΌΠΎΡΠΎΡΠ½ΠΎΠΉ ΡΠ΅Π½ΡΠΎΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ, Π·Π½Π°Π½ΠΈΠ΅ ΡΡΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΈΠ½Π°Π΄Π»Π΅ΠΆΠ½ΠΎΡΡΠΈ ΠΏΡΠΎΠ±Π°Π½Π΄Π° Ρ ΡΠ°Π½Π½Π΅ΠΉ ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠΏΡΠΎΡΠ°Π΅Ρ ΠΏΠΎΠΈΡΠΊ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΈΡΠΈΠ½Ρ Π±ΠΎΠ»Π΅Π·Π½ΠΈ
Π€Π΅Π½ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠ°Ρ Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΡΡΡ TRPV4-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΉ ΠΈ Π½Π΅ΠΉΡΠΎΠ½ΠΎΠΏΠ°ΡΠΈΠΉ: ΡΠ΅ΡΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ
TRPV4βassociated neuromuscular diseases represent a clinical spectrum of neuropathies and motor neuron disorders. To date, 3 phenotypic forms are distinguished. There are CharcotβMarieβTooth disease type 2C, distal hereditary motor neuropathy type 8 (DHMN8), scapuloβperoneal spinal muscular atrophy (SPSMA). Here we report 3 families with DNMN8 and one family with SPSMA. In all cases, DNAβanalysis revealed single nucleotide variants in the TRPV4 gene previously reported as pathogenic. In 3 probands, a combination of signs of both motor and motorβsensory neuropathies led to difficulties in the establishment of the clinical diagnosis. Patients had mild sensory disturbances in the feet, but in all of these cases nerve conduction study revealed normal sensory nerve action potentials. Considering the prevailing signs of motor neuropathy, these patients were diagnosed with DNMN8. Clinical signs of sensory disturbances are regarded as notΒ contradictingΒ theΒ diagnosis,Β sinceΒ theyΒ canΒ beΒ observedΒ inΒ variousΒ formsΒ ofΒ distalΒ motorΒ neuropathies. The clinical features of SPSMA in one patient corresponded to those previously described in the literature. The involvement of the shoulder girdle muscles and the peroneal muscles and neurogenic changes in needle electromyography allow suspecting SPSMA clinically. A distinctive features of TRPV4βassociated neuromuscular diseases are the vocal cords paresis, sensorineural hearing loss and respiratory failure, however they are not obligatory according to our clinical reports.TRPV4βΠ°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Π½Π΅ΡΠ²Π½ΠΎβΠΌΡΡΠ΅ΡΠ½ΡΠ΅ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡ ΡΠΎΠ±ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΏΠ΅ΠΊΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ, Π² ΠΊΠΎΡΠΎΡΠΎΠΌ Π²ΡΠ΄Π΅Π»ΡΡΡ 3 ΡΠ΅Π½ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠΎΡΠΌΡ: Π±ΠΎΠ»Π΅Π·Π½Ρ Π¨Π°ΡΠΊΠΎβΠΠ°ΡΠΈβΠ’ΡΡΠ° 2Π‘, Π΄ΠΈΡΡΠ°Π»ΡΠ½ΡΡ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΡΡ ΠΌΠΎΡΠΎΡΠ½ΡΡ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡ 8βΠ³ΠΎ ΡΠΈΠΏΠ° (ΠΠΠΠ8), ΡΠΊΠ°ΠΏΡΠ»ΠΎβΠΏΠ΅ΡΠΎΠ½Π΅Π°Π»ΡΠ½ΡΡ ΡΠΏΠΈΠ½Π°Π»ΡΠ½ΡΡ ΠΌΡΡΠ΅ΡΠ½ΡΡ Π°ΡΡΠΎΡΠΈΡ (Π‘ΠΠ‘ΠΠ). Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ 3 ΡΠ΅ΠΌΠ΅ΠΉ Ρ ΠΠΠΠ8 ΠΈ 1 ΡΠ΅ΠΌΡΠΈ Ρ Π‘ΠΠ‘ΠΠ, Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΠΠβΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° Π²ΡΡΠ²ΠΈΠ»Π° Π²Π°ΡΠΈΠ°Π½ΡΡ Π½ΡΠΊΠ»Π΅ΠΎΡΠΈΠ΄Π½ΠΎΠΉ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π² Π³Π΅Π½Π΅ TRPV4, ΡΠ°Π½Π΅Π΅ ΠΎΠΏΠΈΡΠ°Π½Π½ΡΠ΅ ΠΊΠ°ΠΊ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΡΠ΅. Π£ ΠΎΡΠΌΠΎΡΡΠ΅Π½Π½ΡΡ
Π½Π°ΠΌΠΈ 3 ΠΏΡΠΎΠ±Π°Π½Π΄ΠΎΠ² ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π²ΡΠ·Π²Π°Π»ΠΎ Π·Π°ΡΡΡΠ΄Π½Π΅Π½ΠΈΡ Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ΠΌ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΊΠ°ΠΊ ΠΌΠΎΡΠΎΡΠ½ΠΎΠΉ, ΡΠ°ΠΊ ΠΈ ΠΌΠΎΡΠΎΡΠ½ΠΎβΡΠ΅Π½ΡΠΎΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΈ. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ Π»Π΅Π³ΠΊΠΈΠ΅ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π² ΡΡΠΎΠΏΠ°Ρ
, Π½ΠΎ ΠΏΡΠΈ ΡΡΠΎΠΌ Π½ΠΈ Π² ΠΎΠ΄Π½ΠΎΠΌ ΠΈΠ· ΡΡΠΈΡ
ΡΠ»ΡΡΠ°Π΅Π² Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π½ΡΠΎΡΠ½ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ Π½Π΅ΡΠ²ΠΎΠ² ΡΡΠΊ ΠΈ Π½ΠΎΠ³ ΠΏΡΠΈ ΡΠ»Π΅ΠΊΡΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΠΈ. Π‘ ΡΡΠ΅ΡΠΎΠΌ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠΎΡΠΎΡΠ½ΠΎΠΉ ΠΏΠΎΡΡΠΈΠΈ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΏΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΈ ΡΠ»Π΅ΠΊΡΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π΄Π°Π½Π½ΡΠΌ ΡΡΠΈΠΌ Π±ΠΎΠ»ΡΠ½ΡΠΌ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠΠΠΠ8. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ°ΡΡΠ΅Π½Π΅Π½Ρ ΠΊΠ°ΠΊ Π½Π΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠ΅ΡΠ°ΡΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Ρ, ΡΠ°ΠΊ ΠΊΠ°ΠΊ ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎ, ΡΡΠΎ Π»Π΅Π³ΠΊΠΈΠ΅ ΡΠ΅Π½ΡΠΎΡΠ½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΌΠΎΠ³ΡΡ ΠΎΡΠΌΠ΅ΡΠ°ΡΡΡΡ ΠΏΡΠΈ ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌΠ°Ρ
Π΄ΠΈΡΡΠ°Π»ΡΠ½ΡΡ
ΠΌΠΎΡΠΎΡΠ½ΡΡ
Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΉ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ Π‘ΠΠ‘ΠΠ ΠΎΠ΄Π½ΠΎΠΉ Π±ΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΎΠ²Π°Π»ΠΈ ΡΠ°Π½Π΅Π΅ ΠΎΠΏΠΈΡΠ°Π½Π½ΡΠΌ Π² Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅. Π‘ΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΌΡΡΡ ΠΏΠ»Π΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΠΎΡΡΠ° ΠΈ ΠΏΠ΅ΡΠΎΠ½Π΅Π°Π»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Π½Π΅ΠΉΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΈΠ³ΠΎΠ»ΡΡΠ°ΡΠΎΠΉ ΡΠ»Π΅ΠΊΡΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π·Π°ΠΏΠΎΠ΄ΠΎΠ·ΡΠΈΡΡ Π΄Π°Π½Π½ΡΡ ΡΠΎΡΠΌΡ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΡΠ°ΠΏΠ΅. ΠΡΠ»ΠΈΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΠΌΠΈ TRPV4βΠ°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π½Π΅ΡΠ²Π½ΠΎβΠΌΡΡΠ΅ΡΠ½ΡΡ
Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΡΠ²Π»ΡΡΡΡΡ ΠΏΠ°ΡΠ΅Π· Π³ΠΎΠ»ΠΎΡΠΎΠ²ΡΡ
ΡΠ²ΡΠ·ΠΎΠΊ, Π½Π΅ΠΉΡΠΎΡΠ΅Π½ΡΠΎΡΠ½Π°Ρ ΡΡΠ³ΠΎΡΡ
ΠΎΡΡΡ ΠΈ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½Π°Ρ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡ. ΠΠ΄Π½Π°ΠΊΠΎ, ΠΊΠ°ΠΊ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ Π½Π°ΡΠΈ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ, ΡΡΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π½Π΅ ΡΠ²Π»ΡΡΡΡΡ ΠΎΠ±Π»ΠΈΠ³Π°ΡΠ½ΡΠΌΠΈ
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