Molecular EPISTOP, a comprehensive multi-omic analysis of blood from Tuberous Sclerosis Complex infants age birth to two years

We present a comprehensive multi-omic analysis of the EPISTOP prospective clinical trial of early intervention with vigabatrin for pre-symptomatic epilepsy treatment in Tuberous Sclerosis Complex (TSC), in which 93 infants with TSC were followed from birth to age 2 years, seeking biomarkers of epilepsy development. Vigabatrin had profound effects on many metabolites, increasing serum deoxycytidine monophosphate (dCMP) levels 52-fold. Most serum proteins and metabolites, and blood RNA species showed significant change with age. Thirty-nine proteins, metabolites, and genes showed significant differences between age-matched control and TSC infants. Six also showed a progressive difference in expression between control, TSC without epilepsy, and TSC with epilepsy groups. A multivariate approach using enrollment samples identified multiple 3-variable predictors of epilepsy, with the best having a positive predictive value of 0.987. This rich dataset will enable further discovery and analysis of developmental effects, and associations with seizure development in TSC.</p

Mass spectrometric analysis of surfactant metabolism in human volunteers using deuteriated choline

urfactant reduces surface tension at pulmonary air–liquid interfaces. Although its major component is dipalmitoyl–phosphatidylcholine (PC16:0/16:0), other PC species, principally palmitoylmyristoyl–PC, palmitoylpalmitoleoyl–PC, and palmitoyloleoyl–PC, are integral components of surfactant. The composition and metabolism of PC species depend on pulmonary development, respiratory rate, and pathologic alterations, which have largely been investigated in animals using radiolabeled precursors. Recent advances in mass spectrometry and availability of precursors carrying stable isotopes make metabolic experiments in human subjects ethically feasible. We introduce a technique to quantify surfactant PC synthesis in vivo using deuteriated choline coupled with electrospray ionization tandem mass spectrometry. Endogenous PC from induced sputa of healthy volunteers comprised 54.0 ± 1.5% PC16:0/16:0, 9.7 ± 0.7% palmitoylmyristoyl–PC, 10.0 ± 1.0% palmitoylpalmitoleoyl–PC, and 13.1 ± 0.3% palmitoyloleoyl–PC. Infusion of deuteriated choline chloride (3.6 mg/kg body weight) over 3 hours resulted in linear incorporation into PC over 30 hours. After a plateau of 0.61 ± 0.04% labeled PC between 30 and 48 hours, incorporation decreased to 0.30 ± 0.02% within 7 days. Compared with native PC, fractional label was initially lower for PC16:0/16:0 (31.9 ± 8.3%) but was higher for palmitoyloleoyl–PC (21.0 ± 1.2%), and equilibrium was achieved after only 48 hours. We conclude that infusion of deuteriated choline and electrospray ionization tandem mass spectrometry is useful to investigate surfactant metabolism in humans in vivo

Dynamics of Hydride Ions in Metal Hydride-Reduced BaTiO3 Samples Investigated with Quasielastic Neutron Scattering

Perovskite-type oxyhydrides, BaTiO3-xHx, have been recently shown to exhibit hydride-ion (H-) conductivity at elevated temperatures, but the underlying mechanism of hydride-ion conduction and how it depends on temperature and oxygen vacancy concentration remains unclear. Here, we investigate, through the use of quasielastic neutron scattering techniques, the nature of the hydride-ion dynamics in three metal hydride-reduced BaTiO3 samples that are characterized by the simultaneous presence of hydride ions and oxygen vacancies. Measurements of elastic fixed window scans upon heating reveal the presence of quasielastic scattering due to hydride-ion dynamics for temperatures above ca. 200 K. Analyses of quasielastic spectra measured at low (225 and 250 K) and high (400-700 K) temperature show that the dynamics can be adequately described by established models of jump diffusion. At low temperature, &lt;= 250 K, all of the models feature a characteristic jump distance of about 2.8 angstrom, thus of the order of the distance between neighboring oxygen atoms or oxygen vacancies of the perovskite lattice and a mean residence time between successive jumps of the order of 0.1 ns. At higher temperatures, &gt;400 K, the jump distance increases to about 4 angstrom, thus of the order of the distance between next-nearest neighboring oxygen atoms or oxygen vacancies, with a mean residence time of the order of picoseconds. A diffusion constant D was computed from the data measured at low and high temperatures, respectively, and takes on values of about 0.4 X 10(-6) cm(-2) s(-1) at the lowest applied temperature of 225 K and between ca. 20 X 10(-6) and 100 X 10(-6) cm(-2) s(-1) at temperatures between 400 and 700 K. Activation energies E-a were derived from the measurements at high temperatures and take on values of about 0.1 eV and show a slight increase with increasing oxygen vacancy concentration

TSC2pathogenic variants are predictive of severe clinical manifestations in TSC infants: results of the EPISTOP study

PURPOSE: To perform comprehensive genotyping of TSC1 and TSC2 in a cohort of 94 infants with tuberous sclerosis complex (TSC) and correlate with clinical manifestations. METHODS: Infants were enrolled at age <4 months, and subject to intensive clinical monitoring including electroencephalography (EEG), brain magnetic resonance imaging (MRI), and neuropsychological assessment. Targeted massively parallel sequencing (MPS), genome sequencing, and multiplex ligation-dependent probe amplification (MLPA) were used for variant detection in TSC1/TSC2. RESULTS: Pathogenic variants in TSC1 or TSC2 were identified in 93 of 94 (99%) subjects, with 23 in TSC1 and 70 in TSC2. Nine (10%) subjects had mosaicism. Eight of 24 clinical features assessed at age 2 years were significantly less frequent in those with TSC1 versus TSC2 variants including cortical tubers, hypomelanotic macules, facial angiofibroma, renal cysts, drug-resistant epilepsy, developmental delay, subependymal giant cell astrocytoma, and median seizure-free survival. Additionally, quantitative brain MRI analysis showed a marked difference in tuber and subependymal nodule/giant cell astrocytoma volume for TSC1 versus TSC2. CONCLUSION: TSC2 pathogenic variants are associated with a more severe clinical phenotype than mosaic TSC2 or TSC1 variants in TSC infants. Early assessment of gene variant status and mosaicism might have benefit for clinical management in infants and young children with TSC.status: publishe

Early Clinical Predictors of Autism Spectrum Disorder in Infants with Tuberous Sclerosis Complex: Results from the EPISTOP Study

Autism spectrum disorder (ASD) is highly prevalent in subjects with Tuberous Sclerosis Complex (TSC), but we are not still able to reliably predict which infants will develop ASD. This study aimed to identify the early clinical markers of ASD and/or developmental delay (DD) in infants with an early diagnosis of TSC. We prospectively evaluated 82 infants with TSC (6-24 months of age), using a detailed neuropsychological assessment (Bayley Scales of Infant Development-BSID, and Autism Diagnostic Observation Schedule-ADOS), in the context of the EPISTOP (Long-term, prospective study evaluating clinical and molecular biomarkers of EPIleptogenesiS in a genetic model of epilepsy-Tuberous SclerOsis ComPlex) project (NCT02098759). Normal cognitive developmental quotient at 12 months excluded subsequent ASD (negative predictive value 100%). The total score of ADOS at 12 months clearly differentiated children with a future diagnosis of ASD from children without (p = 0.012). Atypical socio-communication behaviors (p < 0.001) were more frequently observed than stereotyped/repetitive behaviors in children with ASD at 24 months. The combined use of BSID and ADOS can reliably identify infants with TSC with a higher risk for ASD at age 6-12 months, allowing for clinicians to target the earliest symptoms of abnormal neurodevelopment with tailored intervention strategies.status: publishe

Molecular EPISTOP, a comprehensive multi-omic analysis of blood from Tuberous Sclerosis Complex infants age birth to two years

Abstract We present a comprehensive multi-omic analysis of the EPISTOP prospective clinical trial of early intervention with vigabatrin for pre-symptomatic epilepsy treatment in Tuberous Sclerosis Complex (TSC), in which 93 infants with TSC were followed from birth to age 2 years, seeking biomarkers of epilepsy development. Vigabatrin had profound effects on many metabolites, increasing serum deoxycytidine monophosphate (dCMP) levels 52-fold. Most serum proteins and metabolites, and blood RNA species showed significant change with age. Thirty-nine proteins, metabolites, and genes showed significant differences between age-matched control and TSC infants. Six also showed a progressive difference in expression between control, TSC without epilepsy, and TSC with epilepsy groups. A multivariate approach using enrollment samples identified multiple 3-variable predictors of epilepsy, with the best having a positive predictive value of 0.987. This rich dataset will enable further discovery and analysis of developmental effects, and associations with seizure development in TSC