Clinical and molecular data from 61 Brazilian cases of Congenital Hyperinsulinemic Hypoglycemia

Objective: To study the clinical and molecular characteristics of a sample of Brazilian patients with Congenital Hyperinsulinemic Hypoglycemia (CHH).Methods: Electronic message was sent to members from Endocrinology Department-Brazilian Society of Pediatrics requesting clinical data for all cases of CHH. A whole blood sample from living patients was requested for DNA extraction followed by a search for mutations of the genes ABCC8, KCNJ11, GCK, GLUD1, HADH, SLC16A1 and HNF4A.Results: of the 61 patients evaluated, 36 (59%) were boys, and only 16 (26%) were born by normal delivery. Gestational age ranged from 32 to 41 weeks (mean = 37 weeks and 6 days). Birth weight ranged from 1590 to 5250 g (mean = 3430 g). Macrossomia occurred in 14 cases (28%). Age at diagnosis ranged from 1 to 1080 days (mean = 75 days). DNA for molecular analysis was obtained from 53 of the 61 patients. Molecular changes in the ABCC8 gene were detected in 15 (28%) of these 53 cases, and mutations in the KCNJ11 gene were detected in 6 (11%). Mutations in the GLUD1 gene were detected in 9 cases (17%) of the total series. Mutations of the GCK gene in heterozygosis were detected in 3 cases. No mutations were detected in the sequencing of genes HADH, SLC16A1 and HNF4A.Conclusion: the present study conducted in Brazil permitted the collaborative compilation of an important number of CHH cases and showed that the present clinical and molecular data are similar to those of published global series.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Ribeirao Preto Med Sch, BR-14049 Ribeirao Preto, SP, BrazilState Univ Campinas UNICAMP, Dept Pediat, Sch Med Sci, Campinas, SP, BrazilUniv São Paulo, Hosp Clin, Inst Crianca, Pediat Endocrine Unit, São Paulo, SP, BrazilUniv Fed Minas Gerais, Dept Pediat, Med Sch, Hosp Clin, Belo Horizonte, MG, BrazilFAPESP: 2011/09355-0Web of Scienc

Evaluation of anti-neoplastic effects of NF-kB inhibition by DHMEQ (Dehidroximetilepoxiquinomicina) in medulloblastoma cell lines

Meduloblastoma é um câncer do sistema nervoso central, altamente invasivo, de origem embrionária, localizado no cerebelo. É mais comum em crianças e corresponde a aproximadamente 20% de todos os tumores intracranianos pediátricos. Os tratamentos mais utilizados são cirurgia e quimioterapia, sendo que a radioterapia é aplicada somente em crianças com mais de 3 anos devido aos seus efeitos colaterais. Diversos estudos têm mostrado o papel do NF-B na regulação de genes envolvidos com o processo neoplásico. NF-B é um fator de transcrição chave na regulação da resposta imune e no processo de inflamação e está envolvido na regulação da transcrição de um grande número de genes relacionados ao processo de tumorigênese, além de ser constitutivamente ativo em diversos tipos de câncer, sendo um importante potencial alvo terapêutico. O DHMEQ (Dehidroximetilepoxiquinomicina) é uma droga que inibe a translocação do NF-B do citoplasma para o núcleo, inibindo assim a sua atuação como ativador transcricional. Vários trabalhos tem mostrado os efeitos antineoplásicos do DHMEQ em inúmeros tipos tumorais, entretanto, não há trabalhos que evidenciem esses efeitos em meduloblastoma. Assim, o presente estudo objetivou avaliar os efeitos dessa droga nas linhagens UW402, UW473 e ONS-76 de meduloblastoma pediátrico através de estudos funcionais e moleculares. Os resultados de proliferação demostraram uma significativa diminuição do crescimento celular nas linhagens de meduloblastoma, inibindo cerca de 80, 70 e 60% nas linhagens UW402, UW473 e ONS-76, respectivamente, na dose de 20 g/mL, e apresentou um IC50 de 10g/mL em 48h para as linhagens UW402 e UW473 e em 72h na linhagem ONS-76. Adicionalmente, elevou o nível de apoptose para 50, 17 e 31% nessas linhagens, respectivamente, inibiu fortemente a capacidade clonogênica, a migração e a invasão celular nas três linhagens e foi sinérgico na combinação com outros quimioterápicos em grande parte dos pontos de combinação, além de radiossensibilizar fortemente as três linhagens. Os resultados são congruentes com o potencial efeito antitumoral de DHMEQ.Medulloblastoma is a cancer of the central nervous system, highly invasive, of embryonic origin, located in the cerebellum. It is more common among children and accounts for approximately 20% of all pediatric intracranial tumors. The most common treatments are surgery and chemotherapy, and radiotherapy is only to children older than 3 years old due to its side effects. Several studies have demonstrated the role of NF-B in the regulation of genes involved in the neoplastic process. NF-B is a key transcription factor in the regulation of immune response and inflammation process, and it is involved in the transcriptional regulation of a large number of genes related to the tumorigenesis process, and constitutively active in many types of cancer, being an important potential therapeutic target. DHMEQ (Dehidroximetilepoxiquinomicina) is a drug that inhibits the translocation of NF-B from the cytoplasm to the nucleus, thus inhibiting its activity as a transcriptional activator. Several studies have shown the antineoplastic effects of DHMEQ in numerous tumor types, however, there is no surveys that have tested their effects in medulloblastoma. Thus, the present study aimed to evaluate the effects of this drug in UW402, UW473 and ONS-76 pediatric medulloblastoma cell lines through functional and molecular studies. The proliferation test results demonstrated a significant decrease in the cell growth in the medulloblastoma cell lines, inhibiting approximately 80, 70 and 60% for UW402, UW473 and ONS-76, respectively, at a dose of 20g/mL, and showed an IC50 of 10g/mL at 48h for UW402 and UW473 and at 72h in ONS-76. Additionally, increased the level of apoptosis to 50, 17 and 31% in these cell lines, respectively, strongly inhibited the clonogenic capacity, the migration and cell invasion in the three lines and it was synergistic in combination with other chemotherapeutic agents in most combination points, and radiosensitization strongly the three cell lines. The results are congruent with the potential antitumor effect of DHMEQ

Avaliação do padrão de metilação da DMR (Differentially Methylated Region) dos gnes IGF2 e H19 em carcinomas uroteliais

Os padrões anormais de metilação do DNA, especialmente a hipermetilação de genes com provável função supressora de tumor, representam um dos mais promissores marcadores moleculares do câncer por levarem à inativação funcional de genes críticos. Estudos prévios documentaram altos níveis de expressão do gene H19 em carcinoma de bexiga recorrentes. O gene H19 é regulado por imprinting, está localizado em 11p15.5 adjacente ao gene IGF2 (insulin-like growth factor 2 – somatomedin A) e codifica um transcrito não codificador de proteínas (micro RNA miR-675). Uma região que atua de forma coordenada no controle da expressão desses genes, chamada DMR (Differentially Methylated Region), atua na determinação do imprinting recíproco e na expressão mutuamente exclusiva dos genes IGF2 e H19. Ela encontra-se não metilada no homólogo materno e metilada no homólogo paterno e contém sete regiões de ligação da proteína CTCF (proteína bloqueadora do acentuador), que é sensível à metilação do DNA. Um relato prévio da literatura sugeriu que somente o sexto sítio de ligação do fator CTCF apresenta metilação parental específica. Este achado foi correlacionado com o padrão de expressão regulado por imprinting dos genes IGF2 e H19 em câncer de bexiga. No presente estudo, o padrão de metilação alelo-específico do gene H19 foi determinado em duas regiões distintas: no sexto sítio de ligação do fator CTCF contido na DMR e no primeiro éxon do gene H19 utilizando-se três abordagens diferentes: MSRE-PCR-RFLP (Methylation Sensitive Restriction Enzyme - Polymerase Chain Reaction - Restriction Fragment Length Polymorphism), qMSP (quantitative real time Methylation Specific Polymerase Chain Reaction) para o sexto sítio e MSP-CTPP (Methylation Specific Polymerase Chain Reaction with Confontring Two Pair-Primers) para a região do primeiro éxon em 52 amostras de tecidos...Abnormal patterns of DNA methylation, especially hypermethylation of genes demonstrating tumoral suppressor functions represent one of the most promising molecular markers of cancer because they can lead to functional inactivation of critical genes. Previous studies have documented high levels of H19 gene expression in recurrent bladder carcinomas. The H19 gene is regulated by imprinting, is located at 11p15.5 adjacent to the IGF2 gene (insulin-like growth factor 2 - somatomedin A) and encodes a non-coding transcript (micro RNA miR-675). A Differentially Methylated Region (DMR) region acts in a coordinated manner to control the expression of the IGF2 and H19 genes by determining their reciprocal imprinting and mutually exclusive expression patterns. The H19-DMR contains seven potential CTCF-binding sites. These sites are located upstream to the transcriptional initiation site, and the gamete-specific methylation acts as an insulator by precluding CTCF binding in the paternal allele. A previous literature report have suggested that only the sixth CTCF-binding site shows parental specific methylation. This finding was correlated with the imprinting expression pattern of IGF2 and H19 genes in bladder cancer. In the present study, the allele-specific methylation pattern of the H19 gene was evaluated in two distinct target regions: the sixth CTCF-binding site located in the DMR and the first exon of the H19 gene using three different approaches: MSRE-PCR-RFLP (Methylation Sensitive Restriction Enzyme - Polymerase Chain Reaction - Restriction Fragment Length Polymorphism), qMSP (quantitative real time Methylation Specific Polymerase Chain Reaction) for the sixth CTCF-binding site, and the first exon of the H19 gene was analyzed by MSP-CTPP (Methylation Specific Polymerase Chain Reaction with Confronting Two-Pair Primers) in 52 samples of bladder tumors matched to normal adjacent tissues obtained... (Complete abstract click electronic access below)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Clinical and molecular data from 61 brazilian cases of congenital hyperinsulinemic hypoglycemia

To study the clinical and molecular characteristics of a sample of Brazilian patients with Congenital Hyperinsulinemic Hypoglycemia (CHH). Electronic message was sent to members from Endocrinology Department-Brazilian Society of Pediatrics requesting clinical data for all cases of CHH. A whole blood sample from living patients was requested for DNA extraction followed by a search for mutations of the genes ABCC8, KCNJ11, GCK, GLUD1, HADH, SLC16A1 and HNF4A. Of the 61 patients evaluated, 36 (59%) were boys, and only 16 (26%) were born by normal delivery. Gestational age ranged from 32 to 41 weeks (mean = 37 weeks and 6 days). Birth weight ranged from 1590 to 5250 g (mean = 3430 g). Macrossomia occurred in 14 cases (28%). Age at diagnosis ranged from 1 to 1080 days (mean = 75 days). DNA for molecular analysis was obtained from 53 of the 61 patients. Molecular changes in the ABCC8 gene were detected in 15 (28%) of these 53 cases, and mutations in the KCNJ11 gene were detected in 6 (11%). Mutations in the GLUD1 gene were detected in 9 cases (17%) of the total series. Mutations of the GCK gene in heterozygosis were detected in 3 cases. No mutations were detected in the sequencing of genes HADH, SLC16A1 and HNF4A. The present study conducted in Brazil permitted the collaborative compilation of an important number of CHH cases and showed that the present clinical and molecular data are similar to those of published global series7FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2011/09355-

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