Role of the repeat expansion size in predicting age of onset and severity in RFC1 disease

RFC1 disease, caused by biallelic repeat expansion in RFC1, is clinically heterogeneous in terms of age of onset, disease progression and phenotype. We investigated the role of the repeat size in influencing clinical variables in RFC1 disease. We also assessed the presence and role of meiotic and somatic instability of the repeat. In this study, we identified 553 patients carrying biallelic RFC1 expansions and measured the repeat expansion size in 392 cases. Pearson’s coefficient was calculated to assess the correlation between the repeat size and age at disease onset. A Cox model with robust cluster standard errors was adopted to describe the effect of repeat size on age at disease onset, on age at onset of each individual symptoms, and on disease progression. A quasi-Poisson regression model was used to analyse the relationship between phenotype and repeat size. We performed multivariate linear regression to assess the association of the repeat size with the degree of cerebellar atrophy. Meiotic stability was assessed by Southern blotting on first-degree relatives of 27 probands. Finally, somatic instability was investigated by optical genome mapping on cerebellar and frontal cortex and unaffected peripheral tissue from four post-mortem cases. A larger repeat size of both smaller and larger allele was associated with an earlier age at neurological onset [smaller allele hazard ratio (HR) = 2.06, P < 0.001; larger allele HR = 1.53, P < 0.001] and with a higher hazard of developing disabling symptoms, such as dysarthria or dysphagia (smaller allele HR = 3.40, P < 0.001; larger allele HR = 1.71, P = 0.002) or loss of independent walking (smaller allele HR = 2.78, P < 0.001; larger allele HR = 1.60; P < 0.001) earlier in disease course. Patients with more complex phenotypes carried larger expansions [smaller allele: complex neuropathy rate ratio (RR) = 1.30, P = 0.003; cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) RR = 1.34, P < 0.001; larger allele: complex neuropathy RR = 1.33, P = 0.008; CANVAS RR = 1.31, P = 0.009]. Furthermore, larger repeat expansions in the smaller allele were associated with more pronounced cerebellar vermis atrophy (lobules I–V β = −1.06, P < 0.001; lobules VI–VII β = −0.34, P = 0.005). The repeat did not show significant instability during vertical transmission and across different tissues and brain regions. RFC1 repeat size, particularly of the smaller allele, is one of the determinants of variability in RFC1 disease and represents a key prognostic factor to predict disease onset, phenotype and severity. Assessing the repeat size is warranted as part of the diagnostic test for RFC1 expansion

Efeito da adição de agentes tróficos na dieta de leitões desmamados sobre a estrutura e ultraestrutura do intestino delgado e sobre o desempenho

Foram estudados os efeitos da glutamina, dos ácidos graxos poli-insaturados e da parede celular de levedura (PCL) sobre a estrutura e ultraestrutura do intestino delgado e o desempenho de leitões. Foram utilizados 45 leitões, desmamados aos 21 dias de idade, para testar os seguintes tratamentos: T1 - dieta basal; T2 - dieta basal + 1% de glutamina; T3 - dieta basal + 0,2% de PCL; T4 - dieta basal + 5% de óleo de peixe. Nos dias sete e 14 pós-desmame, foram abatidos cinco leitões de cada tratamento. Os aditivos testados não alteraram a altura e a densidade dos vilos nem a profundidade das criptas do intestino delgado. Foi observado efeito de idade, mostrando redução na altura e na densidade dos vilos e na profundidade das criptas após o desmame. No duodeno e jejuno, foram observados maiores valores de relação vilo:cripta, que aumentaram com a idade pós-desmame. Ocorreram redução da altura dos microvilos do duodeno aos sete dias e aumento da largura dos microvilos do jejuno aos 14 dias pós-desmame. A área de superfície apical dos enterócitos não foi alterada pelos fatores estudados. Os aditivos estudados não foram eficientes em prevenir a atrofia da mucosa intestinal do jejuno, ao não interferir na sua ultraestrutura. Os aditivos incluídos na dieta não influenciaram o desempenho dos leitões no pós-desmame.The effects of glutamine, poliunsatured fatty acids and cellular wall of yeast (CWY) under the structure and ultra structure of the small gut and the performance of the piglets were studied. Forty five piglets weaned at 21 days were used to test the following treatments: T1 - basal diet; T2 - basal diet + 1% of glutamine; T3 - basal diet + 0,2% of CWY; T4 - basal diet + 5% of fish oil. At seven and 14 post weaning days, five piglets of each treatment were slaughtered. The height, density of villus and depth of small gut crypts were not altered by the inclusion of additives. The effect of age was observed, showing a reduction in the height and density of villus and depth of crypts after weaning. In duodenum and jejunum higher values were observed in the relation villus:crypt, which increased with the post wean age. There was a decrease in the height of microvillus of the duodenum at 7 days and an increase of the width of the microvillus of jejunum at 14 days after wean. The area of the apical surface of the enterocytes was not altered by the studied factors. The studied additives were not efficient to prevent the atrophy of the intestinal mucosa of the jejunum, since they did not interfere on its ultra structure. Piglet performance was not affected by the additives included in the diet