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http://www.ncbi.nlm.nih.gov/pubmed/27709644
1. Andrologia. 2017 Oct;49(8). doi: 10.1111/and.12711. Epub 2016 Oct 6. A case of hypopituitarism accompanying Kearns-Sayre syndrome treated with human chorionic gonadotropin: A case report and literature review. Kang YX(1), Wang YJ(1), Zhang Q(1), Pang XH(1), Gu W(1). Author information: (1)Department of Endocrinology, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China. Comment in Andrologia. 2017 Dec;49(10). doi: 10.1111/and.12810. Kearns-Sayre syndrome (KSS) is a disorder caused by mutations in mitochondrial DNA. Here, we report an unusual case of Kearns-Sayre syndrome accompanied by hypopituitarism (deficiencies in reproductive and growth hormones). A 20-year-old male presented with growth retardation for the last 8 years, as well as the following findings: short stature, delayed puberty, myasthenia, an extraocular movement deficit, drooping eyelids, pectus carinatum and scoliosis. Cerebral enhanced magnetic resonance imaging revealed dysplasias of the pituitary, white matter and cerebellum. Laboratory work-up showed subnormal testosterone and growth hormone levels, a subnormal testicular volume, sensorineural deafness, pigmentary retinopathy, complete right bundle branch block and left anterior bundle branch block. Pathological examination revealed ragged red muscle fibres. Thus, this rare case involved the coexistence of Kearns-Sayre syndrome and hypopituitarism in a patient. Administration of coenzyme Q10 for the KSS and hormone replacement therapy for the endocrinopathies were performed for treatment of this patient. © 2016 Blackwell Verlag GmbH. DOI: 10.1111/and.12711 PMID: 27709644 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/22231766
1. RETRACTED ARTICLE Indian J Pediatr. 2012 May;79(5):650-4. doi: 10.1007/s12098-011-0618-3. Epub 2012 Jan 10. Kearns Sayre Syndrome--case report with review of literature. Phadke M(1), Lokeshwar MR, Bhutada S, Tampi C, Saxena R, Kohli S, Shah KN. Author information: (1)Department of Pediatrics, Lilavati Hospital and Research Center, Mumbai, India. Retraction in Indian J Pediatr. 2013 Nov;80(11):982. doi: 10.1007/s12098-013-1123-7. Kearns-Sayre Syndrome is form of rare mitochondrial cytopathy, first described by Thomas P. Kearns and George Pomeroy Sayre in 1958 and is characterized by progressive external opthalmoplegia, cardiac conduction block, pigmentary retinal degeneration, variable number of red ragged fibers on muscle biopsy. It presents before the child reaches the age of twenty. Kearns-Sayre syndrome may affect many organ systems and additional features may include myopathy, dystonia, bulbar symptoms in the form of dysarthria and nasal regurgitation and bilateral facial weakness. Endocrine abnormalities (e.g., diabetes, growth retardation/short stature, and hypoparathyroidism), bilateral sensorineural deafness, dementia, cataracts, and proximal renal tubular acidosis, skeletal muscle weakness (proximal more than distal) and exercise intolerance are additional features. Kearns Sayre Syndrome occurs as a result of large-scale single deletions (or rearrangements) of mitochondrial DNA (mtDNA), which is usually not inherited but occurs spontaneously, probably at the germ-cell level or very early in embryonic development. No disease-modifying therapy is available for Kearns-Sayre syndrome (KSS). Management is supportive vigilance for detection of associated problems. In the future, potential treatment in patients with Kearns-Sayre syndrome may attempt to inhibit mutant mtDNA replication or encourage replication of wild-type mtDNA. DOI: 10.1007/s12098-011-0618-3 PMID: 22231766 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/26884075
1. BMJ Case Rep. 2016 Feb 16;2016:bcr2015213813. doi: 10.1136/bcr-2015-213813. Dilated cardiomyopathy with cardiogenic shock in a child with Kearns-Sayre syndrome. Sehgal S(1), Choudhry S(2), Debelenko L(3), L'Ecuyer T(1). Author information: (1)Department of Pediatric Cardiology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan, USA. (2)Children's Hospital of Michigan, Detroit Medical Center and Washington University School of Medicine, St Louis, Missouri. (3)Department of Pathology, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan. Kearns-Sayre syndrome (KSS) is a mitochondrial myopathy resulting from mitochondrial DNA deletion. This syndrome primarily involves the central nervous system, eyes, skeletal muscles and the heart. The most well-known cardiac complications involve the conduction system; however, there have been case reports describing cardiomyopathy. We describe a case of a child with KSS who presented with decompensated cardiac failure from dilated cardiomyopathy representing cardiomyocyte involvement of KSS. Our patient had a rapidly progressing course, despite maximal medical management, requiring emergent institution of extracorporeal membrane oxygenation and transition to a ventricular assist device. To the best of our knowledge, this is the youngest patient in the literature to have dilated cardiomyopathy in KSS. 2016 BMJ Publishing Group Ltd. DOI: 10.1136/bcr-2015-213813 PMCID: PMC5483557 PMID: 26884075 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/35477912
1. Neurosciences (Riyadh). 2022 Apr;27(2):111-115. doi: 10.17712/nsj.2022.2.20210123. Kearns-Sayre syndrome with rare imaging finding of SLC25A4 Mutation. Zhao H(1), Shi M(1), Yang F(1), Yang X(1). Author information: (1)From the Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China. Kearns-Sayre Syndrome (KSS) is a subtype of chronic progressive external ophthalmoplegia (CPEO). In this case, A 21-year-old man diagnosed with KSS, and presented with chronic progressive blepharoptosis (ptosis) and external ophthalmoplegia, diffuse depigmentation of the retinal pigment epithelium, and cerebellar ataxia, with a cerebrospinal fluid protein of 254 mg/dL, was reported. Genetic screening revealed a novel mutated gene in SLC25A4 in the patient as well as in his mother: NM_001151:c.170G>C in exon 2. Its imaging finding is a characteristic progressive atrophy of the right cerebellar hemisphere. In conclusion, we found a case of KSS with a novel mutated gene in SLC25A4: NM_001151:c.170G>C in exon 2 as the pathogenic mechanism, and found that KSS can be caused only when the proportion of mutations in the SLC25A4 gene reach a certain degree, and the patient with KSS showed a unique cranial imaging feature of unilateral progressive cerebellar atrophy. Copyright: © Neurosciences. DOI: 10.17712/nsj.2022.2.20210123 PMCID: PMC9257918 PMID: 35477912 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/16735969
1. Diabetes Metab. 2006 Apr;32(2):182-6. doi: 10.1016/s1262-3636(07)70267-7. Kearns Sayre syndrome: an unusual form of mitochondrial diabetes. Laloi-Michelin M(1), Virally M, Jardel C, Meas T, Ingster-Moati I, Lombès A, Massin P, Chabriat H, Tielmans A, Mikol J, Guillausseau PJ. Author information: (1)Department of Internal Medicine-Diabetes and Metabolic Diseases, Hôpital Lariboisière, Paris, France. [email protected] Kearns Sayre syndrome (KSS) is a mitochondrial disorder characterized by the emergence before age 20 of progressive external ophthalmoplegia, pigmentary retinopathy, together with other heterogeneous clinical manifestations, including cardiac conduction defects, muscle abnormalities and endocrinopathies. KSS is associated with large heteroplasmic deletions in mitochondrial DNA. We report the case of a 43-year-old woman, with diabetes mellitus as a first manifestation at age 19. Later, she exhibited bilateral ptosis and external ophthalmoplegia with progressive worsening. DNA analysis identified a large mitochondrial DNA (mtDNA) deletion, which confirmed the diagnosis of KSS. By reporting this case with diabetes mellitus as first manifestation, we aim at emphasizing problems of diagnosis in these subtypes of mitochondrial diabetes. DOI: 10.1016/s1262-3636(07)70267-7 PMID: 16735969 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/35031921
1. Neurol Sci. 2022 Mar;43(3):2081-2084. doi: 10.1007/s10072-022-05881-8. Epub 2022 Jan 14. Kearns-Sayre syndrome: expanding spectrum of a "novel" mitochondrial leukomyeloencephalopathy. Moscatelli M(#)(1), Ardissone A(#)(2), Lamantea E(3), Zorzi G(2), Bruno C(4), Moroni I(2), Erbetta A(5), Chiapparini L(5). Author information: (1)Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. [email protected]. (2)Child Neurology Unit, Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. (3)Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. (4)Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genova, Italy. (5)Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. (#)Contributed equally Erratum in Neurol Sci. 2022 Nov;43(11):6607. doi: 10.1007/s10072-022-05950-y. Kearns-Sayre syndrome (KSS) is a rare mitochondrial disease associated to a widespread cerebral leukodystrophy. MRI shows a typical centripetal pattern where U-fibers are mainly affected with a relative spare of periventricular white matter. Recently, different patterns of spinal cord involvement have been described in KSS. Here we report 4 new cases with typical cerebral leukodystrophy associated with spinal cord lesions. A pattern characterized by abnormal signal intensity in the H gray matter and posterior columns was found in 2 patients, while the remaining 2 presented a peculiar involvement of the spinal trigeminal nuclei at the junction of low medulla and cervical cord. MRI spinal cord involvement in KSS is probably an underestimated finding and should be evaluated in the diagnostic work up of these patients. © 2022. Fondazione Società Italiana di Neurologia. DOI: 10.1007/s10072-022-05881-8 PMID: 35031921 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/25061332
1. Int J Gen Med. 2014 Jul 3;7:325-32. doi: 10.2147/IJGM.S65560. eCollection 2014. Kearns-Sayre syndrome: a case series of 35 adults and children. Khambatta S(1), Nguyen DL(1), Beckman TJ(1), Wittich CM(1). Author information: (1)Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. BACKGROUND: Kearns-Sayre syndrome (KSS) is a rare mitochondrial cytopathy, first described at Mayo Clinic in 1958. AIMS: We aimed to define patient and disease characteristics in a large group of adult and pediatric patients with KSS. METHODS: We retrospectively searched the Mayo Clinic medical index patient database for the records of patients with KSS between 1976 and 2009. The 35 patients identified with KSS were analyzed in terms of demographic characteristics, presenting signs and symptoms, diagnostic features, clinical evolution, and associations between disease features and the development of disability. RESULTS: The mean (standard [SD]) age at KSS presentation was 17 (10) years, but the mean age at diagnosis was 26 (15) years. Ophthalmologic symptoms developed in all patients, and neurologic and cardiac involvement was common. Only four patients (11%) in the series died, but all deaths were from sudden cardiac events. The development of physical disability was significantly associated with cognitive decline (P=0.004) but not with other clinical features, such as sex or sudden cardiac death. CONCLUSION: We report the largest case series to date of patients with KSS from a single institution. In addition to the conduction system abnormalities identified in previous series, our cohort included patients with syncope and sudden cardiac death. This underscores the need to consider formal electrophysiologic studies and prophylactic defibrillators in patients with KSS. DOI: 10.2147/IJGM.S65560 PMCID: PMC4086664 PMID: 25061332
http://www.ncbi.nlm.nih.gov/pubmed/33030289
1. Mol Genet Genomic Med. 2020 Nov;8(11):e1509. doi: 10.1002/mgg3.1509. Epub 2020 Oct 8. Mitochondrial DNA deletion and duplication in Kearns-Sayre Syndrome (KSS) with initial presentation as Pearson Marrow-Pancreas Syndrome (PMPS): Two case reports in Barranquilla, Colombia. Sabella-Jiménez V(1), Otero-Herrera C(1), Silvera-Redondo C(2), Garavito-Galofre P(2). Author information: (1)Genetics and Molecular Medicine Research Group, Universidad del Norte, Barranquilla, Colombia. (2)Genetics, Department of Medicine, Genetics and Molecular Medicine Research Group, Universidad del Norte, Barranquilla, Colombia. BACKGROUND: Kearns-Sayre Syndrome (KSS) and Pearson Marrow-Pancreas Syndrome (PMPS) are among the classic phenotypes caused by mitochondrial DNA (mtDNA) deletions. KSS is a rare mitochondrial disease defined by a classic triad of progressive external ophthalmoplegia, atypical pigmentary retinopathy, and onset before 20 years. PMPS presents in the first year of life with bone marrow failure and exocrine pancreatic dysfunction, and can evolve into KSS later in life. Even though an mtDNA deletion is the most frequent mutation in KSS and PMPS, cases of duplications and molecular rearrangements have also been described. In Colombia, few case reports of KSS and PMPS have been published in indexed journals or have been registered in scientific events. METHODS: We discuss clinical and genetic aspects of two case reports of pediatric female patients, with initial clinical diagnosis of PMPS who later evolved into KSS, with confirmatory molecular studies of an mtDNA deletion and an mtDNA duplication. RESULTS: A large-scale mtDNA deletion, NC_012920.1:m.8286_14416del, was confirmed by Southern Blot in patient 1. An mtDNA duplication of 7.9 kb was confirmed by MLPA in patient 2. CONCLUSIONS: Our findings are compatible with the phenotypic and genetic presentation of PMPS and KSS. We present the first molecularly confirmed case reports of Colombian patients, diagnosed initially with PMPS, who later evolved to KSS. © 2020 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC. DOI: 10.1002/mgg3.1509 PMCID: PMC7667363 PMID: 33030289 [Indexed for MEDLINE] Conflict of interest statement: The authors have no conflicts of interests to declare.
http://www.ncbi.nlm.nih.gov/pubmed/16977556
1. Neurologia. 2006 Sep;21(7):357-64. [Mitochondrial DNA deletions in Kearns-Sayre syndrome]. [Article in Spanish] Carod-Artal FJ(1), Lopez Gallardo E, Solano A, Dahmani Y, Herrero MD, Montoya J. Author information: (1)Servicio de Neurología, Hospital Sarah. INTRODUCTION: Kearns-Sayre syndrome (KSS) is a mitochondrial disorder characterized by progressive external ophthalmoplegia, pigmentary retinopathy, onset before 20 years, and ragged-red fibers on muscle biopsy. KSS has been associated to mitochondrial DNA (mtDNA) mutations. We report neurological manifestations and mtDNA deletions in KSS. METHODS: Six KSS patients underwent neurological examination, biochemical analysis (muscle enzymes, lactate, cerebrospinal fluid analysis), electromicrography, muscle biopsy (Gomori stain, electronic microscopy), electrocardiogram, echocardiography, MRI/CT scan. MtDNA deletions were studied in blood and muscle samples using Southern blotting and long polymerase chain reaction. RESULTS: Four males and two females (mean age: 27.7 years; range: 17-42; mean age at onset: 8.2 years) were studied. Initial symptoms were ptosis and gaze restriction, fatigue, exercise intolerance and proximal limb weakness. Syncope and neurosensory hypoacusia were initial symptoms in two patients. All of them presented a unique deletion in the mitochondrial genome, in heteroplasmy, and their size was in the range of 4,420 and 9,437 basis pairs. Three of these deletions are reported for the first time in this article. Most of the deletions are flanked by small direct repeats elements. CONCLUSIONS: Proximal muscle weakness and fatigue appear frequently in KSS patients during follow up. The syndrome in these patients has been caused by mtDNA deletions. PMID: 16977556 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9832255
1. Clin Neuropathol. 1998 Nov-Dec;17(6):291-6. Mitochondrial cytochrome b gene deletion in Kearns-Sayre syndrome associated with a subclinical type of peripheral neuropathy. Zanssen S(1), Molnar M, Buse G, Schröder JM. Author information: (1)Institut für Biochemie, Universitätsklinikum, RWTH, Aachen, Germany. Kearns-Sayre syndrome (KSS) is a progressive neuromuscular disease characterized by ophthalmoplegia, cardiac conduction block, and pigmentary retinopathy associated with abnormal mitochondrial structure and function. Usually mitochondrial DNA (mtDNA) deletions have been associated with Kearns-Sayre syndrome and chronic progressive external ophthalmoplegia. Size and position of the deletions differ markedly among these patients. The present study confirms this observation for a patient with KSS by a muscle and nerve biopsy in which we detected a 1.2 kb mtDNA deletion. The location of the deletion, however, is unusual in this case: its position comprises nucleotides 14952 to 15739. The defect is heteroplasmic and concerns the cytochrome b and tRNA genes. Complex I and IV of the respiratory chain were intact in this case, indicating that below a threshold of tRNA formation, the impaired biosynthesis and membrane integration of one respiratory complex may cause the phenotypical appearance of the KSS syndrome associated with a subclinical neuropathy. PMID: 9832255 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/31158487
1. J AAPOS. 2019 Oct;23(5):295-297. doi: 10.1016/j.jaapos.2019.05.005. Epub 2019 May 31. Exophthalmos in Kearns-Sayre syndrome. Tauber J(1), Polla DJ(2), Park S(3). Author information: (1)New York University School of Medicine, New York, New York. (2)Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. (3)Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: [email protected]. Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA (mtDNA) deletion syndrome that typically presents before 20 years of age and is characterized by chronic progressive external ophthalmoplegia, pigmentary retinopathy, and a combination of cardiac conduction defects, cerebellar ataxia, and elevated cerebrospinal fluid protein levels. The mtDNA defects interfere with oxidative phosphorylation and can affect a number of cellular energy processes in various organs. We report the case of a 15-year-old girl with KSS that was uniquely associated with bilateral, symmetrical exophthalmos. Copyright © 2019 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jaapos.2019.05.005 PMID: 31158487 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/23102393
1. Indian Heart J. 2012 Sep-Oct;64(5):515-7. doi: 10.1016/j.ihj.2012.07.010. Epub 2012 Jul 27. Symptomatic complete heart block leading to a diagnosis of Kearns-Sayre syndrome. Puri A(1), Pradhan A, Chaudhary G, Singh V, Sethi R, Narain VS. Author information: (1)Chhatrapati Shahuji Maharaj Medical University, Lucknow, India. [email protected] Kearns-Sayre syndrome (KSS) is a rare syndrome characterized by the triad of progressive external ophthalmoplegia, pigmentary retinopathy and cardiac conduction system disturbances; it is a mitochondrial encephalomyopathy with which usually presents before the patient reaches the age of 20. Here we present a case report of a patient with KSS who presented with symptomatic complete heart block. Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.ihj.2012.07.010 PMCID: PMC3860714 PMID: 23102393 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/27442316
1. Cornea. 2016 Sep;35(9):1250-4. doi: 10.1097/ICO.0000000000000927. Coenzyme Q10 in the Treatment of Corneal Edema in Kearns-Sayre: Is There an Application in Fuchs Endothelial Corneal Dystrophy? Kim J(1), Medsinge A, Chauhan B, Wiest C, Scanga H, Monaghan R, Moore WH, Nischal KK. Author information: (1)*University of Pittsburgh School of Medicine, Pittsburgh, PA; †Pediatric Ophthalmology, Strabismus and Adult Motility, UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; ‡Drexel University College of Medicine, Philadelphia, PA; §Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom; and ¶UPMC Eye Center, Pittsburgh, PA. Comment in Cornea. 2016 Dec;35(12):e39. doi: 10.1097/ICO.0000000000001043. PURPOSE: Corneal involvement in mitochondrial disease is seldom described. Kearns-Sayre syndrome (KSS) is a mitochondrial disorder characterized by retinitis pigmentosa, external ophthalmoplegia, and heart block. We report 2 patients with KSS with corneal lesions involving the endothelium, which improved with Coenzyme Q10 (CoQ10). Based on recent research regarding the role of dysfunctional oxidative metabolism in Fuchs Endothelial Corneal Dystrophy (FECD), we propose that mitochondrial diseases and FECD share a final pathway. METHODS: A chart review was performed and a review of the literature was completed with a PubMed search using the terms "Kearns-Sayre Syndrome", "mitochondria", "endothelium", "Fuchs endothelial corneal dystrophy", and "cornea". RESULTS: There are 19 reports of corneal involvement in clinical phenotypes of mitochondrial disease. Nine of these 19 cases had findings consistent with KSS. Our patients with KSS had microcystic changes throughout the cornea and excrescences on the endothelial surface seen with ultrasound biomicroscopy, similar to the clinical findings in FECD. CoQ10 improved corneal disease in both children. CoQ10 deficiency has been reported in a variety of mitochondrial diseases, and efficacy of supplementation has been demonstrated. It may be beneficial in these patients because of its antioxidant properties and role in oxidative phosphorylation. CONCLUSIONS: The common deletion found in patients with KSS has recently been implicated in FECD, which has recently been shown to be a disease related to dysfunctional oxidative metabolism. Future research should explore the use of antioxidants, such as CoQ10 in patients with FECD. DOI: 10.1097/ICO.0000000000000927 PMID: 27442316 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/16773512
1. Neuropediatrics. 2006 Apr;37(2):110-3. doi: 10.1055/s-2006-924226. Atypical MRI findings in Kearns-Sayre syndrome: T2 radial stripes. Hourani RG(1), Barada WM, Al-Kutoubi AM, Hourani MH. Author information: (1)Department of Diagnostic Radiology, The American University of Beirut Medical Center, Riad El Solh 1107, 2020 Beirut, Lebanon. [email protected] Kearns-Sayre syndrome (KSS) is a mitochondrial disorder consisting of external ophthalmoplegia, retinitis pigmentosa, ataxia and heart block. Magnetic resonance imaging (MRI) shows abnormal T2 high signal intensity in the deep gray matter nuclei, the cerebellar and the subcortical white matter. We report an unusual MR pattern of KSS, where the T2 images revealed radially oriented, hypointense stripes in hyperintense white matter, a characteristic MRI pattern of lysosomal disease not previously reported in KSS. DOI: 10.1055/s-2006-924226 PMID: 16773512 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/32787478
1. Ophthalmic Genet. 2020 Oct;41(5):497-500. doi: 10.1080/13816810.2020.1799416. Epub 2020 Aug 13. Retinoschisis associated with Kearns-Sayre syndrome. Chertkof J(1), Hufnagel RB(1), Blain D(1), Gropman AL(2), Brooks BP(1). Author information: (1)Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health , Bethesda, Maryland, USA. (2)Department of Neurology, Children's National Medical Center , Washington, District of Columbia, USA. Comment in Ophthalmic Genet. 2021 Feb;42(1):99. doi: 10.1080/13816810.2020.1827444. Ophthalmic Genet. 2021 Feb;42(1):100. doi: 10.1080/13816810.2020.1832295. BACKGROUND: Kearns-Sayre Syndrome (KSS) is characterized by pigmentary retinopathy, external ophthalmoplegia and heart block. We report on a now 24-year-old male with clinical retinoschisis and molecularly confirmed KSS. MATERIALS AND METHODS: Physical and complete ophthalmic examination, molecular diagnosis. RESULTS: Over nine years of follow-up, the subject manifested progressive signs and symptoms of KSS, including external ophthalmoplegia/strabismus, ptosis, pigmentary retinopathy, corneal edema, Type I diabetes mellitus, gut dysmotility, sensorineural deafness and heart block. At age 21 he was incidentally found to have retinoschisis on optical coherence tomography that remained stable over three years follow-up. Sequencing of the RS1 gene revealed no pathogenic variants, effectively ruling out co-existing X-linked retinoschisis. CONCLUSIONS: These findings suggest retinoschisis may be a rare manifestation of KSS. A trial of a carbonic anhydrase inhibitor was frustrated by coexisting corneal edema associated with the condition. DOI: 10.1080/13816810.2020.1799416 PMCID: PMC8127726 PMID: 32787478 [Indexed for MEDLINE] Conflict of interest statement: Declaration of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.
http://www.ncbi.nlm.nih.gov/pubmed/9677732
1. Turk J Pediatr. 1998 Apr-Jun;40(2):255-9. Kearns-Sayre syndrome. A case report. Altunbaşak S(1), Bingöl G, Ozbarlas N, Akçören Z, Hergüner O. Author information: (1)Department of Pediatric Neurology, Cukurova University Faculty of Medicine, Adana, Turkey. Kearns-Sayre syndrome (KSS) is a mitochondrial disorder. There is a large-scale mitochondrial DNA (mtDNA) deletion in most of the case. In this article, a case of KSS who has progressive external ophthalmoplegia (PEO), retinitis pigmentosa (RP), complete heart block, encephalopathy attacks, type-1 diabetes mellitus, ragged-red fiber (RRF) and lactic acidosis is presented and discussed in light of the literature available on this subjects. Diagnosis is confirmed by determination of mtDNA deletion. PMID: 9677732 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/1424198
1. Clin Endocrinol (Oxf). 1992 Jul;37(1):97-103. doi: 10.1111/j.1365-2265.1992.tb02289.x. Endocrine dysfunction in Kearns-Sayre syndrome. Harvey JN(1), Barnett D. Author information: (1)St. James University Hospital, Leeds, UK. Kearns-Sayre syndrome (KSS) is a form of mitochondrial myopathy in which specific clinical features, namely progressive external ophthalmoplegia, pigmentary retinal degeneration and cardiac conduction defects, occur. KSS has also been associated with a variety of endocrine and metabolic disorders, in particular short stature, gonadal failure, diabetes mellitus, thyroid disease, hyperaldosteronism, hypomagnesaemia, and bone, tooth and calcification abnormalities. A case is described exhibiting all of these features. A survey of the literature was conducted to determine the prevalence of these conditions among reported cases. Cases with hypoparathyroidism were considered separately to see if they constituted a distinct subgroup with multiple endocrine dysfunction. Short stature was common, being documented in 38% of cases. Gonadal dysfunction before or after puberty was also common (20% of cases) and affected both sexes equally. Diabetes mellitus was recorded in 13% of cases, half of which required insulin. Thyroid disease, hyperaldosteronism and hypomagnesaemia were uncommon but were probably not looked for in many cases. Bone or tooth abnormalities and calcification of the basal ganglia were found both in those with and without hypoparathyroidism. While endocrine and metabolic dysfunction was found more commonly in those with hypoparathyroidism this is likely to be due to increased recognition rather than increased prevalence. No evidence of an autoimmune polyendocrine syndrome including hypoparathyroidism was found. DOI: 10.1111/j.1365-2265.1992.tb02289.x PMID: 1424198 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/572507
1. Neurology. 1979 Aug;29(8):1172-4. doi: 10.1212/wnl.29.8.1172. Familial Kearns-Sayre syndrome. Schnitzler ER, Robertson WC Jr. The Kearns-Sayre syndrome (KSS) is a distinctive type of progressive external ophthalmoplegia, characterized by pigmentary degeneration of the retina, heart block, elevated concentration of cerebrospinal fluid protein, and abnormal muscle mitochondria. Previously described cases have all been sporadic. Consequently, viral infections and autoimmune disorders have been proposed as etiologies. The occurrence of KSS in two brothers suggests that genetic factors may play a role in the pathogenesis of some cases. DOI: 10.1212/wnl.29.8.1172 PMID: 572507 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/16735000
1. Funct Neurol. 2006 Jan-Mar;21(1):39-41. Unusual clinical presentation of a patient carrying a novel single 1.8 kb deletion of mitochondrial DNA. Zoccolella S(1), Torraco A, Amati A, Lamberti P, Serlenga L, Papa S, Petruzzella V. Author information: (1)Department of Neurological Sciences, University of Bari, Italy. Kearns-Sayre syndrome (KSS) is a mitochondrial encephalomyopathy characterized by progressive external ophthalmoplegia (PEO), pigmentary retinopathy and onset before the age of 20 years. Cerebellar ataxia, as well as short stature and increased protein content in the cerebrospinal fluid, are frequent additional symptoms. A single large mitochondrial (mt) DNA deletion of 4,977 bp is the most common molecular defect in KSS. Recently, different mutations have also been associated with incomplete, KSS-like phenotypes. We describe the unusual clinical presentation of a patient carrying a novel 1,814-bp deletion of mtDNA. In contrast with typical KSS, the clinical picture of this patient did not include either palpebral ptosis or PEO and was dominated by an ataxic syndrome. PMID: 16735000 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/17763890
1. Pediatr Cardiol. 2008 May;29(3):659-62. doi: 10.1007/s00246-007-9040-z. Epub 2007 Aug 29. Kearns-Sayre syndrome presenting as complete heart block. Chawla S(1), Coku J, Forbes T, Kannan S. Author information: (1)Pediatrics, Children's Hospital of Michigan, 3901 Beaubien Blvd., Detroit, MI 48201, USA. Kearns-Sayre syndrome (KSS) is a rare mitochondrial disorder characterized by large-scale deletions of mitochondrial DNA. Neuromuscular and cardiac conduction systems are most commonly involved in these patients. Here, we discuss a 10-year-old patient with diabetes mellitus who presented in complete heart block leading to the diagnosis of KSS. The cardiovascular complications of this syndrome are reviewed and discussed. DOI: 10.1007/s00246-007-9040-z PMID: 17763890 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/11018246
1. J Neurol Sci. 2000 Sep 1;178(1):29-36. doi: 10.1016/s0022-510x(00)00354-3. Kearns-sayre syndrome: oncocytic transformation of choroid plexus epithelium. Tanji K(1), Schon EA, DiMauro S, Bonilla E. Author information: (1)Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. Kearns-Sayre syndrome (KSS) is a sporadic multisystem disorder due to a defect of oxidative phosphorylation and associated with clonally-expanded rearrangements of mitochondrial DNA (mtDNA) deletions (Delta-mtDNAs) and/or duplications (dup-mtDNAs). To gain further insight into the pathogenesis of CNS dysfunction in KSS, we studied the choroid plexus from two autoptic cases using in situ hybridization (ISH) of mtDNA, and immunohistochemistry to detect mtDNA and nuclear DNA-encoded subunits of the respiratory chain. Neuropathological examination of both cases showed oncocytic transformation of choroid plexus epithelial cells. In the same cells, ISH demonstrated that the predominant species of mtDNA were Delta-mtDNAs, and immunohistochemistry showed a decreased expression of mtDNA-encoded proteins. We suggest that mitochondrial abnormalities due to the presence of abundant Delta-mtDNAs in the choroid plexus play an important role in causing the increased cerebrospinal fluid (CSF) protein and reduced folic-acid levels that are characteristic of KSS. DOI: 10.1016/s0022-510x(00)00354-3 PMID: 11018246 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/22981519
1. J Fr Ophtalmol. 2012 Nov;35(9):718.e1-4. doi: 10.1016/j.jfo.2012.06.010. Epub 2012 Sep 12. [Kearns-Sayre syndrome: a case report]. [Article in French] Gaboune L(1), Baha Ali T, Benfdil N, Khoumiri R, Ouaggag B, Sayouti A, Moutaouakil A. Author information: (1)Service d'ophtalmologie, hôpital Mère-Enfant, CHU Mohamed VI, BP 2360, avenue Ibn Sina Ammerchich, Marrakech, Maroc. [email protected] Kearns-Sayre syndrome (KSS), first described in 1958, is a multisystem disease defined by a characteristic triad of progressive external ophthalmoplegia, pigmentary retinopathy and atrioventricular block. These signs are frequently associated with increased cerebrospinal fluid protein level and cerebellar ataxia. This syndrome is caused by deletions in mitochondrial DNA, the age of onset is generally below 20, and the degree of severity differs between patients, as well as the prognosis, which may be fatal. The ocular manifestations include: bilateral ptosis, progressive external ophthalmoplegia and atypical pigmentary retinopathy. By way of this case report, the authors discuss the epidemiologic, clinical and therapeutic aspects of KSS, including the difficulty in managing ptosis in these cases. Copyright © 2012. Published by Elsevier Masson SAS. DOI: 10.1016/j.jfo.2012.06.010 PMID: 22981519 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/12007693
1. Int J Cardiol. 2002 May;83(2):179-81. doi: 10.1016/s0167-5273(02)00040-2. Alarming atrioventricular block and mitral valve prolapse in the Kearns-Sayre syndrome. Katsanos KH, Pappas CJ, Patsouras D, Michalis LK, Kitsios G, Elisaf M, Tsianos EV. Kearns-Sayre syndrome (KSS) is a multisystem mitochondrial disorder characterized by the invariant triad: onset before 20, progressive external ophthalmoplegia and pigmentary retinal degeneration, plus at least one of the following: complete (or not) heart block, cereberal dysfunction and CSF protein above 100 mg/dl. Autopsies from patients with KSS revealed widespread tissue distribution mtDNA deletions. These deletions result in significantly lower activities of the enzymes of the respiratory chain. The same deletion of mitochondrial DNA present in skeletal muscle is found in myocardial tissue. An 18-year-old girl diagnosed with the KSS was admitted to our hospital because of an upper respiratory tract infection and dysphagia. ECG showed cardiac conduction defects. The patient had no history of syncope. At her surface ECG there was a complete RBBB (QRS duration approximately 130 ms), a clockwise rotation with an axis of approximately 90 degrees and a slight QT prolongation (420 ms). Echocardiography showed prolapse with thickening and degeneration of both mitral valve leaflets but without mitral regurgitation. The patient was started on a diet rich in potassium and pharmaceutical therapy with magnesium oxide (240 mg of elemental Mg p.o. per day), 1 g of calcium carbonate t.i.d., vitamin D (calcitriol 0.25 microg p.o. per day) and coenzyme Q(10) 100 mg daily and discharged 6 days later with slightly improved biochemical profile but apparent clinical improvement. Urgent pacemaker implantation was decided but unfortunately the patient died due to acute cardiac arrest 10 days later. DOI: 10.1016/s0167-5273(02)00040-2 PMID: 12007693 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/7630231
1. Med Clin (Barc). 1995 Jul 1;105(5):180-4. [Progressive external ophthalmoplegia and the Kearns-Sayre syndrome: a clinical and molecular study of 6 cases]. [Article in Spanish] Barrientos A(1), Casademont J, Grau JM, Cardellach F, Montoya J, Estivill X, Urbano-Márquez A, Nunes V. Author information: (1)Servei de Medicina Interna General, Hospital Clínic i Provincial, Universitat de Barcelona. The Kearns-Sayre syndrome (KSS) associates progressive external ophthalmoplegia initiating prior to the age of 20 years and pigmentary retinitis with a series of other heterogeneous clinical manifestations. The incomplete syndrome is usually denominated progressive external ophthalmoplegia (PEO)-plus which is a sporadically appearing mitochondrial cytopathy associated with large deletions of a variable proportion of mitochondrial DNA (mtDNA) molecules. Six patients with PEO-plus/KSS in whom muscle biopsy was performed following a complete clinical study are described. The muscle was processed by conventional histochemical techniques, electron microscopy, and genetic study (Southern transference, polymerase chain reaction, restriction cartography and both manual and automatic sequencing). The percentage of mutated mtDNA molecules for each patient was obtained by densitometry. The 6 patients presented multiorganic clinical manifestations characteristics of most mitochondrial diseases. The presence of destructured red fibers were observed in all the biopsies. All the patients presented a deletion in the mtDNA of a size between 4,861 to 7,437 base pairs (bp). All the deletions appeared flanked by direct repetitions from 4 to 13 bp and one also presented inverse repetitions from 5 to 6 bp in the zone next to the rupture point. In the 6 cases heteroplasmia was observed with a variable percentage of deleted molecules from 23 to 56%. The molecular basis of progressive external ophthalmoplegia-plus/Kearns-Sayre syndrome appears to be the existence of sole, large deletions in the mitochondrial DNA with the varying in location and percentage conditioning the appearance of different phenotypes similar among themselves. The 7,437 base pair deletion was the most frequently observed in the patients analyzed. PMID: 7630231 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9286453
1. Am J Med Genet. 1997 Sep 5;71(4):443-52. doi: 10.1002/(sici)1096-8628(19970905)71:4<443::aid-ajmg14>3.0.co;2-g. High proportions of mtDNA duplications in patients with Kearns-Sayre syndrome occur in the heart. Fromenty B(1), Carrozzo R, Shanske S, Schon EA. Author information: (1)Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. Kearns-Sayre syndrome (KSS) is a sporadic multisystem mitochondrial disorder characterized by progressive external ophthalmoplegia, pigmentary retinopathy, onset before age 20, and severe cardiac conduction defects that can lead to death. KSS patients harbor partial deletions of mitochondrial DNA (delta-mtDNA), sometimes associated with the corresponding mtDNA duplication (dup-mtDNA). As reports on the distribution of dup-mtDNAs among KSS tissues are scarce, we searched for the presence of dup-mtDNAs in different autopsy tissues of two such patients, one of whom carried the so-called "common deletion." Using a newly developed long polymerase chain reaction (PCR) protocol in conjunction with Southern blot analyses, we found dup-mtDNAs in most of the examined tissues from both patients. The proportion of dup-mtDNA in these tissues was much lower than the proportion of delta-mtDNA, with one notable exception: in both patients, we found an unusually high level of dup-mtDNA in the heart. These data suggest that dup-mtDNAs may be more stable in heart tissue of KSS patients than in other long-lived postmitotic tissues. DOI: 10.1002/(sici)1096-8628(19970905)71:4<443::aid-ajmg14>3.0.co;2-g PMID: 9286453 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/17342029
1. Pediatr Endocrinol Rev. 2006 Dec-2007 Jan;4(2):117-37. The clinical diagnosis and molecular genetics of kearns-sayre syndrome: a complex mitochondrial encephalomyopathy. Maceluch JA(1), Niedziela M. Author information: (1)Department of Pediatric Endocrinology and Diabetes, Poznan University of Medical Sciences, Poznan, Poland. From the first description by Kearns and Sayre in 1958, this syndrome has been diagnosed in several hundred patients. However, the labile character of its clinical manifestations makes diagnosis difficult and delayed. Only recently, some thirty years from the first diagnosis, have we recognized mitochondrial DNA rearrangements as the molecular basis of the disease. This has lead to increasing interest in the contribution which mtDNA deletions make to Kearns-Sayre Syndrome (KSS) and other disorders. Although the true prevalence of this syndrome in the general population is unknown, a basic awareness of the KSS phenotype, as well as of the essential elements of patient evaluation is important for appropriate patient management. Although methods of assessing patients for mtDNA rearrangements are well developed, ambiguity in patient diagnosis often remains even after detailed, multisystem testing. Advances in our understanding of the genetic background and the tissue specific effects of mtDNA deletions, in addition to resolving the inheritance pattern, will also increase our ability to diagnose, manage and counsel patients with this disorder. PMID: 17342029 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/32609007
1. DNA Cell Biol. 2020 Aug;39(8):1449-1457. doi: 10.1089/dna.2019.5010. Epub 2020 Jun 29. Clinical Phenotype and Genetic Features of a Pair of Chinese Twins with Kearns-Sayre Syndrome. Guo L(1)(2), Wang X(3)(4), Ji H(1)(2)(5). Author information: (1)State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, ENT Institute and Otorhinolaryngology Department, Fudan University Eye & ENT Hospital, Shanghai, People's Republic of China. (2)NHC Key Laboratory of Hearing Medicine and Fudan University, Shanghai, People's Republic of China. (3)Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China. (4)Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong, People's Republic of China. (5)Department of Otorhinolaryngology, Affiliated Eye and ENT Hospital of Fudan University, Shanghai, China. Comment in DNA Cell Biol. 2020 Oct;39(10):1907-1908. doi: 10.1089/dna.2020.5882. Kearns-Sayre Syndrome (KSS) is a severe mitochondrial disorder involving the central nervous system, eyes, ears, skeletal muscles, and heart. The mitochondrial DNA (mtDNA) rearrangements, especially the deletions, are present in almost all KSS patients and considered as the disease-causing factor. However, the size and position of mtDNA deletions are distinct in different individuals. In this study, we report the case of a pair of Chinese twins with KSS. The twin patients revealed typical KSS clinical symptoms, including heart block, bilateral sensorineural hearing loss, progressive external ophthalmoplegia, exercise intolerance, proximal limb weakness, and endocrine disorders. Using long-range polymerase chain reactions (long-range PCR) and next-generation sequencing (NGS), the genetic features of the twin patients were investigated. A large 6600 bp mtDNA deletion, ranging from position 8702 to 15,302, was detected in both patients. To our knowledge, this kind of mtDNA deletion has never been described previously. Our study enriched the mutation spectrum of KSS and showed that NGS is a powerful tool for detecting mtDNA large variants. DOI: 10.1089/dna.2019.5010 PMID: 32609007 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9727847
1. Eur J Pediatr. 1998 Aug;157(8):643-7. doi: 10.1007/s004310050902. Mitochondrial DNA deletion with Kearns Sayre syndrome in a child with Addison disease. Boles RG(1), Roe T, Senadheera D, Mahnovski V, Wong LJ. Author information: (1)Medical Genetics, Children's Hospital Los Angeles, CA 90027, USA. [email protected] Kearns Sayre syndrome (KSS) is a multisystem disorder with a confounding variety of clinical manifestations, including ocular myopathy, pigmentary retinopathy, heart block and ataxia. Endocrinopathies are common in KSS, including growth hormone deficiency, hypogonadism, diabetes mellitus and hypoparathyroidism. A variety of deletions of mitochondrial DNA (mtDNA) are found in most cases. We report on a 5-year-old boy with Addison disease in whom further investigation revealed a 4.9 kilobase mtDNA deletion and KSS. Later he developed severe lactic acidosis and expired. CONCLUSION: The degree of mutant mtDNA heteroplasmy in various tissues on autopsy did not correlate well with the clinical manifestations, although this may be due at least in part to replacement with other tissue types. Our report is the first of non-autoimmune Addison disease in KSS and patients with KSS should be evaluated for adrenal insufficiency. Early recognition of adrenal insufficiency is crucial to prevent mortality from this cause. DOI: 10.1007/s004310050902 PMID: 9727847 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/15869681
1. Pacing Clin Electrophysiol. 2005 May;28(5):454-7. doi: 10.1111/j.1540-8159.2005.40049.x. Kearns-Sayre syndrome: a case report and review of cardiovascular complications. Young TJ(1), Shah AK, Lee MH, Hayes DL. Author information: (1)Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA. [email protected] Kearns-Sayre syndrome (KSS) is a rare genetic abnormality. Classified as a mitochondrial cytopathy, the primary pathology of this syndrome is a disturbance of mitochondrial DNA, which codes for the proteins required for the respiratory chain reaction. Onset occurs before age 20, and is manifest as chronic progressive external ophthalmoplegia and retinal degeneration. Management issues of KSS include prophylactic cardiac pacing for conduction defects, which has been shown to improve survival. Other clinical considerations relate to dietary supplements to attempt to control the progressive effects of the disease. DOI: 10.1111/j.1540-8159.2005.40049.x PMID: 15869681 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/25539952
1. Orphanet J Rare Dis. 2014 Dec 24;9:217. doi: 10.1186/s13023-014-0217-2. Follow-up of folinic acid supplementation for patients with cerebral folate deficiency and Kearns-Sayre syndrome. Quijada-Fraile P(1), O'Callaghan M(2), Martín-Hernández E(3), Montero R(4)(5), Garcia-Cazorla À(6)(7), de Aragón AM(8), Muchart J(9), Málaga I(10), Pardo R(11), García-Gonzalez P(11), Jou C(12), Montoya J(13)(14), Emperador S(15), Ruiz-Pesini E(16)(17), Arenas J(18)(19), Martin MA(20)(21), Ormazabal A(22)(23), Pineda M(24)(25), García-Silva MT(26)(27), Artuch R(28)(29). Author information: (1)Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain. [email protected]. (2)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (3)Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain. [email protected]. (4)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (5)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (6)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (7)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (8)Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain. [email protected]. (9)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (10)Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain. [email protected]. (11)Servicios de Pediatría y Radiología, Hospital de Cabueñes, Asturias, Spain. [email protected]. (12)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (13)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (14)Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. [email protected]. (15)Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. [email protected]. (16)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (17)Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. [email protected]. (18)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (19)Mitochondrial Diseases Laboratory, Hospital 12 de Octubre Research Institute (i + 12), Madrid, Spain. [email protected]. (20)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (21)Mitochondrial Diseases Laboratory, Hospital 12 de Octubre Research Institute (i + 12), Madrid, Spain. [email protected]. (22)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (23)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (24)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (25)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. (26)Unidad de Enfermedades Mitocondriales-Enfermedades Metabólicas Hereditarias. Dpto. de Pediatría y Radiología, Hospital 12 de Octubre, Madrid, Spain. [email protected]. (27)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (28)Centre For research in rare diseases (CIBERER), Institut de Salud Carlos III, Madrid, Spain. [email protected]. (29)Pediatric Neurology, Clinical Biochemistry, Histopathology and Radiology Departments, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2., Esplugues, Barcelona, 08950, Spain. [email protected]. BACKGROUND: Kearns-Sayre syndrome (KSS) is a mitochondrial DNA deletion syndrome that presents with profound cerebral folate deficiency and other features. Preliminary data support the notion that folinic acid therapy might be useful in the treatment of KSS patients. Our aim was to assess the clinical and neuroimaging outcomes of KSS patients receiving folinic acid therapy. PATIENTS: We recruited eight patients with diagnoses of KSS. Four cases were treated at 12 de Octubre Hospital, and the other two cases were treated at Sant Joan de Déu Hospital. Two patients refused to participate in the treatment protocol. METHODS: Clinical, biochemical and neuroimaging data (magnetic resonance imaging or computed tomography scan) were collected in baseline conditions and at different time points after the initiation of therapy. Cerebrospinal fluid 5-methyltetrahydrofolate levels were analysed with HPLC and fluorescence detection. Large-scale mitochondrial DNA deletions were analysed by Southern blot. TREATMENT PROTOCOL: The follow-up periods ranged from one to eight years. Cases 1-4 received oral folinic acid at a dose of 1 mg/kg/day, and cases 6 and 8 received 3 mg/kg/day. RESULTS: No adverse effects of folinic acid treatment were observed. Cerebral 5-methyltetrahydrofolate deficiencies were observed in all cases in the baseline conditions. Moreover, all three patients who accepted lumbar puncture after folinic acid therapy exhibited complete recoveries of their decreased basal cerebrospinal fluid 5-methyltetrahydrofolate levels to normal values. Two cases neurologically improved after folinic therapy. Disease worsened in the other patients. Post-treatment neuroimaging was performed for the 6 cases that received folinic acid therapy. One patient exhibited improvements in white matter abnormalities. The remaining patients displayed progressions in subcortical cerebral white matter, the cerebellum and cerebral atrophy. CONCLUSIONS: Four patients exhibited clinical and radiological progression of the disease following folinic acid treatment. Only one patient who was treated in an early stage of the disease exhibited both neurological and radiological improvements following elevated doses of folinic acid, and an additional patient experienced neurological improvement. Early treatment with high-dose folinic acid therapy seems to be advisable for the treatment of KSS. TRIAL REGISTRATION: Eudrac T2007-00-6748-23. DOI: 10.1186/s13023-014-0217-2 PMCID: PMC4302586 PMID: 25539952 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19344916
1. J Neurol Sci. 2009 Jun 15;281(1-2):110-2. doi: 10.1016/j.jns.2009.03.007. Epub 2009 Apr 2. Diffusion tensor imaging in a case of Kearns-Sayre syndrome: striking brainstem involvement as a possible cause of oculomotor symptoms. Duning T(1), Deppe M, Keller S, Mohammadi S, Schiffbauer H, Marziniak M. Author information: (1)Department of Neurology, University Hospital Muenster, Germany. [email protected] Kearns-Sayre syndrome (KSS) is a rare autosomal dominant mitochondrial disorder affecting the central nervous system. Progressive external ophthalmoplegia is an early and characteristic clinical symptom of the disease. We describe a 22-year-old female patient with a typical KSS including early and severe external ophthalmoplegia. Conventional MRI and diffusion tensor imaging (DTI) was performed to investigate the early involvement of the central nervous system (CNS). DTI revealed substantial white matter alterations that were primarily confined to the brainstem. These early DTI changes support the hypothesis that regional affection of the brainstem may play a role in the pathogenesis of the early oculomotor symptoms. DTI might be helpful to detect an early involvement of the CNS in KSS. DOI: 10.1016/j.jns.2009.03.007 PMID: 19344916 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/25368789
1. Korean J Anesthesiol. 2014 Oct;67(4):283-6. doi: 10.4097/kjae.2014.67.4.283. Epub 2014 Oct 27. Obstetric anesthesia considerations in Kearns-Sayre syndrome: a case report. Faris AS(1), Tawfic QA(1), Jeyaraj L(1). Author information: (1)Department of Anesthesiology, The Ottawa Hospital and University of Ottawa, Ottawa, Canada. Kearns-Sayre syndrome (KSS) is a rare mitochondrial myopathy that usually develops before 20 years of age. It demonstrates multisystemic involvement with a triad of cardinal features: progressive ophthalmoplegia, pigmentary retinopathy, and cardiac conduction abnormalities. In addition, patients might have cerebellar ataxia, a high content of protein in the cerebrospinal fluid, proximal myopathy, multiple endocrinopathies, and renal tubular acidosis. We herein report the successful obstetric analgesic and anesthetic management of a 28-year-old parturient patient with KSS who required labor analgesia and proceeded to deliver by cesarean section. We extrapolate that regional analgesia/anesthesia might be beneficial for reducing the metabolic demands associated with the stress and pain of labor in patients with KSS. Efficient postoperative analgesia should be provided to decrease oxygen requirements. DOI: 10.4097/kjae.2014.67.4.283 PMCID: PMC4216793 PMID: 25368789
http://www.ncbi.nlm.nih.gov/pubmed/32026421
1. Drugs. 2020 Feb;80(3):329-333. doi: 10.1007/s40265-020-01267-2. Golodirsen: First Approval. Heo YA(1). Author information: (1)Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. [email protected]. Golodirsen (Vyondys 53™), an antisense oligonucleotide of the phophorodiamidate morpholino oligomer (PMO) subclass designed to induce exon 53 skipping, has been developed by Sarepta Therapeutics for the treatment of Duchenne muscular dystrophy (DMD). In December 2019, intravenous golodirsen received its first global approval in the USA for the treatment of DMD in patients with a confirmed mutation of the DMD gene that is amenable to exon 53 skipping, based on positive results from a phase I/II clinical trial. Golodirsen is in phase III clinical development for the treatment of DMD worldwide. This article summarizes the milestones in the development of golodirsen leading to this first approval for DMD. DOI: 10.1007/s40265-020-01267-2 PMID: 32026421 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/33025945
1. Drugs Today (Barc). 2020 Aug;56(8):491-504. doi: 10.1358/dot.2020.56.8.3159186. Golodirsen for Duchenne muscular dystrophy. Anwar S(1), Yokota T(2). Author information: (1)Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. (2)Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; The Friends of Garrett Cumming Research and Muscular Dystrophy Canada, HM Toupin Neurological Science Research Chair, Edmonton, Alberta, Canada. [email protected]. Duchenne muscular dystrophy (DMD) is a life-shortening X-linked genetic disorder characterized by progressive wasting and weakening of muscles in boys. Loss-of-function mutations in the DMD gene, which codes for dystrophin, lead to this disease. The majority of mutations in this gene result in the exclusion of one or more exons from the transcript, eventually causing the remaining exons not to fit together correctly (i.e., out-of-frame mutations). Antisense oligonucleotides, e.g., phosphorodiamidate morpholino oligomers (PMOs), can induce therapeutic exon skipping during pre-mRNA processing to restore the reading frame of the primary transcript of DMD. As a result, truncated but partially functional dystrophin is produced, potentially slowing down the disease progression. Golodirsen is a provisionally approved PMO-based drug for approx. 8% of all DMD patients amenable to exon 53 skipping. This article summarizes golodirsen's pharmacology, efficacy and safety information. It also discusses some controversies that golodirsen met after the approval. Copyright 2020 Clarivate Analytics. DOI: 10.1358/dot.2020.56.8.3159186 PMID: 33025945 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/36401027
1. Methods Mol Biol. 2023;2587:125-139. doi: 10.1007/978-1-0716-2772-3_7. Restoring Dystrophin Expression with Exon 44 and 53 Skipping in the DMD Gene in Immortalized Myotubes. Echigoya Y(1)(2), Yokota T(3)(4). Author information: (1)Laboratory of Biomedical Science, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan. [email protected]. (2)Nihon University Veterinary Research Center, Fujisawa, Kanagawa, Japan. [email protected]. (3)Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. (4)The Friends of Garrett Cumming Research & Muscular Dystrophy Canada, HM Toupin Neurological Science Research Chair, Edmonton, AB, Canada. Phosphorodiamidate morpholino oligomer (PMO)-mediated exon skipping is a therapeutic approach that applies to many Duchenne muscular dystrophy (DMD) patients harboring out-of-frame deletion mutations in the DMD gene. In particular, PMOs for skipping exon 44 have been developing in clinical trials, such as the drug NS-089/NCNP-02. Two exon 53 skipping PMOs, golodirsen and viltolarsen, have received conditional approval for treating patients due to their ability to restore dystrophin protein expression. Although promising, further development of exon-skipping technology is needed for patients to have more therapeutic benefit. This chapter describes evaluation methods of exon 44 and 53 skipping PMOs in immortalized DMD patient-derived skeletal muscle cells. We introduce how to quantify exon-skipping efficiencies and dystrophin rescue levels represented by RT-PCR and western blotting, respectively. The screening methods using immortalized patient myotubes can serve to find exon-skipping PMO drug candidates. © 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature. DOI: 10.1007/978-1-0716-2772-3_7 PMID: 36401027 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/35213020
1. Methods Mol Biol. 2022;2434:217-233. doi: 10.1007/978-1-0716-2010-6_14. Evaluation of Exon Skipping and Dystrophin Restoration in In Vitro Models of Duchenne Muscular Dystrophy. López-Martínez A(1), Soblechero-Martín P(1)(2), Arechavala-Gomeza V(3)(4). Author information: (1)Neuromuscular Disorders, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain. (2)Osakidetza Basque Health Service, Bilbao-Basurto Integrated Health Organisation, Basurto University Hospital, Clinical Laboratory Service, Bilbao, Spain. (3)Ikerbasque, Basque Foundation for Science, Bilbao, Spain. [email protected]. (4)Neuromuscular Disorders Research Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain. [email protected]. Several exon skipping antisense oligonucleotides (eteplirsen, golodirsen, viltolarsen, and casimersen) have been approved for the treatment of Duchenne muscular dystrophy, but many more are in development targeting an array of different DMD exons. Preclinical screening of the new oligonucleotide sequences is routinely performed using patient-derived cell cultures, and evaluation of their efficacy may be performed at RNA and/or protein level. While several methods to assess exon skipping and dystrophin expression in cell culture have been developed, the choice of methodology often depends on the availability of specific research equipment.In this chapter, we describe and indicate the relevant bibliography of all the methods that may be used in this evaluation and describe in detail the protocols routinely followed at our institution, one to evaluate the efficacy of skipping at RNA level (nested PCR) and the other the restoration of protein expression (myoblot ), which provide good results using equipment largely available to most research laboratories. © 2022. The Author(s). DOI: 10.1007/978-1-0716-2010-6_14 PMCID: PMC9703204 PMID: 35213020 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/36031908
1. J Neuromuscul Dis. 2022;9(5):649-654. doi: 10.3233/JND-220823. Muscle MRI as a Diagnostic Challenge in Emery-Dreifuss Muscular Dystrophy. Pinto MJ(1)(2), Fromes Y(3)(4), Ackermann-Bonan I(3)(4), Leturcq F(5), Verebi C(5), Romero NB(6)(7)(8), Stojkovic T(6)(7). Author information: (1)Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal. (2)Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal. (3)Nuclear Magnetic Resonance Laboratory, Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, Paris, France. (4)Nuclear Magnetic Resonance Laboratory, CEA, DRF, IBFJ, Molecular Imaging Research Center, Paris, France. (5)Department of Genomic Medicine and Systemic Diseases, APHP, University of Paris, Cochin Hospital, Paris, France. (6)Reference Center for Neuromuscular Disorders, APHP, Myology Institute, Pitié-Salpêtrière Hospital, Paris, France. (7)Centre de Recherche en Myologie, GH Pitié-Salpêtrière, Sorbonne Université-Inserm UMRS974, Paris, France. (8)Neuromuscular Morphology Unit, Institute of Myology, Pitié-Salpêtrière Hospital, Paris, France.  Emery-Dreifuss Muscular Dystrophy (EDMD) is an early-onset, slowly-progressive group of myopathies, presenting with joint contractures, muscle weakness and cardiac abnormalities. Variants in the EMD gene cause an X-linked recessive form (EDMD1). The scarce EDMD1 muscle MRI accounts in the literature describe fatty replacement of posterior thigh and leg muscles.We report a 22-year-old patient with early-onset bilateral joint contractures, slowly progressive muscle weakness and minor cardiac rhythm abnormalities. A novel loss-of-function variant of EMD was identified and deemed probably pathogenic in the absence of emerin detection by immunofluorescence and Western Blot. MRI revealed fatty replacement of the lumbar spinal erectors and the posterior compartment of lower limbs. Interestingly, Short Tau Inversion Recovery (STIR) sequences showed a heterogenous hyper signal on the vasti, hamstrings and left lateral gastrocnemius muscles.Oedema-like abnormalities were previously reported in early stages of other muscular dystrophies, preceding fatty replacement and muscle atrophy, but not in EDMD1 patients. We hypothesize that these oedema-like changes may be a marker of early muscle pathology in EDMD1. Further studies focusing on these abnormalities in the early phase of EDMD1 are required to test our hypothesis. DOI: 10.3233/JND-220823 PMID: 36031908 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/36250567
1. Orthop Surg. 2022 Dec;14(12):3448-3454. doi: 10.1111/os.13526. Epub 2022 Oct 17. Surgical Treatment for Severe Cervical Hyperlordosis and Thoracolumar Kyphoscoliosis with Emery-Dreifuss Muscular Dystrophy: A Case Report and Literature Review. Tang Z(1), Hu Z(2), Qin X(2), Zhu Z(1)(2), Liu Z(1)(2). Author information: (1)Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Clinical College of Nanjing Medical University, Nanjing, China. (2)Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China. BACKGROUND: Emery-Dreifuss muscular dystrophy (EDMD) is an uncommon, gradually progressive X-linked myopathy, and it could result in rigid spinal deformity. Only a few case reports have described surgical treatment of cervical hyperlordosis and thoracolumbar kyphoscoliosis secondary to EDMD. We report a rare case of EDMD to present the surgical strategies of severe cervical hyperlordosis and thoracolumbar kyphoscoliosis. CASE PRESENTATION: The patient was a 22-year-old man with EDMD who had severe cervical hyperlordosis and thoracolumbar kyphoscoliosis. A posterior spinal fusion from T9-S2 was performed to correct the thoracolumbar kyphoscoliosis at the age of 21 years. Six months later, with an anterior C7-T1 closing wedge bone-disc-bone osteotomy and a posterior-anterior-posterior cervicothoracic fusion from C4-T4, the cervical deformity was corrected, thus achieving a horizontal gaze. During 1.5-year follow-up, no loss of correction was observed. CONCLUSION: Cervical posterior-anterior-posterior closing-wedge osteotomy combined with long fusion at thoracolumbar spine can be a reliable surgical technique to correct severe spine deformity in EDMD. This two-stage revision surgical strategy can help restore a horizontal gaze on the basis of a balanced trunk. Cervical deformity in such patients should be corrected in the first stage considering its role as a "driver" of the global spine deformity. © 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. DOI: 10.1111/os.13526 PMCID: PMC9732636 PMID: 36250567 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/36274837
1. Front Cell Dev Biol. 2022 Oct 6;10:1007120. doi: 10.3389/fcell.2022.1007120. eCollection 2022. Emerin interacts with histone methyltransferases to regulate repressive chromatin at the nuclear periphery. Marano N(1), Holaska JM(1). Author information: (1)Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, United States. X-Linked Emery-Dreifuss muscular dystrophy is caused by mutations in the gene encoding emerin. Emerin is an inner nuclear membrane protein important for repressive chromatin organization at the nuclear periphery. Myogenic differentiation is a tightly regulated process characterized by genomic reorganization leading to coordinated temporal expression of key transcription factors, including MyoD, Pax7, and Myf5. Emerin was shown to interact with repressive histone modification machinery, including HDAC3 and EZH2. Using emerin-null myogenic progenitor cells we established several EDMD-causing emerin mutant lines in the effort to understand how the functional interaction of emerin with HDAC3 regulates histone methyltransferase localization or function to organize repressive chromatin at the nuclear periphery. We found that, in addition to its interaction with HDAC3, emerin interacts with the histone methyltransferases EZH2 and G9a in myogenic progenitor cells. Further, we show enhanced binding of emerin HDAC3-binding mutants S54F and Q133H to EZH2 and G9a. Treatment with small molecule inhibitors of EZH2 and G9a reduced H3K9me2 or H3K27me3 throughout differentiation. EZH2 and G9a inhibitors impaired cell cycle withdrawal, differentiation commitment, and myotube formation in wildtype progenitors, while they had no effect on emerin-null progenitors. Interestingly, these inhibitors exacerbated the impaired differentiation of emerin S54F and Q133H mutant progenitors. Collectively, these results suggest the functional interaction between emerin and HDAC3, EZH2, and G9a are important for myogenic differentiation. Copyright © 2022 Marano and Holaska. DOI: 10.3389/fcell.2022.1007120 PMCID: PMC9583931 PMID: 36274837 Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
http://www.ncbi.nlm.nih.gov/pubmed/27179216
1. Folia Neuropathol. 2016;54(1):1-8. doi: 10.5114/fn.2016.58910. Emery-Dreifuss muscular dystrophy: the most recognizable laminopathy. Madej-Pilarczyk A(1), Kochański A. Author information: (1)Dr Agnieszka Madej-Pilarczyk, Neuromuscular Unit, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawińskiego St., 02-106 Warsaw, Poland, phone: +48 22 608 66 01, fax: +48 22 608 65 31, e-mail: [email protected]. Emery-Dreifuss muscular dystrophy (EDMD), a rare inherited disease, is characterized clinically by humero-peroneal muscle atrophy and weakness, multijoint contractures, spine rigidity and cardiac insufficiency with conduction defects. There are at least six types of EDMD known so far, of which five have been associated with mutations in genes encoding nuclear proteins. The majority of the EDMD cases described so far are of the emerinopathy (EDMD1) kind, with a recessive X-linked mode of inheritance, or else laminopathy (EDMD2), with an autosomal dominant mode of inheritance. In the work described here, the authors have sought to describe the history by which EDMD came to be distinguished as a separate entity, as well as the clinical and genetic characteristics of the disease, the pathophysiology of lamin-related muscular diseases and, finally, therapeutic issues, prevention and ethical aspects. DOI: 10.5114/fn.2016.58910 PMID: 27179216 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10838246
1. Neuromuscul Disord. 2000 Jun;10(4-5):228-32. doi: 10.1016/s0960-8966(00)00105-x. Emery-Dreifuss muscular dystrophy - a 40 year retrospective. Emery AE(1). Author information: (1)Department of Neurology, Royal Devon & Exeter Hospital, EX2 5DW, Exeter, UK. Emery-Dreifuss muscular dystrophy (EDMD) was delineated as a separate form of muscular dystrophy nearly 40 years ago, based on the distinctive clinical features of early contractures and humero-peroneal weakness, and cardiac conduction defects. The gene, STA at Xq28, for the commoner X-linked EDMD encodes a 34 kD nuclear membrane protein designated 'emerin', and in almost all cases on immunostaining is absent in muscle, skin fibroblasts, leucocytes and even exfoliative buccal cells, and a mosaic pattern in female carriers. The gene, LMNA at 1q21, for the autosomal dominant Emery-Dreifuss muscular dystrophy encodes other nuclear membrane proteins, lamins A/C. The diagnosis (at present) depends on mutation analysis rather than protein immunohistochemistry. It is still not at all clear how defects in these nuclear membrane proteins are related to the phenotype, even less clear that LMNA mutations can also be associated with familial dilated cardiomyopathy with no weakness, and even familial partial lipodystrophy with diabetes mellitus and coronary heart disease! What began as clinical studies in a relatively rare form of dystrophy has progressed to detailed research into the functions of nuclear membrane proteins particularly in regard to various forms of heart disease. DOI: 10.1016/s0960-8966(00)00105-x PMID: 10838246 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/1998333
1. Am J Hum Genet. 1991 Mar;48(3):468-80. Assignment of Emery-Dreifuss muscular dystrophy to the distal region of Xq28: the results of a collaborative study. Consalez GG(1), Thomas NS, Stayton CL, Knight SJ, Johnson M, Hopkins LC, Harper PS, Elsas LJ, Warren ST. Author information: (1)Department of Biochemistry, Emory University School of Medicine, Atlanta, GA 30322. Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked humeroperoneal dystrophy associated with cardiomyopathy that is distinct from the Duchenne and Becker forms of X-linked muscular dystrophy. Linkage analysis has assigned EDMD to the terminal region of the human X chromosome long arm. We report here further linkage analysis in two multigenerational EDMD families using seven Xq28 marker loci. Cumulative lod scores suggest that EDMD is approximately 2 cM from DXS52 (lod = 15.67) and very close to the factor VIII (F8C) and the red/green color pigment (R/GCP) loci, with respective lod scores of 9.62 and 10.77, without a single recombinant. Several recombinations between EDMD and three proximal Xq28 markers suggest that the EDMD gene is located in distal Xq28. Multipoint linkage analysis indicates that the odds are 2,000:1 that EDMD lies distal to DXS305. These data substantially refine the ability to perform accurate carrier detection, prenatal diagnosis, and the presymptomatic diagnosis of at-risk males for EDMD by linkage analysis. The positioning of the EDMD locus close to the loci for F8C and R/GCP will assist in future efforts to identify and isolate the disease gene. PMCID: PMC1682981 PMID: 1998333 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/21496632
1. Handb Clin Neurol. 2011;101:155-66. doi: 10.1016/B978-0-08-045031-5.00012-8. Emery-Dreifuss muscular dystrophy. Puckelwartz M(1), McNally EM. Author information: (1)University of Chicago, Chicago, IL 60637, USA. Emery-Dreifuss muscular dystrophy (EDMD) is a progressive muscle-wasting disorder defined by early contractures of the Achilles tendon, spine, and elbows. EDMD is also distinctive for its association with defects of the cardiac conduction system that can result in sudden death. It can be inherited in an X-linked, autosomal dominant, or autosomal recessive fashion and is caused by mutations in proteins of the nuclear membrane. Mutations in the EMD gene, which encodes emerin, a transmembrane protein found at the inner nuclear membrane, are responsible for X-linked EDMD. The most common etiology of autosomal dominant EDMD is an LMNA gene mutation; LMNA encodes the intermediate filament protein lamins A and C, which constitute the major scaffolding protein of the inner nuclear membrane. Murine models of LMNA gene mutations have helped to identify different mechanisms of disease. Loss of LMNA function leads to nuclear fragility as well as other defects, such as abnormal nuclear function. Additional genes encoding nuclear membrane proteins such as SYNE1 and SYNE2 have also been implicated in EDMD, and in some cases their importance for cardiac and muscle function has been supported by animal modeling. Copyright © 2011 Elsevier Inc. All rights reserved. DOI: 10.1016/B978-0-08-045031-5.00012-8 PMID: 21496632 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/31840275
1. Muscle Nerve. 2020 Apr;61(4):436-448. doi: 10.1002/mus.26782. Epub 2019 Dec 28. Emery-Dreifuss muscular dystrophy. Heller SA(1), Shih R(2), Kalra R(3), Kang PB(1)(3)(4). Author information: (1)Department of Neurology, University of Florida College of Medicine, Gainesville, Florida. (2)Congenital Heart Center, University of Florida College of Medicine, Gainesville, Florida. (3)Division of Pediatric Neurology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida. (4)Genetics Institute and Myology Institute, University of Florida, Gainesville, Florida. Emery-Dreifuss muscular dystrophy (EDMD) is a rare muscular dystrophy, but is particularly important to diagnose due to frequent life-threatening cardiac complications. EDMD classically presents with muscle weakness, early contractures, cardiac conduction abnormalities and cardiomyopathy, although the presence and severity of these manifestations vary by subtype and individual. Associated genes include EMD, LMNA, SYNE1, SYNE2, FHL1, TMEM43, SUN1, SUN2, and TTN, encoding emerin, lamin A/C, nesprin-1, nesprin-2, FHL1, LUMA, SUN1, SUN2, and titin, respectively. The Online Mendelian Inheritance in Man database recognizes subtypes 1 through 7, which captures most but not all of the associated genes. Genetic diagnosis is essential whenever available, but traditional diagnostic tools can help steer the evaluation toward EDMD and assist with interpretation of equivocal genetic test results. Management is primarily supportive, but it is important to monitor patients closely, especially for potential cardiac complications. There is a high potential for progress in the treatment of EDMD in the coming years. © 2019 The Authors. Muscle & Nerve published by Wiley Periodicals, Inc. DOI: 10.1002/mus.26782 PMCID: PMC7154529 PMID: 31840275 [Indexed for MEDLINE] Conflict of interest statement: Scott A. Heller has no conflicts of interest to disclose. Peter B. Kang has served as a consultant for AveXis and ChromaDex. He has served on an advisory board for Sarepta Therapeutics. He has received honoraria from Wiley for serving as an associate editor for Muscle & Nerve and from Wolters Kluwer for contributing material to UpToDate.
http://www.ncbi.nlm.nih.gov/pubmed/16550925
1. Acta Myol. 2005 Oct;24(2):98-103. X-linked form of Emery-Dreifuss muscular dystrophy. Hayashi YK(1). Author information: (1)Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan. [email protected] Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscular disorder clinically characterized by slowly progressive weakness affecting humero-peroneal muscles, early joint contractures and cardiomyopathy with conduction defects. Autosomal dominant and recessive forms are caused by mutations in lamin A/C gene. Lamin A/C is a major component of nuclear lamina, and its gene mutations cause several human disorders including muscular dystrophy, cardiomyopathy, lipodystrophy, neuropathy, and progeria syndrome. X-linked recessive form of EDMD is caused by mutation in EMD (or STA) gene encoding an integral protein of the inner nuclear membrane. Emerin expresses ubiquitously, but its deficiency affects only limited tissues of skeletal and cardiac muscles and joints. In this paper, I will focus on clinical and pathological aspects of X-EDMD and possible functions of emerin. PMID: 16550925 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9436433
1. Nihon Rinsho. 1997 Dec;55(12):3186-9. [Emery-Dreifuss muscular dystrophy]. [Article in Japanese] Kubo S(1), Tsukahara T, Arahata K. Author information: (1)Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP). Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscular disorder characterized by the triad of progressive weakness in humero-peroneal muscles, early onset contractures and cardiomyopathy with conduction block that shows a high risk of sudden death. In 1994, the gene responsible for X-linked EDMD has been identified to Xq28 (designated as STA), that encodes a serine-rich protein of 254 amino acids, named emerin. In 1996, we discovered a nuclear membrane localization of emerin in the normal skeletal, cardiac and smooth muscles, but not in the tissues from patients with X-linked EDMD who had a nonsense mutation in the gene. In conclusion, molecular and genetic analyses of emerin are essential for accurate diagnosis of patients with EDMD. PMID: 9436433 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10711990
1. Semin Neurol. 1999;19(1):67-79. doi: 10.1055/s-2008-1040827. Emery-Dreifuss muscular dystrophy. Zacharias AS(1), Wagener ME, Warren ST, Hopkins LC. Author information: (1)Department of Neurology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. Emery-Dreifuss muscular dystrophy (EDMD) is the third most common X-linked muscular dystrophy. This disorder is characterized by childhood onset of early contractures, humeroperoneal muscle atrophy, and cardiac conduction abnormalities. Weakness is slowly progressive, but there is a broad spectrum of clinical severity. Patients and carriers are at risk of sudden death. Regular cardiac evaluation is mandatory to assess the risk of cardiac arrhythmias. Unique atrial pathology is seen at autopsy. The mutated gene in EDMD is localized to the long arm of the X chromosome. Mutations in the gene lead to abolished synthesis of the gene product, emerin. Emerin is localized to the nuclear membrane of skeletal, cardiac, and smooth muscle. The term Emery-Dreifuss syndrome describes patients who have the EDMD phenotype without X-linked inheritance. There is no treatment for the underlying disease, but early placement of pacemakers may be lifesaving. DOI: 10.1055/s-2008-1040827 PMID: 10711990 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/16804269
1. Neurol India. 2006 Jun;54(2):197-9. Emery dreifuss muscular dystrophy: a clinico-pathological study. Gayathri N(1), Taly AB, Sinha S, Suresh TG, Gorai D. Author information: (1)Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India. [email protected] Emery-Dreifuss muscular dystrophy (EDMD) is a rare and genetically heterogeneous disorder. We report two patients with emerin deficient X-linked EDMD and two probable patients with EDMD with typical early contractures, progressive muscle weakness and cardiac involvement. Family history was noted in one case. Muscle biopsy revealed features of dystrophy in all. PMID: 16804269 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/11973618
1. Eur J Hum Genet. 2002 Mar;10(3):157-61. doi: 10.1038/sj.ejhg.5200744. Emery-Dreifuss muscular dystrophy. Helbling-Leclerc A(1), Bonne G, Schwartz K. Author information: (1)Inserm U523, Institut de Myologie, GH Pitié-Salpétrière, Paris, France. Emery-Dreifuss muscular dystrophy (EDMD) is characterised by early contractures, slowly progressive muscle wasting and weakness with a distinctive humero-peroneal distribution and cardiac conduction defects leading to dilated cardiomyopathy. The genes known to be responsible for EDMD encode proteins associated with the nuclear envelope: the emerin and the lamins A and C. DOI: 10.1038/sj.ejhg.5200744 PMID: 11973618 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10080180
1. Nat Genet. 1999 Mar;21(3):285-8. doi: 10.1038/6799. Mutations in the gene encoding lamin A/C cause autosomal dominant Emery-Dreifuss muscular dystrophy. Bonne G(1), Di Barletta MR, Varnous S, Bécane HM, Hammouda EH, Merlini L, Muntoni F, Greenberg CR, Gary F, Urtizberea JA, Duboc D, Fardeau M, Toniolo D, Schwartz K. Author information: (1)INSERM UR153, GH Pitié-Salpétriêre, Paris, [email protected] Emery-Dreifuss muscular dystrophy (EDMD) is characterized by early contractures of elbows and Achilles tendons, slowly progressive muscle wasting and weakness, and a cardiomyopathy with conduction blocks which is life-threatening. Two modes of inheritance exist, X-linked (OMIM 310300) and autosomal dominant (EDMD-AD; OMIM 181350). EDMD-AD is clinically identical to the X-linked forms of the disease. Mutations in EMD, the gene encoding emerin, are responsible for the X-linked form. We have mapped the locus for EDMD-AD to an 8-cM interval on chromosome 1q11-q23 in a large French pedigree, and found that the EMD phenotype in four other small families was potentially linked to this locus. This region contains the lamin A/C gene (LMNA), a candidate gene encoding two proteins of the nuclear lamina, lamins A and C, produced by alternative splicing. We identified four mutations in LMNA that co-segregate with the disease phenotype in the five families: one nonsense mutation and three missense mutations. These results are the first identification of mutations in a component of the nuclear lamina as a cause of inherited muscle disorder. Together with mutations in EMD (refs 5,6), they underscore the potential importance of the nuclear envelope components in the pathogenesis of neuromuscular disorders. DOI: 10.1038/6799 PMID: 10080180 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/7894480
1. Nat Genet. 1994 Dec;8(4):323-7. doi: 10.1038/ng1294-323. Identification of a novel X-linked gene responsible for Emery-Dreifuss muscular dystrophy. Bione S(1), Maestrini E, Rivella S, Mancini M, Regis S, Romeo G, Toniolo D. Author information: (1)Istituto di Genetica Biochimica ed Evoluzionistica CNR, Pavia, Italy. Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked recessive disorder characterized by slowly progressing contractures, wasting of skeletal muscle and cardiomyopathy. Heart block is a frequent cause of death. The disease gene has been mapped to distal Xq28. Among many genes in this region, we selected eight transcripts expressed at high levels in skeletal muscle, heart and/or brain as the best candidates for the disease. We now report, in all five patients studied, unique mutations in one of the genes, STA: these mutations result in the loss of all or part of the protein. The EDMD gene encodes a novel serine-rich protein termed emerin, which contains a 20 amino acid hydrophobic domain at the C terminus, similar to that described for many membrane proteins of the secretory pathway involved in vesicular transport. DOI: 10.1038/ng1294-323 PMID: 7894480 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10689937
1. Rinsho Shinkeigaku. 1999 Nov;39(11):1138-43. [A novel splice-site mutation in the STA gene in a Japanese patient with Emery-Dreifuss muscular dystrophy]. [Article in Japanese] Hasegawa T(1), Kobayashi K, Arahata K, Itoyama Y. Author information: (1)Department of Neurology, Tohoku University School of Medicine, Sendai, Japan. Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked recessive or autosomal dominant progressive muscular dystrophy characterized by progressive muscle wasting and weakness with scapulo-humero-peroneal distribution, early contracture and cardiomyopathy with conduction block. The responsible gene for EDMD, designated as 'STA', has been mapped to Xq 28 and cloned. It encodes a serine-rich protein of 254-amino-acid, called 'emerin', localized in the inner nuclear rim. We performed genetic analysis of a 23-year-old male clinically diagnosed as EDMD and found a novel point mutation. Total RNA was extracted from skeletal muscle and reverse-transcription and polymerase chain reaction amplification was performed using a set of oligonucleotide primers between 5'-flanking site of exon 1 and exon 4. Our patient gave a smaller PCR product (about 30 bp) than normal control. The determined cDNA sequence revealed a deletion of 29 bp, spanning position 164 to 192 in exon 1. To clarify the mutant allele, we performed genomic DNA sequence. Genomic DNA sequence from the initiation of exon 1 to the upstream lesion of exon 2 confirmed a novel point mutation G to C, at nucleotide 197 in the donor splice site of intron 1. This point mutation may interfere with the correct splicing of the mRNA and cause frameshift, resulted in truncation of predicted protein by premature stop. We report a novel point mutation G to C, at nucleotide 197 in the intron 1 of STA gene corresponding the truncation of predicted protein, which differs from any of the previously reported mutations. PMID: 10689937 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9361031
1. Hum Mol Genet. 1997 Dec;6(13):2257-64. doi: 10.1093/hmg/6.13.2257. Heart-specific localization of emerin: new insights into Emery-Dreifuss muscular dystrophy. Cartegni L(1), di Barletta MR, Barresi R, Squarzoni S, Sabatelli P, Maraldi N, Mora M, Di Blasi C, Cornelio F, Merlini L, Villa A, Cobianchi F, Toniolo D. Author information: (1)Institute of Genetics, Biochemistry and Evolution CNR, Via Abbiategrasso 207, 27100 Pavia, Italy. Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked inherited disease characterized by early contracture of the elbows, Achilles tendons and post-cervical muscles, slow progressive muscle wasting and weakness and cardiomyopathy presenting with arrhythmia and atrial paralysis: heart block can eventually lead to sudden death. The EDMD geneencodes a novel ubiquitous protein, emerin, which decorates the nuclear rim of many cell types. Amino acid sequence homology and cellular localization suggested that emerin is a member of the nuclear lamina-associated protein family. These findings did not explain the role of emerin nor account for the skeletal muscle- and heart-specific clinical manifestations associated with the disorder. Now we report that emerin localizes to the inner nuclear membrane, via its hydrophobic C-terminal domain, but that in heart and cultured cardiomyocytes it is also associated with the intercalated discs. We propose a general role for emerin in membrane anchorage to the cytoskeleton. In the nuclear envelope emerin plays a ubiquitous and dispensable role in association of the nuclear membrane with the lamina. In heart its specific localization to desmosomes and fasciae adherentes could account for the characteristic conduction defects described in patients. DOI: 10.1093/hmg/6.13.2257 PMID: 9361031 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/31645980
1. Hum Genome Var. 2019 Sep 3;6:42. doi: 10.1038/s41439-019-0072-8. eCollection 2019. Targeted next-generation sequencing identified a known EMD mutation in a Chinese patient with Emery-Dreifuss muscular dystrophy. Dai X(1)(2), Zheng C(3), Chen X(2)(4), Tang Y(2), Zhang H(2), Yan C(1)(2), Ma H(1)(2), Li X(1)(2). Author information: (1)1School of Medicine, University of Electronic Science and Technology of China, 610072 Chengdu, Sichuan China. (2)2Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, 610072 Chengdu, Sichuan China. (3)Shenzhen RealOmics (Biotech) Co., Ltd., 518081 Shenzhen, China. (4)4ZunYi Medical University, 563000 Zunyi, Guizhou China. Emery-Dreifuss muscular dystrophy (EDMD) is a rare X-linked recessive disease characterized by the clinical triad of early childhood joint contractures, progressive weakness in muscles and cardiac involvement and can result in sudden death. Targeted next-generation sequencing was performed for a Chinese patient with EDMD and the previously reported mutation [NM_000117.2: c.251_255del (p.Leu84Profs*7)] in exon 3 of the emerin gene (EMD) was identified. © The Author(s) 2019. DOI: 10.1038/s41439-019-0072-8 PMCID: PMC6804839 PMID: 31645980 Conflict of interest statement: Conflict of interestThe authors declare that they have no conflict of interest.
http://www.ncbi.nlm.nih.gov/pubmed/23622360
1. Handb Clin Neurol. 2013;113:1367-76. doi: 10.1016/B978-0-444-59565-2.00007-1. Emery-Dreifuss muscular dystrophy, laminopathies, and other nuclear envelopathies. Bonne G(1), Quijano-Roy S. Author information: (1)Inserm, U974; Université Pierre et Marie Curie - Paris 6, UM 76; CNRS, UMR 7215; Institut de Myologie, and AP-HP - U.F. Cardiogénétique et Myogénétique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. Electronic address: [email protected]. The nuclear envelopathies, more frequently known as laminopathies are a rapidly expanding group of human hereditary diseases caused by mutations of genes that encode proteins of the nuclear envelope. The most frequent and best known form is Emery-Dreifuss muscular dystrophy (EDMD), a skeletal myopathy characterized by progressive muscular weakness, joint contractures, and cardiac disease. EMD gene, encoding emerin, causes the X-linked form of EDMD, while LMNA gene encoding lamins A and C, is responsible for autosomal forms, usually with a dominant transmission. In the last years, the spectrum of conditions has been extraordinarily enlarged, from a congenital muscular dystrophy with severe paralytic or rapidly progressive picture due to de novo mutations in LMNA (L-CMD) to a limb-girdle muscular dystrophy with adult onset and much milder weakness (LGMD1B). LMNA has also been involved in a form of isolated cardiomyopathy associated with cardiac conduction disease and in an axonal form of hereditary neuropathy. Identification of this gene has been reported also in a number of non-neuromuscular disorders including lipodystrophy syndromes and a wide spectrum of premature aging syndromes ranging from mandibuloacral dysplasia to restrictive dermopathy. Mutations in other genes implicated in the processing or maturation of nuclear lamins have also been found. The extraordinary complexity of the molecular and pathophysiological mechanisms of these diseases is still not well known and the occurrence of modifying factors or genes is highly suspected. Identification of new genes and investigation of new therapeutic approaches are in progress. Copyright © 2013 Elsevier B.V. All rights reserved. DOI: 10.1016/B978-0-444-59565-2.00007-1 PMID: 23622360 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10220866
1. Neuromuscul Disord. 1999 Mar;9(2):108-14. doi: 10.1016/s0960-8966(98)00097-2. Emerin and cardiomyopathy in Emery-Dreifuss muscular dystrophy. Funakoshi M(1), Tsuchiya Y, Arahata K. Author information: (1)Department of Neuromuscular Research, National Institute of Neuroscience, Tokyo, Japan. Emery-Dreifuss muscular dystrophy (EDMD) is an inherited disorder characterized by the clinical triad of life-threatening progressive cardiomyopathy with conduction defect, early onset joint contractures and slow progressive muscle weakness in scapulo-humero-peroneal distribution. Cardiomyopathy in EDMD is usually noticed after the second to third decade of life, and becomes worse with age. Permanent auricular paralysis occurs frequently and is considered a hallmark of EDMD cardiomyopathy. Cardiac involvement may also occur in female carriers. In autopsy cases, enlargement of the atria with remarkable thinning have been observed. Identification of the gene responsible for X-linked EDMD (X-EDMD) and the protein product, emerin, provided a diagnostic clue for EDMD. Since the emerin gene is rather small, the entire sequence can easily be surveyed. Western blot and immunohistochemistry show an absence of emerin in muscle and skin tissues and oral exfoliating cells in male patients with X-EDMD, and a reduction of the protein content with a mosaic expression pattern in female carriers. Emerin anchors at the inner nuclear membrane of cardiac, skeletal and smooth muscles, and interacts with lamins and nucleoplasm, thereby possibly maintaining the mechanical stability of the nuclear membrane of muscle cells that shows rigorous contraction/relaxation. More recently, positive emerin staining at the cardiac demosomes and fasciae adherentes was noticed in addition to the specific localization at the inner nuclear membrane. This localization implies a physiological role for the protein in cardiac conduction. DOI: 10.1016/s0960-8966(98)00097-2 PMID: 10220866 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/32304242
1. Muscle Nerve. 2020 Jul;62(1):128-136. doi: 10.1002/mus.26892. Epub 2020 May 6. Histone acetyltransferase inhibition rescues differentiation of emerin-deficient myogenic progenitors. Bossone KA(1)(2), Ellis JA(2), Holaska JM(1)(2). Author information: (1)Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, New Jersey, United States. (2)Department of Pharmaceutical Sciences, University of the Sciences, Philadelphia, Pennsylvania, United States. INTRODUCTION: Emery-Dreifuss muscular dystrophy (EDMD) is a disease characterized by skeletal muscle wasting, major tendon contractures, and cardiac conduction defects. Mutations in the gene encoding emerin cause EDMD1. Our previous studies suggested that emerin activation of histone deacetylase 3 (HDAC3) to reduce histone 4-lysine 5 (H4K5) acetylation (ac) is important for myogenic differentiation. METHODS: Pharmacological inhibitors (Nu9056, L002) of histone acetyltransferases targeting acetylated H4K5 were used to test whether increased acetylated H4K5 was responsible for the impaired differentiation seen in emerin-deficient myogenic progenitors. RESULTS: Nu9056 and L002 rescued impaired differentiation in emerin deficiency. SRT1720, which inhibits the nicotinamide adenine dinucleotide (NAD)+ -dependent deacetylase sirtuin 1 (SIRT1), failed to rescue myotube formation. DISCUSSION: We conclude that emerin regulation of HDAC3 activity to affect H4K5 acetylation dynamics is important for myogenic differentiation. Targeting H4K5ac dynamics represents a potential new strategy for ameliorating the skeletal muscle wasting seen in EDMD1. © 2020 Wiley Periodicals, Inc. DOI: 10.1002/mus.26892 PMCID: PMC7382944 PMID: 32304242 [Indexed for MEDLINE] Conflict of interest statement: CONFLICT OF INTEREST The authors declare no potential conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
http://www.ncbi.nlm.nih.gov/pubmed/10732816
1. Neurogenetics. 1997 Sep;1(2):135-40. doi: 10.1007/s100480050020. Emerin, deficiency of which causes Emery-Dreifuss muscular dystrophy, is localized at the inner nuclear membrane. Yorifuji H(1), Tadano Y, Tsuchiya Y, Ogawa M, Goto K, Umetani A, Asaka Y, Arahata K. Author information: (1)Department of Anatomy II, National Defense Medical College, Saitama, Japan. X-linked recessive Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscle disorder characterized by the clinical triad of progressive wasting of humero-peroneal muscles, early contractures of the elbows, Achilles tendons and postcervical muscles, and cardiac conduction block with a high risk of sudden death. The gene for EDMD on Xq28 encodes a novel protein named emerin that localizes at the nuclear membrane of skeletal, cardiac and smooth muscles and some other non-muscle tissues. To investigate a possible physiological role for emerin, we examined the ultrastructural localization of the protein in human skeletal muscle and HeLa cells, using ultrathin cryosections. We found that the immune-labeled colloidal gold particles were localized on the nucleoplasmic surface of the inner nuclear membrane, but not on the nuclear pore. Emerin stayed on the cytoplasmic surface of the nuclear lamina, even after detergent treatment that solubilizes membrane lipids and washes out membrane proteins. These results suggest that emerin anchors at the inner nuclear membrane through the hydrophobic stretch, and protrudes from the hydrophilic region to the nucleoplasm where it interacts with the nuclear lamina. We speculate that emerin contributes to maintain the nuclear structure and stability, as well as nuclear functions, particularly in muscle tissues that have severe stress with rigorous contraction-relaxation movements and calcium flux. DOI: 10.1007/s100480050020 PMID: 10732816 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/11385714
1. Hum Mutat. 2001 Jun;17(6):522. doi: 10.1002/humu.1139. Novel mutations in the emerin gene in Israeli families. Nevo Y(1), Ahituv S, Yaron Y, Kedmi M, Shomrat R, Legum C, Orr-Urtreger A. Author information: (1)Pediatric Neuromuscular Service, Dana Hospital, Tel Aviv Sourasky Medical Center, Israel. [email protected] Emery-Dreifuss Muscular Dystrophy (EMD or EDMD) is a rare X-linked recessive disorder, characterized by progressive muscle wasting and weakness, contractures, and cardiomyopathy, manifesting as heart block. Mutation analysis at the EMD gene locus was performed in 4 unrelated Israeli families with X-linked EMD and in one sporadic case. In the 4 families 4 different mutations were found, 3 of which were novel. These included two frame shift mutations in exon 2 (333delT and 412insA) and one base pair substitution at the consensus +1 donor splice in intron 5 (1429G-->A). The fourth mutation in exon 6 (1675-1678delTCCG) has been previously described. No mutations were identified in the one sporadic case. Two of the three novel mutations were found in exon 2. A summary of the previously published mutations described in the EMD Mutation Database (http://www.path.cam.ac.uk/emd/) as well as the mutations described in our study suggest that the distribution of mutations in EMD gene is not entirely random and that exon 2 is prone to mutations. Hum Mutat 17:522, 2001. Copyright 2001 Wiley-Liss, Inc. DOI: 10.1002/humu.1139 PMID: 11385714 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/21372459
1. Intern Med. 2011;50(5):459-62. doi: 10.2169/internalmedicine.50.4598. Epub 2011 Mar 1. Ventricular arrhythmia in X-linked Emery-Dreifuss muscular dystrophy: a lesson from an autopsy case. Ishikawa K(1), Mimuro M, Tanaka T. Author information: (1)Department of Cardiology, Okazaki City Hospital, Japan. [email protected] Emery-Dreifuss muscular dystrophy (EDMD) is a distinctive form of muscular dystrophy which is often associated with cardiac abnormalities. Conduction disturbances are frequently observed, and may necessitate pacemaker implantation to prevent sudden death. In this case report, we present an autopsy of a 31-year-old man with X-linked EDMD who developed only minimal skeletal muscle symptoms, and who died from ventricular arrhythmia despite undergoing a previous pacemaker implantation. Ventricular arrhythmias in X-linked EDMD patients are also discussed. DOI: 10.2169/internalmedicine.50.4598 PMID: 21372459 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/17042210
1. Tunis Med. 2006 Jun;84(6):361-4. [Cardiac involvement in Emery-Dreifuss muscular dystrophy: a case report]. [Article in French] Chabrak S(1), Ammar S, Ammar N, Ouali S, Mghaieth F, Larbi N, Kafsi N, Hentati F, Mechmeche R. Author information: (1)Service des Explorations Fonctionnelles et de Réanimatin Cardiologique, La Rabta, Tunis. Emery Dreifuss muscular dystrophy (EDMD) is an uncommon hereditary myopathy characterized by 3 symptoms: slow progressive muscular atrophy, muscular contractures and cardiac disease which affect prognosis. We report a 22 year-old patient with EDMD which shows the typical features of the associated dilated cardiomyopathy, ventricular arrhythmia, atrio-ventricular block, atrial standstill then atrial paralysis. PMID: 17042210 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/29633897
1. Nucleus. 2018 Jan 1;9(1):268-274. doi: 10.1080/19491034.2018.1462635. Clinical aspects of Emery-Dreifuss muscular dystrophy. Madej-Pilarczyk A(1). Author information: (1)a Neuromuscular Unit, Mossakowski Medical Research Centre, Polish Academy of Sciences , Warsaw , Poland. Emery-Dreifuss muscular dystrophy (EDMD), clinically characterized by scapulo-humero-peroneal muscle atrophy and weakness, multi-joint contractures with spine rigidity and cardiomyopathy with conduction defects, is associated with structural/functional defect of genes that encode the proteins of nuclear envelope, including lamin A and several lamin-interacting proteins. This paper presents clinical aspects of EDMD in context to causative genes, genotype-phenotype correlation and its emplacement within phenotypic spectrum of skeletal muscle diseases associated with envelopathies. DOI: 10.1080/19491034.2018.1462635 PMCID: PMC5973255 PMID: 29633897 [Indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/12075650
1. Anaesth Intensive Care. 2002 Jun;30(3):372-5. doi: 10.1177/0310057X0203000320. Anaesthetic management of a patient with Emery-Dreifuss muscular dystrophy. Shende D(1), Agarwal R. Author information: (1)Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi. Emery-Dreifuss muscular dystrophy is a rare form of muscular dystrophy associated with cardiac implications such as cardiomyopathy and arrhythmias leading to sudden death. We describe the anesthetic management of a patient with Emery-Dreifuss muscular dystrophy who presented for orthopaedic surgery and discuss the disorder and its potential anaesthetic implications. DOI: 10.1177/0310057X0203000320 PMID: 12075650 [Indexed for MEDLINE]