Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neurotransmission is regulated by neurotransmitters at the synapses in the neuronal circuits. Main neurotransmitters are classified into the groups of amino acids, amines, purines, peptides, and nitric oxide. In principle, neurotransmitters except peptides are synthesized in the presynaptic neuroterminals from the precursors by the synthesizing enzymes, stored in the synaptic vesicles, released by exocytosis into the synaptic cleft, combined with the postsynaptic membrane receptors, and induce a series of signal transduction to produce acute, short-term, or long-term physiological effects. Termination of the neurotransmission is carried out either by re-uptake into presynaptic nerve terminals through plasma membrane transporters and storage into synaptic vesicles through vesicular transporters or by degradation through metabolizing enzymes (acetylcholine and peptides). Almost all genes related to neurotransmitters have been cloned and the structures of the genes and the protein products have been characterized. Molecular mechanisms of neurotransmission have been elucidated by mouse molecular genetics such as transgenic or knockout mice. Over-expression of human tyrosine hydroxylase (TH). the rate-limiting enzyme of catecholamine synthesis, in transgenic mice (Kaneda et al, Neuron 6, 583-584, 1991) or conversion of norepinephrine neurons to epinephrine neurons (Kobayashi et al, Proc Natl Acad Sci USA 89, 1631-1635, 1992) does not significantly change the phenotype due to compensatory mechanisms such as receptor down-regulation. In contrast, TH (-/-) mutant mice die at perinatal period due to heart failure caused by norepinephrine deficiency in the sympathetic neurons (Kobayashi et al, J Biol Chem 270, 27235-27243, 1995). TH (+/-) mice show a partial decrease in norepinephrine and a modest memory impairment (Kobayashi et al, J Neurosci 20, 2418-2426, 2000). One problem with adult phenotype in transgenic or knockout mice is that mutations cause the confounding effect of the developmental compensation. Thus conditional knockout of a specific type of neurons at a definite time after birth is required. Immunotoxin mediated conditional cell targeting (IMCT) (Kobayashi et al, Proc Natl Acad Sci 92, 1132-1136, 1995) is a novel transgenic technique for elucidating the function of a neuron in a neuronal circuit. Human molecular genetics of genetic neurological diseases are also useful for elucidating molecular mechanisms of neurotransmission. Autosomal dominant dopa-responsive dystonia (DRD) (Segawa's disease) with mutations of GTP cyclohydrolase I (Ichinose et al, Nature Genet 8, 236-242, 1994) causes a partial decrease in dopamine in the nigrostriatal dopamine neurons and produces a dystonia phenotype (Segawa's syndrome). In contrast, autosomal recessive GTP cyclohydrolase I deficiency with complete loss of the enzyme activity produces deficiencies of dopamine, norepinephrine, and serotonin and complex phenotypes with severe neurological symptoms (Ichinose et al, J Biol Chem 270, 10062-10071, 1995).
 ...
PMID:[Molecular mechanisms of neurotransmission]. 1146 53

Dopa-responsive dystonia (DRD) is an autosomal dominant disorder typically presenting as dystonia with diurnal variability. Described is an 8-year-old boy who had had waddling gait, generalized hypotonia, and proximal weakness since early childhood. He responded well to low-dose L-dopa. He had a point mutation of the GTP cyclohydrolase I gene. The patient's father and sister had the same mutation but did not have proximal weakness. GTP cyclohydrolase I deficiency can present with hypotonia and weakness.
 ...
PMID:Atypical presentation of dopa-responsive dystonia: generalized hypotonia and proximal weakness. 1157 50

DOPA responsive dystonia (DRD) and sepiapterin reductase (SR) deficiency are inherited disorders of tetrahydrobiopterin (BH4) metabolism characterized by the signs and symptoms related to monoamine neurotransmitter deficiency. In contrast to classical forms of BH4 deficiency DRD and SR deficiency present without hyperphenylalaninemia and thus cannot be detected by the neonatal screening for phenylketonuria (PKU). While DRD is mostly caused by autosomal dominant mutations in the GTP cyclohydrolase I gene (GCH1), SR deficiency is an autosomal recessive disease. The most important biochemical investigations for the diagnosis of these neurological diseases includes CSF investigations for neurotransmitter metabolites and pterins as well as neopterin and biopterin production in cytokine-stimulated fibroblasts. Discovery of SR deficiency opened new insights into alternative pathways of the cofactor BH4 via carbonyl, aldose, and dihydrofolate reductases. As a consequence of the low dihydrofolate reductase activity in the brain, dihydrobiopterin intermediate accumulates and inhibits tyrosine and tryptophan hydroxylases and uncouples nitric oxide synthase (nNOS), leading to neurotransmitter deficiency and possibly also to neuronal cell death.
 ...
PMID:Tetrahydrobiopterin deficiencies without hyperphenylalaninemia: diagnosis and genetics of dopa-responsive dystonia and sepiapterin reductase deficiency. 1159 14

Tetrahydrobiopterin ((6R)-L-erythro-tetrahydrobiopterin, BH4) is de novo synthesized from GTP. Enzymes involved in its synthesis are the rate limiting enzyme GTP cyclohydrolase I, 6-pyruvoyl tetrahydropterin synthase (PTPS) and sepiapterin reductase. Abnormalities in the metabolism of BH4 have been demonstrated in some diseases affecting the central nervous systems such as atypical phenylketonuria, hereditary progressive dystonia (Segawa's disease). Furthermore, BH4 has been shown to be involved in vascular protection. It is suggested that the dysfunction of endothelial BH4 leads to atherosclerosis. Recently we established BH4-deficient mice by disrupting the PTPS gene to investigate the effects of BH4 depletion on the animals and the involvement of BH4 in regulating biological functions including neural systems. Investigation utilizing this model animal can contribute to the development of new therapeutic strategies toward various diseases involving neurological and vascular systems. Pterin derivatives other than biopterin may also be involved in the regulation of a variety of biological functions. We found that ciliated protozoan Tetrahymena pyriformis synthesizes tetrahydromonapterin, isomer of BH4, and its levels alter according to the progress of the cell cycle. How pterin derivatives are related to the human physiology and diseases is an interesting subject of investigation.
 ...
PMID:[Perspectives on tetrahydrobiopterin research]. 1177 54

Dopa-responsive dystonia (DRD) is an eminently treatable condition and its recognition is therefore of crucial importance. In classical cases, the disease manifests in early childhood with walking problems due to dystonia of the lower limbs. The dystonia is frequently accompanied by "parkinsonian" features such as reduced facial expression or slowing of fine finger movements. Biochemically, the disorder is typically characterized by low levels of the neurotransmitter metabolite homovanillic acid and reduced levels of neopterin and tetrahydrobiopterin (BH4) in the cerebrospinal fluid. This is due to heterozygote mutations of the GTP cyclohydrolase I gene, which is the rate-limiting enzyme in the synthesis of BH4. BH4 is an essential co-factor for tyrosine hydroxylase (TH), the rate-limiting enzyme in the synthesis of dopamine. Reduced levels of BH4 lead to the dopamine-deficit syndrome DRD because of reduced TH activity. Other genes implicated in the pathogenesis of this disorder are the TH gene itself and the parkin gene. This article summarizes all relevant aspects of DRD including recent advances in the genetics of this disorder and the widening phenotype. Particular emphasis is given to clinically relevant aspects such as diagnostic difficulties and atypical presentations in infancy and early childhood.
 ...
PMID:Dopa-responsive dystonia -- the story so far. 1193 Feb 68

Dopa responsive dystonia (DRD) is an autosomal dominant dystonia caused by mutations in the gene GCH1 in about 50% of cases. GCH1 codes for GTP cyclohydrolase I, a rate limiting enzyme in the synthesis of tetrahydrobiobterin (BH(4)) from GTP. There is reduced penetrance and pronounced variation in expressivity of GCH1 mutations in families with DRD. Correlations between given mutations in GCH1 and phenotypes cannot be established. Mutations in GCH1 appear to function as dominant-negatives but the exact mechanism remains unclear. Additional open questions in DRD include the molecular mechanisms resulting in highly variable expressivity of symptoms and the more likely occurrence of symptoms in a female than in a male carrier of a GCH1 mutation.
 ...
PMID:Mutations of GCH1 in Dopa-responsive dystonia. 1195 54

Currently, at least 12 types of dystonia can be distinguished on a genetic basis. Advances in the molecular genetics of dystonia have led to the recent identification of a 3-bp deletion in the DYT1 gene, causing early-onset generalized torsion dystonia (TD), and to the detection of mutations in the GTP cyclohydrolase I and the tyrosine hydroxylase genes causing dopa-responsive dystonia (DYT5). A missense change in the D2 dopamine receptor has been shown to be associated with myoclonus-dystonia in one family. In addition, six other dystonia gene loci have been mapped to chromosomal regions, including a locus for a mixed dystonia phenotype (DYT6), one form of focal dystonia (DYT7), two types of paroxysmal dystonia (DYT8, DYT9), X-linked dystonia-parkinsonism (DYT3), and rapid-onset dystonia parkinsonism (DYT12). No positive linkage studies have as yet been reported for autosomal recessive TD (DYT2) and in several other large families with various types of dominantly inherited TD (DYT4). It may be anticipated that the traditional clinical and etiological classifications of dystonia will increasingly be replaced by a genetic one and that the identification of more dystonia genes may lead to a better understanding of these largely nondegenerative disorders.
 ...
PMID:Genetics of primary dystonia. 1219 83

The authors report two twin sisters, age 15 years, with recessive GTP cyclohydrolase deficiency, who presented with neonatal onset of rigidity, tremor, and dystonia but with no other symptoms suggestive of a diffuse CNS involvement. The plasma phenylalanine levels were normal. Treatment with L-dopa/carbidopa, started at age 1 year, was associated with sustained recovery from all neurologic signs. The patients were homozygous for a new recessive mutation in the GHI gene.
 ...
PMID:Neonatal dopa-responsive extrapyramidal syndrome in twins with recessive GTPCH deficiency. 1255 57

Treatment of dopa-responsive dystonia is one of the more satisfying experiences in clinical neurology. The response to treatment with levodopa is usually dramatic and complete with no long-term complications. Carbidopa/levodopa is the mainstay in treating dopa-responsive dystonia. There is some experience using anticholinergic agents, but they are more likely to cause side effects and do not treat the underlying biochemical abnormality. Dopa-responsive dystonia caused by guanosine triphosphate cyclohydrolase I deficiency typically presents with dystonia in the lower extremities in the first decade of life. However, the presenting symptoms can vary. Thus, it is this author's recommendation that any child with dystonia receive a trial of carbidopa/levodopa.
 ...
PMID:Dopa-responsive Dystonia in Children. 1279 Nov 94

In neurodevelopmental disorders, the characteristic symptoms appear age-dependently along with the functional and morphological development of the affected neurons and the neuronal pathways. Most of them have the primary lesion in the subcortical structures as these mature earlier, which include the aminergic neurons of the brainstem and the midbrain having important roles for development of the higher cortical function (HCF). Thus, to clarify the pathophysiologies of the symptoms appearing age-dependently makes it possible to demonstrate the process of development of the HCF. Here, I reviewed the characteristic symptoms and their pathophysiologies of Rett syndrome, DYT-1, autosomal dominant GTP cyclohydrolase I (ADGCH I) deficiency, Tourette syndrome (TS) and Early-onset ataxia with ocular motor apraxia and hypoalbuminemia (EAOH), and suggested that the brainstem aminergic neurons modulating the locomotion have roles for development of the frontal cortex, the dopaminergic neurons and basal ganglia pathways involving in the action dystonia for motor execution and the serotonergic and the dopaminergic neurons projectioning to the nonmotor basal ganglia thalamocortical circuits for development of the frontal area, the targets of the circuits. While, postural dystonia, tics in GTS and symptoms in EAOH reflect the development of the causative neurons and the neuronal systems.
 ...
PMID:[Visual child neurology]. 1515 53


<< Previous 1 2 3 4 5 6 7 8 9 Next >>