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Oculopharyngeal muscular dystrophy
(
OPMD
) is an adult-onset disorder characterized by progressive eyelid drooping (
ptosis
), swallowing difficulties (dysphagia), and proximal limb weakness. The autosomal dominant form of this disease is caused by expansions of a (GCG)6 repeat to (GCG)8-13 in the PABPN1 gene. These mutations lead to the expansion of a polyalanine stretch from 10 to 12-17 alanines in the N-terminal domain of PABPN1. Mutated PABPN1 (mPABPN1) induces the formation of muscle intranuclear inclusions that are thought to be the hallmark of this disease. In this review, we discuss: 1)
OPMD
genetics and PABPN I function studies; 2) diseases caused by polyalanine expansions and cellular polyalanine toxicity; 3) mPABPN1-induced intranuclear inclusion toxicity; 4) role of oligomerization of mPABPNI in the formation and toxicity of
OPMD
intranuclear inclusions and; 5) recruitment of subcellular components to the
OPMD
inclusions. We present a potential molecular mechanism for
OPMD
pathogenesis that accounts for these observations.
...
PMID:Progress in understanding the pathogenesis of oculopharyngeal muscular dystrophy. 1261 77
Oculopharyngeal muscular dystrophy
is a hereditary pathology transmitted in an autosomal dominant manner. The clinical symptoms are palpebral
ptosis
, oropharyngeal dysphagia and proximal limb weakness. Upper gastro-esophageal endoscopy is recommended to study the dysphagia, a video-radiology study with barium and an esophageal manometry to study the pharyngeo-esophageal motor disorder. Muscle biopsy reveals the presence of atrophic fibers substituted by an increase in fat and connective tissue. In 1998 Brais described the genetic alteration responsible for this pathology, a limited expansion of the triplet of GCG nucleotides in PABP2 gene on chromosome 14q11. Normal individuals have the homozygotic form (GCG)6 of this triplet, whereas patients with the described syndrome have the heterozygotic form (GCG)6-(GCG)9 or (GCG)6-(GCG)10. We present three siblings from the same family with diagnoses and genetic confirmations of oculopharyngeal dystrophy. Two of the patients underwent cricopharyngeal myotomy to relieve the dysphagia.
...
PMID:Diagnosis and treatment of oculopharyngeal dystrophy: a report of three cases from the same family. 1282 21
Oculopharyngeal muscular dystrophy
(
OPMD
) is a muscle disease of late onset associated with progressive
ptosis
of the eyelids, dysphagia, and unique tubulofilamentous intranuclear inclusions (INIs).
OPMD
is usually transmitted as an autosomal dominant trait (OMIM 164300). A rarer allelic autosomal recessive form has also been observed (OMIM 257950). Both forms are caused by short (GCG)8-13 expansions in the polyadenylate-binding protein nuclear 1 gene (PABPN1) located on chromosome 14q11.1. The mutations cause the lengthening of an N-terminal polyalanine domain. Both slippage and unequal recombination have been proposed as the mutation mechanisms. The size of the mutation has not yet been conclusively shown to inversely correlate with the severity of the phenotype. Mutated PABPN1 proteins have been shown to be constituents of the INIs. The INIs also contain ubiquitin, proteasome subunits, HSP 40, HSP 70, SKIP, and abundant poly(A)-mRNA. The exact mechanism responsible for polyalanine toxicity in
OPMD
is unknown. Various intranuclear inclusion dependent and independent mechanisms have been proposed based on the major known function of PABPN1 in polyadenylation of mRNA and its shuttling from the nucleus to the cytoplasm.
OPMD
is one of the few triplet-repeat diseases for which the function of the mutated gene is known. Because of the increasing number of diseases caused by polyalanine expansions and the pathological overlap with CAG/polyglutamine diseases, what pathological insight is gained by the study of
OPMD
could lead to a better understanding of a much larger group of developmental and degenerative diseases.
...
PMID:Oculopharyngeal muscular dystrophy: a late-onset polyalanine disease. 1452 87
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant late-onset neuromuscular degenerative disease characterised by proximal muscle weakness,
ptosis
and swallowing difficulty. The causative genetic abnormality is an expansion consisting of 2-7 additional base triplets in a repeat sequence in exon 1 of the PABPN1 (PABP2) gene and results in an increase in length of the polyalanine tract in the PABPN1 protein from 10 to 12-17 residues. The expansions are stable through meiosis and mitosis suggesting a different mechanism of mutation from that of most other triplet repeat mutations. Most reports describe
OPMD
expansions as consisting of multiples of a GCG sequence. However, some studies have detected GCA interspersions. We have analysed 86
OPMD
patients with a PABPN1 gene expansion, including three compound heterozygotes, and have identified 13 different types of expansion mutation, six of which contain GCA and GCG and almost all of which are consistent with a mutational mechanism of unequal recombination.
...
PMID:Oculopharyngeal muscular dystrophy (OPMD): analysis of the PABPN1 gene expansion sequence in 86 patients reveals 13 different expansion types and further evidence for unequal recombination as the mutational mechanism. 1564 84
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant disorder of middle age presenting as progressive dysphagia and eyelid
ptosis
, due to short expansions of the GCG trinucleotide repeat (from GCG6 to GCG8-13) in the polyadenylate binding-protein nuclear 1 (PABPN1) gene.
OPMD
is rarely seen in Asians and morphologically and/or genetically confirmed cases have been reported in Japanese kindreds only. We report a 64 year old Chinese-Malaysian woman who presented with progressive dysphagia and bilateral
ptosis
for about 6 years. Her mother and elder brother (both deceased) were believed to be affected. Muscle histopathology revealed angulated fibres with rimmed vacuoles. Genetic analysis showed repeat expansion in one allele to (GCG)9 while normal in the other (GCG)6. This is the first non-Japanese Asian family with genetically confirmed
OPMD
.
...
PMID:Oculopharyngeal muscular dystrophy with PABPN1 mutation in a Chinese Malaysian woman. 1572 89
The muscular dystrophies are a heterogeneous group of disorders for which there are currently no cures.
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant late-onset, progressive disease that generally presents in the fifth or sixth decade with dysphagia,
ptosis
and proximal limb weakness.
OPMD
is caused by the abnormal expansion of a (GCG)n trinucleotide repeat in the coding region of the poly-(A) binding protein nuclear 1 (PABPN1) gene. In unaffected individuals, (GCG)6 codes for the first six alanines in a homopolymeric stretch of ten alanines. In most individuals with
OPMD
this (GCG)6 repeat is expanded to (GCG)8-13, leading to a stretch of 12-17 alanines in mutant PABPN1. PABPN1 with an expanded polyalanine tract forms aggregates consisting of tubular filaments within the nuclei of skeletal muscle fibers. We have developed a transgenic mouse model of
OPMD
that manifests progressive muscle weakness accompanied by intranuclear aggregates and TUNEL-stained nuclei in skeletal muscle fibers. The onset and severity of these abnormalities were substantially delayed and attenuated by doxycycline treatment, which may exert its therapeutic effect by reducing aggregates and by distinct antiapoptotic properties. Doxycycline may represent a safe and feasible therapeutic for this disease.
...
PMID:Doxycycline attenuates and delays toxicity of the oculopharyngeal muscular dystrophy mutation in transgenic mice. 1586 13
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant disease that presents in the fifth or sixth decade with dysphagia,
ptosis
and proximal limb weakness.
OPMD
is caused by the abnormal expansion of a polyalanine tract within the coding region of polyA binding protein nuclear 1 (PABPN1). The resultant mutant PABPN1 forms aggregates within the nuclei of skeletal muscle fibres. We have previously described a transgenic mouse model of
OPMD
that recapitulates the human disease and develops progressive muscle weakness accompanied by the formation of aggregates in skeletal muscle nuclei. The chemical chaperone trehalose has been used effectively to alleviate symptoms in a mouse model of Huntington's disease and is thought to elicit its effect by binding and stabilizing partially folded polyglutamine proteins and inhibiting the formation of aggregates. Here, we show that trehalose reduces aggregate formation and toxicity of mutant PABPN1 in cell models. Furthermore, oral administration of trehalose attenuated muscle weakness, reduced aggregate formation and decreased the number of TUNEL-labelled nuclei in skeletal muscle in an
OPMD
transgenic mouse model. Thus, anti-aggregation therapy may prove effective in the treatment of human
OPMD
.
...
PMID:Trehalose reduces aggregate formation and delays pathology in a transgenic mouse model of oculopharyngeal muscular dystrophy. 1631 Dec 54
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant muscle disorder, usually of late onset.
OPMD
is among the few triplet repeat diseases/ polyalanine (poly(A)) expansion diseases for which the function of the mutated gene is quite well established. The disease is characterised by slowly progressive bilateral
ptosis
, dysphagia and proximal limb weakness, appearing after the age of 40 years. Prevalence and incidence of
OPMD
are low, but the disease occurs all over the world. The pedigrees of two Swiss kindred have been previously reported in Switzerland. In the last 2 years, accumulation of newly diagnosed cases in North-West Switzerland have been observed, which suggests that
OPMD
may be more prevalent than previously thought. Primary care providers, opthalmologists and neurologists that are alert for the almost specific combination of clinical signs, together with the availability of reliable genetic testing may help to recognise currently undiagnosed patients. They can advance knowledge and the characterisation of the
OPMD
population in Switzerland. Since the number of disorders linked to poly(A) expansions is growing rapidly, the study of
OPMD
may contribute to the understanding of a large group of other developmental and degenerative diseases. On the basis of a patient with "classical"
OPMD
, this review summarises the clinical, therapeutic, epidemiological, pathomechanistic and genetic aspects of
OPMD
, provides practical information about the differential diagnosis of
OPMD
, and presents a survey of different investigational methods.
...
PMID:Oculopharyngeal muscular dystrophy - an under-diagnosed disorder? 1633 69
Oculopharyngeal muscular dystrophy
(
OPMD
) is a late-onset polyalanine disorder characterized clinically by progressive
ptosis
, dysphagia, and limb weakness and pathological hallmarked by unique intranuclear inclusions in the muscles. It is caused by heterozygous expansion of a 10-alanine stretch to 12-17 alanine residues in the N-terminus of the poly(A)-binding protein, nuclear 1 (PABPN1). Although PABPN1 is a major component of the inclusions in
OPMD
, the associated pathogenic mechanism is undetermined. No animal models of
OPMD
have been discovered in nature; therefore, we generated transgenic mice expressing human PABPN1 (hPABPN1) using a chicken beta-actin (CAG) promoter. While transgenic mice lines expressing normal hPABPN1 did not show myopathic changes, lines expressing high levels of expanded hPABPN1 with a 13-alanine stretch showed myopathy phenotype with aging. The latter mice disclosed intranuclear inclusions consisting of aggregated mutant hPABPN1 and scattered rimmed vacuoles restricted in the muscles. In particular, the nuclear inclusions closely resembled those of
OPMD
muscles on electron microscopy, and myopathic changes were more prominent in the eyelid and pharyngeal muscles. The results demonstrated that we had established the first transgenic
OPMD
model mouse. Recently, two other transgenic mice expressing mutated hPABPN1 with a 17-alanine stretch have been generated; however, the transgenic mouse using its natural promoter did not show myopathy phenotype, and the other using the human skeletal actin (HSA1) promoter disclosed quite different intranuclear inclusions from those of human
OPMD
muscles. Our transgenic
OPMD
model mouse appears to have more dramatic alterations in myofiber viability, but is useful for elucidating of molecular mechanisms and establishing therapeutic trials.
...
PMID:Animal model of oculopharyngeal muscular dystrophy. 1655 Sep 22
Oculopharyngeal muscular dystrophy
is a rare disease, presenting with bilateral
ptosis
and dysphagia, followed by slow progressive muscle weakness. The pathological hallmark of the disease is the presence of intranuclear inclusions in muscle cells. Inheritance is autosomal dominant in almost all cases. The mutation responsible is a short guanine-cytosine-guanine (GCG) expansion in the 'poly adenylate binding nuclear I protein' (PABN1) gene. This expansion is stable in subsequent generations and is translated into a polyalanine tract. The aberrant protein is found within the intranuclear inclusions and interferes with normal mRNA function.
...
PMID:[From gene to disease; the PABN1 gene and oculopharyngeal muscular dystrophy]. 1675 25
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