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Oculopharyngeal muscular dystrophy
(
OPMD
) is a late-onset muscle disorder characterized by progressive dysphagia and bilateral
ptosis
. Mutations in the polyadenylate binding protein nuclear 1 (PABPN1) gene have been found to cause
OPMD
. The typical mutation is a stable trinucleotide repeat expansion in the first exon of the PABPN1 gene, in which (GCG)(6) is the normal repeat length. We investigated a Korean patient with
OPMD
and identified a novel mutation: a heterozygous insertion of a 9-bp sequence [(GCG)(GCA)(GCA); c.27_28insGCGGCAGCA] instead of the (GCG) repeat expansion, resulting in an in-frame insertion of three alanines (p.A10insAAA). To the best of our knowledge, this is the first report of a genetically confirmed case of
OPMD
in Korea.
...
PMID:Identification of a novel mutation in a Korean patient with oculopharyngeal muscular dystrophy. 1713 75
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant disease that usually manifests itself within the fifth decade. The most prominent symptoms are progressive
ptosis
, dysphagia, and proximal limb muscle weakness. The disorder is caused by trinucleotide (GCG) expansions in the N-terminal part of the poly(A)-binding protein 1 (PABPN1) that result in the extension of a 10-alanine segment by up to seven more alanines. In patients, biopsy material displays intranuclear inclusions consisting primarily of PABPN1. Poly l-alanine-dependent fibril formation was studied using the recombinant N-terminal domain of PABPN1. In the case of the protein fragment with the expanded poly l-alanine sequence [N-(+7)Ala], fibril formation could be induced by low amounts of fragmented fibrils serving as seeds. Besides homologous seeds, seeds derived from fibrils of the wild-type fragment (N-WT) also accelerated fibril formation of N-(+7)Ala in a concentration-dependent manner. Seed-induced fibrillation of N-WT was considerably slower than that of N-(+7)Ala. Using atomic force microscopy, differences in fibril morphologies between N-WT and N-(+7)Ala were detected. Furthermore, fibrils of N-WT showed a lower resistance against solubilization with the chaotropic agent guanidinium thiocyanate than those from N-(+7)Ala. Our data clearly reveal biophysical differences between fibrils of the two variants that are likely caused by divergent fibril structures.
...
PMID:Effect of oculopharyngeal muscular dystrophy-associated extension of seven alanines on the fibrillation properties of the N-terminal domain of PABPN1. 1722 42
Muscular dystrophies are commonly considered hereditary progressive degenerative diseases that affect skeletal and cardiac muscles.
Oculopharyngeal muscular dystrophy
is a rare hereditary disorder of later onset consisting of progressive dysphagia and bilateral blepharoptosis unlike the peripheral muscular weakness common to other muscular dystrophies. The symptoms of progressive dysphagia, with bilateral
ptosis
, usually occur after the age of 40 years. The authors present a patient with oculopharyngeal muscular dystrophy and chronic facial pain relieved by midface soft tissue support, namely, the reconstructive rhytidectomy.
...
PMID:Reconstructive rhytidectomy? 1723 67
Oculopharyngeal muscular dystrophy
(
OPMD
) is a late onset myopathy usually presenting in the 5th or 6th decade of life with progressive
ptosis
, dysphagia and proximal muscle weakness. It is usually dominantly inherited; however, a rare recessive form has also been described although documentation of such cases in the literature is very sparse. Here we report two siblings with recessive
OPMD
, in one of whom the clinical picture is complicated by ankylosing spondilitis and pneumonia. They exhibit later onset and milder symptoms than is typical for patients with dominantly inherited
OPMD
. This and the possibility that
OPMD
may be masked by symptoms of other diseases of the elderly may account for the paucity of cases of recessive
OPMD
reported in the literature.
...
PMID:Siblings with recessive oculopharyngeal muscular dystrophy. 1729 97
Oculopharyngeal muscular dystrophy
(
OPMD
) is typically inherited in an autosomal dominant fashion and is characterized by late onset proximal muscle weakness,
ptosis
and difficulty swallowing. It is caused by expansion mutations in the PABPN1 gene on chromosome 14q11. There is also a rare recessive form of the disease caused by homozygosity of a very small expansion mutation in the same gene. Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant disorder characterized by recurrent peripheral monofocal neuropathies. In this report a patient with both recessive
OPMD
and HNPP is described. The presence of two genetically unlinked neurological diagnoses in the same individual is a rare event and may have delayed the diagnoses.
...
PMID:A case of rare recessive oculopharyngeal muscular dystrophy (OPMD) coexisting with hereditary neuropathy with liability to pressure palsies (HNPP). 1835 98
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant form of late-onset muscular dystrophy.
Ptosis
(droopy eyelids) and dysphagia (difficulty swallowing) are the most common presenting symptoms. The purpose of this phenomenological study was to describe the experience of living with
OPMD
. Purposeful sampling was used to recruit individuals with genetically confirmed
OPMD
who displayed
ptosis
and dysphagia, were 40 years or older, English speaking, and were willing to consent to the tape-recording of the interviews. An unstructured interview format was used to solicit the participants' perspectives of living with droopy eyelids, difficulty swallowing, and a genetic disorder. The interviews were audiotaped and transcribed verbatim. Colaizzi's Method was used to analyze the data, which identified five comprehensive themes. The themes that emerged describing the experience of living with
OPMD
were "Adjusting to Change", "Managing Misconceptions", "Seeking Normality", "Facing the Future", and "Informing Children". The information derived from this study will assist nurses to identify the burdens of living with
OPMD
and to intervene appropriately early in the course of the disease.
...
PMID:Living with oculopharyngeal muscular dystrophy: a phenomenological study. 1843 80
Oculopharyngeal muscular dystrophy
(
OPMD
) is an adult-onset disorder characterized by
ptosis
, dysphagia and proximal limb weakness. Autosomal-dominant
OPMD
is caused by a short (GCG)(8-13) expansions within the first exon of the poly(A)-binding protein nuclear 1 gene (PABPN1), leading to an expanded polyalanine tract in the mutated protein. Expanded PABPN1 forms insoluble aggregates in the nuclei of skeletal muscle fibres. In order to gain insight into the different physiological processes affected in
OPMD
muscles, we have used a transgenic mouse model of
OPMD
(A17.1) and performed transcriptomic studies combined with a detailed phenotypic characterization of this model at three time points. The transcriptomic analysis revealed a massive gene deregulation in the A17.1 mice, among which we identified a significant deregulation of pathways associated with muscle atrophy. Using a mathematical model for progression, we have identified that one-third of the progressive genes were also associated with muscle atrophy. Functional and histological analysis of the skeletal muscle of this mouse model confirmed a severe and progressive muscular atrophy associated with a reduction in muscle strength. Moreover, muscle atrophy in the A17.1 mice was restricted to fast glycolytic fibres, containing a large number of intranuclear inclusions (INIs). The soleus muscle and, in particular, oxidative fibres were spared, even though they contained INIs albeit to a lesser degree. These results demonstrate a fibre-type specificity of muscle atrophy in this
OPMD
model. This study improves our understanding of the biological pathways modified in
OPMD
to identify potential biomarkers and new therapeutic targets.
...
PMID:Molecular and phenotypic characterization of a mouse model of oculopharyngeal muscular dystrophy reveals severe muscular atrophy restricted to fast glycolytic fibres. 2020 26
Oculopharyngeal muscular dystrophy
(
OPMD
) is a progressive skeletal muscle dystrophy characterized by
ptosis
, dysphagia, and upper and lower extremity weakness. We examined eight genetically confirmed
OPMD
patients to detect a MRI pattern and correlate muscle involvement, with validated clinical evaluation methods. Physical assessment was performed using the Motor Function Measurement (MFM) scale. We imaged the lower extremities on a 1.5 T scanner. Fatty replacement was graded on a 4-point visual scale. We found prominent affection of the adductor and hamstring muscles in the thigh, and soleus and gastrocnemius muscles in the lower leg. The MFM assessment showed relative mild clinical impairment, mostly affecting standing and transfers, while distal motor capacity was hardly affected. We observed a high (negative) correlation between the validated clinical scores and our visual imaging scores suggesting that quantitative and more objective muscle MRI might serve as outcome measure for clinical trials in muscular dystrophies.
...
PMID:Muscular involvement assessed by MRI correlates to motor function measurement values in oculopharyngeal muscular dystrophy. 2134 May 22
Oculopharyngeal muscular dystrophy
(
OPMD
) is an autosomal dominant myopathic disease which provokes oropharyngeal dysphagia, palpabral
ptosis
and proximal limb weakness. It is the abnormal expression of the GCG triplet in the PABPN1 gene on chromosome 14 that causes this disease. The study of the oropharyngeal dysphagia that these patients suffer from should include upper gastrointestinal endoscopy, barium video-radiology and oesophageal manometry. Genetic study confirms the diagnosis. We report 6 patients (3 of whom were siblings) referred to our department with a confirmed diagnosis of
OPMD
, who underwent cricopharyngeal myotomy to achieve normal swallowing.
...
PMID:Cricopharyngeal myotomy in the treatment of oculopharyngeal muscular dystrophy. 2289 42
Oculopharyngeal muscular dystrophy
(
OPMD
) is a late-onset autosomal dominant inherited dystrophy caused by an abnormal trinucleotide repeat expansion in the poly(A)-binding-protein-nuclear 1 (PABPN1) gene. Primary muscular targets of
OPMD
are the eyelid elevator and pharyngeal muscles, including the cricopharyngeal muscle (CPM), the progressive involution of which leads to
ptosis
and dysphagia, respectively. To understand the consequences of PABPN1 polyalanine expansion in
OPMD
, we studied muscle biopsies from 14
OPMD
patients, 3 inclusion body myositis patients, and 9 healthy controls. In
OPMD
patient CPM (n = 6), there were typical dystrophic features with extensive endomysial fibrosis and marked atrophy of myosin heavy-chain IIa fibers. There were more PAX7-positive cells in all CPM versus other muscles (n = 5, control; n = 3, inclusion body myositis), and they were more numerous in
OPMD
CPM versus control normal CPM without any sign of muscle regeneration. Intranuclear inclusions were present in all
OPMD
muscles but unaffected
OPMD
patient muscles (i.e. sternocleidomastoid, quadriceps, or deltoid; n = 14) did not show evidence of fibrosis, atrophy, or increased PAX7-positive cell numbers. These results suggest that the specific involvement of CPM in
OPMD
might be caused by failure of the regenerative response with dysfunction of PAX7-positive cells and exacerbated fibrosis that does not correlate with the presence of PABPN1 inclusions.
...
PMID:Atrophy, fibrosis, and increased PAX7-positive cells in pharyngeal muscles of oculopharyngeal muscular dystrophy patients. 2339 99
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