Growth Retardation Research Articles

Congenital cytomegalovirus infection: A narrative review

Cytomegalovirus (CMV) infection poses significant health risks, particularly for vulnerable populations including fetuses infected in utero, premature infants, and immunocompromised individuals. CMV infection is the most prevalent cause of congenital infection, affecting approximately 0.5% to 2% of all live births worldwide. Congenital transmission during pregnancy is a major concern, with a variety of fetal and neonatal outcomes ranging from asymptomatic infection to severe abnormalities, including sensorineural hearing loss, visual impairment, various neurological sequelae, growth retardation and potentially fatal consequences. Congenital transmission of CMV from mother to fetus can occur through primary infection, or reactivation of a previous infection. Diagnosis involves imaging techniques and invasive procedures to detect CMV DNA. Antiviral medications have limited data for use during pregnancy, while ganciclovir or valganciclovir demonstrates potential benefits in neonates with symptomatic disease. Routine antenatal screening is not yet recommended, but serological testing may be warranted in specific circumstances. Preventive measures focus on simple hygiene practices. Childbirth and breastfeeding present potential risks of CMV transmission, highlighting the importance of close monitoring and informed decision-making. This narrative review aims to provide a comprehensive summary of the epidemiology, transmission patterns, clinical manifestations, diagnostic approaches, treatment modalities, screening methods, preventive measures, and breastfeeding considerations related to CMV infection. This knowledge is essential for healthcare professionals to effectively manage CMV infection and improve outcomes for affected individuals and their families.

Congenital Gerbode Defect: A Left Ventricular to Right Atrial Shunt—State-of-the-Art Review of Its General Data, Diagnostic Modalities, and Treatment Strategies

The congenital Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium. This review aimed to summarize existing evidence, shed light on the clinical implications, and identify knowledge gaps. The systematic literature search was conducted in the PubMed and Google Scholar medical databases using specifically selected keywords. The inclusion of each publication was assessed according to predefined eligibility criteria based on the PICOM (Population, Phenomenon of Interest, Context, Methodology) schema. Titles and abstracts were screened independently by two authors. Available full-text versions of included publications were reviewed and relevant information was extracted. A total of 78 reports were included. The compilation of all congenital Gerbode defect cases described in the literature revealed a variety of clinical presentations comprising dyspnea, palpitations, growth retardation, and asymptomatology. A suitable multimodal diagnostic approach for newborns consists of auscultation, TTE, and optionally TEE and MRI. Because of its rarity, diversity of findings, unknown pathophysiology, and similarity to more common cardiac diseases, the diagnostic challenge remains significant. To prevent untreated long-term sequelae, early individualized treatment is recommended. Surgical defect closure is preferred to device closure for evidence reasons, although major developments are currently taking place. In conclusion, the congenital Gerbode defect provides a diagnostic challenge for pediatricians to allow early diagnosis and intervention in order to improve patients’ quality of life.

THE EFFECT OF CONSUMING FE TABLETS AND VITAMIN C COMBINATION TABLETS ON HB LEVELS IN PREGNANT WOMEN AT SHAQI CLINIC SEYEGAN IN 2023

Pregnancy with anemia increases the risk of morbidity and mortality because it causes postpartum hemorrhage. In addition, mothers with anemia can experience difficulty breathing, fainting, fatigue, increased heart rate, difficulty sleeping, perinatal infections, and pre eclampsia. It also has an impact on pregnancy outcomes, namely babies can experience Intra Uterine Growth Retardation (IUGR) and LBW. The study aims to determine the effect of consuming Fe tablets and Vitamin C combination tablets on Hb levels in pregnant women. This study employed Quasy experimental research with One Group pre-test and post-test design obtained directly from respondents through questionnaires that have been prepared by researchers and the data obtained by researchers are processed using the Wilcoxon test. The results of statistical tests using the Wilcoxon test showed a P value of 0.001 (<0.05), meaning that there was an effect before and after giving FE tablets combined with vitamin C on hemoglobin levels in pregnant women. The results showed that from a total of 15 respondents who experienced anemia before treatment decreased to 2 respondents who experienced anemia after treatment. The patients are suggested to follow the instructions given by health workers when doing ANC anywhere to be obedient in taking Fe tablets combined with vitamin C as prevention and treatment of anemia during pregnancy.

Clinical genomics expands the link between erroneous cell division, primary microcephaly and intellectual disability.

Primary microcephaly is a rare neurogenic and genetically heterogeneous disorder characterized by significant brain size reduction that results in numerous neurodevelopmental disorders (NDD) problems, including mild to severe intellectual disability (ID), global developmental delay (GDD), seizures and other congenital malformations. This disorder can arise from a mutation in genes involved in various biological pathways, including those within the brain. We characterized a recessive neurological disorder observed in nine young adults from five independent consanguineous Pakistani families. The disorder is characterized by microcephaly, ID, developmental delay (DD), early-onset epilepsy, recurrent infection, hearing loss, growth retardation, skeletal and limb defects. Through exome sequencing, we identified novel homozygous variants in five genes that were previously associated with brain diseases, namely CENPJ (NM_018451.5: c.1856A > G; p.Lys619Arg), STIL (NM_001048166.1: c.1235C > A; p.(Pro412Gln), CDK5RAP2 (NM_018249.6 c.3935T > G; p.Leu1312Trp), RBBP8 (NM_203291.2 c.1843C > T; p.Gln615*) andCEP135(NM_025009.5 c.1469A > G; p.Glu490Gly). These variants were validated by Sanger sequencing across all family members, and in silico structural analysis. Protein 3D homology modeling of wild-type and mutated proteins revealed substantial changes in the structure, suggesting a potential impact on function. Importantly, all identified genes play crucial roles in maintaining genomic integrity during cell division, with CENPJ, STIL, CDK5RAP2, and CEP135 being involved in centrosomal function. Collectively, our findings underscore the link between erroneous cell division, particularly centrosomal function, primary microcephaly and ID.

Clinical Features and Analysis in Pituitary Stalk Interruption Syndrome

Objective. Pituitary stalk interruption syndrome (PSIS) is characterized by the absence of pituitary stalk, pituitary hypoplasia, and ectopic posterior pituitary. Because the etiology and clinical cognition of PSIS remain elusive, we analyzed the clinical features of PSIS in Chinese patients. Methods. A retrospective analysis was conducted on the clinical presentation, laboratory data, imaging examination, and management of 24 PSIS inpatients from our center over 10 years. Results. Among the 24 PSIS patients, there were 22 males (91.7%) and 2 females (8.3%). Growth hormone deficiency was present in all 24 cases (100%), hypogonadism in 24 cases (100%), secondary adrenal insufficiency in 22 cases (91.2%), and hypothyroidism in 21 cases (87.5%). 20 cases (83.3%) of PSIS patients exhibited deficiencies in four anterior pituitary hormones, 3 cases (12.5%) exhibited deficiencies in three anterior pituitary hormones, and 1 case (4.2%) exhibited deficiencies in two anterior pituitary hormones, with none exhibiting deficiencies in posterior pituitary hormones. Among the 24 PSIS patients, 12 had a history of growth hormone therapy before admission, and 12 had no such history. Additionally, 19 cases (79.2%) with PSIS were complicated by dyslipidemia, 15 cases (62.5%) were complicated by nonalcoholic fatty liver disease, and 9 cases (37.5%) were complicated by hyperuricemia. Conclusions. PSIS often presents with growth retardation and hypogonadotropic hypogonadism, but in some cases, short stature is not exhibited. PSIS is prone to complications such as dyslipidemia, nonalcoholic fatty liver disease, and hyperuricemia, increasing the risk of cardiovascular and cerebrovascular diseases. In clinical practice, the diagnostic ability of PSIS should be improved, and pituitary function and complications should be evaluated in a timely manner to avoid delayed treatment.

Pectinose induces cell cycle arrest in luminal A and triple-negative breast cancer cells by promoting autophagy through activation of the p38 MAPK signaling pathway

Breast cancer patients often have a poor prognosis largely due to lack of effective targeted therapy. It is now well established that monosaccharide enhances growth retardation and chemotherapy sensitivity in tumor cells. However, Pectinose whether has capability to restrict the proliferation of tumor cells remain unclear. Here, we report that Pectinose induced cytotoxicity is modulated by autophagy and p38 MAPK signaling pathway in breast cancer cell lines. The proliferation of cells was dramatically inhibited by Pectinose exposure in a dose-dependent manner, which was relevant to cell cycle arrest, as demonstrated by G2/M cell cycle restriction and ectopic expression of Cyclin A, Cyclin B, p21and p27. Mechanistically, we further identified that Pectinose is positively associated with autophagy and the activation of the p38 MAPK signaling in breast cancer. In contrast, 3-Ma or SB203580, the inhibitor of autophagy or p38 MAPK, reversed the efficacy of Pectinose suppressing on breast cancer cell lines proliferation and cell cycle process. Additionally, Pectinose in vivo treatment could significantly inhibit xenograft growth of breast cancer cells. Taken together, our findings were the first to reveal that Pectinose triggered cell cycle arrest by inducing autophagy through the activation of p38 MAPK signaling pathway in breast cancer cells,especially in luminal A and triple-negative breast cancer.

A variant of uncertain significance of the HMGA2 gene in a child with Silver-Russell syndrome-like phenotype: a case report.

Silver-Russell syndrome 5 (SRS5) is characterized by asymmetric intrauterine growth restriction (IUGR), poor postnatal growth, macrocephaly at birth, and feeding difficulties. Other possible features include triangular shaped face, prominent forehead, hypertelorism, epicanthus, micrognathia, brachydactyly, clinodactyly of the 5th finger, and syndactyly of the 2nd and 3rd toes. Pathogenic variants of the HMGA2 (high mobility group AT-hook 2) gene, on chromosome 12q14, which regulates the transcription of growth factor IGF2, have recently been associated with this syndrome. Herein, we present a 2.5-year-old boy with growth delay, SRS-like phenotype, and a variant of uncertain significance in the HMGA2 gene, which has not, to the best of our knowledge, been described to date in the medical literature. So far, 28 pathogenic variants ofthe HMGA2 gene in patients with clinical SRS phenotype have recently been reported. Therefore, HMGA2 gene testing should alwaysbe done in SRS patients who are found to be negative for the typical 11p15 (epi)mutations and matUPD7, while the mutations should also be added to growth retardation disorder panels.

Challenges of Access to Treatments: The Case Of Laron Syndrome and the Fight For Social Inclusion

Objective: To identify and disseminate the challenges faced by patients with Laron syndrome in accessing Mecasermin treatment in Ecuador. Theoretical Framework: Laron syndrome is a rare genetic disease characterised by metabolic disorders such as hypoglycemia and severe growth retardation. Treatment with Mecasermin improves growth and thus quality of life for those affected. Ecuador has the largest Laron syndrome population in the world, extensively studied contributing to understanding the peculiarities and needs of these patients. Method: Official documents, letters, news articles from national and international press, and legal and medical databases were reviewed. Legal and medical advice was sought for this study. Results and Discussion: Over approximately ten years, a group of parents pursued national and international legal action to provide their children with the only scientifically validated treatment for this syndrome. However, authorities denied these requests without justification. It was only after the Inter-American Commission on Human Rights report the admissibility of this case that Ecuador began administering medication to children with Laron syndrome. Research Implications: Increase public awareness of this rare disease and barriers faced by those affected, fostering empathy, and understanding of patients' needs. Originality/Value: Identification of specific barriers to accessing treatment, while the quality of life of patients and their families is affected.

Biotransformation of Cynomorium flavan-3-ols in dairy sheep and their effects on inflammation and liver growth retardation.

The stems of Cynomorium songaricum are used in traditional Chinese medicine as a tonic and also used locally as a food material and livestock feed. It is known that some of the falvan-3-ol monomers and dimers that entered the milk of dairy sheep fed with C. songaricum stems are biotransformation products of the original flavan-3-ol polymers in C. songaricum stems. This study was performed to investigate the biotransformation process of the flavan-3-ols in dairy sheep and to evaluate the bioactivities. The results showed that procyanidin A2 and epicatechin could be released from the polymeric flavan-3-ols of C. songaricum through rumen microbial metabolism. On traumatic and lipopolysaccharide (LPS)-induced inflammation models of Tg (mpx: EGFP) zebrafish larvae and LPS-induced liver injury models of Tg (fabp10a: DsRed) zebrafish larvae, the milk from sheep fed with C. songaricum stems showed stronger anti-inflammatory and hepatoprotective activities compared to blank milk. The absorbed chemical constituents of C. songaricum stems and the metabolites also exhibited anti-inflammatory and hepatoprotective activities, with the dimeric flavan-3-ols being more effective than the monomers. The milk, the absorbed chemical constituents of C. songaricum stems, and the metabolites alleviated the increased level of reactive oxygen species induced by LPS in zebrafish larvae. PRACTICAL APPLICATION: This study found that C. songaricum stems as livestock feed could produce milk that has a beneficial impact on consumer and livestock health in terms of anti-inflammation and hepatoprotection.

HISTOSTRUCTURAL ALTERATIONS IN THE CEREBRAL ARCHITECTURE ASSOCIATED WITH THE PROGRESSION OF ALCOHOL INTOXICATION: AN EXPERIMENTAL ANALYSIS

The aim of this study is to evaluate the histological changes in the cerebellum of rat brains following chronic alcohol intoxication. Materials and Methods. We employed a classical approach for modeling chronic alcohol intoxication by administering 40% ethanol to rats (n=55) in a dosage of 2 ml per 100 g of body weight daily for three months. The cerebellar structure was then analyzed. Results. This study investigates the impact of chronic alcohol intoxication on the histological structures of the cerebellar cortex. The cerebellum, like the nervous system overall, possesses a significant cellular and functional reserve. However, teratogenic factors, including ethanol, notably influence the activity of cerebellar neurons, increasing it. Ethanol exposure during early pregnancy can lead to prenatal growth retardation, stillbirth, cleft palate, hydrocephaly, and reductions in fetal body size. There is evidence suggesting a correlation between blood ethanol levels and a reduction in the number of Purkinje cells. Chronic alcohol consumption results in cerebellar ataxia, alterations in upper limb movements, decreased reaction speeds, reduced attention concentration, impaired coordination accuracy, and disturbances in postural stability and balance. Conclusion. The cerebellum, especially during development, is particularly vulnerable to the toxic effects of alcohol. Recent research suggests that changes in the neurotransmission of gamma-aminobutyric acid (GABA)-dependent receptors may contribute to cerebellar dysfunction induced by ethanol. Ethanol exposure increases the release of GABA not only in Purkinje cells but also in the interneurons of the molecular layer and granule cells.

OP-004 Reversing the reversed: successful case of early-onset fetal growth retardation

OP-004 Reversing the reversed: successful case of early-onset fetal growth retardation

Prenatal diagnosis of Silver–Russell syndrome with 8q12 deletion including the PLAG1 gene: a case report and review

Silver–Russell syndrome (SRS) is a clinically and genetically heterogeneous disorder. A retrospective analysis predicted that the live birth prevalence of SRS in Estonia is 1:15,886 [Yakoreva et al., Eur J Hum Genet, 2019, 27(11), 1649–1658]. The most common causative genetic mechanism in the proband is loss of paternal methylation in the imprinted control region 1 (ICR1) at 11p15.5 chromosome. A few studies suggested that inherited or de novo loss-of-function alterations of the PLAG1 gene, including the whole-gene deletion and intragenic pathogenic variants, could cause a rare type of SRS. To date, less than 20 unrelated PLAG1-related SRS cases have been reported, and the clinical information about these cases is limited. We report the first prenatal case of SRS with 8q12 deletion (including the PLAG1 gene). The fetus presented with intrauterine growth retardation, small for gestational age, relative macrocephaly at birth, and a protruding forehead. Unlike classical SRS cases, the fetus had micrognathia and did not show body asymmetry. We hope that the literature review in this study provides new insights into genotype–phenotype relationships of PLAG1-related SRS.

MULTIFOCAL ATRIAL TACHYCARDIA AND HYPERTROPHIC CARDIOMYOPATHY IN THREE PATIENTS WITH COSTELLO SYNDROME

Abstract Introduction Costello syndrome is a rare disease, caused by mutation of the HRAS gene, associated with intellectual disability, growth retardation, facial dimorphisms. Cardiac abnormalities, mainly cardiac hypertrophy and multifocal atrial tachycardia, are present in 1/3 of patients. Clinical Cases From 2019 to 2023, 3 newborns with Costello syndrome came under our observation. M.M. showed respiratory distress, hypotonia and dysmorphic notes; genetic analysis highlighted the pathogenic variant c.64C>A (p.Gln22Lys). On the echocardiogram, septal hypertrophic cardiomyopathy was found with left outflow obstruction and mitral insufficiency. Therapy with propranolol was undertaken. Holter ECG never revealed arrhythmias. At the last check–up, SIV hypertrophy, continent mitral valve, free left ventricular outflow. The second patient, O.L., arrived at 10 days of age following a run of supraventricular tachycardia. He had bilateral clubfoot and facial dimorphisms. The echocardiogram was normal. On Holter ECG atrial tachycardia interrupted by rare sinus beats. Therapy with flecainide was undertaken, without benefit. Subsequently, was undertaken amiodarone, then associated with digitalis. She was discharged with satisfactory control of the average ventricular rate, but later due to the appearance of chaotic atrial arrhythmia, propranolol was added; on the Holter ECG in triple therapy, periods of sinus rhythm alternating with short episodes of atrial tachycardia were observed. Genetic analysis revealed the pathogenic variant c.34G>A, p.(Gly12Ser) of the HRAS gene. The third patient, F.A., presented atrial tachycardia. Flecainide therapy had transient benefit. Subsequently propranolol was added, without benefit. Therapy with amiodarone was initiated. Transesophageal electrophysiological study demonstrated multifocal atrial tachycardia, unresponsive to overdrive pacing. Partial control of the average ventricular rate was achieved in triple therapy. On the echocardiogram, mild concentric hypertrophy and dysplastic pulmonary valve. Genetic testing detected the c.35G>C, p(Gly12Ala) variant of the HRAS gene. Conclusions Costello syndrome requires cardiac monitoring for the possible presence of multifocal atrial tachycardia and hypertrophic cardiomyopathy. Arrhythmia, which can also occur independently of hypertrophy, can be self–limited in the first months of life with aggressive pharmacological treatment but can persist or worsen in ¼ of patients.

D-arabinose induces cell cycle arrest by promoting autophagy via p38 MAPK signaling pathway in breast cancer

Breast cancer patients often have a poor prognosis largely due to lack of effective targeted therapy. It is now well established that monosaccharide enhances growth retardation and chemotherapy sensitivity in tumor cells. We investigated whether d-arabinose has capability to restrict the proliferation of tumor cells and its mechanism. Here, we report that d-arabinose induced cytotoxicity is modulated by autophagy and p38 MAPK signaling pathway in breast cancer cell lines. The proliferation of cells was evaluated by CCK-8 and Colony formation assay. The distribution of cells in cell cycle phases was analyzed by flow cytometry. Cell cycle, autophagy and MAPK signaling related proteins were detected by western blotting. Mouse xenograft model was used to evaluate the efficacy of d-arabinose in vivo. The proliferation of cells was dramatically inhibited by d-arabinose exposure in a dose-dependent manner, which was relevant to cell cycle arrest, as demonstrated by G2/M cell cycle restriction and ectopic expression of cell cycle related proteins. Mechanistically, we further identified that d-arabinose is positively associated with autophagy and the activation of the p38 MAPK signaling in breast cancer. In contrast, 3-Ma or SB203580, the inhibitor of autophagy or p38 MAPK, reversed the efficacy of d-arabinose. Additionally, d-arabinose in vivo treatment could significantly inhibit xenograft growth of breast cancer cells. Our findings were the first to reveal that d-arabinose triggered cell cycle arrest by inducing autophagy through the activation of p38 MAPK signaling pathway in breast cancer cells.

DETERMINATION OF THE SENSITIVITY OF DERMATOMYCOSIS CAUSES TO FUNGICIDES

A microbiological study of the affected areas of the skin of dogs and cats was carried out for the detection of microscopic fungi. The following microscopic fungi were isolated from the pathological material: Candida spp., Aspergillus brasiliensis, Epidermophyton spp., Microsporum spp., Mucor spp., Trichophyton spp., Mallasseria spp., Sporotrich spp. Isolated microscopic fungi of the genus Malassezia spp. belong to the superficial mycoses (keratomycoses) and affect the surface layers of the skin and fur. Epidermatophytes: Trichophyton spp., Epidermophyton spp., Microsporum spp. affect the epidermis, skin, and coat. In addition, opportunistic fungi of the genus Aspergillus brasiliensis were found in the studied samples. It was established that the sensitivity of fungi isolated from the affected areas of the skin of dogs and cats to a 1% solution of ketonazole and clotrimazole is different. In particular, a 1% solution of ketonazole showed significantly higher activity compared to a 1% solution of clotrimazole. Thus, when determining the fungicidal effect of ketonazole, the growth retardation zone of the dermatophyte Trichophyton spp. was 34.3±0.6 mm, and the 1% clotrimazole solution was 21.3±0.3 mm. Ketonazol also showed higher fungicidal activity against the microscopic fungi Aspergillus brasiliensis and Candida spp., compared to clotrimazole. Thus, the activity of ketonazole was, respectively, 55.7 and 48.4% higher compared to clotrimazole. Clotrimazole showed the lowest fungicidal effect on Aspergillus brasiliensis, Mallasseria spp., Mucor spp., and Epidermophyton spp., the growth retardation zones of microscopic fungi were, respectively, 14.3±0.3, 14.3±0.6, 14.6± 0.6 and 16.6±0.3 mm.

Mutation delTTCT 1471 de l’intolérance aux protéines dibasiques : Caractéristiques cliniques d’une série pédiatrique tunisienne.

Lysinuric protein intolerance (LPI) is a rare inherited metabolic disease. It is caused by a deficiency in cationic amino acid transport caused by mutations in SLC7A7 gene. To identify the clinical, diagnostic and therapeutic features of lysnuric protein intolerance. This was a retrospective study conducted in the pediatric department of La Rabta Hospital over a period of 30 years (1992 to 2022). We included patients with clinical signs suggestive of lysinuric protein intolerance and orotic acid in the urine. We enrolled seven patients. The median age at disease onset was nine months. The median age at positive diagnosis was 21 months. Growth retardation, hepatosplenomegaly and haematological abnormalities were the main features of the disease. Hyperammonia and increased urinary orotic acid were present in all patients. Molecular biology revealed the del TTCT 1471 mutation in five patients. All patients were prescribed a low protein diet and citrulline supplementation. Complications of the disease were growth retardation (n=7), psychomotor or intellectual retardation (n=5), haemophagocytic lymphohistiocytosis (n=4) and osteoporosis (n=3). After a median follow-up of 11 years, six of our patients are still alive. One patient died from acute hyperammonemic encephalopathy. In this paediatric series, delays in diagnosis and treatment of LPI were responsible for long-term sequelae, particularly bone and neurological. The delTTCT1471 mutation appears to be the mutation of paediatric-onset forms in Tunisia. This mutation was not associated with pulmonary involvement, which is a prognostic factor and the main cause of death.

Renal Lymphangiectasia: A Diagnostic and Therapeutic Challenge

Renal lymphangiectasia, a rare lymphatic disorder, manifests as cystic infiltration in the perirenal and para-pyelic space due to lymphatic drainage defects. Diagnosis hinges on imaging modalities like ultrasound, CT, and MRI. However, lack of awareness can lead to confusion with other renal cystic pathologies. Here, we present a case of renal lymphangiectasia in a child, detailing diagnostic and therapeutic strategies. The patient, a 2-year-old and 2-month-old girl from a consanguineous marriage, presented with persistent abdominal distension. Clinical examination revealed growth retardation and normal blood pressure but abdominal distension with dullness. Lab investigations indicated acute renal failure with non-nephrotic proteinuria. Radiologically, renal lymphangiectasia was confirmed by ultrasound showing microcysts and perirenal cystic lesions with ascites, corroborated by MRI and CT scans. Treatment involved nephroprotective therapy and diuretics for ascites. Surgical intervention was necessitated due to cyst size and compressive nature, involving iterative punctures, marsupialization, and percutaneous drainage. Postoperatively, recurrent ascites temporarily worsened renal function but returned to baseline afterward. renal lymphangiectasia necessitates careful management due to its potential to progress to chronic renal failure. The prognosis depends on factors like initial proteinuria severity, treatment response, and complication management. Personalized approaches are pivotal in its diagnosis and management.

A novel NTRK1 splice site variant causing congenital insensitivity to pain with anhidrosis in a Chinese family.

Congenital insensitivity to pain with anhidrosis (CIPA, OMIM #256800), also known as hereditary sensory and autonomic neuropathy type Ⅳ (HSAN-IV), is a rare autosomal recessive disorder characterized by recurrent episodic fevers, anhidrosis, insensitivity to noxious stimuli, self-mutilating behavior and intellectual disability. CIPA can be caused by the variants in NTRK1 gene, which encodes a high-affinity tyrosine kinase receptor for nerve growth factor. To ascertain the hereditary cause of a patient with CIPA accompanied by the additional symptoms of mild growth retardation, prone to fracture, underdeveloped nails of fingers and toes, irregular tooth alignment, enamel hypoplasia, postoperative wound healing difficulty, hand and limb deformity, and dislocation of hip joint, whole exome sequencing was used and revealed a compound heterozygous variant in NTRK1. DNA was extracted from peripheral blood samples of pediatric patients and their parents, and subjected to comprehensive analysis using whole-exome sequencing (WES), followed by verification of variant sites in the NTRK1 gene through Sanger sequencing. To elucidate the functional impact of the newly discovered variants, an in vitro experimental system was established. Splicing analysis was conducted using PCR and Sanger sequencing, while expression levels were assessed through qPCR and Western blot techniques. One hotspot variant c.851-33T>A(ClinVar ID: 21308) and a novel variant c.850 + 5G>A(ClinVar ID:3069176) was inherited from her father and mother, respectively, identified in the affected individuals. The c.850 + 5G>A variant in NTRK1 resulted in two forms of aberrant mRNA splicing: 13bp deletion (c.838_850del13, p. Val280Ser fs180) and 25bp deletion (826_850del25, p. Val276Ser fs180) in exon 7, both leading to a translational termination at a premature stop codon and forming a C-terminal truncated protein. The expression of two abnormal splicing isoforms was decreased both in the level of mRNA and protein. In conclusion, this study elucidated the genetic cause of a patient with CIPA and identified a novel variant c.850 + 5G>A in NTRK1, which broadened the and enriched the NTRK1 mutation spectrum.

Analysis of ADAR gene variants in a Chinese pedigree affected with Dyschromatosis symmetrica hereditaria in conjunct with developmental delay

To explore the clinical characteristics and genetic etiology for a Chinese pedigree affected with Dyschromatosis symmetrica hereditaria (DSH) in conjunct with developmental delay. A child who had presented at the First Affiliated Hospital of Zhengzhou University on May 28 2021 for abnormal skin pigmentation of the extremities and growth retardation for over 2 years was selected as the study subject. Clinical data of the child and his pedigree (11 individuals from three generations) was collected. The child was subjected to whole exome sequencing, and candidate variant was verified by Sanger sequencing. The child, a two-year-and-seven-month-old male, had hyper- and hypopigmentation on his hands, feet and face, in addition with delayed development. All members of his pedigree had typical presentation of DSH. A heterozygous c.2657G>A variant was found in exon 8 of the ADAR gene in the child, his mother, and elder sister. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted as likely pathogenic (PM1+PM2_Supporting+PP1+PP3). The c.2657G>A variant of the ADAR gene probably underlay the DSH in this pedigree.

Feeding Eucommia ulmoides extract enhances protection against high-temperature stress in chicks

Chick's susceptibility to heat stress often leads to growth retardation, immune function impairment, disease, and mortality. This thesis explores the potential ameliorative effect of 0.8% Eucommia ulmoides extract (EUE) into the diet of heat-stressed chicks in a 15-d feeding trial. The investigation reveals that feeding EUE significantly enhances the BW, ADG, AFI, and F/G of chicks experiencing heat stress. Additionally, the EUE groups exhibited higher levels of T-AOC (at 7 and 15d), SOD (at 15 d), GSH-Px (at 15 d), as well as lower MDA concentrations (at 7 and 15d) in chick serum. Pathological changes and H&E staining revealed that EUE effectively improved tissue damage in the duodenum, heart, and stomach induced by heat stress in the chicks. The EUE groups also showed higher levels of IgA (at 7 d), IgG and IgM (at 7 and 15 d). RNA-seq and WGCNA analysis revealed that EUE mitigates cellular damage and losses in heat-stressed chicks primarily through pathways involving signal transduction, protein synthesis and degradation, as well as cell cycle regulation, particularly the latter. This investigation serves as a fundamental and cognitive framework for the development and application of Eucommia ulmoides feed additives aimed at safeguarding the well-being of chicks in adverse environmental conditions.