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Neurological manifestations of Fabry disease
Reková, Petra ; Kemlink, David (advisor) ; Karetová, Debora (referee) ; Kešnerová, Petra (referee)
Neurological manifestations of Fabry disease Abstract The presented thesis deals with cerebrovascular manifestations of a rare X-linked disease, Fabry disease (FD). Screening programs can detect unrecognized disease and increase awareness of the disease with the goal of early diagnosis and initiation of therapy before developing an irreversible organ damage. Identifying vascular abnormalities and the influence of comorbidities on the cerebrovascular phenotype of FD patients may help to promote the knowledge of the pathophysiology of cerebrovascular involvement. The main objectives of the studies underlying this thesis were to determine the prevalence of FD and to evaluate the relevance of FD diagnosis in an at-risk group of patients with acute ischemic stroke, to analyse the cerebrovascular phenotype of patients with FD using ultrasound, and to identify predictors of significant cerebrovascular involvement. In this thesis we showed a relatively high prevalence of FD in adult patients with acute stroke, proposed to reclassify the G325S variant, and identified a novel R30K variant. We noted that the combination of aseptic meningitis with lacunar stroke in a young person should lead to suspicion of FD. We further demonstrated multiple differences in neurosonological parameters between patients with FD and a...
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Role of Next Generation Sequencing in Diagnostics and Prognosis of X-linked Lysosomal Storage Disorders
Řeboun, Martin ; Dvořáková, Lenka (advisor) ; Fajkusová, Lenka (referee) ; Krejčí, Jan (referee)
The characterisation of the molecular-genetic etiology of monogenic diseases includes not only the identification of the pathogenic variant, but also the description of its effect on the RNA structure and stability. Additionally, the X-inactivation plays an important role in X-linked diseases. In the presented thesis, we applied the methods of next generation sequencing to study three lysosomal disorders (mukopolysacharidosis type II, MPS II; Danon disease, DD; Fabry disease, FD). Two methodological approaches have been used: 1) panel sequencing with hybridization probes for identification of single nucleotide variants, small deletions/duplications and structure variants (CNVs) 2) amplicon sequencing for analysis of somatic mosaicism and allele specific expression. The panel sequencing enabled us to confirm the molecular-genetic basis of DD in two patients with the identification of two exons duplication and five exons deletion in LAMP2, respectively. The somatic mosaicism was being analyzed by the amplicon sequencing in families with DD, MPS II. We could identify the first case of somatic mosaicism in a patient with DD. The allele specific expression has enlarged the group of methods used in X-inactivation analysis. Its impact has been proved particularly in minimizing misinterpretation of XCI...
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Pathobiochemistry of lysosomal storage disorders: Study of Fabry disease and generation of cellular models of X-linked disorders.
Rybová, Jitka
Human autopsy or biopsy tissue samples, mouse models and cell cultures of various types represent the most common materials in the investigation of cell pathogenesis of inherited diseases. This dissertation is devoted to all these approaches in the study of two X-linked lysosomal storage diseases, Fabry disease (FD,α-galactosidase A (AGAL) deficiency) and mucopolysaccharidosis type II (MPSII, idunorate-2- sulfatase (IDS) deficiency). The primary goal of the work was analysis of lipid blood group B antigens with terminal α-galactose (B-GSL) in the pancreas of FD patients with blood group B (FD-B).,In addition to the main glycosphingolipid (GSL) substrate, globotriaosylceramide (Gb3Cer), B-GSLs represent another minor substrate of AGAL. The deposition of undegraded B-GSL has been demonstrated in FD-B pancreas where it was significantly higher than in other organs such as the kidneys and lungs which accumulate mainly Gb3Cer. High concentration of lipid and non-lipid B-antigens was primarily confirmed in exocrine acinar epithelial cells of FD-B, accompanied by massive accumulation of ceroid (secondary sign of lysosomal storage). Unlike acini, the endocrine portion of the pancreas remained unaffected by accumulation of AGAL substrates. This interesting phenomenon of cell biology shows how a specific...
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Pathobiochemistry of lysosomal storage disorders: Study of Fabry disease and generation of cellular models of X-linked disorders.
Rybová, Jitka
Human autopsy or biopsy tissue samples, mouse models and cell cultures of various types represent the most common materials in the investigation of cell pathogenesis of inherited diseases. This dissertation is devoted to all these approaches in the study of two X-linked lysosomal storage diseases, Fabry disease (FD,α-galactosidase A (AGAL) deficiency) and mucopolysaccharidosis type II (MPSII, idunorate-2- sulfatase (IDS) deficiency). The primary goal of the work was analysis of lipid blood group B antigens with terminal α-galactose (B-GSL) in the pancreas of FD patients with blood group B (FD-B).,In addition to the main glycosphingolipid (GSL) substrate, globotriaosylceramide (Gb3Cer), B-GSLs represent another minor substrate of AGAL. The deposition of undegraded B-GSL has been demonstrated in FD-B pancreas where it was significantly higher than in other organs such as the kidneys and lungs which accumulate mainly Gb3Cer. High concentration of lipid and non-lipid B-antigens was primarily confirmed in exocrine acinar epithelial cells of FD-B, accompanied by massive accumulation of ceroid (secondary sign of lysosomal storage). Unlike acini, the endocrine portion of the pancreas remained unaffected by accumulation of AGAL substrates. This interesting phenomenon of cell biology shows how a specific...
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Gene expression of mutant alleles and X inactivation pattern in patients with selected X-linked disorders
Černá, Alena ; Dvořáková, Lenka (advisor) ; Sedláček, Zdeněk (referee)
In comparison to men, the number of X-linked genes is doubled in women as they have two chromosomes X while men are hemizygotes for X-linked genes. This imbalance is compensated by X inactivation (XCI) process, also known as primary X-inactivation, occurring in the early stage of embryogenesis. X inactivation is a random process and females are mosaics of two cell populations. The ratio of expressed alleles in women can be random (50:50) or skewed (≥80:20). The skewed X inactivation may occur due to selection when one of the alleles is preferentially inactivated (secondary X inactivation). In this study XCI status in heterozygous females with various severity of phenotypic symptoms and traits in selected X linked inherited metabolic diseases is analysed, with the focus being Fabry disease - the deficiency of the enzyme alpha-galactosidase A encoded by GLA gene. Moreover, XCI in one family with X linked agammaglobulinemia is examined. Mutant alleles and XCI status based on various loci, different methodical approaches and different tissues is subjected to examination. For the first time, the direct analysis of GLA gene transcript to detect the allele ratio was used alongside with the single-nucleotide polymorphisms in the IDS and LAMP genes for allele-specific expression (ASE) and the AR, RP2 and...
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Pathobiochemistry of lysosomal storage disorders: Study of Fabry disease and generation of cellular models of X-linked disorders.
Rybová, Jitka ; Ledvinová, Jana (advisor) ; Entlicher, Gustav (referee) ; Živný, Jan (referee)
Human autopsy or biopsy tissue samples, mouse models and cell cultures of various types represent the most common materials in the investigation of cell pathogenesis of inherited diseases. This dissertation is devoted to all these approaches in the study of two X-linked lysosomal storage diseases, Fabry disease (FD,α-galactosidase A (AGAL) deficiency) and mucopolysaccharidosis type II (MPSII, idunorate-2- sulfatase (IDS) deficiency). The primary goal of the work was analysis of lipid blood group B antigens with terminal α-galactose (B-GSL) in the pancreas of FD patients with blood group B (FD-B).,In addition to the main glycosphingolipid (GSL) substrate, globotriaosylceramide (Gb3Cer), B-GSLs represent another minor substrate of AGAL. The deposition of undegraded B-GSL has been demonstrated in FD-B pancreas where it was significantly higher than in other organs such as the kidneys and lungs which accumulate mainly Gb3Cer. High concentration of lipid and non-lipid B-antigens was primarily confirmed in exocrine acinar epithelial cells of FD-B, accompanied by massive accumulation of ceroid (secondary sign of lysosomal storage). Unlike acini, the endocrine portion of the pancreas remained unaffected by accumulation of AGAL substrates. This interesting phenomenon of cell biology shows how a specific...
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Molecular basis of phenotypic variability in male and female patients with Fabry disease
Rieger, Vojtěch ; Dvořáková, Lenka (advisor) ; Rothová, Olga (referee)
Fabry disease is an X linked illness caused by mutation in the GLA gene which codes lysosomal enzyme α-galactosidase A. The defect of this enzyme leads to progressive storage of neutral glycosphigolipids in the lysosomes which has significant physiological implications. Fabry disease has very variable clinical manifestations because of the combination of many factors, yet not all of them are known. Even though heterozygotic women carry also a wild type allel, they are not asymptomatic. Their symptoms, however, are usually in a milder form. Due the random inactivation of one of the X gonosomes, there is a posibility of skewed X inactivation pattern, which may inflict an increase of symptoms on the disordered woman. Many studies concerning X inactivation have been published, however their conclusions were contradictory. The purpose of this work is to summarise the causes of fenotypic variability in hemizygotes and heterozygotes with skewed X inactivation.
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