PubMed HealthSearch

Biomedical subjects

C J Witkop

Publications and source records attributed to C J Witkop.

At least 19 recordsLinked to original sources

Quantification of a novel dense granule protein (granulophysin) in platelets of patients with dense granule storage pool deficiency.

An antigen-capture sandwich enzyme-linked immunosorbent assay (ELISA) was developed for a novel protein granulophysin, a constituent of the platelet dense granule (DG) membrane and used to characterize patients with dense granule storage pool deficiency (delta-SPD). The assay uses two monoclonal antibodies against the protein, one of which is conjugated to peroxidase. Purified DGs, an enriched source of the protein, were used for the standard curve. Granulophysin levels were only low in forms of delta-SPD associated with albinism. Granulophysin levels in platelet homogenates of 30 patients with the Hermansky-Pudlak syndrome form of delta-SPD were 1/4 to 1/5 of levels in controls or obligate heterozygotes. Two patients with the Chediak-Higashi form of delta-SPD syndrome also had markedly reduced levels of granulophysin. Patients with other forms of delta-SPD had normal levels of granulophysin. Two sisters with delta-SPD in one family had normal granulophysin present in empty dense granule membrane vesicles. Three members of another family with delta-SPD had low DG counts but normal granulophysin levels, indicating that in this group the level of granulophysin was maintained despite the reduction in granule formation. Thus, granulophysin quantitation facilitates characterization of delta-SPD patients and may provide clues to the nature of defective granules in delta-SPD subtypes.

Adult

A single base insertion in the putative transmembrane domain of the tyrosinase gene as a cause for tyrosinase-negative oculocutaneous albinism.

We have determined a molecular defect to be the likely basis for inactivity of the tyrosinase (EC 1.14.18.1) from a patient with tyrosinase-negative oculocutaneous albinism. A single base (thymine) was inserted in exon 5 of the tyrosinase gene following codon 471 in the putative transmembrane coding region. This insertion caused a shift in the reading frame of 19 amino acids at the 3' end and introduced a premature termination signal that would be expected to truncate the protein by 21 amino acids at the carboxyl terminus. The albino tyrosinase was not recognized by antibodies directed to the carboxyl terminus of tyrosinase. Furthermore, as shown by gel electrophoresis of the immunoprecipitated protein, the tyrosinase was approximately 3 kDa smaller than normal. Similar immunoprecipitation data were obtained when cloned normal and mutant tyrosinases were expressed in COS-1 cells.

Albinism, Oculocutaneous

Variable expression of albinism within a single kindred.

We studied the albinotic characteristics in 13 members of a white family (age range, 2 to 73 years), which were graded according to severity and were correlated with visual acuity. Clinical, electrophysiologic, and biochemical characteristics of this family do not fit any known category of human albinism. The degree of heterogeneity in expression of albinotic features was unexpected. The correlation between visual acuity and nystagmus was particularly strong. The brown-haired propositus had severe skin involvement, iris transillumination, fundus hypopigmentation, and foveal hypoplasia. He had no manifest nystagmus, however, and his visual acuity was nearly normal. These observations suggest that nystagmus imposes a visual deficit beyond that related to foveal hypoplasia alone.

Adolescent

Hermansky-Pudlak syndrome (HPS). An epidemiologic study.

A study of albinism in Puerto Rico identified 693 persons with albinism. Among these, the type of albinism was determined in 595, Hermansky-Pudlak syndrome (HPS) was found in 495. Approximately five of every six Puerto Rican albinos had HPS. The highest prevalence of HPS yet reported was in the northwestern quarter of the island where at least 1 in 1,800 persons had HPS, and approximately 1 in 21 were carriers. The HPS albino pigment phenotype was variable, and HPS albinos phenotypically resembled other types of oculocutaneous and ocular albinos. Ceroid storage was also variable. The consistent finding in HPS was storage pool deficient platelets. HPS is best diagnosed by lack of platelet dense bodies seen by electron microscopy. Evidence from family studies indicates that HPS is a distinct disorder due to the pleiotropic effects of a single gene mutation or a small deletion.

Albinism

Albinism and Hermansky-Pudlak syndrome in Puerto Rico.

Five types of oculocutaneous albinism and two types of ocular albinism were found among 349 Puerto Rican albinos. The most prevalent type of albinism was the Hermansky-Pudlak syndrome (HPS). HPS was observed in five of every six albinos in Puerto Rico. The prevalence of HPS was highest in the northwestern quarter of the island, affecting approximately one in 1,800 persons, and approximately one in 22 are carriers of the gene. HPS is an autosomal recessively inherited triad of a tyrosinase-positive type of albinism, a hemorrhagic diathesis due to storage pool deficient platelets and accumulation of ceroid in tissues. The pigmentary phenotype of HPS albinos resembled that of any other type of oculocutaneous or ocular albinism. The most reliable method of diagnosing HPS is by a deficiency of platelet dense bodies observed by electron microscopy. The accumulation of ceroid in the tissues is associated with fibrotic restrictive lung disease and granulomatous enteropathic disease. The enteropathic disorder resembles Crohn's disease and with few exceptions, had its onset after 13 years of age. The major causes of death were fibrotic restrictive pulmonary disease, hemorrhagic episodes and sequelae of granulomatous enteropathic disease. Menometrorrhagia was common in women with HPS. No immune deficiency was found in HPS patients. The majority of patients with HPS had visual acuities of 20/200 or worse and consequently were legally blind. Albinos of all types, including HPS, lacked binocular vision due to nearly complete crossing of the optic tracts.

Albinism, Ocular

The role of ceroid in lung and gastrointestinal disease in Hermansky-Pudlak syndrome.

Studies of ceroid associated lesions in Hermansky-Pudlak syndrome (HPS) indicate that restrictive lung disease and granulomatous gastrointestinal lesions are among the most frequent and account for 60% of the deaths of the patients. No defects in the immune system in HPS were found. Histological, ultrastructural and chemical studies show accumulation of non-biodegradable ceroid in tissue cells and associated macrophages of HPS patients. There is no known degradative pathway for ceroid. Ceroid is eliminated from cells by exocytosis. Wild type and pale eared mice treated with leupeptin, which inhibits exocytosis, accumulate ceroid in organ cells in the same sequence seen in HPS. Young HPS patients without significant pulmonary function deficits were lavaged, the macrophages examined by TEM and tested for platelet derived growth factor. Macrophages contained ceroid and 7/12 patients had 27 +/- 42 units of PDGF bioactivity compared to zero activity in controls. Purified ceroid was fed to macrophages lavaged from the lungs of non-smoking control subjects. Prior to feeding, less than 5% of cells contained one or two small yellow-orange autofluorescent granules resembling ceroid. After feeding, approximately 20% of control cells had ingested ceroid, but PDGF was not increased. The immunologic and histologic studies and the production of PDGF by macrophages which precedes lung fibrosis all point to a central role of the macrophage in these lesions. These studies did not distinguish whether the macrophages ingested ceroid from other cells, or whether ceroid is produced intrinsically by the HPS macrophage.

Adolescent

Prepubertal diagnosis of Klinefelter syndrome in a patient with taurodontic teeth.

A 9-year, 10-month-old male presented for dental treatment planning for multiple missing permanent teeth. Panoramic radiographs revealed taurodontic permanent first molars and primary second molars. The patient was of slim build with a long lower body and moderately long fingers. Because of the presence of taurodontic teeth, chromosomal analysis was done and revealed 47,XXY - Klinefelter syndrome. Patients with meso- or hypertaurodontic teeth who do not have a syndrome known to be associated with taurodontic teeth should be considered for chromosome analysis because of the high association of taurodontic teeth with X-chromosome aneuploidy syndromes.

Anodontia

Hereditary mucoepithelial dysplasia. Case report and review of the literature.

Hereditary mucoepithelial dysplasia, a dyshesive, dyskeratotic epithelial syndrome caused by an abnormality in desmosomes and gap junctions, involves the mucosae, skin, hair, eyes, and lungs. A 16-year-old patient had nontender, fire-red mucosae; keratosis pilaris; diffuse, nonscarring alopecia; cataracts; photophobia; corneal vascularization; and decreased visual acuity. Histologic examination of gingival sections showed a dyshesive epithelium with atrophy, dyskeratosis, lack of keratinization, and unusual cytoplasmic inclusions. Results of electron microscopic studies showed a reduced number of desmosomes, amorphous intercellular material, and cytoplasmic inclusions resembling tonofilaments and gap junction material. The patient described in this report represents an apparently sporadic case of hereditary mucoepithelial dysplasia. Other cases described previously in the literature are reviewed. We believe this disorder should be brought to the attention of dermatologists because patients with hereditary mucoepithelial dysplasia have numerous skin problems and are susceptible to recurrent infection and potentially fatal bullous lung disease. Also, misinterpreted abnormal results from cervical Pap smears could lead to hysterectomy being performed unnecessarily on these patients.

Adolescent

Taurodontism: an anomaly of teeth reflecting disruptive developmental homeostasis.

Two models concerning morphometric traits occurring frequently in aneuploidy states posit, respectively, 1) that they reflect the expression of specific major oligogenes for that trait on the chromosome involved or 2) that they result from a generalized disruption of developmental homeostasis. In contrast to previous studies that have investigated variations in morphometric traits in a single aneuploidy state, this study investigates a single morphometric trait, taurodontism, as it occurs in otherwise normal individuals, in nonchromosomal syndromes, and in aneuploidy syndromes to determine whether the trait best fits the oligogene or the disrupted developmental homeostasis model. Taurodontism is diagnosed from dental radiographs. It is an extreme variation in tooth form seen in multirooted teeth in which the bifurcation or trifurcation of the roots is displaced toward the apex of the root, resulting in increased size of the pulp chamber. The point of furcation, and consequently the size of the pulp chamber, is a quasicontinuously distributed trait. The results indicate that taurodontism most likely is the result of disrupted developmental homeostasis.

Adolescent

Hermansky-Pudlak syndrome. Ophthalmic findings.

Prospective ophthalmic evaluation was performed in 20 individuals with Hermansky-Pudlak syndrome, a type of oculocutaneous albinism with an associated deficiency of dense bodies in platelets. The extent of visual impairment and the possible relationship to the degree of hypopigmentation were studied. All patients showed nystagmus, visual acuity ranged from 20/60 to 20/400, and correction of refractive error provided a mild improvement in vision. Iris pigmentation varied in amount and did not correlate with the visual acuity measurement. Foveal hypoplasia was found in all patients, but variability in macular transparency and vascular architecture was noted. Visual-evoked potentials performed in 11 patients demonstrated excessive decussation of optic fibers. Recognition of this form of oculocutaneous albinism is important because of the associated pulmonary, gastrointestinal, renal, and cardiac manifestations of Hermansky-Pudlak syndrome.

Adolescent

Thioredoxin reductase activity in Hermansky-Pudlak syndrome: a method for identification of putative heterozygotes.

Recent studies indicate that membrane-associated thioredoxin reductase (TR) is a possible regulator of melanin biosynthesis via the inhibition of tyrosinase by reduced thioredoxin. In normal individuals, the levels of TR activity in skin correlate linearly to the Fitzpatrick classification of skin type, being lowest in type I skin and highest in skin type VI. In this study, TR was measured in 3-mm skin biopsies in Hermansky-Pudlak syndrome (HPS) patients and their relatives. Forty-five individuals from seven Puerto Rican kindreds were tested, including 12 homozygotes, nine obligate heterozygotes, and 24 unclassified individuals. In addition, seven separate nonkindred HPS patients were tested. With one exception, TR activity was markedly decreased in 18 homozygotes. TR activity was decreased in eight obligate heterozygotes and in 12 unclassified kindred members, whereas 10 subjects had normal TR activity when compared to the expected activity of their skin type. Four individuals were excluded from the analysis because of inadequate controls for their age group or immunosuppressive treatment for kidney transplant. The results indicate that decreased TR activity assayed in 3-mm skin punch biopsies is a useful method for detecting carriers of the HPS gene.

Adolescent

Reliability of absent platelet dense bodies as a diagnostic criterion for Hermansky-Pudlak syndrome.

The clinical, pigmentary, and ceroid storage manifestations of the Hermansky-Pudlak syndrome (HPS) triad of albinism, hemorrhagic diathesis, and ceroid storage disease are variable. Therefore, a rapid and accurate method of diagnosing HPS is needed. Platelets of 66 albinos were examined by electron microscopy for the presence or absence of dense bodies. Results show that patients reexamined over a period of 1 year had consistent findings. Those lacking dense bodies (15) when first examined also lacked dense bodies when reexamined a year later, and they had evidence of ceroid storage. Those with dense bodies when first examined (8) also had dense bodies when reexamined, did not have evidence of storage disease, and had types of albinism other than HPS. Of 20 propositi lacking dense bodies, all 32 albino relatives also lacked dense bodies, while 6 albino relatives of 6 propositi with dense bodies also had dense bodies in their platelets. The evidence supports the concept that HPS is a distinct genetic and biochemical disease in which the components of the triad are the result of a single genetic defect, either a point mutation or a small deletion. Comparison of whole mount preparations with thin section preparations of 13 albinos shows that whole mount preparations are an accurate and rapid method for diagnosing HPS. The most consistent diagnostic feature of HPS is lack of platelet dense bodies.

Albinism

Agenesis of succedaneous teeth: an expression of the homozygous state of the gene for the pegged or missing maxillary lateral incisor trait.

Agenesis of the permanent teeth that replace the primary teeth, the succedaneous teeth, was found in children from two kindreds wherein both parents had pegged maxillary lateral incisor teeth. The trait small-pegged-missing maxillary lateral incisor teeth is inherited in an autosomal dominant manner, as demonstrated in the literature and in these families. Agenesis of succedaneous teeth is most likely an autosomal recessive trait due to the homozygous state of the gene for small-pegged-missing maxillary incisor teeth.

Adolescent

Elevated urinary dolichol excretion in the Hermansky-Pudlak syndrome. Indicator of lysosomal dysfunction.

The Hermansky-Pudlak syndrome, a triad of albinism, platelets lacking dense bodies, and storage of ceroid-like material in tissues, occurs approximately once in 2,000 northwestern Puerto Ricans. The manifestations of storage disease are variable and include granulomatous colitis, restrictive lung disease, kidney failure, and cardiomyopathy. The autofluorescent material stored in the Hermansky-Pudlak syndrome is histochemically similar to that stored in neuronal ceroid/lipofuscinosis. The material in neuronal ceroid/lipofuscinosis contains dolichols, which are components of lysosomes, and patients show increased urinary excretion of dolichols. This study of 49 patients with the Hermansky-Pudlak syndrome found that urinary dolichol levels are increased in those patients with evidence of ceroid storage in the kidneys but are not elevated when storage occurs in tissues other than the kidneys. The excretion of ceroid was not influenced by the saturation state of dietary fat. A defect in processing of membranes of lysosomes, melanosomes, and dense bodies may be involved in the syndrome.

Albinism

Syndrome of amelogenesis imperfecta, nephrocalcinosis, impaired renal concentration, and possible abnormality of calcium metabolism.

We describe a brother and sister with amelogenesis imperfecta, nephrocalcinosis and impaired renal concentrating ability. This is the second sibship reported, further substantiating autosomal recessive inheritance of this condition. There is lack of enamel, lifelong nocturnal enuresis, progressive punctate nephrocalcinosis, and decreased calcium and phosphate excretion over 24 hours and after an acute load. Increased serum osteocalcin and decreased urine delta-carboxyglutamic acid suggest involvement of vitamin K-dependent calcium binding proteins, although this may represent a secondary finding. No other evidence of abnormal calcium metabolism was found. Renal function is stable in the early teens, but the previously reported patients went on to renal failure.

1-Carboxyglutamic Acid

The questionable relation between cochlear pigmentation and noise-induced hearing loss.

Some evidence has suggested that susceptibility to noise-induced hearing loss may be inversely proportional to the amount of melanin in the cochlea. However, published data have not been consistent in demonstrating this relation, and some results may be contaminated by lack of genetic control in experimental animals. In this investigation, noise-induced hearing loss was evaluated in pigmented and albino C57BL/6J mice that differed only in their ability to produce melanin. Surface-recorded electric responses to sound were used to assess auditory sensitivity. Results indicated no difference between the two groups either in pre-exposure thresholds or in magnitude of noise-induced threshold shift.

Animals