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Biomedical subjects

M Meroni

Publications and source records attributed to M Meroni.

At least 37 records · Page 2Linked to original sources

Major COL4A5 gene rearrangements in patients with juvenile type Alport syndrome.

Mutations in the COL4A5 gene, which encodes the a5 chain of type IV collagen, are found in a large fraction of patients with X-linked Alport syndrome. The recently discovered COL4A6, tightly linked and highly homologous to COL4A5, represents a second candidate gene for Alport syndrome. We analyzed 177 Italian Alport syndrome families by Southern blotting using cDNA probes from both COL4A5 and COL4A6. Nine unrelated families, accounting for 5% of the cases, were found to have a rearrangement in COL4A5. No rearrangements were found in COL4A6, with the exception of a deletion encompassing the 5' ends of both COL4A5 and COL4A6 genes in a patient with Alport syndrome and leiomyomatosis. COL4A5 rearrangements were all intragenic and included 1 duplication and 7 deletions. Polymerase chain reaction (PCR) analysis was carried out to characterize deletion and duplication boundaries and to predict the resulting protein abnormality. The two smallest deletions involved a single exon (exons 17 and 40, respectively), while the largest ones spanned exons 1 to 36. The clinical phenotype of patients in whom a rearrangement in COL4A5 was detected was severe, with progression to end-stage renal failure in juvenile age and hypoacusis occurring in most cases. These data have some important implications in the diagnosis of patients with Alport syndrome.

Adolescent↗

Renal transplantation from living donor parents in two brothers with Alport syndrome. Can asymptomatic female carriers of the Alport gene be accepted as kidney donors?

Renal transplantation from living donor parents was performed in two brothers with end-stage renal failure due to Alport syndrome (AS). Two years later, the patient receiving the kidney graft from the mother, obligate carrier of AS, presented persistent microhematuria and proteinuria with normal renal function. The histological study demonstrated ultrastructural glomerular lesions consistent with AS. The authors conclude that: (1) Alport patients should not be deprived of renal transplantation from living donors, since anti-GBM nephritis is a rare complication; (2) an oligosymptomatic female carrier of the Alport gene may be considered as living renal donor, although a longer follow-up is needed in order to draw definitive conclusions.

Adult↗

Inhibition of monoamine oxidase by clorgyline analogues.

N-Methyl-N-propargyl-3-(4-phenoxy)phenoxypropylamine, an analogue of the MAO-A-selective irreversible inhibitor clorgyline in which the 2,4-dichloro- substitution in clorgyline was replaced by a 2-H atom and a 4-phenoxy group, has been synthesised and assessed as an inhibitor of monoamine oxidase (MAO). This compound proved to be a time-dependent irreversible inhibitor of both MAO-A and -B. However, unlike clorgyline, it was selective towards MAO-B, both in its initial, non-covalent, binding to the enzyme and as an irreversible inhibitor. In order to assess the influence of side-chain length on inhibitory potency, analogues were synthesised in which the side-chain was reduced to 2 CH2 units (N-methyl-N-propargyl-2- (4-phenoxy)phenoxyethylamine) or increased to 4 CH2 units (N-methyl-N-propargyl-4-(4- phenoxy)phenoxybutylamine). Both these compounds were also time-dependent irreversible inhibitors with selectivity towards MAO-B. In the case of the initial, non-covalent, inhibition all these compounds were competitive inhibitors of MAO-A, with respect to the amine substrate, and the affinity for inhibitor binding increased with carbon chain length. In contrast the compounds were all mixed inhibitors of MAO-B. The competitive element of this inhibition (measured by Kis) was similar for the 2 and 3 carbon-chain compounds but decreased markedly when the chain-length was increased to 4 carbons. The uncompetitive inhibition (measured by Kii) decreased as the carbon chain-length was increased from 2 to 3, but there was no significant further change when the length was increased to 4 carbons. The time-dependent irreversible inhibition (measured as the IC50 values after 60 min enzyme-inhibitor preincubation) showed that the potency towards MAO-A increased when the side-chain length was increased from 2 to 3 carbons but that there was no significant difference between the 3 and 4 carbon-chain compounds. In the case of MAO-B inhibition, the 2 and 3 carbon-chain compounds had similar inhibitory potencies but this increased substantially when the chain length was increased to 4 carbons. The significance of the inhibitory behaviour of these compounds is discussed in terms of the structure-activity relationships of mechanism-based irreversible MAO inhibitors.

Chemical Phenomena↗

Variability of clinical phenotype in a large Alport family with Gly 1143 Ser change of collagen alpha 5(IV)-chain.

In a large Italian family with adult-onset Alport syndrome, molecular analysis of the COL4A5 gene, which encodes the alpha 5(IV)-chain of glomerular basement membrane collagen, revealed a GGC-->AGC change in exon 38, resulting in substitution of a serine for a glycine in position 1143 of the polypeptide chain, between interruptions 19 and 20 of the triple helical domain. The mutation leads to loss of a restriction site for the enzyme Msp I, and could thus be easily recognized in several female and male relatives. Among relatives of both sexes who carried the same mutation, the clinical phenotype of Alport syndrome was variable as for the onset of renal failure and the presence of associated ear and eye abnormalities.

Adolescent↗

Two-step tumour targetting in ovarian cancer patients using biotinylated monoclonal antibodies and radioactive streptavidin.

A new method for intraperitoneal tumour targetting in ovarian cancer using biotinylated monoclonal antibodies (MoAb) and radioactive streptavidin is described. Fifteen patients with histologically documented ovarian carcinoma were injected intraperitoneally with 2 mg of biotinylated MoAb MOv18, followed 3-5 days later by 100-150 micrograms of indium-111 streptavidin, at the specific activity of 280-370 MBq/mg in 500 ml of normal saline. No toxicity was observed. Tumours were imaged from 2 to 48 h after radioactivity injection by recording both planar and single photon emission tomography (SPET) data. All patients underwent surgery 1-8 days later (mean 3 days) after scanning. The resected tumour and normal tissue radioactivity were measured. On the day of surgery, the tumour to normal tissue ratio was 9:1 (range 3:1-30:1) and 45:1 (range 12:1-120:1) for intra- and extraperitoneal samples, respectively. The mean tumor to blood ratio was 14:1 (range 4:1-30:1). The injected dose (i.d.) per gram of tumour was 0.112 (range 0.01-0.3) for recurrences and 0.05 for primary tumour (range 0.005-0.2). Over 24-48 h 14% i.d. (range 8-18% i.d.) was found in the urine, 14% i.d. (range 6-29% i.d.) in the blood and 63% i.d. (range 56-70% i.d.) was still in the peritoneal cavity. These preliminary clinical data suggest that this two-step strategy may be superior to the conventional approach (radiolabelled antibodies) for intraperitoneal radioimmunolocalization and radioimmunotherapy of ovarian cancer.

Bacterial Proteins↗

[Postoperative radiotherapy in the treatment of adenocarcinoma of the endometrium in pathological stage I].

We report on 49 patients with pathologic stage I endometrial adenocarcinoma who underwent postoperative whole-pelvis irradiation (RT) (45-50 Gy in 5-6 weeks) from November 1981 to December 1988. RT was performed when one or more of the following unfavorable prognostic factors were discovered: myometrial infiltration greater than 1/3 (42 cases, or 85.7%), poorly-differentiated tumor (10, or 20.4%), tubaric angles involvement (4; or 8.2%), pelvic nodal metastases (1, or 2.0%). Five-year actuarial disease-free survival was 91.4%. After an average follow-up of 58 months, we observed recurrent disease in 4 patients (8.2%) (3 cases with distant metastases, 6.1%; 1 case with vaginal relapse, 2.0%). All recurrences were observed within 18 months from treatment and occurred only in patients with both myometrial infiltration greater than 1/3 and poorly or moderately differentiated tumor. The patient with vaginal relapse had a complete response after endocavitary curietherapy, but died later on from lung metastases. None of the treated patients experienced severe complications related to the treatment. Our results are comparable with those of the most recent literature, and confirm the good tolerance and efficacy of postoperative RT to prevent loco-regional relapses in early stage endometrial cancer with unfavorable prognostic factors.

Adenocarcinoma↗

Two brothers with idiopathic membranous nephropathy and familial sensorineural deafness.

Genetic factors could play an important role in the pathogenesis of idiopathic membranous nephropathy, and a few cases of familial membranous nephropathy have been described: an increased incidence of some HLA antigens as DR3 and others has been reported. We present two brothers with idiopathic membranous nephropathy and sensorineural deafness. HLA typing was performed in the two patients and in the members of the family, and it showed the absence of linkage of an HLA antigen with the renal disease in the family.

Adult↗

Change in visual function and viewing distance during work with VDTs.

Seven female volunteer bank clerks aged between 24 and 32 yr were selected for a laboratory trial after a preliminary ocular examination which showed them to be emmetropic or slightly myopic (less than or equal to 1D) and to have normal ocular motility or only minor deficiencies. Near and far point refraction and phorias and near point fusional vergences were measured before and immediately after a 6 h workday at a PC workstation. Eye screen distance (viewing distance) was monitored. Near and far distance refraction showed an increase and a decrease of accommodation in 13 out of 14 eyes respectively. Fusional convergence decreased in six out of seven cases: a smaller decrease in divergence was recorded in all subjects. These changes were statistically significant. Viewing distance, though showing some interindividual differences, increased considerably during the last 2 h of the trial, without reaching statistical significance.

Adult↗