Publications by authors named "Eduardo Tizzano"

Noonan syndrome and related disorders are a group of well-known genetic conditions caused by dysregulation of the Ras/mitogen-activated protein kinase (RAS/MAPK) pathway. Because of the overlap of clinical and molecular features, they are now called RASopathies. In this study, we retrospectively analyzed the clinical data of 121 patients with a molecularly confirmed diagnosis of RASopathy, describing frequencies for clinical features in all organ systems as well as molecular data.

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Cilia are essential organelles and variants in genes governing ciliary function result in ciliopathic diseases. The Ciliogenesis and PLANar polarity Effectors (CPLANE) protein complex is essential for ciliogenesis in animals models but remains poorly defined. Notably, all but one subunit of the CPLANE complex have been implicated in human ciliopathy.

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  • The study investigates 11 previously unreported patients with a neurodevelopmental disorder (NDD) caused by genetic changes in the RNU4-2 gene, highlighting the need for better diagnostic approaches as many NDDs remain undiagnosed.
  • The patients, ranging from 13 months to 36 years old, exhibited severe developmental delays, distinct physical features, and other health issues like microcephaly and intrauterine growth retardation.
  • The findings enhance the understanding of RNU4-2 syndrome's phenotypic spectrum, emphasizing the importance of thorough clinical evaluations in identifying and characterizing new syndromes in patients with NDDs.
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Twin girls born at 30 weeks' gestation with spinal muscular atrophy (SMA) received onsasemnogene-abeparvovec (OA) at 3.5 weeks of life. They had no treatment-related adverse events, normal acquisition of motor milestones, and normal neurological examination at 19 months.

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  • * Recent research identified recurrent mutations in the U2 snRNA gene that contribute to a related neurodevelopmental disorder, affecting 15 total cases.
  • * The disorder is characterized by symptoms including intellectual disability, neurodevelopmental delays, autism, microcephaly, hypotonia, epilepsy, and severe seizures, highlighting the importance of snRNAs in these conditions.
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  • * Nineteen patients were involved, all asymptomatic at diagnosis, with a median age of 3.0 months when treated; all 12 children evaluated achieved new motor milestones including standing and walking independently.
  • * The findings suggest that this treatment leads to improved motor function with manageable adverse events, aligning with previously documented results.
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Purpose: Valproic acid or valproate is an effective antiepileptic drug; however, embryonic exposure to valproate can result in a teratogenic disorder referred to as fetal valproate syndrome (OMIM #609442). Currently there are no diagnostic biomarkers for the condition. This study aims to define an episignature biomarker for teratogenic antenatal exposure to valproate.

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: Non-Invasive prenatal test (NIPT) is used as a universal or contingent test after prior risk assessment. Screening is mainly performed for common trisomies (T21, T13, T18), although other chromosomal anomalies may be detected. Our objective was to study the performance of GWNIPT in the detection of chromosomal abnormalities in pregnancies in which an invasive prenatal study was performed and in early pregnancy losses, in comparison with the reference test.

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  • Palmoplantar keratoderma (PPK) is a skin condition that causes thick skin and abrasions on the hands and feet, linked to genetic factors, including mutations in a specific gene.
  • A new harmful variant (c.794G>C, p.Arg265Pro) in this gene was found in a 60-year-old female PPK patient, who had various symptoms such as skin changes, brittle nails, and thin hair.
  • This study suggests that the identified gene variant affects the stability of a protein crucial for WNT signaling, which is important for skin health, indicating that disrupted signaling may contribute to the development of PPK in the patient.
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  • - Spinal muscular atrophy (SMA) is caused by mutations in the SMN1 gene, and its severity is often related to the number of copies of a related gene, SMN2, but discrepancies between the two exist.
  • - In a study with 31 SMA patients, researchers found hybrid genes in about 45% of them, identifying 25 hybrid alleles with varying structures, some not detected by standard methods.
  • - Despite expectations that hybrid genes might indicate milder symptoms, the study did not find a consistent link, highlighting the complexity of hybrid structures and the need for further individualized research.
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Background: Tatton-Brown-Rahman syndrome (TBRS) is a rare disorder, caused by heterozygous pathogenic variants, and first described in 2014. TBRS is characterised by overgrowth, intellectual disability, facial dysmorphism, hypotonia and musculoskeletal features, as well as neurological and psychiatric features. Cardiac manifestations have also been reported, mainly congenital malformations such as atrial septal defect, ventricular septal defect and cardiac valvular disease.

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Background: Defects in GNAO1, the gene encoding the major neuronal G-protein Gαo, are related to neurodevelopmental disorders, epilepsy, and movement disorders. Nevertheless, there is a poor understanding of how molecular mechanisms explain the different phenotypes.

Objectives: We aimed to analyze the clinical phenotype and the molecular characterization of GNAO1-related disorders.

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  • * One key treatment is the gene therapy called onasemnogene abeparvovec (Zolgensma®), which is effective for patients with specific genetic profiles, although its broad usage raises concerns about safety for less clear cases.
  • * A European expert group has investigated the use of Zolgensma® for older and heavier SMA patients, resulting in 12 consensus statements that reflect the evolving understanding of its effectiveness based on new clinical and real-world evidence.
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  • Previous studies showed high but varied levels of urine metabolites related to prostaglandins in cystic fibrosis patients, prompting this study to evaluate genetic factors affecting prostaglandin production and their potential as severity markers.
  • The research involved 30 healthy individuals and 103 cystic fibrosis patients, analyzing urine metabolites and clinical severity through scoring and CT scans.
  • Results indicated higher urinary levels of prostaglandin metabolites in cystic fibrosis patients compared to controls, with significant variations based on disease severity, but identified genetic polymorphisms did not correlate with disease severity or urine metabolite levels.
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Background: Spinal Muscular Atrophy (SMA) is a rare neuromuscular disorder characterized by progressive degeneration of motor neurons and muscle weakness resulting in premature death or severe motor disability. Over the last decade, SMA has dramatically changed thanks to new advances in care and the emergence of disease-specific treatments. RegistrAME is a self-reported specific disease registry with an accurate curation system.

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  • * Researchers found 23 specific changes in a gene related to this complex that affect 38 people, leading to problems with brain cell growth and learning in animals.
  • * By targeting certain stress response proteins, they discovered ways to help fix some of the immune issues caused by these disorders, leading to new ideas for treatments.
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Spinal muscular atrophy was the most common inherited cause of infant death until 2016, when three therapies became available: the antisense oligonucleotide nusinersen, gene replacement therapy with onasemnogene abeparvovec, and the small-molecule splicing modifier risdiplam. These drugs compensate for deficient survival motor neuron protein and have improved lifespan and quality of life in infants and children with spinal muscular atrophy. Given the lifelong implications of these innovative therapies, ways to detect and manage treatment-modified disease characteristics are needed.

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  • Long-term real-world data on the effectiveness and safety of onasemnogene abeparvovec for spinal muscular atrophy (SMA) is crucial for understanding outcomes outside clinical trials.
  • The RESTORE registry tracked 168 patients treated with this therapy, revealing a median age of 3 months at treatment and a majority identified through newborn screening.
  • Results showed all patients maintained or achieved motor milestones, but nearly half experienced at least one adverse event, reinforcing the treatment's safety profile.
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  • The 270th ENMC workshop focused on improving the methods for accurately determining SMN2 gene copy number, which is vital for making treatment decisions in SMA (Spinal Muscular Atrophy) patients.
  • It brought together experts from neuromuscular medicine, clinical practice, patient advocacy, and industry to discuss the challenges faced by laboratories in this testing process.
  • Participants concluded with a set of recommendations for enhancing molecular prognosis, newborn screening, treatment approaches, and guidelines for laboratory kit manufacturers to reduce errors in testing.
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Objective: The aim of this study was to provide an overview of the clinical phenotypes associated with 4 SMN2 copies.

Methods: Clinical phenotypes were analyzed in all the patients with 4 SMN2 copies as part of a nationwide effort including all the Italian pediatric and adult reference centers for spinal muscular atrophy (SMA).

Results: The cohort includes 169 patients (102 men and 67 women) with confirmed 4 SMN2 copies (mean age at last follow-up = 36.

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  • The research aimed to create a structured method for classifying treatments aimed at modifying diseases related to survival motor neuron (SMA).
  • The classification system categorizes treatments based on whether they are initial therapies or involve the continuation/discontinuation of further therapies, with specific treatment scenarios identified.
  • By applying this classification to 443 patients in the RESTORE registry, the study examined patient demographics and established a framework for analyzing the safety and effectiveness of various treatment combinations in SMA.
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Spinal muscular atrophy (SMA) is a prevalent severe genetic condition that follows an autosomal recessive inheritance pattern. Over the last decade, advances in innovative therapies have improved the course of the disease for many patients. There is evidence that early diagnosis and therapeutic intervention contribute toward better outcomes for these patients.

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  • - Tuberous sclerosis complex (TSC) is a genetic disorder causing hamartomas in various organs and is linked to mutations in the TSC1 and TSC2 genes, with many cases remaining undiagnosed despite genetic testing.
  • - The authors developed a comprehensive diagnostic method combining multiplex ligation-dependent probe amplification and advanced next-generation sequencing to better identify genetic variants in TSC patients.
  • - Their approach successfully identified the molecular cause in 29 out of 42 patients, including 12 new pathogenic variants, and highlighted the presence of low-frequency mosaic variants in some patients, enhancing the accuracy of TSC diagnosis.
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Introduction: Pathogenic expansions in RFC1 have been described as a cause of a spectrum of disorders including late-onset ataxia, chronic cough, and cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). Sensory neuronopathy/neuropathy appears to be a major symptom of RFC1-disorder, and RFC1 expansions are common in patients with sensory chronic idiopathic axonal neuropathy or sensory ganglionopathy. We aimed to investigate RFC1 expansions in patients with suspected RFC1-related disease followed-up in a Neuromuscular Diseases Unit, with a particular interest in the involvement of the peripheral nervous system.

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Background: Consanguineous couples have an increased risk of severe diseases in offspring due to autosomal recessive disorders. Exome sequencing (ES) offers the possibility of extensive preconception carrier screening (PCS) in consanguineous couples who may be at risk of rare genetic disorders.

Methods: We retrospectively analysed ES data from 65 probands affected with rare genetic disorders born from consanguineous couples.

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