Publications by authors named "Julian Martinez-Agosto"

Heterozygous mutations in are associated with an early-onset, progressive and often complex dystonia (DYT28). Key characteristics of typical disease include focal motor features at disease presentation, evolving through a caudocranial pattern into generalized dystonia, with prominent oromandibular, laryngeal and cervical involvement. Although -related disease is emerging as one of the most common causes of early-onset genetic dystonia, much remains to be understood about the full spectrum of the disease.

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Purpose: Patients with neurodevelopmental disorders (NDDs) have high rates of neuropsychiatric comorbidities. Genomic medicine may help guide care because pathogenic variants are identified in up to 50% of patients with NDDs. We evaluate the impact of a genomics-informed, multidisciplinary, neuropsychiatric specialty clinic on the diagnosis and management of patients with NDDs.

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We report a patient who initially presented at 4 days old with hypocalcemia, hypoparathyroidism, and elevated phosphorous level. Treatment was initiated with calcitriol, calcium carbonate (CaCO), vitamin D, and low phosphorous formula. Family history was positive for an activating calcium sensing receptor () variant (R990G) identified previously in 2 older siblings who were treated with CaCO and calcitriol.

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Article Synopsis
  • * Five pediatric patients with VHL-associated hemangioblastomas were treated with belzutifan, leading to improvements in tumor size and vision for those with retinal lesions, and benefits in neurologic symptoms for patients with intracranial tumors.
  • * The treatment resulted in minor side effects, such as grade 1-2 anemia in four patients, and suggests belzutifan could be a promising therapy for young patients with these tumors.
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  • The study identified specific characteristics linked to genetic diagnoses in patients with neurodevelopmental disorders and created a decision tree to help clinicians predict which patients might benefit from genetic testing.
  • Researchers analyzed the records of 316 patients and found that those with genetic diagnoses were typically female and more likely to show signs like motor delay and hypotonia.
  • The conclusion emphasizes that motor delay and hypotonia are key indicators for genetic conditions, and future work could refine decision trees to improve screening processes for genetic testing in this patient group.
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Purpose: Epigenetic dysregulation has been associated with many inherited disorders. RBBP5 (HGNC:9888) encodes a core member of the protein complex that methylates histone 3 lysine-4 and has not been implicated in human disease.

Methods: We identify 5 unrelated individuals with de novo heterozygous variants in RBBP5.

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Data repositories, particularly those storing data on vulnerable populations, increasingly need to carefully consider not only what data is being collected, but how it will be used. As such, the Autism Intervention Research Network on Physical Health (AIR-P) has created the Infrastructure for Collaborative Research (ICR) to establish standards on data collection practices in Autism repositories. The ICR will strive to encourage inter-site collaboration, amplify autistic voices, and widen accessibility to data.

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Objective: PTEN, a known tumor suppressor gene, is a mediator of neurodevelopment. Individuals with germline pathogenic variants in the PTEN gene, molecularly defined as PTEN hamartoma tumor syndrome (PHTS), experience a variety of neurological and neuropsychiatric challenges during childhood, including autism spectrum disorder (ASD). However, the frequency and nature of seizures and the utilization of allied health services have not been described.

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  • Recent advancements in genomics for diagnosing rare diseases focus on "N-of-1" analyses, allowing for tailored studies on individual patients with ultra-rare conditions.
  • The Undiagnosed Diseases Network (UDN) enables collaborative research across various U.S. clinical and research centers, which enhances the ability to analyze whole genome sequencing data from multiple patients simultaneously.
  • Introducing a new software package, RaMeDiES, the team provides tools for automated comparisons of genomic data, leading to novel disease associations and improving overall understanding of genetic links to these rare diseases.
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  • - The study explores pre-mRNA splicing, its critical role in neurodevelopment, and how mutations in spliceosome-related genes U2AF2 and PRPF19 contribute to neurodevelopmental disorders (NDDs).
  • - Researchers found multiple pathogenic variants in U2AF2 and PRPF19 across unrelated individuals, with functional analysis showing that specific U2AF2 variants disrupted normal splicing and neuritogenesis in human neurons.
  • - Additionally, investigations in Drosophila models revealed that the loss of function in U2AF2 and PRPF19 caused severe developmental defects and social issues, pointing to a genetic network wherein splicing factors like Rbfox1 play a significant role in brain development and function. *
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Introduction: Autistic individuals, now representing one in 36 individuals in the U.S., experience disproportionate physical health challenges relative to non-autistic individuals.

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Purpose: Coffin-Siris and Nicolaides-Baraitser syndromes are recognizable neurodevelopmental disorders caused by germline variants in BAF complex subunits. The SMARCC2 BAFopathy was recently reported. Herein, we present clinical and molecular data on a large cohort.

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Equitable and just genetic research and clinical translation require an examination of the ethical questions pertaining to vulnerable and marginalized communities. Autism research and advocate communities have expressed concerns over current practices of genetics research, urging the field to shift towards paradigms and practices that ensure benefits and avoid harm to research participants and the wider autistic community. Building upon a framework of bioethical principles, we provide the background for the concerns and present recommendations for ethically sustainable and justice-oriented genetic and genomic autism research.

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Crouzon Syndrome is a genetic craniosynostosis disorder associated with a high risk of ophthalmologic sequelae secondary to structural causes. However, ophthalmologic disorders due to intrinsic nerve aberrations in Crouzon Syndrome have not been described. Optic pathway gliomas (OPGs) are low grade gliomas that are intrinsic to the visual pathway, frequently associated with Neurofibromatosis type 1 (NF-1).

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Jansen-de Vries syndrome (JdVS) is a neurodevelopmental condition attributed to pathogenic variants in Exons 5 and 6 of PPM1D. As the full phenotypic spectrum and natural history remain to be defined, we describe a large cohort of children and adults with JdVS. This is a retrospective cohort study of 37 individuals from 34 families with disease-causing variants in PPM1D leading to JdVS.

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Background: Unbalanced translocations can cause developmental delay (DD), intellectual disability (ID), growth problems, dysmorphic features, and congenital anomalies. They may arise de novo or may be inherited from a parent carrying a balanced rearrangement. It is estimated that 1/500 people is a balanced translocation carrier.

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  • The paper discusses a family affected by spastic paraparesis due to a novel genetic mutation (F388S), with symptoms starting at age 23 and leading to significant mobility loss by their late 20s.
  • Comprehensive medical evaluations, including imaging and pathology, revealed abnormal amyloid-β and tau levels, linking the condition to characteristics typically seen in Alzheimer's disease, although with distinct patterns noted in brain imaging.
  • Neuropathological findings confirmed abnormal plaques and damage in specific brain areas, suggesting this mutation results in a severe form of spastic paraparesis with early onset linked to increased production of longer amyloid-β peptides.
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Background: Individuals with PTEN hamartoma tumor syndrome (PHTS) demonstrate a distinct neurobehavioral profile suggesting primary disruption of frontal lobe symptoms, with more severe cognitive deficits in those with associated autism spectrum disorder (ASD) that extend to other areas of neurobehavioral function as well (e.g., adaptive behavior, sensory deficits).

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Endometriosis is a common reproductive disease with a heterogeneous presentation. Classification attempts have thus far not offered insight into its cause or its symptoms. Endometriosis may result from the migration of shed endometrium to the peritoneal cavity.

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  • LETM1 is a gene that encodes a protein in the inner mitochondrial membrane involved in regulating mitochondrial volume and ion balance, and its dysfunction is linked to various mitochondrial diseases.
  • Research has discovered 18 individuals from 11 families with rare LETM1 mutations, showing severe symptoms mostly beginning in infancy, such as developmental delays, hearing loss, and neurodegeneration.
  • Further studies in human cells and yeast have shown that these LETM1 mutations can lead to impaired potassium efflux and dysfunctional mitochondria, contributing to the observed neurological issues and other health problems.
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Variants in RAC3, encoding a small GTPase RAC3 which is critical for the regulation of actin cytoskeleton and intracellular signal transduction, are associated with a rare neurodevelopmental disorder with structural brain anomalies and facial dysmorphism. We investigated a cohort of 10 unrelated participants presenting with global psychomotor delay, hypotonia, behavioural disturbances, stereotyped movements, dysmorphic features, seizures and musculoskeletal abnormalities. MRI of brain revealed a complex pattern of variable brain malformations, including callosal abnormalities, white matter thinning, grey matter heterotopia, polymicrogyria/dysgyria, brainstem anomalies and cerebellar dysplasia.

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Objectives: In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda.

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Background: Dermatologic phenotypes in PTEN hamartoma tumor syndrome (PHTS) are heterogeneous and poorly documented.

Objective: To characterize dermatologic findings among PHTS and conduct an analysis of genotype-dermatologic phenotype associations.

Methods: Mucocutaneous findings were reviewed in a multicenter cohort study of PHTS.

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