Publications by authors named "Lerario A"

Introduction: The profile of genetic and nongenetic factors associated with progression to kidney failure (KF) in steroid-resistant nephrotic syndrome (SRNS) is largely unknown in admixed populations.

Methods: A total of 101 pediatric patients with primary SRNS were genetically assessed targeting Mendelian causes and status with a 62-NS-gene panel or whole exome sequencing, as well as genetic ancestry. Variant pathogenicity was evaluated using the American College Medical of Genetics and Genomics (ACMG) criteria.

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Silver-Russell syndrome (SRS) is an imprinting disorder mainly characterized by pre- and postnatal growth restriction. Most SRS cases are due to 11p15.5 loss of methylation (11p15.

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  • Becker muscular dystrophy (BMD) is an X-linked neuromuscular disorder caused by mutations in the DMD gene, impacting dystrophin production in muscle tissues, which is important for patient care and treatment development.
  • A study of 943 BMD patients revealed the median age at diagnosis was 7.5 years, with significant findings including that about 13.5% lost mobility by an estimated age of 69, while 30% experienced cardiac issues.
  • Different types of DMD mutations correlated with variations in disease progression, particularly affecting loss of ambulation and heart functionality, highlighting the importance of precise genetic characterization for managing BMD.
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  • The study aims to uncover genetic changes linked to prolactinomas, ultimately identifying a mutation (ESR1Y537S) in an aggressive case of this tumor type at Brigham and Women's Hospital.
  • A group of twenty patients was analyzed using advanced sequencing techniques, revealing the ESR1Y537S mutation in a post-menopausal woman, which is known to enhance estrogen receptor activity without needing a hormone trigger.
  • The discovery of this mutation allowed for targeted treatment with elacestrant, in combination with radiotherapy, effectively managing tumor growth and significantly lowering prolactin levels in the patient.
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The steroid hormone aldosterone, produced by the zona glomerulosa (zG) of the adrenal gland, is a master regulator of plasma electrolytes and blood pressure. While aldosterone control by the renin-angiotensin system is well understood, other key regulatory factors have remained elusive. Here, we replicated a prior association between a non-coding variant in and an increased risk of primary aldosteronism, a prevalent and debilitating disease caused by excessive aldosterone production.

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Introduction: Mutations in the thyroid hormone receptor alpha (THRA) gene are a rare cause of thyroid hormone resistance, which leads to a pleomorphic phenotypic spectrum. Hormonal profiles are variable and subtle, making laboratory diagnoses challenging. Genetic evaluation can be a helpful tool in diagnosing these cases.

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Context: Genetic analysis of sporadic medullary thyroid carcinoma (MTC) has revealed somatic variants in , , and occasionally other genes. However, around 20% of patients with sporadic MTC lack a known genetic driver.

Objective: To uncover potential new somatic or germline drivers, we analyze a distinct cohort of patients with sporadic, very early-onset, and aggressive MTC.

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Background: In Europe and Italy, marginalized communities have a higher risk for both contracting sexually transmitted infections (STI) and progressing towards adverse outcomes.

Objectives: This study focuses on the screening of HIV, HBV, HCV, and syphilis among homeless individuals and agricultural migrant workers living in Apulia, Italy. It aims to assess STI prevalence and investigate factors that might hinder return to collect test results.

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Hyperaldosteronism is often associated with inappropriate aldosterone production and aldosterone synthase (Cyp11b2) expression. Normally, Cyp11b2 expression is limited to the adrenal zona glomerulosa (ZG) and regulated by angiotensin II which signals through Gq protein-coupled receptors. As cells migrate inwards, they differentiate into 11β-hydroxylase-expressing zona fasciculata (ZF) cells lacking Cyp11b2.

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Collapsing glomerulopathy (CG) is most often associated with fast progression to kidney failure with an incidence apparently higher in Brazil than in other countries. However, the reason for this occurrence is unknown. To better understand this, we performed an integrated analysis of clinical, histological, therapeutic, causative genetic and genetic ancestry data in a highly genetically admixed cohort of 70 children and adult patients with idiopathic CG (ICG).

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Background: The efficiency of the management of an outpatient clinic largely depends on the administration of patient flows and waiting times increase costs and affect clinical quality. In this study, we verify if the visit acceptance times are influenced by demographic or geographical factors in a large cohort of patients referred to a city and suburban private outpatient multidisciplinary clinic.

Methods: We included all scheduled visits of patients aged from 18 to 75 years who arrived in 2021, 2022 and 2023 in our private outpatient clinics, consisting of 34 medical clinics scattered in Milan metropolitan city and hinterland.

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Objective: To evaluate the presence of multiple genetic diagnoses in syndromic growth disorders.

Study Design: We carried out a cross-sectional study to evaluate 115 patients with syndromic tall (n = 24) or short stature (n = 91) of unknown cause from a tertiary referral center for growth disorders. Exome sequencing was performed to assess germline single nucleotide, InDel, and copy number variants.

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Introduction: In a recent study, we have shown that atorvastatin is clinically safe for dermatomyositis (DM) and antisynthetase syndrome (ASS) patients with dyslipidemia. Herein, we showed in an unprecedented way, the safety of atorvastatin on the muscular tissues of these patients.

Methods: Transcriptome analysis was performed on samples of the vastus lateralis muscle obtained at baseline and after 12 weeks of atorvastatin (20 mg/day) intervention in DM or ASS patients with dyslipidemia [6DM and 5ASS received atorvastatin, and 2DM and 3ASS received placebo].

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Background & Aims: CXADR-like membrane protein (CLMP) is structurally related to coxsackie and adenovirus receptor. Pathogenic variants in CLMP gene have been associated with congenital short bowel syndrome, implying a role for CLMP in intestinal development. However, the contribution of CLMP to regulating gut development and homeostasis is unknown.

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Primary aldosteronism (PA) is the most common form of endocrine hypertension and is characterized by inappropriately elevated aldosterone production via a renin-independent mechanism. Driver somatic mutations for aldosterone excess have been found in approximately 90% of aldosterone-producing adenomas (APAs). Other causes of lateralized adrenal PA include aldosterone-producing nodules (APNs).

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  • The study explores how genetic variations influence the wide range of physical characteristics seen in people with SHOX deficiency, a common genetic cause of short stature.
  • Researchers analyzed genetic data from 98 individuals across 48 families, focusing on the SHOX gene and other genes that might affect growth, but found no harmful variants directly in the SHOX gene's promoter or intronic regions.
  • They discovered several potentially harmful variants in other genes that may act as modifiers, highlighting that families with SHOX regulatory region alterations were more likely to have additional significant mutations, which may affect the severity of short stature.
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Adrenocortical carcinoma (ACC) is a rare but highly aggressive cancer with limited treatment options and poor survival for patients with advanced disease. An improved understanding of the transcriptional programs engaged in ACC will help direct rational, targeted therapies. Whereas activating mutations in Wnt/β-catenin signaling are frequently observed, the β-catenin-dependent transcriptional targets that promote tumor progression are poorly understood.

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A wearable microdialysis device measures ultradian patterns of adrenal hormone secretion in humans at minute scale (Upton .).

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Pompe disease (PD) is a monogenic autosomal recessive disorder caused by biallelic pathogenic variants of the gene encoding lysosomal alpha-glucosidase; its loss causes glycogen storage in lysosomes, mainly in the muscular tissue. The genotype-phenotype correlation has been extensively discussed, and caution is recommended when interpreting the clinical significance of any mutation in a single patient. As there is no evidence that environmental factors can modulate the phenotype, the observed clinical variability in PD suggests that genetic variants other than pathogenic GAA mutations influence the mechanisms of muscle damage/repair and the overall clinical picture.

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  • Adrenocortical carcinoma (ACC) is a rare and deadly cancer characterized by a specific subtype called CIMP-high, which is associated with abnormal DNA methylation and mutations in β-catenin.
  • Research shows that the differentiation in CIMP-high ACC relies on a complex interaction between β-catenin and certain transcription factors, maintaining its cancerous state throughout its development.
  • Targeting the epigenetic regulator EZH2 can disrupt these interactions, leading to reduced tumor growth and presenting a potential therapeutic approach for treating β-catenin-driven cancers.
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The aim of this paper is to give a thorough insight into the relationship between the Rumin complex on Carnot groups and the spectral sequence obtained from the filtration on forms by homogeneous weights that computes the de Rham cohomology of the underlying group.

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Proliferating cell nuclear antigen (PCNA) is a sliding clamp protein that coordinates DNA replication with various DNA maintenance events that are critical for human health. Recently, a hypomorphic homozygous serine to isoleucine (S228I) substitution in PCNA was described to underlie a rare DNA repair disorder known as PCNA-associated DNA repair disorder (PARD). PARD symptoms range from UV sensitivity, neurodegeneration, telangiectasia, and premature aging.

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  • Exome sequencing is highlighted as a valuable resource in both prenatal and postnatal genetics, particularly for finding new candidate genes essential to human development.
  • The study discusses seven unpublished cases of individuals with rare genetic variants related to recessive diseases involving the TBC1D32 gene, including both fetal and pediatric patients.
  • TBC1D32 plays a role in cilia development and function, and the researchers present new data on its associated severe prenatal phenotypes linked to significant congenital abnormalities.
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Glioblastoma (GBM) is an aggressive brain cancer associated with poor overall survival. The metabolic status and tumor microenvironment of GBM cells have been targeted to improve therapeutic strategies. TLR4 is an important innate immune receptor capable of recognizing pathogens and danger-associated molecules.

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  • - The study focused on children with idiopathic short stature (ISS) to see if a multigene analysis could provide a genetic diagnosis, as many remain undiagnosed after extensive evaluations.
  • - Researchers analyzed 102 children with ISS using targeted panel sequencing, finding pathogenic or likely pathogenic genetic variants in 17 children, resulting in a diagnostic yield of 16.7%.
  • - The findings revealed that a multigene sequencing approach can identify genetic causes of short stature, potentially changing the classification of ISS cases and affecting clinical management, especially in those with more severe short stature.
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