The potential of nitisinone for the treatment of alkaptonuria
EXPERT OPINION ON ORPHAN DRUGS
Authors: Taylor, Adam M.; Shepherd, Laura
Abstract
Introduction: Alkaptonuria is an iconic disease, dating back to the Egyptians and has continued to prove a valuable teaching tool to many medics as an example of an inborn error of metabolism. In recent years, much progress has been made on understanding the condition and its symptoms; the single defective gene has been identified and cloned. In humans, novel phenotypic presentations of the condition have been documented, and in vitro models developed to understand the disease. Furthermore, a mouse model has studied and most recently clinical trials into the effectiveness of nitisinone have been undertaken. Nitisinone has been on a miraculous journey from its discovery as a weed killer to its effective treatment in hereditary tyrosinemia type - 1. Areas covered: The authors describe research into nitisinone and its application in the model and human systems in both hereditary tyrosinemia type 1 (HTT-1) and Alkaptonuria. The published literature was searched for outputs relating to 'Alkaptonuria', 'ochronosis', 'nitisinone', 'hereditary tyrosinemia type 1'. Any paper not in English or had no translation were excluded. Expert opinion: Now nitisinone is being studied for use in Alkaptonuria and this paper documents the journey of AKU and the promising potential of nitisinone in the treatment of Alkaptonuria.
Huntingtin geneCAGrepeat size affects autism risk: Family-based and case-control association study
AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS
Authors: Piras, Ignazio Stefano; Picinelli, Chiara; Iennaco, Raffaele; Baccarin, Marco; Castronovo, Paola; Tomaiuolo, Pasquale; Cucinotta, Francesca; Ricciardello, Arianna; Turriziani, Laura; Nanetti, Lorenzo; Mariotti, Caterina; Gellera, Cinzia; Lintas, Carla; Sacco, Roberto; Zuccato, Chiara; Cattaneo, Elena; Persico, Antonio M.
Abstract
The Huntingtin (HTT) gene contains a CAG repeat in exon 1, whose expansion beyond 39 repeats consistently leads to Huntington's disease (HD), whereas normal-to-intermediate alleles seemingly modulate brain structure, function and behavior. The role of the CAG repeat in Autism Spectrum Disorder (ASD) was investigated applying both family-based and case-control association designs, with the SCA3 repeat as a negative control. Significant overtransmission of "long" CAG alleles (>= 17 repeats) to autistic children and of "short" alleles (<= 16 repeats) to their unaffected siblings (allp < 10(-5)) was observed in 612 ASD families (548 simplex and 64 multiplex). Surprisingly, both 193 population controls and 1,188 neurological non-HD controls have significantly lower frequencies of "short" CAG alleles compared to 185 unaffected siblings and higher rates of "long" alleles compared to 548 ASD patients from the same families (p < .05-.001). The SCA3 CAG repeat displays no association. "Short" HTT alleles seemingly exert a protective effect from clinically overt autism in families carrying a genetic predisposition for ASD, while "long" alleles may enhance autism risk. Differential penetrance of autism-inducing genetic/epigenetic variants may imply atypical developmental trajectories linked to HTT functions, including excitation/inhibition imbalance, cortical neurogenesis and apoptosis, neuronal migration, synapse formation, connectivity and homeostasis.