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1. Dietary practices in methylmalonic acidaemia: a European survey

Author

Pinto, A., Evans, S., Daly, A., Almeida, M.F., Assoun, M., Belanger-Quintana, A., Bernabei, S.M., Bollhalder, S., Cassiman, D., Champion, H., Chan, H., Corthouts, K., Dalmau, J., Boer, F. de, Laet, C. de, Meyer, A, Desloovere, A., Dianin, A., Dixon, M., Dokoupil, K., Dubois, S., Eyskens, F., Faria, A., Fasan, I., Favre, E., Feillet, F., Fekete, A., Gallo, G., Gingell, C., Gribben, J., Hansen, K.K., Horst, N.T., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jouault, C., Kahrs, G.E., Kok, I., Kowalik, A., Laguerre, C., Verge, S.L., Liguori, A., Lilje, R., Maddalon, C., Mayr, D., Meyer, U., Micciche, A., Och, U., Robert, M., Rocha, J.C., Rogozinski, H., Rohde, C., Ross, K., Saruggia, I., Schlune, A., Singleton, K., Sjoqvist, E., Skeath, R., Stolen, L.H., Terry, A., Timmer, C., Tomlinson, L., Tooke, A., Kerckhove, K.V., Dam, E. van, Hurk, D.V.D., Ploeg, L.V., Driessche, M. Van, Rijn, M. van de, Wegberg, A.M. van, Vasconcelos, C., Vestergaard, H., Vitoria, I., Webster, D., White, F., White, L., Zweers, H.E., MacDonald, A., Pinto, A., Evans, S., Daly, A., Almeida, M.F., Assoun, M., Belanger-Quintana, A., Bernabei, S.M., Bollhalder, S., Cassiman, D., Champion, H., Chan, H., Corthouts, K., Dalmau, J., Boer, F. de, Laet, C. de, Meyer, A, Desloovere, A., Dianin, A., Dixon, M., Dokoupil, K., Dubois, S., Eyskens, F., Faria, A., Fasan, I., Favre, E., Feillet, F., Fekete, A., Gallo, G., Gingell, C., Gribben, J., Hansen, K.K., Horst, N.T., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jouault, C., Kahrs, G.E., Kok, I., Kowalik, A., Laguerre, C., Verge, S.L., Liguori, A., Lilje, R., Maddalon, C., Mayr, D., Meyer, U., Micciche, A., Och, U., Robert, M., Rocha, J.C., Rogozinski, H., Rohde, C., Ross, K., Saruggia, I., Schlune, A., Singleton, K., Sjoqvist, E., Skeath, R., Stolen, L.H., Terry, A., Timmer, C., Tomlinson, L., Tooke, A., Kerckhove, K.V., Dam, E. van, Hurk, D.V.D., Ploeg, L.V., Driessche, M. Van, Rijn, M. van de, Wegberg, A.M. van, Vasconcelos, C., Vestergaard, H., Vitoria, I., Webster, D., White, F., White, L., Zweers, H.E., and MacDonald, A.

Abstract

Contains fulltext : 220058.pdf (Publisher’s version ) (Open Access), Background The dietary management of methylmalonic acidaemia (MMA) is a low-protein diet providing sufficient energy to avoid catabolism and to limit production of methylmalonic acid. The goal is to achieve normal growth, good nutritional status and the maintenance of metabolic stability. Aim To describe the dietary management of patients with MMA across Europe. Methods A cross-sectional questionnaire was sent to European colleagues managing inherited metabolic disorders (IMDs) (n=53) with 27 questions about the nutritional management of organic acidaemias. Data were analysed by different age ranges (0-6 months; 7-12 months; 1-10 years; 11-16 years; >16 years). Results Questionnaires were returned from 53 centres. Twenty-five centres cared for 80 patients with MMA vitamin B12 responsive (MMAB12r) and 43 centres managed 215 patients with MMA vitamin B12 non-responsive (MMAB12nr). For MMAB12r patients, 44% of centres (n=11/25) prescribed natural protein below the World Health Organization/Food and Agriculture Organization/United Nations University (WHO/FAO/UNU) 2007 safe levels of protein intake in at least one age range. Precursor-free amino acids (PFAA) were prescribed by 40% of centres (10/25) caring for 36% (29/80) of all the patients. For MMAB12nr patients, 72% of centres (n=31/43) prescribed natural protein below the safe levels of protein intake (WHO/FAO/UNU 2007) in at least one age range. PFAA were prescribed by 77% of centres (n=33/43) managing 81% (n=174/215) of patients. In MMAB12nr patients, 90 (42%) required tube feeding: 25 via a nasogastric tube and 65 via a gastrostomy. Conclusions A high percentage of centres used PFAA in MMA patients together with a protein prescription that provided less than the safe levels of natural protein intake. However, there was inconsistent practices across Europe. Long-term efficacy studies are needed to study patient outcome when using PFAA with different severities of natural protein restrictions in patients with MMA to

Published
2020

2. Dietary practices in isovaleric acidemia: A European survey

Author

Pinto, A., Daly, A., Evans, S., Almeida, M.F., Assoun, M., Belanger-Quintana, A., Bernabei, S., Bollhalder, S., Cassiman, D., Champion, H., Chan, H., Dalmau, J., Boer, F. de, Laet, C. de, Meyer, A, Desloovere, A., Dianin, A., Dixon, M., Dokoupil, K., Dubois, S., Eyskens, F., Faria, A., Fasan, I., Favre, E., Feillet, F., Fekete, A., Gallo, G., Gingell, C., Gribben, J., Kaalund-Hansen, K., Horst, N., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jouault, C., Kahrs, G.E., Kok, I.L., Kowalik, A., Laguerre, C., Verge, S. Le, Lilje, R., Maddalon, C., Mayr, D., Meyer, U., Micciche, A., Robert, M., Rocha, J.C., Rogozinski, H., Rohde, C., Ross, K., Saruggia, I., Schlune, A., Singleton, K., Sjoqvist, E., Stolen, L.H., Terry, A., Timmer, C., Tomlinson, L., Tooke, A., Kerckhove, K. Vande, Dam, E. van, Hurk, T. van den, Ploeg, L. van der, Driessche, M. Van, Rijn, M. van de, Teeffelen-Heithoff, A. van, Wegberg, A.M. van, Vasconcelos, C., Vestergaard, H., Vitoria, I., Webster, D., White, F.J., White, L., Zweers, H.E., Macdonald, A., Pinto, A., Daly, A., Evans, S., Almeida, M.F., Assoun, M., Belanger-Quintana, A., Bernabei, S., Bollhalder, S., Cassiman, D., Champion, H., Chan, H., Dalmau, J., Boer, F. de, Laet, C. de, Meyer, A, Desloovere, A., Dianin, A., Dixon, M., Dokoupil, K., Dubois, S., Eyskens, F., Faria, A., Fasan, I., Favre, E., Feillet, F., Fekete, A., Gallo, G., Gingell, C., Gribben, J., Kaalund-Hansen, K., Horst, N., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jouault, C., Kahrs, G.E., Kok, I.L., Kowalik, A., Laguerre, C., Verge, S. Le, Lilje, R., Maddalon, C., Mayr, D., Meyer, U., Micciche, A., Robert, M., Rocha, J.C., Rogozinski, H., Rohde, C., Ross, K., Saruggia, I., Schlune, A., Singleton, K., Sjoqvist, E., Stolen, L.H., Terry, A., Timmer, C., Tomlinson, L., Tooke, A., Kerckhove, K. Vande, Dam, E. van, Hurk, T. van den, Ploeg, L. van der, Driessche, M. Van, Rijn, M. van de, Teeffelen-Heithoff, A. van, Wegberg, A.M. van, Vasconcelos, C., Vestergaard, H., Vitoria, I., Webster, D., White, F.J., White, L., Zweers, H.E., and Macdonald, A.

Abstract

Contains fulltext : 169955.pdf (publisher's version ) (Open Access), BACKGROUND: In Europe, dietary management of isovaleric acidemia (IVA) may vary widely. There is limited collective information about dietetic management. AIM: To describe European practice regarding the dietary management of IVA, prior to the availability of the E-IMD IVA guidelines (E-IMD 2014). METHODS: A cross-sectional questionnaire was sent to all European dietitians who were either members of the Society for the Study of Inborn Errors of Metabolism Dietitians Group (SSIEM-DG) or whom had responded to previous questionnaires on dietetic practice (n = 53). The questionnaire comprised 27 questions about the dietary management of IVA. RESULTS: Information on 140 patients with IVA from 39 centres was reported. 133 patients (38 centres) were given a protein restricted diet. Leucine-free amino acid supplements (LFAA) were routinely used to supplement protein intake in 58% of centres. The median total protein intake prescribed achieved the WHO/FAO/UNU [2007] safe levels of protein intake in all age groups. Centres that prescribed LFAA had lower natural protein intakes in most age groups except 1 to 10 y. In contrast, when centres were not using LFAA, the median natural protein intake met WHO/FAO/UNU [2007] safe levels of protein intake in all age groups. Enteral tube feeding was rarely prescribed. CONCLUSIONS: This survey demonstrates wide differences in dietary practice in the management of IVA across European centres. It provides unique dietary data collectively representing European practices in IVA which can be used as a foundation to compare dietary management changes as a consequence of the first E-IMD IVA guidelines availability.

Published
2017

3. Key European guidelines for the diagnosis and management of patients with phenylketonuria

Author

Spronsen, F.J. van, Wegberg, A.M.J. van, Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Trefz, F.K., Rijn, M. van de, Walter, J.H., Macdonald, A., Spronsen, F.J. van, Wegberg, A.M.J. van, Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Trefz, F.K., Rijn, M. van de, Walter, J.H., and Macdonald, A.

Abstract

Item does not contain fulltext, We developed European guidelines to optimise phenylketonuria (PKU) care. To develop the guidelines, we did a literature search, critical appraisal, and evidence grading according to the Scottish Intercollegiate Guidelines Network method. We used the Delphi method when little or no evidence was available. From the 70 recommendations formulated, in this Review we describe ten that we deem as having the highest priority. Diet is the cornerstone of treatment, although some patients can benefit from tetrahydrobiopterin (BH4). Untreated blood phenylalanine concentrations determine management of people with PKU. No intervention is required if the blood phenylalanine concentration is less than 360 mumol/L. Treatment is recommended up to the age of 12 years if the phenylalanine blood concentration is between 360 mumol/L and 600 mumol/L, and lifelong treatment is recommended if the concentration is more than 600 mumol/L. For women trying to conceive and during pregnancy (maternal PKU), untreated phenylalanine blood concentrations of more than 360 mumol/L need to be reduced. Treatment target concentrations are as follows: 120-360 mumol/L for individuals aged 0-12 years and for maternal PKU, and 120-600 mumol/L for non-pregnant individuals older than 12 years. Minimum requirements for the management and follow-up of patients with PKU are scheduled according to age, adherence to treatment, and clinical status. Nutritional, clinical, and biochemical follow-up is necessary for all patients, regardless of therapy.

Published
2017

4. Issues with European guidelines for phenylketonuria - Authors' reply

Author

Spronsen, F.J. van, Wegberg, A.M.J. van, Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Trefz, F.K., Rijn, M. van de, Macdonald, A., Spronsen, F.J. van, Wegberg, A.M.J. van, Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Trefz, F.K., Rijn, M. van de, and Macdonald, A.

Abstract

Item does not contain fulltext

Published
2017

5. The complete European guidelines on phenylketonuria: diagnosis and treatment

Author

Wegberg, A.M.J. van, Macdonald, A., Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Rijn, M. van de, Trefz, F., Walter, J.H., Spronsen, F.J. van, Wegberg, A.M.J. van, Macdonald, A., Ahring, K., Belanger-Quintana, A., Blau, N., Bosch, A.M., Burlina, A., Campistol, J., Feillet, F., Gizewska, M., Huijbregts, S.C.J., Kearney, S., Leuzzi, V., Maillot, F., Muntau, A.C., Rijn, M. van de, Trefz, F., Walter, J.H., and Spronsen, F.J. van

Abstract

Contains fulltext : 182674.pdf (publisher's version ) (Open Access), Phenylketonuria (PKU) is an autosomal recessive inborn error of phenylalanine metabolism caused by deficiency in the enzyme phenylalanine hydroxylase that converts phenylalanine into tyrosine. If left untreated, PKU results in increased phenylalanine concentrations in blood and brain, which cause severe intellectual disability, epilepsy and behavioural problems. PKU management differs widely across Europe and therefore these guidelines have been developed aiming to optimize and standardize PKU care. Professionals from 10 different European countries developed the guidelines according to the AGREE (Appraisal of Guidelines for Research and Evaluation) method. Literature search, critical appraisal and evidence grading were conducted according to the SIGN (Scottish Intercollegiate Guidelines Network) method. The Delphi-method was used when there was no or little evidence available. External consultants reviewed the guidelines. Using these methods 70 statements were formulated based on the highest quality evidence available. The level of evidence of most recommendations is C or D. Although study designs and patient numbers are sub-optimal, many statements are convincing, important and relevant. In addition, knowledge gaps are identified which require further research in order to direct better care for the future.

Published
2017

6. The neonatal tetrahydrobiopterin loading test in phenylketonuria: what is the predictive value?

Author

Anjema, K., Hofstede, F.C., Bosch, A.M., Rubio-Gozalbo, M.E., Vries, M.C. de, Boelen, C.C., Rijn, M. van de, Spronsen, F.J. van, Anjema, K., Hofstede, F.C., Bosch, A.M., Rubio-Gozalbo, M.E., Vries, M.C. de, Boelen, C.C., Rijn, M. van de, and Spronsen, F.J. van

Abstract

Contains fulltext : 171759.pdf (publisher's version ) (Open Access), BACKGROUND: It is unknown whether the neonatal tetrahydrobiopterin (BH4) loading test is adequate to diagnose long-term BH4 responsiveness in PKU. Therefore we compared the predictive value of the neonatal (test I) versus the 48-h BH4 loading test (test II) and long-term BH4 responsiveness. METHODS: Data on test I (>1991, 20 mg/kg) at T = 8 (n = 85) and T = 24 (n = 5) were collected and compared with test II and long-term BH4 responsiveness at later age, with >/=30 % Phe decrease used as the cut-off. RESULTS: The median (IQR) age at hospital diagnosis was 9 (7-11) days and the age at test II was 11.8 (6.6-13.7) years. The baseline Phe concentrations at test I were significantly higher compared to test II (1309 (834-1710) versus 514 (402-689) mumol/L, respectively, P = 0.000). 15/85 patients had a positive test I T = 8. All, except one patient who was not tested for long-term BH4 responsiveness, showed long-term BH4 responsiveness. In 20/70 patients with a negative test I T = 8, long-term BH4 responsiveness was confirmed. Of 5 patients with a test I T = 24, 1/5 was positive at both tests and showed long-term BH4 responsiveness, 2/5 had negative results at both tests and 2/5 showed a negative test I T = 24, but a positive test II with 1/2 showing long-term BH4 responsiveness. CONCLUSIONS: Both a positive neonatal 8- and 24-h BH4 loading test are predictive for long-term BH4 responsiveness. However, a negative test does not rule out long-term BH4 responsiveness. Other alternatives to test for BH4 responsiveness at neonatal age should be investigated.

Published
2016

7. Clinical pathways for inborn errors of metabolism: warranted and feasible

Author

Demirdas, S., Kessel, I.N. van, Korndewal, M.J., Hollak, C.E.M., Meutgeert, H., Klaren, A., Rijn, M. van de, Spronsen, F.J. van, Bosch, A.M., Janssen, M.C.H., and Morava, E.

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, Glycostation disorders [IGMD 4], Health aging / healthy living Cardiovascular diseases [IGMD 5]
Abstract

Contains fulltext : 118156.pdf (Publisher’s version ) (Open Access) Inborn errors of metabolism (IEMs) are known for their low prevalence and multidisciplinary care mostly founded on expert opinion. Clinical pathways are multidisciplinary tools to organise care which provide a clear route to the best care and improve communication. In 2010 the Dutch Society for Children and Adults with an Inborn Error of Metabolism (VKS) initiated development of clinical pathways for inborn errors of metabolism. In this letter to the editor we describe why it is warranted to develop clinical pathways for IEMs and shortly discuss the process of development for these pathways in the Netherlands.

Published
2013

8. Practices in prescribing protein substitutes for PKU in Europe: No uniformity of approach

Author

Aguiar, A., Ahring, K., Almeida, M.F., Assoun, M., Belanger Quintana, A., Bigot, S., Bihet, G., Malmberg, K., Burlina, A., Bushueva, T., Caris, A., Chan, H., Clark, A., Clark, S., Cochrane, B., Corthouts, K., Dalmau, J., Dassy, M., Meyer, A, Didycz, B., Diels, M., Dokupil, K., Dubois, S., Eftring, K., Ekengren, J., Ellerton, C., Evans, S., Faria, A., Fischer, A., Ford, S., Freisinger, P., Gizewska, M., Gokmen-Ozel, H., Gribben, J., Gunden, F., Heddrich-Ellerbrok, M., Heiber, S., Heidenborg, C., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jonkers, C., Joerg-Streller, M., Kaalund-Hansen, K., Kiss, E., Lammardo, A.M., Lang, K., Lier, D., Lilje, R., Lowry, S., Luyten, K., Macdonald, A., Meyer, U., Moor, D., Pal, A., Robert, M., Robertson, L., Rocha, J.C., Rohde, C., Ross, K., Saruhan, S., Sjoqvist, E., Skeath, R., Stoelen, L., Horst, N.M. Ter, Terry, A., Timmer, C., Tuncer, N., Kerckhove, K. Vande, Ploeg, L. van der, Rijn, M. van de, Spronsen, F.J. van, Teeffelen-Heithoff, A. van, Wegberg, A. van, Wyk, K. van, Vasconcelos, C., Vitoria, I., Wildgoose, J., Webster, D., White, F.J., Zweers, H.E., Aguiar, A., Ahring, K., Almeida, M.F., Assoun, M., Belanger Quintana, A., Bigot, S., Bihet, G., Malmberg, K., Burlina, A., Bushueva, T., Caris, A., Chan, H., Clark, A., Clark, S., Cochrane, B., Corthouts, K., Dalmau, J., Dassy, M., Meyer, A, Didycz, B., Diels, M., Dokupil, K., Dubois, S., Eftring, K., Ekengren, J., Ellerton, C., Evans, S., Faria, A., Fischer, A., Ford, S., Freisinger, P., Gizewska, M., Gokmen-Ozel, H., Gribben, J., Gunden, F., Heddrich-Ellerbrok, M., Heiber, S., Heidenborg, C., Jankowski, C., Janssen-Regelink, R.G., Jones, I., Jonkers, C., Joerg-Streller, M., Kaalund-Hansen, K., Kiss, E., Lammardo, A.M., Lang, K., Lier, D., Lilje, R., Lowry, S., Luyten, K., Macdonald, A., Meyer, U., Moor, D., Pal, A., Robert, M., Robertson, L., Rocha, J.C., Rohde, C., Ross, K., Saruhan, S., Sjoqvist, E., Skeath, R., Stoelen, L., Horst, N.M. Ter, Terry, A., Timmer, C., Tuncer, N., Kerckhove, K. Vande, Ploeg, L. van der, Rijn, M. van de, Spronsen, F.J. van, Teeffelen-Heithoff, A. van, Wegberg, A. van, Wyk, K. van, Vasconcelos, C., Vitoria, I., Wildgoose, J., Webster, D., White, F.J., and Zweers, H.E.

Abstract

Item does not contain fulltext, BACKGROUND: There appears little consensus concerning protein requirements in phenylketonuria (PKU). METHODS: A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein substitute [PS]) by age, administration frequency and method, monitoring, and type of protein substitute. Data were analysed by European region using descriptive statistics. RESULTS: The amount of total protein (from PS and natural/intact protein) varied according to the European region. Higher median amounts of total protein were prescribed in infants and children in Northern Europe (n=24 centres) (infants <1 year, >2-3g/kg/day; 1-3 years of age, >2-3 g/kg/day; 4-10 years of age, >1.5-2.5 g/kg/day) and Southern Europe (n=10 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, 2 g/kg/day; 4-10 years of age, 1.5-2 g/kg/day), than by Eastern Europe (n=4 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, >2-2.5 g/kg/day; 4-10 years of age, >1.5-2 g/kg/day) and with Western Europe (n=25 centres) giving the least (infants <1 year, >2-2.5 g/kg/day, 1-3 years of age, 1.5-2 g/kg/day; 4-10 years of age, 1-1.5 g/kg/day). Total protein prescription was similar in patients aged >10 years (1-1.5 g/kg/day) and maternal patients (1-1.5 g/kg/day). CONCLUSIONS: The amounts of total protein prescribed varied between European countries and appeared to be influenced by geographical region. In PKU, all gave higher than the recommended 2007 WHO/FAO/UNU safe levels of protein intake for the general population.

Published
2015

9. Identification of IG-clonality status as a pre-treatment predictor for mortality in patients with immunodeficiency-associated Epstein-Barr virus-related lymphoproliferative disorders

Author

Velden, W.J.F.M. van der, Nissen, L.H.C., Rijn, M. van de, Rijntjes, J., Haan, A.F.J. de, Venkatraman, L., Catherwood, M., Liu, H., El-Daly, H., Laar, L. van de, Craenmehr, M.H.C., Krieken, J.H.J.M. van, Stevens, W.B.C., Groenen, P.J.T.A., Velden, W.J.F.M. van der, Nissen, L.H.C., Rijn, M. van de, Rijntjes, J., Haan, A.F.J. de, Venkatraman, L., Catherwood, M., Liu, H., El-Daly, H., Laar, L. van de, Craenmehr, M.H.C., Krieken, J.H.J.M. van, Stevens, W.B.C., and Groenen, P.J.T.A.

Abstract

Contains fulltext : 153041.pdf (publisher's version ) (Open Access)

Published
2015

10. How strict is galactose restriction in adults with galactosaemia? International practice

Author

Adam, S., Akroyd, R., Bernabei, S., Bollhalder, S., Boocock, S., Burlina, A., Coote, T., Corthouts, K., Dalmau, J., Dawson, S., Defourny, S., Meijer, A, Desloovere, A., Devlin, Y., Diels, M., Dokoupil, K., Donald, S., Evans, S., Fasan, I., Ferguson, C., Ford, S., Forga, M., Gallo, G., Grunert, S.C., Heddrich-Ellerbrok, M., Heidenborg, C., Jonkers, C., Lefebure, K., Luyten, K., Macdonald, A., Meyer, U., Micciche, A., Muller, E., Portnoi, P., Ripley, S., Robert, M., Robertson, L.V., Rosenbaum-Fabian, S., Sahm, K., Schultz, S., Singleton, K., Sjoqvist, E., Stoelen, L., Terry, A., Thompson, S., Timmer, C., Kerckhove, K. Vande, Ploeg, L. van der, Driessche, M. Van, Rijn, M. van de, Teeffelen-Heithoff, A. van, Vitoria, I., Voillot, C., Wenz, J., Westbrook, M., Wildgoose, J., Zweers, H.E., Adam, S., Akroyd, R., Bernabei, S., Bollhalder, S., Boocock, S., Burlina, A., Coote, T., Corthouts, K., Dalmau, J., Dawson, S., Defourny, S., Meijer, A, Desloovere, A., Devlin, Y., Diels, M., Dokoupil, K., Donald, S., Evans, S., Fasan, I., Ferguson, C., Ford, S., Forga, M., Gallo, G., Grunert, S.C., Heddrich-Ellerbrok, M., Heidenborg, C., Jonkers, C., Lefebure, K., Luyten, K., Macdonald, A., Meyer, U., Micciche, A., Muller, E., Portnoi, P., Ripley, S., Robert, M., Robertson, L.V., Rosenbaum-Fabian, S., Sahm, K., Schultz, S., Singleton, K., Sjoqvist, E., Stoelen, L., Terry, A., Thompson, S., Timmer, C., Kerckhove, K. Vande, Ploeg, L. van der, Driessche, M. Van, Rijn, M. van de, Teeffelen-Heithoff, A. van, Vitoria, I., Voillot, C., Wenz, J., Westbrook, M., Wildgoose, J., and Zweers, H.E.

Abstract

Item does not contain fulltext, Dietary management of 418 adult patients with galactosaemia (from 39 centres/12 countries) was compared. All centres advised lactose restriction, 6 restricted galactose from galactosides +/- fruits and vegetables and 12 offal. 38% (n=15) relaxed diet by: 1) allowing traces of lactose in manufactured foods (n=13) or 2) giving fruits, vegetables and galactosides (n=2). Only 15% (n=6) calculated dietary galactose. 32% of patients were lost to dietetic follow-up. In adult galactosaemia, there is limited diet relaxation.

Published
2015

11. Genome-wide transcriptome analyses reveal p53 inactivation mediated loss of miR-34a expression in malignant peripheral nerve sheath tumours

Author

Subramanian, S., Thayanithy, V., West, R.B., Lee, C.H., Beck, A.H., Zhu, S., Downs-Kelly, E., Montgomery, K., Goldblum, J.R., Hogendoom, P.C.W., Corless, C.L., Oliveira, A.M., Dry, S.M., Nielsen, T.O., Rubin, B.P., Fletcher, J.A., Fletcher, C.D.M., and Rijn, M. van de

Subjects
peripheral nerve sheath tumours malignant transformation expression profiling microRNA growth-factor receptor soft-tissue tumors gene-expression synovial sarcoma neurofibromatosis 1 suppressor network human cancer factor snail micrornas apoptosis
Abstract

Malignant peripheral nerve sheath tumours (MPNSTs) are aggressive soft tissue tumours that occur either sporadically or in patients with neurofibromatosis type 1. The malignant transformation of the benign neurofibroma to MPNST is incompletely understood at the molecular level. We have determined the gene expression signature for benign and malignant PNSTs and found that the major trend in malignant transformation from neurofibroma to MPNST consists of the loss of expression of a large number of genes, rather than widespread increase in gene expression. Relatively few genes are expressed at higher levels in MPNSTs and these include genes involved in cell proliferation and genes implicated in tumour metastasis. In addition, a gene expression signature indicating p53 inactivation is seen in the majority of MPNSTs. Subsequent microRNA profiling of benign and malignant PNSTs indicated a relative down-regulation of miR-34a in most MPNSTs compared to neurofibromas. In vitro studies using the cell lines MPNST-14 (NF1 mutant) and MPNST-724 (from a non-NF1 individual) show that exogenous expression of p53 or miR-34a promotes apoptotic cell death. In addition, exogenous expression of p53 in MPNST cells induces miR-34a and other miRNAs. Our data show that p53 inactivation and subsequent loss of expression of miR-34a may significantly contribute to the MPNST development. Collectively, our findings suggest that deregulation of miRNAs has a potential role in the malignant transformation process in peripheral nerve sheath tumours. Copyright (C) 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Published
2010
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12. Dietary practices in pyridoxine non-responsive homocystinuria: A European survey.

Author

Adam, S., Almeida, M.F., Carbasius Weber, E., Champion, H., Chan, H., Daly, A., Dixon, M., Dokoupil, K., Egli, D., Evans, S., Eyskens, F., Faria, A., Ferguson, C., Hallam, P., Heddrich-Ellerbrok, M., Jacobs, J., Jankowski, C., Lachmann, R., Lilje, R., Link, R., Lowry, S., Luyten, K., Macdonald, A., Maritz, C., Martins, E., Meyer, U., Muller, E., Murphy, E., Robertson, L.V., Rocha, J.C., Saruggia, I., Schick, P., Stafford, J., Stoelen, L., Terry, A., Thom, R., Hurk, T. van den, Rijn, M. van de, Teefelen-Heithoff, A. van, Webster, D., White, F.J., Wildgoose, J., Zweers, H., Adam, S., Almeida, M.F., Carbasius Weber, E., Champion, H., Chan, H., Daly, A., Dixon, M., Dokoupil, K., Egli, D., Evans, S., Eyskens, F., Faria, A., Ferguson, C., Hallam, P., Heddrich-Ellerbrok, M., Jacobs, J., Jankowski, C., Lachmann, R., Lilje, R., Link, R., Lowry, S., Luyten, K., Macdonald, A., Maritz, C., Martins, E., Meyer, U., Muller, E., Murphy, E., Robertson, L.V., Rocha, J.C., Saruggia, I., Schick, P., Stafford, J., Stoelen, L., Terry, A., Thom, R., Hurk, T. van den, Rijn, M. van de, Teefelen-Heithoff, A. van, Webster, D., White, F.J., Wildgoose, J., and Zweers, H.

Abstract

1 december 2013, Item does not contain fulltext, BACKGROUND: Within Europe, the management of pyridoxine (B6) non-responsive homocystinuria (HCU) may vary but there is limited knowledge about treatment practice. AIM: A comparison of dietetic management practices of patients with B6 non-responsive HCU in European centres. METHODS: A cross-sectional audit by questionnaire was completed by 29 inherited metabolic disorder (IMD) centres: (14 UK, 5 Germany, 3 Netherlands, 2 Switzerland, 2 Portugal, 1 France, 1 Norway, 1 Belgium). RESULTS: 181 patients (73% >16years of age) with HCU were identified. The majority (66%; n=119) were on dietary treatment (1-10years, 90%; 11-16years, 82%; and >16years, 58%) with or without betaine and 34% (n=62) were on betaine alone. The median natural protein intake (g/day) on diet only was, by age: 1-10years, 12g; 11-16years, 11g; and >16years, 45g. With diet and betaine, median natural protein intake (g/day) by age was: 1-10years, 13g; 11-16years, 20g; and >16years, 38g. Fifty-two percent (n=15) of centres allocated natural protein by calculating methionine rather than a protein exchange system. A methionine-free l-amino acid supplement was prescribed for 86% of diet treated patients. Fifty-two percent of centres recommended cystine supplements for low plasma concentrations. Target treatment concentrations for homocystine/homocysteine (free/total) and frequency of biochemical monitoring varied. CONCLUSION: In B6 non-responsive HCU the prescription of dietary restriction by IMD centres declined with age, potentially associated with poor adherence in older patients. Inconsistencies in biochemical monitoring and treatment indicate the need for international consensus guidelines.

Published
2013

13. Dietary management of urea cycle disorders: European practice.

Author

Adam, S., Almeida, M.F., Assoun, M., Baruteau, J., Bernabei, S.M., Bigot, S., Champion, H., Daly, A., Dassy, M., Dawson, S., Dixon, M., Dokoupil, K., Dubois, S., Dunlop, C., Evans, S., Eyskens, F., Faria, A., Favre, E., Ferguson, C., Goncalves, C., Gribben, J., Heddrich-Ellerbrok, M., Jankowski, C., Janssen-Regelink, R.G., Jouault, C., Laguerre, C., Verge, S. Le, Link, R., Lowry, S., Luyten, K., Macdonald, A., Maritz, C., McDowell, S., Meyer, U., Micciche, A., Robert, M., Robertson, L.V., Rocha, J.C., Rohde, C., Saruggia, I., Sjoqvist, E., Stafford, J., Terry, A., Thom, R., nde Kerckhove, K. Va, Rijn, M. van de, Teeffelen-Heithoff, A. van, Wegberg, A.M.J. van, Wyk, K. van, Vasconcelos, C., Vestergaard, H., Webster, D., White, F.J., Wildgoose, J., Zweers, H., Adam, S., Almeida, M.F., Assoun, M., Baruteau, J., Bernabei, S.M., Bigot, S., Champion, H., Daly, A., Dassy, M., Dawson, S., Dixon, M., Dokoupil, K., Dubois, S., Dunlop, C., Evans, S., Eyskens, F., Faria, A., Favre, E., Ferguson, C., Goncalves, C., Gribben, J., Heddrich-Ellerbrok, M., Jankowski, C., Janssen-Regelink, R.G., Jouault, C., Laguerre, C., Verge, S. Le, Link, R., Lowry, S., Luyten, K., Macdonald, A., Maritz, C., McDowell, S., Meyer, U., Micciche, A., Robert, M., Robertson, L.V., Rocha, J.C., Rohde, C., Saruggia, I., Sjoqvist, E., Stafford, J., Terry, A., Thom, R., nde Kerckhove, K. Va, Rijn, M. van de, Teeffelen-Heithoff, A. van, Wegberg, A.M.J. van, Wyk, K. van, Vasconcelos, C., Vestergaard, H., Webster, D., White, F.J., Wildgoose, J., and Zweers, H.

Abstract

1 december 2013, Item does not contain fulltext, BACKGROUND: There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. METHODS: Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1 Sweden) was collected by questionnaire describing management of patients with UCD on prescribed protein restricted diets. RESULTS: Data for 464 patients: N-acetylglutamate synthase (NAGS) deficiency, n=10; carbamoyl phosphate synthetase (CPS1) deficiency, n=29; ornithine transcarbamoylase (OTC) deficiency, n=214; citrullinaemia, n=108; argininosuccinic aciduria (ASA), n=80; arginase deficiency, n=23 was reported. The majority of patients (70%; n=327) were aged 0-16y and 30% (n=137) >16y. Prescribed median protein intake/kg body weight decreased with age with little variation between disorders. The UK tended to give more total protein than other European countries particularly in infancy. Supplements of essential amino acids (EAA) were prescribed for 38% [n=174] of the patients overall, but were given more commonly in arginase deficiency (74%), CPS (48%) and citrullinaemia (46%). Patients in Germany (64%), Portugal (67%) and Sweden (100%) were the most frequent users of EAA. Only 18% [n=84] of patients were prescribed tube feeds, most commonly for CPS (41%); and 21% [n=97] were prescribed oral energy supplements. CONCLUSIONS: Dietary treatment for UCD varies significantly between different conditions, and between and within European IMD centres. Further studies examining the outcome of treatment compared with the type of dietary therapy and nutritional support received are required.

Published
2013

14. The 48-hour tetrahydrobiopterin loading test in patients with phenylketonuria: evaluation of protocol and influence of baseline phenylalanine concentration.

Author

Anjema, K., Venema, G., Hofstede, F.C., Carbasius Weber, E.C., Bosch, A.M., Horst, N.M. Ter, Hollak, C.E.M., Jonkers, C.F., Rubio-Gozalbo, M.E., Ploeg, E.M. van der, Vries, M.C. de, Janssen-Regelink, R.G., Janssen, M.C.H., Zweers-van Essen, H.E.E., Boelen, C.C., Herberg-van de Wetering, N.A. van der, Heiner-Fokkema, M.R., Rijn, M. van de, Spronsen, F.J. van, Anjema, K., Venema, G., Hofstede, F.C., Carbasius Weber, E.C., Bosch, A.M., Horst, N.M. Ter, Hollak, C.E.M., Jonkers, C.F., Rubio-Gozalbo, M.E., Ploeg, E.M. van der, Vries, M.C. de, Janssen-Regelink, R.G., Janssen, M.C.H., Zweers-van Essen, H.E.E., Boelen, C.C., Herberg-van de Wetering, N.A. van der, Heiner-Fokkema, M.R., Rijn, M. van de, and Spronsen, F.J. van

Abstract

Item does not contain fulltext, BACKGROUND: The 24- and 48-hour tetrahydrobiopterin (BH4) loading test (BLT) performed at a minimum baseline phenylalanine concentration of 400 mumol/l is commonly used to test phenylketonuria patients for BH4 responsiveness. This study aimed to analyze differences between the 24- and 48-hour BLT and the necessity of the 400 mumol/l minimum baseline phenylalanine concentration. METHODS: Data on 186 phenylketonuria patients were collected. Patients were supplemented with phenylalanine if phenylalanine was <400 mumol/l. BH4 20mg/kg was administered at T = 0 and T = 24. Blood samples were taken at T=0, 8, 16, 24 and 48 h. Responsiveness was defined as >/= 30% reduction in phenylalanine concentration at >/= 1 time point. RESULTS: Eighty-six (46.2%) patients were responsive. Among responders 84% showed a >/= 30% response at T = 48. Fifty-three percent had their maximal decrease at T = 48. Fourteen patients had >/= 30% phenylalanine decrease not before T = 48. A >/= 30% decrease was also seen in patients with phenylalanine concentrations <400 mumol/l. CONCLUSION: In the 48-hour BLT, T = 48 seems more informative than T = 24. Sampling at T = 32, and T = 40 may have additional value. BH4 responsiveness can also be predicted with baseline blood phenylalanine <400 mumol/l, when the BLT is positive. Therefore, if these results are confirmed by data on long-term BH4 responsiveness, we advise to first perform a BLT without phenylalanine loading and re-test at higher phenylalanine concentrations when no response is seen. Most likely, the 48-hour BLT is a good indicator for BH4 responsiveness, but comparison with long term responsiveness is necessary.

Published
2011

15. Histone deacetylase inhibitors reverse SS18-SSX-mediated polycomb silencing of the tumor suppressor early growth response 1 in synovial sarcoma.

Author

Lubieniecka, J.M., Bruijn, D.R.H. de, Su, L., Dijk, A.H.A. van, Subramanian, S., Rijn, M. van de, Poulin, N., Geurts van Kessel, A.H.M., Nielsen, T.O., Lubieniecka, J.M., Bruijn, D.R.H. de, Su, L., Dijk, A.H.A. van, Subramanian, S., Rijn, M. van de, Poulin, N., Geurts van Kessel, A.H.M., and Nielsen, T.O.

Abstract

Contains fulltext : 69997.pdf (publisher's version ) (Closed access), Synovial sarcoma is a soft tissue malignancy characterized by the fusion of SS18 to either SSX1, SSX2, or SSX4 genes. SS18 and SSX are transcriptional cofactors involved in activation and repression of gene transcription, respectively. SS18 interacts with SWI/SNF, whereas SSX associates with the polycomb chromatin remodeling complex. Thus, fusion of these two proteins brings together two opposing effects on gene expression and chromatin structure. Recent studies have shown that a significant number of genes are down-regulated by the SS18-SSX fusion protein and that the clinically applicable histone deacetylase (HDAC) inhibitor romidepsin inhibits synovial sarcoma growth. Therefore, we set out to identify direct targets of SS18-SSX among genes down-regulated in synovial sarcoma and investigated if romidepsin can specifically counteract SS18-SSX-mediated transcriptional dysregulation. Here, we report that the tumor suppressor early growth response 1 (EGR1) is repressed by the SS18-SSX protein through a direct association with the EGR1 promoter. This SS18-SSX binding correlates with trimethylation of Lys(27) of histone H3 (H3K27-M3) and recruitment of polycomb group proteins to this promoter. In addition, we found that romidepsin treatment reverts these modifications and reactivates EGR1 expression in synovial sarcoma cell models. Our data implicate polycomb-mediated epigenetic gene repression as a mechanism of oncogenesis in synovial sarcoma. Furthermore, our work highlights a possible mechanism behind the efficacy of a clinically applicable HDAC inhibitor in synovial sarcoma treatment.

Published
2008

17. Immunoprofile of cervical and endometrial adenocarcinomas using a tissue microarray

Author

Alkushi, A., Irving, J., Hsu, F., Dupuis, B., Liu, C. L., Rijn, M. van de, and Gilks, C. B.

Abstract

Abstract Adenocarcinomas of the uterine cervix show a wide range of morphological features, and can be confused with endometrial adenocarcinoma in biopsy or curetting specimens. The objective of this study was to use tissue microarray technology to evaluate the immunoprofile of a large set of uterine adenocarcinomas with an extended panel of antibodies, comparing the profile of primary cervical and endometrial adenocarcinomas. A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 141 hysterectomy specimens. Duplicate 0.6-mm cores were obtained from 57 cervical adenocarcinomas (16 in situ and 41 invasive) and 84 endometrial adenocarcinomas. Tissue array sections were immunostained with 21 commercially available antibodies [B72.3, CD 99, carcinoembryonic antigen (CEA), c-kit, pancytokeratin, CK 5/6, CK 7, CK8/18, CK19, CK 20, CK 22, EMA, estrogen receptor (ER), KP-1, melan-A, p53, PLAP, S-100, synaptophysin, TTF-1, and vimentin] utilizing the avidin-biotin (ABC) technique. Hierarchical clustering analysis of the tumors was done based on the immunostaining results. Only ER (P&lt;0.001), CEA (P=0.04), vimentin (P&lt;0.001), and CK 8/18 (P=0.002) showed a significantly different frequency of positivity in endometrial relative to cervical adenocarcinomas. ER, vimentin, and CK 8/18 were more likely to be expressed in endometrial adenocarcinomas, while cervical adenocarcinomas more frequently expressed CEA. We were able to identify immunoprofiles that were highly specific for endocervical adenocarcinoma (ER−, vimentin−, CK 8/18−, CEA+) or endometrial adenocarcinoma (ER+, vimentin+, CK 8/18+, CEA−), but most tumors showed an intermediate, non-specific immunophenotype. Hierarchical clustering analysis was useful in the interpretation of these intermediate immunophenotypes. Papillary serous adenocarcinoma of the endometrium was less likely to express vimentin (P=0.002) than endometrioid carcinoma of the endometrium.

Published
2003
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18. Ultrastructural Localization of CD34 in Soft Tissue Tumors

Author

Bailey, G.W., Alexander, K.B., Jerome, W.G., Bond, M.G., McCarthy, J.J., Minda, J. M., Lawton, T. J., and Rijn, M. van de

Abstract

The CD34 antigen is a single chain, heavily glycosylated transmembrane protein originally identified in hematopoietic stem cells. Subsequently it was found to be expressed in cells of normal endothelium and a variety of soft tissue tumors, including: epithelioid sarcoma, solitary fibrous tumor,’ gastrointestinal stromal tumor and dermatofibrosarcoma protuberans. Using paraffin immunohistochemistry, membranous and cytoplasmic staining for CD34 can be seen in these lesions, with most showing a combination of both. The findings of cytoplasmic staining is unexpected, as CD34 is a transmembrane cell surface protein. We analyzed the ultrastructural localization of CD34 on two soft tissue tumors with membranous and combined membranous and cytoplasmic staining.Biopsy specimens were fixed with a mixture of 4% paraformaldehyde and 1% glutaraldehyde in 0.1M sodium cacodylate buffer, pH = 7.4 for 1-2 hours, and embedded in Poly/Bed 812 with osmium tetroxide post-fixation, or in LR White without osmication. The immunogold method was performed on ultrathin sections placed on Nickel grids,

Published
1998
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