BACKGROUND ACTA2 gene is a specific gene that encodes actinα2.Multisystem smooth muscle dysfunction syndrome(MSMDS)is a multisystem disease characterized by aortic and cerebrovascular lesions caused by ACTA2 gene mut...BACKGROUND ACTA2 gene is a specific gene that encodes actinα2.Multisystem smooth muscle dysfunction syndrome(MSMDS)is a multisystem disease characterized by aortic and cerebrovascular lesions caused by ACTA2 gene mutations.There have been many reports of cardiac,pulmonary and cerebrovascular lesions caused by MSMDS;however,few studies have focused on seizures caused by MSMDS.CASE SUMMARY Our patient was a girl aged 7 years and 8 mo with recurrent cough,asthma and seizures for 7 years.She was diagnosed with severe pneumonia,congenital heart disease,cardiac insufficiency,and malnutrition in the local hospital.Cardiac ultrasonography revealed congenital heart disease,patent ductus arteriosus(with a diameter of 0.68 cm),left coronary arteriectasis,patent oval foramen(0.12 cm),tricuspid and pulmonary regurgitation,and pulmonary hypertension.Cerebral magnetic resonance imaging and magnetic resonance angiography indicated stiffness in the brain vessels,together with multiple aberrant signaling shadows in bilateral paraventricular regions.A heterozygous mutation(c.536G>A)was identified in the ACTA2 gene,resulting in generation of p.R179H.Finally,the girl was diagnosed with MSMDS combined with epilepsy.The patient had 4 episodes of seizures before treatment,and no onset of seizure was reported after oral administration of sodium valproate for 1 year.CONCLUSION MSMDS has a variety of clinical manifestations and unique cranial imaging features.Cerebrovascular injury and white matter injury may lead to seizures.Gene detection can confirm the diagnosis and prevent missed diagnosis or misdiagnosis.展开更多
目的探讨microRNA-78(miR-78)抑制心肌部分梗死模型大鼠心肌纤维化的作用机制。方法采用结扎左前降支建立大鼠心肌梗死模型,分析miR-78在模型大鼠心肌梗死部位的表达,采用miR-78前体慢病毒载体过表达来分析miR-78在大鼠心肌梗死过程中...目的探讨microRNA-78(miR-78)抑制心肌部分梗死模型大鼠心肌纤维化的作用机制。方法采用结扎左前降支建立大鼠心肌梗死模型,分析miR-78在模型大鼠心肌梗死部位的表达,采用miR-78前体慢病毒载体过表达来分析miR-78在大鼠心肌梗死过程中的作用。评价心肌功能,并测定纤维化相关因子Ⅰ胶原(COL1)和ACTA2表达水平。从新生的大鼠中分离出心肌纤维化细胞,进行荧光素酶试验,转染野生型或突变型GATA43’UTR质粒和miR-78,研究GATA4和miR-78表达水平之间的关系。并通过转染GATA4特异性小干扰RNA验证COL1和ACTA2表达水平的变化。结果与假手术组相比,手术组I区和B区的miR-78表达水平均显著降低(P<0.05),术后2周的表达水平降低最明显,术后4周表达水平略有升高。实时荧光定量聚合酶链式反应(RT-PCR)结果显示,premiR-78组的miR-78水平明显高于转染对照组(P<0.05);转染对照组梗死面积约为50%,但miR-78过表达后,梗死面积明显减少至约30%。假手术组左室射血分数(LVEF)约为60%,术后降至约20%;左室缩短率(LVFS)由手术前的30%左右减少到手术后的15%左右,miR-78表达水平明显恢复。心肌梗死诱导后COL1 m RNA和ACTA2 m RNA表达水平均明显升高(P<0.05),而miR-78过表达时两者均受到抑制(P<0.05)。当靶序列发生突变(mut-GATA43’UTR)时,miR-78的过表达对荧光素酶活性影响不显著(P>0.05);Si-GATA4组与对照组相比,GATA4 m RNA显著下调表达水平(P<0.05);当GATA4被抑制时,COL1和ACTA2的蛋白水平均被抑制。结论miR-78可抑制心肌部分梗死模型大鼠心肌纤维化,作用机制可能为下调GATA4表达,导致COL1和ACTA2的表达下调。展开更多
基金Zhejiang Medical and Health Science and Technology Program,No.2020KY327 and No.2017KY660.
文摘BACKGROUND ACTA2 gene is a specific gene that encodes actinα2.Multisystem smooth muscle dysfunction syndrome(MSMDS)is a multisystem disease characterized by aortic and cerebrovascular lesions caused by ACTA2 gene mutations.There have been many reports of cardiac,pulmonary and cerebrovascular lesions caused by MSMDS;however,few studies have focused on seizures caused by MSMDS.CASE SUMMARY Our patient was a girl aged 7 years and 8 mo with recurrent cough,asthma and seizures for 7 years.She was diagnosed with severe pneumonia,congenital heart disease,cardiac insufficiency,and malnutrition in the local hospital.Cardiac ultrasonography revealed congenital heart disease,patent ductus arteriosus(with a diameter of 0.68 cm),left coronary arteriectasis,patent oval foramen(0.12 cm),tricuspid and pulmonary regurgitation,and pulmonary hypertension.Cerebral magnetic resonance imaging and magnetic resonance angiography indicated stiffness in the brain vessels,together with multiple aberrant signaling shadows in bilateral paraventricular regions.A heterozygous mutation(c.536G>A)was identified in the ACTA2 gene,resulting in generation of p.R179H.Finally,the girl was diagnosed with MSMDS combined with epilepsy.The patient had 4 episodes of seizures before treatment,and no onset of seizure was reported after oral administration of sodium valproate for 1 year.CONCLUSION MSMDS has a variety of clinical manifestations and unique cranial imaging features.Cerebrovascular injury and white matter injury may lead to seizures.Gene detection can confirm the diagnosis and prevent missed diagnosis or misdiagnosis.
文摘目的探讨microRNA-78(miR-78)抑制心肌部分梗死模型大鼠心肌纤维化的作用机制。方法采用结扎左前降支建立大鼠心肌梗死模型,分析miR-78在模型大鼠心肌梗死部位的表达,采用miR-78前体慢病毒载体过表达来分析miR-78在大鼠心肌梗死过程中的作用。评价心肌功能,并测定纤维化相关因子Ⅰ胶原(COL1)和ACTA2表达水平。从新生的大鼠中分离出心肌纤维化细胞,进行荧光素酶试验,转染野生型或突变型GATA43’UTR质粒和miR-78,研究GATA4和miR-78表达水平之间的关系。并通过转染GATA4特异性小干扰RNA验证COL1和ACTA2表达水平的变化。结果与假手术组相比,手术组I区和B区的miR-78表达水平均显著降低(P<0.05),术后2周的表达水平降低最明显,术后4周表达水平略有升高。实时荧光定量聚合酶链式反应(RT-PCR)结果显示,premiR-78组的miR-78水平明显高于转染对照组(P<0.05);转染对照组梗死面积约为50%,但miR-78过表达后,梗死面积明显减少至约30%。假手术组左室射血分数(LVEF)约为60%,术后降至约20%;左室缩短率(LVFS)由手术前的30%左右减少到手术后的15%左右,miR-78表达水平明显恢复。心肌梗死诱导后COL1 m RNA和ACTA2 m RNA表达水平均明显升高(P<0.05),而miR-78过表达时两者均受到抑制(P<0.05)。当靶序列发生突变(mut-GATA43’UTR)时,miR-78的过表达对荧光素酶活性影响不显著(P>0.05);Si-GATA4组与对照组相比,GATA4 m RNA显著下调表达水平(P<0.05);当GATA4被抑制时,COL1和ACTA2的蛋白水平均被抑制。结论miR-78可抑制心肌部分梗死模型大鼠心肌纤维化,作用机制可能为下调GATA4表达,导致COL1和ACTA2的表达下调。
