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Familial primary hyperparathyroidism (HPT) is a rare disorder that is treated surgically and mostly occurs in association with tumor-susceptibility syndromes, like multiple endocrine neoplasia and the hyperparathyroidism-jaw tumor syndrome. Familial hypercalciuric hypercalcemia (FHH) is another cause of hereditary hypercalcemia that generally is considered to require no treatment and is genetically and pathophysiologically distinct from HPT. Inactivating mutations in the calcium receptor gene cause FHH, whereas the down-regulated expression of the CaR in HPT never has been coupled to CaR gene mutations. Family screening revealed a hitherto unknown familial condition with characteristics of both FHH and HPT. The hypercalcemia was mapped to a point mutation in the intracellular domain of the CaR gene that was coupled to relative calcium resistance of the PTH release by transient expression in HEK 294 cells. Unusually radical excision of parathyroid glands was required to normalise the hypercalcemia. The mildly enlarged parathyroid glands displayed hyperplasia with nodular components. Frequent allelic loss on especially 12q was found and contrasts to findings in HPT. Allelic loss was also seen in loci typical for primary HPT like 1p, 6q and 15q, but not 11q13. Quantitative mRNA analysis showed that the glands had mild increase in a proliferation index (PCNA/GAPDH mRNA ratio) and mild reduction in genes important to parathyroid cell function, like CaR, PTH, VDR and LRP2. A previously unrecognized variant of hypercalcemia is explored that could be one explanation for persistent hypercalcemia after apparently typical routine operations for HPT. It also raises the issue of possibilities to treat FHH with parathyroidectomy provided it is radical enough.

L'objectif de cette thèse était d'analyser le déterminisme génétique de la croissance foliaire (LER) du maïs (Zea mays L.). Nous avons combiné plusieurs approches visant à (i) résumer l'information génétique tirée de trois populations de cartographie de QTL (une d'origine tropicale et deux tempérées), (ii) tester l'effet de l'introgresssion de diversité allélique dans les QTL les plus prometteurs, (iii) évaluer jusqu'à quel point les QTL de croissance foliaire affectent la croissance d'autres organes de la plante (iv) disséquer des QTLs d'intérêt par cartographie fine ou génétique d'association locale. La première partie de ce travail concerne le déterminisme génétique de la croissance foliaire maximale (LERmax) évaluée dans des conditions optimales la nuit. LERmax, telle que mesurée en plateforme de phénotypage, partage dans une forte proportion, son contrôle génétique avec la croissance d'autres organes. Des QTL qui affectaient LERmax ou/et la croissance d'autres organes ont alors été disséqués. Une région génomique a été cartographiée avec 23 lignées quasi-isogéniques (NILs) séquentiellement introgressées dans les bins 1.10-11, réduisant ainsi l'intervalle de confiance du QTL d'un facteur 3. Une seconde région génomique a été analysée par une méthode innovante fondée sur une étude d'association ciblée sur une région génomique dans un série allélique générée par introgression de 62 allèles donneurs tirés des lignées parentales d'hybrides cultivés et de populations historiques de maïs d'Amérique Latine dans une lignée élite. L'étude d'association dans cette région relativement petite révèle plus de polymorphismes causaux qu'attendus (six SNP en faible déséquilibre de liaison vs trois QTL consensus).La seconde partie de ce travail considère la sensibilité de la croissance foliaire à la demande évaporative et au déficit hydrique du sol. Un détermisme génétique commun aux deux sensibilités a été mis en évidence par méta-analyse de QTLs initialement détectés dans trois populations en ségrégation et par le test de NILs. Huit métaQTL situés dans quatre régions génomiques ont été testés avec 6 à 17 allèles introgressés pour identifier des NILs qui manifestaient les plus forts effets sur le phénotype. Nous avons initié une cartographie fine dans une de ces régions génomiques à partir d'une populations de recombinants issues de l'introgresssion d'un donneur d'origine tropicale dans B73. / The objective of this thesis was to analyze the genetic control of the Leaf Elongation Rate (LER) of maize (Zea mays L.). We combined approaches that (i) summarize the QTL information of three mapping populations (one tropical, two temperate), (ii) tested the impact of the introgression of allelic diversity at most promising QTLs, (iii) test to what extent QTLs of LER affect different traits (iv) dissect QTLs of interest by fine mapping or local association mapping.The first part of this document focuses on the genetic control of maximum LER (LERmax) measured in near-optimal conditions during the night. LERmax, as measured in a phenotyping platform, shares an appreciable proportion of its genetic control with the growth abilities of other organs. QTLs affecting LERmax and/or the growth of other organs were therefore dissected. One genomic region was fine-mapped with 23 Near-Isogenic Lines (NILs), sequentially introgressed in the bins 1.10-11, resulting in a reduction of the confidence interval by a factor 3. A second genomic region was analysed after the development of an innovative method of local association mapping on a collection of NILs, introgressed with 62 donor parents from historical populations from different altitude and latitudes in Latin America. This relatively small region harbors more causal polymorphisms than expected (six associated markers in low linkage disequilibrium vs three cQTLs).The second part focuses on the sensitivities of LER to evaporative demand or to soil water deficit. The two sensitivities share a large part of their genetic control as demonstrated by a metaQTL analysis on three mapping populations and the test of NILs. Eight metaQTLs in four genomic regions were tested with 6 to 17 different alleles to find the NILs that best impact the phenotype. We started a fine mapping on one genomic region by using one population of NILs involving a tropical donor.

O angioedema hereditário (AEH) é uma doença autossômica dominante, caracterizada por episódios recorrentes de edema subcutâneo, do trato gastrointestinal e das vias aéreas superiores. Em sua forma clássica, o AEH é causado por deficiência do inibidor de C1 (C1- INH) e está associado a mutações no gene SERPING1. Recentemente, foi descrito o AEH com inibidor de C1 normal, resultante de mutações no gene F12, que codifica o Fator XII da coagulação (FXII), denominado AEH-FXII; e de mutações nos genes PLG e ANGPT1, que codificam Plasminogênio e Angiopoietina-1, caracterizando os tipos AEH-PLG e AEHANGPT1. O AEH com inibidor de C1 normal não cursa com diminuição de C1-INH quantitativo e/ou funcional, ou de C4, sendo o diagnóstico realizado pela presença de sintomas clínicos sugestivos e história familiar. Os objetivos do presente estudo foram: avaliar a discriminação alélica como método alternativo ao sequenciamento por método de Sanger, para o diagnóstico de AEH com inibidor de C1 normal por mutação c.983C>A no gene F12; determinar se a discriminação alélica seria uma técnica de melhor custo-benefício; e investigar outras mutações previamente descritas no exon 9 do gene F12, e nos genes PLG e ANGPT1 em pacientes com suspeita clínica de AEH com inibidor de C1 normal, e negativos para mutação c.983C>A em F12. Cento e oitenta e quatro indivíduos incluindo 51 pacientes- índice com suspeita clínica de AEH com inibidor de C1 normal, e seus familiares, foram previamente investigados por sequenciamento de Sanger. Esses indivíduos foram investigados por discriminação alélica, e a concordância entre os resultados para a mutação c.983C>A foi verificada por estatística Kappa. Custos e tempo de execução entre os dois métodos foram avaliados. Casos-índice negativos para a mutação c.983C>A no gene F12 foram avaliados para outras mutações no exon 9 do gene F12 e para mutações previamente descritas c.988A>G e c.807G>T em PLG e ANGPT1, respectivamente, usando sequenciamento por método de Sanger. Mutação no gene F12 foi identificada em 96 indivíduos (24 pacientes- índice e 72 familiares). Em todos esses pacientes foi encontrada a mutação c.983C>A. 88 indivíduos foram negativos para esta mutação. Os resultados foram 100% concordantes entre os dois métodos. Setenta e um dos 96 pacientes positivos para mutação c.983C>A eram do sexo feminino; 78,9% e 56% eram pacientes sintomáticos do sexo feminino e masculino, respectivamente. A discriminação alélica apresentou custo e tempo de execução 79,7% e 82,3% menores em comparação ao sequenciamento por Sanger, respectivamente. Outras mutações no gene F12, e mutações em PLG e ANGPT1 não foram encontradas. Entre os pacientes negativos para mutações associadas ao AEH com inibidor de C1 normal, 11 foram diagnosticados como AEH-desconhecido e 16 como angioedema idiopático adquirido não histaminérgico. Os resultados do presente estudo nos permitiram construir um algoritmo para diagnóstico de pacientes com AEH com inibidor de C1 normal. Em áreas onde a mutação c.983C>A em F12 é predominante entre pacientes com AEH-FXII, a discriminação alélica pode ser um método adequado para screening inicial. Em pacientes com resultados negativos, sequenciamento do exon 9 de F12 pelo método de Sanger estaria indicado. Pacientes remanescentes com resultados negativos seriam genotipados para mutações previamente descritas em PLG e ANGPT1. Estudos futuros em outros locais serão necessários para estabelecer se a discriminação alélica apresentaria melhor custo-benefício, com potencial para mais acessibilidade ao diagnóstico em pacientes portadores da doença no Brasil / Hereditary angioedema (HAE) is an autosomal dominant disease characterized by recurrent episodes of edema of subcutaneous tissue, gastrointestinal tract, and upper airways. In its classical form, HAE is caused by deficiency of C1 inhibitor (C1-INH) and it is associated with mutations in the SERPING1 gene. Recently, HAE with normal C1 inhibitor has been described, resulting from mutations in F12 gene, which encodes coagulation factor XII (FXII), designated as FXII-HAE; and from mutations in PLG and ANGPT1 genes, which encode Plasminogen and Angiopoietin-1, characterizing PLG-HAE and ANGPT1-HAE types. HAE with normal C1-INH does not present with decrease in quantitative and/or functional levels of C1-INH or C4, and diagnosis is carried out by presence of suggestive clinical symptoms and family history. Diagnosis can only be confirmed by genetic sequencing. The objectives of the present study were: to evaluate the allelic discrimination as an alternative method to sequencing by Sanger method for the diagnosis of HAE with normal C1-INH due to mutation c.983C>A in F12 gene; to determine whether allelic discrimination would be a better cost-effective technique; and to investigate presence of other mutations previously described in exon 9 of F12 gene and in PLG and ANGPT1 genes in patients with clinical suspicion of HAE with normal C1-INH who were negative for c.983C>A mutation in F12. One hundred and eighty-four individuals including 51 index patients with clinical suspicion of HAE with normal C1-INH and their relatives were previously investigated by Sanger sequencing. These individuals were investigated for allelic discrimination, and concordance of the results for the c.983C>A mutation was verified by Kappa statistics. Costs and execution time of the two methods were evaluated. Negative index cases for c.983C>A mutation in F12 gene were evaluated for other mutations in exon 9 of the F12 gene and for mutations previously described c.988A>G and c.807G>T in PLG and ANGPT1, respectively, using sequencing by Sanger method. Mutation in F12 gene was identified in 96 individuals (24 index patients and 72 relatives). In all these patients, the c.983C>A mutation was found. 88 subjects were negative for this mutation. The results were 100% concordant between the two methods. Seventy-one of the 96 patients positive for the c.983C>A mutation were female; 78.9% and 56% were symptomatic female and male patients, respectively. The allelic discrimination presented cost and execution time 79.7% and 82.3% lower in comparison to sequencing by Sanger, respectively. Other mutations in F12 gene, and mutations in PLG and ANGPT1 were not found. Among patients who were negative for mutations associated to HAE with normal C1-INH, 11 were diagnosed as unknown HAE and 16 as idiopathic nonhistaminergic acquired angioedema. The results of present study allowed us to construct an algorithm for diagnosis of patients with HAE with normal C1-INH. In areas where the c.983C>A mutation in F12 is predominant among patients with FXII-HAE, allelic discrimination may be a suitable method for initial screening. In patients with negative results, sequencing of F12 exon 9 by the Sanger method would be indicated. Remaining patients with negative results would be genotyped for mutations previously described in PLG and ANGPT1. Future studies at other sites will be needed to establish whether allelic discrimination would be more cost-effective, with potential for more accessibility to diagnosis in patients with the disease in Brazil

Made available in DSpace on 2016-08-10T10:39:16Z (GMT). No. of bitstreams: 1 NURIA ALONSO LOPEZ CID.pdf: 1461437 bytes, checksum: 7aabd2e9fb0164bdf7480906eadb35b7 (MD5) Previous issue date: 2016-04-14 / The advances in Anesthesiology took place at the same time as the development of drugs that ensured greater control over pain, patient comfort, and safety during surgical anesthetic procedures. Pharmacogenetics is the science that enables enhanced healthcare, by understanding the genetic variations that may affect the different responses to treatments. CYP3A are the most important enzymes involved in the metabolism of drugs prescribed in clinical practice, showing extensive genetic variability in their expression. CYP3A5 presents the highest number of functional variants, with significant differences in the frequencies observed among different population groups around the world and in Brazil. This study aimed and at assessing the frequency of CYP3A5*3 and CYP3A5*6 genotypic and allelic variants and to estimate the metabolizing profile according to these variants, as well as any potential implications on adverse events with drugs used in anesthesia. The sample used for this study included 166 subjects users of the Laboratório da Área de Saúde da PUCGoiás (PUC Healthcare Laboratory city of Goiás). They were all born in the Brazilian Midwest, over 18 years of age, and from both genders. The blood samples were obtained from each individual and genotyped for CYP3A5*3, A>G (rs 776746) and CYP3A5*6, G>A (rs 10264272) by real time Polymerase Chain Reaction using TaqMan assays. Data analysis of the allelic frequency was conducted by calculating the percentage for the established groups, according to color or race, compared to the total sample. In individuals from the Brazilian Midwest, assessed in this study, the frequency of the allelic variant CYP3A5*3 was 40% and 2% for CYP3A5*6. The frequency observed for the CYP3A5*3 allelic variant in subjects from the Midwest was lower than that from other Brazilian studies and also lower than the frequencies observed in Europeans and Asians, however, they were similar to the frequency seen in populations from East and West Africa. The frequency of the CYP3A5*6 allelic variant, in this study, was higher than that found in European studies and similar of the subjects in the North of Africa. Based on the results, one may infer that 72% would be poor metabolizers. The higher frequency of the poor metabolizer profile shows that there is potential for a greater occurrence of adverse events when using drugs metabolized by CYP3A5 in this population from the Brazilian Midwest. / O progresso da Anestesiologia junto com o desenvolvimento de drogas garantiram maior controle da dor, conforto ao paciente e segurança durante o ato anestésicocirúrgico. A Farmacogenética é uma ciência que permite a melhora da assistência à saúde, por meio do conhecimento das variações genéticas que podem estar envolvidas com as diferenças na resposta terapêutica. As CYP3A são as enzimas mais importantes envolvidas com o metabolismo de drogas prescritas na prática clínica, apresentando grande variabilidade genética na sua expressão. A CYP3A5 é a forma que apresenta mais variantes funcionais e com diferenças expressivas nas frequências observadas em diferentes grupos populacionais do mundo. Este estudo teve como objetivo avaliar a frequência das variantes genotípicas e alélicas do CYP3A5*3 e CYP3A5*6 e inferir sobre o perfil metabolizador dos indivíduos em função destas variantes em relação a drogas usadas em anestesia. O grupo avaliado incluiu 166 indivíduos usuários do Laboratório da Área de Saúde da PUCGoiás, nascidos na região Centro-Oeste do Brasil, maiores de 18 anos e de ambos os sexos. As amostras de sangue foram obtidas de cada indivíduo e genotipados para CYP3A5*3, A>G (rs 776746) and CYP3A5*6, G>A (rs 10264272) por Reação em Cadeia de Polimerase usando sondas TaqMan. A análise dos dados das frequências alélicas foi realizada através do cálculo das porcentagens para os grupos estabelecidos, segundo a cor ou raça, em relação a amostra total. Nos indivíduos da região Centro-Oeste do Brasil avaliados neste estudo, a frequência da variante alélica CYP3A5*3 foi de 40% e da CYP3A5*6 foi de 2%. A frequência observada para a variante alélica CYP3A5*3 em indivíduos da região Centro-Oeste foi menor que a de outros estudos brasileiros e também menor que as frequências verificadas em europeus e asiáticos, porém similar à observada na população do leste e oeste da África. A frequência da variante alélica CYP3A5*6, neste estudo, foi maior que a encontrada em estudos europeus e com valores mais próximos daqueles observados no norte da África. Com base nos resultados obtidos da amostra pode-se inferir que 72% dos indivíduos seriam fracos metabolizadores. A maior frequência do perfil de fraco metabolizador mostra que existe potencial de maior ocorrência de eventos adversos no uso de fármacos metabolizados pela CYP3A5 nesta população da região Centro-Oeste do Brasil.

<p> </p><p>Genotyping can be used to link genetic variation among individuals to certain diseases or conditions. Some known disorders and states that are dependent on single nucleotide polymorphism (SNPs) are lactose intolerance, venous thrombosis, hereditary hemochromatosis and the difference in sensibility among people to metabolise drugs.</p><p>In this project a new kit, TaqManÒ Sample-to-SNP KitÔ <strong>for extraction of DNA and preparation of the extract for genotyping with real-time PCR and allelic discrimination, was evaluated. QIAamp® DNA Blood Biorobot® MDx Kit was used as the reference method.</strong></p><p>The purpose of the comparison was to find a method that makes DNA extraction from blood samples cheaper and faster, but with the same reliability as the reference procedure.</p><p>The results of the evaluation showed a complete agreement of the genotype results between the methods tested, which means that the new method was as reliable as the reference method. The costs of reagents and material would be reduced with 52% if the new method is adopted, that alone would result in a cost reduction of 144 000SEK a year with a sample volume of 650 samples/month. The time for DNA extraction would also be reduced with the new procedure.</p><p> </p>

<p>Familial primary hyperparathyroidism (HPT) is a rare disorder that is treated surgically and mostly occurs in association with tumor-susceptibility syndromes, like multiple endocrine neoplasia and the hyperparathyroidism-jaw tumor syndrome. Familial hypercalciuric hypercalcemia (FHH) is another cause of hereditary hypercalcemia that generally is considered to require no treatment and is genetically and pathophysiologically distinct from HPT. Inactivating mutations in the calcium receptor gene cause FHH, whereas the down-regulated expression of the CaR in HPT never has been coupled to CaR gene mutations. </p><p>Family screening revealed a hitherto unknown familial condition with characteristics of both FHH and HPT. The hypercalcemia was mapped to a point mutation in the intracellular domain of the CaR gene that was coupled to relative calcium resistance of the PTH release by transient expression in HEK 294 cells. Unusually radical excision of parathyroid glands was required to normalise the hypercalcemia. The mildly enlarged parathyroid glands displayed hyperplasia with nodular components. Frequent allelic loss on especially 12q was found and contrasts to findings in HPT. Allelic loss was also seen in loci typical for primary HPT like 1p, 6q and 15q, but not 11q13. Quantitative mRNA analysis showed that the glands had mild increase in a proliferation index (PCNA/GAPDH mRNA ratio) and mild reduction in genes important to parathyroid cell function, like CaR, PTH, VDR and LRP2. </p><p>A previously unrecognized variant of hypercalcemia is explored that could be one explanation for persistent hypercalcemia after apparently typical routine operations for HPT. It also raises the issue of possibilities to treat FHH with parathyroidectomy provided it is radical enough.</p>

Familial primary hyperparathyroidism (HPT) is a rare disorder that is treated surgically and mostly occurs in association with tumor-susceptibility syndromes, like multiple endocrine neoplasia and the hyperparathyroidism-jaw tumor syndrome. Familial hypercalciuric hypercalcemia (FHH) is another cause of hereditary hypercalcemia that generally is considered to require no treatment and is genetically and pathophysiologically distinct from HPT. Inactivating mutations in the calcium receptor gene cause FHH, whereas the down-regulated expression of the CaR in HPT never has been coupled to CaR gene mutations. Family screening revealed a hitherto unknown familial condition with characteristics of both FHH and HPT. The hypercalcemia was mapped to a point mutation in the intracellular domain of the CaR gene that was coupled to relative calcium resistance of the PTH release by transient expression in HEK 294 cells. Unusually radical excision of parathyroid glands was required to normalise the hypercalcemia. The mildly enlarged parathyroid glands displayed hyperplasia with nodular components. Frequent allelic loss on especially 12q was found and contrasts to findings in HPT. Allelic loss was also seen in loci typical for primary HPT like 1p, 6q and 15q, but not 11q13. Quantitative mRNA analysis showed that the glands had mild increase in a proliferation index (PCNA/GAPDH mRNA ratio) and mild reduction in genes important to parathyroid cell function, like CaR, PTH, VDR and LRP2. A previously unrecognized variant of hypercalcemia is explored that could be one explanation for persistent hypercalcemia after apparently typical routine operations for HPT. It also raises the issue of possibilities to treat FHH with parathyroidectomy provided it is radical enough.

Genotyping can be used to link genetic variation among individuals to certain diseases or conditions. Some known disorders and states that are dependent on single nucleotide polymorphism (SNPs) are lactose intolerance, venous thrombosis, hereditary hemochromatosis and the difference in sensibility among people to metabolise drugs. In this project a new kit, TaqManÒ Sample-to-SNP KitÔ for extraction of DNA and preparation of the extract for genotyping with real-time PCR and allelic discrimination, was evaluated. QIAamp® DNA Blood Biorobot® MDx Kit was used as the reference method. The purpose of the comparison was to find a method that makes DNA extraction from blood samples cheaper and faster, but with the same reliability as the reference procedure. The results of the evaluation showed a complete agreement of the genotype results between the methods tested, which means that the new method was as reliable as the reference method. The costs of reagents and material would be reduced with 52% if the new method is adopted, that alone would result in a cost reduction of 144 000SEK a year with a sample volume of 650 samples/month. The time for DNA extraction would also be reduced with the new procedure.