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1
Inheritance
6
Pathophys.
8
Phenotypes
17
Pathograph
1
Genes
2
Differentials
1
Deep Research
👪

Inheritance

1
Autosomal recessive inheritance HP:0000007
Huppke-Brendel syndrome is caused by biallelic SLC33A1 pathogenic variants.
Autosomal recessive inheritance
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay."
This directly supports autosomal recessive inheritance.

Pathophysiology

6
SLC33A1 acetyl-CoA transporter deficiency
Biallelic SLC33A1 variants impair the endoplasmic-reticulum acetyl-CoA transporter AT-1.
SLC33A1 link
acetyl-CoA transmembrane transport link ↓ DECREASED
acetyl-CoA transmembrane transporter activity link ↓ DECREASED
endoplasmic reticulum link
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins."
This directly identifies AT-1 deficiency from SLC33A1 mutations as the initiating molecular defect.
Defective secretory-pathway acetylation
Loss of AT-1 function disrupts acetylation-dependent processing of glycoproteins and gangliosides in the secretory pathway.
protein acetylation link ⚠ ABNORMAL
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins."
This directly supports defective AT-1-dependent acetylation in the secretory pathway as the core biochemical mechanism.
Reduced ceruloplasmin secretion
AT-1 deficiency reduces ceruloplasmin secretion, explaining the low serum ceruloplasmin and secondary low serum copper pattern without primary copper deficiency.
hepatocyte link
protein secretion link ↓ DECREASED
Show evidence (1 reference)
PMID:22243965 SUPPORT In Vitro
"We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency."
Cell-model evidence directly supports reduced ceruloplasmin secretion downstream of AT-1 loss.
Cerebral and cerebellar developmental injury
Defective AT-1-dependent acetylation disrupts normal brain development and contributes to cerebellar hypoplasia and hypomyelination.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"The severity of the phenotype implies an essential role of AT-1 in proper posttranslational modification of numerous proteins, without which normal lens and brain development is interrupted."
This explicitly links AT-1 dysfunction to interrupted lens and brain development.
Cochlear developmental injury
AT-1 deficiency disrupts normal auditory-system development and contributes to congenital sensorineural hearing loss.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay."
This directly supports auditory-system developmental injury as a downstream tissue consequence of the syndrome.
Lens developmental injury
AT-1 deficiency disrupts normal lens development and produces congenital cataract.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"The severity of the phenotype implies an essential role of AT-1 in proper posttranslational modification of numerous proteins, without which normal lens and brain development is interrupted."
This directly supports lens developmental injury as a downstream consequence of defective AT-1-dependent acetylation.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Huppke-Brendel syndrome Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

8
Ear 1
Sensorineural hearing impairment OBLIGATE Sensorineural hearing impairment (HP:0000407)
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay."
This directly supports hearing loss as an obligate phenotype in the initial 5/5 reported patients.
Eye 1
Cataract OBLIGATE Developmental cataract (HP:0000519)
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay."
This directly supports congenital cataract as an obligate phenotype in the initial 5/5 reported patients.
Musculoskeletal 1
Hypotonia Hypotonia (HP:0001252)
Show evidence (1 reference)
PMID:36119696 SUPPORT Human Clinical
"The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type."
This adult case expands the recognized neurologic phenotype to include hypotonia.
Nervous System 4
Intellectual disability Intellectual disability (HP:0001249)
Show evidence (1 reference)
PMID:36119696 SUPPORT Human Clinical
"The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type."
This adult case confirms persistent intellectual disability as part of the phenotype spectrum.
Cerebellar hypoplasia OBLIGATE Cerebellar hypoplasia (HP:0001321)
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Cerebral MRI showed pronounced cerebellar hypoplasia and hypomyelination."
This directly supports cerebellar hypoplasia as an obligate imaging phenotype in the initial 5/5 reported patients.
Spastic ataxia Ataxia (HP:0001251)
Show evidence (1 reference)
PMID:36119696 SUPPORT Human Clinical
"The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type."
This adult case expands the recognized neurologic phenotype to include spastic ataxia.
Tremor Tremor (HP:0001337)
Show evidence (1 reference)
PMID:36119696 SUPPORT Human Clinical
"The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type."
This adult case expands the recognized neurologic phenotype to include tremor.
Other 1
CNS hypomyelination OBLIGATE CNS hypomyelination (HP:0003429)
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Cerebral MRI showed pronounced cerebellar hypoplasia and hypomyelination."
This directly supports hypomyelination as an obligate neuroimaging phenotype in the initial 5/5 reported patients.
🧬

Genetic Associations

1
SLC33A1 (Loss-of-function)
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins."
This directly establishes SLC33A1 as the causal gene.
🔬

Biochemical Markers

2
Serum ceruloplasmin (DECREASED)
Pathograph Readouts
Readout Of Reduced ceruloplasmin secretion Negative Diagnostic
Low serum ceruloplasmin reports reduced ceruloplasmin secretion downstream of AT-1 deficiency.
Show evidence (1 reference)
PMID:22243965 SUPPORT In Vitro
"We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency."
The abstract ties low serum ceruloplasmin to reduced ceruloplasmin secretion after AT-1 knockdown.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Furthermore, AT-1 defects are a new and important differential diagnosis in patients with low copper and ceruloplasmin in serum."
This directly identifies AT-1 defects as a differential diagnosis in patients with low serum ceruloplasmin, supporting it as a defining biochemical abnormality in Huppke-Brendel syndrome.
Serum copper (DECREASED)
Pathograph Readouts
Readout Of Reduced ceruloplasmin secretion Negative Diagnostic
Low serum copper reflects reduced ceruloplasmin-bound copper rather than primary copper deficiency.
Show evidence (1 reference)
PMID:22243965 SUPPORT In Vitro
"We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency."
The abstract states that low serum copper is due to reduced ceruloplasmin levels.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Furthermore, AT-1 defects are a new and important differential diagnosis in patients with low copper and ceruloplasmin in serum."
This directly identifies AT-1 defects as a differential diagnosis in patients with low serum copper, supporting it as a defining biochemical abnormality in Huppke-Brendel syndrome.
🔀

Differential Diagnoses

2

Conditions with similar clinical presentations that must be differentiated from Huppke-Brendel syndrome:

Overlapping Features Low ceruloplasmin can lead to confusion with Wilson disease, especially in adults.
Show evidence (1 reference)
PMID:36119696 SUPPORT Human Clinical
"With neurologic involvement and ceruloplasmin deficiency, it may mimic Wilson disease (WD)."
This directly supports Wilson disease as an important differential diagnosis.
Overlapping Features Menkes disease also presents with low serum copper and ceruloplasmin and enters the differential diagnosis.
Show evidence (1 reference)
PMID:22243965 SUPPORT Human Clinical
"Low copper and ceruloplasmin in serum are the diagnostic hallmarks for Menkes disease, Wilson disease, and aceruloplasminemia."
This directly identifies Menkes disease as part of the biochemical differential diagnosis.
{ }

Source YAML

click to show
name: Huppke-Brendel syndrome
creation_date: '2026-04-14T12:05:00Z'
updated_date: '2026-05-19T02:11:36Z'
category: Mendelian
description: >-
  Huppke-Brendel syndrome is a severe autosomal recessive SLC33A1-related
  neurodevelopmental disorder caused by deficiency of the endoplasmic reticulum
  acetyl-CoA transporter AT-1. The syndrome is characterized by congenital
  cataracts, hearing loss, developmental delay, low serum copper and
  ceruloplasmin, and a characteristic neuroimaging pattern of cerebellar
  hypoplasia and hypomyelination.
disease_term:
  preferred_term: Huppke-Brendel syndrome
  term:
    id: MONDO:0013772
    label: Huppke-Brendel syndrome
parents:
- hereditary disease
- inborn error of metabolism
inheritance:
- name: Autosomal recessive inheritance
  inheritance_term:
    preferred_term: Autosomal recessive inheritance
    term:
      id: HP:0000007
      label: Autosomal recessive inheritance
  description: >-
    Huppke-Brendel syndrome is caused by biallelic SLC33A1 pathogenic variants.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay.
    explanation: >-
      This directly supports autosomal recessive inheritance.
pathophysiology:
- name: SLC33A1 acetyl-CoA transporter deficiency
  description: >-
    Biallelic SLC33A1 variants impair the endoplasmic-reticulum acetyl-CoA
    transporter AT-1.
  genes:
  - preferred_term: SLC33A1
    term:
      id: hgnc:95
      label: SLC33A1
  molecular_functions:
  - preferred_term: acetyl-CoA transmembrane transporter activity
    modifier: DECREASED
    term:
      id: GO:0008521
      label: acetyl-CoA transmembrane transporter activity
  biological_processes:
  - preferred_term: acetyl-CoA transmembrane transport
    modifier: DECREASED
    term:
      id: GO:0035348
      label: acetyl-CoA transmembrane transport
  cellular_components:
  - preferred_term: endoplasmic reticulum
    term:
      id: GO:0005783
      label: endoplasmic reticulum
  chemical_entities:
  - preferred_term: acetyl-CoA
    modifier: DECREASED
    term:
      id: CHEBI:15351
      label: acetyl-CoA
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins.
    explanation: >-
      This directly identifies AT-1 deficiency from SLC33A1 mutations as the
      initiating molecular defect.
  downstream:
  - target: Defective secretory-pathway acetylation
    description: AT-1 deficiency limits lumenal acetyl-CoA supply for normal protein and ganglioside acetylation.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins.
      explanation: >-
        SLC33A1 encodes the AT-1 acetyl-CoA transporter required for
        acetylation of gangliosides and glycoproteins, supporting this direct
        link.
- name: Defective secretory-pathway acetylation
  description: >-
    Loss of AT-1 function disrupts acetylation-dependent processing of
    glycoproteins and gangliosides in the secretory pathway.
  biological_processes:
  - preferred_term: protein acetylation
    modifier: ABNORMAL
    term:
      id: GO:0006473
      label: protein acetylation
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins.
    explanation: >-
      This directly supports defective AT-1-dependent acetylation in the
      secretory pathway as the core biochemical mechanism.
  downstream:
  - target: Cerebral and cerebellar developmental injury
    description: Secretory-pathway dysfunction disrupts normal brain development.
  - target: Cochlear developmental injury
    description: Secretory-pathway dysfunction also impairs development of the hearing system.
  - target: Lens developmental injury
    description: Secretory-pathway dysfunction disrupts normal lens development.
  - target: Reduced ceruloplasmin secretion
    description: AT-1 loss reduces secretion of ceruloplasmin from hepatocyte-like cells.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
      explanation: >-
        HepG2 knockdown evidence links AT-1 loss to reduced ceruloplasmin
        secretion.
- name: Reduced ceruloplasmin secretion
  description: >-
    AT-1 deficiency reduces ceruloplasmin secretion, explaining the low serum
    ceruloplasmin and secondary low serum copper pattern without primary copper
    deficiency.
  biological_processes:
  - preferred_term: protein secretion
    modifier: DECREASED
    term:
      id: GO:0009306
      label: protein secretion
  cell_types:
  - preferred_term: hepatocyte
    term:
      id: CL:0000182
      label: hepatocyte
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
    explanation: >-
      Cell-model evidence directly supports reduced ceruloplasmin secretion
      downstream of AT-1 loss.
  downstream:
  - target: Serum ceruloplasmin
    description: Reduced ceruloplasmin secretion lowers circulating ceruloplasmin.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
      explanation: >-
        The abstract links AT-1 knockdown to reduced ceruloplasmin secretion and
        low serum ceruloplasmin.
  - target: Serum copper
    description: Lower circulating ceruloplasmin decreases measured serum copper.
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - reduced circulating ceruloplasmin-bound copper
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
      explanation: >-
        The abstract explicitly interprets low serum copper as secondary to low
        ceruloplasmin rather than copper deficiency.
- name: Cerebral and cerebellar developmental injury
  description: >-
    Defective AT-1-dependent acetylation disrupts normal brain development and
    contributes to cerebellar hypoplasia and hypomyelination.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The severity of the phenotype implies an essential role of AT-1 in proper posttranslational modification of numerous proteins, without which normal lens and brain development is interrupted.
    explanation: >-
      This explicitly links AT-1 dysfunction to interrupted lens and brain
      development.
  downstream:
  - target: Intellectual disability
    description: Disrupted brain development contributes to intellectual disability.
    causal_link_type: DIRECT
  - target: Cerebellar hypoplasia
    description: Impaired cerebellar development is expressed as cerebellar hypoplasia.
    causal_link_type: DIRECT
  - target: CNS hypomyelination
    description: Abnormal brain development is expressed radiographically as CNS hypomyelination.
    causal_link_type: DIRECT
  - target: Spastic ataxia
    description: Cerebellar and broader CNS injury is associated with spastic ataxia in the adult phenotype.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:36119696
      reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
      explanation: >-
        The adult case reports spastic ataxia as part of the neurologic
        phenotype.
  - target: Hypotonia
    description: Brain-development injury is associated with hypotonia in the adult phenotype.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:36119696
      reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
      explanation: >-
        The adult case reports hypotonia as part of the neurologic phenotype.
  - target: Tremor
    description: Brain-development injury is associated with tremor in the adult phenotype.
    causal_link_type: INDIRECT_UNKNOWN_INTERMEDIATES
    evidence:
    - reference: PMID:36119696
      reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
      explanation: >-
        The adult case reports parkinsonian-type tremor as part of the
        neurologic phenotype.
- name: Cochlear developmental injury
  description: >-
    AT-1 deficiency disrupts normal auditory-system development and contributes
    to congenital sensorineural hearing loss.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay.
    explanation: >-
      This directly supports auditory-system developmental injury as a
      downstream tissue consequence of the syndrome.
  downstream:
  - target: Sensorineural hearing impairment
    description: Cochlear developmental injury is expressed clinically as sensorineural hearing impairment.
    causal_link_type: DIRECT
- name: Lens developmental injury
  description: >-
    AT-1 deficiency disrupts normal lens development and produces congenital
    cataract.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The severity of the phenotype implies an essential role of AT-1 in proper posttranslational modification of numerous proteins, without which normal lens and brain development is interrupted.
    explanation: >-
      This directly supports lens developmental injury as a downstream
      consequence of defective AT-1-dependent acetylation.
  downstream:
  - target: Cataract
    description: Lens developmental injury is expressed clinically as congenital cataract.
    causal_link_type: DIRECT
phenotypes:
- name: Cataract
  category: Ophthalmologic
  frequency: OBLIGATE
  description: >-
    Congenital cataracts are one of the signature presenting features of
    Huppke-Brendel syndrome.
  phenotype_term:
    preferred_term: Congenital cataract
    term:
      id: HP:0000519
      label: Developmental cataract
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay.
    explanation: >-
      This directly supports congenital cataract as an obligate phenotype in
      the initial 5/5 reported patients.
- name: Sensorineural hearing impairment
  category: Otologic
  frequency: OBLIGATE
  description: >-
    Hearing loss is part of the classic syndromic triad.
  phenotype_term:
    preferred_term: Sensorineural hearing impairment
    term:
      id: HP:0000407
      label: Sensorineural hearing impairment
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We report on five patients from four unrelated families with these biochemical findings who presented with a lethal autosomal-recessive syndrome of congenital cataracts, hearing loss, and severe developmental delay.
    explanation: >-
      This directly supports hearing loss as an obligate phenotype in the
      initial 5/5 reported patients.
- name: Intellectual disability
  category: Neurologic
  description: >-
    Severe developmental delay or later intellectual disability is a prominent
    neurologic manifestation.
  phenotype_term:
    preferred_term: Intellectual disability
    term:
      id: HP:0001249
      label: Intellectual disability
  evidence:
  - reference: PMID:36119696
    reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
    explanation: >-
      This adult case confirms persistent intellectual disability as part of
      the phenotype spectrum.
- name: Cerebellar hypoplasia
  category: Neurologic
  frequency: OBLIGATE
  description: >-
    Neuroimaging characteristically shows cerebellar hypoplasia.
  phenotype_term:
    preferred_term: Cerebellar hypoplasia
    term:
      id: HP:0001321
      label: Cerebellar hypoplasia
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Cerebral MRI showed pronounced cerebellar hypoplasia and hypomyelination.
    explanation: >-
      This directly supports cerebellar hypoplasia as an obligate imaging
      phenotype in the initial 5/5 reported patients.
- name: CNS hypomyelination
  category: Neurologic
  frequency: OBLIGATE
  description: >-
    Central nervous system hypomyelination is a characteristic MRI finding.
  phenotype_term:
    preferred_term: CNS hypomyelination
    term:
      id: HP:0003429
      label: CNS hypomyelination
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Cerebral MRI showed pronounced cerebellar hypoplasia and hypomyelination.
    explanation: >-
      This directly supports hypomyelination as an obligate neuroimaging
      phenotype in the initial 5/5 reported patients.
- name: Hypotonia
  category: Neurologic
  description: >-
    Hypotonia has been documented in the adult phenotypic spectrum of
    Huppke-Brendel syndrome.
  phenotype_term:
    preferred_term: Hypotonia
    term:
      id: HP:0001252
      label: Hypotonia
  evidence:
  - reference: PMID:36119696
    reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
    explanation: >-
      This adult case expands the recognized neurologic phenotype to include
      hypotonia.
- name: Spastic ataxia
  category: Neurologic
  description: >-
    Spastic ataxia has been reported in an adult patient with Huppke-Brendel
    syndrome.
  phenotype_term:
    preferred_term: Spastic ataxia
    term:
      id: HP:0001251
      label: Ataxia
  evidence:
  - reference: PMID:36119696
    reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
    explanation: >-
      This adult case expands the recognized neurologic phenotype to include
      spastic ataxia.
- name: Tremor
  category: Neurologic
  description: >-
    Parkinsonian-type tremor has been reported in an adult patient with
    Huppke-Brendel syndrome.
  phenotype_term:
    preferred_term: Tremor
    term:
      id: HP:0001337
      label: Tremor
  evidence:
  - reference: PMID:36119696
    reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type.
    explanation: >-
      This adult case expands the recognized neurologic phenotype to include
      tremor.
biochemical:
- name: Serum ceruloplasmin
  presence: DECREASED
  notes: >-
    Low serum ceruloplasmin is a cardinal biochemical hallmark of
    Huppke-Brendel syndrome.
  biomarker_term:
    preferred_term: ceruloplasmin measurement
    term:
      id: NCIT:C100432
      label: Ceruloplasmin Measurement
  readouts:
  - target: Reduced ceruloplasmin secretion
    relationship: READOUT_OF
    direction: NEGATIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Low serum ceruloplasmin reports reduced ceruloplasmin secretion downstream of AT-1 deficiency.
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
      explanation: >-
        The abstract ties low serum ceruloplasmin to reduced ceruloplasmin
        secretion after AT-1 knockdown.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Furthermore, AT-1 defects are a new and important differential diagnosis
      in patients with low copper and ceruloplasmin in serum.
    explanation: >-
      This directly identifies AT-1 defects as a differential diagnosis in
      patients with low serum ceruloplasmin, supporting it as a defining
      biochemical abnormality in Huppke-Brendel syndrome.
- name: Serum copper
  presence: DECREASED
  notes: >-
    Low serum copper is a cardinal biochemical hallmark of Huppke-Brendel
    syndrome.
  biomarker_term:
    preferred_term: copper measurement
    term:
      id: NCIT:C111161
      label: Copper Measurement
  readouts:
  - target: Reduced ceruloplasmin secretion
    relationship: READOUT_OF
    direction: NEGATIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Low serum copper reflects reduced ceruloplasmin-bound copper rather than primary copper deficiency.
    evidence:
    - reference: PMID:22243965
      reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
      supports: SUPPORT
      evidence_source: IN_VITRO
      snippet: >-
        We also showed that AT-1 knockdown in HepG2 cells leads to reduced ceruloplasmin secretion, indicating that the low copper in serum is due to reduced ceruloplasmin levels and is not a sign of copper deficiency.
      explanation: >-
        The abstract states that low serum copper is due to reduced
        ceruloplasmin levels.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Furthermore, AT-1 defects are a new and important differential diagnosis
      in patients with low copper and ceruloplasmin in serum.
    explanation: >-
      This directly identifies AT-1 defects as a differential diagnosis in
      patients with low serum copper, supporting it as a defining biochemical
      abnormality in Huppke-Brendel syndrome.
genetic:
- name: SLC33A1
  association: Loss-of-function
  gene_term:
    preferred_term: SLC33A1
    term:
      id: hgnc:95
      label: SLC33A1
  notes: >-
    Huppke-Brendel syndrome results from biallelic pathogenic variants in the
    ER acetyl-CoA transporter gene SLC33A1.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Deep sequencing and conventional sequencing disclosed homozygous or compound heterozygous mutations for all affected subjects in SLC33A1 encoding a highly conserved acetylCoA transporter (AT-1) required for acetylation of multiple gangliosides and glycoproteins.
    explanation: >-
      This directly establishes SLC33A1 as the causal gene.
environmental: []
treatments: []
diagnosis:
- name: SLC33A1 genetic testing
  diagnosis_term:
    preferred_term: genetic testing
    term:
      id: MAXO:0000127
      label: genetic testing
  description: >-
    Molecular testing confirms the diagnosis by identifying biallelic
    pathogenic SLC33A1 variants.
  results: Biallelic pathogenic SLC33A1 variants support the diagnosis of Huppke-Brendel syndrome.
- name: Brain MRI
  diagnosis_term:
    preferred_term: magnetic resonance imaging procedure
    term:
      id: MAXO:0000424
      label: magnetic resonance imaging procedure
  description: >-
    MRI documents the characteristic pattern of cerebellar hypoplasia and
    hypomyelination.
  results: Cerebellar hypoplasia with hypomyelination supports the diagnosis.
differential_diagnoses:
- name: Wilson disease
  disease_term:
    preferred_term: Wilson disease
    term:
      id: MONDO:0010200
      label: Wilson disease
  description: >-
    Low ceruloplasmin can lead to confusion with Wilson disease, especially in
    adults.
  evidence:
  - reference: PMID:36119696
    reference_title: "Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      With neurologic involvement and ceruloplasmin deficiency, it may mimic Wilson disease (WD).
    explanation: >-
      This directly supports Wilson disease as an important differential
      diagnosis.
- name: Menkes disease
  disease_term:
    preferred_term: Menkes disease
    term:
      id: MONDO:0010651
      label: Menkes disease
  description: >-
    Menkes disease also presents with low serum copper and ceruloplasmin and
    enters the differential diagnosis.
  evidence:
  - reference: PMID:22243965
    reference_title: Mutations in SLC33A1 cause a lethal autosomal-recessive disorder with congenital cataracts, hearing loss, and low serum copper and ceruloplasmin.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Low copper and ceruloplasmin in serum are the diagnostic hallmarks for Menkes disease, Wilson disease, and aceruloplasminemia.
    explanation: >-
      This directly identifies Menkes disease as part of the biochemical
      differential diagnosis.
clinical_trials: []
datasets: []
📚

References & Deep Research

Deep Research

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Asta
Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Huppke-Brendel syndrome. Core disease mechanisms, molecular and cellular p...
Asta Scientific Corpus Retrieval 20 citations 2026-04-14T16:27:15.612021

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Huppke-Brendel syndrome. Core disease mechanisms, molecular and cellular p...

This report is retrieval-only and is generated directly from Asta results.

  • Papers retrieved: 20
  • Snippets retrieved: 20

Relevant Papers

[1] Case report: Huppke–Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years

  • Authors: F. Kirk, Ditte Emilie Munk, J. Ek, L. Birk Møller, Mette Bendixen Thorup et al.
  • Year: 2022
  • Venue: Frontiers in Neurology
  • URL: https://www.semanticscholar.org/paper/ab2470b229b7d9850bd92e756f5a826e7baeeca7
  • DOI: 10.3389/fneur.2022.957794
  • PMID: 36119696
  • PMCID: 9475109
  • Citations: 8
  • Summary: Adult patients with Huppke–Brendel syndrome exist and may be confused with WD, and low ceruloplasmin and the absence of ATP7B variants should raise suspicion.
  • Evidence snippets:
  • Snippet 1 (score: 0.438) > Huppke-Brendel (HB) syndrome was first described in 2012 (1). Since less than ten patients have been reported, all pediatric (2). Clinical presentation is characterized by congenital cataracts, deafness, developmental delay, and death before the age of 6. MRI shows hypomyelination, cerebral atrophy with wide subarachnoid spaces, and cerebellar hypoplasia (1,3). > Huppke-Brendel syndrome is caused by pathogenic biallelic variants in the SLC33A1 gene located on the long arm of chromosome 3. The protein product is acetyl-coenzyme A transporter 1 (AT-1), a highly conserved transmembrane protein located in the endoplasmic reticulum (ER) (4). AT-1 is involved in the acetylation of gangliosides and glycoproteins, by transporting acetyl-CoA from cytosol to the ER lumen (5). AT-1 dysfunction alters protein modification, delays Golgi-to-plasma protein trafficking, and increases in number of lysosomes (6). Thus AT-1 dysfunction may affect many proteins and processes due to its involvement in the secretory pathway (1,7,8). > One consequence of AT-1 dysfunction in HB is ceruloplasmin deficiency with low plasma copper and severe neurological phenotype. Biochemically, HB resembles other copper metabolism disorders such as Wilson disease (WD), Menkes disease, and aceruloplasminemia (1,9). > Here, we present a Danish woman diagnosed in 1996 at age 29 with WD. In 2021, the diagnosis was revised, and HB was identified after the detection of two pathogenic variants in the SLC33A1 gene.

[2] New therapeutic targets in rare genetic skeletal diseases

  • Authors: M. Briggs, Peter A. Bell, M. Wright, K. A. Pirog
  • Year: 2015
  • Venue: Expert Opinion on Orphan Drugs
  • URL: https://www.semanticscholar.org/paper/1363107f71ae6d2d60abca471cddf3da5d13644b
  • DOI: 10.1517/21678707.2015.1083853
  • PMID: 26635999
  • PMCID: 4643203
  • Citations: 37
  • Influential citations: 1
  • Summary: An overview of disease mechanisms that are shared amongst groups of different GSDs and potential therapeutic approaches that are under investigation are described to generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.398) > proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e. chondrocyte) to the abnormal extracellular environment is also important for disease progression as illustrated by several GSDs discussed in this review. > It is important that 'omics'-based approaches and technologies are systematically applied to the study of rare GSDs so that definitive reference profiles and disease signatures are generated for each phenotype. These can then be used in a Systems Biology approach to identify both common and dissimilar pathological signatures and disease mechanisms. This approach is entirely dependent upon relevant in vitro and in vivo models (and also novel 'disease-mechanism phenocopies' [107]) for testing new diagnostic and prognostic tools and for determining the molecular mechanisms that underpin the pathophysiology so that effective therapeutic treatments can be developed and validated. This approach will eventually lead to personalized treatments and care strategies centred on shared disease mechanisms with the use of relevant biomarkers to monitor the efficacy of treatment and disease progression. > It is vital that all relevant stakeholders are involved from the outset in defining the appropriate outcomes of any potential therapeutic regime. The perceptions of a successful therapy can differ widely between the clinical academic community and the relevant patient-support groups and it is vital that there is engagement on all these issues. > In summary, the identification of causative genes and mutations for GSDs over the last 20 years, coupled with the generation and in-depth analysis of a plethora of relevant cell and mouse models, has derived new knowledge on disease mechanisms and suggested potential therapeutic targets. The fast-evolving hypothesis that clinically disparate diseases can share common disease mechanisms is a powerful concept that will generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.

[3] Therapies for Mitochondrial Disease: Past, Present, and Future

  • Authors: Megan Ball, Nicole J. Van Bergen, A. Compton, David R Thorburn, S. Rahman et al.
  • Year: 2025
  • Venue: Journal of Inherited Metabolic Disease
  • URL: https://www.semanticscholar.org/paper/196ee50a950f29bc4134cfb8fe6bdfa9a3a1468b
  • DOI: 10.1002/jimd.70065
  • PMID: 40714961
  • PMCID: 12301291
  • Citations: 3
  • Summary: The latest developments in the pursuit to identify effective treatments for mitochondrial disease are examined and the barriers impeding their success in translation to clinical practice are discussed.
  • Evidence snippets:
  • Snippet 1 (score: 0.390) > Mitochondrial disease is a diverse group of clinically and genetically complex disorders caused by pathogenic variants in nuclear or mitochondrial DNA‐encoded genes that disrupt mitochondrial energy production or other important mitochondrial pathways. Mitochondrial disease can present with a wide spectrum of clinical features and can often be difficult to recognize. These conditions can be devastating; however, for the majority, there is no targeted treatment. In the last 60 years, mitochondrial medicine has experienced significant evolution, moving from the pre‐molecular era to the Age of Genomics in which considerable gene discovery and advancement in our understanding of the pathophysiology of mitochondrial disease have been made. In the last decade, in response to the urgent need for effective treatments, a wide range of emerging therapies have been developed, driven by innovative approaches addressing both the genetic and cellular mechanisms underpinning the diseases. Emerging therapies include dietary intervention, small molecule therapies aimed to restore mitochondrial function, stem cell or liver transplantation, and gene or RNA‐based therapies. However, despite these advances, translation to clinical practice is complicated by the sheer genetic and clinical complexity of mitochondrial disease, difficulty in efficient and precise delivery of therapies to affected tissues, rarity of individual genetic conditions, lack of reliable biomarkers and clinically relevant outcome measures, and the dearth of natural history data. This review examines the latest developments in the pursuit to identify effective treatments for mitochondrial disease and discusses the barriers impeding their success in translation to clinical practice. While treatment for mitochondrial disease may be on the horizon, many challenges must be addressed before it can become a reality.

[4] Novel Approaches to Studying SLC13A5 Disease

  • Authors: Adriana S. Beltran
  • Year: 2024
  • Venue: Metabolites
  • URL: https://www.semanticscholar.org/paper/8469c534cd81d96f84b61e2d963dead12088feb7
  • DOI: 10.3390/metabo14020084
  • PMID: 38392976
  • PMCID: 10890222
  • Citations: 2
  • Summary: Current technologies for generating patient-specific induced pluripotent stem cells (iPSCs) and their inherent advantages and limitations are discussed, followed by a summary of the methods for differentiating iPSCs into neurons, hepatocytes, and organoids.
  • Evidence snippets:
  • Snippet 1 (score: 0.382) > The precise pathophysiology underlying how SLC13A5 loss-of-function results in epilepsy refractory to treatment is a subject of open and ongoing research. Several hypotheses suggest SLC13A5 alters metabolic pathways, leading to neuronal dysfunction. Conversely, therapeutic inhibition of NaCT in the liver is a target to improve metabolic diseases, including non-alcoholic fatty liver disease, obesity, and insulin resistance. Thus, functionally accurate modeling and characterization of the mechanisms involved in citrate transport disruption are critical for understanding its role in human disease. > IPSC-derived cellular systems are a powerful tool for modeling rare human genetic diseases, such as SLC13A5 (Figure 5). IPSCs derived from patients containing the genetic information of the disease can overcome the limitations of animal models, providing access to relevant human cell types that recapitulate the disease phenotype. For instance, patient-derived iPSCs differentiated into neurons or hepatocytes can be used to investigate molecular and cellular mechanisms, including citrate transport and accumulation, energy metabolism, oxidative stress, and other cellular processes. They can also be used to define the spectrum of the disease and how different mutations might lead to various disease severities, screen for potential therapeutic compounds that can restore the transporter function or ameliorate the symptoms, and enable personalized medicine approaches that can tailor treatments to individual patients based on their genetic background and disease severity. > transport disruption are critical for understanding its role in human disease. > IPSC-derived cellular systems are a powerful tool for modeling rare human genetic diseases, such as SLC13A5 (Figure 5). IPSCs derived from patients containing the genetic information of the disease can overcome the limitations of animal models, providing access to relevant human cell types that recapitulate the disease phenotype. For instance, patient-derived iPSCs differentiated into neurons or hepatocytes can be used to investigate molecular and cellular mechanisms, including citrate transport and accumulation, energy metabolism, oxidative stress, and other cellular processes.

[5] Computational drug discovery approaches identify mebendazole as a candidate treatment for autosomal dominant polycystic kidney disease

  • Authors: P. Brownjohn, A. Zoufir, Daniel J O’Donovan, Saatviga Sudhahar, A. Syme et al.
  • Year: 2024
  • Venue: Frontiers in Pharmacology
  • URL: https://www.semanticscholar.org/paper/a595e78572ca02b8cb2897bfc4a989a2b021b279
  • DOI: 10.3389/fphar.2024.1397864
  • PMID: 38846086
  • PMCID: 11154008
  • Citations: 3
  • Summary: It is determined that the anthelmintic mebendazole was a potent anti-cystic agent in human cellular and in vivo models of ADPKD, and is likely acting through the inhibition of microtubule polymerisation and protein kinase activity.
  • Evidence snippets:
  • Snippet 1 (score: 0.379) > Targets and molecules were ultimately filtered for validation based on biological and chemical insights, and the potential for clinical translation.Earlier this year, Wilk et al., 2023 applied a similar transcriptomic approach to us, in that case making use of publicly available transcriptomic datasets to create Pkd2-specific ADPKD disease signatures, from which signature reversion was sought from the Library of Integrated Network-based Cellular Signatures (LINCs) drug signature database in order to identify drug repurposing candidates.While one group has previously made use of a knowledge graph-based approach to prioritise preclinically active compounds with the highest chance of clinical translation (Malas et al., 2019), to our knowledge, the current study provides the first combined application of transcriptomic and machine-learning approaches to identify and prioritise putative treatments for ADPKD, and further deconvolute potential mechanisms of action for experimental validation. > In summary we report, using computational, in vitro and in vivo approaches, that the anthelmintic drug mebendazole ameliorates disease-relevant phenotypes in cellular and animal models of ADPKD.We further show that this effect is likely primarily due to the inhibitory effect of mebendazole on the polymerisation of microtubules, which underlie cellular processes important in ADPKD, including cell proliferation, transport, and cilia signalling, and extends previous work linking the importance of the microtubule network to ADPKD pathophysiology.We also describe the inhibitory profile of mebendazole on known and novel protein kinase targets, some of which have previously been implicated in ADPKD, suggesting mebendazole may be acting via polypharmacology to impact disease mechanisms.We acknowledge that further experimental efforts will be required to confirm the actions of mebendazole on these putative targets in relevant disease model systems.It would be particularly informative to investigate these mechanisms in dedicated in vivo studies, where the effects of mebendazole on a wider range of ADPKD-relevant cell types and phenotypes could be evaluated.

[6] Changes in Serum Proteomic Profiles at Different Stages of Pregnancy Toxemia in Goats

  • Authors: M. Uzti̇mür, C. N. Ünal, Gurler Akpinar
  • Year: 2025
  • Venue: Journal of Veterinary Internal Medicine
  • URL: https://www.semanticscholar.org/paper/4b9c488b5dbd65d7b26fd2ad9aed70e8c4b59942
  • DOI: 10.1111/jvim.70139
  • PMID: 40492724
  • PMCID: 12150350
  • Summary: Understanding the serum proteome profiles of goats with pregnancy toxemia might help identify the proteomes and pathways responsible for the development of this disease and improve diagnosis and treatment.
  • Evidence snippets:
  • Snippet 1 (score: 0.375) > The pathophysiology and progression of this disease are not fully understood. > Traditional biomedical research has focused on the analysis of single genes, proteins, metabolites, or metabolic pathways in diseases. This molecular reductionist approach is based on the assumption that identifying genetic variations and molecular components will lead to new treatments for diseases [13][14][15][16]. However, many diseases are complex and multifactorial, and in order to determine the phenotype of such diseases, it is necessary to understand the changes that occur in more than one gene, pathway, protein, or metabolite at the cellular, tissue, and organismal levels [17][18][19]. Therefore, in recent years, proteomics, as one field of multi-omics technologies, has helped in evaluating the complex pathogenetic mechanisms of different diseases from a broad perspective and has made substantial contributions [20,21]. In veterinary medicine, proteomic analysis of metabolic diseases such as ketosis [16], hypocalcemia [22], and fatty liver [23] in dairy cows has contributed valuable insights for the definition of new pathophysiological pathways and new diagnosis and treatment protocols for these diseases. The proteomic approach can contribute importantly to a broad and detailed understanding of the changes that occur at the organismal level associated with the increase in BHBA concentration in goats with pregnancy toxemia. Our aim was to evaluate the serum protein profiles of goats with SPT or CPT using proteomic techniques to determine the proteomic profiles of these animals and to identify the relevant pathophysiological mechanisms.

[7] Investigating the role of NPR1 in dilated cardiomyopathy and its potential as a therapeutic target for glucocorticoid therapy

  • Authors: Yaomeng Huang, Tongxin Li, Shichao Gao, Shuyu Li, Xiaoran Zhu et al.
  • Year: 2023
  • Venue: Frontiers in Pharmacology
  • URL: https://www.semanticscholar.org/paper/be229f6f2059faab4c97ec0a04bd055adab9dfe1
  • DOI: 10.3389/fphar.2023.1290253
  • PMID: 38026943
  • PMCID: 10662320
  • Citations: 3
  • Summary: Natriuretic peptide receptor 1 (NPR1) was identified as a core gene associated with DCM through bioinformatics analysis and led to substantial improvements in cardiac and renal function, accompanied by an upregulation of NPR1 expression.
  • Evidence snippets:
  • Snippet 1 (score: 0.371) > Multiple pathways and molecules are involved in this process; however, the detailed underlying mechanisms remain unclear. In recent years, with the development of high-throughput sequencing and gene chip technologies, the use of bioinformatics technology to explore the occurrence, development, and prognosis of diseases has become a hot topic for scholars worldwide (Hwang et al., 2018;Nayor et al., 2019;Rinschen et al., 2019;Sturm et al., 2019;Montaner et al., 2020). > The present study aimed to use bioinformatics technology to screen for DCM-related genes and investigate their mechanisms, with the purpose of revealing the pathogenesis of DCM and seeking treatment methods. The GSE3586 dataset, containing expression profiles related to DCM, was selected from the Gene Expression Omnibus (GEO) database. This study aimed to predict the core genes that may play crucial roles in disease progression at the molecular level through the enrichment of relevant molecular pathways associated with DCM. Furthermore, the phenotype of the core genes was validated to further support the results of the bioinformatics analysis through basic and clinical experiments. Additionally, the role of glucocorticoids in DCM treatment is discussed in this article with the purpose of providing a theoretical and experimental basis for exploring the pathogenesis of DCM and elucidating therapeutic methods. This study also provides a theoretical reference for the interpretation, early diagnosis, and treatment of DCM.

[8] 18O-assisted dynamic metabolomics for individualized diagnostics and treatment of human diseases

  • Authors: E. Nemutlu, Song Zhang, N. Juranic, A. Terzic, S. Macura et al.
  • Year: 2012
  • Venue: Croatian Medical Journal
  • URL: https://www.semanticscholar.org/paper/880f053c7f060db4b990e447d0a22c4b69372ddb
  • DOI: 10.3325/cmj.2012.53.529
  • PMID: 23275318
  • PMCID: 3541579
  • Citations: 28
  • Summary: The potential use of dynamic phosphometabolomic platform for disease diagnostics currently under development at Mayo Clinic is described and discussed briefly.
  • Evidence snippets:
  • Snippet 1 (score: 0.369) > Living cells represent an integrated and interacting network of genes, transcripts, proteins, small signaling molecules, and metabolites that define cellular phenotype and function. Traditionally the focus of biomedical research was on individual genes, single protein targets, single metabolites, and metabolic or signaling pathways. This "molecular reductionist" paradigm was based on the assumption that identifying genetic variations and molecular components would lead to discovery of cures for human diseases. However, most of diseases are complex and multi-factorial and the disease phenotype is determined by the alterations of multiple genes, pathways, proteins and metabolites (at cellular, tissue, and organismal levels). Therefore, an integrated "omics" approach is more viable direction for uncovering alterations in metabolic networks, disease mechanisms, and mechanisms of drug effects. > Recent advent of large-scale metabolomics and fluxomic (metabolite dynamics and metabolic flux analysis) completed the "omics revolution" (Figure 1), where genomics, transcriptomics, proteomics, metabolomics, and fluxomics all together complement phenotype determination of living organism. Such integrated "omics" cascades provide a framework for advances in system and network biology, integrative physiology, and system medicine as well as system pharmacology and regenerative medicine. Noteworthy is the "reverse omic" approach or "metabolomicsinformed pharmacogenomics, " where discovery of specific metabolite changes have led to discovery of genetic alterations (2). Therefore, bringing new "omics" technologies to clinical practice will improve disease diagnostics and treatment by targeting drugs and procedures for each unique transcriptomic and metabolomic profiles.

[9] Solving the Evidence Interpretability Crisis in Health Technology Assessment: A Role for Mechanistic Models?

  • Authors: E. Courcelles, J. Boissel, J. Massol, I. Klingmann, R. Kahoul et al.
  • Year: 2022
  • Venue: Frontiers in Medical Technology
  • URL: https://www.semanticscholar.org/paper/877d5b1b75599745f704a9c8371f74601ff17e2f
  • DOI: 10.3389/fmedt.2022.810315
  • PMID: 35281671
  • PMCID: 8907708
  • Citations: 6
  • Summary: Light is shed on different stakeholder's contributions and needs in the appraisal phase and how mechanistic modeling strategies and reporting can contribute to this effort to implement mechanistic models central in the evidence generation, synthesis, and appraisal of HTA so that the totality of mechanistic and clinical evidence can be leveraged by all relevant stakeholders.
  • Evidence snippets:
  • Snippet 1 (score: 0.369) > A second limitation in HTA is the fact that currently population (and sometimes stratified) medicine is pursued during clinical Uncertainty not completely addressed in competent authority assessment report Example use of MIDD relevant to address uncertainty potentially also during HTA What is the optimal dosage in the clinical context? > Physiologically based pharmacokinetic models can investigate dosing-regimens relevant for regulatory review and product labels (9) and can also mimic real-life adherence to prescribed treatment regimens (see also below) or pharmacology-relevant characteristics of special populations as well as drug-drug interactions. > What is the duration of the effectiveness, especially with chronic use of a treatment? > Mechanistic models can predict the long-term disease progression by extrapolation of shorter-term findings under the constraints of how the components of the system function (and these constraints convey biological plausibility by design). An example is the use of a mechanism-based disease progression model for comparison of long-term effects of pioglitazone, metformin, and gliclazide on disease processes underlying Type 2 Diabetes Mellitus (10). Another example is prediction of long-term outcomes by short-term marker data as demonstrated by a semi-mechanistic approach in context of osteoporosis treatment (11). > What is the efficacy for relevant clinical outcomes? > Mechanistic models combined with pharmacometric approaches can translate findings for one outcome to a range of other outcomes. An example of survival modeling on the back of a mechanistic description is the modeling framework for CD19-Specific CAR-T cell immunotherapy using a quantitative systems pharmacology model (12). > What is the size of the clinical effect dependent on patient characteristics and extrinsic factors? > Data-driven modeling techniques can capture correlation within clinical data. Describing the clinical effect of a drug can also be based on mechanistic considerations. Such models either (a) link disease phenotypes to increasingly granular mathematical representations of pathophysiologic processes (top-down approach) or (b) derive functional, computable cellular networks from the molecular building blocks of genes and proteins to elucidate the impact of pathologic or therapeutic alterations on network operating states and hence clinical phenotype (bottom-up) [

[10] Nasopharyngeal Carcinoma Signaling Pathway: An Update on Molecular Biomarkers

  • Authors: W. Tulalamba, T. Janvilisri
  • Year: 2012
  • Venue: International Journal of Cell Biology
  • URL: https://www.semanticscholar.org/paper/307cb9186444d9dad6e2e3b53763be0de76de186
  • DOI: 10.1155/2012/594681
  • PMID: 22500174
  • PMCID: 3303613
  • Citations: 93
  • Influential citations: 5
  • Summary: The molecular signaling pathways in the NPC are discussed for the holistic view of NPC development and progression and the important insights toward NPC pathogenesis may offer strategies for identification of novel biomarkers for diagnosis and prognosis.
  • Evidence snippets:
  • Snippet 1 (score: 0.369) > In the pregenomic eras, highly integrated and complex circuitry of molecular signaling in NPC pathogenesis was only partially understood. Over the past decade, the knowledge of the molecular mechanisms in NPC carcinogenesis has been rapidly accumulated. Dysregulation and abnormal protein expression of molecules in certain signaling pathways involved in cellular functions including proliferation, adhesion, survival, and apoptosis has been demonstrated in the NPC cells. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in NPC will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for this cancer. Refining molecular markers into clinically relevant assays may assist in the detection of NPC in asymptomatic patients, as well as stage classification and monitoring disease progression and treatments. Furthermore, selective regulation of particular proteins targeting cancer cell proliferation, invasion, and apoptosis is a hopeful prospect for future anticancer therapy that slow disease progression and improve survival.

[11] Common immunopathogenesis of central nervous system diseases: the protein-homeostasis-system hypothesis

  • Authors: Kyung-Yil Lee
  • Year: 2022
  • Venue: Cell & Bioscience
  • URL: https://www.semanticscholar.org/paper/2984270ae67451b93007040848d9694d19714c9f
  • DOI: 10.1186/s13578-022-00920-5
  • PMID: 36384812
  • PMCID: 9668226
  • Citations: 9
  • Influential citations: 1
  • Summary: This article proposes a common immunopathogenesis of CNS diseases, including prion diseases, Alzheimer’s disease, and genetic diseases, through the PHS hypothesis, which proposes that the immune systems in the host control those substances according to the size and biochemical properties of the substances.
  • Evidence snippets:
  • Snippet 1 (score: 0.368) > There are hundreds of genetic diseases of the CNS. The defective proteins in genetic disorders include structural proteins for neurotransmitter receptors and other receptors or ion channels on CNS cells, and proteins involved in enzymatic process, metabolism (transport), or signal transduction pathways in various communication systems [98]. Because a discussion of each genetic disease is beyond the scope of this review, only crucial points about the pathogenesis of genetic diseases are discussed. Singlegene defect diseases of the CNS can be caused by a defective product from a gene, i.e., a protein deficiency or a malfunctioning protein. In general, autosomal dominant genetic diseases are caused by structural protein defects, and autosomal recessive diseases are caused by defects in enzymatic proteins. However, certain genetic diseases that involve an enzymatic or multifunctional protein defect can induce structural cell injury during the natural course of the illness. > Patients with genetic diseases, including HD, familial JCD, GSS, and the genetic forms of AD and PD, show different clinical manifestations from other affected people in their family, including the time of onset of neurological symptoms, speed of progression of the disease, and prognosis, suggesting that phenotypes can vary even when the genotypes are identical. Likewise, similar phenotypes of CNS symptoms can be found in different genetic diseases. In genetic animal models, the phenotypes of single gene knockout can vary by strain in mice, and the clinical manifestations of a gene defect can differ between mice and humans, and mice null for some genes have also no observable phenotypic abnormalities compared with controls [99]. These findings suggest that default of a protein might be at least partly controlled by individual's control systems and that there might exist a similar immune/repair system against cell injury in genetic diseases. > The pathophysiology of most genetic diseases in the CNS is complex because any affected gene is associated with numerous proteins and their corresponding activations of genes and epigenetic changes that occur during disease processes. Thus, the use of a genetic marker for diagnosing or predicting a prognosis remains impractical in clinical settings [100].

[12] Role of Transcriptomics in Precision Oncology

  • Authors: Ruby Srivastava
  • Year: 2024
  • Venue: Reports of Radiotherapy and Oncology
  • URL: https://www.semanticscholar.org/paper/0bd862558bbb7286336111d9dfd232b5f905d3d9
  • DOI: 10.5812/rro-142195
  • Citations: 4
  • Summary: : Transcriptome profiling is one of the most widely used approaches in the field of multiomics research. It plays a crucial role in the prognostic, diagnostic, and predictive treatment of cancer patients. Novel next-generation sequencing (NGS) technologies permit the identification of cancer biomarkers, gene signatures, and their abnormal expression, affecting oncogenic and molecular targets and novel biomarkers for cancer therapies. Multiomics studies have changed the overall understanding o...
  • Evidence snippets:
  • Snippet 1 (score: 0.368) > : Transcriptome profiling is one of the most widely used approaches in the field of multiomics research. It plays a crucial role in the prognostic, diagnostic, and predictive treatment of cancer patients. Novel next-generation sequencing (NGS) technologies permit the identification of cancer biomarkers, gene signatures, and their abnormal expression, affecting oncogenic and molecular targets and novel biomarkers for cancer therapies. Multiomics studies have changed the overall understanding of cancer and opened a precise perspective for tumor diagnostics and therapy. The use of these approaches has strengthened our understanding of disease pathophysiology and classifications at the molecular level, including specific interference with drug mechanisms of action. Still, it has limited added value in the clinical setting. The omics data on precision medicine include the application of data from genes, transcripts, and proteins for diagnosis, monitoring of diseases, risk factor determination, counseling, and development of novel therapeutics. Bioinformatics applications have expanded statistics-based analysis toward deriving molecular pathways and process models for characterizing phenotypes and drug action mechanisms. In this review, we will discuss transcriptomics and interference analysis that allows the identification of predictive biomarkers at the molecular level to test drug response and analyze the molecular process interface of disease progression-relevant pathophysiology and mechanism of action to propose predictive biomarkers.

[13] Recent Evidences of Epigenetic Alterations in Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review

  • Authors: R. Ragusa, Pasquale Bufano, A. Tognetti, M. Laurino, Chiara Caselli
  • Year: 2025
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/2660cdbbe1f205c631fe890e5c6a3c8d9b81ce5f
  • DOI: 10.3390/ijms26062571
  • PMID: 40141213
  • PMCID: 11942187
  • Citations: 4
  • Summary: A systematic review of the latest knowledge on epigenetic modifications that characterize COPD, summarizing epigenetic factors that could serve as potential novel biomarkers and therapeutic targets for the treatment of COPD patients.
  • Evidence snippets:
  • Snippet 1 (score: 0.366) > The papers included were clustered according to epigenetic mechanisms involved in COPD (molecular and cellular processes, as biomarker or therapeutic target). Tables 4-9 describe the extracted information, including the following: Study = name of first author et al., year; Country (Region) = where the study took place; Number of participants = sample size; Type of sample = biological sample employed; Gene affected = gene or group of genes whose expression can be "regulated" by epigenetic mechanisms; Epigenetic alteration = type of epigenetic alteration observed in the presence of disease; Activity in COPD = involvement of epigenetic elements in different molecular and cellular mechanisms associated with COPD; and Role of epigenetic mechanisms = epigenetic modifications that can be used to explain the pathophysiology of COPD or as biomarkers and therapeutic targets.

[14] Modeling psychiatric disorders: from genomic findings to cellular phenotypes

  • Authors: Anna Falk, Vivi M. Heine, A. Harwood, Patrick F. Sullivan, M. Peitz et al.
  • Year: 2016
  • Venue: Molecular Psychiatry
  • URL: https://www.semanticscholar.org/paper/235b41240d78140de7ab06a3ad8a7d0b1bdff1a5
  • DOI: 10.1038/mp.2016.89
  • PMID: 27240529
  • PMCID: 4995546
  • Citations: 77
  • Influential citations: 2
  • Summary: The challenges for modeling of psychiatric disorders, potential solutions and how iPSC technology can be used to develop an analytical framework for the evaluation and therapeutic manipulation of fundamental disease processes are critically reviewed.
  • Evidence snippets:
  • Snippet 1 (score: 0.365) > The key challenge for iPSC-based disease modeling is to identify one or more relevant cellular phenotypes that accurately represent the disease pathophysiology. Increasing numbers of reports have demonstrated that for many diseases specific pathophysiology can be captured in human iPSC-based disease models. These range from cardiovascular disease, 44,45 cancer, 46,47 ocular disease, 48,49 diabetes mellitus 50,51 and neurological disorders of the brain. 52,53 Can the same approach be applied to complex psychiatric disorders? > The problem is that almost all psychiatric disorders are characterized by clinical signs and symptoms, but lack independent verification from objective biomarkers. Thus, how might these clinical phenotypes manifest themselves in terms of cell behavior? The identity of robust cellular 'readouts', which typify any psychiatric disorder, is a crucial unsolved problem and an area of intense study 54 (Table 2). When satisfactorily answered, this will herald a new degree of biological objectivity and quantification for the study of psychiatric disorders. > The aim is to find a single or small number of cell phenotypes or parameters that strongly associate with psychiatric disorders, and establish a cellular profile characteristic of cells derived from the general patient population. Although a consensus set of cellular phenotypes for psychiatric disorder is yet to be established, we can define some of their desired characteristics. First, cellular phenotypes have to relate to the biological pathways identified by genetics. Second, although there are many risk genes in disparate biological pathways, at some level, phenotypes should converge onto a much smaller grouping. Third, phenotypes need to be quantifiable. Finally, to be useful for drug development cellular phenotypes should be reversed by pharmacological treatment, although not necessarily by drugs in current use. > Although human iPSC-based approaches underrepresent the complexity of the human central nervous system, cellular phenotypes are likely to lie more proximal to molecular disease mechanisms than phenotypes seen at the level of a tissue or organism, 55 and thus may bypass compensatory homeostatic (2) Gene expression profiles of SCZ human iPSC neurons identified altered expression of many components of the cyclic AMP and WNT signaling pathways. > (3

[15] Towards Mutation-Specific Precision Medicine in Atypical Clinical Phenotypes of Inherited Arrhythmia Syndromes

  • Authors: T. Nakajima, S. Tamura, M. Kurabayashi, Y. Kaneko
  • Year: 2021
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/3d299f57f344d42eff9d3565d1581dae7fb87a54
  • DOI: 10.3390/ijms22083930
  • PMID: 33920294
  • PMCID: 8069124
  • Citations: 6
  • Influential citations: 1
  • Summary: Since the epileptic phenotype appears to manifest prior to cardiac events in this mutation carrier, identifying KCND3 mutations in patients with epilepsy and providing optimal therapy will help prevent sudden unexpected death in epilepsy.
  • Evidence snippets:
  • Snippet 1 (score: 0.365) > Recent advances in molecular genetics have identified many causal genes for inherited arrhythmia syndromes (IASs) such as long QT syndrome (LQTS) [1], short QT syndrome (SQTS) [2], Brugada syndrome (BrS) [3,4] and early repolarization (ER) syndrome (ERS) [3,5]. Most causal genes for IASs encode cardiac ion channels or their related proteins. Genotype-phenotype studies and functional analyses of mutant genes, using heterologous expression systems and experimental animal models, have revealed the pathophysiology of IASs and enabled the establishment of causal gene-specific precision medicine [6][7][8]. Furthermore, analyses of patient-specific and/or genome-edited induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have provided further insights into the pathophysiology of IASs and novel promising therapeutic strategies for IASs, although there are still some limitations of using iPSC-CMs, such as immature structure and function and mixed population of atrial, ventricular, and nodal cells, as a standard technology [9]. > The altered function of causal genes that encode cardiac ion channels is caused by multiple mechanisms, including trafficking defects, producing non-functional channels, altered channel gating properties, and a combination thereof. These altered functions of mutant channels underly the clinical phenotypes of IASs [10][11][12]. Particularly, unique electrophysiological properties of mutant channels have been shown to be associated with the atypical clinical phenotypes of IASs [10,13]. Furthermore, the elucidation of the mechanisms underlying the atypical clinical phenotypes of IASs has raised the possibility of mutation-specific precision medicine. > We herein review the current knowledge of genotype-phenotype relationships, underlying molecular and cellular mechanisms, and established pharmacological therapies of IASs, including LQTS, SQTS, and J wave syndrome (BrS and ERS).

[16] Transcriptional profiling of Hutchinson-Gilford progeria patients identifies primary target pathways of progerin

  • Authors: Sandra Vidak, Sohyoung Kim, Tom Misteli
  • Year: 2026
  • Venue: Nucleus
  • URL: https://www.semanticscholar.org/paper/4bd99b0875508364d8672b6da5a50d024d485a53
  • DOI: 10.1080/19491034.2025.2611484
  • PMID: 41489464
  • PMCID: 12773485
  • Summary: To probe the clinical relevance of previously implicated cellular pathways and to address the extent of gene expression heterogeneity between patients, transcriptomic analysis of a comprehensive set of HGPS patients finds misexpression of several cellular pathways, including multiple signaling pathways, the UPR and mesodermal cell fate specification.
  • Evidence snippets:
  • Snippet 1 (score: 0.364) > Oxidative stress represents another key pathogenic mechanism in HGPS, as impaired NRF2 activity or increased reactive oxygen species (ROS) levels are sufficient to recapitulate HGPSassociated phenotypes [17,32,60]. Collectively, these findings underscore the multifactorial nature of HGPS pathogenesis, implicating interconnected signaling cascades involved in inflammation, oxidative stress, proteostasis, and vascular remodeling. Reassuringly, our findings indicate that many of the major pathways that have been described to contribute to HGPS phenotypes in mouse and cellular disease models are also misregulated in progeria patients, and targeting these pathways may provide therapeutic avenues to mitigate disease severity and improve outcomes in HGPS. > Although individuals with HGPS typically exhibit a characteristic set of clinical features, such as craniofacial abnormalities, growth retardation, and cardiovascular complications, there is notable variability in the age of onset, severity, and progression of symptoms between patients [7,9]. At the cellular level, HGPS is associated with several hallmark abnormalities, including nuclear envelope defects, decreased expression of several nuclear proteins and epigenetic marks, mitochondrial dysfunction, and increased cellular senescence [1,11,30,31,61]. These cellular phenotypes also exhibit considerable variation between patients, possibly contributing to differences in clinical outcomes. Our results indicate that even though some degree of transcriptional heterogeneity between the individual patients exists, the majority of patients exhibit misregulation of a set of shared pathways, suggesting that these pathways are universal driver mechanisms in HGPS. Further work is needed to understand the molecular and genetic factors that underlie inter-individual variability in disease expression and progression. > A limitation of pathway analysis of HGPS patient samples is to distinguish the pathways which are directly targeted by the disease-causing progerin protein and the emergence of adaptive secondary response pathways during progression of the disease in patients during their lifetime. The same caveat applies to the use of cell-based models used in the study of HGPS disease mechanisms.

[17] Frontiers in metabolic physiology grand challenges

  • Authors: J. Imig
  • Year: 2022
  • Venue: Frontiers in Physiology
  • URL: https://www.semanticscholar.org/paper/19e2780d459288513f034516e0a7d5fa4e12298f
  • DOI: 10.3389/fphys.2022.879617
  • PMID: 36035475
  • PMCID: 9399398
  • Citations: 1
  • Summary: In this chapter seven subsequent studies of the determinants of infectious disease in eight operation rooms were studied.
  • Evidence snippets:
  • Snippet 1 (score: 0.362) > Research in this area will identify novel therapeutic targets for diabetic complications at the levels of transcription and translation, protein expression and activity, and cell and organ levels. Major challenges in diabetes include defining molecular mechanisms and pathways implicated in insulin metabolism, evaluating transcriptomics of high glucose on different cell types, defining the contribution of the innate immune response and NLRP3 inflammasome, understanding metabolic mechanisms that drive beta cell dysfunction, and defining metabolic processes in key insulin-target tissues. > NAFLD is a rapidly growing public health concern that occurs in 25% of the world population and is driven in large part by the obesity and type 2 diabetes epidemic (Caussy et al., 2021;Targher et al., 2021). Intriguingly, NAFLD can be as high as 75% in diabetic patients (Caussy et al., 2021;Targher et al., 2021). Non-alcoholic steatosis (NASH) is a type of NAFLD that is associated with inflammation and hepatocyte lipotoxicity which leads to liver fibrosis and cancer (Caussy et al., 2021;Targher et al., 2021). NASH is expected to become the leading cause for liver transplantation in the next decade (Nephew and Serper, 2021). Mechanisms that contribute to NAFLD and progression to NASH include regulation of de novo lipogenesis by acetyl-CoA carboxylase, regulation of bile acid signaling by farnesoid X receptor (FXR), or oxidative stress induced fibrogenesis and inflammation by apoptosis signal-regulating kinase 1 (ASK1) (Attia et al., 2021;Koo and Han, 2021). Although often associated with obesity and diabetes, understanding pathophysiological mechanisms at the cellular hepatocyte and organ liver levels that result in NAFLD and progression to NASH will be key to developing therapeutics. > Major challenges to the epidemic of metabolic diseases are the focus of several publications in Frontiers in Metabolic Physiology. Studies in mice with type 2 diabetes have revealed metabolites involved in diabetic kidney disease.

[18] Clinical Phenotypes of Cardiovascular and Heart Failure Diseases Can Be Reversed? The Holistic Principle of Systems Biology in Multifaceted Heart Diseases

  • Authors: K. Lourida, G. Louridas
  • Year: 2022
  • Venue: Cardiogenetics
  • URL: https://www.semanticscholar.org/paper/3960806730c4c1115f527e22d6d0a76536570ec5
  • DOI: 10.3390/cardiogenetics12020015
  • Citations: 4
  • Influential citations: 1
  • Summary: Only by understanding the complexity of chronic heart diseases and explaining the interrelationship between different interconnected biological networks can the probability for clinical phenotypes reversal be increased.
  • Evidence snippets:
  • Snippet 1 (score: 0.361) > Treatment with ACEIs, ARBs, and β-blockers impedes deterioration of myocardial function as well as clinical deterioration caused by the deleterious impact of the compensatory systems [58,59]. Therefore, the therapy with ACEIs, ARBs, and β-blockers is the appropriate therapy to block LV remodeling and HF progression and reduce symptoms and/or mortality [55]. > In general, the HF syndrome demonstrates a modular construction with predictable behavior of functional clinical phenotypes having a strong impact on biological networks from epigenetic, cellular to regulatory systems [18]. The importance of individual genes for the pathogenesis and clinical progression of the HF syndrome is restricted to the hypertrophic and dilated cardiomyopathies. It seems that some HF patients have a complex multigenic inheritance, but the importance of individual genes is limited. In contrast, the significant role of epigenetics, proteomics, and metabolomics is increased; but, the complete genetic network system and the interactions between multiomics systems are still uncertain [60]. Multimodal systems that include genetic networks, multiomics, metabolic pathways, environmental factors, and sophisticated disease-related clinical networks are required to be integrated and provide a new holistic and realistic picture. > Significant breakthroughs have been made to understand many of the pathophysiological mechanisms of HFrEF but the natural pathophysiological history and clinical progression of HFpEF still remains inadequately defined [39]. The subclinical progression of pre-clinical diastolic dysfunction (PDD) of LV "to clinical phenotype of HFpEF and the further clinical progression to some more complex clinical models with multi-organ involvement . . . continue to be poorly understood" [40]. Prospective studies are expected to clarify the natural history and clinical progression of HFpEF and define the LV remodeling mechanisms involved. The pathophysiology of LV systolic dysfunction is different to the diastolic dysfunction, as systolic dysfunction is considered a disease of calcium handling and diastolic dysfunction is regarded as a disease of increased myofilament sensitivity to calcium [61][62][63].

[19] Mitochondrial Dysfunction in Diabetes: Shedding Light on a Widespread Oversight

  • Authors: F. Iheagwam, A. J. Joseph, E. D. Adedoyin, Olawumi Toyin Iheagwam, Samuel Akpoyowvare Ejoh
  • Year: 2025
  • Venue: Pathophysiology
  • URL: https://www.semanticscholar.org/paper/dbf8042761c1a5fc50f8cd894cc498505abac7cb
  • DOI: 10.3390/pathophysiology32010009
  • PMID: 39982365
  • PMCID: 12077258
  • Citations: 25
  • Summary: This review aims to elucidate the complex link between mitochondrial dysfunction and diabetes, covering the spectrum of diabetes types, the role of mitochondria in insulin resistance, highlighting pathophysiological mechanisms, mitochondrial DNA damage, and altered mitochondrial biogenesis and dynamics.
  • Evidence snippets:
  • Snippet 1 (score: 0.358) > The landscape of DM research is continuously evolving, with emerging technologies and approaches offering new insights into the pathophysiology of the disease and potential therapeutic targets. Advancements in omics technologies, encompassing genomes, transcriptomics, proteomics, and metabolomics, have transformed the molecular mechanisms underlying DM [134]. High-throughput sequencing techniques enable comprehensive analysis of genetic variants, gene expression profiles, protein abundance, and metabolite levels associated with DM and its complications [135]. Single-cell omics approaches provide unprecedented resolution and granularity, allowing researchers to dissect cellular heterogeneity and identify novel cell types, subpopulations, and signalling pathways involved in DM pathogenesis. Integrating multi-omics data sets offers a systems-level perspective of DM, unravelling complex networks of molecular interactions and regulatory circuits underlying disease progression [136]. > In addition to omics technologies, advances in imaging modalities, such as MRI, PET, and optical imaging, enable non-invasive visualisation and quantification of metabolic, functional, and structural changes. Molecular imaging probes targeting specific biomarkers and metabolic pathways provide valuable insights into disease mechanisms and treatment responses in preclinical and clinical settings [85]. Despite significant progress in DM research, numerous unanswered questions and knowledge gaps persist, hindering the ability to develop effective prevention and treatment strategies. Key areas requiring further investigation include the role of epigenetics, environmental factors, and the microbiome in DM susceptibility and progression. Moreover, the interaction between environmental cues and genetic predisposition remains incompletely understood, highlighting the need for comprehensive multi-omics studies and large-scale epidemiological analyses to identify gene-environment interactions and modifiable risk factors for DM [137]. Furthermore, the heterogeneity of DM phenotypes and clinical outcomes poses a challenge for personalised medicine approaches, necessitating robust biomarkers and predictive models to stratify patients based on disease subtypes, prognosis, and treatment response [138].

[20] The ties that bind: functional clusters in limb-girdle muscular dystrophy

  • Authors: E. Barton, C. A. Pacak, Whitney L. Stoppel, P. Kang
  • Year: 2020
  • Venue: Skeletal Muscle
  • URL: https://www.semanticscholar.org/paper/653422e1a9dc9cc7f16758b10f3f203155bc68c9
  • DOI: 10.1186/s13395-020-00240-7
  • PMID: 32727611
  • PMCID: 7389686
  • Citations: 24
  • Summary: A deeper understanding of these disease pathways could yield a new generation of precision therapies that would each be expected to treat a broader range of LGMD patients than a single subtype, thus expanding the scope of the molecular medicines that may be developed for this complex array of muscular dystrophies.
  • Evidence snippets:
  • Snippet 1 (score: 0.358) > Pyridine nucleotide-disulfide reductase [55] Many of the protein functions listed require further confirmation or are disputed these methodologies. Those patients with moderate disease phenotypes regardless of the underlying causative gene mutation would likely fall into a category where there may be interest in testing a pharmacological treatment (that could be halted) but reduced interest in a more permanent experimental strategy. For all of the above-mentioned reasons, the identification of unifying therapeutic targets applicable to multiple subtypes of > LGMDs is highly desirable. > To identify such targets, we should first consider the question: What binds all of these LGMDs together? The two core phenotypic features are progressive proximal muscle weakness, along with characteristic signs of muscle fiber destruction on biopsy, referred to as "dystrophic" features. Nuances in clinical presentation have helped to distinguish some of the LGMDs, such as the frequent occurrence of difficulty walking on tiptoes in LGMD R2 (LGMD2B), caused by dysferlin deficiency. However, heterogeneity associated with variable ages of onset and ranges of severity makes it generally difficult to distinguish and diagnose LGMD subtypes based on clinical presentation alone. A change in perspective is in order to aid in understanding disease pathways responsible for clinical features even when the genetic mutation is unknown. Further, given the large number of genespecific LGMD subtypes, it could very well be that several major disease mechanisms may be shared across the family of diseases. Yet despite careful studies that have collectively determined the cellular localization of most proteins associated with LGMD (Fig. 1), there is limited knowledge of potentially unifying molecular disease mechanisms. We assert that the identification of functional clusters of these proteins, grouped by such common mechanisms, will streamline our understanding of the disease processes and identify therapeutic targets relevant to individuals in multiple disease subgroups, including individuals whose pathogenic mutations have not been found. By extension, this approach may serve as a tool to not only find common mechanisms, but may also help to distinguish LGMD subtypes that do not share similar functional patterns, and afford further refinement of potential treatments.

Notes

  • This provider combines search_papers_by_relevance with snippet_search.
  • No synthesis or second-stage model call is performed.