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1
Inheritance
3
Pathophys.
5
Phenotypes
16
Pathograph
1
Genes
1
Treatments
1
Differentials
1
Deep Research
👪

Inheritance

1
Autosomal recessive inheritance HP:0000007
Aceruloplasminemia is caused by biallelic pathogenic variants in CP.
Autosomal recessive inheritance
Show evidence (1 reference)
PMID:39990010 SUPPORT Human Clinical
"Plain Language Summary: Aceruloplasminemia is a rare autosomal recessive iron metabolism disorder."
This case series directly states the canonical inheritance pattern.

Pathophysiology

3
Ceruloplasmin ferroxidase deficiency
Loss of ceruloplasmin impairs ferroxidase-dependent iron handling and disrupts normal copper and iron metabolism.
CP link
iron ion transport link ⚠ ABNORMAL intracellular iron ion homeostasis link ⚠ ABNORMAL
ferroxidase activity link ↓ DECREASED
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Ceruloplasmin gene encodes ceruloplasmin protein, which has ferroxidase activity and is involved in copper and iron metabolism."
This directly supports loss of ceruloplasmin ferroxidase function as the initiating molecular defect.
Multi-organ iron accumulation
Impaired ceruloplasmin-dependent iron handling causes progressive iron deposition in the brain, liver, pancreas, and retina.
iron ion transport link ⚠ ABNORMAL intracellular iron ion homeostasis link ⚠ ABNORMAL
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Aceruloplasminemia inherited autosomal recessively in the ceruloplasmin gene is a progressive disease with iron accumulation in various organs such as the brain, liver, pancreas, and retina."
This directly supports progressive multi-organ iron deposition as the key downstream pathological event.
Brain iron accumulation
Progressive iron deposition in deep gray matter and cerebellar structures drives the neurologic manifestations of aceruloplasminemia.
iron ion transport link ⚠ ABNORMAL intracellular iron ion homeostasis link ⚠ ABNORMAL
Show evidence (1 reference)
PMID:40729217 SUPPORT Human Clinical
"Brain MRI revealed significant iron accumulation in multiple brain regions, including the dentate nuclei, cerebellar cortex, basal ganglia, thalamus, brainstem nuclei, and hypothalamus."
This case report directly supports brain iron accumulation as the immediate pathophysiologic driver of neurologic disease.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for aceruloplasminemia 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

5
Endocrine 1
Diabetes mellitus Diabetes mellitus (HP:0000819)
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Progressive neurotoxicity, retinopathy, and diabetes may develop in about 40-60 decades."
This directly supports diabetes mellitus as a recognized later manifestation.
Eye 1
Retinopathy Retinopathy (HP:0000488)
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Progressive neurotoxicity, retinopathy, and diabetes may develop in about 40-60 decades."
This directly supports retinopathy as part of the classic later phenotype.
Nervous System 2
Cognitive impairment Cognitive impairment (HP:0100543)
Show evidence (1 reference)
PMID:40729217 SUPPORT Human Clinical
"Here, we report the first case of ACP in Greece. Case Presentation: Our patient was a 53-year-old male who was referred to our movement disorders center for a 6-month history of mild, unspecific, episodic dizziness and postural instability, and attention and memory deficits."
Attention and memory deficits in a disease-specific case report support cognitive impairment as part of the neurologic spectrum.
Postural instability Postural instability (HP:0002172)
Show evidence (1 reference)
PMID:40729217 SUPPORT Human Clinical
"Here, we report the first case of ACP in Greece. Case Presentation: Our patient was a 53-year-old male who was referred to our movement disorders center for a 6-month history of mild, unspecific, episodic dizziness and postural instability, and attention and memory deficits."
This disease-specific case report directly supports postural instability as part of the neurologic phenotype.
Other 1
Microcytic anemia Microcytic anemia (HP:0001935)
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"In addition, microcytic anemia accompanied by high ferritin and low ceruloplasmin level that develop at earlier ages can be first manifestation."
This directly supports microcytic anemia as an early disease phenotype.
🧬

Genetic Associations

1
CP (Loss of function mutation)
Show evidence (2 references)
PMID:40729217 SUPPORT Human Clinical
"Background and Clinical Significance: Aceruloplasminemia (ACP), a member of the neurodegeneration with brain iron accumulation (NBIA) spectrum of disorders, is a rare disorder caused by mutations in the ceruloplasmin (CP) gene."
This directly identifies CP as the disease gene.
"CP | HGNC:2295 | aceruloplasminemia | MONDO:0011426 | AR | Definitive"
ClinGen classifies the CP-aceruloplasminemia gene-disease relationship as definitive with autosomal recessive inheritance.
💊

Treatments

1
Iron chelation therapy
Action: chelator agent therapy MAXO:0001223
Agent: deferiprone
Iron chelation is used to reduce systemic and neurologic iron-related toxicity.
Mechanism Target:
MODULATES Multi-organ iron accumulation — Iron chelation is used to reduce iron-related toxicity downstream of multi-organ iron accumulation.
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Iron chelation may be utilized in the treatment to reduce the toxicity."
Disease-specific review text supports iron chelation as a treatment aimed at reducing iron-related toxicity.
Show evidence (1 reference)
PMID:33839643 SUPPORT In Vitro
"In particular, deferiprone is currently being exploited to treat several NBIA diseases (Vroegindeweij et al., 2020, Klopstock et al., 2019)."
This directly supports deferiprone-based iron chelation as a disease-relevant treatment strategy within the NBIA spectrum that includes aceruloplasminemia.
🔬

Biochemical Markers

6
Serum ceruloplasmin (DECREASED)
Context: Very low serum ceruloplasmin is a core laboratory abnormality.
Pathograph Readouts
Readout Of Ceruloplasmin ferroxidase deficiency Negative Diagnostic
Low serum ceruloplasmin directly reports the CP/ceruloplasmin deficiency state.
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels."
This directly supports low ceruloplasmin as a key biochemical hallmark.
Serum copper (DECREASED)
Context: Serum copper is low in aceruloplasminemia because loss of circulating ceruloplasmin reduces the major copper-bearing plasma protein pool.
Pathograph Readouts
Readout Of Ceruloplasmin ferroxidase deficiency Negative Diagnostic
Low serum copper tracks with severe loss of circulating ceruloplasmin.
Show evidence (2 references)
PMID:36308763 SUPPORT Human Clinical
"Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels."
Disease-specific case evidence directly documents low copper with low ceruloplasmin.
PMID:40729217 SUPPORT Human Clinical
"Subsequent testing revealed extremely low serum CP and low serum copper."
Independent case evidence supports low serum copper as part of the diagnostic laboratory pattern.
Ferritin (INCREASED)
Context: Hyperferritinemia reflects systemic iron overload and is often present before major neurologic manifestations.
Pathograph Readouts
Readout Of Multi-organ iron accumulation Positive Diagnostic
Elevated ferritin reports systemic iron storage and iron misdistribution in aceruloplasminemia.
Show evidence (1 reference)
PMID:39990010 SUPPORT Human Clinical
"Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms."
This directly supports elevated ferritin as a recurring pre-symptomatic laboratory clue.
Transferrin saturation (DECREASED)
Context: Low transferrin saturation is an early laboratory clue that accompanies the microcytic anemia and hyperferritinemia pattern.
Pathograph Readouts
Readout Of Ceruloplasmin ferroxidase deficiency Negative Diagnostic
Low transferrin saturation reflects impaired ceruloplasmin-dependent iron mobilization despite tissue iron loading.
Show evidence (1 reference)
PMID:39990010 SUPPORT Human Clinical
"Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms."
This directly supports decreased transferrin saturation as a recurrent biochemical feature of aceruloplasminemia.
Tissue iron accumulation (INCREASED)
Context: Iron accumulates across multiple organs, including brain, liver, pancreas, and retina, downstream of ceruloplasmin-dependent iron handling failure.
Pathograph Readouts
Readout Of Multi-organ iron accumulation Positive Diagnostic
Increased tissue iron burden reports the central multi-organ iron accumulation mechanism.
Show evidence (1 reference)
PMID:36308763 SUPPORT Human Clinical
"Aceruloplasminemia inherited autosomal recessively in the ceruloplasmin gene is a progressive disease with iron accumulation in various organs such as the brain, liver, pancreas, and retina."
Disease-specific review text directly identifies multi-organ tissue iron accumulation.
Brain MRI iron accumulation (INCREASED)
Context: MRI can show increased iron burden in multiple brain regions, including dentate nuclei, cerebellar cortex, basal ganglia, thalamus, brainstem nuclei, and hypothalamus.
Pathograph Readouts
Readout Of Brain iron accumulation Positive Diagnostic
MRI-visible brain iron reports the neurologic iron-accumulation branch.
Show evidence (1 reference)
PMID:40729217 SUPPORT Human Clinical
"Brain MRI revealed significant iron accumulation in multiple brain regions, including the dentate nuclei, cerebellar cortex, basal ganglia, thalamus, brainstem nuclei, and hypothalamus."
MRI evidence directly documents the brain iron accumulation readout.
🔀

Differential Diagnoses

1

Conditions with similar clinical presentations that must be differentiated from aceruloplasminemia:

Overlapping Features Wilson disease overlaps through low ceruloplasmin and hepatic-neurologic manifestations, but has primary copper transport failure rather than ceruloplasmin-linked iron overload.
Distinguishing Features
  • Wilson disease is primarily an ATP7B-related copper overload disorder.
  • Aceruloplasminemia instead shows microcytic anemia, low transferrin saturation, and hyperferritinemia before the neurologic syndrome.
Show evidence (1 reference)
PMID:39990010 SUPPORT Human Clinical
"It is important to differentiate aceruloplasminemia from Wilson disease, another disease with low ceruloplasmin."
This directly supports Wilson disease as a key differential diagnosis.
{ }

Source YAML

click to show
name: aceruloplasminemia
creation_date: "2026-04-15T17:35:00Z"
updated_date: "2026-05-20T11:51:03Z"
description: >-
  Aceruloplasminemia is an autosomal recessive CP-related iron metabolism
  disorder characterized by absent ceruloplasmin ferroxidase activity,
  multi-organ iron accumulation, and progressive neurologic, retinal, metabolic,
  and hematologic disease.
category: Mendelian
parents:
- hereditary disease
- neurodegeneration with brain iron accumulation
disease_term:
  preferred_term: aceruloplasminemia
  term:
    id: MONDO:0011426
    label: aceruloplasminemia
inheritance:
- name: Autosomal recessive inheritance
  inheritance_term:
    preferred_term: Autosomal recessive inheritance
    term:
      id: HP:0000007
      label: Autosomal recessive inheritance
  description: >-
    Aceruloplasminemia is caused by biallelic pathogenic variants in CP.
  evidence:
  - reference: PMID:39990010
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Plain Language Summary: Aceruloplasminemia is a rare autosomal recessive iron metabolism disorder.
    explanation: >-
      This case series directly states the canonical inheritance pattern.
pathophysiology:
- name: Ceruloplasmin ferroxidase deficiency
  description: >-
    Loss of ceruloplasmin impairs ferroxidase-dependent iron handling and
    disrupts normal copper and iron metabolism.
  genes:
  - preferred_term: CP
    term:
      id: hgnc:2295
      label: CP
  biological_processes:
  - preferred_term: iron ion transport
    term:
      id: GO:0006826
      label: iron ion transport
    modifier: ABNORMAL
  - preferred_term: intracellular iron ion homeostasis
    term:
      id: GO:0006879
      label: intracellular iron ion homeostasis
    modifier: ABNORMAL
  molecular_functions:
  - preferred_term: ferroxidase activity
    term:
      id: GO:0004322
      label: ferroxidase activity
    modifier: DECREASED
  chemical_entities:
  - preferred_term: iron
    term:
      id: CHEBI:18248
      label: iron atom
    modifier: ABNORMAL
  - preferred_term: copper
    term:
      id: CHEBI:28694
      label: copper atom
    modifier: DECREASED
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Ceruloplasmin gene encodes ceruloplasmin protein, which has ferroxidase activity and is involved in copper and iron metabolism.
    explanation: >-
      This directly supports loss of ceruloplasmin ferroxidase function as the
      initiating molecular defect.
  downstream:
  - target: Multi-organ iron accumulation
    description: Loss of ceruloplasmin ferroxidase activity causes progressive tissue iron deposition.
  - target: Serum ceruloplasmin
    description: Ceruloplasmin loss is reflected clinically by very low serum ceruloplasmin levels.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:36308763
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels.
      explanation: This disease-specific case report supports low ceruloplasmin as a biochemical readout of the CP/ceruloplasmin defect.
  - target: Serum copper
    description: Low serum copper accompanies severe ceruloplasmin loss because most circulating copper is ceruloplasmin-bound.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:36308763
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels.
      explanation: Disease-specific laboratory findings support low copper together with low ceruloplasmin.
  - target: Transferrin saturation
    description: Ceruloplasmin-dependent iron export failure presents clinically with low transferrin saturation despite tissue iron loading.
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - impaired cellular iron export and iron sequestration
    evidence:
    - reference: PMID:39990010
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms.
      explanation: The case series supports low transferrin saturation as part of the aceruloplasminemia iron-misdistribution laboratory pattern.
- name: Multi-organ iron accumulation
  description: >-
    Impaired ceruloplasmin-dependent iron handling causes progressive iron
    deposition in the brain, liver, pancreas, and retina.
  biological_processes:
  - preferred_term: iron ion transport
    term:
      id: GO:0006826
      label: iron ion transport
    modifier: ABNORMAL
  - preferred_term: intracellular iron ion homeostasis
    term:
      id: GO:0006879
      label: intracellular iron ion homeostasis
    modifier: ABNORMAL
  chemical_entities:
  - preferred_term: iron
    term:
      id: CHEBI:18248
      label: iron atom
    modifier: INCREASED
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Aceruloplasminemia inherited autosomal recessively in the ceruloplasmin gene is a progressive disease with iron accumulation in various organs such as the brain, liver, pancreas, and retina.
    explanation: >-
      This directly supports progressive multi-organ iron deposition as the key
      downstream pathological event.
  downstream:
  - target: Microcytic anemia
    description: Systemic iron dysregulation produces early microcytic anemia.
  - target: Retinopathy
    description: Retinal iron deposition contributes to progressive retinopathy.
  - target: Diabetes mellitus
    description: Pancreatic iron deposition contributes to diabetes mellitus.
  - target: Brain iron accumulation
    description: Cerebral iron deposition drives the neurologic disease branch.
  - target: Tissue iron accumulation
    description: Multi-organ iron deposition is directly reflected by increased tissue iron burden.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:36308763
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Aceruloplasminemia inherited autosomal recessively in the ceruloplasmin gene is
        a progressive disease with iron accumulation in various organs such as the
        brain, liver, pancreas, and retina.
      explanation: Disease-specific review text directly supports increased iron across multiple organs.
  - target: Ferritin
    description: Systemic iron misdistribution and storage are reflected by high serum ferritin.
    causal_link_type: INDIRECT_KNOWN_INTERMEDIATES
    intermediate_mechanisms:
    - increased iron storage and ferritin release
    evidence:
    - reference: PMID:39990010
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms.
      explanation: The case series supports high serum ferritin as a recurring biochemical feature of aceruloplasminemia-related iron dysregulation.
- name: Brain iron accumulation
  description: >-
    Progressive iron deposition in deep gray matter and cerebellar structures
    drives the neurologic manifestations of aceruloplasminemia.
  biological_processes:
  - preferred_term: iron ion transport
    term:
      id: GO:0006826
      label: iron ion transport
    modifier: ABNORMAL
  - preferred_term: intracellular iron ion homeostasis
    term:
      id: GO:0006879
      label: intracellular iron ion homeostasis
    modifier: ABNORMAL
  chemical_entities:
  - preferred_term: iron
    term:
      id: CHEBI:18248
      label: iron atom
    modifier: INCREASED
  evidence:
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Brain MRI revealed significant iron accumulation in multiple brain regions, including the dentate nuclei, cerebellar cortex, basal ganglia, thalamus, brainstem nuclei, and hypothalamus.
    explanation: >-
      This case report directly supports brain iron accumulation as the
      immediate pathophysiologic driver of neurologic disease.
  downstream:
  - target: Cognitive impairment
    description: Brain iron accumulation contributes to cognitive decline.
  - target: Postural instability
    description: Brain iron accumulation contributes to gait and postural dysfunction.
  - target: Brain MRI iron accumulation
    description: Brain iron accumulation is measured by characteristic MRI susceptibility abnormalities.
    causal_link_type: DIRECT
    evidence:
    - reference: PMID:40729217
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Brain MRI revealed significant iron accumulation in multiple brain regions,
        including the dentate nuclei, cerebellar cortex, basal ganglia, thalamus,
        brainstem nuclei, and hypothalamus.
      explanation: MRI findings directly report increased iron burden in the affected brain regions.
phenotypes:
- name: Microcytic anemia
  category: Hematologic
  description: >-
    Persistent microcytic anemia is often an early clinical clue and can precede
    the later neurologic syndrome.
  phenotype_term:
    preferred_term: Microcytic anemia
    term:
      id: HP:0001935
      label: Microcytic anemia
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In addition, microcytic anemia accompanied by high ferritin and low ceruloplasmin level that develop at earlier ages can be first manifestation.
    explanation: >-
      This directly supports microcytic anemia as an early disease phenotype.
- name: Retinopathy
  category: Ophthalmologic
  description: >-
    Progressive retinal involvement develops as part of the later disease
    course.
  phenotype_term:
    preferred_term: Retinopathy
    term:
      id: HP:0000488
      label: Retinopathy
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Progressive neurotoxicity, retinopathy, and diabetes may develop in about 40-60 decades.
    explanation: >-
      This directly supports retinopathy as part of the classic later phenotype.
- name: Diabetes mellitus
  category: Endocrine
  description: >-
    Pancreatic iron deposition can contribute to diabetes mellitus later in the
    disease course.
  phenotype_term:
    preferred_term: Diabetes mellitus
    term:
      id: HP:0000819
      label: Diabetes mellitus
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Progressive neurotoxicity, retinopathy, and diabetes may develop in about 40-60 decades.
    explanation: >-
      This directly supports diabetes mellitus as a recognized later
      manifestation.
- name: Cognitive impairment
  category: Neurologic
  description: >-
    Cognitive decline can emerge as part of the neurologic phenotype in patients
    with progressive brain iron deposition.
  phenotype_term:
    preferred_term: Cognitive impairment
    term:
      id: HP:0100543
      label: Cognitive impairment
  evidence:
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Here, we report the first case of ACP in Greece. Case Presentation: Our patient was a 53-year-old male who was referred to our movement disorders center for a 6-month history of mild, unspecific, episodic dizziness and postural instability, and attention and memory deficits.
    explanation: >-
      Attention and memory deficits in a disease-specific case report support
      cognitive impairment as part of the neurologic spectrum.
- name: Postural instability
  category: Neurologic
  description: >-
    Postural instability can emerge as part of the movement-disorder spectrum in
    patients with brain iron accumulation.
  phenotype_term:
    preferred_term: Postural instability
    term:
      id: HP:0002172
      label: Postural instability
  evidence:
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Here, we report the first case of ACP in Greece. Case Presentation: Our patient was a 53-year-old male who was referred to our movement disorders center for a 6-month history of mild, unspecific, episodic dizziness and postural instability, and attention and memory deficits.
    explanation: >-
      This disease-specific case report directly supports postural instability
      as part of the neurologic phenotype.
genetic:
- name: CP
  association: Loss of function mutation
  gene_term:
    preferred_term: CP
    term:
      id: hgnc:2295
      label: CP
  evidence:
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Background and Clinical Significance: Aceruloplasminemia (ACP), a member of the neurodegeneration with brain iron accumulation (NBIA) spectrum of disorders, is a rare disorder caused by mutations in the ceruloplasmin (CP) gene.
    explanation: >-
      This directly identifies CP as the disease gene.
  - reference: CGGV:assertion_c54ee607-edd6-42dc-a4ac-f4060ae6b209-2025-11-26T180000.000Z
    reference_title: "CP / aceruloplasminemia (Definitive)"
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "CP | HGNC:2295 | aceruloplasminemia | MONDO:0011426 | AR | Definitive"
    explanation: ClinGen classifies the CP-aceruloplasminemia gene-disease relationship as definitive with autosomal recessive inheritance.
diagnosis:
- name: CP molecular genetic testing
  description: >-
    Molecular testing confirms the diagnosis by identifying biallelic
    pathogenic variants in CP in the context of the characteristic iron-study
    profile.
  diagnosis_term:
    preferred_term: molecular genetic testing
    term:
      id: MAXO:0000533
      label: molecular genetic testing
    qualifiers:
    - predicate:
        preferred_term: has participant
        term:
          id: RO:0000057
          label: has participant
      value:
        preferred_term: CP
        term:
          id: hgnc:2295
          label: CP
  results: Biallelic pathogenic CP variant.
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      A novel homozygous c.690delG variant was detected in ceruloplasmin by whole exome sequencing.
    explanation: >-
      This directly supports molecular confirmation of aceruloplasminemia by
      identifying a homozygous pathogenic CP variant.
biochemical:
- name: Serum ceruloplasmin
  presence: DECREASED
  context: >-
    Very low serum ceruloplasmin is a core laboratory abnormality.
  readouts:
  - target: Ceruloplasmin ferroxidase deficiency
    relationship: READOUT_OF
    direction: NEGATIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Low serum ceruloplasmin directly reports the CP/ceruloplasmin deficiency state.
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels.
    explanation: >-
      This directly supports low ceruloplasmin as a key biochemical hallmark.
- name: Serum copper
  presence: DECREASED
  context: >-
    Serum copper is low in aceruloplasminemia because loss of circulating
    ceruloplasmin reduces the major copper-bearing plasma protein pool.
  biomarker_term:
    preferred_term: copper
    term:
      id: CHEBI:28694
      label: copper atom
  readouts:
  - target: Ceruloplasmin ferroxidase deficiency
    relationship: READOUT_OF
    direction: NEGATIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Low serum copper tracks with severe loss of circulating ceruloplasmin.
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Anemia was accompanied by microcytosis, high ferritin, and low copper and ceruloplasmin levels.
    explanation: Disease-specific case evidence directly documents low copper with low ceruloplasmin.
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Subsequent testing revealed extremely low serum CP and low serum copper.
    explanation: Independent case evidence supports low serum copper as part of the diagnostic laboratory pattern.
- name: Ferritin
  presence: INCREASED
  context: >-
    Hyperferritinemia reflects systemic iron overload and is often present before
    major neurologic manifestations.
  readouts:
  - target: Multi-organ iron accumulation
    relationship: READOUT_OF
    direction: POSITIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Elevated ferritin reports systemic iron storage and iron misdistribution in aceruloplasminemia.
  evidence:
  - reference: PMID:39990010
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms.
    explanation: >-
      This directly supports elevated ferritin as a recurring pre-symptomatic
      laboratory clue.
- name: Transferrin saturation
  presence: DECREASED
  context: >-
    Low transferrin saturation is an early laboratory clue that accompanies the
    microcytic anemia and hyperferritinemia pattern.
  readouts:
  - target: Ceruloplasmin ferroxidase deficiency
    relationship: READOUT_OF
    direction: NEGATIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Low transferrin saturation reflects impaired ceruloplasmin-dependent iron mobilization despite tissue iron loading.
  evidence:
  - reference: PMID:39990010
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Patients with aceruloplasminemia often present with microcytic anemia, low transferrin saturation ratio, and high serum ferritin levels before the onset of symptoms.
    explanation: >-
      This directly supports decreased transferrin saturation as a recurrent
      biochemical feature of aceruloplasminemia.
- name: Tissue iron accumulation
  presence: INCREASED
  context: >-
    Iron accumulates across multiple organs, including brain, liver, pancreas,
    and retina, downstream of ceruloplasmin-dependent iron handling failure.
  biomarker_term:
    preferred_term: iron
    term:
      id: CHEBI:18248
      label: iron atom
  readouts:
  - target: Multi-organ iron accumulation
    relationship: READOUT_OF
    direction: POSITIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Increased tissue iron burden reports the central multi-organ iron accumulation mechanism.
  evidence:
  - reference: PMID:36308763
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Aceruloplasminemia inherited autosomal recessively in the ceruloplasmin gene is
      a progressive disease with iron accumulation in various organs such as the
      brain, liver, pancreas, and retina.
    explanation: Disease-specific review text directly identifies multi-organ tissue iron accumulation.
- name: Brain MRI iron accumulation
  presence: INCREASED
  context: >-
    MRI can show increased iron burden in multiple brain regions, including
    dentate nuclei, cerebellar cortex, basal ganglia, thalamus, brainstem nuclei,
    and hypothalamus.
  biomarker_term:
    preferred_term: iron
    term:
      id: CHEBI:18248
      label: iron atom
  readouts:
  - target: Brain iron accumulation
    relationship: READOUT_OF
    direction: POSITIVE
    endpoint_context: DIAGNOSTIC
    interpretation: MRI-visible brain iron reports the neurologic iron-accumulation branch.
  evidence:
  - reference: PMID:40729217
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Brain MRI revealed significant iron accumulation in multiple brain regions,
      including the dentate nuclei, cerebellar cortex, basal ganglia, thalamus,
      brainstem nuclei, and hypothalamus.
    explanation: MRI evidence directly documents the brain iron accumulation readout.
treatments:
- name: Iron chelation therapy
  description: >-
    Iron chelation is used to reduce systemic and neurologic iron-related
    toxicity.
  treatment_term:
    preferred_term: chelator agent therapy
    term:
      id: MAXO:0001223
      label: chelator agent therapy
    therapeutic_agent:
    - preferred_term: deferiprone
      term:
        id: CHEBI:68554
        label: deferiprone
  target_mechanisms:
  - target: Multi-organ iron accumulation
    treatment_effect: MODULATES
    description: Iron chelation is used to reduce iron-related toxicity downstream of multi-organ iron accumulation.
    evidence:
    - reference: PMID:36308763
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: >-
        Iron chelation may be utilized in the treatment to reduce the toxicity.
      explanation: Disease-specific review text supports iron chelation as a treatment aimed at reducing iron-related toxicity.
  evidence:
  - reference: PMID:33839643
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: >-
      In particular, deferiprone is currently being exploited to treat several NBIA diseases (Vroegindeweij et al., 2020, Klopstock et al., 2019).
    explanation: >-
      This directly supports deferiprone-based iron chelation as a disease-relevant
      treatment strategy within the NBIA spectrum that includes aceruloplasminemia.
differential_diagnoses:
- name: Wilson disease
  description: >-
    Wilson disease overlaps through low ceruloplasmin and hepatic-neurologic
    manifestations, but has primary copper transport failure rather than
    ceruloplasmin-linked iron overload.
  distinguishing_features:
  - Wilson disease is primarily an ATP7B-related copper overload disorder.
  - Aceruloplasminemia instead shows microcytic anemia, low transferrin saturation, and hyperferritinemia before the neurologic syndrome.
  disease_term:
    preferred_term: Wilson disease
    term:
      id: MONDO:0010200
      label: Wilson disease
  evidence:
  - reference: PMID:39990010
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      It is important to differentiate aceruloplasminemia from Wilson disease, another disease with low ceruloplasmin.
    explanation: >-
      This directly supports Wilson disease as a key differential diagnosis.
clinical_trials: []
datasets: []
📚

References & Deep Research

Deep Research

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Asta Literature Retrieval: Pathophysiology and clinical mechanisms of aceruloplasminemia. Core disease mechanisms, molecular and cellular pathwa...
Asta Scientific Corpus Retrieval 20 citations 2026-04-15T12:03:59.547222

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of aceruloplasminemia. Core disease mechanisms, molecular and cellular pathwa...

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  • Papers retrieved: 20
  • Snippets retrieved: 20

Relevant Papers

[1] 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: 0.368) > 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.

[2] Targeting Hepatic Stellate Cells for the Prevention and Treatment of Liver Cirrhosis and Hepatocellular Carcinoma: Strategies and Clinical Translation

  • Authors: Hao Xiong, Jinsheng Guo
  • Year: 2025
  • Venue: Pharmaceuticals
  • URL: https://www.semanticscholar.org/paper/76e92127053136900f7e3f10e2c9278251ced5d2
  • DOI: 10.3390/ph18040507
  • PMID: 40283943
  • PMCID: 12030350
  • Citations: 8
  • Summary: HSC-targeted approaches using specific surface markers and receptors may enable the selective delivery of drugs, oligonucleotides, and therapeutic peptides that exert optimized anti-fibrotic and anti-HCC effects.
  • Evidence snippets:
  • Snippet 1 (score: 0.366) > Significant progress has been made in elucidating the cellular and molecular mechanisms of liver fibrosis; however, only a few findings have been successfully translated into clinical applications. Firstly, the high cost of drug development and target validation necessitates prolonged timelines and substantial financial investment. Secondly, as regulatory requirements become more stringent, there is an increasing demand for drugs with well-defined clinical efficacy and safety profiles. Moreover, the efficacy observed in animal models often fails to fully translate to clinical settings due to differences in pharmacokinetics, extracellular matrix (ECM) cross-linking, and disease pathophysiology. Despite advancements in anti-fibrotic drug development, accurately identifying ideal noninvasive biomarkers for fibrotic activity and establishing consensus on optimal clinical endpoints remain significant challenges [113,114]. > Currently, addressing the underlying cause remains the only proven strategy to halt or reverse liver fibrosis progression, while the development of effective anti-fibrotic therapies continues to pose a major challenge in liver disease management. Over the past few decades, substantial progress has been made in elucidating the cellular and molecular mechanisms underlying liver fibrosis. Liver fibrosis is a complex pathological change involving multiple cells, factors, and pathways, and the study of the cellular and molecular mechanisms of its occurrence and development provides an important theoretical basis and therapeutic target for clinical drug development. It is anticipated that improved animal models and well-designed clinical trials will facilitate the successful translation of anti-fibrotic research into effective clinical treatments in the near future.

[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: 0.361) > 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] 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].

[5] Quantification of different iron forms in the aceruloplasminemia brain to explore iron-related neurodegeneration

  • Authors: L. Vroegindeweij, L. Bossoni, A. Boon, J.H. Paul Wilson, Marjolein Bulk et al.
  • Year: 2020
  • Venue: NeuroImage : Clinical
  • URL: https://www.semanticscholar.org/paper/c067b3377d4439c46119da7f99c78452be8e7b6f
  • DOI: 10.1016/j.nicl.2021.102657
  • PMID: 33839643
  • PMCID: 8055714
  • Citations: 13
  • Summary: Of the two quantitative MRI metrics, R2* was the most illustrative of the pattern of iron accumulation and returned relaxation rates up to 0.49 ms-1, which were primarily driven by the abundance of ferrihydrite-iron.
  • Evidence snippets:
  • Snippet 1 (score: 0.358) > Aceruloplasminemia (OMIM #604290) is a severe adult-onset form of Neurodegeneration with Brain Iron Accumulation (NBIA), caused by homozygous or compound heterozygous mutations in the ceruloplasmin (CP) gene. Iron accumulation in aceruloplasminemia has been directly linked to its genetic background, as ceruloplasmin-mediated oxidation of ferrous iron (Fe 2+ ) to ferric iron (Fe 3+ ) is a prerequisite for transport of iron across cell membranes and for binding to transferrin (Miyajima et al., 2003). As a result of ceruloplasmin dysfunction in the brain Abbreviations: NBIA, Neurodegeneration with Brain Iron Accumulation; CP, ceruloplasmin; QSM, Quantitative Susceptibility Mapping; EPR, Electron Paramagnetic Resonance; SQUID, Superconducting Quantum Interference Device; ROI, Region of interest; IRM, Isothermal Remanent Magnetization; SIRM, Saturation Isothermal Remanent Magnetization. leading to insufficient cellular iron efflux, iron accumulates within perivascular astrocytes, with total iron concentrations reaching over 600 µg/g in the basal ganglia , which is at least five times the normal concentration (Morita et al., 1995;. However, the exact role of different iron forms in the pathophysiology and clinical phenotype of aceruloplasminemia is still not clear. Molecular specification of the massive iron pool in the aceruloplasminemia brain can aid our understanding of iron related neurodegeneration, and perhaps improve therapeutic considerations, which are currently based on iron chelation. > Among the molecular forms in which iron can be found in the brain, three are particularly relevant. In the healthy human brain, iron is predominantly stored within the core of ferritin and hemosiderin, in the form of Fe 3+ -containing ferrihydrite nanocrystals (Fe 5 O 8 H) (Sassi and Rosso, 2019;Dobson, 2001). These iron stores are generally regarded as non-damaging and are required for normal brain functions. In contrast,

[6] 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: 0.356) > 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.

[7] Organoids in gastrointestinal diseases: from bench to clinic

  • Authors: Qinying Wang, Fanying Guo, Qinyuan Zhang, Tingting Hu, Yutao Jin et al.
  • Year: 2024
  • Venue: MedComm
  • URL: https://www.semanticscholar.org/paper/9b8880d8b9d45670da950197d7e353794f51d09e
  • DOI: 10.1002/mco2.574
  • PMID: 38948115
  • PMCID: 11214594
  • Citations: 12
  • Summary: A comprehensive and systematical depiction of organoids models is drawn, providing a novel insight into the utilization of organoids models from bench to clinic and clinical adhibition.
  • Evidence snippets:
  • Snippet 1 (score: 0.351) > Organoids models offer a robust platform for investigating the potential mechanisms of GI diseases and evaluating potential therapeutic interventions.By culturing organoids derived from patients' tissues or stem cells, researchers can delve into disease-specific cellular and molecular pathways, encompassing aberrant cell signaling, perturbed immune responses, and dysfunctional metabolic processes.These disease-specific phenotypes enable the study of disease progression, screening of prospective therapeutics, as well as identification of novel drug targets and mechanisms of action for GI diseases in a clinically relevant context.

[8] Pathophysiology, Clinical Heterogeneity, and Therapeutic Advances in Amyotrophic Lateral Sclerosis: A Comprehensive Review of Molecular Mechanisms, Diagnostic Challenges, and Multidisciplinary Management Strategies

  • Authors: M. González-Sánchez, M. J. Ramírez-Expósito, J. M. Martínez-Martos
  • Year: 2025
  • Venue: Life
  • URL: https://www.semanticscholar.org/paper/068cd6b38871f5b807d15db5e20bb35d9d2610f5
  • DOI: 10.3390/life15040647
  • PMID: 40283201
  • PMCID: 12029092
  • Citations: 17
  • Influential citations: 1
  • Summary: This comprehensive review synthesizes the current knowledge on ALS pathophysiology, clinical heterogeneity, diagnostic frameworks, and evolving therapeutic strategies to highlight the need for patient-centered communication and palliative strategies.
  • Evidence snippets:
  • Snippet 1 (score: 0.346) > This review on ALS underscores the inherent complexity of this neurodegenerative disease, from its phenotypic heterogeneity to the intricate network of pathophysiological mechanisms that contribute to its progression. ALS manifests as a diagnostic challenge due to its clinical variability, requiring a comprehensive approach that combines a detailed neurological evaluation with complementary tests to confirm upper and lower motor neuron involvement. The application of standardized diagnostic criteria, such as the revised El Escorial criteria, facilitates a more accurate classification of the disease, which in turn allows for better patient stratification and more informed therapeutic decision-making. > Pathophysiology research has revealed the involvement of multiple molecular and cellular pathways in ALS, including alterations in autophagy, RNA metabolism, nucleocytoplasmic transport, and protein aggregate formation. Genes such as C9orf72, SOD1, TDP-43, and FUS play a crucial role in these pathological processes, and their dysfunction contributes to motor neuron degeneration and disease progression. Understanding these underlying mechanisms is critical for the development of targeted therapies that can modify the course of ALS and improve the clinical outcomes. > Treatment of ALS remains a challenge, but advances in multidisciplinary care and the development of new drugs offer hope for patients and their families. Riluzole, edavarone, and tofersen are approved treatments that have been shown to modestly prolong survival in some ALS patients. However, their efficacy is limited, and more effective therapies are urgently needed. A multidisciplinary approach, including physiotherapy, occupational therapy, speech therapy, and psychosocial support, is essential to optimize patients' quality of life and address the multiple symptoms and complications of the disease. > The management of specific symptoms, such as dysphagia, dysarthria, cramping, and sleep disturbances, requires an individualized approach and the application of specific strategies, such as airway clearance techniques, noninvasive ventilation, and neuropathic pain management. The prognosis for ALS remains variable, but ongoing research and advances in clinical care offer promise for improving the quality of life and prolonging the survival of patients affected by this devastating disease.

[9] Human Dermal Fibroblast: A Promising Cellular Model to Study Biological Mechanisms of Major Depression and Antidepressant Drug Response

  • Authors: P. Mesdom, R. Colle, É. Lebigot, S. Trabado, Eric Deflesselle et al.
  • Year: 2020
  • Venue: Current Neuropharmacology
  • URL: https://www.semanticscholar.org/paper/79368e365458486de96794333613c12a6063bf54
  • DOI: 10.2174/1570159X17666191021141057
  • PMID: 31631822
  • PMCID: 7327943
  • Citations: 12
  • Summary: This review highlights the great and still underused potential of HDF, which stands out as a very promising tool in the understanding of MDD and AD mechanisms of action.
  • Evidence snippets:
  • Snippet 1 (score: 0.346) > Background: Human dermal fibroblasts (HDF) can be used as a cellular model relatively easily and without genetic engineering. Therefore, HDF represent an interesting tool to study several human diseases including psychiatric disorders. Despite major depressive disorder (MDD) being the second cause of disability in the world, the efficacy of antidepressant drug (AD) treatment is not sufficient and the underlying mechanisms of MDD and the mechanisms of action of AD are poorly understood. Objective The aim of this review is to highlight the potential of HDF in the study of cellular mechanisms involved in MDD pathophysiology and in the action of AD response. Methods The first part is a systematic review following PRISMA guidelines on the use of HDF in MDD research. The second part reports the mechanisms and molecules both present in HDF and relevant regarding MDD pathophysiology and AD mechanisms of action. Results HDFs from MDD patients have been investigated in a relatively small number of works and most of them focused on the adrenergic pathway and metabolism-related gene expression as compared to HDF from healthy controls. The second part listed an important number of papers demonstrating the presence of many molecular processes in HDF, involved in MDD and AD mechanisms of action. Conclusion The imbalance in the number of papers between the two parts highlights the great and still underused potential of HDF, which stands out as a very promising tool in our understanding of MDD and AD mechanisms of action

[10] 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: 0.345) > 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.

[11] 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: 0.344) > 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.

[12] Cardiomyocytes Derived from Induced Pluripotent Stem Cells as a Disease Model for Propionic Acidemia

  • Authors: Esmeralda Alonso-Barroso, B. Pérez, L. Desviat, E. Richard
  • Year: 2021
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/da649a0f04477c53b448c5ac5f873f8762235290
  • DOI: 10.3390/ijms22031161
  • PMID: 33503868
  • PMCID: 7865492
  • Citations: 16
  • Influential citations: 1
  • Summary: The novel results show that PA iPSC-cardiomyocytes represent a promising model for investigating the pathological mechanisms underlying PA cardiomyopathies, also serving as an ex vivo platform for therapeutic evaluation.
  • Evidence snippets:
  • Snippet 1 (score: 0.342) > The study of the mechanisms involved in disease physiopathology has been mainly performed using the hypomorphic PA mouse model that mimics the biochemical and clinical phenotype [5]. Using this model, bioenergetic failure, oxidative damage and deregulation of miRNAs induced by accumulating propionyl-CoA have been described as potential mechanisms contributing to PA physiopathology [6][7][8]. The limitations of animal models for the study of cardiac energy metabolism [9] and of the commonly available cellular human models such as fibroblasts, underline the importance of generating new relevant cell models to provide deeper insight into the underlying mechanisms of disease. The use of in vitro models with human cellular context is highly recommended and, in this sense, induced pluripotent stem cells (iPSCs) have certain advantages since they provide the genetic background of the patient and represent an unlimited source of biological material for the study of pathophysiology and treatment effectiveness [10]. We have previously generated an iPSC line from a PA patient with defects in the PCCA gene that showed full pluripotency, differentiation capacity and genetic stability [11]. > In the present study, we aimed to establish a platform that served as a disease model to study the cellular and molecular alterations operating in cardiac tissue affected by PA disease. We described the characterization of cardiomyocytes derived from the PCCA iPSC line (PCCA iPSC-CMs) and the analysis of specific pathways potentially involved in cardiac PA physiopathology.

[13] Cellular and molecular mechanisms of aspartoacylase and its role in Canavan disease

  • Authors: Martin Grønbæk-Thygesen, R. Hartmann-Petersen
  • Year: 2024
  • Venue: Cell & Bioscience
  • URL: https://www.semanticscholar.org/paper/d2dfbaee9666d4b1f681d466dae63d5a770fd34a
  • DOI: 10.1186/s13578-024-01224-6
  • PMID: 38582917
  • PMCID: 10998430
  • Citations: 7
  • Summary: The importance of high-throughput technologies and computational prediction tools for making genotype–phenotype predictions as they await the results of ongoing trials with gene therapy for Canavan disease is highlighted.
  • Evidence snippets:
  • Snippet 1 (score: 0.339) > Canavan disease is an autosomal recessive and lethal neurological disorder, characterized by the spongy degeneration of the white matter in the brain. The disease is caused by a deficiency of the cytosolic aspartoacylase (ASPA) enzyme, which catalyzes the hydrolysis of N-acetyl-aspartate (NAA), an abundant brain metabolite, into aspartate and acetate. On the physiological level, the mechanism of pathogenicity remains somewhat obscure, with multiple, not mutually exclusive, suggested hypotheses. At the molecular level, recent studies have shown that most disease linked ASPA gene variants lead to a structural destabilization and subsequent proteasomal degradation of the ASPA protein variants, and accordingly Canavan disease should in general be considered a protein misfolding disorder. Here, we comprehensively summarize the molecular and cell biology of ASPA, with a particular focus on disease-linked gene variants and the pathophysiology of Canavan disease. We highlight the importance of high-throughput technologies and computational prediction tools for making genotype–phenotype predictions as we await the results of ongoing trials with gene therapy for Canavan disease.

[14] From molecular signatures to predictive biomarkers: modeling disease pathophysiology and drug mechanism of action

  • Authors: A. Heinzel, P. Perco, G. Mayer, R. Oberbauer, A. Lukas et al.
  • Year: 2014
  • Venue: Frontiers in Cell and Developmental Biology
  • URL: https://www.semanticscholar.org/paper/36d6c03a528c1358c0ae5b667cca5ce73b2fbee5
  • DOI: 10.3389/fcell.2014.00037
  • PMID: 25364744
  • PMCID: 4207010
  • Citations: 23
  • Summary: This work exemplifies a computational workflow for expanding from statistics-based association analysis toward deriving molecular pathway and process models for characterizing phenotypes and drug mechanism of action, in turn providing precision medicine hypotheses utilizing predictive biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.339) > In such scenario a biomarker needs to serve as proxy of key mechanistic factors characterizing and driving a disease on a patient-specific level, combined with educating on the specific interference of disease mechanism with drug mechanism of action. For capturing these constraints a detailed molecular map of a clinical phenotype and its interference with a drug mechanism of action is needed, and here integration of Omics profiling adds to identifying such mechanisms (Fechete et al., 2011;Mühlberger et al., 2012). > An a priori stratification of patients based on an appropriately chosen biomarker panel reflecting the pathophysiology of a given patient (group) allowing to determine a match with a specific drug's mechanism of action appears as promising approach. As recently discussed by Himmelfarb et al. fresh approaches are critical in finding therapies to kidney disease benefiting patients, outlining the importance of improving the translational aspect in clinical research (Himmelfarb and Tuttle, 2013). Here, omics technologies have added significantly to the data landscape characterizing chronic kidney disease, however, in a first instance mainly expanding the candidate set of apparently relevant processes and pathways, going in hand with a large number of biomarker candidates, which individually hamper clinically relevant assessment on disease progression (Fechete et al., 2011;Hellemons et al., 2012). > Integrative approaches in the realm of Systems Biology have been proposed for reaching a consensus description of chronic kidney disease pathophysiology, including molecular models of DN as well as of the reno-cardial axis (He et al., 2012;Komorowsky et al., 2012;Mayer et al., 2012;Heinzel et al., 2013). Still, a translation process needs to be followed, joining disease pathophysiology, stratification markers allowing enrichment strategies, combined with on a molecular mechanistic level matching drugs for allowing precision medicine (Mirnezami et al., 2012). In this work we exemplify such procedure on DN being the major clinical presentation leading to end stage renal disease.

[15] Multimarker Panels in Diabetic Kidney Disease: The Way to Improved Clinical Trial Design and Clinical Practice?

  • Authors: P. Perco, M. Pena, H. Heerspink, G. Mayer
  • Year: 2018
  • Venue: Kidney International Reports
  • URL: https://www.semanticscholar.org/paper/7a5d5fe26a543e117b4bc1adc9ef195d0469aa75
  • DOI: 10.1016/j.ekir.2018.12.001
  • PMID: 30775618
  • PMCID: 6365367
  • Citations: 23
  • Influential citations: 1
  • Summary: Evidence on the variation of DKD disease progression as well as the response to therapy is summarized and procedures to model disease pathophysiology supporting biomarker panel construction are outlined.
  • Evidence snippets:
  • Snippet 1 (score: 0.339) > The explained variability of annual eGFR loss by the biomarkers indicated by the adjusted R 2 was 15% and 34% for patients with $60 and <60 ml/ min per 1.73 m 2 , respectively, and by clinical predictors 20% and 29%, respectively. A combination of molecular and clinical predictors increased the adjusted R 2 to 35% and 64%, respectively. 41 dentifying specific molecular processes associated with a specific phenotype of DKD and biomarkers associated with these processes, based on a molecular model of DKD, can be used to characterize the progression of patients based on individual pathophysiology. Matching the molecular mode of action of drug(s) to these specific molecular processes might allow selecting a specific drug or drug combinations that prevent or reverse deregulations in identified molecular pathways and thus guide therapy. This situation mirrors the one applied in infectious diseases, in which repetitively pathogens are identified and antimicrobial therapy is adjusted according to the results obtained. Matching a DKD disease progression model to a drug mechanism of action model was used in a study by Pena et al. 45 A panel of serum metabolites being linked to molecular processes of inflammation and stress response, as well as downstream consequences of fibrosis and extracellular matrix rearrangement, was able to predict albuminuria response to ARBs in both type 1 and type 2 DM. This observation supports the concept that improved molecular characterization of drug effect and disease pathophysiology can predict treatment response.

[16] Clinical metabolomics in type 2 diabetes mellitus: from pathogenesis to biomarkers

  • Authors: Chuanxin Liu, Hetao Chen, Yujin Ma, Lei Zhang, Lulu Chen et al.
  • Year: 2025
  • Venue: Frontiers in Endocrinology
  • URL: https://www.semanticscholar.org/paper/36f8d26a208b7b96763df2e9aa3211e440031c0e
  • DOI: 10.3389/fendo.2025.1501305
  • PMID: 40070584
  • PMCID: 11893406
  • Citations: 11
  • Summary: The results facilitate understanding the pathophysiology and mechanism of type 2 diabetes mellitus and supports research in accurate diagnosis, risk prediction, curative effect, distinct stages, and prognosis judgment of T2DM.
  • Evidence snippets:
  • Snippet 1 (score: 0.338) > The metabolome is sensitive to a variety of genetic and environmental stimuli and susceptible to genetic, environmental, and gut microbiome pressures, so subtle differences between individuals can lead to large perturbations in metabolite concentrations and fluxes (15, 24). At present, cystatin C has become an ideal endogenous marker for evaluating glomerular filtration function because it is not affected by sex, age or muscle mass (25). In addition, more and more evidence shows that serum CysC is involved in the pathological process of vascular remodeling and neovascularization, which is closely related to the occurrence and development of diabetic microangiopathy (26). > Eighty-four papers were included in this review and obtained through database searches, namely, PubMed, Cochrane Library, China national knowledge internet(CNKI), General Purpose, and VIP Database. The keywords for the searches were "metabolomics" and "type 2 diabetes mellitus" and its complications. The papers were incorporated by reading and summarizing the literature according to the classification standards (27). The profound analysis of clinical differential metabolites identified in type 2 diabetes and its complications were conducted concerning composition, frequency of category, sample type, and pathways to explore the pathological mechanism of type 2 diabetes and its complications to provide a systematic basis for clinical diagnosis, risk stratification, comprehending disease progression, prognosis assessment, and drug efficacy. Our goal is to apply metabolomics to clinical diagnostic biomarkers, metabolic mechanisms, and prognostic observations, and early diagnosis can be made through metabolites to avoid progression to more serious complications.

[17] Perspectives in Amyotrophic Lateral Sclerosis: Biomarkers, Omics, and Gene Therapy Informing Disease and Treatment

  • Authors: Nina Bono, F. Fruzzetti, Giorgia Farinazzo, Gabriele Candiani, S. Marcuzzo
  • Year: 2025
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/37fa957837679879485794fb4292e8a730519f55
  • DOI: 10.3390/ijms26125671
  • PMID: 40565135
  • PMCID: 12193257
  • Citations: 8
  • Summary: This review examines innovative approaches transforming ALS research and clinical management, and highlights current gene therapy strategies, including antisense oligonucleotides (ASOs), RNA interference (RNAi), and CRISPR/Cas9 gene editing systems, alongside advanced delivery methods for crossing the blood–brain barrier.
  • Evidence snippets:
  • Snippet 1 (score: 0.338) > The recently approved AMX0035 (Relyvrio; 2022) targets endoplasmic reticulum stress and mitochondrial dysfunction with encouraging but still incremental survival benefits [90]. > These approved treatments share fundamental limitations: they address single pathways in a disease characterized by multiple interacting mechanisms, fail to target specific genetic causes, cannot restore lost motor neurons, and face significant challenges in crossing the BBB to achieve adequate therapeutic concentrations in the CNS. Perhaps most significantly, they provide symptomatic relief rather than disease modification, highlighting the urgent need for transformative approaches toward a true disease-modifying treatment for this devastating illness. > The limited success of ALS clinical trials can be ascribed to multiple factors, with a poor understanding of disease mechanisms being paramount. Additional challenges include limited bioavailability of therapeutic agents, inefficient therapeutic delivery to the CNS, difficulties in administration, lack of effective biomarkers for patient stratification and treatment response monitoring, late diagnosis reducing the therapeutic window, and lack of clinically relevant disease models that fully recapitulate human pathophysiology. The multifactorial nature of ALS and the complexity of its pathogenic mechanisms have made it exceptionally difficult to develop interventions that effectively address the disease progression. > Recent advances in the understanding of ALS pathophysiology, including the discovery of many of its genetic underpinnings, have enabled the development of targeted therapies, with today's clinical trials holding growing promise for more efficacious treatments that address the fundamental limitations of current therapeutic approaches. > Numerous clinical trials are currently investigating various therapeutic approaches targeting different pathological mechanisms of ALS. These range from ASOs, designed to silence mutated genes, to AAV-delivered gene therapies, stem cell treatments, and small molecule interventions. The diversity of approaches reflects both the complex multifactorial nature of ALS and the rapidly evolving landscape of therapeutic technologies [3].

[18] 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: 0.336) > 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.

[19] Chemotherapy and Mechanisms of Resistance in Breast Cancer

  • Authors: A. Oliveira, R. E. Santos, F. F. O. Rodrigues
  • Year: 2012
  • Venue: Unknown venue
  • URL: https://www.semanticscholar.org/paper/502a86d8bcd7208be6f539fcceba631f82f25a7d
  • DOI: 10.5772/24629
  • Summary: The addition of adjuvant polychemotherapy in advanced breast cancer showed gain by controlling survival of micrometastases in patients with lymph nodes affected by cancer or not.
  • Evidence snippets:
  • Snippet 1 (score: 0.336) > The main reasons responsible for treatment failure in cancer patients are the mechanisms of drug resistance and emergence of disseminated disease (Terek et al, 2003). We identified two types of resistance most relevant to BC: primary resistance, which corresponds to the clinical situation where the patient showed no response to therapy, and secondary or acquired resistance in which, initially, there is an observed response and a subsequent failure of the treatment regimen (Kroger et al, 1999). Several mechanisms may cause the phenotype of multidrug resistance to chemotherapy drugs and are well characterized in in vitro experiments, including alterations in systemic pharmacology (pharmacokinetics and metabolism), extracellular mechanisms (tumor environment, multicellular drug resistance), and cellular mechanisms (cellular pharmacology, activation and inactivation of drugs, modification of specific targets and regulatory pathways of apoptosis) (Leonessa et al, 2003, Riddick et al, 2005. Identification of factors that affect cell metabolism, which are related to drug resistance, will enable the identification of which patients are at particular risk of treatment failure. Among the biochemical and molecular mechanisms of drug resistance, we stress: changes in the activity of topoisomerase II, alterations in the DNA repair mechanism, overexpression of P-glycoprotein; high intracellular concentrations of enzymes purification of cellular metabolism -among them enzymes the family of glutathione S-transferases (GSTs) and changes in the mechanisms of signaling via c-Jun N-terminal kinase 1 (JNK1) -and "apoptosis signal-regulating kinase (ASK1) required for activation of the" mitogenactivated protein (MAP kinases) in apoptosis and cellular restoration. These pathways are also mediated by proteins encoded by genes of GSTs (O'Brien, Tew, 1996;Burg, Mulder, 2002, L'Ecuyer et al, 2004). Different response rates to particular chemotherapy regimens, as observed in patient groups with the same biological characteristics and stage, suggest the existence of different mechanisms of drug resistance, probably induced by genetic alterations (Hayes, Pulford, 1995;O'Brien , Tew, 1996;Pakunlu et al, 2003). Among the mechanisms of purification of cellular metabolism involved in the

[20] Exome sequencing and metabolomic analysis of a chronic kidney disease and hearing loss patient family revealed RMND1 mutation induced sphingolipid metabolism defects

  • Authors: Nagwa Gaboon, B. Banaganapalli, K. Nasser, M. Razeeth, Mosab S. Alsaedi et al.
  • Year: 2019
  • Venue: Saudi Journal of Biological Sciences
  • URL: https://www.semanticscholar.org/paper/f1f1341fd61e31f39a5129e7c80ff67cd0b6fb0f
  • DOI: 10.1016/j.sjbs.2019.10.001
  • PMID: 31889854
  • PMCID: 6933272
  • Citations: 17
  • Influential citations: 1
  • Summary: Genetic defects in RMND1 gene alters the mitochondrial energy metabolism leading to the accumulation of ceramide, and subsequently promote dysregulated apoptosis and tissue necrosis in kidneys, this study suggests.
  • Evidence snippets:
  • Snippet 1 (score: 0.335) > One of the recently identified nuclear genes involved in mitochondrial respiratory chain deficiencies is RMND1 (Required for Meiotic Nuclear Division protein 1) (Garcia-Diaz et al., 2012;Janer et al., 2012). It has been demonstrated that various novel and common recessive mutations in RMND1 are associated with multiple phenotypes characterized by delayed maturation of vision, developmental delay, dilated cardiomyopathy, deafness and neurological defects (Gupta et al., 2016), renal tubular acidosis type 4 presented as hyponatraemia and hyperkalaemia and cystic/hypoplastic kidneys (Ng et al., 2016). Likewise, complex clinical spectrum of patients with RMND1 mutations is emerging with infantile encephalomyopathy with lactic acidosis (Garcia-Diaz et al., 2012;Casey et al., 2016) to a less severe form of developmental delay, hypotonia, renal disease and congenital sensorineural deafness (Janer et al., 2015). Therefore, molecular screening of RMND1 gene will help identify the inheritance mode of causative genetic mutations in patients with renal and or neurological defects. > MIDs have complex etiologies with underlying cross talk of inter and intra molecular signaling. Hence, metabolomic studies on these patients could provide a better understanding of the interconnectivity between genetic and molecular networks (Davies, 2018). Metabolomic profiling examines the metabolic changes in body fluids driven from cellular processes to understand the onset and pathogenesis of disease phenotype (Abbiss et al., 2019). Metabolomics analyzes metabolites by either targeted or untargeted approaches. The untargeted approach involves hypothesis free surveying of hundreds of thousands of small molecule metabolites for discovering novel mechanisms or pathways, whereas the targeted one refers to measuring predefined sets of metabolites, typically focusing on a few pathways of interest (Kalim and Rhee, 2017). The specific relationship between inherited mutations in mitochondrial proteins and their functional impacts in terms of metabolic defects in chronic kidney disease (CKD) is not yet well characterized.

Notes

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