Estudo clinico-molecular e analise da textura epidermica de pacientes com sindrome de Sjogren-Larsson / Molecular genetic study and texture analysis of the epidermis in patients with Sjogren-Larsson Syndrome

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Background: Sjögren-Larsson syndrome (SLS) is an autosomal recessive disorder characterized by ichthyosis, mental retardation, and spasticity. Various mutations in the ALDH3A2 gene that codes for fatty aldehyde dehydrogenase (FALDH) are responsible for the disease but the genotype-phenotype relationships are undefined. Objectives: The purpose of this study was to describe ten individuals with Sjögren-Larsson syndrome from four families representing the first cohort of Brazilian patients defined at the molecular level and investigate whether image analysis of routine H&E skin sections using fast Fourier transformation (FFT) could detect structural alterations in SLS. Patients and methods: A 5-mm punch biopsy for histologic analysis was obtained under local anesthesia from each patient. Similar biopsies were obtained from age- and anatomical site-matched from 17 controls. The samples were stained with haematoxylin and eosin and observed under a light microscope. Digital images of routine histologic sections were taken and their gray scale luminance was analyzed by FFT. The inertia values were determined for different ranges of the spatial frequencies in the vertical and horizontal directions. Skin biopsies were also obtained from nine patients with SLS for establishing fibroblast cultures using standard methods to determine FALDH enzyme activity. MR imaging was performed in eight patients. Singel-voxel proton MR spectra were acquired from cerebral white matter in seven patients with SLS and in seven controls. Total genomic DNA was extracted from peripheral blood of nine patients using standard methods. ALDH3A2 exons and their flanking sequences were amplified by PCR and sequenced. Results: All patients were homozygous for a unique c.1108-1G>C splice-site mutation and displayed a profound reduction in fatty aldehyde dehydrogenase enzyme activity. The patients exhibited a moderate-to-severe form of Sjögren-Larsson syndrome with respect to mental retardation, spastic diplegia and ichthyosis. Within this phenotypic context, patients varied, even within a family, in the presence of pruritus, thickness of the epidermal granular layer, retinal glistening white dots and photophobia. Brain MR imaging revealed retardation of myelination. Proton MR spectroscopy of white matter revealed abnormal high-lipid peak. The study of epidermal spinous layer texture by Fast Fourier Transform showed higher amplitudes in the vertical direction in SLS patients, corresponding to greater nuclei and nucleoli, higher number of nucleoli and focal thickening of keratinocytes? carioteca. Conclusion: We concluded that the latter clinical features are not strictly determined by the c.1108-1G>C mutation, but are subject to modification by other genetic/environmental factors. The c.1108-1G>C mutation may be classified as a common cause of Sjögren-Larsson syndrome in Brazil. The textural findings are in keeping with higher DNA synthesis and a 3.5x turn over that were demonstrated in SLS epidermis

ASSUNTO(S)

mutation (biology) ictiose sjorgren-larsson syndrome mutação (biologia) sindrome de sjogren-larsson ichthyosis

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