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Soaped palmitic acid (PA) has been reported to be excreted in stool after feeding infant formulas containing low sn-2 palmitate levels, which corresponds to high sn-1 or -3 palmitate levels. While an in vitro study showed that soaped PA inhibits the Bifidobacteria growth, few clinical studies have evaluated effects of soaped PA on intestinal environments of infants. In this study, we aimed to evaluate associations between increased fecal soaped PA levels and inhibition of growth of the intestinal microbiome using clinical data, and to evaluate changes in the intestinal environment with formula-feeding. This study was conducted as a secondary analysis to our observational study of Japanese 1-month-old infants (n = 172). Infant formulas were classified into high sn-2 formula (≥ 50%) and low sn-2 formula (< 50%) according to the sn-2 binding ratio of PA. Multiple regression analyses and path analysis were performed as statistical analyses. In the multiple regression analysis, the occupancy of Bifidobacteria was negatively correlated with the fecal soaped PA levels (β = -0.15, 95% confidence interval = -0.28- - 0.02). A path analysis suggested that low sn-2 formula feeding led to increased fecal soaped PA levels, decreased Bifidobacteria occupancy, and finally increased fecal pH. Our clinical data showed significant associations between higher fecal soaped PA levels and lower Bifidobacteria occupancy in the newborn gut, which agreed well with the report of the in vitro study. Our study also suggests that feeding infant formula with low sn-2 palmitate causes changes in the intestinal environment through an increase in fecal soaped palmitic acids.

A girl was born with sclerocornea of the right eye, corneal staphyloma of the left eye and lumbar myelomeningocele. The myelomeningocele was repaired soon after birth. The corneal staphyloma was perforated during infancy. She received keratoplasty and achieved light perception. Her right kidney revealed multicystic dysplasia and was non-functioning at birth. She had neurogenic bladder, and her renal function deteriorated gradually. Peters plus syndrome was diagnosed based on anterior ocular segment anomalies, short stature, developmental delay and characteristic face. Anterior ocular segment anomalies are rare findings, but seem to be occasionally associated with spina bifida and renal anomalies. Myelomeningocele and chronic renal failure in patients with Peters plus syndrome have not been reported to our knowledge.

The expansion of polyalanine repeats is known to cause at least nine disorders, including congenital central hypoventilation syndrome (CCHS). Unequal crossover has been speculated as the expanding mechanism, in contrast to strand slippage in polyglutamine expansion disorders. We carried out segregation analysis of PHOX2B in 13 de novo families with CCHS and found that 6 families were informative regarding a parental origin of polyalanine expansion, with all 6 mutants being of paternal origin. Four of them were also informative regarding a chromosomal event and their mutants were derived from unequal sister chromatid exchange. It is probable that de novo expansion of polyalanine repeats in CCHS results mainly from unequal sister chromatid exchange during spermatogenesis due to the secondary DNA structure of imperfect trinucleotide repeats encoding polyalanine tracts.

Abstract Lactadherin is a major protein in the milk fat globule membrane (MFGM) and is associated with anti-rotaviral effect. Although lactadherin level in breast milk is generally quantified using enzyme-linked immunosorbent assay (ELISA), the many contaminants in the milk samples raise concerns of low accuracy. The aim of this study was to develop a high accuracy method of absolute quantification for breast milk lactadherin using a proteomics-based technique. The developed method uses a full-length expressed stable isotope-labelled protein from the wheat germ cell-free expression system with in-gel digestion and showed much higher accuracy (97.0%–109.9%,) than ELISA (27.2%–31.6%). The developed method revealed lactadherin levels in Japanese breast milk (1 month of postpartum 7.2 [2.2–25.7] mg/100 ml, 6 months of postpartum: 3.8 [1.2–22.8] mg/100 ml). This study has shown that a proteomics approach using a full-length expressed stable isotope-labelled protein with in-gel digestion achieves high accuracy quantification for breast milk lactadherin. Graphical Abstract Graphical Abstract

The binding ratio of palmitic acid (PA) at the sn-2 position of triacylglycerols in infant formulas is lower than that in breast milk, resulting in higher levels of fecal PA. Even if the ratio is increased to 40–50%, fecal PA levels in formula-fed infants remain higher than those in breast–fed infants. In Japan, infant formulas with 50% or more of PA bound to sn-2 (high sn-2 PA milk) are commercially available; however, their effects on PA excretion have not been investigated. Therefore, this observational study aimed to preliminarily evaluate whether the feeding volume of high sn-2 PA milk is significantly associated with fecal total/soaped PA levels in newborns. Infant formulas were classified as high (≥50% of PA bound to sn-2) or low sn-2 (<50%) PA milk. Associations between feeding volume of high or low sn-2 PA milk and fecal PA levels were evaluated using multiple regression analysis models. The results showed that the feeding volume of low sn-2 PA milk was positively associated with fecal total/soaped PA levels, while there was no significant association between those of high sn-2 PA milk and fecal total/soaped PA levels. Our preliminary study suggests that high sn-2 PA milk may reduce increased fecal PA levels in formula-fed newborns.

With congenital central hypoventilation syndrome (CCHS), most patients have a de novo 5–13 polyalanine expansion mutation in PHOX2B . We reported previously that de novo polyalanine expansion mutations were of paternal origin and were derived from unequal sister chromatid exchange during spermatogenesis in six and four informative families, respectively. In this study, we analyzed the relationship between haplotypes and de novo polyalanine expansion in PHOX2B and found that haplotypes carrying rs17884724:A>C were detected frequently in 7-alanine expanded (27-alanine) mutant alleles, which are the most prevalent mutations in CCHS. The allele with rs17884724:A>C made fewer nucleotide mismatches in the misalignment at crossing-over than the allele without rs17884724:A>C. The high frequency of rs17884724:A>C in 7-alanine expansion (27-alanine) mutations also supported the unequal crossover mechanism for polyalanine expansion. We also confirmed the paternal origin of de novo polyalanine expansion mutation and unequal sister chromatid exchange association in three more patients. In spite of paternal bias, the paternal age effect on CCHS incidence was not observed. De novo polyalanine expansion mutations are mainly derived from unequal sister chromatid exchange during spermatogenesis because of replication and/or repair systems that are specific for spermatogenesis.

Periaxin (PRX) plays an important role in the myelination of the peripheral nerve and consequently in the pathogenesis of Charcot-Marie-Tooth disease (CMT). To date, nine nonsense or frameshift PRX mutations have been reported in eight families with CMT. The patients with PRX mutations appeared to show characteristic clinical features with early onset but slow or no progression, a common result of mutations that lead to missing a C-terminal acidic domain. Here, we report a Japanese CMT patient with these characteristic clinical features, who was a compound heterozygote for PRX R1070X and L132FsX153 mutations. We previously reported that three Japanese isolated families also had the homozygous R1070X mutation. To examine the potential founder effect of the R1070X mutation in the Japanese population, we performed haplotype analysis and found that each R1070X allele lay on a different haplotype background in these four families. Therefore, the high frequency of the R1070X mutation among the Japanese population is not likely the consequence of a founder effect, but probably a result of a mutation hot spot.

Advancements in large-scale analysis of metabolites in human peripheral blood samples revealed the links between metabolite concentrations and genetic variations. This field is known as metabolome-genome-wide association study (MGWAS). Although MGWAS is a powerful tool, it has some limitations, particularly in terms of the number of metabolites that can be measured. Whether the observed associations are directly due to genetic variation or indirectly due to changes in unmeasured metabolites is unclear. To address this, we used simulations of metabolic pathway models to investigate the influence of genetic variants on metabolite concentrations and enhance the interpretation of MGWAS results. By systematically adjusting the enzyme reaction rates to simulate genetic variants, we observed changes in the metabolite levels. Our simulations accurately represented most of the variant-metabolite pairs identified by MGWAS with significant p -values, thereby demonstrating the potential of our approach. Furthermore, our simulations revealed additional marked fluctuations in metabolite levels that the MGWAS did not detect, suggesting that some variant-metabolite pairs might become more significant with larger sample sizes. We also categorized the enzymes into three types based on their impact on metabolite concentrations, highlighting enzymes with minimal impact. This indicated that genetic variations in these enzymes may have limited biological significance. Our study not only validates key MGWAS findings, but also provides a systematic framework for understanding enzyme-metabolite relationships. This approach offers valuable insights for future experimental studies and potential therapeutic interventions.

Abnormal branching of the aorta associated with the right aortic arch (RAA) has been reported as isolation of left subclavian artery (ILSA), isolation of left common carotid artery, isolation of brachiocephalic artery. ILSA is a rare aortic branch anomaly that originates in the left subclavian artery from the pulmonary artery via ductus arteriosus. Several reports have described ILSA associated with 22q11.2 deletion syndrome and tetralogy of Fallot. Here, we present a very unusual case of RAA with ILSA associated with D-transposition of the great arteries and inferior vena cava interrupted with azygos continuation.

Runs of homozygosity (ROHs) are widely observed across the genomes of various species and have been reported to be associated with many traits and common diseases, as well as rare recessive diseases, in human populations. Although single nucleotide polymorphism (SNP) array data have been used in previous studies on ROHs, recent advances in whole-genome sequencing (WGS) technologies and the development of nationwide cohorts/biobanks are making high-density genomic data increasingly available, and it is consequently becoming more feasible to detect ROHs at higher resolution. In the study, we searched for ROHs in two high-coverage WGS datasets from 3552 Japanese individuals and 192 three-generation families (consisting of 1120 family members) in prospective genomic cohorts. The results showed that a considerable number of ROHs, especially short ones that may have remained undetected in conventionally used SNP-array data, can be detected in the WGS data. By filtering out sequencing errors and leveraging pedigree information, longer ROHs are more likely to be detected in WGS data than in SNP-array data. Additionally, we identified gene families within ROH islands that are associated with enriched pathways related to sensory perception of taste and odors, suggesting potential signatures of selection in these key genomic regions.