1. Recurrent syncope related to catecholaminergic polymorphic ventricular tachycardia due to de novo RyR2-R2401H mutation
Xin LIU ; Juxiang LI ; Jinzhu HU ; Yang SHEN ; Rong WAN ; Qinmei XIONG ; Qiongqiong ZHOU ; Jinyan XIE ; Jiejing JIN ; Xia YAN ; Jianhua YU ; Kui HONG
Chinese Journal of Cardiology 2017;45(1):39-43
Objective:
To explore the clinical and molecular genetic features of a Chinese patient with catecholaminergic polymorphic ventricular tachycardia (CPVT).
Methods:
Clinical data including resting electrocardiography, echocardiography and treadmill exercise testing of a patient with CPVT admitted to our department in March 2013 were analyzed, and the peripheral venous blood samples of the patient and his family members and 400 ethnicity-matched healthy controls were obtained. All exons and exon-intron boundaries of the six CPVT-related genes including RYR2, CASQ2, TRDN, CALM1, KCNJ2 and ANKB were sequenced to detect the variants related to CPVT. The relationship between the genotypes and phenotypes was analyzed to direct the target therapy.
Results:
Recurrent syncope induced either by exercise or extreme frightened fear was observed in this patient. There was no positive family history of syncope or sudden death. The resting electrocardiography and echocardiography of the patient were normal, while the exercise testing revealed bidirectional and polymorphic ventricular tachycardia. A cardiac ryanodine receptor gene mutation (R2401H) was identified in this patient, while this mutation was absent in his parents and sister and 400 controls. No variant was detected in the remaining five candidate genes. Treatment with high dose of metoprolol succinate (118.75 mg/d) was effective and patient was free of syncopal attack during the 2 years follow-up.
Conclusion
This is the first report on RyR2-R2401H mutation in Chinese patient with CPVT, and high dose of metoptolol is the effective therapy option for CPVT related to RyR2 mutation.
2.A consensus on the standardization of the next generation sequencing process for the diagnosis of genetic diseases (4)-Report interpretation and genetic counseling
Hui HUANG ; Yiping SHEN ; Weihong GU ; Yi HUANG ; Xiaodong WANG ; Yong GAO ; Hui XIONG ; Zaiwei ZHOU ; Jing WU ; Duan MA ; Dongyan AN ; Wei ZHANG ; Qinmei FU ; Xi XIONG ; Zhiyu PENG ; Liang WANG ; Shangzhi HUANG ; Ming QI
Chinese Journal of Medical Genetics 2020;37(3):352-357
Clinical genetic testing results are compiled into a standardized report by genetic specialists and provided to clinicians and patients (Should the patient be intellectually disabled or under 18,the report will be provided to his/her parents or legal guardians).The content of genetic testing report should conform to relevant guidelines,industry standards and consensus.The decisions of clinicians will be made based on the report and clinical indications.Genetic counselors should provide post-test counseling to clinicians and patients or their authorized family members.A mechanism of follow-up visit after the genetic testing should be established with informed consent.Data should be shared by clinical institutions and genome sequencing institutions.As findings upon follow-up visit can help with further evaluation of the results,genome sequencing institutions should regularly re-analyze historical and follow-up data,and the updated results should be shared with clinical institutions.All activities involving reporting,genetic counselling,follow-up visiting,and re-analyzing should follow the relevant guidelines and regulations.
3.Identification of chemical constituents in Shenfu injection and study on anti-inflammatory activities of its poly- acetylene compounds
Qi ZHENG ; Xiaoya WANG ; Jie LIU ; Cheng PENG ; Liang XIONG ; Yaning ZHU ; Qinmei ZHOU
China Pharmacy 2022;33(16):1931-1936
OBJECTIVE To study the chemical constituents in S henfu injection and the anti-inflammatory activities of its polyacetylene compounds. METHODS Shenfu injection was separated and purified by macroporous adsorption resin ,medium pressure liquid chromatography ,preparative thin layer chromatography and reversed-phase semi-preparative high-performance liquid chromatography,and the compound structure was identified according to the physicochemical properties and spectral data. RAW 264.7 cell inflammation model was used to evaluate the anti-inflammatory activities of polyacetylene compounds . The effects of active polyacetylene compounds on the expressions of cyclooxygenase- 2(COX-2)protein were evaluated by Western blot assay. RESULTS Twelves compounds were isolated and identified from Shenfu injection ,including 8 ginsenoside compounds ,i.e. ginsenoside Rg 1(1),ginsenoside Re (2),ginsenoside Rb 1(3),ginsenoside Rk 1(4),20(R)-ginsenoside Rh 1(5),20(S)-ginsenoside Rg3 (6),notoginsenoside R 1(7),panaxatriol(8);4 polyacetylene compounds ,i.e.(3R,9R,10R)-panaxytriol(9),panaxydol(10), heptadeca-1,8-dien-4,6-diyne-3,10-diol(11)and panaxynol (12). Among 4 polyacetylene compounds ,only compound 10 had anti-inflammatory activity. Compound 10 was not toxic to normal RAW 264.7 cells;when the concentration of compound 10 ranged 12.5-50.0 μmol/L,it could significantly reverse the lipopolysaccharide-induced NO content increase in cell supernatant (P<0.05 or P<0.01);when the concentration of co mpound 10 was 50.0 μmol/L,it could significantly reverse the lipopolysaccharide-induced protein expression increase of COX- 2 in cells (P<0.05). CONCLUSIONS Compounds 4,7,10-12 are identified and reported in Shenfu injection for the first time ,and panaxydol possesses a certain anti-inflammatory effect.