1.Regulation of methyltransferase METTL3 on radiotherapy sensitivity of oral squamous cell carcinoma cells
Qingzhe MENG ; Junhong HUANG ; Xinjie YANG ; Huan LI ; Zihui YANG ; Jun WANG ; Yahui LI ; Rong LIU ; Jianhua WEI
Journal of Practical Stomatology 2025;41(2):206-213
Objective:To study the influence of methyltransferases like 3(METTL3)on the radiosensitivity of oral squamous cell carcinoma cells(OSCCs).Methods:The apoptosis level of OSCCs CAL27,SCC9 and SCC15 treated with X-ray radiation doses of 2,4 and 8 Gy respectively was compared by flow cytometry,the expression of methylated gene RNA and protein in the cells were examined by qRT-PCR and Western blot.m6A in the cells was quantified by LC/LC-MS method.qRT-PCR and Western blot were used to investigate the expression of methylated gene RNA and protein in the cells.Flow cytometry was used to examine the cell apoptosis level of CAL27 and SCC15 cells treated with METTL3 overexpression and knockdown respectively.The clone forma-tion of CAL27 and SCC15 cells after knockdown and overexpression of target genes followed by radiation treatment was observed by clonogenic assays.Results:The apoptosis rate of all the cell lines increased with the increase dose of radiation at each dose,CAL27 cells showed the highest and SCC15 showed the lowerst apoptosis rate.The RNA and protein expression levels of METTL3 in CAL27 were significantly lower than those of SCC15.m6A quantification showed that the methylation modification in CAL27 cells was lower than that in SCC15.The expression of METTL3 was increased in CAL27 and SCC15 cells after radiation treatment.Knockdown of METTL3 increaced the apoptosis rate and decreased the clonogenesity,overession of METTL3 the decreaced the ap optosis rate and increased the clonogenecity of the cells.Conclusion:Regulation of METTL3 can affect the radiotherapy sensitivity of OSCCs,METTL3 may become a new target for radiosensitization of OSCCs.
2.Expression and significance of miR-1243 and lncRNA HULC in papillary thyroid carcinoma tissues
Mingyue GAO ; Duxian LIU ; Jizong ZHANG ; Cheng GONG ; Xiaoya ZHANG ; Junhong MENG
Journal of Chinese Physician 2025;27(10):1543-1547
Objective:To investigate the expression of miR-1243 and long non-coding RNA (lncRNA) HULC in papillary thyroid carcinoma (PTC) tissues, and their relationships with clinicopathological features and postoperative prognosis of patients.Methods:A total of 116 PTC patients treated in the Second Hospital of Nanjing from August 2021 to August 2023 were selected. The expression levels of miR-1243 and lncRNA HULC in PTC tissues and adjacent normal tissues were detected by real-time fluorescent quantitative polymerase chain reaction (PCR). The differences in the expression levels of miR-1243 and lncRNA HULC between PTC tissues and adjacent normal tissues, as well as among PTC tissues with different clinical features and different prognoses, were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the value of miR-1243 in predicting postoperative recurrence of PTC patients.Results:The relative expression level of miR-1243 in PTC tissues was significantly lower than that in adjacent normal tissues ( P<0.05), while the relative expression level of lncRNA HULC was higher than that in adjacent normal tissues ( P<0.05). The relative expression level of lncRNA HULC in PTC tissues of patients with tumor diameter ≥2 cm, tumor node metastasis (TNM) stage Ⅲ-Ⅳ, and lymph node metastasis was higher than that in patients with tumor diameter <2 cm, TNM stage Ⅰ-Ⅱ, and no lymph node metastasis (all P<0.05). The relative expression level of miR-1243 in PTC tissues of patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis was lower than that in patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis (all P<0.05). There was no significant correlation between the expression of miR-1243 and lncRNA HULC in PTC tissues ( r=0.129, P=0.167). All patients were followed up for 12 months, and 20 patients had postoperative recurrence. The proportion of TNM stage Ⅲ-Ⅳ in recurrent patients was 70.00%(14/20), which was higher than that in non-recurrent patients [29.17%(28/96), P<0.05], and the relative expression level of miR-1243 was lower than that in non-recurrent patients ( P<0.05). There was no significant difference in the relative expression level of lncRNA HULC between recurrent and non-recurrent patients ( P>0.05). The area under the ROC curve of miR-1243 relative expression level in predicting postoperative recurrence of PTC patients was 0.809(95% CI: 0.711-0.907, P<0.05), with a cut-off value of 1.17, sensitivity of 65.00% and specificity of 87.50%. Conclusions:The expression of miR-1243 is down-regulated and lncRNA HULC is up-regulated in PTC tissues, and both are related to clinicopathological features such as lymph node metastasis and TNM stage. Among them, the expression of miR-1243 is related to postoperative recurrence.
3.Study on the expression of miR-873-5p and CXCL16 in thyroid cancer tissues and their relationship with pathological parameters and prognosis
Mingyue GAO ; Jizong ZHANG ; Cheng GONG ; Junhong MENG ; Xiaoya ZHANG ; Duxian LIU
International Journal of Laboratory Medicine 2025;46(13):1620-1625
Objective To investigate the expression of microRNA-873-5p(miR-873-5p)and C-X-C motif chemokine ligand 16(CXCL16)in thyroid cancer tissue and their relationship with pathological parameters and prognosis.Methods A total of 125 patients with thyroid cancer who underwent surgery at Nanjing Sec-ond Hospital from January 2018 to June 2019 were selected as the research subjects.Some cancer tissues and corresponding adjacent tissues of the patients were collected,and the expressions of miR-873-5p and CXCL16 mRNA were detected by real-time fluorescence quantitative polymerase chain reaction.The binding sites of miR-873-5p and CXCL16 were predicted through the online database.Pearson correlation was used to analyze the correlation between miR-873-5p and CXCL16 mRNA expression,and the correlation between miR-873-5p,CXCL16 mRNA expression and pathological parameters.According to the median expression of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues,they were classified as high expression and low expression.The survival curves of patients with high and low expression of miR-873-5p and CXCL16 mRNA were plotted by the Kaplan-Meier method.Taking the survival status of patients with thyroid cancer as the dependent varia-ble,Cox regression was used to determine the relationship between the expressions of miR-873-5p and CX-CL16 mRNA and the death of patients with thyroid cancer.Results The expressions of miR-873-5p and CX-CL16 mRNA in thyroid cancer tissues were 0.83±0.12 and 1.54±0.25,respectively,and those in adjacent tissues were 1.13±0.15 and 0.98±0.13,respectively,the differences were statistically significant(t=-18.160,21.089).P<0.001).Pearson correlation analysis showed that the expression of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues was negatively correlated(r=-0.722,P<0.001).The expression of miR-873-5p in thyroid cancer tissues was negatively correlated with pathological type,TNM stage and lymph node metastasis(r=-0.510,—0.262,-0.315,P<0.05).The expression of CXCL16 mRNA was positively correlated with pathological type,TNM stage and lymph node metastasis(r=0.593,0.275,0.314,P<0.05).The Kaplan-Meier survival curve showed that the 5-year overall survival rate of patients with high expression of miR-873-5p was higher than that of patients with low expression of miR-873-5p.The 5-year o-verall survival rate of patients with high expression of CXCL16 mRNA was lower than that of patients with low expression of CXCL16 mRNA,and the difference was statistically significant(x2=11.328,10.514,all P=0.001).miR-873-5p≥0.84 was an independent protective factor for death in patients with thyroid cancer,and CXCL16 mRNA≥1.55 was an independent risk factor for death in patients with thyroid cancer(P<0.05).Conclusion The expressions of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues are related to patho-logical parameters and prognosis,and may become prognostic markers for patients with thyroid cancer.
4.Regulation of methyltransferase METTL3 on radiotherapy sensitivity of oral squamous cell carcinoma cells
Qingzhe MENG ; Junhong HUANG ; Xinjie YANG ; Huan LI ; Zihui YANG ; Jun WANG ; Yahui LI ; Rong LIU ; Jianhua WEI
Journal of Practical Stomatology 2025;41(2):206-213
Objective:To study the influence of methyltransferases like 3(METTL3)on the radiosensitivity of oral squamous cell carcinoma cells(OSCCs).Methods:The apoptosis level of OSCCs CAL27,SCC9 and SCC15 treated with X-ray radiation doses of 2,4 and 8 Gy respectively was compared by flow cytometry,the expression of methylated gene RNA and protein in the cells were examined by qRT-PCR and Western blot.m6A in the cells was quantified by LC/LC-MS method.qRT-PCR and Western blot were used to investigate the expression of methylated gene RNA and protein in the cells.Flow cytometry was used to examine the cell apoptosis level of CAL27 and SCC15 cells treated with METTL3 overexpression and knockdown respectively.The clone forma-tion of CAL27 and SCC15 cells after knockdown and overexpression of target genes followed by radiation treatment was observed by clonogenic assays.Results:The apoptosis rate of all the cell lines increased with the increase dose of radiation at each dose,CAL27 cells showed the highest and SCC15 showed the lowerst apoptosis rate.The RNA and protein expression levels of METTL3 in CAL27 were significantly lower than those of SCC15.m6A quantification showed that the methylation modification in CAL27 cells was lower than that in SCC15.The expression of METTL3 was increased in CAL27 and SCC15 cells after radiation treatment.Knockdown of METTL3 increaced the apoptosis rate and decreased the clonogenesity,overession of METTL3 the decreaced the ap optosis rate and increased the clonogenecity of the cells.Conclusion:Regulation of METTL3 can affect the radiotherapy sensitivity of OSCCs,METTL3 may become a new target for radiosensitization of OSCCs.
5.Causal relationship between peripheral blood cells and osteoporosis
Kedi LIU ; Yongxi CHEN ; Haibiao QIN ; Shenghui GUO ; Zhongshe QIN ; Juewei MENG ; Shanlin CUI ; Junhong FAN
Chinese Journal of Tissue Engineering Research 2025;29(12):2605-2613
BACKGROUND:Epidemiologic investigations and some experiments have shown that there is a close relationship between peripheral blood cells and osteoporosis,but the causal relationship between the two at the genetic level is still unclear. OBJECTIVE:To explore the causal relationship between peripheral blood cells and osteoporosis using Mendelian randomization methods. METHODS:Genome-wide association study data sets on peripheral blood cells,overall bone density at different ages,and calcaneal bone density were obtained from databases such as Blood Cell Consortium and MRC Integrative Epidemiology Unit. Blood cells were used as exposure data,with bone density at different ages and calcaneal bone density serving as outcome data. Mendelian randomization analyses were performed using methods such as inverse variance weighting,MR-Egger,weighted median method,and simple median. The results were assessed for heterogeneity,pleiotropy,and sensitivity using Cochran's Q,MR-Egger regression,and Leave-one-out method. The causal relationship between exposure and outcomes was evaluated using β values. RESULTS AND CONCLUSION:Due to the heterogeneity revealed by Cochran's Q test in the Mendelian randomization results,the results of the study were based on the inverse variance weighting method. The inverse variance weighting results showed that when age-specific bone density was used as an outcome,there was a negative causal relationship between white blood cell count and whole-body bone mineral density at the age of 45-60 years[β=-0.07,95% confidence interval (CI):-0.13,-0.01,P=0.02],a positive causal relationship between monocyte count and whole-body bone mineral density at the age of 45-60 years (β=0.05,95% CI:0.00,0.10,P=0.037),a negative causal relationship between white blood cell and basophil counts and whole-body bone mineral density over 60 years old (β=-0.04,95% CI:-0.07,-0.01,P=0.005;β=-0.04,95% CI:-0.07,-0.00,P=0.038),a positive causal relationship between hemoglobin concentration and hematocrit and whole-body bone mineral density over 60 years old (β=0.04,95% CI:0.01,0.08,P=0.012;β=0.04,95% CI:0.00,0.07,P=0.039),and a negative causal relationship between white cell count and whole-body bone mineral density at an undistinguished age (β=-0.10,95% CI:-0.16,-0.03,P=0.002). When heel bone mineral density was used as an outcome,there was a negative causal relationship between white cell count and heel bone mineral density (β=-0.04,95% CI:-0.07,-0.01,P=0.016),and a positive causal relationship between hemoglobin concentration and hematocrit and heel bone mineral density (β=0.05,95% CI:0.01,0.08,P=0.007;β=0.05,95% CI:0.01,0.08,P=0.004). To ensure the robustness of the results,meta-analyses of Mendelian randomization results of peripheral blood cells and whole-body bone mineral density as well as heel bone mineral density in different age groups were conducted. The results suggested that for every standard deviation decrease in log-transformed white blood cell count,there was a 5% reduction in the risk of decreased bone mineral density (OR=0.95,95% CI:0.94,0.97,P<0.001);whereas for every standard deviation increase in hemoglobin concentration and hematocrit,there was a 4% reduction in the risk of decreased bone density (OR=1.04,95% CI:1.03,1.06,P<0.001). In conclusion,increased white blood cell count in peripheral blood is a risk factor for bone mineral density;whereas increased hematocrit and hemoglobin concentration are protective factors for bone mineral density.
6.Causal relationship between peripheral blood cells and osteoporosis
Kedi LIU ; Yongxi CHEN ; Haibiao QIN ; Shenghui GUO ; Zhongshe QIN ; Juewei MENG ; Shanlin CUI ; Junhong FAN
Chinese Journal of Tissue Engineering Research 2025;29(12):2605-2613
BACKGROUND:Epidemiologic investigations and some experiments have shown that there is a close relationship between peripheral blood cells and osteoporosis,but the causal relationship between the two at the genetic level is still unclear. OBJECTIVE:To explore the causal relationship between peripheral blood cells and osteoporosis using Mendelian randomization methods. METHODS:Genome-wide association study data sets on peripheral blood cells,overall bone density at different ages,and calcaneal bone density were obtained from databases such as Blood Cell Consortium and MRC Integrative Epidemiology Unit. Blood cells were used as exposure data,with bone density at different ages and calcaneal bone density serving as outcome data. Mendelian randomization analyses were performed using methods such as inverse variance weighting,MR-Egger,weighted median method,and simple median. The results were assessed for heterogeneity,pleiotropy,and sensitivity using Cochran's Q,MR-Egger regression,and Leave-one-out method. The causal relationship between exposure and outcomes was evaluated using β values. RESULTS AND CONCLUSION:Due to the heterogeneity revealed by Cochran's Q test in the Mendelian randomization results,the results of the study were based on the inverse variance weighting method. The inverse variance weighting results showed that when age-specific bone density was used as an outcome,there was a negative causal relationship between white blood cell count and whole-body bone mineral density at the age of 45-60 years[β=-0.07,95% confidence interval (CI):-0.13,-0.01,P=0.02],a positive causal relationship between monocyte count and whole-body bone mineral density at the age of 45-60 years (β=0.05,95% CI:0.00,0.10,P=0.037),a negative causal relationship between white blood cell and basophil counts and whole-body bone mineral density over 60 years old (β=-0.04,95% CI:-0.07,-0.01,P=0.005;β=-0.04,95% CI:-0.07,-0.00,P=0.038),a positive causal relationship between hemoglobin concentration and hematocrit and whole-body bone mineral density over 60 years old (β=0.04,95% CI:0.01,0.08,P=0.012;β=0.04,95% CI:0.00,0.07,P=0.039),and a negative causal relationship between white cell count and whole-body bone mineral density at an undistinguished age (β=-0.10,95% CI:-0.16,-0.03,P=0.002). When heel bone mineral density was used as an outcome,there was a negative causal relationship between white cell count and heel bone mineral density (β=-0.04,95% CI:-0.07,-0.01,P=0.016),and a positive causal relationship between hemoglobin concentration and hematocrit and heel bone mineral density (β=0.05,95% CI:0.01,0.08,P=0.007;β=0.05,95% CI:0.01,0.08,P=0.004). To ensure the robustness of the results,meta-analyses of Mendelian randomization results of peripheral blood cells and whole-body bone mineral density as well as heel bone mineral density in different age groups were conducted. The results suggested that for every standard deviation decrease in log-transformed white blood cell count,there was a 5% reduction in the risk of decreased bone mineral density (OR=0.95,95% CI:0.94,0.97,P<0.001);whereas for every standard deviation increase in hemoglobin concentration and hematocrit,there was a 4% reduction in the risk of decreased bone density (OR=1.04,95% CI:1.03,1.06,P<0.001). In conclusion,increased white blood cell count in peripheral blood is a risk factor for bone mineral density;whereas increased hematocrit and hemoglobin concentration are protective factors for bone mineral density.
7.Expression and significance of miR-1243 and lncRNA HULC in papillary thyroid carcinoma tissues
Mingyue GAO ; Duxian LIU ; Jizong ZHANG ; Cheng GONG ; Xiaoya ZHANG ; Junhong MENG
Journal of Chinese Physician 2025;27(10):1543-1547
Objective:To investigate the expression of miR-1243 and long non-coding RNA (lncRNA) HULC in papillary thyroid carcinoma (PTC) tissues, and their relationships with clinicopathological features and postoperative prognosis of patients.Methods:A total of 116 PTC patients treated in the Second Hospital of Nanjing from August 2021 to August 2023 were selected. The expression levels of miR-1243 and lncRNA HULC in PTC tissues and adjacent normal tissues were detected by real-time fluorescent quantitative polymerase chain reaction (PCR). The differences in the expression levels of miR-1243 and lncRNA HULC between PTC tissues and adjacent normal tissues, as well as among PTC tissues with different clinical features and different prognoses, were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the value of miR-1243 in predicting postoperative recurrence of PTC patients.Results:The relative expression level of miR-1243 in PTC tissues was significantly lower than that in adjacent normal tissues ( P<0.05), while the relative expression level of lncRNA HULC was higher than that in adjacent normal tissues ( P<0.05). The relative expression level of lncRNA HULC in PTC tissues of patients with tumor diameter ≥2 cm, tumor node metastasis (TNM) stage Ⅲ-Ⅳ, and lymph node metastasis was higher than that in patients with tumor diameter <2 cm, TNM stage Ⅰ-Ⅱ, and no lymph node metastasis (all P<0.05). The relative expression level of miR-1243 in PTC tissues of patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis was lower than that in patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis (all P<0.05). There was no significant correlation between the expression of miR-1243 and lncRNA HULC in PTC tissues ( r=0.129, P=0.167). All patients were followed up for 12 months, and 20 patients had postoperative recurrence. The proportion of TNM stage Ⅲ-Ⅳ in recurrent patients was 70.00%(14/20), which was higher than that in non-recurrent patients [29.17%(28/96), P<0.05], and the relative expression level of miR-1243 was lower than that in non-recurrent patients ( P<0.05). There was no significant difference in the relative expression level of lncRNA HULC between recurrent and non-recurrent patients ( P>0.05). The area under the ROC curve of miR-1243 relative expression level in predicting postoperative recurrence of PTC patients was 0.809(95% CI: 0.711-0.907, P<0.05), with a cut-off value of 1.17, sensitivity of 65.00% and specificity of 87.50%. Conclusions:The expression of miR-1243 is down-regulated and lncRNA HULC is up-regulated in PTC tissues, and both are related to clinicopathological features such as lymph node metastasis and TNM stage. Among them, the expression of miR-1243 is related to postoperative recurrence.
8.Analysis of the relationship between KRT15 and KRT18 protein expression and clinicopathological features and prognosis in colorectal cancer tissue
Junhong MENG ; Mingyue GAO ; Cheng GONG ; Xiaoya ZHANG ; Wenjie SHI ; Duxian LIU
International Journal of Laboratory Medicine 2024;45(4):435-440
Objective To investigate the relationship between the expression of keratin 15(KRT15)and keratin 18(KRT18)proteins in colorectal cancer tissue and their clinicopathological features and prognosis.Methods A total of 97 patients with colorectal cancer who underwent surgical treatment in a hospital from June 2018 to June 2019 were selected as the study objects.Immunohistochemistry was used to detect the ex-pression of KRT15 and KRT18 protein in colorectal cancer tissues and adjacent tissues,and the differences of KRT15 and KRT18 protein expression in colorectal cancer patients with different clinicopathological features were compared.The patients with colorectal cancer were followed up for 3 years after discharge,and their o-verall survival(OS)during the follow-up period was analyzed.Kaplan-Meier survival curve and Log-rank test were used to analyze the difference in OS rate among colorectal cancer patients with different KRT15 and KRT18 protein expression.Univariate and multivariate COX proportional regression analysis was performed to analyze the factors affecting the prognosis of patients with colorectal cancer.Results The positive expres-sion rates of KRT15 and KRT18 protein in colorectal cancer tissues were higher than those in adjacent tis-sues,and the difference was statistically significant(P<0.05).The positive expression rates of KRT15 and KRT18 protein in colorectal cancer tissues of patients with low differentiation,TNM Ⅲ stage,perineural inva-sion and preoperative carcinoembryonic antigen(CEA)level ≥5 ng/mL were higher than those of patients with medium-high differentiation,TNM Ⅰ-Ⅱ stage,without perineural invasion and preoperative CEA level<5 ng/mL,the difference was statistically significant(P<0.05).The 3-year OS rates of colorectal cancer patients with positive expression of KRT15 and KRT18 protein were 64.29%and 60.00%respectively,which were lower than those of patients with negative expression of KRT15 and KRT18 protein(83.64%and 85.96%respec-tively),and the difference was statistically significant(x2=6.497,7.987,P<0.05).Multivariate COX pro-portional regression analysis showed that TNM stage Ⅲ,positive expression of KRT15 protein and positive expression of KRT18 protein were risk factors affecting the survival of patients with colorectal cancer(P<0.05).Conclusion The expression of KRT15 and KRT18 protein in colorectal cancer tissues can provide ref-erence for prognosis assessment of patients with colorectal cancer.
9.CGG Repeat Expansion in NOTCH2NLC Causing Overlapping Oculopharyngodistal Myopathy and Neuronal Intranuclear Inclusion Disease With Diffusion Weighted Imaging Abnormality in the Cerebellum
Jing MA ; Huiqiu ZHANG ; Bing MENG ; Jiangbo QIN ; Hongye LIU ; Xiaomin PANG ; Rongjuan ZHAO ; Juan WANG ; Xueli CHANG ; Junhong GUO ; Wei ZHANG
Journal of Clinical Neurology 2024;20(6):580-590
Background:
and Purpose CGG repeat expansion in the 5' untranslated region (5'UTR) of the Notch 2 N-terminal-like C gene (NOTCH2NLC) has been associated with neuronal intranuclear inclusion disease (NIID) and oculopharyngodistal myopathy type 3 (OPDM3). Few OPDM3 patients have been reported. This report describes two OPDM3 patients with novel imaging findings who presented the typical features of NIID, and reviews all OPDM3 cases available in the literature.
Methods:
The available clinical, imaging, and pathological information was reviewed and investigated. CGG repeat expansion in the 5'UTR of NOTCH2NLC was tested using the repeatprimed polymerase chain reaction (PCR), followed by the fluorescence amplicon-length PCR to determine the number of CGG repeats.
Results:
Our two OPDM3 patients and most patients reported in the literature developed the typical clinical characteristics of NIID, including leukoencephalopathy, peripheral neuropathy, cognitive deterioration, pigmentary retinopathy, ataxia, tremor, acute encephalitis-like episodes, pigmentary retinopathy, miosis, and sensorineural hearing loss. In addition to typical imaging findings of NIID, our two patients exhibited diffusion weighted imaging (DWI) hyperintensities in the middle cerebellar peduncles, which have not been described previously. Muscle biopsies revealed rimmed vacuoles and p62-positive intranuclear inclusions in the myofibers in both patients. The skin biopsy performed in one patient detected typical eosinophilic intranuclear inclusions. Genetic analysis identified CGG repeat expansion in NOTCH2NLC as the causative mutation in the two patients.
Conclusions
Our two patients with OPDM3 had clinical characteristics of NIID and exhibited DWI abnormality in the cerebellum. Our results indicate that OPDM3 is within the spectrum of NIID and that DWI hyperintensities in the cerebellum are helpful for diagnosing NIID or OPDM3.
10.CGG Repeat Expansion in NOTCH2NLC Causing Overlapping Oculopharyngodistal Myopathy and Neuronal Intranuclear Inclusion Disease With Diffusion Weighted Imaging Abnormality in the Cerebellum
Jing MA ; Huiqiu ZHANG ; Bing MENG ; Jiangbo QIN ; Hongye LIU ; Xiaomin PANG ; Rongjuan ZHAO ; Juan WANG ; Xueli CHANG ; Junhong GUO ; Wei ZHANG
Journal of Clinical Neurology 2024;20(6):580-590
Background:
and Purpose CGG repeat expansion in the 5' untranslated region (5'UTR) of the Notch 2 N-terminal-like C gene (NOTCH2NLC) has been associated with neuronal intranuclear inclusion disease (NIID) and oculopharyngodistal myopathy type 3 (OPDM3). Few OPDM3 patients have been reported. This report describes two OPDM3 patients with novel imaging findings who presented the typical features of NIID, and reviews all OPDM3 cases available in the literature.
Methods:
The available clinical, imaging, and pathological information was reviewed and investigated. CGG repeat expansion in the 5'UTR of NOTCH2NLC was tested using the repeatprimed polymerase chain reaction (PCR), followed by the fluorescence amplicon-length PCR to determine the number of CGG repeats.
Results:
Our two OPDM3 patients and most patients reported in the literature developed the typical clinical characteristics of NIID, including leukoencephalopathy, peripheral neuropathy, cognitive deterioration, pigmentary retinopathy, ataxia, tremor, acute encephalitis-like episodes, pigmentary retinopathy, miosis, and sensorineural hearing loss. In addition to typical imaging findings of NIID, our two patients exhibited diffusion weighted imaging (DWI) hyperintensities in the middle cerebellar peduncles, which have not been described previously. Muscle biopsies revealed rimmed vacuoles and p62-positive intranuclear inclusions in the myofibers in both patients. The skin biopsy performed in one patient detected typical eosinophilic intranuclear inclusions. Genetic analysis identified CGG repeat expansion in NOTCH2NLC as the causative mutation in the two patients.
Conclusions
Our two patients with OPDM3 had clinical characteristics of NIID and exhibited DWI abnormality in the cerebellum. Our results indicate that OPDM3 is within the spectrum of NIID and that DWI hyperintensities in the cerebellum are helpful for diagnosing NIID or OPDM3.

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