Browsing by Subject "SHANK3"

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    Stratification of a Phelan-McDermid Syndrome Population Based on Their Response to Human Growth Hormone and Insulin-like Growth Factor
    (MDPI, 2023-02-15) Moffitt, Bridgette A.; Sarasua, Sara M.; Ivankovic, Diana; Ward, Linda D.; Valentine, Kathleen; Bennett, William E., Jr.; Rogers, Curtis; Phelan, Katy; Boccuto, Luigi; Pediatrics, School of Medicine
    Phelan-McDermid syndrome (PMS), caused by pathogenic variants in the SHANK3 gene or 22q13 deletions, is characterized by intellectual disability, autistic features, developmental delays, and neonatal hypotonia. Insulin-like growth factor 1 (IGF-1) and human growth hormone (hGH) have been shown to reverse neurobehavioral deficits in PMS. We assessed the metabolic profiling of 48 individuals with PMS and 50 controls and determined subpopulations by taking the top and bottom 25% of responders to hGH and IGF-1. A distinct metabolic profile for individuals with PMS showed a reduced ability to metabolize major energy sources and a higher metabolism of alternative energy sources. The analysis of the metabolic response to hGH or IGF-1 highlighted a major overlap between both high and low responders, validating the model and suggesting that the two growth factors share many target pathways. When we investigated the effect of hGH and IGF-1 on the metabolism of glucose, the correlation between the high-responder subgroups showed less similarity, whereas the low-responders were still relatively similar. Classification of individuals with PMS into subgroups based on responses to a compound can allow an investigation into pathogenic mechanisms, the identification of molecular biomarkers, an exploration of in vitro responses to candidate drugs, and eventually the selection of better candidates for clinical trials.
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    Updated Consensus Guidelines on the Management of Phelan-McDermid Syndrome
    (Wiley, 2023) Srivastava, Siddharth; Sahin, Mustafa; Buxbaum, Joseph D.; Berry-Kravis, Elizabeth; Valluripalli Soorya, Latha; Thurm, Audrey; Bernstein, Jonathan A.; Asante-Otoo, Afua; Bennett, William E., Jr.; Betancur, Catalina; Brickhouse, Tegwyn H.; Bueno, Maria Rita Passos; Chopra, Maya; Christensen, Celanie K.; Cully, Jennifer L.; Dies, Kira; Friedman, Kate; Gummere, Brittany; Holder, J. Lloyd, Jr.; Jimenez-Gomez, Andres; Kerins, Carolyn A.; Khan, Omar; Kohlenberg, Teresa; Lacro, Ronald V.; Levi, Lori A.; Levy, Tess; Linnehan, Diane; Loth, Eva; Moshiree, Baharak; Neumeyer, Ann; Paul, Scott M.; Phelan, Katy; Persico, Antonio; Rapaport, Robert; Rogers, Curtis; Saland, Jeffrey; Sethuram, Swathi; Shapiro, Janine; Tarr, Phillip I.; White, Kerry M.; Wickstrom, Jordan; Williams, Kent M.; Winrow, Dana; Wishart, Brian; Kolevzon, Alexander; Pediatrics, School of Medicine
    Phelan-McDermid syndrome (PMS) is a genetic condition caused by SHANK3 haploinsufficiency and characterized by a wide range of neurodevelopmental and systemic manifestations. The first practice parameters for assessment and monitoring in individuals with PMS were published in 2014; recently, knowledge about PMS has grown significantly based on data from longitudinal phenotyping studies and large-scale genotype-phenotype investigations. The objective of these updated clinical management guidelines was to: (1) reflect the latest in knowledge in PMS and (2) provide guidance for clinicians, researchers, and the general community. A taskforce was established with clinical experts in PMS and representatives from the parent community. Experts joined subgroups based on their areas of specialty, including genetics, neurology, neurodevelopment, gastroenterology, primary care, physiatry, nephrology, endocrinology, cardiology, gynecology, and dentistry. Taskforce members convened regularly between 2021 and 2022 and produced specialty-specific guidelines based on iterative feedback and discussion. Taskforce leaders then established consensus within their respective specialty group and harmonized the guidelines. The knowledge gained over the past decade allows for improved guidelines to assess and monitor individuals with PMS. Since there is limited evidence specific to PMS, intervention mostly follows general guidelines for treating individuals with developmental disorders. Significant evidence has been amassed to guide the management of comorbid neuropsychiatric conditions in PMS, albeit mainly from caregiver report and the experience of clinical experts. These updated consensus guidelines on the management of PMS represent an advance for the field and will improve care in the community. Several areas for future research are also highlighted and will contribute to subsequent updates with more refined and specific recommendations as new knowledge accumulates.