@article {8092, title = {Genetic analysis of Italian patients with congenital tufting enteropathy.}, journal = {World J Pediatr}, year = {2015}, month = {2015 Dec 18}, abstract = {

BACKGROUND: Congenital tufting enteropathy (CTE), an inherited autosomal recessive rare disease, is a severe diarrhea of infancy which is clinically characterized by absence of inflammation and presence of intestinal villous atrophy. Mutations in the EpCAM gene were identified to cause CTE. Recent cases of syndromic tufting enteropathy harboring the SPINT2 (19q13.2) mutation were described.

METHODS: Four CTE Italian patients were clinically and immunohistochemically characterized. Direct DNA sequencing of EpCAM and SPINT2 genes was performed.

RESULTS: All patients were of Italian origin. Three different mutations were detected (p.Asp219Metfs*15, Tyr186Phefs*6 and p.Ile146Asn) in the EpCAM gene; one of them is novel (p.Ile146Asn). Two patients (P1 and P2) showed compound heterozygosity revealing two mutations in separate alleles. A third patient (P3) was heterozygous for only one novel EpCAM missense mutation (p.Ile146Asn). In a syndromic patient (P4), no deleterious EpCAM mutation was found. Additional SPINT2 mutational analysis was performed. P4 showed a homozygous SPINT2 mutation (p.Y163C). No SPINT2 mutation was found in P3. CLDN7 was also evaluated as a candidate gene by mutational screening in P3 but no mutation was identified.

CONCLUSIONS: This study presented a molecular characterization of CTE Italian patients, and identified three mutations in the EpCAM gene and one in the SPINT2 gene. One of EpCAM mutations was novel, therefore increasing the mutational spectrum of allelic variants of the EpCAM gene. Molecular analysis of the SPINT2 gene also allowed us to identify a SPINT2 substitution mutation (c.488A>G) recently found to be associated with syndromic CTE subjects.

}, issn = {1867-0687}, doi = {10.1007/s12519-015-0070-y}, author = {d{\textquoteright}Apolito, Maria and Pisanelli, Daniela and Faletra, Flavio and Giardino, Ida and Gigante, Maddalena and Pettoello-Mantovani, Massimo and Goulet, Olivier and Gasparini, Paolo and Campanozzi, Angelo} } @article {1706, title = {Usefulness of the measurement of azathioprine metabolites in the assessment of non-adherence.}, journal = {J Crohns Colitis}, volume = {4}, year = {2010}, month = {2010 Nov}, pages = {599-602}, abstract = {

Azathioprine is a thiopurine immunosuppressive antimetabolite used to chronically treat inflammatory bowel disease and autoimmune hepatitis. Azathioprine treatment is a long-term therapy and therefore it is at risk for non-adherence, which is considered an important determinant of treatment inefficacy. Measurement of 6-thioguanine and 6-methylmercaptopurine nucleotides has been recently suggested as a screener for non-adherence detection. We describe four young patients in which non-adherence to azathioprine therapy was detected only through the measurement of drug metabolite concentrations, and the criterion for non-adherence was undetectable metabolite levels. After the identification of non-adherence, patients and their families were approached and the importance of a correct drug administration was thoroughly enlightened and discussed; this allowed obtaining a full remission in all subjects. Our observations support the use of undetectable metabolite levels as indicators of non-adherence to therapy in azathioprine treated patients. The additional level of medical supervision given by this assay allows getting a better adherence to medical treatment, which results in an improvement in the response to therapy; these benefits may justify the costs associated with the assay.

}, keywords = {6-Mercaptopurine, Adolescent, Azathioprine, Child, Child, Preschool, Female, Guanine Nucleotides, Hepatitis, Autoimmune, Humans, Immunosuppressive Agents, Inflammatory Bowel Diseases, Male, Medication Adherence, Thionucleotides, Young Adult}, issn = {1876-4479}, doi = {10.1016/j.crohns.2010.04.003}, author = {Stocco, Gabriele and Londero, Margherita and Campanozzi, Angelo and Martelossi, Stefano and Marino, Sara and Malus{\`a}, Noelia and Bartoli, Fiora and Decorti, Giuliana and Ventura, Alessandro} }