RESUMEN

A 17-year-old mixed race male has been followed in our adolescent clinic for severe obesity, dysmorphic features, and behavioral issues. Among other interventions, he has received symptomatic treatment for hypertension, insulin resistance, and attention deficit hyperactivity disorder. Genetic investigation identified a 16p11.2 microdeletion, commonly associated with severe obesity and developmental delay. We present the clinical history, treatment, and implications for this patient.

RESUMEN

Using a canine model of classical late-infantile neuronal ceroid lipofuscinosis (CLN2 disease), a study was conducted to evaluate the potential pharmacological activity of recombinant human tripeptidyl peptidase-1 (rhTPP1) enzyme replacement therapy administered directly to the cerebrospinal fluid (CSF). CLN2 disease is a hereditary neurodegenerative disorder resulting from mutations in CLN2, which encodes the soluble lysosomal enzyme tripeptidyl peptidase-1 (TPP1). Infants with mutations in both CLN2 alleles develop normally but in the late-infantile/early-childhood period undergo progressive neurological decline accompanied by pronounced brain atrophy. The disorder, a form of Batten disease, is uniformly fatal, with clinical signs starting between 2 and 4 years of age and death usually occurring by the early teenage years. Dachshunds homozygous for a null mutation in the canine ortholog of CLN2 (TPP1) exhibit a similar disorder that progresses to end stage at 10.5-11 months of age. Administration of rhTPP1 via infusion into the CSF every other week, starting at approximately 2.5 months of age, resulted in dose-dependent significant delays in disease progression, as measured by delayed onset of neurologic deficits, improved performance on a cognitive function test, reduced brain atrophy, and increased life span. Based on these findings, a clinical study evaluating the potential therapeutic value of rhTPP1 administration into the CSF of children with CLN2 disease has been initiated.

Asunto(s)

Aminopeptidasas/uso terapéutico , Dipeptidil-Peptidasas y Tripeptidil-Peptidasas/uso terapéutico , Terapia de Reemplazo Enzimático/métodos , Lipofuscinosis Ceroideas Neuronales/terapia , Lipofuscinosis Ceroideas Neuronales/veterinaria , Serina Proteasas/uso terapéutico , Aminopeptidasas/genética , Análisis de Varianza , Animales , Encéfalo/patología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/terapia , Dipeptidil-Peptidasas y Tripeptidil-Peptidasas/genética , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Perros , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Aprendizaje por Laberinto/fisiología , Mutación/genética , Examen Neurológico , Lipofuscinosis Ceroideas Neuronales/complicaciones , Lipofuscinosis Ceroideas Neuronales/genética , Proteínas Recombinantes de Fusión/administración & dosificación , Serina Proteasas/genética , Análisis de Supervivencia , Tripeptidil Peptidasa 1

RESUMEN

Ni-centered deltahedral Sn(9) clusters with a charge of 4-, i.e., [Ni@Sn(9)](4-), were extracted in ethylenediamine in high yield directly from intermetallic precursors with the nominal composition "K(4)Sn(9)Ni(3)". The new endohedral clusters were crystallized and structurally characterized in K[K(18-crown-6)](3)[Ni@Sn(9)]·3benzene (1a, triclinic, P1̅, a = 10.2754(5) Å, b = 19.5442(9) Å, and c = 20.5576(13) Å, α = 73.927(3)°, ß = 79.838(4)°, and γ = 84.389(3)°, V = 3899.6(4) Å(3), Z = 2) and K[K(2,2,2-crypt)](3)[Ni@Sn(9)] (1b, triclinic, P1, a = 15.8028(8) Å, b = 16.21350(9) Å, and c = 20.1760(12) Å, α = 98.71040(10)°, ß = 104.4690(10)°, and γ = 118.3890(10)°, V = 4181.5(4) Å(3), Z = 2). The alternative method of a post-synthetic insertion of a Ni atom in empty Sn(9) clusters by a reaction with Ni(cod)(2) predominantly produces the more-oxidized clusters with a charge of 3-, i.e., the recently reported [Ni@Sn(9)](3-). Nonetheless, using substoichiometric amounts of 18-crown-6 as a cation sequestering agent, we also have been able to isolate the 4- clusters as a minor phase from such reactions. They were structurally characterized in K[K(en)][K(18-crown-6)](2)[Ni@Sn(9)]·0.5en (2, monoclinic, P2(1)/n, a = 10.4153(5) Å, b = 25.6788(11) Å, and c = 20.6630(9) Å, ß = 102.530(2)°, V = 5394.7(4) Å(3), Z = 2). The ability of the Ni-centered clusters to exist with both 3- and 4- charges parallels the same ability of the empty clusters and is very promising for similarly rich chemistry involving electron transfer and flexible "oxidation states". We also report the synthesis and characterization of the endohedral heteroatomic dimer [{Ni@Sn(8)(µ-Ge)(1/2)}(2)](4-) composed of two [Ni@(Sn(8)Ge)]-clusters fused at the Ge-vertex. The dimer was synthesized by reacting an ethylenediamine solution of a ternary precursor with the nominal composition "K(4)Ge(4.5)Sn(4.5)", which is known to produce heteroatomic Ge(9-x)Sn(x) clusters, with Ni(cod)(2). It is isostructural with the reported [{Ni@Sn(8)(µ-Sn)(1/2)}(2)](4-) and is structurally characterized in [K-(2,2,2-crypt)](4)[{Ni@Sn(8)(µ-Ge)(1/2)}(2)]·2en (3, monoclinic, C2/c, a = 30.636(2) Å, b = 16.5548(12) Å, and c = 28.872(2) Å, ß = 121.2140(10)°, V = 12523.5(15) Å(3), Z = 4).

RESUMEN

Nickel atoms were inserted into nine-atom deltahedral Zintl ions of E(9)(4-) (E = Ge, Sn) via reactions with Ni(cod)(2) (cod = cyclooctadiene), and [Ni@Sn(9)](3-) was structurally characterized. Both the empty and the Ni-centered clusters react with TlCp (Cp = cyclopentadienyl anion) and add a thallium vertex to form the deltahedral ten-atom closo-species [E(9)Tl](3-) and [Ni@E(9)Tl](3-), respectively. The structures of [Ge(9)Tl](3-) and [Ni@Sn(9)Tl](3-) showed that, as expected, the geometry of the ten-atom clusters is that of a bicapped square antiprism where the Tl-atom occupies one of the two capping vertices. This illustrates that centering a nine-atom cluster with a nickel atom does not change its reactivity toward TlCp. All compounds were characterized by electrospray mass spectrometry.