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      Disferlinopatias: revisão crítica para norteamento de abordagens terapêuticas Translated title: Dysferlinopathies: critical review to guide the therapeutic approaches Translated title: Disferlinopatías: actualización para el manejo de los enfoques terapéuticos

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      Cadernos de Pós-Graduação em Distúrbios do Desenvolvimento
      Universidade Presbiteriana Mackenzie
      distrofia muscular do cíngulo dos membros, distrofias musculares, doenças musculares, distrofia muscular distal, miopatias distais, reabilitação, fisioterapia, modalidades de fisioterapia, distrofia muscular de cinturas, distrofias musculares, enfermedades musculares, miopatias distales, rehabilitación, fisioterapia, modalidades de fisioterapia, muscular dystrophies, limb-girdle, muscular dystrophies, muscular diseases, distal myopathies, rehabilitation, physiotherapy, physical therapy specialty, physical therapy modalities

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          Abstract

          Disferlinopatias são doenças neuromusculares de herança autossômica recessiva causadas pela alteração na proteína disferlina, presente na membrana muscular. Os fenótipos são miopatia de Miyoshi e distrofia muscular de cinturas do tipo 2B, sendo esta, a segunda em frequência em diversos países. Os estudos são amplos, mas não contemplam aspectos que permitam análise crítica e ampla sobre a funcionalidade e intervenção terapêutica. Trabalho de revisão bibliográfica crítica da literatura para elucidação e norteamento do tratamento fisioterapêutico, com busca na base de dados Medline-PubMed, US National Library of Medicine National - Institutes of Health, usando combinações das palavras chaves. Critérios de inclusão: língua inglesa, portuguesa e espanhola, artigos de clinical trial e review, com humanos, no período de 2006 a 2016. Critérios de exclusão: ausência de citação de características das disferlinopatias e outras línguas. Foram encontrados 82 artigos, destes, 20 eram repetidos e cinco foram excluídos, restando 57 artigos sobre o tema. Os resultados foram divididos em: definição, fisiopatologia, diagnóstico, epidemiologia, quadro clínico-funcional e tratamento. O quadro de fraqueza muscular não é correlacionado com achados funcionais. Os resultados permitem elucidar o quadro clínico das disferlinopatias fornecendo informações relevantes para nortear profissionais da saúde na elaboração de protocolos de avaliação e tratamento.

          Translated abstract

          Dysferlinopathies are neuromuscular diseases of autosomal recessive inheritance caused by the alteration in the protein dysferline, present in the muscular membrane. The phenotypes are Miyoshi myopathy and limb-girdle muscular dystrophy type 2B, this being the second in frequency in several countries. The studies are broad, but do not contemplate aspects that allow a critical and wide analysis on the functionality and therapeutic intervention. Critical bibliographic review of the literature for the elucidation and orientation of the physiotherapeutic treatment, with search in the database Medline-PubMed, US National Library of Medicine National - Institutes of Health, using combinations of the key words. Inclusion criteria: English, Portuguese and Spanish, articles of clinical trial and review, with humans, from 2006 to 2016. Exclusion criteria: absence of citation of characteristics of dysferlinopathies and other languages. We found 82 articles, of which 20 were repeated and 5 were excluded, leaving 57 articles on the topic. The results were divided into: definition, pathophysiology, diagnosis, epidemiology, clinical-functional and treatment. The clinical of muscle weakness is not correlated with functional findings. The results allow elucidating the clinical of dysferlinopathies, providing relevant information to guide health professionals in the elaboration of evaluation and treatment protocols.

          Translated abstract

          Disferlinopatías son enfermedades neuromusculares de herencia autosómica recesiva causadas por la alteración de la proteína disferlina, presente en la membrana muscular. Los fenotipos son miopatía de Miyoshi y distrofia muscular de cinturas del tipo 2B, siendo ésta la segunda en frecuencia en diversos países. Los estudios son amplios, pero no contemplan aspectos que permitan análisis crítico y amplio sobre la funcionalidad e intervención terapéutica. El trabajo de revisión bibliográfica crítica de la literatura para elucidación y orientación del tratamiento fisioterapéutico, con búsqueda en la base de datos Medline-PubMed, US National Library of Medicine National - Institutos de Salud, usando combinaciones de las palabras clave. Criterios de inclusión: lengua inglesa, portuguesa y española, artículos de clinical trial e review, con humanos, en el período de 2006 a 2016. Criterios de exclusión: ausencia de citación de características de las disferlinopatías y otras lenguas. Se encontraron 82 artículos, de éstos, 20 eran repetidos y cinco fueron excluidos, restando 57 artículos sobre el tema. Los resultados se dividieron en: definición, fisiopatología, diagnóstico, epidemiología, cuadro clínico-funcional y tratamiento. El cuadro de debilidad muscular no está correlacionado con hallazgos funcionales. Los resultados permiten elucidar el cuadro clínico de las disferlinopatías proporcionando informaciones relevantes para orientar a profesionales de la salud en la elaboración de protocolos de evaluación y tratamiento.

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          Most cited references53

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          Recessive mutations in the putative calcium-activated chloride channel Anoctamin 5 cause proximal LGMD2L and distal MMD3 muscular dystrophies.

          The recently described human anion channel Anoctamin (ANO) protein family comprises at least ten members, many of which have been shown to correspond to calcium-activated chloride channels. To date, the only reported human mutations in this family of genes are dominant mutations in ANO5 (TMEM16E, GDD1) in the rare skeletal disorder gnathodiaphyseal dysplasia. We have identified recessive mutations in ANO5 that result in a proximal limb-girdle muscular dystrophy (LGMD2L) in three French Canadian families and in a distal non-dysferlin Miyoshi myopathy (MMD3) in Dutch and Finnish families. These mutations consist of a splice site, one base pair duplication shared by French Canadian and Dutch cases, and two missense mutations. The splice site and the duplication mutations introduce premature-termination codons and consequently trigger nonsense-mediated mRNA decay, suggesting an underlining loss-of-function mechanism. The LGMD2L phenotype is characterized by proximal weakness, with prominent asymmetrical quadriceps femoris and biceps brachii atrophy. The MMD3 phenotype is associated with distal weakness, of calf muscles in particular. With the use of electron microscopy, multifocal sarcolemmal lesions were observed in both phenotypes. The phenotypic heterogeneity associated with ANO5 mutations is reminiscent of that observed with Dysferlin (DYSF) mutations that can cause both LGMD2B and Miyoshi myopathy (MMD1). In one MMD3-affected individual, defective membrane repair was documented on fibroblasts by membrane-resealing ability assays, as observed in dysferlinopathies. Though the function of the ANO5 protein is still unknown, its putative calcium-activated chloride channel function may lead to important insights into the role of deficient skeletal muscle membrane repair in muscular dystrophies. Copyright (c) 2010 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
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            Dysferlin and muscle membrane repair.

            The ability to repair membrane damage is conserved across eukaryotic cells and is necessary for the cells to survive a variety of physiological and pathological membrane disruptions. Membrane repair is mediated by rapid Ca(2+)-triggered exocytosis of various intracellular vesicles, such as lysosomes and enlargeosomes, which lead to the formation of a membrane patch that reseals the membrane lesion. Recent findings suggest a crucial role for dysferlin in this repair process in muscle, possibly as a Ca(2+) sensor that triggers vesicle fusion. The importance of membrane repair is highlighted by the genetic disease, dysferlinopathy, in which the primary defect is the loss of Ca(2+)-regulated membrane repair due to dysferlin deficiency. Future research on dysferlin and its interacting partners will enhance the understanding of this important process and provide novel avenues to potential therapies.
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              Genetic basis of limb-girdle muscular dystrophies: the 2014 update

              Limb-girdle muscular dystrophies (LGMD) are a highly heterogeneous group of muscle disorders, which first affect the voluntary muscles of the hip and shoulder areas. The definition is highly descriptive and less ambiguous by exclusion: non-Xlinked, non-FSH, non-myotonic, non-distal, nonsyndromic, and non-congenital. At present, the genetic classification is becoming too complex, since the acronym LGMD has also been used for a number of other myopathic disorders with overlapping phenotypes. Today, the list of genes to be screened is too large for the gene-by-gene approach and it is well suited for targeted next generation sequencing (NGS) panels that should include any gene that has been so far associated with a clinical picture of LGMD. The present review has the aim of recapitulating the genetic basis of LGMD ordering and of proposing a nomenclature for the orphan forms. This is useful given the pace of new discoveries. Thity-one loci have been identified so far, eight autosomal dominant and 23 autosomal recessive. The dominant forms (LGMD1) are: LGMD1A (myotilin), LGMD1B (lamin A/C), LGMD1C (caveolin 3), LGMD1D (DNAJB6), LGMD1E (desmin), LGMD1F (transportin 3), LGMD1G (HNRPDL), LGMD1H (chr. 3). The autosomal recessive forms (LGMD2) are: LGMD2A (calpain 3), LGMD2B (dysferlin), LGMD2C (γ sarcoglycan), LGMD2D (α sarcoglycan), LGMD2E (β sarcoglycan), LGMD2F (δ sarcoglycan), LGMD2G (telethonin), LGMD2H (TRIM32), LGMD2I (FKRP), LGMD2J (titin), LGMD2K (POMT1), LGMD2L (anoctamin 5), LGMD2M (fukutin), LGMD2N (POMT2), LGMD2O (POMTnG1), LGMD2P (dystroglycan), LGMD2Q (plectin), LGMD2R (desmin), LGMD2S (TRAPPC11), LGMD2T (GMPPB), LGMD2U (ISPD), LGMD2V (Glucosidase, alpha ), LGMD2W (PINCH2).
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                cpdd
                Cadernos de Pós-Graduação em Distúrbios do Desenvolvimento
                Cad. Pós-Grad. Distúrb. Desenvolv.
                Universidade Presbiteriana Mackenzie (São Paulo, SP, Brazil )
                1519-0307
                1809-4139
                December 2017
                : 17
                : 2
                : 65-78
                Affiliations
                [5] orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina
                [1] orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina
                [4] orgnameUniversidade Católica de São Paulo
                [3] orgnameUniversidade Ibirapuera
                [2] orgnameUniversidade Ibirapuera
                Article
                S1519-03072017000200007
                10.5935/cadernosdisturbios.v17n2p65-78
                752e5a11-21fc-4488-898c-53065f5a35b7

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 10 October 2017
                : 28 November 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 59, Pages: 14
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                SciELO Periódicos Eletrônicos em Psicologia


                distrofia muscular de cinturas,distrofia muscular do cíngulo dos membros,distrofias musculares,doenças musculares,distrofia muscular distal,miopatias distais,reabilitação,fisioterapia,modalidades de fisioterapia,enfermedades musculares,miopatias distales,rehabilitación,muscular dystrophies,limb-girdle,muscular diseases,distal myopathies,rehabilitation,physiotherapy,physical therapy specialty,physical therapy modalities

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