Refine
Document Type
- Article (1)
- Contribution to a Periodical (1)
- Magister's Thesis (1)
Has Fulltext
- yes (3)
Is part of the Bibliography
- no (3)
Keywords
- Depressionstherapie (1)
- Diskurs (1)
- Wissen (1)
- explizites/implizites Wissen (1)
- klinische Depressionstherapie (1)
- strategischer Synkretismus (1)
Institute
- Kulturwissenschaften (1)
- Medizin (1)
- Präsidium (1)
- Sprach- und Kulturwissenschaften (1)
An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease
(2019)
Aims: Pompe disease is caused by pathogenic mutations in the alpha 1,4‐glucosidase (GAA) gene and in patients with late onset Pome disease (LOPD), genotype–phenotype correlations are unpredictable. Skeletal muscle pathology includes glycogen accumulation and altered autophagy of various degrees. A correlation of the muscle morphology with clinical features and the genetic background in GAA may contribute to the understanding of the phenotypic variability.
Methods: Muscle biopsies taken before enzyme replacement therapy were analysed from 53 patients with LOPD. On resin sections, glycogen accumulation, fibrosis, autophagic vacuoles and the degree of muscle damage (morphology‐score) were analysed and the results were compared with clinical findings. Additional autophagy markers microtubule‐associated protein 1A/1B‐light chain 3, p62 and Bcl2‐associated athanogene 3 were analysed on cryosections from 22 LOPD biopsies.
Results: The myopathology showed a high variability with, in most patients, a moderate glycogen accumulation and a low morphology‐score. High morphology‐scores were associated with increased fibrosis and autophagy highlighting the role of autophagy in severe stages of skeletal muscle damage. The morphology‐score did not correlate with the patient's age at biopsy, disease duration, nor with the residual GAA enzyme activity or creatine‐kinase levels. In 37 patients with LOPD, genetic analysis identified the most frequent mutation, c.‐32‐13T>G, in 95%, most commonly in combination with c.525delT (19%). No significant correlation was found between the different GAA genotypes and muscle morphology type.
Conclusions: Muscle morphology in LOPD patients shows a high variability with, in most cases, moderate pathology. Increased pathology is associated with more fibrosis and autophagy.
Die vorliegende Arbeit betrachtet aus der Perspektive der Kulturanthropologie, auf welchen Wissensprozessen die Erklärungsmodelle von Psychiatern im Bezug auf die klinische Depressionstherapie beruhen. Die Elemente, aus denen das Wissenskonzept eines Arztes zusammengesetzt ist, müssen sich im praktischen Handeln, also in der therapeutischen Situation mit dem Patienten, bewähren. Dabei ist weitaus mehr notwendig als das Verordnen einer Pille, die das chemische Ungleichgewicht im Gehirn reguliert. Anhand derklinischen Depressionstherapie soll deutlich werden, auf welche Weise Psychiater in ihrer Praxis auf explizites und implizites Wissen zurückgreifen und dieses in ihr Erklärungsmodell integrieren, wann ihr Erfahrungswissen relevant wird und wie damit Handeln auch angesichts von Unsicherheiten oder widersprüchlichen Diskursen in der psychiatrischen Profession möglich ist.