Laryngeal dystonia in xeroderma pigmentosum

We report on three patients with xeroderma pigmentosum group A (XPA) who showed laryngeal stridor in their 20s. The stridor appeared on feeding and emotional excitation, was exaggerated during respiratory infection and was life-threatening on some occasions. Adduction of the vocal cords during inspiration, observed by laryngoscopy, confirmed laryngeal dystonia in all cases. This type of focal dystonia may be characteristic in XPA and requires special attention during the management of these patients to avoid serious complications.     

Excellent response of basal cell carcinomas and pigmentary changes in xeroderma pigmentosum to imiquimod 5% cream

Xeroderma pigmentosum (XP) is an autosomal recessive disease in which patients have a 1000-fold increased risk of developing cutaneous neoplasms. Management of patients with XP is a difficult therapeutic challenge as they usually present with many cutaneous malignancies and continue to form skin tumours at a high rate. We describe a 19-year-old woman with XP who had been previously treated with many different therapeutic approaches. She had an excellent clinical response of her multiple small pigmented basal cell carcinomas and pigmentary changes using imiquimod 5% cream with only minor side-effects.     

干扰素对丝裂霉素C诱发的姊妹染色单体互换和紫外线诱发的DNA修复合成影响的研究

本文报告了关于干扰素对丝裂霉素C诱发的姊妹染色单体互换频率和(或)对紫外线诱发的非合成期DNA合成的影响的研究。结果发现,4例正常人和3例着色性干皮病病人的淋巴细胞经干扰素处理后再用丝裂霉素C所诱发的姊妹染色单体互换频率显著地低于对照组,而2例正常人和2例着色性干皮病病人的淋巴细胞经干扰素处理后再用紫外线所诱发的非合成期DNA合成水平则与对照组相似。作者认为,干素扰可能具有抗变效应。     

Cutaneous angiosarcoma in a patient with xeroderma pigmentosum

Xeroderma pigmentosum (XP) is a DNA repair defect syndrome associated with an increased risk to developing skin neoplasms on sun-exposed cutaneous surfaces. This report describes the case of a 15-year-old boy with XP who developed cutaneous angiosarcoma. The patient was cured with surgery alone, despite incomplete resection, and he is alive without evidence of disease 40 months after diagnosis. It is the fourth reported case—and the third in pediatric age—of the association of XP with this soft part sarcoma.     

Ocular manifestations in the inherited DNA repair disorders

Deoxyribonucleic acid (DNA) repair is a fundamental process designed to keep the integrity of genomic DNA that is continuously challenged by intrinsic or environmental induced alterations. Numerous genes involved in DNA repair have been cloned and are involved in different DNA repair pathways: base excision repair, nucleotide excision repair, mismatch repair, DNA recombination. Inherited conditions due to mutations in DNA repair genes include mainly: xeroderma pigmentosum, Cockayne syndrome, Trichothiodystrophy, Bloom syndrome, Rothmund-Thomson syndrome, and Werner syndrome. Minor to major ocular manifestations occur in these syndromes. For example, eyelid skin cancers in xeroderma pigmentosum and retinal dystrophy in Cockayne syndrome are major features of these syndromes. This review focuses on the DNA repair pathways, the general and ocular features of the related syndromes, the laboratory tests useful for diagnosis, and the general processes implied with DNA repair (ultraviolet sensitivity, carcinogenesis, apoptosis, oxydative stress, and premature aging).     

The role of nucleotide excision repair and loss of p53 in mutagenesis and carcinogenesis

Xpa mice, which have a completely defective nucleotide excision repair (NER) pathway, have a cancer predisposition when exposed to several carcinogens. NER is one of the major DNA repair pathways in the mammalian cell, and is involved in the removal of a wide variety of DNA lesions, such as those induced by UV light, bulky adducts and DNA crosslinks. To study the role of NER in both mutagenesis and carcinogenesis, NER-defective Xpa mice were crossed with transgenic lacZ/pUR288 mutation-indicator mice. Furthermore, the relationship between the tumor suppressor gene p53, NER, induction of mutations and tumor development was studied in Xpa/p53^+/−/lacZ triple transgenic mice. Using the genotoxic carcinogens benzo[a]pyrene (B[a]P) and 2-acetylaminofluorene (2-AAF), it is shown that mutations in the inactive (non-transcribed) lacZ reporter gene reliably predict cancer risk. In tissues at risk for the development of tumors, increased mutant frequencies could be found at much earlier stages. A heterozygous loss of p53 appears to act synergistically to a NER defect, both in mutation- as well as tumor-induction. Surprisingly, however, the effect of a heterozygous loss of p53 appeared to be tissue-restricted, being apparent in the bladder but absent in liver and spleen.