{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:57:55Z","timestamp":1791496675965,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,2]],"date-time":"2017-12-02T00:00:00Z","timestamp":1512172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000765","name":"University College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000765","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Mutations in the small heat\u2010shock protein 22 gene (<jats:italic><jats:styled-content style=\"fixed-case\">HSPB<\/jats:styled-content>8<\/jats:italic>) have been associated with Charcot\u2010Marie\u2010Tooth disease type 2L, distal hereditary motor neuropathy (dHMN) type <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>a and, more recently, distal myopathy\/myofibrillar myopathy (<jats:styled-content style=\"fixed-case\">MFM<\/jats:styled-content>) with protein aggregates and <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 inclusions. The aim was to report a novel family with <jats:italic><jats:styled-content style=\"fixed-case\">HSPB<\/jats:styled-content>8<\/jats:italic><jats:sup>K141E<\/jats:sup>\u2010related dHMN\/<jats:styled-content style=\"fixed-case\">MFM<\/jats:styled-content> and to investigate, in a patient muscle biopsy, whether the presence of protein aggregates was paralleled by altered <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed clinical and genetic data. We assessed <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 expression by <jats:styled-content style=\"fixed-case\">qPCR<\/jats:styled-content> and alternative splicing of four previously validated direct <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 target exons in four genes by reverse transcriptase\u2013polymerase chain reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The triplets and their mother presented in the second to third decade of life with progressive weakness affecting distal and proximal lower limb and truncal muscles. Nerve conduction study showed a motor axonal neuropathy. The clinical features, moderately raised creatin kinase levels, selective pattern of muscle involvement on magnetic resonance imaging and pathological changes on muscle biopsy, including the presence of protein aggregates, supported the diagnosis of a contemporary primary muscle involvement. In affected muscle tissue we observed a consistent alteration of <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043\u2010dependent splicing in three out of four <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043\u2010target transcripts (<jats:italic><jats:styled-content style=\"fixed-case\">POLDIP<\/jats:styled-content>3<\/jats:italic>,<jats:italic> <jats:styled-content style=\"fixed-case\">FNIP<\/jats:styled-content>1<\/jats:italic> and <jats:italic><jats:styled-content style=\"fixed-case\">BRD<\/jats:styled-content>8<\/jats:italic>), as well as a significant decrease of <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 <jats:styled-content style=\"fixed-case\">mRNA<\/jats:styled-content> levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study confirmed the role of mutated <jats:styled-content style=\"fixed-case\">HSPB<\/jats:styled-content>8 as a cause of a combined neuromuscular disorder encompassing dHMN and <jats:styled-content style=\"fixed-case\">MFM<\/jats:styled-content> with protein aggregates. We identified impaired <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> metabolism, secondary to <jats:styled-content style=\"fixed-case\">TDP<\/jats:styled-content>\u201043 loss of function, as a possible pathological mechanism of <jats:italic><jats:styled-content style=\"fixed-case\">HSPB<\/jats:styled-content>8<\/jats:italic><jats:sup>K141E<\/jats:sup> toxicity, leading to muscle and nerve degeneration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13478","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T17:06:40Z","timestamp":1507914400000},"page":"154-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Altered <scp>TDP<\/scp>\u201043\u2010dependent splicing in <i><scp>HSPB<\/scp>8<\/i>\u2010related distal hereditary motor neuropathy and myofibrillar myopathy"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2208-5311","authenticated-orcid":false,"given":"A.","family":"Cortese","sequence":"first","affiliation":[{"name":"C. 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