Genetica molecolare dell'autismo: studi di associazione ed analisi di geni candidati

Autism is a neurodevelpmental disorder characterized by impaired verbal communication, limited reciprocal social interaction, restricted interests and repetitive behaviours. Twin and family studies indicate a large genetic contribution to ASDs (Autism Spectrum Disorders). During my Ph.D. I have been involved in several projects in which I used different genetic approaches in order to identify susceptibility genes in autism on chromosomes 2, 7 and X: 1)High-density SNP association and CNV analysis of two Autism Susceptibility Loci. The International Molecular Genetic Study of Autism Consortium (IMGSAC) previously identified linkage loci on chromosomes 7 and 2, termed AUTS1 and AUTS5, respectively. In this study, we evaluated the patterns of linkage disequilibrium (LD) and the distribution of haplotype blocks, utilising data from the HapMap project, across the two strongest peaks of linkage on chromosome 2 and 7. More than 3000 SNPs have been selected in each locus in all known genes, as well as SNPs in non-genic highly conserved sequences. All markers have been genotyped to perform a high-density association analysis and to explore copy number variation within these regions. The study sample consisted of 127 and 126 multiplex families, showing linkage to the AUTS1 and AUTS5 regions, respectively, and 188 gender-matched controls. Association and CNV analysis implicated several new genes, including IMMP2L and DOCK4 on chromosome 7 and ZNF533 and NOSTRIN on the chromosome 2. Particularly, my contribution to this project focused on the characterization of the best candidate gene in each locus: On the AUTS5 locus I carried out a transcript study of ZNF533 in different human tissues to verify which isoforms and start exons were expressed. High transcript variability and a new exon, never described before, has been identified in this analysis. Furthermore, I selected 31 probands for the risk haplotype and performed a mutation screen of all known exons in order to identify novel coding variants associated to autism. On the AUTS1 locus a duplication was detected in one multiplex family that was transmitted from father to an affected son. This duplication interrupts two genes: IMMP2L and DOCK4 and warranted further analysis. Thus, I performed a screening of the cohort of IMGSAC collection (285 multiplex families), using a QMPSF assay (Quantitative Multiplex PCR of Short fluorescent Fragments) to analyse if CNVs in this genic region segregate with autism phenotype and compare their frequency with a sample of 475 UK controls. Evidence for a role of DOCK4 in autism susceptibility was supported by independent replication of association at rs2217262 and the finding of a deletion segregating in a sib-pair family. 2)Analysis of X chromosome inactivation. Skewed X chromosome inactivation (XCI) is observed in females carrying gene mutations involved in several X-linked syndromes. We aimed to estimate the role of X-linked genes in ASD susceptibility by ascertaining the XCI pattern in a sample of 543 informative mothers of children with ASD and in a sample of 164 affected girls. The study sample included families from different european consortia. I analysed the XCI inactivation pattern in a sample of italian mothers from singletons families with ASD and also a control groups (144 adult females and 40 young females). We observed no significant excess of skewed XCI in families with ASD. Interestingly, two mothers and one girl carrying known mutations in X-linked genes (NLGN3, ATRX, MECP2) showed highly skewed XCI, suggesting that ascertainment of XCI could reveal families with X-linked mutations. Linkage analysis was carried out in the subgroup of multiplex families with skewed XCI (≥80:20) and a modest increased allele sharing was obtained in the Xq27-Xq28 region, with a peak Z score of 1.75 close to rs719489. In this region FMR1 and MECP2 have been associated in some cases with austim and therefore represent candidates for the disorder. I performed a mutation screen of MECP2 in 33 unrelated probands from IMGSAC and italian families, showing XCI skewness. Recently, Xq28 duplications including MECP2, have been identified in families with MR, with asymptomatic carrier females showing extreme (>85%) skewing of XCI. For these reason I used the sample of probands from X-skewed families to perform CNV analysis by Real-time quantitative PCR. No duplications have been found in our sample. I have also confirmed all data using as alternative method the MLPA assay (Multiplex Ligation dependent Probe Amplification). 3)ASMT as functional candidate gene for autism. Recently, a possible involvement of the acetylserotonin O-methyltransferase (ASMT) gene in susceptibility to ASDs has been reported: mutation screening of the ASMT gene in 250 individuals from the PARIS collection revealed several rare variants with a likely functional role; Moreover, significant association was reported for two SNPs (rs4446909 and rs5989681) located in one of the two alternative promoters of the gene. To further investigate these findings, I carried out a replication study using a sample of 263 affected individuals from the IMGSAC collection and 390 control individuals. Several rare mutations were identified, including the splice site mutation IVS5+2T>C and the L326F substitution previously reported by Melke et al (2007), but the same rare variants have been found also in control individuals in our study. Interestingly, a new R319X stop mutation was found in a single autism proband of Italian origin and is absent from the entire control sample. Furthermore, no replication has been found in our case-control study typing the SNPs on the ASMT promoter B.

Characterization of the genetic control of fruit flesh color in peach

The analysis of a carotenoid cleavage dioxygenase gene in a pool of peach cultivars revealed the existence of a functional allele (W1), associated with the white flesh trait, and three independent mutations associated with the yellow phenotype: a 2 bp insertion within a repetitive sequence (y1), a large transposable element within the intron (y2) and a single base substitution generating a premature stop codon (y3). Based on these evidences, the yellow flesh phenotype seems to have arisen from at least three independent mutational events.

Riabilitazione e valutazione di pazienti con deficit neurologici mediante l'utilizzo di realtà virtuale, feedback aumentati, sensori inerziali e tecnologie video a basso costo.

La neuroriabilitazione è un processo attraverso cui individui affetti da patologie neurologiche mirano al conseguimento di un recupero completo o alla realizzazione del loro potenziale ottimale benessere fisico, mentale e sociale. Elementi essenziali per una riabilitazione efficace sono: una valutazione clinica da parte di un team multidisciplinare, un programma riabilitativo mirato e la valutazione dei risultati conseguiti mediante misure scientifiche e clinicamente appropriate. Obiettivo principale di questa tesi è stato sviluppare metodi e strumenti quantitativi per il trattamento e la valutazione motoria di pazienti neurologici. I trattamenti riabilitativi convenzionali richiedono a pazienti neurologici l’esecuzione di esercizi ripetitivi, diminuendo la loro motivazione. La realtà virtuale e i feedback sono in grado di coinvolgerli nel trattamento, permettendo ripetibilità e standardizzazione dei protocolli. È stato sviluppato e valutato uno strumento basato su feedback aumentati per il controllo del tronco. Inoltre, la realtà virtuale permette l’individualizzare il trattamento in base alle esigenze del paziente. Un’applicazione virtuale per la riabilitazione del cammino è stata sviluppata e testata durante un training su pazienti di sclerosi multipla, valutandone fattibilità e accettazione e dimostrando l'efficacia del trattamento. La valutazione quantitativa delle capacità motorie dei pazienti viene effettuata utilizzando sistemi di motion capture. Essendo il loro uso nella pratica clinica limitato, una metodologia per valutare l’oscillazione delle braccia in soggetti parkinsoniani basata su sensori inerziali è stata proposta. Questi sono piccoli, accurati e flessibili ma accumulano errori durante lunghe misurazioni. È stato affrontato questo problema e i risultati suggeriscono che, se il sensore è sul piede e le accelerazioni sono integrate iniziando dalla fase di mid stance, l’errore e le sue conseguenze nella determinazione dei parametri spaziali sono contenuti. Infine, è stata presentata una validazione del Kinect per il tracking del cammino in ambiente virtuale. Risultati preliminari consentono di definire il campo di utilizzo del sensore in riabilitazione.

The role of medial parieto occipital cortex in visuospatial attention and reach planning: electrophysiological studies in human and non-human primates

We usually perform actions in a dynamic environment and changes in the location of a target for an upcoming action require both covert shifts of attention and motor planning update. In this study we tested whether, similarly to oculomotor areas that provide signals for overt and covert attention shifts, covert attention shifts modulate activity in cortical area V6A, which provides a bridge between visual signals and arm-motor control. We performed single cell recordings in monkeys trained to fixate straight-ahead while shifting attention outward to a peripheral cue and inward again to the fixation point. We found that neurons in V6A are influenced by spatial attention demonstrating that visual, motor, and attentional responses can occur in combination in single neurons of V6A. This modulation in an area primarily involved in visuo-motor transformation for reaching suggests that also reach-related regions could directly contribute in the shifts of spatial attention necessary to plan and control goal-directed arm movements. Moreover, to test whether V6A is causally involved in these processes, we have performed a human study using on-line repetitive transcranial magnetic stimulation over the putative human V6A (pV6A) during an attention and a reaching task requiring covert shifts of attention and reaching movements towards cued targets in space. We demonstrate that the pV6A is causally involved in attention reorienting to target detection and that this process interferes with the execution of reaching movements towards unattended targets. The current findings suggest the direct involvement of the action-related dorso-medial visual stream in attentional processes, and a more specific role of V6A in attention reorienting. Therefore, we propose that attention signals are used by the V6A to rapidly update the current motor plan or the ongoing action when a behaviorally relevant object unexpectedly appears at an unattended location.

Code synchronization and interference management techniques for satellite navigation and communications

This thesis collects the outcomes of a Ph.D. course in Telecommunications engineering and it is focused on enabling techniques for Spread Spectrum (SS) navigation and communication satellite systems. It provides innovations for both interference management and code synchronization techniques. These two aspects are critical for modern navigation and communication systems and constitute the common denominator of the work. The thesis is organized in two parts: the former deals with interference management. We have proposed a novel technique for the enhancement of the sensitivity level of an advanced interference detection and localization system operating in the Global Navigation Satellite System (GNSS) bands, which allows the identification of interfering signals received with power even lower than the GNSS signals. Moreover, we have introduced an effective cancellation technique for signals transmitted by jammers, exploiting their repetitive characteristics, which strongly reduces the interference level at the receiver. The second part, deals with code synchronization. More in detail, we have designed the code synchronization circuit for a Telemetry, Tracking and Control system operating during the Launch and Early Orbit Phase; the proposed solution allows to cope with the very large frequency uncertainty and dynamics characterizing this scenario, and performs the estimation of the code epoch, of the carrier frequency and of the carrier frequency variation rate. Furthermore, considering a generic pair of circuits performing code acquisition, we have proposed a comprehensive framework for the design and the analysis of the optimal cooperation procedure, which minimizes the time required to accomplish synchronization. The study results particularly interesting since it enables the reduction of the code acquisition time without increasing the computational complexity. Finally, considering a network of collaborating navigation receivers, we have proposed an innovative cooperative code acquisition scheme, which allows exploit the shared code epoch information between neighbor nodes, according to the Peer-to-Peer paradigm.

Fattori di rischio biomeccanico e valori limite di esposizione (TLV-ACGIH®) nell’ambito dello studio di coorte della sindrome del tunnel carpale occupazionale

OBIETTIVI: Per esplorare il contributo dei fattori di rischio biomeccanico, ripetitività (hand activity level – HAL) e forza manuale (peak force - PF), nell’insorgenza della sindrome del tunnel carpale (STC), abbiamo studiato un’ampia coorte di lavoratori dell’industria, utilizzando come riferimento il valore limite di soglia (TLV©) dell’American Conference of Governmental Industrial Hygienists (ACGIH). METODI: La coorte è stata osservata dal 2000 al 2011. Abbiamo classificato l’esposizione professionale rispetto al limite di azione (AL) e al TLV dell’ACGIH in: “accettabile” (sotto AL), “intermedia” (tra AL e TLV) e “inaccettabile” (sopra TLV). Abbiamo considerato due definizioni di caso: 1) sintomi di STC; 2) sintomi e positività allo studio di conduzione nervosa (SCN). Abbiamo applicato modelli di regressione di Poisson aggiustati per sesso, età, indice di massa corporea e presenza di patologie predisponenti la malattia. RISULTATI: Nell’intera coorte (1710 lavoratori) abbiamo trovato un tasso di incidenza (IR) di sintomi di STC di 4.1 per 100 anni-persona; un IR di STC confermata dallo SCN di 1.3 per 100 anni-persona. Gli esposti “sopra TLV” presentano un rischio di sviluppare sintomi di STC di 1.76 rispetto agli esposti “sotto AL”. Un andamento simile è emerso per la seconda definizione di caso [incidence rate ratios (IRR) “sopra TLV”, 1.37 (intervallo di confidenza al 95% (IC95%) 0.84–2.23)]. Gli esposti a “carico intermedio” risultano a maggior rischio per la STC [IRR per i sintomi, 3.31 (IC95% 2.39–4.59); IRR per sintomi e SCN positivo, 2.56 (IC95% 1.47–4.43)]. Abbiamo osservato una maggior forza di associazione tra HAL e la STC. CONCLUSIONI: Abbiamo trovato un aumento di rischio di sviluppare la STC all’aumentare del carico biomeccanico: l’aumento di rischio osservato già per gli esposti a “carico intermedio” suggerisce che gli attuali valori limite potrebbero non essere sufficientemente protettivi per alcuni lavoratori. Interventi di prevenzione vanno orientati verso attività manuali ripetitive.

Fattori eziologici della Sindrome del Tunnel Carpale: una revisione sistematica con meta-analisi degli studi analitici

OBIETTIVO: sintetizzare le evidenze disponibili sulla relazione tra i fattori di rischio (personali e lavorativi) e l’insorgenza della Sindrome del Tunnel Carpale (STC). METODI: è stata condotta una revisione sistematica della letteratura su database elettronici considerando gli studi caso-controllo e di coorte. Abbiamo valutato la qualità del reporting degli studi con la checklist STROBE. Le stime studio-specifiche sono state espresse come OR (IC95%) e combinate con una meta-analisi condotta con un modello a effetti casuali. La presenza di eventuali bias di pubblicazione è stata valutata osservando l’asimmetria del funnel plot e con il test di Egger. RISULTATI: Sono stati selezionati 29 studi di cui 19 inseriti nella meta-analisi: 13 studi caso-controllo e 6 di coorte. La meta-analisi ha mostrato un aumento significativo di casi di STC tra i soggetti obesi sia negli studi caso-controllo [OR 2,4 (1,9-3,1); I(2)=70,7%] che in quelli di coorte [OR 2,0 (1,6-2,7); I(2)=0%]. L'eterogeneità totale era significativa (I(2)=59,6%). Risultati simili si sono ottenuti per i diabetici e soggetti affetti da malattie della tiroide. L’esposizione al fumo non era associata alla STC sia negli studi caso-controllo [OR 0,7 (0,4-1,1); I(2)=83,2%] che di coorte [OR 0,8 (0,6-1,2); I(2)=45,8%]. A causa delle molteplici modalità di valutazione non è stato possibile calcolare una stima combinata delle esposizioni professionali con tecniche meta-analitiche. Dalla revisione, è risultato che STC è associata con: esposizione a vibrazioni, movimenti ripetitivi e posture incongrue di mano-polso. CONCLUSIONI: I risultati della revisione sistematica confermano le evidenze dell'esistenza di un'associazione tra fattori di rischio personali e STC. Nonostante la diversa qualità dei dati sull'esposizione e le differenze degli effetti dei disegni di studio, i nostri risultati indicano elementi di prova sufficienti di un legame tra fattori di rischio professionali e STC. La misurazione dell'esposizione soprattutto per i fattori di rischio professionali, è un obiettivo necessario per studi futuri.

Toxoplasma gondii in animals and the environment

Toxoplasma gondii is an obligate intracellular parasite capable of infecting virtually all warm-blooded species, including humans, but cats are the only definitive hosts. Humans or animals acquire T. gondii infection by ingesting food or water contaminated with sporulated oocysts or by ingesting tissue cysts containing bradyzoites. Toxoplasmosis has the highest human incidence among zoonotic parasitic diseases, but it is still considered an underreported zoonosis. The importance of T. gondii primary infection in livestock is related to the ability of the parasite to produce tissue cysts in infected animals, which may represent important sources of infection for humans. Consumption of undercooked mutton and pork are considered important sources of human Toxoplasma gondii. The first aim of this thesis was to develop a rapid and sensitive in- house indirect ELISA for the detection of antibodies against T. gondii in sheep sera. ROC-curve analysis showed high discriminatory power (AUC=0.999) and high sensitivity (99.4%) and specificity (99.8%) of the method. The ELISA was used to test a batch of sheep sera (375) collected in the Forli-Cesena district. The overall prevalence was estimated at 41.9% demonstrating that T. gondii infection is widely distributed in sheep reared in Forli-Cesena district. Since the epidemiological impact of waterborne transmission route of T.gondii to humans is now thought to be more significant than previously believed, the second aim of the thesis was to evaluate PCR based methods for detecting T. gondii DNA in raw and finished drinking water samples collected in Scotland. Samples were tested using a quantitative PCR on 529 bp repetitive elements. Only one raw water sample (0.3%), out of the 358 examined, tested T. gondii positive demonstrating that there is no evidence that tap water is a source of Toxoplasma infection in Scotland.

Emotional engagement and brain potentials: repetition in affective picture processing

The present thesis addresses several experimental questions regarding the nature of the processes underlying the larger centro-parietal Late Positive Potential (LPP) measured during the viewing of emotional(both pleasant and unpleasant) compared to neutral pictures. During a passive viewing condition, this modulatory difference is significantly reduced with picture repetition, but it does not completely habituate even after a massive repetition of the same picture exemplar. In order to investigate the obligatory nature of the affective modulation of the LPP, in Study 1 we introduced a competing task during repetitive exposure of affective pictures. Picture repetition occurred in a passive viewing context or during a categorization task, in which pictures depicting any mean of transportation were presented as targets, and repeated pictures (affectively engaging images) served as distractor stimuli. Results indicated that the impact of repetition on the LPP affective modulation was very similar between the passive and the task contexts, indicating that the affective processing of visual stimuli reflects an obligatory process that occurs despite participants were engaged in a categorization task. In study 2 we assessed whether the decrease of the LPP affective modulation persists over time, by presenting in day 2 the same set of pictures that were massively repeated in day 1. Results indicated that the reduction of the emotional modulation of the LPP to repeated pictures persisted even after 1-day interval, suggesting a contribution of long-term memory processes on the affective habituation of the LPP. Taken together, the data provide new information regarding the processes underlying the affective modulation of the late positive potential.

Characterization of the Caspr2 and NLGN2 ligands: a proteomic and biochemical approach

Autism Spectrum Disorder (ASD) is a range of early-onset conditions classified as neurodevelopmental disorders, characterized by deficits in social interactions and communication, as well as by restricted interest and repetitive behaviors. Among the proteins associated with this spectrum of disease there are Caspr2, α-NRXN1, NLGN1-4. Caspr2 is involved in the clustering of K+ channels at the juxtaparanodes, where it is proposed to bind TAG-1. Recent works reported a synaptic localization of Caspr2, but little is know on its role in this compartment. NRXNs and their ligand NLGNs, instead, have a well-defined role in the formation and maintenance of synapses. Among the neuroligins, NLGN2 binds NRXNs with the lowest affinity, suggesting that it could have other not yet characterized ligands. The aim of this work was to better characterize the binding of Caspr2 to TAG-1 and to identify new potential binding partner for Caspr2 and NLGN2. Unexpectedly, using Isothermal Titration Calorimetry and co-immunoprecipitation experiments the direct association of the first two proteins could not be verified and the results indicate that the first evidences reporting it were biased by false-positive artifacts. These findings, together with the uncharacterized synaptic localization of Caspr2, made the identification of new potential binding partners for this protein necessary. To find new proteins that associate with Caspr2 and NLGN2, affinity chromatography in tandem with mass spectrometry experiments were performed. Interestingly, about 25 new potential partners were found for these two proteins and NLGN1, that was originally included as a control: 5 of those, namely SFRP1, CLU, APOE, CNTN1 and TNR, were selected for further investigations. Only the association of CLU to NLGN2 was confirmed. In the future, screenings of the remaining candidates have to be carried out and the functional role for the proposed NLGN2-CLU complex has to be studied.