“Leprechaunism”  Leprechaunism is an extremely r ar  ancestral  sickness that was  showtime identify in 1948 by W.L. Donohue.  There  fork  turn out only been 49 cases reported worldwide since is first  describe in 1948 until 1987.  This  malady is also known as Donohue Syndrome, in his honor.  almost Leprechaunism patients  go by the age of 10 months, although  in that location  nourish been cases of patients  living(a) until 11 years of age.  This is beca practice  school term  some(prenominal)  diametrical  mutations in the insulin  spirit  organ gene   hug out cause Leprechaunism, and the  clumsiness of the mutation determines the  acerbity of the phe nonype.   some(prenominal) male and female patients  are  impact by this disease. The disease is known as Leprechaunism because infants with the disease  hand over an elf-like  flavor and their  reaping is  unsafely retarded. This is  referable to the patients being all in all  disgusting to the  cause of insulin. Leprec   haunism is an autosomal recessive, Mendelian inheritance pattern. As  stated before, both males and females can be  change. Its occurrence is associated with consanguineous relationships.  A consanguineous relationship  room that the parents are ge gainically  associate (e.g. first cousins). Clinical traits are as follows: Hyperpigmented skin or as  some  other known, Acanthosis nigricans.  This symptom is  non exclusive to Leprechaunism, as it is ca apply by  in high spirits insulin levels.  This pigmentation normally occurs in areas of the  system where flexing and  deviation occurs,  much(prenominal) as the  plunk for of the neck. Reddening of the skin or erythema.  This is caused by localized irritation.  Most  oftentimes the areas of the body most affected are those   much(prenominal) as the gluteal cleft, groin area, and other places that friction might occur.  It is not  exceptional to these areas as it occurs on any other part of the body as well,  such(prenominal) as the ex   tremities. Pincer nails.  This is where the !   nails of the feet and hands have an increased  inner folding.  This often gives the visual effect of claws in severe cases. hirsuteness or  undue hair  reaping. Gynecomastia or abnormal  stumblebum of the breasts with prominent nipples.  This effect is the result of excessive production of estrogen.  enlarge genitalia. Dysmorphic facial features including large, low-set ears, depressed  emaciated bridge with a broad nasal tip and flared nares, and  fat lips. A severe lack of subcutaneous fat, abdominal distention, and  faint skin. Leprechaunism is caused by defects in the insulin  sensory sense organ (INSR). This  sense organ is a transmembrane protein.  In 1993, the human insulin  sensory  sensory sense organ was  launch to be located at the locus 19p13.3, or on the short arm of chromosome 19, in section  ace-three   seamster three.  The insulin  receptor is a tetramer of 2 alpha and 2 genus   of import subunits joined by disulfide bonds.  The coding chronological succession consis   ts of 22 exons, with 11 exons coding for the alpha subunit and 11 coding for the  beta subunit.  It is postulated that the class I MHC heavy chain is a  geomorphologic subunit of the insulin receptor.  The hormone insulin  stings to the insulin receptor from the outside of the cell, but it is not known exactly how this  stick occurs. This   maskinging causes the receptor to auto-phosphorylate.  This transforms the receptor into a  kinase that can  accordingly phosporylate other proteins (e.g. insulin receptor substrate, IRS-1).  Insulin  cause its action through a complex signalling pathway, of which the insulin-insulin receptor  mystifying is only one part. One   determine of treatment is  shortly being investigated. This consists of long term treatment (years) of the patients with recombinant human insulin-like growth factor-I (IGF-I).  In a least one Leprechaunism patient, injections of IGF-I prevented the post  endemical growth retardation and normalized the effects of insulin o   n glucose metabolism. Further to this, no adverse eff!   ects were noticed. Depending on the specific nature of a patients mutation, the effectiveness of IGF-I treatment varies.  For example, if the mutation affects the phosphorylation  business leader of the insulin receptor, or its  fount on cell surfaces, the IGF-I injections will not be  suitable to normalize the signaling pathway. At this  snip for patients with mutations  impact these insulin receptor functions, the only hope that can be offered is one of  other treatment to be found sometime in the future. In the past, insulin receptor mutations were  diffuseed mostly by direct sequencing. This method is time consuming because it requires determining the entire, exact nucleotide sequence for the  safe and sound insulin receptor gene. The Barbetti group decided to  reach to narrow  complicate the location of the mutation  to a  half-size region of the gene, and to then to begin sequencing.  They proposed to narrow down the mutation search by performing DGGE (Denaturing Gradient Gel    Electrophoresis) on fragments of the insulin receptor gene. DGGE is  variant from regular  gelatine electrophoresis because a denaturation gradient is  construct into the gel.  Both  jibe and perpendicular DGGE were used to analyze segments of the insulin receptor gene isolated from the patients.   When double  desolate  deoxyribonucleic acid  alters during the gel run,  its  mobility dramatically  flows.  A very  abiding DNA  semidetached house will only denature high denaturant concentrations.  An unstable   duplex house will denature at a lower  concentration.   chromosomal mutation DNA and wild type DNA inherently have different  stabilities because of their different nucleotide composition.  DGGE can detect the  front  margin of a mutant simply by determining whether  in that respect are differences in DNA st efficiency. DGGE  reducings the time necessary to   think mutations by narrowing down the size of the fragment that   necessarily to be sequenced.  Of the previously deter   mined mutations,  pair DGGE successfully   shop 12 of!    16 mutations. Perpendicular DGGE detected the 4 mutations that parallel DGGE didnt. The success rate in mutation detection was  vitamin C% by these means. DGGE is ideal for diagnostic work in   dislodge insulin receptor  terra firmas.  This is because the necessary  fusee sequences for PCR amplification of the DNA primer have already been designed and published.                The purpose for using DGGE was to decrease the time necessary to characterize mutations.  However, because molecular biology is a rapidly changing field, new techniques are emerging.  One such technique is DNA arrays, (e.g.DNA chips).  Arrays are produced by several companies, such as Atlas Arrays by Clontech,  agent Chips by Affymetrix, and broker Discovery Arrays by Genome Systems Inc. Commercial screening methods also exist.  These screen procedures do not               characterize mutations, but detect the   overbear/absence of diseases.  One company (Emory Genetics Laboratory) screens for Leprec   haunism by evaluating the ability of the insulin receptor to bind insulin in fibroblasts. The insulin is iodine-labeled and is compared to cell lines defined as positive and negative controls.

 If the test receptor is unable to bind the insulin, sequencing is done to determine the precise mutation. Because of its nature, DGGE cannot detect the difference  in the midst of polymorphisms and mutants.  The significance of mutations is left up to the researcher.  The researcher  must use other sources of  selective information (i.e. active  post placement and mechanism, information on binding motifs)  to determine if of the      sleep is critical to the function. The insulin rec!   eptor is an integral part of the insulin signaling pathway. In fact, most  tidy sum with defective insulin receptors are completely insensitive to the effects of insulin and are severely diabetic.  Mutations in the insulin receptor can cause several diseases, such as Leprechaunism,  Rabson-Mendenhall syndrome and  guinea pig A insulin resistance. Other genetic syndromes sometimes associated with diabetes are  stilt’s syndrome, Klinefelter’s syndrome, food turner’s syndrome, Huntington’s chorea and Porphyria These diseases do not have completely  decided phenotypes, but are related to the severity of insulin receptor mutation. The    much than than severe the mutation, the more severe the phenotype. Most known mutations in the insulin receptor are nonsense mutations, and/or small deletions. Because it’s genetic origins, Leprechaunism is a very  termination condition.  Socially speaking, not much attention is paid to it as the only ones affected by this d   isease are the relatives, researchers and funeral homes.   receivable to it’s   tolerateder and the social stigmata attached to the parents of the patients, it will more than likely remain more of a medical curiosity.   perhaps as more is found out about this disease, applications can be found for it’s successful treatment.      Bibliography  Barbetti R, Pablo GV, Gejman SI, Taylor NR, Aleessandro C, Bonora E, Pizzo P, Moghetti P, Muggeo M, Roth J: Detections of Mutations in Insulin sense organ Gene by Denaturing Gradient Gel Electrophoresis. Diabetes 41: 411-15, 1992. Bajaj et al.  Biochim Biophys Acta 916:220-26, 1987 Cantani, A.; Ziruolo, M. G.; Tacconi, M. L. : A rare polydysmorphic syndrome: Leprechaunism--review of forty-nine cases reported in the literature. Ann. Genet.   30: 221-227, 1987. PubMed ID : 3322162 Donohue, W. L. : Dysendocrinism. journal of Pediatrics 32: 739-748, 1948.  Drugge R, Huntley A: The Electronic schoolbook of Dermatology. Online.  net profi   t: hypertext transfer protocol://www.telemedicine.org!   /dm/dmupdate.htm Emory Genetics Laboratory. Insulin sense organ Assay. Online.  lucre: http://www.emory.edu/WHSC/GENETICSLAB/biochem/insulin.htm HGMD: The Human Gene Mutation Database. Gene   broad Statistics for INSR. Online. Internet: www.uwcm.ac.uk/uwcm/mg/summary/119352.html McKusick, V. OMIM: Online Mendelian Inheritance in Man. Disease Entry: #246200 Leprechaunism. Online. Internet: www3.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?246200 Nakae J, Kato M, Murashita M, Shinohara N, Tajima T, Fujieda K. J Clin Endocrinogic Metabolism 1998 Feb;83(2):542-9  NORD:   reflect Organization for Rare Disorders: Disease Information: Leprechaunism. Online. Internet: http://206.105.18.10/nord/rdb_sum/387.htm  OMIM: Online Mendelian Inheritance in Man. Disease Entry: I147670 Insulin Receptor; INSR. Online. Internet: http://www3.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?147670#TEXT www.vghtpe.gov.tw/~meta/dmclass.htm                                         If you want to get a full essay, order i   t on our website: 
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