Because of the rarity of FOP, many physicians in China, as elsewhere, lack experience in diagnosing FOP and have no prior awareness of the signature presence

of malformed great toes, Selleck CAL 101 a harbinger of soft tissue pre-osseous flare-ups. The diagnosis of FOP is a clinical one and mutational analysis remains a confirmatory study once the diagnosis is suspected [1] and [8]. Our data show that the frequency of FOP variant individuals from China is similar to that reported elsewhere in the world [7], [9], [23], [24], [26], [27], [28], [29], [30] and [31], and supports the fidelity of this rare disorder across wide racial, ethnic, gender and geographic distributions. FOP lesions mature through an endochondral process [32] and [33]. Early pre-chondrogenic flare-ups Epacadostat clinical trial of FOP are intensely inflammatory [34]. Yet, in our patient population there was no consistent marker of systemic

inflammation. The serum hsCRP levels in 95% of our patients (39/41 cases) whose FOP had been active at least one year prior to their evaluation in our clinic were normal. This finding suggests that there may be either a lack of generalized inflammation in this disease or a very brief period of systemic inflammation that has remain undetected due to a paucity of studies that examine longitudinal and stage-specific biomarkers in this disease. Clearly, there is a need for such studies. Importantly, we found that radionuclide bone scan was unhelpful in following the early progression of FOP in our patients. As with previously reported studies, plain radiographs were more than sufficient in monitoring the clinical course of the disease [35] and [36]. In summary, we have reported the clinical and genetic profiles of FOP in China. The results of this study may highlight awareness of this patient population in the worldwide FOP community, aid in understanding worldwide trends in natural history and associated genotype, serve in identifying a

new population for participation in future clinical trials, and bring critical awareness to the Chinese medical community so that prompt and correct clinical diagnosis might ensue and diagnostic delays might be avoided for the remaining Chinese FOP patients yet to be diagnosed. None. This work was supported in part by the National Natural Science Foundation Committee (NSFC) of China (to K.Z.), the tuclazepam International Fibrodysplasia Ossificans Progressiva Association (IFOPA), the Center for Research in FOP and Related Disorders, the Ian Cali Endowment for FOP Research, the Whitney Weldon Endowment for FOP Research, the Isaac and Rose Nassau Professorship of Orthopaedic Molecular Medicine (to F.S.K.), the Cali–Weldon Professorship of FOP Research (to E.M.S.), and the National Institutes of Health (NIH R01-AR41916). We are grateful to China Central Television (CCTV) for disseminating information and knowledge about FOP to the general population, and for the assistance of Drs.