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Congenital Nail Disorders among Children with Suspected Ectodermal Dysplasias. Genes (Basel) 2022; 13:genes13112119. [DOI: 10.3390/genes13112119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022] Open
Abstract
We report on a cohort of 204 children referred between January 2017 and January 2022 to the German Center for Ectodermal Dysplasias, Erlangen. The most frequent reasons for referral were tooth malformations and lack of multiple teeth leading to the suspicion of an ectodermal dysplasia. Many patients also suffered from being unable to perspire. Nail abnormalities, in contrast, represented a much rarer finding, albeit the impact on some individuals was large. As ectodermal dysplasias are congenital genetic conditions affecting the development and/or homeostasis of two or more ectodermal derivatives, including hair, teeth, nails, and certain glands, we analyzed congenital nail disorders detected in these patients. Dystrophic or otherwise abnormal nails were evident in 17 of 18 subjects with pathogenic WNT10A or GJB6 variants but in none of 161 children with EDA variants underlying X-linked hypohidrotic ectodermal dysplasia. However, 2 of 17 children who carry mutations in EDAR or EDARADD, two other genes involved in the ectodysplasin A signaling pathway, showed nail abnormalities, such as brittle or hypoplastic nails. TP63 variants were regularly associated with nail disorders. In one girl, anonychia congenita caused by a compound heterozygous variant of the R-spondin-4 gene (RSPO4) was diagnosed. Thus, nail dysplasia is rarer among patients with ectodermal dysplasia than commonly thought.
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Friedmann I, Campagnolo C, Chan N, Hardy G, Saleh M. TP63-mutation as a cause of prenatal lethal multicystic dysplastic kidneys. Mol Genet Genomic Med 2020; 8:e1486. [PMID: 32881366 PMCID: PMC7667318 DOI: 10.1002/mgg3.1486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/12/2022] Open
Abstract
Background Ectrodactyly‐ectodermal dysplasia‐clefting syndrome 3 (EEC) is one of the six overlapping syndromes caused by mutations in the tumor protein p63 gene (TP63). EEC is suspected when patients have cleft hands or feet, polydactyly, and syndactyly, abnormal development of the ectodermally derived structures, and orofacial clefting. Genitourinary (GU) anomalies have been identified in patients with EEC, yet these are often under‐recognized and under‐reported. The available literature on sonographic prenatal findings is sparse, especially when considering GU anomalies. Methods We present the case of a male stillborn fetus, who was found antenatally to have multicystic dysplastic kidneys and anhydramnios. Following the termination of pregnancy, examination and autopsy further revealed unilateral polydactyly and bilateral syndactyly which had not been previously identified on antenatal ultrasound. Results Whole‐exome sequencing (WES) revealed a de novo heterozygous pathogenic variant in exon 5 of the TP63 gene: p.His247Arg: c.740A>G (NM_003722.4) which has been reported in the literature. The His247Arg variant has been published as a pathogenic variant in association with EEC, both with and without orofacial clefting. Conclusion Our prenatal case expands the phenotypic spectrum of TP63‐related disorders in general. In addition, it adds to the phenotype associated with the His247Arg pathogenic variant responsible for EEC. Further, we highlight the importance of WES as a postnatal tool to help clarify unexpected findings, and as a way to add to the spectrum of existing phenotypes of known single‐gene disorders.
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Affiliation(s)
- Isabel Friedmann
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Carla Campagnolo
- Division of Genetics and Metabolism, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
| | - Nancy Chan
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Pathology, London Health Sciences Centre, London, ON, Canada
| | - Ghislain Hardy
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Department of Obstetrics and Gynecology, London Health Sciences Centre, London, ON, Canada
| | - Maha Saleh
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.,Division of Genetics and Metabolism, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
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Ectrodactyly-ectodermal dysplasia-clefting syndrome with unusual cutaneous vitiligoid and psoriasiform lesions due to a novel single point TP63 gene mutation. Postepy Dermatol Alergol 2019; 36:358-364. [PMID: 31333354 PMCID: PMC6640015 DOI: 10.5114/ada.2018.73437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/06/2018] [Indexed: 12/11/2022] Open
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Zheng J, Liu H, Zhan Y, Liu Y, Wong SW, Cai T, Feng H, Han D. Tooth defects of EEC and AEC syndrome caused by heterozygous TP63 mutations in three Chinese families and genotype-phenotype correlation analyses of TP63-related disorders. Mol Genet Genomic Med 2019; 7:e704. [PMID: 31050217 PMCID: PMC6565570 DOI: 10.1002/mgg3.704] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/14/2019] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ectrodactyly-Ectodermal dysplasia-Cleft lip/palate (EEC) syndrome and Ankyloblepharon-Ectodermal defects-Cleft lip/palate (AEC) syndrome belong to p63 syndromes, a group of rare disorders exhibiting a wide variety of clinical manifestations. TP63 mutations have been reported to be associated with both EEC and AEC. METHODS Analysis of whole exome sequencing (WES) from patients with EEC or AEC syndrome and Sanger sequencing from family members. RESULTS We confirmed that three Chinese pedigrees affected with EEC or AEC harboring a distinct TP63 mutation, and described novel clinical phenotypes of EEC and AEC, including the presence of cubitus valgus deformity and taurodontism, which were discordant to their classical disease features. We also analyzed the genotype-phenotype correlation based on our findings. CONCLUSION We reported that the cubitus valgus deformity in patients with EEC and severe taurodontism in a patient with AEC had not been mentioned previously. Our study expands the phenotypic spectrum of EEC and AEC syndrome.
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Affiliation(s)
- Jinglei Zheng
- Department of Prosthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Haochen Liu
- Department of Prosthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuan Zhan
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, The 3rd Dental Clinic, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yang Liu
- Department of Prosthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Sing-Wai Wong
- Oral and Craniofacial Biomedicine Curriculum, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tao Cai
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland
| | - Hailan Feng
- Department of Prosthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dong Han
- Department of Prosthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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Bartzela TN, Carels C, Maltha JC. Update on 13 Syndromes Affecting Craniofacial and Dental Structures. Front Physiol 2017; 8:1038. [PMID: 29311971 PMCID: PMC5735950 DOI: 10.3389/fphys.2017.01038] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022] Open
Abstract
Care of individuals with syndromes affecting craniofacial and dental structures are mostly treated by an interdisciplinary team from early childhood on. In addition to medical and dental specialists that have a vivid interest in these syndromes and for whom these syndromes are of evident interest, experts of scientific background-like molecular and developmental geneticists, but also computational biologists and bioinformaticians-, become more frequently involved in the refined diagnostic and etiological processes of these patients. Early diagnosis is often crucial for the effective treatment of functional and developmental aspects. However, not all syndromes can be clinically identified early, especially in cases of absence of known family history. Moreover, the treatment of these patients is often complicated because of insufficient medical knowledge, and because of the dental and craniofacial developmental variations. The role of the team is crucial for the prevention, proper function, and craniofacial development which is often combined with orthognathic surgery. Although the existing literature does not provide considerable insight into this topic, this descriptive review aims to provide tools for the interdisciplinary team by giving an update on the genetics and general features, and the oral and craniofacial manifestations for early diagnosis. Clinical phenotyping together with genetic data and pathway information will ultimately pave the way for preventive strategies and therapeutic options in the future. This will improve the prognosis for better functional and aesthetic outcome for these patients and lead to a better quality of life, not only for the patients themselves but also for their families. The aim of this review is to promote interdisciplinary interaction and mutual understanding among all specialists involved in the diagnosis and therapeutic guidance of patients with these syndromal conditions in order to provide optimal personalized care in an integrated approach.
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Affiliation(s)
- Theodosia N Bartzela
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité-Universitätsmedizin, Berlin, Germany.,Department of Orthodontics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Carine Carels
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Jaap C Maltha
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, Netherlands
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Genitourinary malformations: an under-recognized feature of ectrodactyly, ectodermal dysplasia and cleft lip/palate syndrome. Clin Dysmorphol 2017; 26:78-82. [PMID: 28166087 DOI: 10.1097/mcd.0000000000000172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The ectodermal dysplasia and cleft lip/palate (EEC) syndrome describes the association of ectrodactyly, ectodermal dysplasia and orofacial clefting. As with many autosomal dominant disorders, there is variability in expression and not all of these three core features are present in every individual with the condition. Moreover, there may be additional associated features, which are under-recognized. One of these is the presence of genitourinary anomalies, some of which cause significant morbidity. This report details a further two patients with EEC syndrome and genitourinary involvement, including flaccid megacystis with detrusor muscle failure, bilateral hydronephrosis and megaureter, requiring significant renal and urological involvement during their childhood. We go on to review the literature on the diagnosis and management of genitourinary malformations in EEC syndrome.
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Lee SM, Park JS, Lew H. A Case of Ectrodactyly-ectodermal Dysplasia-cleft Syndrome with Bilateral Epiphora. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.12.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Min Lee
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jong Seo Park
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Helen Lew
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Genetics of cleft lip and/or cleft palate: Association with other common anomalies. Eur J Med Genet 2014; 57:381-93. [DOI: 10.1016/j.ejmg.2014.04.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/03/2014] [Indexed: 12/16/2022]
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Gurrieri F, Everman DB. Clinical, genetic, and molecular aspects of split-hand/foot malformation: an update. Am J Med Genet A 2013; 161A:2860-72. [PMID: 24115638 DOI: 10.1002/ajmg.a.36239] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 08/26/2013] [Indexed: 12/26/2022]
Abstract
We here provide an update on the clinical, genetic, and molecular aspects of split-hand/foot malformation (SHFM). This rare condition, affecting 1 in 8,500-25,000 newborns, is extremely complex because of its variability in clinical presentation, irregularities in its inheritance pattern, and the heterogeneity of molecular genetic alterations that can be found in affected individuals. Both syndromal and nonsyndromal forms are reviewed and the major molecular genetic alterations thus far reported in association with SHFM are discussed. This updated overview should be helpful for clinicians in their efforts to make an appropriate clinical and genetic diagnosis, provide an accurate recurrence risk assessment, and formulate a management plan.
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Affiliation(s)
- Fiorella Gurrieri
- Istituto di Genetica Medica, Università Cattolica del Sacro Cuore, Rome, Italy
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Rasouly HM, Lu W. Lower urinary tract development and disease. WILEY INTERDISCIPLINARY REVIEWS. SYSTEMS BIOLOGY AND MEDICINE 2013; 5:307-42. [PMID: 23408557 PMCID: PMC3627353 DOI: 10.1002/wsbm.1212] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Congenital anomalies of the lower urinary tract (CALUT) are a family of birth defects of the ureter, the bladder, and the urethra. CALUT includes ureteral anomaliesc such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUVs). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease, and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, the bladder, and the urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, the bladder and the urethra and associated gene mutations are also presented. As we are entering the postgenomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families.
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Affiliation(s)
- Hila Milo Rasouly
- Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA 02118, USA
| | - Weining Lu
- Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA 02118, USA
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11
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Okamura E, Suda N, Baba Y, Fukuoka H, Ogawa T, Ohkuma M, Ahiko N, Yasue A, Tengan T, Shiga M, Tsuji M, Moriyama K. Dental and Maxillofacial Characteristics of Six Japanese Individuals with Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome. Cleft Palate Craniofac J 2013; 50:192-200. [DOI: 10.1597/11-123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Ectrodactyly-ectodermal dysplasia-clefting syndrome is a congenital anomaly characterized by ectodermal dysplasia, ectrodactyly, cleft lip and palate, and lacrimal duct anomalies. Because this syndrome is frequently accompanied by a congenital lack of teeth, narrow palate, and malocclusion, comprehensive orthodontic intervention is required. Design To highlight the specific dental and maxillofacial characteristics of ectrodactylyectodermal dysplasia-clefting syndrome, six Japanese individuals diagnosed with the syndrome are described here. Patients The subjects consisted of two boys and four girls (age range, 6.0 to 13.9 years) diagnosed with ectrodactyly-ectodermal dysplasia-clefting syndrome by medical and dental specialists. Their conditions included ectodermal dysplasia (hypodontia, microdontia, enamel hypoplasia, and abnormalities in hair and nails), cleft lip and/or palate, and ectrodactyly. Cephalograms, panoramic x-rays, and dental casts were taken; systemic complications were recorded at the first visit to our dental hospital. Results All individuals had severe oligodontia with 9 to 18 missing teeth. The missing teeth were mainly maxillary and mandibular incisors and second bicuspids, arranged in a symmetrical manner. Cephalometric analysis showed retruded and short maxilla due to cleft lip and/or palate. It is interesting that all individuals showed a characteristically shaped mandibular symphysis with a retruded point B. It is likely that this unusual symphyseal morphology is due to the lack of mandibular incisors. Conclusions This study demonstrates the presence of severe oligodontia in the incisal and premolar regions and describes a characteristic maxillary and mandibular structure in Japanese individuals with ectrodactyly-ectodermal dysplasia-clefting syndrome.
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Affiliation(s)
- Erika Okamura
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoto Suda
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Saitama, Japan
| | - Yoshiyuki Baba
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Dentistry, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroki Fukuoka
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Global COE Program of JSPS, International Research Center for Molecular Science in Tooth and Bone Diseases
| | - Takuya Ogawa
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Global COE Program of JSPS, International Research Center for Molecular Science in Tooth and Bone Diseases
| | - Mizue Ohkuma
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nozomi Ahiko
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akihiro Yasue
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Toshimoto Tengan
- Department of Clinical Neuroscience Oral and Maxillofacial Functional Rehabilitation, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Momotoshi Shiga
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michiko Tsuji
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Global COE Program of JSPS, International Research Center for Molecular Science in Tooth and Bone Diseases
| | - Keiji Moriyama
- Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Global COE Program of JSPS, International Research Center for Molecular Science in Tooth and Bone Diseases
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Wilkins S, Zhang KW, Mahfuz I, Quantin R, D'Cruz N, Hutson J, Ee M, Bagli D, Aitken K, Fong FNY, Ng PKS, Tsui SKW, Fung WYW, Banu T, Thakre A, Johar K, Jaureguizar E, Li L, Cheng W. Insertion/deletion polymorphisms in the ΔNp63 promoter are a risk factor for bladder exstrophy epispadias complex. PLoS Genet 2012; 8:e1003070. [PMID: 23284286 PMCID: PMC3527294 DOI: 10.1371/journal.pgen.1003070] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 09/21/2012] [Indexed: 11/23/2022] Open
Abstract
Bladder exstrophy epispadias complex (BEEC) is a severe congenital anomaly; however, the genetic and molecular mechanisms underlying the formation of BEEC remain unclear. TP63, a member of TP53 tumor suppressor gene family, is expressed in bladder urothelium and skin over the external genitalia during mammalian development. It plays a role in bladder development. We have previously shown that p63−/− mouse embryos developed a bladder exstrophy phenotype identical to human BEEC. We hypothesised that TP63 is involved in human BEEC pathogenesis. RNA was extracted from BEEC foreskin specimens and, as in mice, ΔNp63 was the predominant p63 isoform. ΔNp63 expression in the foreskin and bladder epithelium of BEEC patients was reduced. DNA was sequenced from 163 BEEC patients and 285 ethnicity-matched controls. No exon mutations were detected. Sequencing of the ΔNp63 promoter showed 7 single nucleotide polymorphisms and 4 insertion/deletion (indel) polymorphisms. Indel polymorphisms were associated with an increased risk of BEEC. Significantly the sites of indel polymorphisms differed between Caucasian and non-Caucasian populations. A 12-base-pair deletion was associated with an increased risk with only Caucasian patients (p = 0.0052 Odds Ratio (OR) = 18.33), whereas a 4-base-pair insertion was only associated with non-Caucasian patients (p = 0.0259 OR = 4.583). We found a consistent and statistically significant reduction in transcriptional efficiencies of the promoter sequences containing indel polymorphisms in luciferase assays. These findings suggest that indel polymorphisms of the ΔNp63 promoter lead to a reduction in p63 expression, which could lead to BEEC. Bladder exstrophy epispadias complex is a severe congenital abnormality. The affected babies' bladders are born open, leaking urine constantly. Treatment involves multiple major reconstructive surgeries and the need for lifelong care for the complications of the disease. Although a number of studies have suggested a genetic cause of the disease, the genetic and molecular mechanism underlying the formation of BEEC remains unknown. One gene, TP63, plays a crucial role in the early bladder development. Two different genetic promoters of TP63 produce different forms of the protein with opposing properties. We have shown mice lacking p63 displayed a deformity complex identical to human BEEC. There are no genetic mutations in the p63 protein in BEEC, so genetic variants in the promoter could alter protein expression. Our hypothesis was that loss of p63 expression due to sequence polymorphisms in a promoter is a risk factor for BEEC. We found promoter sequence variants that were statistically associated with the disease and the sequence variant location varied between Caucasian and non-Caucasian patients. This is particularly important as Caucasian populations have a higher risk of BEEC. These findings provide an explanation of BECC and a base for further study of TP63 related genes in this disease.
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Affiliation(s)
- Simon Wilkins
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
- * E-mail: (SW); (WC)
| | - Ke Wei Zhang
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
| | - Istiak Mahfuz
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
| | - Renaud Quantin
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
| | - Nancy D'Cruz
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
| | - John Hutson
- Department of Paediatric Urology, University of Melbourne, Melbourne, Australia
| | - Michael Ee
- Women's and Children's Clinical Services, Royal Hobart Hospital, Hobart, Australia
| | - Darius Bagli
- Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Karen Aitken
- Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Fion Nga-Yin Fong
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Kwok-Shing Ng
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Wendy Yin-Wan Fung
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Tahmina Banu
- Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh
| | - Atul Thakre
- Iladevi Cataract and Intraocular Lens Research Centre, Civil Hospital, Ahmedabad, India
| | - Kaid Johar
- Iladevi Cataract and Intraocular Lens Research Centre, Civil Hospital, Ahmedabad, India
| | | | - Long Li
- Department of Surgery, Capital Institute of Pediatrics, Beijing, China
| | - Wei Cheng
- Monash Institute of Medical Research, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
- Department of Paediatrics, Department of Surgery, Southern Medical School, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
- Department of Paediatric Surgery, Monash Children's, Southern Health, Melbourne, Australia
- * E-mail: (SW); (WC)
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Sripathomsawat W, Tanpaiboon P, Heering J, Dötsch V, Hennekam RC, Kantaputra P. Phenotypic analysis of Arg227 mutations of TP63 with emphasis on dental phenotype and micturition difficulties in EEC syndrome. Am J Med Genet A 2010; 155A:228-32. [DOI: 10.1002/ajmg.a.33768] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Clements S, Techanukul T, Coman D, Mellerio J, McGrath J. Molecular basis of EEC (ectrodactyly, ectodermal dysplasia, clefting) syndrome: five new mutations in the DNA-binding domain of the TP63
gene and genotype-phenotype correlation. Br J Dermatol 2009; 162:201-7. [DOI: 10.1111/j.1365-2133.2009.09496.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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15
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A 19-year follow-up of a patient with type 3 ectrodactyly–ectodermal dysplasia–clefting syndrome who developed non-Hodgkin lymphoma. ACTA ACUST UNITED AC 2009; 108:e91-5. [DOI: 10.1016/j.tripleo.2009.04.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 04/16/2009] [Accepted: 04/29/2009] [Indexed: 11/15/2022]
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16
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Allen LM, Maestri MJ. Three-dimensional sonographic findings associated with ectrodactyly ectodermal dysplasia clefting syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:149-154. [PMID: 18096742 DOI: 10.7863/jum.2008.27.1.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Ectrodactyly-ectrodermal dysplasia-clefting (EEC) syndrome is a rare autosomal dominant genetic syndrome. This condition is characterized by varying degrees of ectrodactyly and syndactyly of the hands and feet, a cleft lip with or without a cleft palate, and ectodermal dysplasia. In addition, abnormalities of the genitourinary system occur frequently in association with this syndrome. The wide clinical variability of EEC syndrome has been well documented in the literature, and none of the 3 cardinal signs seem to be obligatory. We present a case of classic familial EEC syndrome diagnosed by prenatal sonography at 17 weeks' gestation. In addition to tetraectrodactyly and a unilateral cleft lip and palate, renal dysplasia was noted on serial sonographic evaluation. Three-dimensional (3D) surface rendering was used to supplement traditional 2-dimensional (2D) imaging to further evaluate the fetal phenotype.
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Affiliation(s)
- Lisa M Allen
- Regional Perinatal Center, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, State University of New York Upstate Medical University, Syracuse, NY 13202, USA.
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Maclean K, Holme SA, Gilmour E, Taylor M, Scheffer H, Graf N, Smith GHH, Onikul E, van Bokhoven H, Moss C, Adès LC. EEC syndrome, Arg227Gln TP63 mutation and micturition difficulties: Is there a genotype-phenotype correlation? Am J Med Genet A 2007; 143A:1114-9. [PMID: 17431922 DOI: 10.1002/ajmg.a.31664] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We report on two unrelated families with EEC syndrome (ectrodactyly, ectodermal dysplasia, cleft lip/palate), each with an Arg227Gln TP63 gene mutation, where the phenotype overlapped extensively with the allelic disorder, limb-mammary syndrome (LMS). Features common to both families were an ectodermal dysplasia principally affecting tooth, breast and nipple development, dacryostenosis and severe micturition difficulties. Additional findings included post-axial digital hypoplasia, cleft uvula, anal stenosis, hypoplasia of the perineal body and biopsy-proven interstitial cystitis. No individual had cleft lip. Split hand-split foot malformation (SHFM) occurred in one child-born after the molecular diagnosis was established. Unlike previous reports, the urinary symptoms were refractory to treatment with oral Fibrase and persisted into adulthood. Of the six cases/families now reported with EEC syndrome and Arg227Gln TP63 mutation, four have manifested this distinct urological abnormality, indicative of a genotype-phenotype correlation.
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Affiliation(s)
- Kenneth Maclean
- Department of Clinical Genetics, Children's Hospital at Westmead (CHW), Sydney, Australia.
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18
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Rinne T, Hamel B, van Bokhoven H, Brunner HG. Pattern of p63 mutations and their phenotypes--update. Am J Med Genet A 2006; 140:1396-406. [PMID: 16691622 DOI: 10.1002/ajmg.a.31271] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Heterozygous mutations in the transcription factor gene p63 cause at least six different syndromes with various combinations of ectodermal dysplasia, orofacial clefting and limb malformations. Here we will present an update of mutations in the p63 gene together with a comprehensive overview of the associated clinical features in 227 patients. These data confirm the previously recognized genotype-phenotype associations. Moreover, we report that there is a large degree of clinical variability in each of the p63-associated disorders. This is illustrated by the different phenotypes that are seen for the five-hotspot mutations that explain almost 90% of all EEC syndrome patients.
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Affiliation(s)
- Tuula Rinne
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
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19
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Reisler TT, Patton MA, Meagher PPJ. Further phenotypic and genetic variation in ADULT syndrome. Am J Med Genet A 2006; 140:2495-500. [PMID: 17041931 DOI: 10.1002/ajmg.a.31482] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ADULT (Acro-dermato-ungual-lacrimal-tooth) syndrome is characterized by ectrodactyly, syndactyly, fingernail and toenail dysplasia, hypoplasia of the breast and nipple, excessive freckling, lacrimal duct atresia, frontal alopecia, primary hypodontia, and/or early loss of permanent teeth. It is a rare autosomal dominant disorder which has been linked to mutation in the p63 gene. The p63 gene has been described in five overlapping limb malformation syndromes including the EEC syndrome (ectodermal ectrodactyly clefting). We report on the first case of ADULT syndrome of a mother and daughter with a new mutation R227Q in exon 6 of the p63 gene. This has not been previously associated with ADULT syndrome but only seen in EEC. In addition to the previously reported features of ADULT syndrome this report also describes some additional findings including hyperextensibility at the distal interphalageal joints, bilateral thumb duplication, bifid toenails, symptoms of urinary retention, vesicoureteric reflux, prominent ears, conductive hearing loss, and an overgrowth of a patch of hair in the midline of the neck. This report expands the knowledge of genotype-phenotype data on the p63 gene and suggests there may be a considerable overlap between the EEC syndrome and the ADULT syndrome.
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Affiliation(s)
- Tom T Reisler
- Department of Plastic and Reconstructive Surgery, St George's Hospital, London, United Kingdom.
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20
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García-Ortiz JE, Banda-Espinoza F, Zenteno JC, Galván-Uriarte LM, Ruiz-Flores P, García-Cruz D. Split hand malformation, hypospadias, microphthalmia, distinctive face and short stature in two brothers suggest a new syndrome. Am J Med Genet A 2005; 135:21-7. [PMID: 15809993 DOI: 10.1002/ajmg.a.30696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Split hand/foot malformation (SHFM) is a genetically heterogeneous limb malformation that may be isolated or associated with other malformations. More than 50 recognizable entities with SHFM have been described and at least 5 mapped genetic loci have been implicated. Two brothers with intrauterine growth retardation, short stature, distinctive face, microphthalmia, genital anomalies, and SHFM are described. Molecular analyses of TP63, HOXA13, and HOXD13 genes were normal. We propose this pattern to be a newly recognized SHFM syndrome.
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Affiliation(s)
- Jose E García-Ortiz
- Departamento de Inmunobiología Molecular, CIB, Facultad de Medicina Universidad Autónoma de Coahuila, Torreón, Coahuila, México.
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21
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Chuangsuwanich T, Sunsaneevithayakul P, Muangsomboon K, Limwongse C. Ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome presenting with a large nephrogenic cyst, severe oligohydramnios and hydrops fetalis: a case report and review of the literature. Prenat Diagn 2005; 25:210-5. [PMID: 15791665 DOI: 10.1002/pd.1101] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To report a case of EEC syndrome with a large nephrogenic cyst detected by prenatal ultrasonography. METHODS Prenatal ultrasonographic detection, genetic counselling, termination of pregnancy, radiographic study, autopsy and ultrastructural study of scalp hair. The literature on EEC syndrome with genitourinary anomalies and prenatal diagnosis was also reviewed. RESULTS A 6-cm cyst in the right side of abdominal cavity was detected in a fetus of 24 weeks' gestational age with severe oligohydramnios and hydrops fetalis. The autopsy revealed bilateral renal dysplasia with a large nephrogenic cyst at the right side and markedly hypoplastic urinary bladder and pulmonary hypoplasia. The fetus also had ectrodactyly and syndactyly of hands and feet and ectodermal dysplasia and left cleft lip and palate. Ultrastructure of hair from scanning electron microscopy revealed no obvious abnormality. CONCLUSION This is a rare case of fetal malformation partly detected prenatally. In order to detect this syndrome, careful ultrasound search for acral anomalies should be performed in cases with renal malformation or obstructive uropathy.
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Affiliation(s)
- Tuenjai Chuangsuwanich
- Department of Pathology, Siriraj Hospital Faculty of Medicine, Mahidol University, Bangkok, Thailand.
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22
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Bigatà X, Bielsa I, Artigas M, Azón A, Ribera M, Ferrándiz C. The ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC): report of five cases. Pediatr Dermatol 2003; 20:113-8. [PMID: 12657005 DOI: 10.1046/j.1525-1470.2003.20203.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report five patients from two different pedigrees with the ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC). All had features of ectodermal dysplasia, but only three had limb ectrodactyly and orofacial clefting. The present patients illustrate the great phenotypic variability in the EEC syndrome. As no single feature, including any of the three cardinal signs, is mandatory for syndrome diagnosis, a meticulous examination of all family members is needed.
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Affiliation(s)
- Xavier Bigatà
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Spain
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23
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Ince TA, Cviko AP, Quade BJ, Yang A, McKeon FD, Mutter GL, Crum CP. p63 Coordinates anogenital modeling and epithelial cell differentiation in the developing female urogenital tract. THE AMERICAN JOURNAL OF PATHOLOGY 2002; 161:1111-7. [PMID: 12368184 PMCID: PMC1867285 DOI: 10.1016/s0002-9440(10)64387-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
p63 is a p53 homologue required for cutaneous development that is expressed in immature squamous epithelium and reserve cells of the cervix. Humans with p63 mutations exhibit defects in limb, accessory organ (skin appendage, breast, prostate), and genitourinary development. Because p63 expression patterns imply a strong role of the gene in the female genital tract development, newborn female p63-/-, +/-, and +/+ mice were examined in situ, dissected, and compared. Nuclear p63 protein was localized to the skin, vagina, bladder, urethra, and basal columnar cells of the caudal uterus in p63+/+ and +/- animals. p63-/- mice exhibited abnormal genital morphogenesis with hypoplastic genitalia, a single cloacal opening, and persistence of columnar epithelium at lower genital tract sites that normally undergo squamous and urothelial differentiation. The defects observed support p63-dependent pathways of genital tract development that permit externally, ectodermal basal cell replenishment integral to reciprocal epithelial stromal signaling, urorectal septation, and modeling of the external genitalia; and internally, the emergence of basal epithelial cell populations capable of divergent epithelial cell differentiation in the vagina, cervix, and urinary tract. Defects in the first pathway explain imperforate anus, vaginal septum, genital hypoplasia, and micropenis reported in humans with p63 mutations. The second is necessary for the generation of multipotential reserve cells in the cervix and may be operative in other epithelial stromal interactions integral to the emergence of uterine basal cells later in life.
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Affiliation(s)
- Tan A Ince
- Department of Pathology, Division of Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
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24
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Barrow LL, van Bokhoven H, Daack-Hirsch S, Andersen T, van Beersum SEC, Gorlin R, Murray JC. Analysis of the p63 gene in classical EEC syndrome, related syndromes, and non-syndromic orofacial clefts. J Med Genet 2002; 39:559-66. [PMID: 12161593 PMCID: PMC1735218 DOI: 10.1136/jmg.39.8.559] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
EEC syndrome is an autosomal dominant disorder with the cardinal signs of ectrodactyly, ectodermal dysplasia, and orofacial clefts. EEC syndrome has been linked to chromosome 3q27 and heterozygous p63 mutations were detected in unrelated EEC families. In addition, homozygous p63 null mice exhibit craniofacial abnormalities, limb truncations, and absence of epidermal appendages, such as hair follicles and tooth primordia. In this study, we screened 39 syndromic patients, including four with EEC syndrome, five with syndromes closely related to EEC syndrome, and 30 with other syndromic orofacial clefts and/or limb anomalies. We identified heterozygous p63 mutations in three unrelated cases of EEC syndrome, two Iowa white families and one sporadic case in a Filipino boy. One family is atypical for EEC and has features consistent with Hay-Wells syndrome. In this family, the mutation ablates a splice acceptor site and, in the other two, mutations produce amino acid substitutions, R280C and R304Q, which alter conserved DNA binding sites. Germline mosaicism was detected in the founder of the mutation in one case. These three cases show significant interfamilial and intrafamilial variability in expressivity. We also screened p63 in 62 patients with non-syndromic orofacial clefts, identifying an intronic single nucleotide polymorphism but finding no evidence of mutations that would explain even a subset of non-syndromic orofacial clefts. This study supports a common role for p63 in classical EEC syndrome, both familial and sporadic, but not in other related or non-syndromic forms of orofacial clefts.
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Affiliation(s)
- L L Barrow
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA
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25
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Witters I, Van Bokhoven H, Goossens A, Van Assche FA, Fryns JP. Split-hand/split-foot malformation with paternal mutation in the p63 gene. Prenat Diagn 2001; 21:1119-22. [PMID: 11787035 DOI: 10.1002/pd.181] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report the prenatal diagnosis at 16 weeks' gestation of bilateral split-hand/split-foot malformation (SHSFM) with severe lobster claw deformity of hands and feet in a male fetus without associated malformations. A minor manifestation of SHSFM was present in the father with only mild bilateral foot involvement (syndactyly I-II; cleft II-III; left cutaneous syndactyly III-IV). Mutation analysis of the p63 gene on chromosome 3q27 showed a missense mutation 577A-->G (predicting amino acid substitution K193E) in the father. This mutation has not been reported so far in SHSFM but resembles the previously reported 580A-->G (predicting amino acid substitution K194E) in a family with SHSFM.
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Affiliation(s)
- I Witters
- Department of Obstetrics and Gynecology, University of Leuven, Leuven, Belgium
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26
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Abstract
Renal abnormalities are some of the commonest and most easily detectable anomalies on ultrasound. Many are an isolated finding but the prognosis may be altered considerably by the detection of other anomalies which could indicate a genetic disorder or syndrome. It is often easier to detect presupposed anomalies and the purpose of this article is to introduce and discuss those syndromes that may present with a renal abnormality on ultrasound. Common renal findings are presented with the range of additional anomalies that should be sought and suggested diagnostic tests. It should be remembered that although for many genetic conditions specific mutation analysis is now available, this usually requires pre-pregnancy investigations. Furthermore, in some cases the definitive diagnosis may not be suspected until post mortem. By this time it may be too late to establish a cell line to confirm the suspicion using laboratory methods. It is therefore important to take tissue samples antenatally where possible, or at delivery, as postnatal samples may have a high culture failure rate.
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Affiliation(s)
- D Wellesley
- Wessex Clinical Genetics Service, Princess Anne Hospital, Coxford Road, Southampton SO16 5YA, UK
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27
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Adanali G, Senen D, Ayhan M, Erdogan B. Ectrodactyly-ectodermal dysplasia clefting syndrome. Ann Plast Surg 2001; 47:350. [PMID: 11562050 DOI: 10.1097/00000637-200109000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Haberlandt E, Löffler J, Hirst-Stadlmann A, Stöckl B, Judmaier W, Fischer H, Heinz-Erian P, Müller T, Utermann G, Smith RJ, Janecke AR. Split hand/split foot malformation associated with sensorineural deafness, inner and middle ear malformation, hypodontia, congenital vertical talus, and deletion of eight microsatellite markers in 7q21.1-q21.3. J Med Genet 2001; 38:405-9. [PMID: 11424924 PMCID: PMC1734906 DOI: 10.1136/jmg.38.6.405] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
MESH Headings
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/pathology
- Anodontia/genetics
- Child, Preschool
- Chromosomes, Human, Pair 7
- Deafness/genetics
- Deafness/pathology
- Ear, Inner/abnormalities
- Ear, Middle/abnormalities
- Ectodermal Dysplasia/genetics
- Facies
- Foot Deformities, Congenital/diagnostic imaging
- Foot Deformities, Congenital/genetics
- Foot Deformities, Congenital/pathology
- Hand Deformities, Congenital/genetics
- Hearing Loss, Sensorineural/genetics
- Hearing Loss, Sensorineural/pathology
- Humans
- Male
- Microsatellite Repeats
- Radiography
- Sequence Deletion
- Syndrome
- Talus/abnormalities
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29
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Zenteno JC, Venegas C, Kofman-Alfaro S. Evidence that AEC syndrome and Bowen--Armstrong syndrome are variable expressions of the same disease. Pediatr Dermatol 1999; 16:103-7. [PMID: 10337671 DOI: 10.1046/j.1525-1470.1999.99009.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Several clinical disorders combine ectodermal dysplasia (ED) and cleft lip and/or palate (CL/P). These conditions have been recognized as a group of diseases with a narrow phenotypic spectrum and multiple points of overlap. We report a patient with a clinical diagnosis of AEC syndrome (ankyloblepharon, ectodermal defects, and CL/P) who additionally has some features observed in a different ED-CL/P disorder, Bowen-Armstrong syndrome. Because of this clinical overlap, we suggest that AEC syndrome and Bowen-Armstrong syndrome may be variable manifestations of the same pathologic entity.
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Affiliation(s)
- J C Zenteno
- Servicio de Genética, Hospital General de México-Facultad de Medicina UNAM, Mexico City, México
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30
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van Bokhoven H, Jung M, Smits AP, van Beersum S, Rüschendorf F, van Steensel M, Veenstra M, Tuerlings JH, Mariman EC, Brunner HG, Wienker TF, Reis A, Ropers HH, Hamel BC. Limb mammary syndrome: a new genetic disorder with mammary hypoplasia, ectrodactyly, and other Hand/Foot anomalies maps to human chromosome 3q27. Am J Hum Genet 1999; 64:538-46. [PMID: 9973291 PMCID: PMC1377763 DOI: 10.1086/302246] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report on a large Dutch family with a syndrome characterized by severe hand and/or foot anomalies, and hypoplasia/aplasia of the mammary gland and nipple. Less frequent findings include lacrimal-duct atresia, nail dysplasia, hypohydrosis, hypodontia, and cleft palate with or without bifid uvula. This combination of symptoms has not been reported previously, although there is overlap with the ulnar mammary syndrome (UMS) and with ectrodactyly, ectodermal dysplasia, and clefting syndrome. Allelism with UMS and other related syndromes was excluded by linkage studies with markers from the relevant chromosomal regions. A genomewide screening with polymorphic markers allowed the localization of the genetic defect to the subtelomeric region of chromosome 3q. Haplotype analysis reduced the critical region to a 3-cM interval of chromosome 3q27. This chromosomal segment has not been implicated previously in disorders with defective development of limbs and/or mammary tissue. Therefore, we propose to call this apparently new disorder "limb mammary syndrome" (LMS). The SOX2 gene at 3q27 might be considered an excellent candidate gene for LMS because the corresponding protein stimulates expression of FGF4, an important signaling molecule during limb outgrowth and development. However, no mutations were found in the SOX2 open reading frame, thus excluding its involvement in LMS.
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MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/physiopathology
- Animals
- Chromosome Mapping
- Chromosomes, Human, Pair 3
- DNA-Binding Proteins/genetics
- Female
- Foot Deformities, Congenital/diagnostic imaging
- Foot Deformities, Congenital/genetics
- Foot Deformities, Congenital/physiopathology
- Genetic Linkage
- HMGB Proteins
- Hand Deformities, Congenital/diagnostic imaging
- Hand Deformities, Congenital/genetics
- Hand Deformities, Congenital/physiopathology
- Humans
- Male
- Mammary Neoplasms, Animal/diagnostic imaging
- Mammary Neoplasms, Animal/genetics
- Mammary Neoplasms, Animal/physiopathology
- Mutation
- Nuclear Proteins/genetics
- Pedigree
- Radiography
- SOXB1 Transcription Factors
- Syndrome
- Transcription Factors
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Affiliation(s)
- H van Bokhoven
- Department of Human Genetics 417, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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31
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O'Quinn JR, Hennekam RC, Jorde LB, Bamshad M. Syndromic ectrodactyly with severe limb, ectodermal, urogenital, and palatal defects maps to chromosome 19. Am J Hum Genet 1998; 62:130-5. [PMID: 9443880 PMCID: PMC1376811 DOI: 10.1086/301687] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Congenital limb malformations rank behind only congenital heart disease as the most common birth defects observed in infants. Finding genes that cause defects in human limb patterning should be straightforward but has been limited, in part, by the bewildering spectrum of phenotypes, which are difficult to separate into etiologically distinct disorders. One approach to the identification of relevant genes is to take advantage of unique extended kindreds in which a defect in limb patterning is segregating. Recently, a large Dutch family with ectrodactyly, ectodermal dysplasia, cleft palate, and urogenital defects (EEC) was described by Maas et al. We have studied this kindred and localized a gene causing EEC to a locus on chromosome 19, in a region defined by D19S894 and D19S416. A second extended kindred with EEC does not map to this locus, indicating that EEC is a genetically heterogeneous disorder. Growth and patterning of the limbs, teeth, hair, and genitourinary system are mediated in part by epithelial-mesenchyme inductive interactions. The identification of both the gene causing EEC and its mutation may further elucidate the general signals mediating inductive mechanisms.
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Affiliation(s)
- J R O'Quinn
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
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