1
|
Hale AT, Boudreau H, Devulapalli R, Duy PQ, Atchley TJ, Dewan MC, Goolam M, Fieggen G, Spader HL, Smith AA, Blount JP, Johnston JM, Rocque BG, Rozzelle CJ, Chong Z, Strahle JM, Schiff SJ, Kahle KT. The genetic basis of hydrocephalus: genes, pathways, mechanisms, and global impact. Fluids Barriers CNS 2024; 21:24. [PMID: 38439105 PMCID: PMC10913327 DOI: 10.1186/s12987-024-00513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 03/06/2024] Open
Abstract
Hydrocephalus (HC) is a heterogenous disease characterized by alterations in cerebrospinal fluid (CSF) dynamics that may cause increased intracranial pressure. HC is a component of a wide array of genetic syndromes as well as a secondary consequence of brain injury (intraventricular hemorrhage (IVH), infection, etc.) that can present across the age spectrum, highlighting the phenotypic heterogeneity of the disease. Surgical treatments include ventricular shunting and endoscopic third ventriculostomy with or without choroid plexus cauterization, both of which are prone to failure, and no effective pharmacologic treatments for HC have been developed. Thus, there is an urgent need to understand the genetic architecture and molecular pathogenesis of HC. Without this knowledge, the development of preventive, diagnostic, and therapeutic measures is impeded. However, the genetics of HC is extraordinarily complex, based on studies of varying size, scope, and rigor. This review serves to provide a comprehensive overview of genes, pathways, mechanisms, and global impact of genetics contributing to all etiologies of HC in humans.
Collapse
Affiliation(s)
- Andrew T Hale
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK.
| | - Hunter Boudreau
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK
| | - Rishi Devulapalli
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Phan Q Duy
- Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Travis J Atchley
- Department of Neurosurgery, University of Alabama at Birmingham, FOT Suite 1060, 1720 2ndAve, Birmingham, AL, 35294, UK
| | - Michael C Dewan
- Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Mubeen Goolam
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Graham Fieggen
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Division of Pediatric Neurosurgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Heather L Spader
- Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Anastasia A Smith
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Jeffrey P Blount
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - James M Johnston
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Brandon G Rocque
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Curtis J Rozzelle
- Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Zechen Chong
- Heflin Center for Genomics, University of Alabama at Birmingham, Birmingham, AL, UK
| | - Jennifer M Strahle
- Division of Pediatric Neurosurgery, St. Louis Children's Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Steven J Schiff
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Kristopher T Kahle
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Sy MR, Chauhan J, Prescott K, Imam A, Kraus A, Beleza A, Salkeld L, Hosdurga S, Parker M, Vasudevan P, Islam L, Goel H, Bain N, Park SM, Mohammed S, Dieterich K, Coutton C, Satre V, Vieville G, Donaldson A, Beneteau C, Ghoumid J, Bogaert KVD, Boogaerts A, Boudry E, Vanlerberghe C, Petit F, Bernardini L, Torres B, Mattina T, Carli D, Mandrile G, Pinelli M, Brunetti-Pierri N, Neas K, Beddow R, Tørring PM, Faletra F, Spedicati B, Gasparini P, Mussa A, Ferrero GB, Lampe A, Lam W, Bi W, Bacino CA, Kuwahara A, Bush JO, Zhao X, Luna PN, Shaw CA, Rosenfeld JA, Scott DA. Exome sequencing efficacy and phenotypic expansions involving esophageal atresia/tracheoesophageal fistula plus. Am J Med Genet A 2022; 188:3492-3504. [PMID: 36135330 PMCID: PMC9669235 DOI: 10.1002/ajmg.a.62976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 01/31/2023]
Abstract
Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a life-threatening birth defect that often occurs with other major birth defects (EA/TEF+). Despite advances in genetic testing, a molecular diagnosis can only be made in a minority of EA/TEF+ cases. Here, we analyzed clinical exome sequencing data and data from the DECIPHER database to determine the efficacy of exome sequencing in cases of EA/TEF+ and to identify phenotypic expansions involving EA/TEF. Among 67 individuals with EA/TEF+ referred for clinical exome sequencing, a definitive or probable diagnosis was made in 11 cases for an efficacy rate of 16% (11/67). This efficacy rate is significantly lower than that reported for other major birth defects, suggesting that polygenic, multifactorial, epigenetic, and/or environmental factors may play a particularly important role in EA/TEF pathogenesis. Our cohort included individuals with pathogenic or likely pathogenic variants that affect TCF4 and its downstream target NRXN1, and FANCA, FANCB, and FANCC, which are associated with Fanconi anemia. These cases, previously published case reports, and comparisons to other EA/TEF genes made using a machine learning algorithm, provide evidence in support of a potential pathogenic role for these genes in the development of EA/TEF.
Collapse
Affiliation(s)
- Mary R. Sy
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
| | - Jaynee Chauhan
- Yorkshire Regional Genetics Service, Leeds Teaching
Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - Katrina Prescott
- Yorkshire Regional Genetics Service, Leeds Teaching
Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - Aliza Imam
- Yorkshire Regional Genetics Service, Leeds Teaching
Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - Alison Kraus
- Yorkshire Regional Genetics Service, Leeds Teaching
Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - Ana Beleza
- Clinical Genetics Department, University Hospitals Bristol
and Weston, Bristol NHS Foundation, Bristol, UK
| | - Lee Salkeld
- Whiteladies Medical Group, Whatley Road, Clifton, Bristol,
UK
| | - Saraswati Hosdurga
- Community Children’s Health Partnership, Sirona
Health and Care, Bristol, UK
| | - Michael Parker
- Sheffield Children’s NHS Foundation Trust,
Sheffield, UK
| | | | - Lily Islam
- Birmingham Women’s and Children’s Hospital
NHS Foundation Trust, Birmingham, UK
| | - Himanshu Goel
- Hunter New England Local Health District, Hunter Genetics,
Waratah, NSW, Australia
- University of Newcastle, Callaghan, NSW, Australia
| | - Nicole Bain
- Department of Molecular Medicine, New South Wales Health
Pathology, Newcastle, Australia
| | - Soo-Mi Park
- East Anglian Medical Genetics Service, Cambridge
University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Klaus Dieterich
- Département de Génétique et
Procréation, Hôpital Couple Enfant, CHU Grenoble, Grenoble Cedex,
France
- INSERM U1216 Grenoble Institut des Neurosciences,
Cellular Myology and Pathology, Grenoble, France
| | - Charles Coutton
- Département de Génétique et
Procréation, Hôpital Couple Enfant, CHU Grenoble, Grenoble Cedex,
France
- Genetic Epigenetic and Therapies of Infertility team,
Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université
Grenoble Alpes, Grenoble, France
| | - Véronique Satre
- Département de Génétique et
Procréation, Hôpital Couple Enfant, CHU Grenoble, Grenoble Cedex,
France
- Genetic Epigenetic and Therapies of Infertility team,
Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université
Grenoble Alpes, Grenoble, France
| | - Gaëlle Vieville
- Département de Génétique et
Procréation, Hôpital Couple Enfant, CHU Grenoble, Grenoble Cedex,
France
| | - Alan Donaldson
- Clinical Genetics Department, St Michaels Hospital,
Bristol, UK
| | - Claire Beneteau
- Nantes Université, CHU de Nantes, UF 9321 de
Fœtopathologie et Génétique, Nantes, France
| | - Jamal Ghoumid
- Université de Lille, ULR7364 RADEME, CHU Lille,
Clinique de Génétique Guy Fontaine, Lille, France
| | - Kris Van Den Bogaert
- Center for Human Genetics, University Hospitals
Leuven–KU Leuven, Leuven, Belgium
| | - Anneleen Boogaerts
- Center for Human Genetics, University Hospitals
Leuven–KU Leuven, Leuven, Belgium
| | - Elise Boudry
- CHU Lille, Institut de Génétique
Médicale, Lille, France
| | - Clémence Vanlerberghe
- Université de Lille, ULR7364 RADEME, CHU Lille,
Clinique de Génétique Guy Fontaine, Lille, France
| | - Florence Petit
- Université de Lille, ULR7364 RADEME, CHU Lille,
Clinique de Génétique Guy Fontaine, Lille, France
| | - Laura Bernardini
- Medical Genetics Unit, Fondazione IRCCS Casa Sollievo
della Sofferenza, San Giovanni Rotondo, Italy
| | - Barbara Torres
- Medical Genetics Unit, Fondazione IRCCS Casa Sollievo
della Sofferenza, San Giovanni Rotondo, Italy
| | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences,
Medical Genetics, University of Catania, Catania, Italy
- Scientific Foundation and Clinic G. B. Morgagni,
Catania, Italy
| | - Diana Carli
- Department of Public Health and Pediatrics, University
of Torino, Torino, Italy
| | - Giorgia Mandrile
- Medical Genetics Unit, San Luigi University Hospital,
University of Torino, Orbassano, Italy
| | - Michele Pinelli
- Department of Molecular Medicine and Medical
Biotechnology, University of Naples Federico II, Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM),
Pozzuoli, Italy
| | - Nicola Brunetti-Pierri
- Telethon Institute of Genetics and Medicine (TIGEM),
Pozzuoli, Italy
- Department of Translational Medicine, University of
Naples Federico II, Naples, Italy
| | | | - Rachel Beddow
- Wellington Regional Genetics laboratory, Wellington, New
Zealand
| | - Pernille M. Tørring
- Department of Clinical Genetics, Odense University
Hospital, Odense C, Denmark
| | - Flavio Faletra
- Institute for Maternal and Child Health - IRCCS Burlo
Garofolo, Trieste, Italy
| | - Beatrice Spedicati
- Department of Medicine, Surgery and Health Sciences,
University of Trieste, Trieste, Italy
| | - Paolo Gasparini
- Institute for Maternal and Child Health - IRCCS Burlo
Garofolo, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences,
University of Trieste, Trieste, Italy
| | - Alessandro Mussa
- Department of Public Health and Pediatrics, University
of Torino, Torino, Italy
- Pediatric Clinical Genetics Unit, Regina Margherita
Childrens Hospital, Torino, Italy
| | | | - Anne Lampe
- South East Scotland Clinical Genetics Service, Western
General Hospital, Edinburgh, UK
| | - Wayne Lam
- Department of Clinical Genetics, Western General
Hospital, Edinburgh, UK
| | - Weimin Bi
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
- Baylor Genetics, Houston, TX, 77021, USA
| | - Carlos A. Bacino
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
| | - Akela Kuwahara
- Department of Cell and Tissue Biology, University of
California San Francisco, San Francisco, USA
- Institute for Human Genetics, University of California
San Francisco, San Francisco, USA
- Eli and Edythe Broad Center of Regeneration Medicine and
Stem Cell Research, University of California San Francisco, San Francisco, USA
| | - Jeffrey O. Bush
- Department of Cell and Tissue Biology, University of
California San Francisco, San Francisco, USA
- Institute for Human Genetics, University of California
San Francisco, San Francisco, USA
- Eli and Edythe Broad Center of Regeneration Medicine and
Stem Cell Research, University of California San Francisco, San Francisco, USA
| | - Xiaonan Zhao
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
- Baylor Genetics, Houston, TX, 77021, USA
| | - Pamela N. Luna
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
| | - Chad A. Shaw
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
| | - Jill A. Rosenfeld
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
| | - Daryl A. Scott
- Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, USA
- Department of Molecular Physiology and Biophysics,
Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
3
|
Identification of rare heterozygous missense mutations in FANCA in esophageal atresia patients using next-generation sequencing. Gene 2018; 661:182-188. [PMID: 29621589 DOI: 10.1016/j.gene.2018.03.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/12/2018] [Accepted: 03/29/2018] [Indexed: 11/23/2022]
Abstract
Esophageal atresia and tracheoesophageal fistula (EA/TEF) are relatively common malformations in newborns, but the etiology of EA/TEF remains unknown. Fanconi anemia (FA) complementation group A (FANCA) is a key component of the FA core complex and is essential for the activation of the DNA repair pathway. The middle region (amino acids 674-1208) of FANCA is required for its interaction with FAAP20. We performed targeted sequencing of this binding region of FANCA (exons 23-36) in 40 EA/TEF patients. We also investigated the effect of the p.A958V mutation on the protein-protein interaction between FANCA and FAAP20 using an in vitro binding assay and co-immunoprecipitation. Immunolocalization analysis was performed to investigate the subcellular localization of FANCA, and tissue sections and immunohistochemistry were used to explore the expression of FANCA. We identified four rare missense variants in the FANCA binding region. FANCA mutations were significantly overrepresented in EA/TEF patients compared with 4300 control subjects from the NHLBI-ESP project (Fisher's exact p = 2.17 × 10-5, odds ratio = 31.75). p.A958V, a novel de novo mutation in the FANCA gene, was identified in one patient with EA/TEF. We provide further evidence that the p.A958V mutation reduces the binding affinity of FANCA for FAAP20. Interestingly, the p.A958V mutation impaired the nuclear localization of the FANCA protein expressed in HeLa cells. We found that FANCA was more highly expressed in stratified squamous epithelium than in smooth muscle. In conclusion, mutations in the FANCA gene are associated with EA/TEF in humans.
Collapse
|
4
|
Aslan D, Karabacak RO, Aslan OD. Maternal serum alpha-fetoprotein levels are normal in Fanconi anemia: Can it be a lack of postnatal inhibition of AFP gene resulting in the elevation? Pediatr Blood Cancer 2017; 64. [PMID: 27805304 DOI: 10.1002/pbc.26297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 11/06/2022]
Abstract
We investigated the feasibility of using serum alpha-fetoprotein (AFP) levels as a screening test for prenatal diagnosis of Fanconi anemia (FA). Serial measurements in maternal serum were recorded. Parents, both heterozygous for FA, had declined prenatal molecular testing. The infant was born with no somatic abnormalities, and FA was confirmed by postnatal molecular analysis. Maternal serum AFP levels during each trimester of pregnancy were normal indicating that these levels cannot be used as a screening test in prenatal diagnosis. Three-year follow-up after birth showed constantly elevated serum levels in the patient from the start, suggesting a lack of postnatal inhibition on AFP gene.
Collapse
Affiliation(s)
- Deniz Aslan
- Faculty of Medicine, Section of Hematology, Department of Pediatrics, Gazi University, Ankara, Turkey
| | - Recep Onur Karabacak
- Faculty of Medicine, Department of Obstetrics and Gynecology, Gazi University, Ankara, Turkey
| | - Oner Deniz Aslan
- Faculty of Medicine, Department of Pediatrics, Başkent University, Ankara, Turkey
| |
Collapse
|
5
|
|
6
|
Zhang T, Wilson AF, Mahmood Ali A, Namekawa SH, Andreassen PR, Ruhikanta Meetei A, Pang Q. Loss of Faap20 Causes Hematopoietic Stem and Progenitor Cell Depletion in Mice Under Genotoxic Stress. Stem Cells 2015; 33:2320-30. [PMID: 25917546 DOI: 10.1002/stem.2048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 03/11/2015] [Indexed: 11/09/2022]
Abstract
20-kDa FANCA-associated protein (FAAP20) is a recently identified protein that associates with the Fanconi anemia (FA) core complex component, FANCA. FAAP20 contains a conserved ubiquitin-binding zinc-finger domain and plays critical roles in the FA-BRCA pathway of DNA repair and genome maintenance. The function of FAAP20 in animals has not been explored. Here, we report that deletion of Faap20 in mice led to a mild FA-like phenotype with defects in the reproductive and hematopoietic systems. Specifically, hematopoietic stem and progenitor cells (HSPCs) from Faap20(-) (/) (-) mice showed defects in long-term multilineage reconstitution in lethally irradiated recipient mice, with milder phenotype as compared to HSPCs from Fanca(-) (/) (-) or Fancc(-) (/) (-) mice. Faap20(-) (/) (-) mice are susceptible to mitomycin C (MMC)-induced pancytopenia. That is, acute MMC stress induced a significant progenitor loss especially the erythroid progenitors and megakaryocyte-erythrocyte progenitors in Faap20(-) (/) (-) mice. Furthermore, Faap20(-) (/) (-) HSPCs displayed aberrant cell cycle pattern during chronic MMC treatment. Finally, using Faap20(-) (/) (-) Fanca(-) (/) (-) double-knockout mice, we demonstrated a possible dominant effect of FANCA in the interaction between FAAP20 and FANCA. This novel Faap20 mouse model may be valuable in studying the regulation of the FA pathway during bone marrow failure progress in FA patients.
Collapse
Affiliation(s)
| | | | | | - Satoshi H Namekawa
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | - Qishen Pang
- Division of Experimental Hematology and Cancer Biology
| |
Collapse
|
7
|
Abstract
Anorectal malformations (ARMs) represent a complex group of congenital anomalies resulting from abnormal development of the hindgut, allantois and Mullerian duct resulting in complete or partial urorectal septal malformations. There is a wide variety of phenotypic expression, ranging from mild anorectal to very complex severe ARM with >75 % having other associated malformations. 50 % of cases are syndromic although many may have other associated anomalies. This suggests a genetic link but the genetics of ARM are highly complex with a number of candidate genes being identified. Many can be classified as "field defects" as a result of a complex set of genetic interactions. Patients with associated malformations can be classified into those with multiple congenital anomalies (non-syndromic), those with chromosomal abnormalities and those with non-chromosomal syndromic associations, also, those with non-chromosomal syndromes and the influence of environmental factors (e.g. drugs in pregnancy). Although much is not known about the aetiology of ARM, the weight of evidence points to genetic factors as major causes for the condition. In this review, we look at the chromosomal and genetic associations and their underlying signalling pathways, to obtain a better understanding of the pathogenetic mechanisms involved in developing ARM. The spectrum of ARM phenotypic expression probably results from involvement and crosstalk between a number of critical signalling systems involved in development of this region. As a result, it may be expressed as a "field developmental defect" with many associated abnormalities. The role of environmental factors in the development of ARM is probably less.
Collapse
Affiliation(s)
- Sam W Moore
- Department of Pediatric Surgery, Faculty of Medicine, University of Stellenbosch, PO Box 19063, Tygerberg 7505, South Africa.
| |
Collapse
|
8
|
Umaña LA, Magoulas P, Bi W, Bacino CA. A male newborn with VACTERL association and Fanconi anemia with a FANCB deletion detected by array comparative genomic hybridization (aCGH). Am J Med Genet A 2011; 155A:3071-4. [PMID: 22052692 DOI: 10.1002/ajmg.a.34296] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 08/15/2011] [Indexed: 11/05/2022]
Abstract
We report on a male newborn with multiple congenital abnormalities consistent with the diagnosis of VACTERL association (vertebral, anal, cardiac, tracheo-esophageal fistula, renal, and limb anomalies), who had Fanconi anemia (complementation group B) recognized by the detection of a deletion in chromosome Xp22.2 using an oligonucleotide array. The diagnosis of Fanconi anemia was confirmed by increased chromosomal breakage abnormalities observed in cultured cells that were treated with cross-linking agents. This is the first report in the literature of Fanconi anemia complementation group B detected by oligonucleotide array testing postnatally.
Collapse
Affiliation(s)
- Luis A Umaña
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas, USA
| | | | | | | |
Collapse
|
9
|
Crossan GP, Patel KJ. The Fanconi anaemia pathway orchestrates incisions at sites of crosslinked DNA. J Pathol 2011; 226:326-37. [PMID: 21956823 DOI: 10.1002/path.3002] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 09/21/2011] [Accepted: 09/22/2011] [Indexed: 12/18/2022]
Abstract
Fanconi anaemia (FA) is a rare, autosomal recessive, genetically complex, DNA repair deficiency syndrome in man. Patients with FA exhibit a heterogeneous spectrum of clinical features. The most significant and consistent phenotypic characteristics are stem cell loss, causing progressive bone marrow failure and sterility, diverse developmental abnormalities and a profound predisposition to neoplasia. To date, 15 genes have been identified, biallelic disruption of any one of which results in this clinically defined syndrome. It is now apparent that all 15 gene products act in a common process to maintain genome stability. At the molecular level, a fundamental defect in DNA repair underlies this complex phenotype. Cells derived from FA patients spontaneously accumulate broken chromosomes and exhibit a marked sensitivity to DNA-damaging chemotherapeutic agents. Despite complementation analysis defining many components of the FA DNA repair pathway, no direct link to DNA metabolism was established until recently. First, it is now evident that the FA pathway is required to make incisions at the site of damaged DNA. Second, a specific component of the FA pathway has been identified that regulates nucleases previously implicated in DNA interstrand crosslink repair. Taken together, these data provide genetic and biochemical evidence that the FA pathway is a bona fide DNA repair pathway that directly mediates DNA repair transactions, thereby elucidating the specific molecular defect in human Fanconi anaemia.
Collapse
Affiliation(s)
- Gerry P Crossan
- MRC Laboratory of Molecular Biology, Division of Protein and Nucleic Acid Chemistry, Cambridge, UK.
| | | |
Collapse
|
10
|
McCauley J, Masand N, McGowan R, Rajagopalan S, Hunter A, Michaud JL, Gibson K, Robertson J, Vaz F, Abbs S, Holden ST. X-linked VACTERL with hydrocephalus syndrome: further delineation of the phenotype caused by FANCB mutations. Am J Med Genet A 2011; 155A:2370-80. [PMID: 21910217 DOI: 10.1002/ajmg.a.33913] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 01/05/2011] [Indexed: 11/11/2022]
Abstract
X-linked VACTERL-hydrocephalus syndrome (X-linked VACTERL-H) is a rare disorder caused by mutations in the gene FANCB which underlies Fanconi Anemia (FA) complementation group B. Cells from affected males have increased chromosome breakage on exposure to DNA cross-linking agents. Only five FANCB mutations found in six affected males, including an affected uncle and nephew, have been reported. We have identified FANCB mutations in a further four affected families. The VACTERL-H phenotype segregates as an X-linked recessive trait in three of these. Each mutation is predicted to truncate the FANCB open reading frame and results in highly skewed X-inactivation in unaffected carrier females. Phenotypic data were available on six affected males. Comparison of the clinical findings in our patients with published clinical data (total 12 patients) shows that ventriculomegaly, bilateral absent thumbs and radii, vertebral defects, renal agenesis, and growth retardation are the major phenotypic signs in affected males. Less frequent are brain, pituitary, ear and eye malformations, gastrointestinal atresias (esophageal, duodenal and anal), tracheoesophageal fistula, lung segmentation defects, and small genitalia. Three of six of our patients survived the perinatal period. One boy lived up to 2 years 10 months but developed aplastic anemia and died of renal failure. These data show that loss-of-function FANCB mutations result in a recognizable, multiple malformation phenotype in hemizygous males for which we propose clinical criteria to aid diagnosis.
Collapse
Affiliation(s)
- Joanna McCauley
- Molecular Genetics Laboratory, GSTS Pathology, Guy's Hospital, London, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Chung B, Shaffer LG, Keating S, Johnson J, Casey B, Chitayat D. From VACTERL-H to heterotaxy: Variable expressivity of ZIC3-related disorders. Am J Med Genet A 2011; 155A:1123-8. [DOI: 10.1002/ajmg.a.33859] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 11/22/2010] [Indexed: 11/08/2022]
|
12
|
Felix JF, de Jong EM, Torfs CP, de Klein A, Rottier RJ, Tibboel D. Genetic and environmental factors in the etiology of esophageal atresia and/or tracheoesophageal fistula: an overview of the current concepts. ACTA ACUST UNITED AC 2009; 85:747-54. [PMID: 19452513 DOI: 10.1002/bdra.20592] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Esophageal atresia and/or tracheoesophageal fistula (EA/TEF) are severe congenital anomalies. Although recent years have brought significant improvement in clinical treatment, our understanding of the etiology of these defects is lagging. Many genes and genetic pathways have been implicated in the development of EA/TEF, but only a few genes have been shown to be involved in humans, in animals, or in both. Extrapolating data from animal models to humans is not always straightforward. Environmental factors may also carry a risk, but the mechanisms are yet to be elucidated. This review gives an overview of the current state of knowledge about both genetic and environmental risk factors in the etiology of EA/TEF.
Collapse
Affiliation(s)
- Janine F Felix
- Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, 3000 CB Rotterdam, the Netherlands
| | | | | | | | | | | |
Collapse
|
13
|
Lategan B, Chodirker BN, Del Bigio MR. Fetal hydrocephalus caused by cryptic intraventricular hemorrhage. Brain Pathol 2009; 20:391-8. [PMID: 19476462 DOI: 10.1111/j.1750-3639.2009.00293.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Cryptic intracerebral hemorrhage as an etiological factor in fetal hydrocephalus has been postulated but not described at autopsy. Four fetuses with overt hydrocephalus diagnosed by in utero ultrasound examination were examined at autopsy at 19-22 weeks gestation. Although a hemorrhagic etiology was not evident on ultrasound, hemosiderin-containing macrophages and associated reactive changes were found to obstruct the otherwise well-formed cerebral aqueduct in all four. Coagulopathy due to thrombocytopenia was implicated in one case. Anomalies involving other parts of the body were identified in two cases, although a direct link to the hydrocephalus was not obvious. The abnormality was isolated in one case. In three cases, possible sites of hemorrhage in the ventricles were identified. This abnormality represents a significant proportion of the fetuses examined for hydrocephalus in our referral center. We discuss the importance of careful autopsy examination in the diagnosis of cryptic intracerebral hemorrhage and the implications for counseling.
Collapse
Affiliation(s)
- Belinda Lategan
- Department of Pathology, University of Manitoba and Health Sciences Centre, Winnipeg, Canada
| | | | | |
Collapse
|
14
|
Abstract
Gastrointestinal development is a complex process comprising folding of the endodermal layer to form the primitive gut tube, cell differentiation along its anteroposterior axis, the budding of the various organ primordia and development of derivative organs like the liver and pancreas and the colonisation of the gut with neuronal precursors. Genetic factors are increasingly recognised as playing a significant role in the disturbance of this developmental process which underlies congenital malformations and gastrointestinal disorders. Furthermore, genetic variation and its interaction with environmental influences play an important role in the pathogenesis of functional gastrointestinal disorders. In this review, we discuss the contribution of genetic variants, ranging from highly penetrant mutations and chromosomal abnormalities to genetic polymorphisms, to the pathogenesis of a number of structural and functional gastrointestinal disorders.
Collapse
Affiliation(s)
- Shirley Hodgson
- Professor of Cancer Genetics, St.George's, University of London, United Kingdom
| | | |
Collapse
|
15
|
Rhombencephalosynapsis and related anomalies: a neuropathological study of 40 fetal cases. Acta Neuropathol 2009; 117:185-200. [PMID: 19057916 DOI: 10.1007/s00401-008-0469-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 11/25/2008] [Accepted: 11/26/2008] [Indexed: 12/12/2022]
Abstract
Rhombencephalosynapsis is an uncommon cerebellar malformation defined by vermian agenesis with fusion of the hemispheres and of the dentate nuclei. Embryologic and genetic mechanisms are still unknown, and to date, no animal models are available. Ultrasound diagnosis is generally suspected after 22 weeks of gestation, and usually the abnormality is suggested by ventriculomegaly. Morphological analysis of 40 fetuses after medical termination of pregnancy allowed us to confirm that rhombencephalosynapsis was always associated with other brain abnormalities or malformations: Purkinje cell heterotopias, fusion of colliculi, forking and/or atresia of the aqueduct and of the third ventricle resulting in a fusion of the thalami, agenesis of the corpus callosum, lobar holoprosencephaly and neural tube defects. Pons and medulla were very infrequently abnormal. Furthermore, complete autopsy made it possible to separate either pure neurologic phenotypes, or associated with extraneural anomalies from syndromic forms: Gomez-Lopez-Hernandez syndrome (1 case) and VACTERL-H syndrome (6 cases). The number of our fetal cases strongly suggests that VACTERL-H association related with rhombencephalosynapsis emerges as a non-random association. Furthermore, recurrence and consanguinity were noted in two different families, which argue for a sporadic or inherited cause. From our results, it could be suggested that rhombencephalosynapsis may be due to defective genes regulating formation of the roof plate and the development of midline cerebellar primordium at the junction of the mesencephalon and of the first rhombomere.
Collapse
|
16
|
Abstract
Esophageal atresia (OA) and tracheoesophageal fistula (TOF) are important human birth defects of unknown etiology. The embryogenesis of OA/TOF remains poorly understood, mirroring the lack of clarity of the mechanisms of normal tracheoesophageal development. The development of rat and mouse models of OA/TOF has allowed the parallel study of both normal and abnormal embryogenesis. Although controversies persist, the fundamental morphogenetic process appears to be a rearrangement of the proximal foregut into separate respiratory (ventral) and gastrointestinal (dorsal) tubes. This process depends on the precise temporal and spatial pattern of expression of a number of foregut patterning genes. Disturbance of this pattern disrupts foregut separation and underlies the development of tracheoesophageal malformations.
Collapse
Affiliation(s)
- Adonis S Ioannides
- Clinical Genetics Unit, Great Ormond Street Hospital, London, United Kingdom.
| | | |
Collapse
|
17
|
Garcia-Barceló MM, Wong KKY, Lui VCH, Yuan ZW, So MT, Ngan ESW, Miao XP, Chung PHY, Khong PL, Tam PKH. Identification of aHOXD13mutation in a VACTERL patient. Am J Med Genet A 2008; 146A:3181-5. [DOI: 10.1002/ajmg.a.32426] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
18
|
Abstract
Fanconi's anemia is one of the inherited causes of bone marrow failure. It is inherited in autosomal recessive fashion. It presents as aplastic anemia usually at the age of 7-8 yr. Leukemias and solid tumours are complications in those who manage to survive beyond two decades. Though it has been seen in siblings, reports in monozygotic twins have been very few.
Collapse
Affiliation(s)
- Fulton D'Souza
- Department of Pediatrics, St. John's Medical College Hospital, Bangalore, India
| | | | | |
Collapse
|
19
|
Abstract
Numerous metabolic disorders, teratogenic agents, and in utero infections lead to congenital bone disease and malformation. This review focuses on hereditary and familial disorders of bone with particular emphasis on impaired hematopoiesis, myelofibrosis, pathologic fractures, and dysmorphology of the forearm and craniofacial structures. The severity of bone disease and marrow dysfunction of any given disorder may vary considerably from one affected individual to the next, and intrapersonal variability over time may be substantial as well. Both can impart difficulty to the appropriate evaluation and delay the correct diagnosis. Many of these disorders are phenotypically quite similar but require very different therapeutic intervention.
Collapse
Affiliation(s)
- Hans-Christoph Rossbach
- Division of Pediatric Hematology/Oncology, St. Joseph Children's Hospital, and University of South Florida, Tampa, Florida 33607, USA.
| |
Collapse
|
20
|
Szajkowski TP, Chodirker BN, MacDonald KM, Evans JA. Maternal serum alpha-fetoprotein levels in fetal hydrocephalus: a retrospective population based study. BMC Pregnancy Childbirth 2006; 6:23. [PMID: 16824231 PMCID: PMC1526755 DOI: 10.1186/1471-2393-6-23] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Accepted: 07/07/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although maternal serum alpha-fetoprotein (MSAFP) is a highly sensitive marker for certain congenital malformations such as open neural tube and ventral wall defects, its usefulness as a screening test for fetal hydrocephalus is uncertain. We wished to determine the distribution of maternal serum alpha-fetoprotein levels associated with fetal hydrocephalus in a population-based screening program in Manitoba, and their potential relationship to additional anomalies. METHODS Cases of fetal hydrocephalus unrelated to neural tube defects were ascertained from multiple sources and reviewed. Cross-reference with the Manitoba Maternal Serum Screening Program database determined which mothers had undergone maternal serum screening. Mean MSAFP levels in both isolated and complex hydrocephalus were calculated and compared with the general population of screened pregnancies using Independent Samples T-tests. RESULTS Mean MSAFP levels in 70 cases of fetal hydrocephalus were significantly higher than those of the general population of screened pregnancies (P = 0.029). This was due to the fact that mean MSAFP levels in those cases with other major anomalies were increased over those of the general population (P = 0.041); cases with hydrocephalus alone showed no significant difference (P = 0.203). Only seven cases (10%) had MSAFP levels > or = 2.3 multiples of the median, the cut-off used in Manitoba. However, six of these (86%) had additional major and/or minor malformations. CONCLUSION MSAFP screening has low sensitivity for fetal hydrocephalus and is rarely elevated in isolated cases. However, when fetal hydrocephalus is detected, elevated MSAFP levels indicate that the fetus is at significant risk to have additional malformations and further investigations, including chromosome breakage studies, may be indicated.
Collapse
Affiliation(s)
- Terrence P Szajkowski
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bernard N Chodirker
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Karen M MacDonald
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jane A Evans
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
21
|
Faivre L, Portnoï MF, Pals G, Stoppa-Lyonnet D, Le Merrer M, Thauvin-Robinet C, Huet F, Mathew CG, Joenje H, Verloes A, Baumann C. Should chromosome breakage studies be performed in patients with VACTERL association? Am J Med Genet A 2005; 137:55-8. [PMID: 16015582 DOI: 10.1002/ajmg.a.30853] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The VACTERL association is characterized as a non-random pattern of defects including at least three of the following cardinal features: vertebral anomalies, anal atresia, cardiovascular malformations, tracheoesophageal fistula, renal and limb anomalies, and is postulated to be a very heterogeneous disorder. These defects can also be seen as part of the Fanconi anemia (FA) spectrum. Although VACTERL with hydrocephaly has clearly been associated with FA, the indication for chromosome breakage studies is not clear in VACTERL without hydrocephaly. We report on three unrelated patients with the VACTERL phenotype and the confirmed diagnosis of FA. Together with the data of 13 similar cases extracted from a European genotype-phenotype correlation study for FA and those from the four reported cases of the literature, we show that (i) in a series of individuals proven to have FA, 5% (13/245) also have the VACTERL phenotype, (ii) all have radial ray anomalies and 12 of these 13 subjects show at least 1 other feature of FA (café au lait spots, growth retardation, microcephaly, dysmorphism), and (iii) the VACTERL phenotype appears to be over represented in the FA complementation groups D1, E, and F. Since the diagnosis of FA is important for genetic counseling and early therapeutic intervention in patients, we conclude that chromosomal breakage studies should be performed, not only in cases of VACTERL with hydrocephaly, but also in cases VACTERL with radial-ray anomalies and especially if the individual has additional FA associated manifestations such as skin pigmentation abnormalities, growth retardation, microcephaly, or microphthalmia.
Collapse
|
22
|
Abstract
A boy is described with Fanconi anemia (FA) and Klippel-Feil anomaly. This suggests the diagnosis of FA should be considered in patients with vertebal malformations as well as other suggestive congenital anomalies.
Collapse
|
23
|
|
24
|
Manouvrier S, Moerman A, Coeslier A, Devisme L, Boute O, Le Merrer M. Radioulnar synostosis, radial ray abnormalities, and severe malformations in the male: a new X-linked dominant multiple congenital anomalies syndrome? AMERICAN JOURNAL OF MEDICAL GENETICS 2000; 90:351-5. [PMID: 10706353 DOI: 10.1002/(sici)1096-8628(20000228)90:5<351::aid-ajmg1>3.0.co;2-k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe a multiple congenital anomalies (MCA) syndrome dominantly transmitted through three generations. Radial ray abnormalities with wide variability of expression were observed in four female patients. Moreover, a 14-week-gestation male fetus had severe radial ray malformation, anencephaly, unilateral renal agenesis, and a common dorsal mesentery. Results of high-resolution karyotyping were normal in the malformed fetus and his affected mother. Furthermore, several spontaneous abortions of male fetuses had occurred in this pedigree. To our knowledge, a similar association has not been described previously. It could represent a new X-linked dominant MCA syndrome, or an autosomal dominant condition with severe expression limited to males.
Collapse
Affiliation(s)
- S Manouvrier
- Consultation de Génétique Clinique, Hôpital Jeanne de Flandre, Lille, France.
| | | | | | | | | | | |
Collapse
|
25
|
Abstract
Recognition of congenital anomalies that predispose to childhood cancer allows for the institution of a cancer surveillance program, identification of relatives with increased cancer risk, and recurrence risk counseling. In this article, a systems approach to the diagnosis of 21 childhood cancer syndromes is set forth in the format of the pediatric physical examination. In the second part of this article, guidelines are presented for genetic testing, cancer screening, and genetic counseling for the 21 cancer syndromes.
Collapse
Affiliation(s)
- C L Clericuzio
- University of New Mexico Pediatrics, ACC3, Albuquerque, NM 87131-5311, USA. ccleri@salud,unm.edu
| |
Collapse
|
26
|
Schrander-Stumpel C, Fryns JP. Congenital hydrocephalus: nosology and guidelines for clinical approach and genetic counselling. Eur J Pediatr 1998; 157:355-62. [PMID: 9625330 DOI: 10.1007/s004310050830] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Congenital hydrocephalus is a serious condition that can arise from multiple causes. It comprises a diverse group of conditions which result in impaired circulation and absorption of cerebrospinal fluid. Congenital malformations of the central nervous system, infections, haemorrhage, trauma, teratogens and, occasionally, tumours can all give rise to hydrocephalus. In this paper we focus on the genetic aspects of hydrocephalus, excluding neural tube defects. The incidence is 0.4-0.8 per 1000 liveborns and stillbirths. X-linked hydrocephalus comprises approximately 5% of all cases. This condition is caused by mutations in the gene at Xq28 encoding for L1, a neural cell adhesion molecule. Carrier detection and prenatal diagnosis can be offered to affected families by means of chorionic villus biopsy and linkage analysis or L1 mutation analysis. In general, recurrence risk for congenital hydrocephalus excluding X-linked hydrocephalus, is low; empiric risk figures found in various studies range from <1% to 4%. Unfortunately, prenatal diagnosis based on an early ultrasound scan is not always reliable as ventriculomegaly usually starts after 20 weeks of gestation. We stress the importance of additional clinical investigations. Prognosis in the prenatally diagnosed patients depends on additional malformations but in general, is not very good. CONCLUSION Congenital hydrocephalus may be non-syndromic and syndromic. Prognosis depends primarily on the underlying cause and/or associated malformations, which have to be delineated on the basis of clinical, cytogenetic and molecular analysis.
Collapse
|
27
|
Kovács T, Csécsei K, Szabó M, Tóth Z, Veress L, Papp Z. Ventriculomegaly with radial and renal defects: Prenatal diagnosis in two consecutive sibs. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/(sici)1096-8628(19971219)73:3<259::aid-ajmg5>3.0.co;2-n] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|