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Xia C, Kumar D, You B, Streck DL, Osborne L, Dermody J, Jiang JG, Pletcher BA. Wolf-Hirschhorn Syndrome with Hyperparathyroidism: A Case Report and a Narrative Review of the Literature. J Pediatr Genet 2023; 12:312-317. [PMID: 38162156 PMCID: PMC10756731 DOI: 10.1055/s-0041-1729751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
Wolf-Hirschhorn syndrome (WHS) is a contiguous gene deletion condition. The WHS core phenotype includes developmental delays, intellectual disabilities, seizures, and distinctive facial features. Various other comorbidities have also been reported, such as hearing loss, heart defects, as well as eye problems and kidney problems. In this report, we present a case of WHS accompanied by hyperparathyroidism and hypercalcemia, which has not been previously reported. A girl was born at 37 weeks of gestation by vaginal delivery. She was small for the gestational age (2,045 g) and admitted to neonatal intensive care unit. She had typical WHS facial features and was found to have bilateral small kidneys associated with transient metabolic acidosis and renal insufficiency. She had right-sided sensorineural hearing loss, a small atrial septal defect, and colpocephaly and hypoplasia of corpus callosum. She had a single seizure which was well controlled with an oral antiepileptic medication. Cytogenetic studies demonstrated a large terminal chromosome 4p deletion (21.4 Mb) and 4p duplication (2.1 Mb) adjacent to the deletion. A unique finding in this patient is her consistently elevated levels of parathyroid hormone and serum calcium, suggesting hyperparathyroidism. We present this rare case along with a review of the literature and hope to draw an attention to a potential relationship between WHS and hyperparathyroidism.
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Affiliation(s)
- Changqing Xia
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Dibyendu Kumar
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Bei You
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Deanna L. Streck
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Lisa Osborne
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - James Dermody
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Jie-Gen Jiang
- Institute of Medical Genetics and Genomics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Beth A. Pletcher
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey, United States
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De Falco L, Vitiello G, Savarese G, Suero T, Ruggiero R, Savarese P, Ianniello M, Petrillo N, Bruno M, Legnante A, Passaretti FF, Ardisia C, Di Spiezio Sardo A, Fico A. A Case Report of a Feto-Placental Mosaicism Involving a Segmental Aneuploidy: A Challenge for Genome Wide Screening by Non-Invasive Prenatal Testing of Cell-Free DNA in Maternal Plasma. Genes (Basel) 2023; 14:668. [PMID: 36980940 PMCID: PMC10048202 DOI: 10.3390/genes14030668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
Non-invasive prenatal testing (NIPT) using cell-free DNA can detect fetal chromosomal anomalies with high clinical sensitivity and specificity. In approximately 0.1% of clinical cases, the NIPT result and a subsequent diagnostic karyotype are discordant. Here we report a case of a 32-year-old pregnant patient with a 44.1 Mb duplication on the short arm of chromosome 4 detected by NIPT at 12 weeks' gestation. Amniocentesis was carried out at 18 weeks' gestation, followed by conventional and molecular cytogenetic analysis on cells from the amniotic fluid. SNP array analysis found a de novo deletion of 1.2 Mb at chromosome 4, and this deletion was found to be near the critical region of the Wolf-Hirschhorn syndrome. A normal 46,XY karyotype was identified by G-banding analysis. The patient underwent an elective termination and molecular investigations on tissues from the fetus, and the placenta confirmed the presence of type VI true fetal mosaicism. It is important that a patient receives counselling following a high-risk call on NIPT, with appropriate diagnostic analysis advised before any decisions regarding the pregnancy are taken. This case highlights the importance of genetic counselling following a high-risk call on NIPT, especially in light of the increasing capabilities of NIPT detection of sub-chromosomal deletions and duplications.
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Affiliation(s)
- Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Giuseppina Vitiello
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Hospital, Via Pansini 5, 80131 Naples, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Teresa Suero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Raffaella Ruggiero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Pasquale Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Mariasole Bruno
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Antonietta Legnante
- Department of Public Health, University of Naples “Federico II”, 80145 Naples, Italy
| | - Francesco Fioravanti Passaretti
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Hospital, Via Pansini 5, 80131 Naples, Italy
| | - Carmela Ardisia
- CRR Genetica Medica, Azienda Ospedaliera s. Maria della Misericordia, 06156 Perugia, Italy
| | | | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
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Wiel LC, Bruno I, Barbi E, Sirchia F. From Wolf-Hirschhorn syndrome to NSD2 haploinsufficiency: a shifting paradigm through the description of a new case and a review of the literature. Ital J Pediatr 2022; 48:72. [PMID: 35550183 PMCID: PMC9097050 DOI: 10.1186/s13052-022-01267-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Wolf-Hirschhorn syndrome (WHS) is a well-defined disorder, whose core phenotype encompasses growth restriction, facial gestalt, intellectual disability and seizures. Nevertheless, great phenotypic variability exists due to the variable extent of the responsible 4p deletion. In addition, exome sequencing analyses, recently identified two genes, namely NSD2 and NELFA, whose loss-of-function variants contribute to a clinical spectrum consistent with atypical or partial WHS. The observation of patients exhibiting clinical features resembling WHS, with only mild developmental delay and without the typical dysmorphic features, carrying microdeletions sparing NSD2, has lead to the hypothesis that NSD2 is responsible for the intellectual disability and the facial gestalt of WHS. While presenting some of the typical findings of WHS (intellectual disability, facial gestalt, microcephaly, growth restriction and congenital heart defects), NSD2-deleted children tend to display a milder spectrum of skeletal abnormalities, usually consisting of clinodactyly, and do not exhibit seizures. We describe the clinical picture of a child with WHS due to a de novo mutation of NSD2 and discuss the clinical and diagnostic implications. Case presentation A 6-year-old boy was evaluated for a history of intrauterine growth restriction, low birth weight, neonatal hypotonia, and psychomotor delay. No episodes of seizure were reported. At physical examination, he displayed marphanoid habitus, muscle hypotrophy and facial dysmorphisms consisting in high frontal hairline, upslanting palpebral fissures and full lips with bifid ugula. Cryptorchidism, shawl scrotum, mild clinodactyly of the right little finger and bilateral syndactyly of the II and III toes with sandal gap were also noted. The radiographic essay demonstrated delayed bone age and echocardiography showed mild mitral prolapse. Whole genome sequencing analysis revealed a heterozygous de novo variant of NSD2 (c.2523delG). Conclusions Full WHS phenotype likely arises from the cumulative effect of the combined haploinsufficiency of several causative genes mapping within the 4p16.3 region, as a contiguous genes syndrome, with slightly different phenotypes depending on the specific genes involved in the deletion. When evaluating children with pictures resembling WHS, in absence of seizures, clinicians should consider this differential diagnosis.
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Affiliation(s)
| | - Irene Bruno
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy.,Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Fabio Sirchia
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
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Simonini C, Hoopmann M, Kagan KO, Schröder T, Gembruch U, Geipel A. Prenatal sonographic findings in confirmed cases of Wolf-Hirschhorn syndrome. BMC Pregnancy Childbirth 2022; 22:327. [PMID: 35428251 PMCID: PMC9013087 DOI: 10.1186/s12884-022-04665-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Wolf-Hirschhorn syndrome (WHS) is a common genetic condition and prenatal diagnosis is difficult due to heterogeneous expression of this syndrome and rather non-specific ultrasound findings. Objective of this study was to examine the prenatal ultrasound findings in fetuses with Wolf-Hirschhorn syndrome (WHS). Methods Retrospective assessment of 18 pregnancies that were seen at three tertiary referral centers (Universities of Bonn, Tuebingen and Nuernberg / Germany). Findings of prenatal ultrasound examinations, genetic results and outcome were compared. Additionally, findings of our study were compared to previous small case series from the literature and then compared to data on postnatal frequencies and abnormalities in affected patients. Results Median gestational age at the time of examination was 23 + 1 weeks’ (range: 13 + 4 to 29 + 1 weeks’) with female-to-male ratio of > 2.5:1. Most frequent ultrasound findings were facial abnormalities, symmetric IUGR and microcephaly that presented in 94.4, 83.3 and 72.2% of cases, respectively. The combination of microcephaly and hypoplastic nasal bone was a particularly characteristic finding. Growth retardation presented in all fetuses > 20 weeks, but not below. Other frequent abnormalities included cardiac anomalies in 50 and single umbilical artery (SUA) in 44.4% of fetuses. Conclusion WHS should be considered in the presence of symmetric IUGR together with microcephaly, hypoplastic nasal bone and facial abnormalities on prenatal ultrasound. Genetic testing by chromosomal microarray analysis (CMA) is strongly recommended in this context.
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Serrano Martín C, Fernández Feijoo J, García Mato E, Varela Aneiros I, Diniz Freitas M, Vázquez García E, Limeres Posse J. "A practical approach to dental care for patients with Wolf-Hirschhorn syndrome". SPECIAL CARE IN DENTISTRY 2021; 42:137-142. [PMID: 34538003 DOI: 10.1111/scd.12644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 11/27/2022]
Abstract
Wolf-Hirschhorn syndrome is a polymalformative chromosomal disorder caused by a deletion in the distal region of the short arm of chromosome 4. The disease is considered rare (1/50,000 births) and predominantly affects females (2:1). In addition to the characteristic facial phenotype ("Greek warrior helmet"), its clinical manifestations include epilepsy, developmental and psychomotor delay, intellectual disability, cardiac and respiratory complications, and eating problems. The most prevalent oral manifestations are hypodontia, delayed tooth eruption, morphological dental abnormalities, dental malocclusions, cleft lip/palate and ogival palate. Based on our clinical experience, Wolf-Hirschhorn syndrome does not represent an absolute contraindication for any type of dental procedure. The feasibility of dental treatment will depend mainly on the degree of epilepsy control and on the level of collaboration, this latter conditioned by the severity of the intellectual disability and communication difficulties.
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Affiliation(s)
- Candela Serrano Martín
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Javier Fernández Feijoo
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Eliane García Mato
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Iván Varela Aneiros
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Marcio Diniz Freitas
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | | | - Jacobo Limeres Posse
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Gavril EC, Luca AC, Curpan AS, Popescu R, Resmerita I, Panzaru MC, Butnariu LI, Gorduza EV, Gramescu M, Rusu C. Wolf-Hirschhorn Syndrome: Clinical and Genetic Study of 7 New Cases, and Mini Review. CHILDREN 2021; 8:children8090751. [PMID: 34572183 PMCID: PMC8471045 DOI: 10.3390/children8090751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
Wolf–Hirschhorn syndrome (WHS), a rare disorder determined by distal 4p deletion, is characterized by a pre and postnatal growth retardation, hypotonia, intellectual disability, epilepsy, craniofacial dysmorphism, and congenital fusion anomalies. The clinical aspects are dependent on the deletion’ size. Our aim was to identify rare specific characteristics in a cohort of seven cases with 4p deletion and to assess the utility of Multiplex ligation-dependent probe amplification (MLPA) (cheap and sensitive test)—combined kits—as a diagnostic test and selection tool for cases that require other investigations (chromosomal microarray analysis—CMA, karyotype). For all cases we conducted a clinical examination with the main features identified: facial dysmorphism, intellectual disability, postnatal development delay, cardiac defects and hypotonia. In some cases, we observed seizures, structural brain abnormalities, immunodeficiencies, and renal anomalies. Prenatal growth retardation was detected in a relatively small number of cases, but postnatal growth failure was a constant feature. In all cases, the clinical diagnosis was confirmed by genetic analyses: karyotype and/or MLPA. In conclusion, renal and brain defects, as well as immunodeficiency are rare manifestations and should be looked for. Although CMA is the standard test, in our experience, MLPA is also a reliable screening method as the identified cases were either confirmed by MLPA or selected for further investigations.
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Affiliation(s)
- Eva-Cristiana Gavril
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
| | - Alina Costina Luca
- Department of Pediatric Cardiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania
- “St. Mary” Children’s Hospital, Vasile Lupu Street, No 62-64, 700309 Iasi, Romania
- Correspondence: (A.C.L.); (A.-S.C.)
| | - Alexandrina-Stefania Curpan
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University of Iasi, Bd. Carol I, 20A, 700505 Iasi, Romania
- Correspondence: (A.C.L.); (A.-S.C.)
| | - Roxana Popescu
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
- “St. Mary” Children’s Hospital, Vasile Lupu Street, No 62-64, 700309 Iasi, Romania
| | - Irina Resmerita
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
| | - Monica Cristina Panzaru
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
- “St. Mary” Children’s Hospital, Vasile Lupu Street, No 62-64, 700309 Iasi, Romania
| | - Lacramioara Ionela Butnariu
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
- “St. Mary” Children’s Hospital, Vasile Lupu Street, No 62-64, 700309 Iasi, Romania
| | - Eusebiu Vlad Gorduza
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
| | - Mihaela Gramescu
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
| | - Cristina Rusu
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, University Street, No 16, 700115 Iasi, Romania; (E.-C.G.); (R.P.); (I.R.); (M.C.P.); (L.I.B.); (E.V.G.); (M.G.); (C.R.)
- “St. Mary” Children’s Hospital, Vasile Lupu Street, No 62-64, 700309 Iasi, Romania
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Schreuder WH, van der Wal JE, de Lange J, van den Berg H. Multiple versus solitary giant cell lesions of the jaw: Similar or distinct entities? Bone 2021; 149:115935. [PMID: 33771761 DOI: 10.1016/j.bone.2021.115935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
The majority of giant cell lesions of the jaw present as a solitary focus of disease in bones of the maxillofacial skeleton. Less frequently they occur as multifocal lesions. This raises the clinical dilemma if these should be considered distinct entities and therefore each need a specific therapeutic approach. Solitary giant cell lesions of the jaw present with a great diversity of symptoms. Recent molecular analysis revealed that these are associated with somatic gain-of-function mutations in KRAS, FGFR1 or TRPV4 in a large component of the mononuclear stromal cells which all act on the RAS/MAPK pathway. For multifocal lesions, a small group of neoplastic multifocal giant cell lesions of the jaw remain after ruling out hyperparathyroidism. Strikingly, most of these patients are diagnosed with jaw lesions before the age of 20 years, thus before the completion of dental and jaw development. These multifocal lesions are often accompanied by a diagnosis or strong clinical suspicion of a syndrome. Many of the frequently reported syndromes belong to the so-called RASopathies, with germline or mosaic mutations leading to downstream upregulation of the RAS/MAPK pathway. The other frequently reported syndrome is cherubism, with gain-of-function mutations in the SH3BP2 gene leading through assumed and unknown signaling to an autoinflammatory bone disorder with hyperactive osteoclasts and defective osteoblastogenesis. Based on this extensive literature review, a RAS/MAPK pathway activation is hypothesized in all giant cell lesions of the jaw. The different interaction between and contribution of deregulated signaling in individual cell lineages and crosstalk with other pathways among the different germline- and non-germline-based alterations causing giant cell lesions of the jaw can be explanatory for the characteristic clinical features. As such, this might also aid in the understanding of the age-dependent symptomatology of syndrome associated giant cell lesions of the jaw; hopefully guiding ideal timing when installing treatment strategies in the future.
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacqueline E van der Wal
- Department of Pathology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatrics / Oncology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
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8
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Battaglia A, Carey JC. The delineation of the Wolf-Hirschhorn syndrome over six decades: Illustration of the ongoing advances in phenotype analysis and cytogenomic technology. Am J Med Genet A 2021; 185:2748-2755. [PMID: 34002939 DOI: 10.1002/ajmg.a.62341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 11/10/2022]
Abstract
Since Hirschhorn's description in 1961, the history and chronology of the clinical, cytogenetic, and molecular characterization of Wolf-Hirschhorn syndrome (WHS) elegantly demonstrates the remarkable advances in genetic technology over the last six decades that have paralleled the delineation of the phenotype. After mention in the Human Chromosome Newsletter of a child with a visible deletion of the top of a B chromosome group, 4-5, Hirschhorn and colleagues companioned their report with that of Wolf et al. in Humangenetik in 1965, and the condition was recognized and named. The 1960-1970s witnessed the description of many of the now classic chromosome disorders, including WHS, while HRB allowed for the recognition of chromosome syndromes with smaller deletions/duplications. FISH probes, developed in the next two decades, enabled the characterization of the critical region of WHS and improved clinical diagnosis with subtelomeric probes. Cytogenomic microarray in the early-mid 2000s led to both improved diagnosis of WHS patients and documentation of microdeletions of <5 megabases, helping to characterize the critical regions for specific component phenotypes (e.g., seizures, face). Recently exome sequencing technology has led to the discovery of WHS patients with WHSC1 loss of function variants, displaying some cardinal features of the phenotype (face, growth, and developmental delay).
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Affiliation(s)
- Agatino Battaglia
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - John C Carey
- Department of Pediatrics, Division of Medical Genetics, University of Utah, Utah, USA
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9
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Rjiba K, Ayech H, Kraiem O, Slimani W, Jelloul A, Ben Hadj Hmida I, Mahdhaoui N, Saad A, Mougou-Zerelli S. Disorders of sex development in Wolf-Hirschhorn syndrome: a genotype-phenotype correlation and MSX1 as candidate gene. Mol Cytogenet 2021; 14:12. [PMID: 33627176 PMCID: PMC7905666 DOI: 10.1186/s13039-021-00531-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/28/2021] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Wolf-Hirschhorn (WHS) is a set of congenital physical anomalies and mental retardation associated with a partial deletion of the short arm of chromosome 4. To establish a genotype-phenotype correlation; we carried out a molecular cytogenetic analysis on two Tunisian WHS patients. Patient 1 was a boy of 1-year-old, presented a typical WHS phenotype while patient 2, is a boy of 2 days presented an hypospadias, a micropenis and a cryptorchidie in addition to the typical WHS phenotype. Both the array comparative genomic hybridization and fluorescence in situ hybridization techniques were used. RESULTS Results of the analysis showed that patient 2 had a greater deletion size (4.8 Mb) of chromosome 4 than patient 1 (3.4 Mb). Here, we notice that the larger the deletion, the more genes are likely to be involved, and the more severe the phenotype is likely to be. If we analyze the uncommon deleted region between patient1 and patient 2 we found that the Muscle Segment Homeobox (MSX1) gene is included in this region. MSX1 is a critical transcriptional repressor factor, expressed in the ventral side of the developing anterior pituitary and implicated in gonadotrope differentiation. Msx1 acts as a negative regulatory pituitary development by repressing the gonadotropin releasing hormone (GnRH) genes during embryogenesis. We hypothesized that the deletion of MSX1 in our patient may deregulate the androgen synthesis. CONCLUSION Based on the MSX1 gene function, its absence might be indirectly responsible for the hypospadias phenotype by contributing to the spatiotemporal regulation of GnRH transcription during development.
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Affiliation(s)
- Khouloud Rjiba
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia.,Higher Institute of Biotechnology, Monastir University, Monastir, Tunisia.,Unité de Services Communs en Génétique Humaine, Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisia
| | - Hédia Ayech
- Pediatric Department, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Olfa Kraiem
- Pediatric Department, Regional Hospital, Kairouan, Tunisia
| | - Wafa Slimani
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia.,Higher Institute of Biotechnology, Monastir University, Monastir, Tunisia.,Unité de Services Communs en Génétique Humaine, Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisia
| | - Afef Jelloul
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Imen Ben Hadj Hmida
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Nabiha Mahdhaoui
- Pediatric Department, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Ali Saad
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia.,Unité de Services Communs en Génétique Humaine, Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisia
| | - Soumaya Mougou-Zerelli
- Laboratory of Human Cytogenetics, Molecular Genetics and Biology of Reproduction, Farhat Hached University Teaching Hospital, Sousse, Tunisia. .,Unité de Services Communs en Génétique Humaine, Faculté de Médecine de Sousse, Université de Sousse, Sousse, Tunisia.
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10
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Çelik G, Batu Oto B, Kızılay O, Kılıçarslan O, Toptan HH. An unusual ophthalmic presentation of Wolf-Hirschhorn syndrome. Ophthalmic Genet 2021; 42:326-328. [PMID: 33599186 DOI: 10.1080/13816810.2021.1888130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: Wolf-Hirschhorn syndrome (WHS) is a rare inherited disease caused by the deletion in short arm of 4th chromosome. Various ocular manifestations in WHS have been described previously. We present an extraordinary clinical case of WHS associated with optic nerve head malformation and optic nerve sheath enlargement in the same eye.Methods: Case reportResults: A male infant was delivered by Caesarean section at 38 weeks with a birth weight of 2040 gr and admitted to neonatal intensive care unit due to multi-systemic abnormalities. The infant had multiple congenital anomalies; a cleft palate, microcephalia, micrognathia, renal pelvicalyceal ectasia, atrial septal defect, transvers arcus hypoplasia, patent ductus arteriosus, hypospadias and undescended testicle. Fundus examination revealed optic disc coloboma of both eyes. Two weeks later, at the second examination, the left optic disc margins were indistinct with vessels radiating from the disc margins which resembles morning glory disc anomaly (MGDA). The MRI demonstrated corpus callosum agenesis and a T1 hypointense, T2 hyperintense, 12 × 9 mm optic nerve sheath enlargement in the retrobulbar area.Conclusion: The case presented here demonstrates that, the optic nerve head malformations and optic nerve sheath enlargement may be due to incomplete closure of choroidal fissure and subsequent accumulation of cerebrospinal fluid may result in a spectrum of optic nerve head malformations.
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Affiliation(s)
- Gökhan Çelik
- Department of Ophthalmology, ROP Screening, Treatment and Training Center, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, Istanbul, Turkey
| | - Bilge Batu Oto
- Department of Ophthalmology, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Osman Kızılay
- Department of Ophthalmology, ROP Screening, Treatment and Training Center, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, Istanbul, Turkey
| | - Oğuzhan Kılıçarslan
- Department of Ophthalmology, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Handan Hakyemez Toptan
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, Istanbul, Turkey
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11
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Mekkawy MK, Kamel AK, Thomas MM, Ashaat EA, Zaki MS, Eid OM, Ismail S, Hammad SA, Megahed H, ElAwady H, Refaat KM, Hussien S, Helmy N, Abd Allah SG, Mohamed AM, El Ruby MO. Clinical and genetic characterization of ten Egyptian patients with Wolf-Hirschhorn syndrome and review of literature. Mol Genet Genomic Med 2020; 9:e1546. [PMID: 33217222 PMCID: PMC8077161 DOI: 10.1002/mgg3.1546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/26/2020] [Accepted: 10/12/2020] [Indexed: 12/25/2022] Open
Abstract
Background Wolf–Hirschhorn syndrome (WHS) (OMIM 194190) is a multiple congenital anomalies/intellectual disability syndrome. It is caused by partial loss of genetic material from the distal portion of the short arm of chromosome. Methods We studied the phenotype–genotype correlation. Results We present the clinical manifestations and cytogenetic results of 10 unrelated Egyptian patients with 4p deletions. Karyotyping, FISH and MLPA was performed for screening for microdeletion syndromes. Array CGH was done for two patients. All patients exhibited the cardinal clinical manifestation of WHS. FISH proved deletion of the specific WHS locus in all patients. MLPA detected microdeletion of the specific locus in two patients with normal karyotypes, while array CGH, performed for two patients, has delineated the extent of the deleted segments and the involved genes. LETM1, the main candidate gene for the seizure phenotype, was found deleted in the two patients tested by array CGH; nevertheless, one of them did not manifest seizures. The study emphasized the previous. Conclusion WHS is a contiguous gene syndrome resulting from hemizygosity of the terminal 2 Mb of 4p16.3 region. The Branchial fistula, detected in one of our patients is a new finding that, to our knowledge, was not reported.
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Affiliation(s)
- Mona K Mekkawy
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Alaa K Kamel
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Manal M Thomas
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Engy A Ashaat
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Maha S Zaki
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Ola M Eid
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Samira Ismail
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Saida A Hammad
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Hisham Megahed
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Heba ElAwady
- Pediatric Department, Faculty of Medicine, Fayoum unIversity, Fayoum, Egypt
| | - Khaled M Refaat
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Shymaa Hussien
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Nivine Helmy
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Sally G Abd Allah
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Amal M Mohamed
- Human Cytogenetics Department, National Research Centre, Cairo, Egypt
| | - Mona O El Ruby
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
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12
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Limeres J, Serrano C, De Nova JM, Silvestre-Rangil J, Machuca G, Maura I, Cruz Ruiz-Villandiego J, Diz P, Blanco-Lago R, Nevado J, Diniz-Freitas M. Oral Manifestations of Wolf-Hirschhorn Syndrome: Genotype-Phenotype Correlation Analysis. J Clin Med 2020; 9:jcm9113556. [PMID: 33158290 PMCID: PMC7694380 DOI: 10.3390/jcm9113556] [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: 09/24/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Wolf-Hirschhorn syndrome (WHS) is a rare disease caused by deletion in the distal moiety of the short arm of chromosome 4. The objectives of this study were to report the most representative oral findings of WHS, relate them with other clinical characteristics of the disease, and establish possible phenotype-genotype correlation. Methods: The study was conducted at 6 reference centers distributed throughout Spain during 2018–2019. The study group consisted of 31 patients with WHS who underwent a standardized oral examination. Due to behavioral reasons, imaging studies were performed on only 11 of the children 6 years of age or older. All participants had previously undergone a specific medical examination for WHS, during which anatomical, functional, epilepsy-related, and genetic variables were recorded. Results: The most prevalent oral manifestations were delayed tooth eruption (74.1%), bruxism (64.5%), dental agenesis (63.6%), micrognathia (60.0%), oligodontia (45.5%), and downturned corners of the mouth (32.3%). We detected strong correlation between psychomotor delay and oligodontia (p = 0.008; Cramér’s V coefficient, 0.75). The size of the deletion was correlated in a statistically significant manner with the presence of oligodontia (p = 0.009; point-biserial correlation coefficient, 0.75). Conclusion: Certain oral manifestations prevalent in WHS can form part of the syndrome’s phenotypic variability. A number of the characteristics of WHS, such as psychomotor delay and epilepsy, are correlated with oral findings such as oligodontia and bruxism. Although most genotype-phenotype correlations are currently unknown, most of them seem to be associated with larger deletions, suggesting that some oral-facial candidate genes might be outside the critical WHS region, indicating that WHS is a contiguous gene syndrome.
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Affiliation(s)
- Jacobo Limeres
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (J.L.); (C.S.); (M.D.-F.)
| | - Candela Serrano
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (J.L.); (C.S.); (M.D.-F.)
| | - Joaquin Manuel De Nova
- Department of Stomatology IV, School of Dentistry, University Complutense de Madrid, 28040 Madrid, Spain;
| | | | - Guillermo Machuca
- Department of Special Care in Dentistry, School of Dentistry, University of Seville, 41009 Sevilla, Spain;
| | - Isabel Maura
- Service of Pediatric Dentistry, Barcelona University Children’s Hospital HM Nens, 08009 Barcelona, Spain;
| | | | - Pedro Diz
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (J.L.); (C.S.); (M.D.-F.)
- Correspondence:
| | - Raquel Blanco-Lago
- Service of Neuropediatrics, University Hospital Central de Asturias, 33011 Oviedo, Spain;
| | - Julian Nevado
- Medical and Molecular Genetics Institute (INGEMM), La Paz University Hospital, IdiPAZ, 28046 Madrid, Spain;
- Institute of Rare Diseases Research (IIER) & Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- ERN (European Reference Network)-ITHACA, La Paz University Hospital, 28046 Madrid, Spain
| | - Marcio Diniz-Freitas
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (J.L.); (C.S.); (M.D.-F.)
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13
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Duplications involving the long range HMX1 enhancer are associated with human isolated bilateral concha-type microtia. J Transl Med 2020; 18:244. [PMID: 32552830 PMCID: PMC7302384 DOI: 10.1186/s12967-020-02409-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023] Open
Abstract
Background Microtia is a congenital anomaly of ear that ranges in severity from mild structural abnormalities to complete absence of the outer ears. Concha-type microtia is considered to be a mild form. The H6 family homeobox 1 transcription factor gene (HMX1) plays an important role in craniofacial structures development. Copy number variations (CNVs) of a downstream evolutionarily conserved enhancer region (ECR) of Hmx1 associated with ear and eye abnormalities have been reported in different animals, but not yet in human. To date, no genetic defects responsible for isolated human microtia has been reported except for mutations in HOXA2. Here we recruited five Chinese families with isolated bilateral concha-type microtia, and attempt to identify the underlying genetic causes. Methods Single Nucleotide polymorphism (SNP) array was performed to map the disease locus and detect CNVs on a genome scale primarily in the largest family (F1). Whole genome sequencing was performed to screen all SNVs and CNVs in the candidate disease locus. Array comparative genomic hybridization (aCGH) was then performed to detect CNVs in the other four families, F2-F5. Quantitative real-time polymerase chain reaction (qPCR) was used to validate and determine the extent of identified CNVs containing HMX1-ECR region. Precise breakpoints in F1 and F2 were identified by gap-PCR and sanger sequencing. Dual-luciferase assays were used to detect the enhancer function. qPCR assays were also used to detect HMX1-ECR CNVs in 61 patients with other types mictrotia. Results Linkage and haplotype analysis in F1 mapped the disease locus to a 1.9 Mb interval on 4p16.1 containing HMX1 and its downstream ECR region. Whole genome sequencing detected no potential pathogenic SNVs in coding regions of HMX1 or other genes within the candidate disease locus, but it detected a 94.6 Kb duplication in an intergenic region between HMX1 and CPZ. aCGH and qPCRs also revealed co-segregated duplications in intergenic region downstream of HMX1 in the other four families. The 21.8 Kb minimal overlapping region encompassing the core sequences consensus with mouse ECR of Hmx1. Luciferase assays confirmed the enhancer function in human sequences, and proved that HOXA2 could increase its enhancer activity. No CNVs were detected in HMX1-ECR regions in 61 patients with other type of microtia. Conclusion Duplications involving long range HMX1 enhancers are associated with human isolated bilateral concha-type microtia. We add to evidences in human that copy number variations in HMX1-ECR associates with ear malformations, as in other species. This study also provides an additional example of functional conserved non-coding elements (CNEs) in humans.
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14
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Mills A, Bearce E, Cella R, Kim SW, Selig M, Lee S, Lowery LA. Wolf-Hirschhorn Syndrome-Associated Genes Are Enriched in Motile Neural Crest Cells and Affect Craniofacial Development in Xenopus laevis. Front Physiol 2019; 10:431. [PMID: 31031646 PMCID: PMC6474402 DOI: 10.3389/fphys.2019.00431] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/28/2019] [Indexed: 01/08/2023] Open
Abstract
Wolf-Hirschhorn Syndrome (WHS) is a human developmental disorder arising from a hemizygous perturbation, typically a microdeletion, on the short arm of chromosome four. In addition to pronounced intellectual disability, seizures, and delayed growth, WHS presents with a characteristic facial dysmorphism and varying prevalence of microcephaly, micrognathia, cartilage malformation in the ear and nose, and facial asymmetries. These affected craniofacial tissues all derive from a shared embryonic precursor, the cranial neural crest (CNC), inviting the hypothesis that one or more WHS-affected genes may be critical regulators of neural crest development or migration. To explore this, we characterized expression of multiple genes within or immediately proximal to defined WHS critical regions, across the span of craniofacial development in the vertebrate model system Xenopus laevis. This subset of genes, whsc1, whsc2, letm1, and tacc3, are diverse in their currently-elucidated cellular functions; yet we find that their expression demonstrates shared tissue-specific enrichment within the anterior neural tube, migratory neural crest, and later craniofacial structures. We examine the ramifications of this by characterizing craniofacial development and neural crest migration following individual gene depletion. We observe that several WHS-associated genes significantly impact facial patterning, cartilage formation, neural crest motility in vivo and in vitro, and can separately contribute to forebrain scaling. Thus, we have determined that numerous genes within and surrounding the defined WHS critical regions potently impact craniofacial patterning, suggesting their role in WHS presentation may stem from essential functions during neural crest-derived tissue formation.
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Affiliation(s)
- Alexandra Mills
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Elizabeth Bearce
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Rachael Cella
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Seung Woo Kim
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Megan Selig
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Sangmook Lee
- Biology Department, Boston College, Chestnut Hill, MA, United States
| | - Laura Anne Lowery
- Biology Department, Boston College, Chestnut Hill, MA, United States
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15
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Bernardini L, Radio FC, Acquaviva F, Gorgone C, Postorivo D, Torres B, Alesi V, Magliozzi M, Lonardo F, Monica MD, Nardone AM, Cesario C, Mattina T, Scarano G, Dallapiccola B, Digilio MC, Novelli A. Small 4p16.3 deletions: Three additional patients and review of the literature. Am J Med Genet A 2018; 176:2501-2508. [PMID: 30244530 DOI: 10.1002/ajmg.a.40512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/05/2018] [Accepted: 07/17/2018] [Indexed: 11/11/2022]
Abstract
Wolf-Hirschhorn syndrome is a well-defined disorder due to 4p16.3 deletion, characterized by distinct facial features, intellectual disability, prenatal and postnatal growth retardation, and seizures. Genotype-phenotype correlations based on differently sized deletions have been attempted, and some candidate genes have been suggested. We report on clinical characteristics of three patients with pure interstitial submicroscopic 4p16.3 deletions, ranging in size from 68 to 166 kb, involving WHSCR1 and/or part of WHSCR2, and review published cases with overlapping 4p16.3 losses. The present study highlights a major role of NSD2 gene in the pathogenesis of the WHS main features and predicts that loss-of-function mutations affecting NSD2 gene could result in microcephaly, prenatal and postnatal growth retardation, psychomotor and language delay, and craniofacial features. Absent seizures in all subjects corroborate the suggestion that this specific feature is causally linked with at least one additional causative gene. Finally, we suggest that mir-943 could play a role in the pathogenesis of CHD in some of these patients.
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Affiliation(s)
- Laura Bernardini
- Cytogenetics Unit, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Francesca C Radio
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Fabio Acquaviva
- Medical Genetics Unit, A.O.R.N. "G. Rummo", Benevento, Italy
| | | | - Diana Postorivo
- Laboratory of Medical Genetics, Policlinico Tor Vergata, Rome, Italy
| | - Barbara Torres
- Cytogenetics Unit, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | - Viola Alesi
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Monia Magliozzi
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | | | - Matteo Della Monica
- Medical Genetics and Laboratory of Medical Genetics Unit, A.O. "Antonio Cardarelli", Naples, Italy
| | - Anna M Nardone
- Laboratory of Medical Genetics, Policlinico Tor Vergata, Rome, Italy
| | - Claudia Cesario
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | | | | | - Bruno Dallapiccola
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Maria C Digilio
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Antonio Novelli
- Medical Genetics Unit and Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
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16
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A structured assessment of motor function, behavior, and communication in patients with Wolf–Hirschhorn syndrome. Eur J Med Genet 2017; 60:610-617. [DOI: 10.1016/j.ejmg.2017.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/21/2017] [Accepted: 08/11/2017] [Indexed: 11/23/2022]
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17
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Mbuyi-Musanzayi S, Lumaka A, Kasole TL, Ilunga EK, Asani BY, Tshilobo PL, Muenze PK, Reychler H, Katombe FT, Devriendt K. Wolf-Hirschhorn Syndrome: Clinical and Genetic Data from a First Case Diagnosed in Central Africa. J Pediatr Genet 2017; 6:186-190. [PMID: 28794913 DOI: 10.1055/s-0037-1599194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/18/2017] [Indexed: 12/19/2022]
Abstract
Wolf-Hirschhorn syndrome (WHS) is a multiple congenital anomaly-intellectual disability syndrome caused by a deletion involving chromosome 4p16.3. We report clinical and genetic findings of the first WHS patient diagnosed in central Africa. This boy who presented with cleft palate, microcephaly, severe growth delay, and intellectual disability was 12 years old. Typical craniofacial features were present, though the characteristic "Greek helmet" appearance of the nose was less evident, probably reflecting a variable expression related to the genetic background. The clinical diagnosis of WHS was confirmed by array CGH, which revealed a terminal 4p16.3 deletion of 3.47 Mb, typically associated with a milder phenotype, contributing to the long survival of this child in a developing country.
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Affiliation(s)
- Sébastien Mbuyi-Musanzayi
- Department of Surgery, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo.,Center for Human Genetics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo
| | - Aimé Lumaka
- Center for Human Genetics, University Hospital, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Pediatrics, University Hospital, University of Kinshasa, Kin XI, Kinshasa, The Democratic Republic of the Congo.,Center for Human Genetics, Faculty of Medicine, University of Kinshasa, Kin XI, Kinshasa, The Democratic Republic of the Congo.,Institut National de Recherche Biomedicale, Kinshasa, The Democratic Republic of the Congo
| | - Toni Lubala Kasole
- Center for Human Genetics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo.,Department of Pediatrics, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo
| | - Erick Kasamba Ilunga
- Center for Human Genetics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo.,Department of Basic sciences, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo
| | - Bienvenu Yogolelo Asani
- Center for Human Genetics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo.,Department of Ophthalmology, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo
| | - Prosper Lukusa Tshilobo
- Center for Human Genetics, University Hospital, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Pediatrics, University Hospital, University of Kinshasa, Kin XI, Kinshasa, The Democratic Republic of the Congo.,Center for Human Genetics, Faculty of Medicine, University of Kinshasa, Kin XI, Kinshasa, The Democratic Republic of the Congo.,Institut National de Recherche Biomedicale, Kinshasa, The Democratic Republic of the Congo
| | - Prosper Kalenga Muenze
- Center for Human Genetics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo.,Department of Basic sciences, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo.,Department of Gynecology, University Hospital, University of Lubumbashi, Lubumbashi, DR Congo
| | - Hervé Reychler
- Department of Oral and Maxillofacial surgery, University Hospital, UC Louvain, Brussels, Belgium
| | | | - Koenraad Devriendt
- Center for Human Genetics, University Hospital, Katholieke Universiteit Leuven, Leuven, Belgium
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18
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Motoi H, Okanishi T, Kanai S, Yokota T, Yamazoe T, Nishimura M, Fujimoto A, Yamamoto T, Enoki H. Wolf-Hirschhorn (4p-) syndrome with West syndrome. EPILEPSY & BEHAVIOR CASE REPORTS 2016; 6:39-41. [PMID: 27504263 PMCID: PMC4969236 DOI: 10.1016/j.ebcr.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/09/2016] [Accepted: 07/09/2016] [Indexed: 11/17/2022]
Abstract
Wolf-Hirschhorn syndrome (WHS) is a chromosome disorder (4p-syndrome) which is characterized by craniofacial features and epileptic seizures. Here, we report a case of WHS with West syndrome, in whom the seizures were refractory to several antiepileptic drugs but were responsive to the addition of lamotrigine. The patient had epileptic spasms at age seven months. The interictal electroencephalogram was hypsarrhythmic. After adding lamotrigine, seizures decreased remarkably, and spasms disappeared. We have identified and described the very rare case of a girl with WHS who also developed West syndrome. In this case, adding lamotrigine to her medications effectively treated the spasms.
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Affiliation(s)
- Hirotaka Motoi
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Tohru Okanishi
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Sotaro Kanai
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Takuya Yokota
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Tomohiro Yamazoe
- Department of Epilepsy Surgery, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Mitsuyo Nishimura
- Laboratory of Neurophysiology, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Ayataka Fujimoto
- Department of Epilepsy Surgery, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Takamichi Yamamoto
- Department of Epilepsy Surgery, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Hideo Enoki
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
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19
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Wu Y, Tao J, Wang YL, Hu WJ, Han X, Cheng WW. A genotype-phenotype correlation study reveals that a non-coding RNA might be associated with cardiovascular anomalies in fetuses with WHS. Prenat Diagn 2016; 36:979-981. [PMID: 27501084 DOI: 10.1002/pd.4884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 07/18/2016] [Accepted: 07/30/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Yi Wu
- Prenatal Diagnosis Center, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China
| | - Jiong Tao
- Department of Reproductive Genetics, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China
| | - Yan-Lin Wang
- Prenatal Diagnosis Center, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China
| | - Wen-Jing Hu
- Department of Reproductive Genetics, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China
| | - Xu Han
- Department of Reproductive Genetics, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China
| | - Wei-Wei Cheng
- Prenatal Diagnosis Center, International Peace Maternal & Child Health Hospital, Medical College, Shanghai JiaoTong University, Shanghai, China.
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20
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Ho KS, South ST, Lortz A, Hensel CH, Sdano MR, Vanzo RJ, Martin MM, Peiffer A, Lambert CG, Calhoun A, Carey JC, Battaglia A. Chromosomal microarray testing identifies a 4p terminal region associated with seizures in Wolf-Hirschhorn syndrome. J Med Genet 2016; 53:256-63. [PMID: 26747863 PMCID: PMC4819617 DOI: 10.1136/jmedgenet-2015-103626] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022]
Abstract
Background Wolf–Hirschhorn syndrome (WHS) is a contiguous gene deletion syndrome involving variable size deletions of the 4p16.3 region. Seizures are frequently, but not always, associated with WHS. We hypothesised that the size and location of the deleted region may correlate with seizure presentation. Methods Using chromosomal microarray analysis, we finely mapped the breakpoints of copy number variants (CNVs) in 48 individuals with WHS. Seizure phenotype data were collected through parent-reported answers to a comprehensive questionnaire and supplemented with available medical records. Results We observed a significant correlation between the presence of an interstitial 4p deletion and lack of a seizure phenotype (Fisher's exact test p=3.59e-6). In our cohort, there were five individuals with interstitial deletions with a distal breakpoint at least 751 kbp proximal to the 4p terminus. Four of these individuals have never had an observable seizure, and the fifth individual had a single febrile seizure at the age of 1.5 years. All other individuals in our cohort whose deletions encompass the terminal 751 kbp region report having seizures typical of WHS. Additional examples from the literature corroborate these observations and further refine the candidate seizure susceptibility region to a region 197 kbp in size, starting 368 kbp from the terminus of chromosome 4. Conclusions We identify a small terminal region of chromosome 4p that represents a seizure susceptibility region. Deletion of this region in the context of WHS is sufficient for seizure occurrence.
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Affiliation(s)
- Karen S Ho
- Lineagen, Inc., Salt Lake City, Utah, USA
| | - Sarah T South
- ARUP Laboratories, Salt Lake City, Utah, USA Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | | | | | | | | | | | - Andreas Peiffer
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Christophe G Lambert
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Amy Calhoun
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - John C Carey
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Agatino Battaglia
- Stella Maris Clinical Research Institute for Child and Adolescent Neuropsychiatry, Pisa, Italy
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Conte F, Oti M, Dixon J, Carels CEL, Rubini M, Zhou H. Systematic analysis of copy number variants of a large cohort of orofacial cleft patients identifies candidate genes for orofacial clefts. Hum Genet 2015; 135:41-59. [PMID: 26561393 PMCID: PMC4698300 DOI: 10.1007/s00439-015-1606-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/15/2015] [Indexed: 12/16/2022]
Abstract
Orofacial clefts (OFCs) represent a large fraction of human birth defects and are one of the most common phenotypes affected by large copy number variants (CNVs). Due to the limited number of CNV patients in individual centers, CNV analyses of a large number of OFC patients are challenging. The present study analyzed 249 genomic deletions and 226 duplications from a cohort of 312 OFC patients reported in two publicly accessible databases of chromosome imbalance and phenotype in humans, DECIPHER and ECARUCA. Genomic regions deleted or duplicated in multiple patients were identified, and genes in these overlapping CNVs were prioritized based on the number of genes encompassed by the region and gene expression in embryonic mouse palate. Our analyses of these overlapping CNVs identified two genes known to be causative for human OFCs, SATB2 and MEIS2, and 12 genes (DGCR6, FGF2, FRZB, LETM1, MAPK3, SPRY1, THBS1, TSHZ1, TTC28, TULP4, WHSC1, WHSC2) that are associated with OFC or orofacial development. Additionally, we report 34 deleted and 24 duplicated genes that have not previously been associated with OFCs but are associated with the BMP, MAPK and RAC1 pathways. Statistical analyses show that the high number of overlapping CNVs is not due to random occurrence. The identified genes are not located in highly variable genomic regions in healthy populations and are significantly enriched for genes that are involved in orofacial development. In summary, we report a CNV analysis pipeline of a large cohort of OFC patients and identify novel candidate OFC genes.
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Affiliation(s)
- Federica Conte
- Department of Molecular Developmental Biology, Faculty of Science, Radboud Institute for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands.,Medical Genetic Unit, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Martin Oti
- Department of Molecular Developmental Biology, Faculty of Science, Radboud Institute for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
| | - Jill Dixon
- Faculty of Medical and Human Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT, UK
| | - Carine E L Carels
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michele Rubini
- Medical Genetic Unit, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
| | - Huiqing Zhou
- Department of Molecular Developmental Biology, Faculty of Science, Radboud Institute for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands. .,Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
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22
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Serra-Juhé C, Cuscó I, Homs A, Flores R, Torán N, Pérez-Jurado LA. DNA methylation abnormalities in congenital heart disease. Epigenetics 2015; 10:167-77. [PMID: 25587870 PMCID: PMC4622722 DOI: 10.1080/15592294.2014.998536] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Congenital heart defects represent the most common malformation at birth, occurring also in ∼50% of individuals with Down syndrome. Congenital heart defects are thought to have multifactorial etiology, but the main causes are largely unknown. We have explored the global methylation profile of fetal heart DNA in comparison to blood DNA from control subjects: an absolute correlation with the type of tissue was detected. Pathway analysis revealed a significant enrichment of differential methylation at genes related to muscle contraction and cardiomyopathies in the developing heart DNA. We have also searched for abnormal methylation profiles on developing heart-tissue DNA of syndromic and non-syndromic congenital heart defects. On average, 3 regions with aberrant methylation were detected per sample and 18 regions were found differentially methylated between groups. Several epimutations were detected in candidate genes involved in growth regulation, apoptosis and folate pathway. A likely pathogenic hypermethylation of several intragenic sites at the MSX1 gene, involved in outflow tract morphogenesis, was found in a fetus with isolated heart malformation. In addition, hypermethylation of the GATA4 gene was present in fetuses with Down syndrome with or without congenital heart defects, as well as in fetuses with isolated heart malformations. Expression deregulation of the abnormally methylated genes was detected. Our data indicate that epigenetic alterations of relevant genes are present in developing heart DNA in fetuses with both isolated and syndromic heart malformations. These epimutations likely contribute to the pathogenesis of the malformation by cis-acting effects on gene expression.
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Affiliation(s)
- Clara Serra-Juhé
- a Department of Experimental and Health Sciences ; Universitat Pompeu Fabra ; Barcelona , Spain
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23
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Battaglia A, Carey JC, South ST. Wolf-Hirschhorn syndrome: A review and update. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2015; 169:216-23. [DOI: 10.1002/ajmg.c.31449] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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24
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Aquino SND, Machado RA, Paranaíba LMR, Coletta RD, Aguiar MJBD, Fernandes C, Martelli Júnior H. Uncommon oral cleft in Wolf-Hirschhorn syndrome. Braz Dent J 2015; 26:203-6. [PMID: 25831115 DOI: 10.1590/0103-6440201302377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) is a syndrome with craniofacial and systemic abnormalities, which is related to 4p deletion. A 3-month old girl with an undiagnosed syndrome was referred for evaluation of the cleft lip and palate. Hypotonia, short stature, cardiac malformation, hypertrophied clitoris, and atypical thumb of both hands was observed. Microcephaly, low-set ear, prominent glabella, downslanting palpebral fissures, a characteristic "Greek warrior helmet" appearance, micrognathia, ears with pits/tags and bilateral incomplete cleft lip apart from incomplete cleft palate were observed as craniofacial findings. With clinical diagnosis of WHS, blood was subjected to karyotyping, which showed a 4p15.2 deletion, consistent with the condition. Here is reported the case of this WHS patient with an uncommon oral cleft extending the phenotypic spectrum of the disorder. The child was referred to a multidisciplinary team to reparative surgery of the cleft lip and palate. The patient is on regular medical follow-up and will be further assisted by dentists, physical therapists, occupational therapists and psychologists. The genotype-phenotype correlation of the affected patient with previous WSH syndrome reports is described.
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Affiliation(s)
| | - Renato A Machado
- Department of Oral Diagnosis, Dental School, UNICAMP - University of Campinas, Piracicaba, SP, Brazil
| | - Lívia Maris R Paranaíba
- Stomatology Clinic, Dental School, UNIMONTES - State University of Montes Claros, Montes Claros, MG, Brazil
| | - Ricardo D Coletta
- Department of Oral Diagnosis, Dental School, UNICAMP - University of Campinas, Piracicaba, SP, Brazil
| | - Marcos J Burle de Aguiar
- Special Genetics Service, Hospital of the Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cassandro Fernandes
- Center for Rehabilitation of Craniofacial Anomalies and School of Medicine, José do Rosário Vellano University, Alfenas, MG, Brazil
| | - Hercílio Martelli Júnior
- Stomatology Clinic, Dental School, UNIMONTES - State University of Montes Claros, Montes Claros, MG, Brazil
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25
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Hart L, Rauch A, Carr AM, Vermeesch JR, O’Driscoll M. LETM1 haploinsufficiency causes mitochondrial defects in cells from humans with Wolf-Hirschhorn syndrome: implications for dissecting the underlying pathomechanisms in this condition. Dis Model Mech 2014; 7:535-45. [PMID: 24626991 PMCID: PMC4007405 DOI: 10.1242/dmm.014464] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 03/03/2014] [Indexed: 12/14/2022] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) represents an archetypical example of a contiguous gene deletion disorder - a condition comprising a complex set of developmental phenotypes with a multigenic origin. Epileptic seizures, intellectual disability, growth restriction, motor delay and hypotonia are major co-morbidities in WHS. Haploinsufficiency of LETM1, which encodes a mitochondrial inner-membrane protein functioning in ion transport, has been proposed as an underlying pathomechanism, principally for seizures but also for other core features of WHS, including growth and motor delay. Growing evidence derived from several model organisms suggests that reduced LETM1 expression is associated with some element of mitochondrial dysfunction. Surprisingly, LETM1-dependent mitochondrial functional deficits have not previously been described in cells from individuals with WHS. Here, using a unique panel of WHS-patient-derived cell lines with deletions of differing sizes, incorporating LETM1 or not, we show, for the first time, that LETM1 expression is reduced in mitochondria isolated from WHS-patient cells. Furthermore, we show that this is associated with distinct mitochondrial phenotypes, including altered intracellular [Ca(2+)] levels, dysfunctional mitochondrial transition-pore opening, hyperpolarization and superoxide leakage from resting mitochondria. Interestingly, we find that these phenotypes segregate with seizures in our WHS cohort. Our findings identify novel cellular phenotypes in WHS attributable to a 50% reduction in LETM1 expression level; these phenotypes could underlie and/or contribute to some of the core clinical features of this condition.
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Affiliation(s)
- Lesley Hart
- Human DNA Damage Response Disorders Group, Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton, BN1 9RQ, UK
- DNA Replication and Cell Cycle Group, Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton, BN1 9RQ, UK
| | - Anita Rauch
- University of Zurich, Institute of Medical Genetics, Wagistrasse 12, CH-8952 Schlieren, Switzerland
| | - Antony M. Carr
- DNA Replication and Cell Cycle Group, Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton, BN1 9RQ, UK
| | - Joris R. Vermeesch
- Center for Human Genetics, UZ Leuven, Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
| | - Mark O’Driscoll
- Human DNA Damage Response Disorders Group, Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton, BN1 9RQ, UK
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Shimizu K, Wakui K, Kosho T, Okamoto N, Mizuno S, Itomi K, Hattori S, Nishio K, Samura O, Kobayashi Y, Kako Y, Arai T, Tsutomu OI, Kawame H, Narumi Y, Ohashi H, Fukushima Y. Microarray and FISH-based genotype-phenotype analysis of 22 Japanese patients with Wolf-Hirschhorn syndrome. Am J Med Genet A 2013; 164A:597-609. [PMID: 24357569 DOI: 10.1002/ajmg.a.36308] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 09/30/2013] [Indexed: 01/17/2023]
Abstract
Wolf-Hirschhorn syndrome (WHS) is a contiguous gene deletion syndrome of the distal 4p chromosome, characterized by craniofacial features, growth impairment, intellectual disability, and seizures. Although genotype-phenotype correlation studies have previously been published, several important issues remain to be elucidated including seizure severity. We present detailed clinical and molecular-cytogenetic findings from a microarray and fluorescence in situ hybridization (FISH)-based genotype-phenotype analysis of 22 Japanese WHS patients, the first large non-Western series. 4p deletions were terminal in 20 patients and interstitial in two, with deletion sizes ranging from 2.06 to 29.42 Mb. The new Wolf-Hirschhorn syndrome critical region (WHSCR2) was deleted in all cases, and duplication of other chromosomal regions occurred in four. Complex mosaicism was identified in two cases: two different 4p terminal deletions; a simple 4p terminal deletion and an unbalanced translocation with the same 4p breakpoint. Seizures began in infancy in 33% (2/6) of cases with small (<6 Mb) deletions and in 86% (12/14) of cases with larger deletions (>6 Mb). Status epilepticus occurred in 17% (1/6) with small deletions and in 87% (13/15) with larger deletions. Renal hypoplasia or dysplasia and structural ocular anomalies were more prevalent in those with larger deletions. A new susceptible region for seizure occurrence is suggested between 0.76 and 1.3 Mb from 4 pter, encompassing CTBP1 and CPLX1, and distal to the previously-supposed candidate gene LETM1. The usefulness of bromide therapy for seizures and additional clinical features including hypercholesterolemia are also described.
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Affiliation(s)
- Kenji Shimizu
- Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan; Division of Medical Genetics, Saitama Children's Medical Center, Saitama, Japan
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27
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Debost-Legrand A, Goumy C, Laurichesse-Delmas H, Déchelotte P, Beaufrère AM, Lémery D, Francannet C, Gallot D. Prenatal ultrasound findings observed in the Wolf-hirschhorn syndrome: Data from the registry of congenital malformations in auvergne. ACTA ACUST UNITED AC 2013; 97:806-11. [DOI: 10.1002/bdra.23194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/08/2013] [Accepted: 08/26/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | - Carole Goumy
- CHU Clermont-Ferrand, Service de Cytogénétique Médicale; Clermont-Ferrand France
| | - Hélène Laurichesse-Delmas
- CHU Clermont-Ferrand, Pole Gynéco-Obstétrique-Reproduction Humaine; Clermont-Ferrand France
- EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement); Univ Clermont1, UFR Médecine, Clermont-Ferrand; Clermont-Ferrand France
| | - Pierre Déchelotte
- CHU Clermont-Ferrand, Anatomie Pathologique; Clermont-Ferrand France
| | | | - Didier Lémery
- CHU Clermont-Ferrand, Pole Gynéco-Obstétrique-Reproduction Humaine; Clermont-Ferrand France
- EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement); Univ Clermont1, UFR Médecine, Clermont-Ferrand; Clermont-Ferrand France
| | | | - Denis Gallot
- CHU Clermont-Ferrand, Pole Gynéco-Obstétrique-Reproduction Humaine; Clermont-Ferrand France
- R2D2-EA7281, Université d'Auvergne, Univ Clermont1, UFR Médecine; Clermont-Ferrand France
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28
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Andersen EF, Carey JC, Earl DL, Corzo D, Suttie M, Hammond P, South ST. Deletions involving genes WHSC1 and LETM1 may be necessary, but are not sufficient to cause Wolf-Hirschhorn Syndrome. Eur J Hum Genet 2013; 22:464-70. [PMID: 23963300 DOI: 10.1038/ejhg.2013.192] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/18/2013] [Accepted: 07/24/2013] [Indexed: 01/01/2023] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) is a complex genetic disorder caused by the loss of genomic material from the short arm of chromosome 4. Genotype-phenotype correlation studies indicated that the loss of genes within 4p16.3 is necessary for expression of the core features of the phenotype. Within this region, haploinsufficiency of the genes WHSC1 and LETM1 is thought to be a major contributor to the pathogenesis of WHS. We present clinical findings for three patients with relatively small (<400 kb) de novo interstitial deletions that overlap WHSC1 and LETM1. 3D facial analysis was performed for two of these patients. Based on our findings, we propose that hemizygosity of WHSC1 and LETM1 is associated with a clinical phenotype characterized by growth deficiency, feeding difficulties, and motor and speech delays. The deletion of additional genes nearby WHSC1 and LETM1 does not result in a marked increase in the severity of clinical features, arguing against their haploinsufficiency. The absence of seizures and typical WHS craniofacial findings in our cohort suggest that deletion of distinct or additional 4p16.3 genes is necessary for expression of these features. Altogether, these results show that although loss-of-function for WHSC1 and/or LETM1 contributes to some of the features of WHS, deletion of additional genes is required for the full expression of the phenotype, providing further support that WHS is a contiguous gene deletion disorder.
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Affiliation(s)
- Erica F Andersen
- 1] Cytogenetics Department, ARUP Laboratories, Salt Lake City, UT, USA [2] Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - John C Carey
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Dawn L Earl
- Department of Genetic Medicine, Division of Medical Genetics, Seattle Children's Hospital, Seattle, WA, USA
| | - Deyanira Corzo
- Division of Clinical Genetics, Boston Children's Hospital, Boston, MA, USA
| | - Michael Suttie
- Molecular Medicine Unit, UCL Institute of Child Health, London, UK
| | - Peter Hammond
- Molecular Medicine Unit, UCL Institute of Child Health, London, UK
| | - Sarah T South
- 1] Cytogenetics Department, ARUP Laboratories, Salt Lake City, UT, USA [2] Department of Pathology, University of Utah, Salt Lake City, UT, USA [3] Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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29
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Bertoli M, Alesi V, Gullotta F, Zampatti S, Abate MR, Palmieri C, Novelli A, Frontali M, Nardone AM. Another patient with 12q13 microduplication. Am J Med Genet A 2013; 161A:2004-8. [PMID: 23824684 DOI: 10.1002/ajmg.a.35991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/01/2013] [Indexed: 11/12/2022]
Abstract
Interstitial duplication of the long arm of chromosome 12 is a rare cytogenetic condition. While several reports describe distal 12q duplication, only one case report of homogeneous, non-mosaic interstitial 12q13 duplication has been documented to date. The authors of that observation proposed that the associated phenotype represented a phenocopy of Wolf-Hirschhorn syndrome [Dallapiccola et al., 2009]. Only a few other recorded patients with deletion 12q13 → 12q21 involved mosaicism. We describe a new patient with homogeneous 12q13 duplication in a 6-year-old girl who, in early infancy, presented with dysmorphic features suggesting Wolf-Hirschhorn syndrome. What is potentially significant about this patient is that her facial phenotype evolved with age, suggesting a different gestalt in older patients.
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Affiliation(s)
- M Bertoli
- S. Pietro Fatebenefratelli Hospital, UOSD Medical Genetics, Rome, Italy.
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30
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Dai Y, Yang J, Chen Y, Bao L, Cheng Q. Microarray analysis of unbalanced translocation in Wolf-Hirschhorn syndrome. Pediatr Int 2013; 55:368-70. [PMID: 23782367 DOI: 10.1111/j.1442-200x.2012.03684.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 05/28/2012] [Accepted: 06/06/2012] [Indexed: 12/01/2022]
Abstract
Wolf-Hirschhorn syndrome (WHS) is caused by deletions involving chromosome region 4p16.3, which is characterized by growth delay, mild-to-severe mental retardation, hypotonia, facial dysmorphisms and shows extensive phenotypic variability include feeding difficulties, epilepsy and congenital anomalies. Variation in the size of the deletion involving chromosome region 4p16.3 may explain the clinical variation. However, previous studies indicate that duplication for another chromosome region due to an unbalanced translocation elucidate approximately 40-45% WHS patients. Therefore, we used whole genomic cytogenetics array to analyze the entire genome at a significantly higher resolution over conventional cytogenetics to characterize the exact subtelomeric aberration region of one patient with developmental delay and several facial characteristics reminiscent Wolf-Hirschhorn syndrome. Here we report that our patient had 3.7 Mb deletion at the 4p16.2 and 6.8 Mb duplication at 8p23.1 resulted from the unbalanced translocations der(4)t(4;8)(p16.2;p23.1). We confirmed that our patient with monosomy 4p16.2 which is consistent with Wolf-Hirschhorn syndrome and trisomy 8p23.1. The combination of the 4p deletion with 8p partial trisomy explains the complex phenotype presented by our patient.
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Affiliation(s)
- Ying Dai
- Department of Primary Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China
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31
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von Elten K, Sawyer T, Lentz-Kapua S, Kanis A, Studer M. A case of Wolf-Hirschhorn syndrome and hypoplastic left heart syndrome. Pediatr Cardiol 2013; 34:1244-6. [PMID: 22639003 DOI: 10.1007/s00246-012-0367-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/07/2012] [Indexed: 11/29/2022]
Abstract
Wolf-Hirschhorn Syndrome (WHS) is a genetic syndrome that includes a typical facial appearance, mental retardation, growth delay, seizures, and congenital cardiac defects. A deletion of the terminal band of the short arm of chromosome 4, with a breakpoint at the 4p15 to 4p16 region, is the most common genetic mutation causing WHS. Congenital heart disease associated with WHS typically includes atrial and ventricular septal defects, though there are a few case reports of associated complex congenital heart disease. Here we report a case of an infant with a large 4p deletion, with a breakpoint at the 4p12 region, and hypoplasic left heart syndrome. We discuss a possible link between the size of the chromosomal deletion in WHS and the severity of the cardiac defect.
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Affiliation(s)
- Kelley von Elten
- Department of Pediatrics, MCHK-PE, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA.
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Prunotto G, Cianci P, Cereda A, Scatigno A, Fossati C, Maitz S, Biondi A, Selicorni A. Two cases of hepatic adenomas in patients with wolf-hirschhorn syndrome: A new rare complication? Am J Med Genet A 2013; 161A:1759-62. [DOI: 10.1002/ajmg.a.35966] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 03/10/2013] [Indexed: 01/05/2023]
Affiliation(s)
- Giulia Prunotto
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Paola Cianci
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Anna Cereda
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Agnese Scatigno
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Chiara Fossati
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Silvia Maitz
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
| | - Andrea Biondi
- Pediatric Hematology-Oncology Unit, Pediatric Department of MBBM Foundation; S.Gerardo Hospital; Monza; Italy
| | - Angelo Selicorni
- Pediatric Genetic Unit, Pediatric Department of Monza Brianza per il Bambino e la sua Mamma (MBBM) Foundation; S.Gerardo Hospital; Monza; Italy
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Nowikovsky K, Pozzan T, Rizzuto R, Scorrano L, Bernardi P. Perspectives on: SGP symposium on mitochondrial physiology and medicine: the pathophysiology of LETM1. ACTA ACUST UNITED AC 2013; 139:445-54. [PMID: 22641639 PMCID: PMC3362517 DOI: 10.1085/jgp.201110757] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Karin Nowikovsky
- Department of Internal Medicine 1, Anna Spiegel Center of Translational Research, Medical University Vienna, 1090 Wien, Austria.
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Liang D, Zhou Z, Meng D, Du J, Wen J, Niikawa N, Wu L. Three patients with Wolf-Hirschhorn syndrome carrying a satellited chromosome 4p. ACTA ACUST UNITED AC 2012; 94:549-52. [PMID: 22641563 DOI: 10.1002/bdra.23019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 03/14/2012] [Accepted: 03/15/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Wolf-Hirschhorn syndrome (WHS) is caused by a deletion involving the 4p16.3 region. Approximately 70% of WHS patients have a de novo isolated deletion and 22% involve unbalanced translocations. However, WHS with unbalanced rearrangements involving the short arm of an acrocentric chromosome are infrequently reported. METHODS Cytogenetic and molecular analyses by using standard G-banding, argyrophilic nucleolar organiser region (Ag-NOR) staining, fluorescence in situ hybridization, and single nucleotide polymorphism array for copy number detection were performed in three patients with WHS phenotype from two Chinese families. RESULTS A heterozygous 2,767,380-bp terminal 4p deletion was detected in patients 1 and 2 and a heterozygous 5,047,291-bp terminal 4p deletion was detected in patient3. Clinical comparisons among our patients and previously reported cases have been reviewed. CONCLUSION Two terminal 4p deletions were identified in three WHS patients with a satellited 4p and an attempt was made to refine the genotypic-phenotypic correlations of the deleted regions.
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Affiliation(s)
- Desheng Liang
- State Key Laboratory of Medical Genetics, Central South University, Changsha, China
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Reichenberger EJ, Levine MA, Olsen BR, Papadaki ME, Lietman SA. The role of SH3BP2 in the pathophysiology of cherubism. Orphanet J Rare Dis 2012; 7 Suppl 1:S5. [PMID: 22640988 PMCID: PMC3359958 DOI: 10.1186/1750-1172-7-s1-s5] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Cherubism is a rare bone dysplasia that is characterized by symmetrical bone resorption limited to the jaws. Bone lesions are filled with soft fibrous giant cell-rich tissue that can expand and cause severe facial deformity. The disorder typically begins in children at ages of 2-5 years and the bone resorption and facial swelling continues until puberty; in most cases the lesions regress spontaneously thereafter. Most patients with cherubism have germline mutations in the gene encoding SH3BP2, an adapter protein involved in adaptive and innate immune response signaling. A mouse model carrying a Pro416Arg mutation in SH3BP2 develops osteopenia and expansile lytic lesions in bone and some soft tissue organs. In this review we discuss the genetics of cherubism, the biological functions of SH3BP2 and the analysis of the mouse model. The data suggest that the underlying cause for cherubism is a systemic autoinflammatory response to physiologic challenges despite the localized appearance of bone resorption and fibrous expansion to the jaws in humans.
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Affiliation(s)
- Ernst J Reichenberger
- Department of Reconstructive Sciences, Center for Regenerative Medicine and Skeletal Development, University of Connecticut Health Center, Farmington, CT, USA.
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Hannes F, Hammond P, Quarrell O, Fryns JP, Devriendt K, Vermeesch JR. A microdeletion proximal of the critical deletion region is associated with mild Wolf-Hirschhorn syndrome. Am J Med Genet A 2012; 158A:996-1004. [PMID: 22438245 DOI: 10.1002/ajmg.a.35299] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 02/01/2012] [Indexed: 11/09/2022]
Abstract
It is generally accepted that the facial phenotype of Wolf-Hirschhorn syndrome is caused by deletions of either Wolf-Hirschhorn critical regions 1 or 2 (WHSCR 1-2). Here, we identify a 432 kb deletion located 600 kb proximal to both WHSCR1-2 in a patient with a WHS facial phenotype. Seven genes are underlying this deletion region including FAM193a, ADD1, NOP14, GRK4, MFSD10, SH3BP2, TNIP2. The clinical diagnosis of WHS facial phenotype was confirmed by 3D facial analysis using dense surface modeling. Our results suggest that the WHSCR1-2 flanking sequence contributes directly or indirectly to the severity of WHS. Sequencing the Wolf-Hirschhorn syndrome candidate 1 and 2 genes did not reveal any mutations. Long range position effects of the deletion that could influence gene expression within the WHSCR were excluded in EBV cell lines derived from patient lymphoblasts. We hypothesize that either (1) this locus harbors regulatory sequences which affect gene expression in the WHSCR1-2 in a defined temporal and spatial developmental window or (2) that this locus is additive to deletions of WHSCR1-2 increasing the phenotypic expression.
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Halder A, Jain M, Chaudhary I, Varma B. Chromosome 22q11.2 microdeletion in monozygotic twins with discordant phenotype and deletion size. Mol Cytogenet 2012; 5:13. [PMID: 22413934 PMCID: PMC3325853 DOI: 10.1186/1755-8166-5-13] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 03/13/2012] [Indexed: 02/01/2023] Open
Abstract
We report on a pair of male monozygotic twins with 22q11.2 microdeletion, discordant phenotype and discordant deletion size. The second twin had findings suggestive of DiGeorge syndrome, while the first twin had milder anomalies without any cardiac malformation. The second twin had presented with intractable convulsion, cyanosis and cardiovascular failure in the fourth week of life and expired on the sixth week of life, whereas the first twin had some characteristic facial appearance with developmental delay but no other signs of the 22q11.2 microdeletion syndrome including cardiovascular malformation. The fluorescence in situ hybridization (FISH) analysis had shown a microdeletion on the chromosome 22q11.2 in both twins. The interphase FISH did not find any evidence for the mosaicism. The genomic DNA microarray analysis, using HumanCytoSNP-12 BeadChip (Illumina), was identical between the twins except different size of deletion of 22q11.2. The zygosity using HumanCytoSNP-12 BeadChip (Illumina) microarray analysis suggested monozygosity. This observation indicates that altered size of the deletion may be the underlying etiology for the discordance in phenotype in monozygotic twins. We think early post zygotic events (mitotic non-allelic homologous recombination) could have been played a role in the alteration of 22q11.2 deletion size and, thus phenotypic variability in the monozygotic twins.
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Affiliation(s)
- Ashutosh Halder
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Jain
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Isha Chaudhary
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Binuja Varma
- The Centre for Genomic Application, 254 Okhla Industrial Area Phase III, New Delhi, India
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Fisch GS, Carpenter N, Howard-Peebles PN, Holden JJA, Tarleton J, Simensen R, Battaglia A. Developmental trajectories in syndromes with intellectual disability, with a focus on Wolf-Hirschhorn and its cognitive-behavioral profile. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:167-79. [PMID: 22515830 DOI: 10.1352/1944-7558-117.2.167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Few studies exist of developmental trajectories in children with intellectual disability, and none for those with subtelomeric deletions. We compared developmental trajectories of children with Wolf-Hirschhorn syndrome to other genetic disorders. We recruited 106 children diagnosed with fragile X, Williams-Beuren syndrome, or Wolf-Hirschhorn syndrome, assessing their intellectual and adaptive behavior abilities. We retested 61 children 2 years later. We compared Time 1 and Time 2 difference scores related to genetic disorder, age, initial IQ, or adaptive behavior composite. Results show genetic disorder and initial IQ score were significant factors for IQ differences, but only genetic disorder affected adaptive behavior differences. Results suggest different gene-brain-behavior pathways likely exist for these genetic disorders. Different developmental trajectories will influence the type and intensity of intervention implemented by caregivers.
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Affiliation(s)
- Gene S Fisch
- New York University Colleges of Dentistry and Nursing and Yeshiva University, New York, New York 10003, USA.
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Sifakis S, Manolakos E, Vetro A, Kappou D, Peitsidis P, Kontodiou M, Garas A, Vrachnis N, Konstandinidou A, Zuffardi O, Orru S, Papoulidis I. Prenatal diagnosis of Wolf-Hirschhorn syndrome confirmed by comparative genomic hybridization array: report of two cases and review of the literature. Mol Cytogenet 2012; 5:12. [PMID: 22373435 PMCID: PMC3307480 DOI: 10.1186/1755-8166-5-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 02/28/2012] [Indexed: 01/26/2023] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) is a well known genetic condition caused by a partial deletion of the short arm of chromosome 4. The great variability in the extent of the 4p deletion and the possible contribution of additional genetic rearrangements lead to a wide spectrum of clinical manifestations. The majority of the reports of prenatally diagnosed WHS cases are associated with large 4p deletions identified by conventional chromosome analysis; however, the widespread clinical use of novel molecular techniques such as array comparative genomic hybridization (a-CGH) has increased the detection rate of submicroscopic chromosomal aberrations associated with WHS phenotype. We provide a report of two fetuses with WHS presenting with intrauterine growth restriction as an isolated finding or combined with oligohydramnios and abnormal Doppler waveform in umbilical artery and uterine arteries. Standard karyotyping demonstrated a deletion on chromosome 4 in both cases [del(4)(p15.33) and del(4)(p15.31), respectively] and further application of a-CGH confirmed the diagnosis and offered a precise characterization of the genetic defect. A detailed review of the currently available literature on the prenatal diagnostic approach of WHS in terms of fetal sonographic assessment and molecular cytogenetic investigation is also provided.
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Affiliation(s)
- Stavros Sifakis
- Department of Obstetrics & Gynecology, University of Crete, Heraklion, Greece
| | - Emmanouil Manolakos
- Eurogenetica S.A., Laboratory of Genetics, Athens-Thessaloniki, Greece
- Cattedra di Genetica Medica, Universita di Cagliari, Cagliari, Italia
| | - Annalisa Vetro
- Dipartimento di Patologia Umana ed Ereditaria, Universita di Pavia, Pavia, Italia
| | - Dimitra Kappou
- Department of Obstetrics & Gynecology, University of Crete, Heraklion, Greece
| | | | - Maria Kontodiou
- Eurogenetica S.A., Laboratory of Genetics, Athens-Thessaloniki, Greece
| | - Antonios Garas
- Department of Obstetrics & Gynecology, University of Thessalia, Larissa, Greece
| | - Nikolaos Vrachnis
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Univeristy of Athens, Athens, Greece
| | | | - Orsetta Zuffardi
- Dipartimento di Patologia Umana ed Ereditaria, Universita di Pavia, Pavia, Italia
| | - Sandro Orru
- Cattedra di Genetica Medica, Universita di Cagliari, Cagliari, Italia
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Kerzendorfer C, Hannes F, Colnaghi R, Abramowicz I, Carpenter G, Vermeesch JR, O'Driscoll M. Characterizing the functional consequences of haploinsufficiency of NELF-A (WHSC2) and SLBP identifies novel cellular phenotypes in Wolf-Hirschhorn syndrome. Hum Mol Genet 2012; 21:2181-93. [PMID: 22328085 DOI: 10.1093/hmg/dds033] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) is a contiguous gene deletion disorder associated with the distal part of the short arm of chromosome 4 (4p16.3). Employing a unique panel of patient-derived cell lines with differing-sized 4p deletions, we provide evidence that haploinsufficiency of SLBP and/or WHSC2 (NELF-A) contributes to several novel cellular phenotypes of WHS, including delayed progression from S-phase into M-phase, reduced DNA replication in asynchronous culture and altered higher order chromatin assembly. The latter is evidenced by reduced histone-chromatin association, elevated levels of soluble chaperone-bound histone H3 and increased sensitivity to micrococcal nuclease digestion in WHS patient-derived cells. We also observed increased camptothecin-induced inhibition of DNA replication and hypersensitivity to killing. Our work provides a novel pathogenomic insight into the aetiology of WHS by describing it, for the first time, as a disorder of impaired chromatin reorganization. Delayed cell-cycle progression and impaired DNA replication likely underlie or contribute to microcephaly, pre- and postnatal growth retardation, which constitute the core clinical features of WHS.
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Affiliation(s)
- Claudia Kerzendorfer
- Human DNA Damage Response Disorders Group, Genome Damage and Stability Centre, University of Sussex, Brighton BN1 9RQ, UK
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Abstract
Wolf-Hirschhorn syndrome is caused by anomalies of the short arm of chromosome 4. About 55% of cases are due to de novo terminal deletions, 40% from unbalanced translocations and 5% from other abnormalities. The facial phenotype is characterized by hypertelorism, protruding eyes, prominent glabella, broad nasal bridge and short philtrum. We used dense surface modelling and pattern recognition techniques to delineate the milder facial phenotype of individuals with a small terminal deletion (breakpoint within 4p16.3) compared to those with a large deletion (breakpoint more proximal than 4p16.3). Further, fine-grained facial analysis of several individuals with an atypical genotype and/or phenotype suggests that multiple genes contiguously contribute to the characteristic Wolf-Hirschhorn syndrome facial phenotype.
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Iwanowski PS, Panasiuk B, Van Buggenhout G, Murdolo M, Myśliwiec M, Maas NM, Lattante S, Korniszewski L, Posmyk R, Pilch J, Zajączek S, Fryns JP, Zollino M, Midro AT. Wolf-Hirschhorn syndrome due to pure and translocation forms of monosomy 4p16.1 → pter. Am J Med Genet A 2011; 155A:1833-47. [DOI: 10.1002/ajmg.a.34005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2008] [Accepted: 09/07/2010] [Indexed: 11/11/2022]
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A family with partial duplication/deletion 4p due to a balanced t (4; 15) (p16.2; p11.2) translocation. Am J Med Genet A 2011; 155A:656-9. [DOI: 10.1002/ajmg.a.33867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 11/24/2010] [Indexed: 11/07/2022]
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Mun SJ, Cho EH, Chey MJ, Shim GH, Shin BM, Lee RK, Ko JK, Yoo SJ. [Recombinant chromosome 4 with partial 4p deletion and 4q duplication inherited from paternal pericentric inversion]. Korean J Lab Med 2010; 30:89-92. [PMID: 20197729 DOI: 10.3343/kjlm.2010.30.1.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pericentric inversion of chromosome 4 can give rise to 2 alternate recombinant (rec) chromosomesby duplication or deletion of 4p. The deletion of distal 4p manifests as Wolf-Hirschhorn syndrome (WHS). Here, we report the molecular cytogenetic findings and clinical manifestations observed in an infant with 46,XX,rec(4)dup(4q)inv(4)(p16q31.3)pat. The infant was delivered by Cesarean section at the 33rd week of gestation because pleural effusion and polyhydramnios were detected on ultrasonography. At birth, the infant showed no malformation or dysfunction, except for a preauricular skin tag. Array comparative genomic hybridization analysis of neonatal peripheral blood samples showed a gain of 38 Mb on 4q31.3-qter and a loss of 3 Mb on 4p16.3, and these results were consistent with WHS. At the last follow-up at 8 months of age (corrected age, 6 months), the infant had not achieved complete head control.
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Affiliation(s)
- Se Jin Mun
- Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Fisch GS, Grossfeld P, Falk R, Battaglia A, Youngblom J, Simensen R. Cognitive-behavioral features of Wolf-Hirschhorn syndrome and other subtelomeric microdeletions. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2010; 154C:417-26. [DOI: 10.1002/ajmg.c.30279] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Background Many chromosomal abnormalities are associated with Central Nervous System (CNS) malformations and other neurological alterations, among which seizures and epilepsy. Some of these show a peculiar epileptic and EEG pattern. We describe some epileptic syndromes frequently reported in chromosomal disorders. Methods Detailed clinical assessment, electrophysiological studies, survey of the literature. Results In some of these congenital syndromes the clinical presentation and EEG anomalies seems to be quite typical, in others the manifestations appear aspecific and no strictly linked with the chromosomal imbalance. The onset of seizures is often during the neonatal period of the infancy. Conclusions A better characterization of the electro clinical patterns associated with specific chromosomal aberrations could give us a valuable key in the identification of epilepsy susceptibility of some chromosomal loci, using the new advances in molecular cytogenetics techniques - such as fluorescent in situ hybridization (FISH), subtelomeric analysis and CGH (comparative genomic hybridization) microarray. However further studies are needed to understand the mechanism of epilepsy associated with chromosomal abnormalities.
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Affiliation(s)
- Giovanni Sorge
- Department of Pediatrics, Azienda Ospedaliera Universitaria Policlinico-Vittorio Emanuele, Università di Catania, Via Santa Sofia 78, Catania 95123, Italy.
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Ferrara P, Del Bufalo F, Nicoletti A, Romano V, Gatto A, Leoni C, Zampino G. Wolf-Hirschhorn syndrome with improvement of renal function. Am J Med Genet A 2010; 152A:1283-4. [PMID: 20425837 DOI: 10.1002/ajmg.a.33357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Wolf-Hirschhorn syndrome (WHS) is a chromosomal disorder characterized by partial deletion of the short arm of chromosome 4. We describe a girl with a de novo unbalanced traslocation t(4;7)(p16.2;p22), associated with a mild version of a classical WHS phenotype. She did not present major urinary tract abnormalities but had parenchymal hyperechogenicity at renal ultrasound at the birth with normal renal scintigraphy. She had also a reduction of GFR with elevated levels of blood urea nitrogen and serum potassium until the age of 6 months. We followed the patient with periodic clinical examination and laboratory and radiological investigations and observed at the age of 5 years a normal renal ultrasound without parenchymal hyperechogenicity.
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Affiliation(s)
- P Ferrara
- Catholic University, A. Gemelli Hospital, Rome, Italy.
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Marshall AT. Impact of chromosome 4p- syndrome on communication and expressive language skills: a preliminary investigation. Lang Speech Hear Serv Sch 2010; 41:265-76. [PMID: 20421614 DOI: 10.1044/0161-1461(2009/08-0098)] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this investigation was to examine the impact of Chromosome 4p- syndrome on the communication and expressive language phenotype of a large cross-cultural population of children, adolescents, and adults. METHOD A large-scale survey study was conducted and a descriptive research design was used to analyze quantitative and qualitative data regarding the communication and expressive language manifestations of 200 children, youth, and adults from 16 countries and Puerto Rico who had been diagnosed with 4p conditions, including Wolf-Hirschhorn syndrome (WHS), Pitt-Rogers-Danks syndrome (PRDS), Proximal 4p Deletion syndrome, and complex chromosomal rearrangements associated with 4p-. RESULTS Individuals with Chromosome 4p- syndrome represent a heterogeneous population with complex phenotypic profiles. The majority of the participants exhibited communication and expressive language skills below the 36-month developmental functioning level. A relatively small cohort of the study population exhibited advanced expressive language skills, a finding not reported in the professional literature. CONCLUSION Results broaden the spectrum of expressive language skills associated with Chromosome 4p- syndrome and highlight the communication potential of a subset of individuals with 4p abnormalities for development of advanced language structures. It is hypothesized that the largest 4p deletion, which includes the 4p16.3 band and contiguous gene regions, results in the most severely affected expressive language phenotype.
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Affiliation(s)
- Althea T Marshall
- Southern Connecticut State University, Department of Communication Disorders, Davis Hall Room 012 L 501, Crescent Street, New Haven, CT 06515, USA.
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Hannes F, Drozniewska M, Vermeesch JR, Haus O. Duplication of the Wolf-Hirschhorn syndrome critical region causes neurodevelopmental delay. Eur J Med Genet 2010; 53:136-40. [PMID: 20197130 DOI: 10.1016/j.ejmg.2010.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 02/21/2010] [Indexed: 01/12/2023]
Abstract
Wolf-Hirschhorn Syndrome (WHS) is caused by deletions on chromosome 4p and is clinically well defined. Genotype-phenotype correlations of patients with WHS point to a critical locus to be responsible for the main characteristics of this disorder. Submicroscopic duplications of this region, however, are not known. Here we report a patient with an interstitial 560 kb duplication overlapping this critical locus. The present case shows that not only deletions but also duplications of the Wolf-Hirshhorn critical region cause mental retardation and multiple congenital anomalies. Interestingly, the duplication phenotype overlaps partially with the deletion phenotype. However, his facial phenotype differs from the typical WHS gestalt.
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Affiliation(s)
- Femke Hannes
- Centre for Human Genetics, University Hospital, K.U. Leuven, Herestraat 49, 3000 Leuven, Belgium
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Nicolae C, Olsen BR. Unexpected matrix diseases and novel therapeutic strategies. Cell Tissue Res 2009; 339:155-65. [PMID: 19813027 DOI: 10.1007/s00441-009-0874-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 09/02/2009] [Indexed: 01/19/2023]
Abstract
Within the framework of a broad definition of the extracellular matrix (ECM), this review discusses three genetic disorders in which major pathogenetic features have been traced back to alterations in the levels/activities of matrix components. In each case, disease-associated alterations are found both intra- and extracellularly. The nature of the ECM involvement is surprising, offers an exciting therapeutic opportunity, and deepens our understanding of ECM-cell interactions. The first of these disorders, cherubism, is a case of inflammatory bone loss in the jaws of children for reasons that are surprisingly systemic in nature, considering the local nature of the disease. The primary defect involves an intracellular signaling molecule, but a major pathogenetic component and therapeutic target of the disease is the extracellular cytokine tumor necrosis factor alpha. The second disorder, Knobloch syndrome, is caused by recessive mutations in collagen XVIII. Although this protein has been classified as belonging to a group of structural macromolecules, the consequence of the mutations is impairment of cellular metabolism. The third disorder, infantile hemangioma, is a common tumor of capillary endothelial cells in infancy. The tumor appears within a few days/weeks after birth, grows rapidly over several months, and regresses over several years. The proliferative phase is the result of constitutively high levels of vascular endothelial cell growth factor (VEGF)-dependent signaling through VEGF receptor 2 (VEGFR2), but recent studies have led to the surprising conclusion that abnormalities in a cell-surface receptor complex controlling expression of the VEGF decoy receptor VEGFR1 is the underlying cause.
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Affiliation(s)
- Claudia Nicolae
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA
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