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Różdżyńska-Świątkowska A, Ciara E, Halat-Wolska P, Krajewska-Walasek M, Jezela-Stanek A. Anthropometric characteristics of 65 Polish Smith-Lemli-Opitz patients. J Appl Genet 2021; 62:469-475. [PMID: 33890232 DOI: 10.1007/s13353-021-00632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 04/07/2021] [Indexed: 11/26/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLOS) belongs to a group of multiple congenital anomaly/developmental delay disorders. Its primary cause lies in the defect in cholesterol biosynthesis-7-dehydrocholesterol reductase (DHCR7)-caused by pathogenic variants in the homonymous gene. Anthropometric anomalies, especially growth restriction and microcephaly, are among the most common physical manifestations of SLOS. There have been no studies analyzing the correlation between genotype, biochemical marker (7-dehydrocholesterol), and the birth and growth parameters for individuals with SLOS. This paper presents anthropometric data from the group of 65 Polish patients (aged 0.1 to 18 years) with Smith-Lemli-Opitz syndrome, with genotype and biochemical correlations for birth parameters, as well as growth in relation to molecular DHCR7 variants.
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Affiliation(s)
| | - E Ciara
- Department of Medical Genetics, The Children's Memorial Health Institute, Warsaw, Poland
| | - P Halat-Wolska
- Department of Medical Genetics, The Children's Memorial Health Institute, Warsaw, Poland
| | - M Krajewska-Walasek
- Department of Medical Genetics, The Children's Memorial Health Institute, Warsaw, Poland
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - A Jezela-Stanek
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
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Zalewski CK, Sydlowski SA, King KA, Bianconi S, Dang Do A, Porter FD, Brewer CC. Auditory phenotype of Smith-Lemli-Opitz syndrome. Am J Med Genet A 2021; 185:1131-1141. [PMID: 33529473 DOI: 10.1002/ajmg.a.62087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/23/2020] [Accepted: 01/07/2021] [Indexed: 11/11/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive multiple congenital malformation and intellectual disability syndrome resulting from variants in DHCR7. Auditory characteristics of persons with SLOS have been described in limited case reports but have not been systematically evaluated. The objective of this study is to describe the auditory phenotype in SLOS. Age- and ability-appropriate hearing evaluations were conducted on 32 patients with SLOS. A subset of 21 had auditory brainstem response testing, from which an auditory neural phenotype is described. Peripheral or retrocochlear auditory dysfunction was observed in at least one ear of 65.6% (21) of the patients in our SLOS cohort. The audiometric phenotype was heterogeneous and included conductive, mixed, and sensorineural hearing loss. The most common presentation was a slight to mild conductive hearing loss, although profound sensorineural hearing loss was also observed. Abnormal auditory brainstem responses indicative of retrocochlear dysfunction were identified in 21.9% of the patients. Many were difficult to test behaviorally and required objective assessment methods to estimate hearing sensitivity. Individuals with SLOS are likely to have hearing loss that may impact communication, including speech and language development. Routine audiologic surveillance should be conducted to ensure prompt management of hearing loss.
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Affiliation(s)
| | - Sarah A Sydlowski
- NIDCD, National Institutes of Health, Bethesda, Maryland, USA.,Cleveland Clinic Head & Neck Institute, Cleveland, Ohio, USA
| | - Kelly A King
- NIDCD, National Institutes of Health, Bethesda, Maryland, USA
| | - Simona Bianconi
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - An Dang Do
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes D Porter
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Carmen C Brewer
- NIDCD, National Institutes of Health, Bethesda, Maryland, USA
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Ballout RA, Bianconi S, Livinski A, Fu Y, Remaley AT, Porter FD. Statins for Smith-Lemli-Opitz syndrome. Cochrane Database Syst Rev 2020; 2020:CD013521. [PMID: 32132878 PMCID: PMC7055734 DOI: 10.1002/14651858.cd013521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: 1. To evaluate the efficacy of statin therapy in reducing the frequency or severity of the neurobehavioral abnormalities seen in people with SLOS (e.g. aggression, anxiety, irritability, self-mutilation, autistic behaviors, sleep disturbances, etc.) (Wassif 2017). 2. To evaluate the potential effects of statin therapy on survival.
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Affiliation(s)
- Rami A Ballout
- National Heart, Lung and Blood Institute, NIHLipoprotein Metabolism Section, Translational Vascular Medicine Branch10 Center Drive, Bldg 10, Rm 5D11BethesdaMDUSA20892
| | - Simona Bianconi
- NIHNational Institute of Child Health and Development10 Center Drive, Building 10, CRC‐ 2‐5132BethesdaUSAMD 20892
| | - Alicia Livinski
- National Institutes of Health Library, Office of Research ServicesDivision of Library ServicesBldg 10, Room 1L19B, MSC 1150BethesdaMarylandUSAMD 20892‐1150
| | - Yi‐Ping Fu
- National Heart, Lung, and Blood Institute, NIHOffice of Biostatistics Research6701 Rockledge Drive, RKL2 Rm9195BethesdaUSAMD 20892
| | - Alan T Remaley
- National Heart, Lung and Blood Institute, NIHLipoprotein Metabolism Laboratory, Translational Vascular Medicine BranchBethesdaUSAMD 20892
| | - Forbes D Porter
- Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of HealthDivision of Translational Research10 Center DriveBethesdaMarylandUSA20892
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Nahhas AF, Oberlin DM, Braunberger TL, Lim HW. Recent Developments in the Diagnosis and Management of Photosensitive Disorders. Am J Clin Dermatol 2018; 19:707-731. [PMID: 29959757 DOI: 10.1007/s40257-018-0365-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Photodermatoses occur in males and females of all races and ages. Onset can be variable in timing and influenced by genetic and environmental factors. Photodermatoses are broadly classified as immunologically mediated, chemical- and drug-induced, photoaggravated, and genetic (defective DNA repair or chromosomal instability) diseases. Advances in the field have led to improved recognition and treatment of many photodermatoses. The purpose of this focused review is to provide an update on the diagnosis and management of a variety of photodermatoses, both common and less common, with review of recent updates in the literature pertaining to their diagnosis and management.
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Affiliation(s)
- Amanda F Nahhas
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - David M Oberlin
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Taylor L Braunberger
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA.
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Smith–Lemli–Opitz Syndrome (SLOS) and the Fetus. JOURNAL OF FETAL MEDICINE 2016. [DOI: 10.1007/s40556-016-0089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cologna SM, Shieh C, Toth CL, Cougnoux A, Burkert KR, Bianconi SE, Wassif CA, Porter FD. Altered cerebrospinal fluid proteins in Smith-Lemli-Opitz syndrome patients. Am J Med Genet A 2016; 170:2060-2068. [PMID: 27148958 DOI: 10.1002/ajmg.a.37720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/13/2016] [Indexed: 11/09/2022]
Abstract
Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive, multiple malformation syndrome with neurocognitive impairment. SLOS arises from mutations in the 7-dehydrocholesterol reductase gene which results in impaired enzymatic conversion of 7-dehydrocholesterol to cholesterol. In the current work, we sought to measure proteins that were altered in the cerebrospinal fluid from SLOS patients compared to pediatric controls. Using a multi-analyte antibody-based assay, we found that 12 proteins are altered in SLOS patients. Validation studies were carried out and the findings from this study suggest alterations in extracellular matrix remodeling and further evidence of oxidative stress within the disease pathophysiology. The results of this study will be used to explore biological pathways altered in SLOS and identifies a set of CSF proteins that can be evaluated as biomarkers in future therapeutic trials. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Stephanie M Cologna
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.,Current Location: Department of Chemistry, University of Illinois at Chicago, Chicago, IL, USA
| | - Christine Shieh
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Cynthia L Toth
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Antony Cougnoux
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Kathryn R Burkert
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Simona E Bianconi
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Christopher A Wassif
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Forbes D Porter
- Section on Molecular Dysmorphology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Platt FM, Wassif C, Colaco A, Dardis A, Lloyd-Evans E, Bembi B, Porter FD. Disorders of cholesterol metabolism and their unanticipated convergent mechanisms of disease. Annu Rev Genomics Hum Genet 2015; 15:173-94. [PMID: 25184529 DOI: 10.1146/annurev-genom-091212-153412] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cholesterol plays a key role in many cellular processes, and is generated by cells through de novo biosynthesis or acquired from exogenous sources through the uptake of low-density lipoproteins. Cholesterol biosynthesis is a complex, multienzyme-catalyzed pathway involving a series of sequentially acting enzymes. Inherited defects in genes encoding cholesterol biosynthetic enzymes or other regulators of cholesterol homeostasis result in severe metabolic diseases, many of which are rare in the general population and currently without effective therapy. Historically, these diseases have been viewed as discrete disorders, each with its own genetic cause and distinct pathogenic cascades that lead to its specific clinical features. However, studies have recently shown that three of these diseases have an unanticipated mechanistic convergence. This surprising finding is not only shedding light on details of cellular cholesterol homeostasis but also suggesting novel approaches to therapy.
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Affiliation(s)
- Frances M Platt
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, United Kingdom;
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Bianconi SE, Cross JL, Wassif CA, Porter FD. Pathogenesis, Epidemiology, Diagnosis and Clinical Aspects of Smith-Lemli-Opitz Syndrome. Expert Opin Orphan Drugs 2015; 3:267-280. [PMID: 25734025 PMCID: PMC4343216 DOI: 10.1517/21678707.2015.1014472] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Smith-Lemli-Opitz Syndrome (SLOS) is a malformation syndrome inherited in an autosomal recessive fashion. It is due to a metabolic defect in the conversion of 7-dehydrocholesterol to cholesterol, which leads to an accumulation of 7-dehydrocholesterol and frequently a deficiency of cholesterol. The syndrome is characterized by typical dysmorphic facial features, multiple malformations, and intellectual disability. AREAS COVERED In this paper we provide an overview of the clinical phenotype and discuss how the manifestations of the syndrome vary depending on the age of the patients. We then explore the underlying biochemical defect and pathophysiological alterations that may contribute to the many disease manifestations. Subsequently we explore the epidemiology and succinctly discuss population genetics as they relate to SLOS. The next section presents the diagnostic possibilities. Thereafter, the treatment and management as is standard of care are presented. EXPERT OPINION Even though the knowledge of the underlying molecular mutations and the biochemical alterations is being rapidly accumulated, there is currently no efficacious therapy addressing neurological dysfunction. We discuss the difficulty of treating this disorder, which manifests as a combination of a malformation syndrome and an inborn error of metabolism. A very important factor in developing new therapies is the need to rigorously establish efficacy in controlled trials.
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Affiliation(s)
- Simona E Bianconi
- National Institute of Child Health and Human Development, Program in Developmental Endocrinology and Genetics, Section on Molecular Dysmorphology, 10 Center Drive, Bld 10 Rm 9D42, Bethesda, MD 20892,
| | - Joanna L Cross
- National Institute of Child Health and Human Development, Program in Developmental Endocrinology and Genetics, Section on Molecular Dysmorphology, 10 Center Drive, Bld 10 CRC, Rm 1-3288, Bethesda, MD 20892
| | - Christopher A Wassif
- National Institute of Child Health and Human Development, Program in Developmental Endocrinology and Genetics, Section on Molecular Dysmorphology, 10 Center Drive, Bld 10 CRC, Rm 1-3288, Bethesda, MD 20892
| | - Forbes D Porter
- National Institute of Child Health and Human Development, Program in Developmental Endocrinology and Genetics, Section on Molecular Dysmorphology, 10 Center Drive, Bld 10, CRC, Rm 2571, Bethesda, MD 20892,
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Witsch-Baumgartner M, Lanthaler B. Birthday of a syndrome: 50 years anniversary of Smith-Lemli-Opitz Syndrome. Eur J Hum Genet 2014; 23:277-8. [PMID: 24824134 DOI: 10.1038/ejhg.2014.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Martina Witsch-Baumgartner
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Human Genetics, Innsbruck, Austria
| | - Barbara Lanthaler
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Human Genetics, Innsbruck, Austria
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Nowaczyk MJM, Irons MB. Smith-Lemli-Opitz syndrome: phenotype, natural history, and epidemiology. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2012; 160C:250-62. [PMID: 23059950 DOI: 10.1002/ajmg.c.31343] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Smith-Lemli-Opitz syndrome (SLOS) is a congenital multiple anomaly/intellectual disability syndrome caused by a deficiency of cholesterol synthesis resulting from a deficiency of 7-dehydrocholesterol (7DHC) reductase encoded by DHCR7. SLOS is inherited in an autosomal recessive pattern. It is characterized by prenatal and postnatal growth retardation, microcephaly, a variable degree of intellectual disability that encompasses normal intelligence to severe intellectual deficiency, and multiple major and minor malformations. External malformations include distinctive facial features, cleft palate, postaxial polydactyly, 2-3 syndactyly of the toes, and underdeveloped external genitalia in males, while internal anomalies may affect every organ system. The clinical spectrum is wide, and rare individuals have been described with normal development and only minor malformations. The clinical diagnosis of SLOS is confirmed by demonstrating an abnormally elevated concentration of the cholesterol precursor, 7DHC, in serum or other tissues, or by the presence of two DHCR7 mutations. The enzymatic deficiency results in decreased cholesterol and increased 7DHC levels, both during embryonic development and after birth. The malformations found in SLOS may result from decreased cholesterol, increased 7DHC or a combination of these two factors. This review discusses the physical and behavioral phenotype of SLOS, the diagnostic approaches, the natural history from the prenatal period to adulthood, and current understanding of the pathophysiology of SLOS.
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Affiliation(s)
- Małgorzata J M Nowaczyk
- Department of Pathology and Molecular Medicine and Department of Pediatrics, McMaster University McMaster University Medical Centre, Room 3N16, 1200 Main Street West, Hamilton ON, Canada L8S 4J9.
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