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Cenni C, Andres S, Hempel M, Strom TM, Thomas E, Davies A, Timoney N, Frigiola A, Logan M, Holder-Espinasse M. TBX3 and TBX5 duplication: A family with an atypical overlapping Holt-Oram/ulnar-mammary syndrome phenotype. Eur J Med Genet 2021; 64:104213. [PMID: 33930582 DOI: 10.1016/j.ejmg.2021.104213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 01/15/2021] [Accepted: 03/25/2021] [Indexed: 11/19/2022]
Abstract
Holt-Oram syndrome (HOS) is a rare, autosomal dominant heart-hand syndrome caused by mutations in the TBX5 gene. A wide spectrum of TBX5 mutations have been reported previously, most resulting in a null allele leading to haploinsufficiency. TBX5 gene duplications have been previously reported in association with typical and atypical HOS phenotypes. Ulnar-Mammary syndrome (UMS) is a distinct rare, autosomal dominant condition caused by mutations in the TBX3 gene. TBX5 and TBX3 are physically linked in cis on human chromosome 12 and contiguous chromosome 12q24 deletions comprising both TBX5 and TBX3 genes have been previously reported but to our knowledge, duplications have never been described. We report on a large German family with at least 17 affected individuals over 6 generations bearing a duplication at 12q24.21 identified on array-CGH comprising both TBX5 and TBX3 genes. Affected patients are presenting with HOS and UMS symptoms, consisting of variable limb anomalies involving the radial and the ulnar rays and cardiac findings such as congenital heart defects, persistent arterial duct or aortic stenosis, and non-classical symptoms, such as supernumerary nipples and cardiomyopathy. Fluorescence in situ hybridisation confirmed a tandem duplication at the 12q24.21 locus. This is the first report of a contiguous TBX3/TBX5 duplication associated with HOS/UMS phenotype.
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MESH Headings
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/pathology
- Breast Diseases/complications
- Breast Diseases/genetics
- Breast Diseases/pathology
- Female
- Gene Duplication
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/genetics
- Heart Defects, Congenital/pathology
- Heart Septal Defects, Atrial/complications
- Heart Septal Defects, Atrial/genetics
- Heart Septal Defects, Atrial/pathology
- Humans
- Lower Extremity Deformities, Congenital/complications
- Lower Extremity Deformities, Congenital/genetics
- Lower Extremity Deformities, Congenital/pathology
- Male
- Pedigree
- Phenotype
- T-Box Domain Proteins/genetics
- Ulna/abnormalities
- Ulna/pathology
- Upper Extremity Deformities, Congenital/complications
- Upper Extremity Deformities, Congenital/genetics
- Upper Extremity Deformities, Congenital/pathology
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Affiliation(s)
- Camille Cenni
- Department of Clinical Genetics, Guy's Hospital, London, UK
| | - Stephanie Andres
- Institute of Human Genetics, Technische Universitat Munchen, Munich, Germany
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim M Strom
- Institute of Human Genetics, Technische Universitat Munchen, Munich, Germany
| | - Ellen Thomas
- Genomics England, Queen Mary University of London, London, UK; Genomic Medicine, Imperial College Healthcare NHS Trust, London, UK
| | | | - Norma Timoney
- Department of Plastic Surgery, St Thomas Hospital, London, UK
| | | | - Malcolm Logan
- Randall Centre for Cell and Molecular Biophysics, King's College London, Guy's Campus, London, UK
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2
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Ushiki A, Zhang Y, Xiong C, Zhao J, Georgakopoulos-Soares I, Kane L, Jamieson K, Bamshad MJ, Nickerson DA, Shen Y, Lettice LA, Silveira-Lucas EL, Petit F, Ahituv N. Deletion of CTCF sites in the SHH locus alters enhancer-promoter interactions and leads to acheiropodia. Nat Commun 2021; 12:2282. [PMID: 33863876 PMCID: PMC8052326 DOI: 10.1038/s41467-021-22470-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/12/2021] [Indexed: 12/18/2022] Open
Abstract
Acheiropodia, congenital limb truncation, is associated with homozygous deletions in the LMBR1 gene around ZRS, an enhancer regulating SHH during limb development. How these deletions lead to this phenotype is unknown. Using whole-genome sequencing, we fine-mapped the acheiropodia-associated region to 12 kb and show that it does not function as an enhancer. CTCF and RAD21 ChIP-seq together with 4C-seq and DNA FISH identify three CTCF sites within the acheiropodia-deleted region that mediate the interaction between the ZRS and the SHH promoter. This interaction is substituted with other CTCF sites centromeric to the ZRS in the disease state. Mouse knockouts of the orthologous 12 kb sequence have no apparent abnormalities, showcasing the challenges in modelling CTCF alterations in animal models due to inherent motif differences between species. Our results show that alterations in CTCF motifs can lead to a Mendelian condition due to altered enhancer-promoter interactions.
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Affiliation(s)
- Aki Ushiki
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Yichi Zhang
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China
| | - Chenling Xiong
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Jingjing Zhao
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Ilias Georgakopoulos-Soares
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Lauren Kane
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Kirsty Jamieson
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Michael J Bamshad
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Brotman-Baty Institute, Seattle, WA, USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Brotman-Baty Institute, Seattle, WA, USA
| | - Yin Shen
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Laura A Lettice
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - Florence Petit
- CHU Lille, University of Lille, EA7364 RADEME, Lille, France
| | - Nadav Ahituv
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA.
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3
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Abualsaud D, Hashem M, AlHashem A, Alkuraya FS. Survey of disorders of sex development in a large cohort of patients with diverse Mendelian phenotypes. Am J Med Genet A 2020; 185:2789-2800. [PMID: 32949114 DOI: 10.1002/ajmg.a.61876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 12/15/2022]
Abstract
Disorders of sex development (DSD) are congenital conditions with atypical development of chromosomal, gonadal, or anatomical sex. The estimated incidence ranges from 1 in 4,500-5,500 for strictly defined "ambiguous genitalia" to 1 in 300 or higher when a broader definition is implemented. In this study, we aim to define DSD phenotypes encountered in a large heterogeneous cohort of molecularly characterized Mendelian disorders in a single center. Data were retrieved for patients with documented abnormal genitalia based on the 2006 consensus criteria. Out of 149 patients (129 families) with compatible human phenotype ontology, 76 patients (68 families) had an identified genetic cause and were included in our analysis. Potentially causal variants were identified in 42 genes, and two patients had a dual molecular diagnosis. Six genes have no associated phenotype in OMIM (PIANP, CELSR2, USP2, FAM179B, TXNDC15, and CCDC96). Thirteen genes have non-DSD OMIM phenotypes, thus we are expanding their phenotype to include DSD. We also highlight how certain disorders are under-recognized despite their established DSD phenotype in OMIM, especially CTU2-related DREAM-PL syndrome and TSPYL1-related sudden infant death with dysgenesis of the testes syndrome. In conclusion, this study of a large heterogeneous Mendelian cohort expands the list of genes and disorders beyond those classically DSD-linked.
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Affiliation(s)
- Dalia Abualsaud
- UCD School of Medicine, University College Dublin, Dublin, Ireland.,Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mais Hashem
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amal AlHashem
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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4
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Tessier A, Callier P, LeMeur N, Frebourg T, Sabourin JC, Patrier S. Postmortem Diagnosis of Heart-hand Syndrome Associated With a 7p22.1p22.3 Deletion in a 16-week-old Fetus. Pediatr Dev Pathol 2019; 22:146-151. [PMID: 30193563 DOI: 10.1177/1093526618799293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a male fetus with a 6.8 Mb deletion on chromosome 7p22.1p22.3 at 16 weeks of gestation. The fetus presented a heart-hand syndrome with great artery malposition, bilateral radial ray deficiency, a single pelvic kidney, and growth retardation. This deletion involves a minimal deleted region for cardiac malformation and the RAC1 gene, previously described in limb anomalies in mice. This fetus is the third human case with limb defects and RAC1 deletion.
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Affiliation(s)
- Aude Tessier
- 1 Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée et Service de Génétique, CHU Charles Nicolle, Rouen, France.,2 Service d'anatomopathologie, CHU Charles Nicolle, Rouen, France
| | - Patrick Callier
- 3 Service de Cytogénétique, Pole Technique et Biologie, CHU Dijon, Dijon, France
| | - Nathalie LeMeur
- 1 Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée et Service de Génétique, CHU Charles Nicolle, Rouen, France
| | - Thierry Frebourg
- 1 Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée et Service de Génétique, CHU Charles Nicolle, Rouen, France
| | | | - Sophie Patrier
- 2 Service d'anatomopathologie, CHU Charles Nicolle, Rouen, France
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5
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Southgate L. Current opinion in the molecular genetics of Adams-Oliver syndrome. Expert Opin Orphan Drugs 2018. [DOI: 10.1080/21678707.2019.1559049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Laura Southgate
- Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK
- Department of Medical and Molecular Genetics, King’s College London, London, UK
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6
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Bedard T, Lowry RB, Sibbald B, Crawford S, Kiefer GN. Congenital limb deficiencies and major associated anomalies in Alberta for the years 1980-2012. Am J Med Genet A 2017; 176:19-28. [PMID: 29168277 DOI: 10.1002/ajmg.a.38513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/23/2017] [Accepted: 09/26/2017] [Indexed: 12/11/2022]
Abstract
There is a wide range of the proportion of congenital anomalies associated with limb deficiencies reported in the literature. This variation is primarily attributed to methodology and classification differences. The distribution of associated anomalies among cases with congenital limb deficiencies in Alberta born between January 1, 1980 and December 31, 2012 is described. Of the 170 cases identified, most were live born (75.3%), male (61.8%), had longitudinal limb deficiencies (78.8%), and had associated anomalies outside the musculoskeletal system (77.6%). Significant associations between the preaxial longitudinal group and the central nervous, gastrointestinal, and cardiovascular systems are reported as well as between the postaxial longitudinal group and congenital hip and foot anomalies. Probable and possible syndrome diagnoses are described for cases with recognized malformation patterns.
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Affiliation(s)
- Tanya Bedard
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - R Brian Lowry
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada.,Departments of Pediatrics and Medical Genetics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Barbara Sibbald
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Susan Crawford
- Alberta Perinatal Health Program, Calgary, Alberta, Canada
| | - Gerhard N Kiefer
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Surgery, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
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7
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Lowry RB, Bedard T, Kiefer GN, Sass KR. Views on the Oberg-Manske-Tonkin Classification System for Congenital Anomalies of the Hand and Upper Limb. J Hand Surg Am 2017; 42:378-381. [PMID: 28473160 DOI: 10.1016/j.jhsa.2017.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/23/2017] [Indexed: 02/02/2023]
Abstract
A new classification system was proposed by Tonkin et al as a replacement for the Swanson/International Federation of Societies for Surgery of the Hand system. We have reviewed their aims and have pointed out a number of problems that will make it difficult to be universally accepted.
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Affiliation(s)
- R Brian Lowry
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada; Departments of Medical Genetics and Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Tanya Bedard
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Gerhard N Kiefer
- Alberta Congenital Anomalies Surveillance System, Alberta Health, Alberta Children's Hospital, Calgary, Alberta, Canada; Divison of Pediatric Orthopedic Surgery, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kimberly R Sass
- Division of Pediatric Plastic Surgery, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada
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