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Cilio Arroyuelo M, Tenorio-Castano J, García-Moya LF, Parra A, Cazalla M, Gallego N, Miranda L, Mori MÁ, García-Gueretta L, Labrandero C, Mansilla E, Rikeros E, García-Santiago F, Vallcorba I, Arias P, Silván C, Deiros Bronte L, Nevado J, Lapunzina P. Mortality in Patients with 22q11.2 Rearrangements. Genes (Basel) 2024; 15:1146. [PMID: 39336737 PMCID: PMC11431692 DOI: 10.3390/genes15091146] [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: 07/17/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 09/30/2024] Open
Abstract
The 22q11.2 region is highly susceptible to genomic rearrangements leading to multiple genomic disorders, including 22q11.2 microdeletion syndrome (22q11.2 DS) (MIM# 188400), 22q11.2 microduplication syndrome (MIM# 608363), supernumerary der(22)t(11;22) syndrome (also known as Emanuel Syndrome; MIM# 609029), and Cat Eye Syndrome (MIM# 115470). In this study, we present data on causes of mortality, average age of death, and the existing associated risk factors in patients with 22q11.2 rearrangements. Our cohort included 223 patients (120 males and 103 females) with confirmed diagnoses of 22q11.2 rearrangements diagnosed through molecular techniques (FISH, MLPA, and CMA). Relatives from patients who have been molecularly confirmed with 22q11.2 rearrangements have also been added to the study, regardless of the presence or absence of symptoms. Of these 223 individuals, 21 (9.4%) died. Deceased patients' rearrangements include 19 microdeletions, 1 microduplication, and 1 patient with a marker chromosome. The median age of death was 3 months and 18 days (ranging from 3 days to 34 years). There were 17 patients who died at pediatric age (80.95%), 3 died at adult age (14.28%), and for 1 of whom, the age of death is unknown (4.76%). Eighteen patients were White Mediterranean (European non-Finnish) (85.71%) whereas three were Amerindian (South American) (14.28%). Mortality from cardiac causes accounted for 71.42%. The second most frequent cause of death was sepsis in two patients (9.52%). One patient died from respiratory failure (4.76%) and one from renal failure (4.76%). Information regarding the cause of death was not available in two patients (9.52%). Most patients who died were diagnosed within the first week of life, the majority on the first day. This study adds additional information on mortality in one of the largest cohorts of patients with 22q11.2 rearrangements in more than 30 years of follow-up.
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Affiliation(s)
- Melisa Cilio Arroyuelo
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
| | - Jair Tenorio-Castano
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Luis Fernández García-Moya
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Alejandro Parra
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Mario Cazalla
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Natalia Gallego
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Lucía Miranda
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
| | - María Ángeles Mori
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Luis García-Gueretta
- Department of Pediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain; (L.G.-G.); (C.L.); (L.D.B.)
| | - Carlos Labrandero
- Department of Pediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain; (L.G.-G.); (C.L.); (L.D.B.)
| | - Elena Mansilla
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Emi Rikeros
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
| | - Fe García-Santiago
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Isabel Vallcorba
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Pedro Arias
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Cristina Silván
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Lucia Deiros Bronte
- Department of Pediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain; (L.G.-G.); (C.L.); (L.D.B.)
| | - Julián Nevado
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
| | - Pablo Lapunzina
- Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, INGEMM-IdIPAZ, 28046 Madrid, Spain (J.T.-C.); (L.F.G.-M.); (A.P.); (M.C.); (N.G.); (L.M.); (M.Á.M.); (E.M.); (E.R.); (F.G.-S.); (I.V.); (P.A.); (C.S.); (J.N.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
- European Reference Network, ITHACA, 1070 Brussels, Belgium
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Zhang R, He Z, Shi Y, Sun X, Chen X, Wang G, Zhang Y, Gao P, Wu Y, Lu S, Duan J, Sun S, Yang N, Fan W, Zhao K, Yang B, Xia Y, Zhang Y, Zhang Y, Yin H. Amplification editing enables efficient and precise duplication of DNA from short sequence to megabase and chromosomal scale. Cell 2024; 187:3936-3952.e19. [PMID: 38936359 DOI: 10.1016/j.cell.2024.05.056] [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: 12/25/2023] [Revised: 03/24/2024] [Accepted: 05/31/2024] [Indexed: 06/29/2024]
Abstract
Duplication is a foundation of molecular evolution and a driver of genomic and complex diseases. Here, we develop a genome editing tool named Amplification Editing (AE) that enables programmable DNA duplication with precision at chromosomal scale. AE can duplicate human genomes ranging from 20 bp to 100 Mb, a size comparable to human chromosomes. AE exhibits activity across various cell types, encompassing diploid, haploid, and primary cells. AE exhibited up to 73.0% efficiency for 1 Mb and 3.4% for 100 Mb duplications, respectively. Whole-genome sequencing and deep sequencing of the junctions of edited sequences confirm the precision of duplication. AE can create chromosomal microduplications within disease-relevant regions in embryonic stem cells, indicating its potential for generating cellular and animal models. AE is a precise and efficient tool for chromosomal engineering and DNA duplication, broadening the landscape of precision genome editing from an individual genetic locus to the chromosomal scale.
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Affiliation(s)
- Ruiwen Zhang
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China; Department of Rheumatology and Immunology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, China
| | - Zhou He
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yajing Shi
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xiangkun Sun
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xinyu Chen
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Guoquan Wang
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Yizhou Zhang
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Pan Gao
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Ying Wu
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Shuhan Lu
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Junyi Duan
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Shangwu Sun
- Shanghai Institute for Advanced Immunochemical Studies and School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Na Yang
- Center for Gene Diagnosis and Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Wei Fan
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Kaitao Zhao
- State Key Laboratory of Virology and Hubei Province Key Laboratory of Allergy and Immunology, Institute of Medical Virology, TaiKang Center for Life and Medical Sciences, TaiKang Medical School, Wuhan University, Wuhan 430071, China
| | - Bei Yang
- Shanghai Institute for Advanced Immunochemical Studies and School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Yuchen Xia
- State Key Laboratory of Virology and Hubei Province Key Laboratory of Allergy and Immunology, Institute of Medical Virology, TaiKang Center for Life and Medical Sciences, TaiKang Medical School, Wuhan University, Wuhan 430071, China
| | - Yan Zhang
- Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Zhang
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China; Department of Rheumatology and Immunology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, China
| | - Hao Yin
- Departments of Urology and Laboratory Medicine, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, State Key Laboratory of Virology, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan 430071, China.
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Cillo F, Coppola E, Habetswallner F, Cecere F, Pignata L, Toriello E, De Rosa A, Grilli L, Ammendola A, Salerno P, Romano R, Cirillo E, Merla G, Riccio A, Pignata C, Giardino G. Understanding the Variability of 22q11.2 Deletion Syndrome: The Role of Epigenetic Factors. Genes (Basel) 2024; 15:321. [PMID: 38540380 PMCID: PMC10969806 DOI: 10.3390/genes15030321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 06/14/2024] Open
Abstract
Initially described as a triad of immunodeficiency, congenital heart defects and hypoparathyroidism, 22q11.2 deletion syndrome (22q11.2DS) now encompasses a great amount of abnormalities involving different systems. Approximately 85% of patients share a 3 Mb 22q11.2 region of hemizygous deletion in which 46 protein-coding genes are included. However, the hemizygosity of the genes of this region cannot fully explain the clinical phenotype and the phenotypic variability observed among patients. Additional mutations in genes located outside the deleted region, leading to "dual diagnosis", have been described in 1% of patients. In some cases, the hemizygosity of the 22q11.2 region unmasks autosomal recessive conditions due to additional mutations on the non-deleted allele. Some of the deleted genes play a crucial role in gene expression regulation pathways, involving the whole genome. Typical miRNA expression patterns have been identified in 22q11.2DS, due to an alteration in miRNA biogenesis, affecting the expression of several target genes. Also, a methylation epi-signature in CpG islands differentiating patients from controls has been defined. Herein, we summarize the evidence on the genetic and epigenetic mechanisms implicated in the pathogenesis of the clinical manifestations of 22q11.2 DS. The review of the literature confirms the hypothesis that the 22q11.2DS phenotype results from a network of interactions between deleted protein-coding genes and altered epigenetic regulation.
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Affiliation(s)
- Francesca Cillo
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Emma Coppola
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Federico Habetswallner
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Francesco Cecere
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Caserta, Italy; (F.C.); (L.P.); (A.R.)
| | - Laura Pignata
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Caserta, Italy; (F.C.); (L.P.); (A.R.)
| | - Elisabetta Toriello
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Antonio De Rosa
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Laura Grilli
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Antonio Ammendola
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80138 Naples, Italy; (A.A.); (P.S.); (G.M.)
| | - Paolo Salerno
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80138 Naples, Italy; (A.A.); (P.S.); (G.M.)
| | - Roberta Romano
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Emilia Cirillo
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Giuseppe Merla
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80138 Naples, Italy; (A.A.); (P.S.); (G.M.)
- Laboratory of Regulatory and Functional Genomics, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Andrea Riccio
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Caserta, Italy; (F.C.); (L.P.); (A.R.)
| | - Claudio Pignata
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
| | - Giuliana Giardino
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, 80138 Naples, Italy; (F.C.); (E.C.); (F.H.); (E.T.); (A.D.R.); (L.G.); (R.R.); (E.C.); (G.G.)
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Wang J, Wang W, Zhou W, Zhou Y, Zhou L, Wang X, Yu B, Zhang B. Preliminary study of noninvasive prenatal screening for 22q11.2 deletion/duplication syndrome using multiplex dPCR assay. Orphanet J Rare Dis 2023; 18:278. [PMID: 37684689 PMCID: PMC10486099 DOI: 10.1186/s13023-023-02903-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE This study aimed to establish a cell-free fetal DNA (cffDNA) assay using multiplex digital PCR (dPCR) for identifying fetuses at increased risk of 22q11.2 deletion/duplication syndrome. METHODS Six detection sites and their corresponding probes were designed for the 22q11.2 recurrent region. A dPCR assay for the noninvasive screening of 22q11.2 deletion/duplication syndrome was established. A total of 130 plasma samples from pregnant women (including 15 samples with fetal 22q11.2 deletion/duplication syndrome) were blindly tested for evaluating the sensitivity and specificity of the established assay. RESULTS DNA with different sizes of 22q11.2 deletion/duplication was detected via dPCR, indicating that the designed probes and detection sites were reasonable and effective. In the retrospective clinical samples, 11 out of 15 samples of pregnant women with 22q11.2 deletion/duplication were detected during the cffDNA assay, and accurate regional localization was achieved. Among the 115 normal samples, 111 were confirmed to be normal. Receiver operating characteristic curves were used for assessing the cut-off values and AUC for these samples. The sensitivity, specificity, and positive as well as negative predictive values were 73.3%, 96.5%, 73.3%, and 96.5%, respectively. CONCLUSION The cffDNA assay based on dPCR technology for the noninvasive detection of 22q11.2 recurrent copy number variants in fetuses detected most affected cases, including smaller but relatively common nested deletions, with a low false-positive rate. It is a potential, efficient and simple method for the noninvasive screening of 22q11.2 deletion/duplication syndrome.
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Affiliation(s)
- Jing Wang
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China
| | - Wei Wang
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China
| | - Wenbo Zhou
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China
| | - Yan Zhou
- Xingzhi Biotechnology Co., LTD, Suzhou, 215000, Jiangsu Province, China
| | - Linna Zhou
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China
| | - Xinyue Wang
- Xingzhi Biotechnology Co., LTD, Suzhou, 215000, Jiangsu Province, China
| | - Bin Yu
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China.
| | - Bin Zhang
- Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu Province, China.
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Verbesselt J, Solot CB, Van Den Heuvel E, Crowley TB, Giunta V, Breckpot J, McDonald-McGinn DM, Zink I, Swillen A. Language Profiles of School-Aged Children with 22q11.2 Copy Number Variants. Genes (Basel) 2023; 14:679. [PMID: 36980951 PMCID: PMC10048271 DOI: 10.3390/genes14030679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/25/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Although it is known that copy number variants (CNVs) on chromosome 22, such as 22q11.2 deletion (22q11.2DS) and 22q11.2 duplication (22q11.2Dup) syndromes, are associated with higher risk for neurodevelopmental issues, few studies have examined the language skills across 22q11.2Dup nor compared them with the 22q11.2DS. The current study aims to characterize language abilities in school-aged children with 22q11.2Dup (n = 29), compared to age-matched children with 22q11.2DS (n = 29). Standardized language tests were administered, assessing receptive and expressive language skills across different language domains. Results indicate that children with 22q11.2Dup demonstrate significantly more language problems compared to the general population. Mean language skills were not significantly different among children with 22q11.2 CNVs in this cohort. While children with 22q11.2DS demonstrated language difficulties starting at the word level, the most common language problems in children with 22q11.2Dup started at the sentence level. Importantly, both expressive and receptive language as well as lexico-semantic and morphosyntactic domains were impaired in children with 22q11.2 CNVs. Early identification, therapeutic intervention, and follow-up of language impairments in children with 22q11.2Dup are recommended to support language development and to reduce longitudinal impact of language and communicative deficits.
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Affiliation(s)
- Jente Verbesselt
- Department of Human Genetics, Catholic University Leuven, 3000 Leuven, Belgium
- Research Group Experimental Oto-Rhino-Laryngology (ExpORL), Department of Neurosciences, Catholic University Leuven, 3000 Leuven, Belgium
| | - Cynthia B. Solot
- Center for Childhood Communication, 22q and You Center, Cleft Lip and Palate Program, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Ellen Van Den Heuvel
- Centre for Developmental Disorders, University Hospital Brussels, 1090 Jette, Belgium
| | | | - Victoria Giunta
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jeroen Breckpot
- Department of Human Genetics, Catholic University Leuven, 3000 Leuven, Belgium
- Centre for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Donna M. McDonald-McGinn
- Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Human Biology and Medical Genetics, Sapienza University, 00185 Rome, Italy
| | - Inge Zink
- Research Group Experimental Oto-Rhino-Laryngology (ExpORL), Department of Neurosciences, Catholic University Leuven, 3000 Leuven, Belgium
- MUCLA, Department of Oto-Rhino-Laryngology, Head & Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ann Swillen
- Department of Human Genetics, Catholic University Leuven, 3000 Leuven, Belgium
- Centre for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
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6
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Bhattarai D, McGinn DE, Crowley TB, Giunta V, Gaiser K, Zackai EH, Emanuel BS, Heimall J, Jyonouchi S, Lee J, Sun D, McDonald-McGinn DM, Sullivan KE. Immunologic, Molecular, and Clinical Profile of Patients with Chromosome 22q11.2 Duplications. J Clin Immunol 2023; 43:794-807. [PMID: 36735193 DOI: 10.1007/s10875-023-01443-5] [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: 09/30/2022] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE Duplication of chromosome 22q11.2 due to meiotic non-allelic homologous recombination results in a distinct syndrome, chromosome 22q11.2 duplication syndrome that has some overlapping phenotypic features with the corresponding 22q11.2 deletion syndrome. Literature on immunologic aspects of the duplication syndrome is limited. We conducted a retrospective study of 216 patients with this syndrome to better define the key features of the duplication syndrome. METHODS Single-center retrospective record review was performed. Data regarding demographics, clinical details, and immunological tests were compiled, extracted into a predetermined data collection form, and analyzed. RESULTS This cohort comprised 113 (52.3%) males and 103 (47.7%) females. The majority (54.6%) of mapped duplications were between low copy repeat regions A-D (LCR22A to -D). Though T cell subsets were relatively preserved, switched memory B cells, immunoglobulins, and specific antibodies were each found to be decreased in a subset of the cohort. One-fifth (17/79, 21.5%) of patients had at least 2 low immunoglobulin values, and panhypogammaglobulinemia was found in 11.7% (9/79) cases. Four children were on regular immunoglobulin replacement therapy. Asthma and eczema were the predominant atopic symptoms in our cohort. CONCLUSION Significant immunodeficiencies were observed in our cohort, particularly in B cells and antibodies. Our study expands the current clinical understanding and emphasizes the need of immunological studies and multidisciplinary approaches for these patients.
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Affiliation(s)
- Dharmagat Bhattarai
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Daniel E McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - T Blaine Crowley
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Victoria Giunta
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Kimberly Gaiser
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Beverly S Emanuel
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Jennifer Heimall
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Soma Jyonouchi
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Juhee Lee
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Di Sun
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Donna M McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Kathleen E Sullivan
- Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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7
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Zamariolli M, Auwerx C, Sadler MC, van der Graaf A, Lepik K, Schoeler T, Moysés-Oliveira M, Dantas AG, Melaragno MI, Kutalik Z. The impact of 22q11.2 copy-number variants on human traits in the general population. Am J Hum Genet 2023; 110:300-313. [PMID: 36706759 PMCID: PMC9943723 DOI: 10.1016/j.ajhg.2023.01.005] [Citation(s) in RCA: 2] [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: 09/05/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
While extensively studied in clinical cohorts, the phenotypic consequences of 22q11.2 copy-number variants (CNVs) in the general population remain understudied. To address this gap, we performed a phenome-wide association scan in 405,324 unrelated UK Biobank (UKBB) participants by using CNV calls from genotyping array. We mapped 236 Human Phenotype Ontology terms linked to any of the 90 genes encompassed by the region to 170 UKBB traits and assessed the association between these traits and the copy-number state of 504 genotyping array probes in the region. We found significant associations for eight continuous and nine binary traits associated under different models (duplication-only, deletion-only, U-shape, and mirror models). The causal effect of the expression level of 22q11.2 genes on associated traits was assessed through transcriptome-wide Mendelian randomization (TWMR), revealing that increased expression of ARVCF increased BMI. Similarly, increased DGCR6 expression causally reduced mean platelet volume, in line with the corresponding CNV effect. Furthermore, cross-trait multivariable Mendelian randomization (MVMR) suggested a predominant role of genuine (horizontal) pleiotropy in the CNV region. Our findings show that within the general population, 22q11.2 CNVs are associated with traits previously linked to genes in the region, and duplications and deletions act upon traits in different fashions. We also showed that gain or loss of distinct segments within 22q11.2 may impact a trait under different association models. Our results have provided new insights to help further the understanding of the complex 22q11.2 region.
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Affiliation(s)
- Malú Zamariolli
- Genetics Division, Universidade Federal de São Paulo, São Paulo, Brazil; Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Chiara Auwerx
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland; Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Marie C Sadler
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | | | - Kaido Lepik
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Tabea Schoeler
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland; Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Anelisa G Dantas
- Genetics Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Zoltán Kutalik
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
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8
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Mustillo PJ, Sullivan KE, Chinn IK, Notarangelo LD, Haddad E, Davies EG, de la Morena MT, Hartog N, Yu JE, Hernandez-Trujillo VP, Ip W, Franco J, Gambineri E, Hickey SE, Varga E, Markert ML. Clinical Practice Guidelines for the Immunological Management of Chromosome 22q11.2 Deletion Syndrome and Other Defects in Thymic Development. J Clin Immunol 2023; 43:247-270. [PMID: 36648576 PMCID: PMC9892161 DOI: 10.1007/s10875-022-01418-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/04/2022] [Indexed: 01/18/2023]
Abstract
Current practices vary widely regarding the immunological work-up and management of patients affected with defects in thymic development (DTD), which include chromosome 22q11.2 microdeletion syndrome (22q11.2del) and other causes of DiGeorge syndrome (DGS) and coloboma, heart defect, atresia choanae, retardation of growth and development, genital hypoplasia, ear anomalies/deafness (CHARGE) syndrome. Practice variations affect the initial and subsequent assessment of immune function, the terminology used to describe the condition and immune status, the accepted criteria for recommending live vaccines, and how often follow-up is needed based on the degree of immune compromise. The lack of consensus and widely varying practices highlight the need to establish updated immunological clinical practice guidelines. These guideline recommendations provide a comprehensive review for immunologists and other clinicians who manage immune aspects of this group of disorders.
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Affiliation(s)
- Peter J Mustillo
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, 43205, USA.
| | - Kathleen E Sullivan
- Division of Allergy Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Ivan K Chinn
- Division of Immunology, Allergy, and Retrovirology, Department of Pediatrics, Texas Children's Hospital, Houston, TX, 77030, USA
| | - Luigi D Notarangelo
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Elie Haddad
- Department of Pediatrics, Department of Microbiology, Infectious Diseases and Immunology, CHU Sainte-Justine, University of Montreal, Montreal, QC, H3T 1C5, Canada
| | - E Graham Davies
- Department of Immunology, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, WC1N 3HJ, UK
| | - Maria Teresa de la Morena
- Division of Immunology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, 98105, USA
| | - Nicholas Hartog
- Spectrum Health Helen DeVos Children's Hospital Department of Allergy and Immunology, Michigan State University College of Human Medicine, East Lansing, USA
| | - Joyce E Yu
- Division of Allergy, Immunology & Rheumatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Winnie Ip
- Department of Immunology, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, WC1N 3JH, UK
| | - Jose Franco
- Grupo de Inmunodeficiencias Primarias, Facultad de Medicina, Universidad de Antioquia UdeA, Medellin, Colombia
| | - Eleonora Gambineri
- Department of "NEUROFARBA", Section of Child's Health, University of Florence, Florence, Italy
- Centre of Excellence, Division of Pediatric Oncology/Hematology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Scott E Hickey
- Division of Genetic & Genomic Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - Elizabeth Varga
- Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, OH, 43205, USA
| | - M Louise Markert
- Department of Immunology, Duke University Medical Center, Durham, NC, 27710, USA
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9
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Verbesselt J, Van Den Heuvel E, Breckpot J, Zink I, Swillen A. Parent-Reported Social-Communicative Skills of Children with 22q11.2 Copy Number Variants and Siblings. Genes (Basel) 2022; 13:1801. [PMID: 36292686 PMCID: PMC9602386 DOI: 10.3390/genes13101801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 01/21/2023] Open
Abstract
22q11.2 deletion (22q11.2DS) and 22q11.2 duplication (22q11.2Dup) confer risk for neurodevelopmental difficulties, but the characterization of speech-language and social skills in 22q11.2Dup is still limited. Therefore, this study aims to delineate social-communicative skills in school-aged children with 22q11.2Dup (n = 19) compared to their non-carrier siblings (n = 11) and age-matched children with 22q11.2DS (n = 19). Parents completed two standardized questionnaires: the Children's Communication Checklist (CCC-2), screening speech, language, and social skills, and the Social Responsiveness Scales (SRS-2), assessing deficits in social behavior. Parents report that both children with 22q11.2Dup and 22q11.2DS show more social-communicative deficits than the general population; children with 22q11.2Dup seem to take an intermediate position between their siblings and children with 22q11.2DS. Compared to 22q11.2DS, they demonstrate less frequent and less severe problems, and more heterogeneous social-communicative profiles, with fewer restricted interests and repetitive behaviors. In siblings of 22q11Dup, milder social-communicative difficulties and equally heterogeneous profiles are reported, which might indicate that-in addition to the duplication-other factors such as the broader genetic context play a role in social-communicative outcomes.
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Affiliation(s)
- Jente Verbesselt
- Centre for Human Genetics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Ellen Van Den Heuvel
- Centre for Developmental Disorders, University Hospital Brussels, Laarbeeklaan 101, 1090 Jette, Belgium
| | - Jeroen Breckpot
- Centre for Human Genetics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Human Genetics, Catholic University Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Inge Zink
- Research Group Experimental Oto-Rhino-Laryngology (ExpORL), Department of Neurosciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- MUCLA, Department of Oto-Rhino-Laryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Ann Swillen
- Centre for Human Genetics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Human Genetics, Catholic University Leuven, Herestraat 49, 3000 Leuven, Belgium
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10
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Mary L, Lavillaureix A, Perrot A, Loget P, Launay E, Leborgne AS, Demurger F, Fradin M, Le Bouar G, Quélin C, Dubourg C, Pasquier L, Odent S, Belaud-Rotureau MA, Jaillard S. Prenatal phenotype of 22q11 micro-duplications: A systematic review and report on 12 new cases. Eur J Med Genet 2022; 65:104422. [PMID: 35026468 DOI: 10.1016/j.ejmg.2022.104422] [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: 05/19/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/23/2022]
Abstract
The 22q11 region is prone to generating recurring Copy Number Variations (CNVs) as a result of the large numbers of Low Copy Repeats (LCRs). Typical duplications encompass the LCR-A-to-D region but atypical duplications of various sizes have also been reported. These duplications are responsible for highly variable phenotypes with incomplete penetrance and expressivity, which is challenging for adequate genetic counselling, especially in the prenatal period. To better delineate prenatal phenotypes associated with these CNVs, we report here a clinical and molecular description of twelve cases (9 foetuses and 3 deceased new-borns babies) carrying recurrent 22q11 duplications (diagnosed via aCGH), along with a review of the existing literature. 22q11 duplications were inherited from an apparently healthy parent in almost 60% of the cases. Other CNVs were diagnosed for 8% of the cases. Increased nuchal translucency and cardiac anomalies (CHD) were the most prominent phenotypes observed, along with mild renal and skeletal anomalies. Duplications encompassing the LCR-C-to-D region (and the CRKL gene) seemed more likely to generate CHDs and renal malformations. Cleft lip/palate were observed in foetuses with duplications encompassing the LCR-A-to-B region or the SPECC1L gene, as previously suggested. However, genotype-phenotype correlations remain difficult to ascertain. Second-hit point variants, epigenetic or environmental variations could play a role in the phenotypic variability of 22q11 duplications, but remain a challenge for assessment in the short period of pregnancy.
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Affiliation(s)
- Laura Mary
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France; INSERM, EHESP, IRSET - UMR_S, 1085, Université Rennes 1, Rennes, France.
| | - Alinoë Lavillaureix
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; ERN ITHACA, Hôpital Sud Rennes France, Université de Rennes, CNRS, IGDR, UMR 6290, F-35000, Rennes, France
| | - Adélie Perrot
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France
| | - Philippe Loget
- Service d'Anatomie Pathologique, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Erika Launay
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France
| | | | | | - Mélanie Fradin
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France
| | - Gwenaelle Le Bouar
- Unité de Médecine fœtale, Service de Gynécologie-Obstétrique, CHU Rennes, Rennes, France
| | - Chloé Quélin
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; Service d'Anatomie Pathologique, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | - Christèle Dubourg
- Laboratoire de Génétique Moléculaire et Génomique, Centre Hospitalier Universitaire de Rennes, Rennes, 35033, France
| | - Laurent Pasquier
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; ERN ITHACA, Hôpital Sud Rennes France, Université de Rennes, CNRS, IGDR, UMR 6290, F-35000, Rennes, France
| | - Sylvie Odent
- Service de Génétique Clinique, CHU Rennes, CLAD Ouest, Rennes, France; ERN ITHACA, Hôpital Sud Rennes France, Université de Rennes, CNRS, IGDR, UMR 6290, F-35000, Rennes, France
| | - Marc-Antoine Belaud-Rotureau
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France; INSERM, EHESP, IRSET - UMR_S, 1085, Université Rennes 1, Rennes, France
| | - Sylvie Jaillard
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France; INSERM, EHESP, IRSET - UMR_S, 1085, Université Rennes 1, Rennes, France
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11
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Verbesselt J, Zink I, Breckpot J, Swillen A. Cross-sectional and longitudinal findings in patients with proximal 22q11.2 duplication: A retrospective chart study. Am J Med Genet A 2022; 188:46-57. [PMID: 34491614 PMCID: PMC8830490 DOI: 10.1002/ajmg.a.62487] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/05/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023]
Abstract
Duplications on Chromosome 22q11.2 (22q11.2 dup) are associated with a wide spectrum of physical and neurodevelopmental features. In this chart review, physical, developmental, and behavioral features of 28 patients with 22q11.2 dup (median age = 17.11 years) are reported, and phenotypes of de novo and inherited duplications are compared. Common medical anomalies include nutritional problems (57%), failure to thrive (33%), transient hearing impairment (52%), and congenital heart defects (33%). Developmental, speech-language, and motor delay are common in infancy, while attention (64%), learning (60%), and motor problems (52%) are typically reported at primary school age. Attention-deficit/hyperactivity disorders are diagnosed in 44%. Median full-scale intelligence quotient is in the borderline range (IQ 76), with one-fifth of patients having mild intellectual disability. Longitudinal data in 11 patients, with the first assessment at a median age of 5.2 years and the second assessment at a median age of 8.8 years, indicate that almost two-third of patients have a relative stable cognitive trajectory, whereas one-third show a growing into deficit profile. In patients with de novo duplications, there is a trend of more failure to thrive, while more patients with inherited duplications follow special education.
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Affiliation(s)
- Jente Verbesselt
- Department of Human Genetics, Catholic University Leuven, Leuven, Belgium
| | - Inge Zink
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), Leuven, Belgium,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, MUCLA, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Breckpot
- Department of Human Genetics, Catholic University Leuven, Leuven, Belgium,Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Ann Swillen
- Department of Human Genetics, Catholic University Leuven, Leuven, Belgium,Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
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12
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Bartik LE, Hughes SS, Tracy M, Feldt MM, Zhang L, Arganbright J, Kaye A. 22q11.2 duplications: Expanding the clinical presentation. Am J Med Genet A 2021; 188:779-787. [PMID: 34845825 DOI: 10.1002/ajmg.a.62577] [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: 06/23/2021] [Revised: 09/06/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
22q11.2 duplication syndrome has a frequency of ~1/700 in the intellectual disability population. Despite this frequency, there is limited information on the variable clinical presentation. Although the phenotype and incidence of congenital anomalies are well described for 22q11.2 deletion syndrome, they are not as well understood for individuals with 22q11.2 duplication syndrome. This study is a single-center, retrospective review of patients diagnosed with 22q11.2 duplication syndrome designed to categorize the variable phenotype seen in these individuals. The data suggest that the incidence of congenital anomalies may be higher than previously reported for this syndrome. Affected individuals are at increased risk for a variety of problems including gastrointestinal complications, endocrine dysfunction, ophthalmologic abnormalities, palatal anomalies, congenital heart disease, musculoskeletal differences, and neurologic abnormalities. Individuals with 22q11.2 duplication syndrome would benefit from care coordinated by a multidisciplinary team and managed according to the 22q11.2 deletion syndrome guidelines.
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Affiliation(s)
- Lauren E Bartik
- Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Susan S Hughes
- Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Meghan Tracy
- Division of Plastic Surgery, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - M Max Feldt
- Division of Pediatric Endocrinology, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Lei Zhang
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Jill Arganbright
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.,Division of Pediatric Otolaryngology, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Alison Kaye
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.,Division of Plastic Surgery, Children's Mercy Hospital, Kansas City, Missouri, USA
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13
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Chu C, Wu H, Xu F, Ray JW, Britt A, Robinson SS, Lupo PJ, Murphy CRC, Dreyer CF, Lee PDK, Hu PC, Dong J. Phenotypes Associated with 16p11.2 Copy Number Gains and Losses at a Single Institution. Lab Med 2021; 51:642-648. [PMID: 32537635 DOI: 10.1093/labmed/lmaa026] [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] [Indexed: 11/13/2022] Open
Abstract
Chromosome 16p11.2 is one of the susceptible sites for recurrent copy number variations (CNVs) due to flanking near-identical segmental duplications. Five segmental duplications, named breakpoints 1 to 5 (BP1-BP5), have been defined as recombination hotspots within 16p11.2. Common CNVs on 16p11.2 include a proximal ~593 kb between BP4 and BP5, and a distal ~220 kb between BP2 and BP3. We performed a search for patients carrying 16p11.2 CNVs, as detected using chromosome microarray (CMA), in the Molecular Diagnostic Laboratory at the University of Texas Medical Branch (UTMB), in Galveston. From March 2013 through April 2018, a total of 1200 CMA results were generated for germline testing, and 14 patients tested positive for 16p11.2 CNVs, of whom 7 had proximal deletion, 2 had distal deletion, 4 had proximal duplication, and 1 had distal duplication. Herein, we provide detailed phenotype data for these patients. Our study results show that developmental delay, abnormal body weight, behavioral problems, and hypotonia are common phenotypes associated with 16p11.2 CNVs.
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Affiliation(s)
- Caleb Chu
- School of Health Professions, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Haotian Wu
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Fangling Xu
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Joseph W Ray
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Allison Britt
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Sally S Robinson
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Pamela J Lupo
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | | | - Charles F Dreyer
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Phillip D K Lee
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas
| | - Peter C Hu
- School of Health Professions, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jianli Dong
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
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Chawner SJ, Watson CJ, Owen MJ. Clinical evaluation of patients with a neuropsychiatric risk copy number variant. Curr Opin Genet Dev 2021; 68:26-34. [PMID: 33461126 PMCID: PMC8219523 DOI: 10.1016/j.gde.2020.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022]
Abstract
Several copy number variants (CNVs) have been identified to confer high risk for a range of neuropsychiatric conditions. Because of advances in genetic testing within clinical settings, patients are increasingly receiving diagnoses of copy number variant genomic disorders. However, clinical guidelines surrounding assessment and management are limited. This review synthesises recent research and makes preliminary recommendations regarding the clinical evaluation of patients with neuropsychiatric risk CNVs. We recommend multi-system assessment beyond the initial referral reason, recognition of the potential need for co-ordinated multidisciplinary care, and that interventions take account of relevant multimorbidity. The frequently complex needs of patients with CNVs across the life-course pose challenges for many health care systems and may be best provided for by the establishment of specialist clinics.
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Affiliation(s)
- Samuel Jra Chawner
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK; Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff, UK
| | - Cameron J Watson
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK; Barts Health NHS Trust, London, UK
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK.
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Huang H, Cai M, Liu L, Xu L, Lin N. Effectiveness of Chromosomal Microarray Analysis for Prenatal Diagnosis of Fetal Echogenic Intracardiac Focus: A Single-Center Experience. Int J Gen Med 2021; 14:1991-1997. [PMID: 34045891 PMCID: PMC8149271 DOI: 10.2147/ijgm.s311800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Echogenic intracardiac focus (EIF) is a common ultrasound finding during pregnancy. However, the correlation between fetal EIF and cardiac abnormality remains in dispute until now. The study aimed to examine the association of fetal EIF with chromosomal abnormality by means of chromosomal microarray analysis (CMA). MATERIALS AND METHODS A total of 192 pregnant women with fetal EIF undergoing amniocentesis or umbilical cord blood puncture were recruited and assigned into groups A (8 cases with isolated EIF alone), B (75 cases with EIF and other cardiac malformations) and C (109 cases with EIF and extracardiac malformations). All fetuses underwent karyotyping analysis and CMA simultaneously. The detection of chromosomal abnormality and copy number variations (CNVs) were compared. RESULTS Chromosomal karyotyping identified 5 fetuses with chromosomal abnormality, including 3 cases with trisomy 21, one fetus with Turner's syndrome, and one fetus with chromosome 8 mosaicism, while CMA detected 6 additional fetuses with CNVs, including 2 fetuses with pathogenic CNVs and 4 fetuses with variants of uncertain significance (VOUS). There was no significant difference among groups A (0), B (5.33%) and C (6.42%) in terms of the prevalence of chromosomal abnormality (P> 0.05). Among the 4 fetuses with VOUS, pregnancy continued in 2 fetuses, and pregnancy was terminated in other 2 fetuses. CONCLUSION An isolated EIF may not correlate with chromosomal abnormality. However, CMA is recommended in fetuses with CMA complicated by other abnormal cardiac ultrasound findings, which facilitates the prediction of fetal outcomes during the genetic counseling and precision assessment of prognosis.
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Affiliation(s)
- Hailong Huang
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Meiying Cai
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Linyu Liu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
- School of Clinical Medicine, Fujian Medical University, Fuzhou City, Fujian Province, 350122, People’s Republic of China
| | - Liangpu Xu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
| | - Na Lin
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of China
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16
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Zodanu GKE, Oszlánczi M, Havasi K, Kalapos A, Rácz G, Katona M, Ujfalusi A, Nagy O, Széll M, Nagy D. Systemic Screening for 22q11.2 Copy Number Variations in Hungarian Pediatric and Adult Patients With Congenital Heart Diseases Identified Rare Pathogenic Patterns in the Region. Front Genet 2021; 12:635480. [PMID: 33995479 PMCID: PMC8117090 DOI: 10.3389/fgene.2021.635480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/07/2021] [Indexed: 11/22/2022] Open
Abstract
Congenital heart defects (CHD) are the most common developmental abnormalities, affecting approximately 0.9% of livebirths. Genetic factors, including copy number variations (CNVs), play an important role in their development. The most common CNVs are found on chromosome 22q11.2. The genomic instability of this region, caused by the eight low copy repeats (LCR A-H), may result in several recurrent and/or rare microdeletions and duplications, including the most common, ∼3 Mb large LCR A-D deletion (classical 22q.11.2 deletion syndrome). We aimed to screen 22q11.2 CNVs in a large Hungarian pediatric and adult CHD cohort, regardless of the type of their CHDs. All the enrolled participants were cardiologically diagnosed with non-syndromic CHDs. A combination of multiplex ligation-dependent probe amplification (MLPA), chromosomal microarray analysis and droplet digital PCR methods were used to comprehensively assess the detected 22q11.2 CNVs in 212 CHD-patients. Additionally, capillary sequencing was performed to detect variants in the TBX1 gene, a cardinal gene located in 22q11.2. Pathogenic CNVs were detected in 5.2% (11/212), VUS in 0.9% and benign CNVs in 1.8% of the overall CHD cohort. In patients with tetralogy of Fallot the rate of pathogenic CNVs was 17% (5/30). Fifty-four percent of all CNVs were typical proximal deletions (LCR A-D). However, nested (LCR A-B) and central deletions (LCR C-D), proximal (LCR A-D) and distal duplications (LCR D-E, LCR D-H, LCR E-H, LCR F-H) and rare combinations of deletions and duplications were also identified. Segregation analysis detected familial occurrence in 18% (2/11) of the pathogenic variants. Based on in-depth clinical information, a detailed phenotype–genotype comparison was performed. No pathogenic variant was identified in the TBX1 gene. Our findings confirmed the previously described large phenotypic diversity in the 22q11.2 CNVs. MLPA proved to be a highly efficient genetic screening method for our CHD-cohort. Our results highlight the necessity for large-scale genetic screening of CHD-patients and the importance of early genetic diagnosis in their clinical management.
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Affiliation(s)
| | - Mónika Oszlánczi
- Second Department of Internal Medicine and Cardiology Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Kálmán Havasi
- Second Department of Internal Medicine and Cardiology Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- Second Department of Internal Medicine and Cardiology Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Gergely Rácz
- Second Department of Internal Medicine and Cardiology Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Márta Katona
- Department of Pediatrics, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Anikó Ujfalusi
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Orsolya Nagy
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Márta Széll
- Department of Medical Genetics, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Dóra Nagy
- Department of Medical Genetics, Faculty of Medicine, University of Szeged, Szeged, Hungary
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Landau Prat D, Nguyen BJ, Strong A, Katowitz WR, Katowitz JA. "Blepharophimosis-plus" syndromes: Frequency of systemic genetic disorders that also include blepharophimosis. Clin Exp Ophthalmol 2021; 49:448-453. [PMID: 33882191 DOI: 10.1111/ceo.13933] [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: 03/03/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND To determine the frequency of isolated blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) versus systemic genetic disorders in patients presenting with blepharophimosis. METHODS Retrospective clinical records review. The records of all patients with blepharophimosis seen in the Division of Ophthalmology at the Children's Hospital of Philadelphia during a 12-year-period (2009-2020) were reviewed for medical history, clinical examination findings and results of genetic analyses. RESULTS The 135 patients identified with blepharophimosis included 72 females (53%) and 63 males (47%) whose mean ± standard deviation age at first visit was 3.5 ± 6.4 years (range 0-39.8 years). Sixty-seven of the patients (50%) had undergone genetic testing for FOXL2 gene mutation. Fifty-four (81%) harboured FOXL2 gene mutations and 13 (19%) did not. Altogether, 126 patients (93%) had a final diagnosis of isolated BPES. The remaining nine (7%) had syndromic diagnoses ("blepharophimosis-plus"), including Dubowitz syndrome (n = 2), Ohdo syndrome (n = 1), 22q11.2 duplication (n = 1) and 3q22 deletion (n = 2). Three patients with multiple congenital anomalies remain undiagnosed. CONCLUSIONS Blepharophimosis is an eyelid feature occurring most commonly in isolation due to FOXL2 gene mutation, but can also be a harbinger of multisystem disease not exclusive to isolated BPES, as observed in 7% of cases in this series. The ophthalmologist is often the first to recognise these unique features, and must consider and rule out non-BPES syndromes before establishing a diagnosed classic BPES. A comprehensive genetic evaluation is, therefore, indicated in all cases.
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Affiliation(s)
- Daphna Landau Prat
- Division of Ophthalmology, Oculoplastic and Orbital Surgery Service, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall, Center for Human Appearance, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Brian J Nguyen
- Division of Ophthalmology, Oculoplastic and Orbital Surgery Service, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall, Center for Human Appearance, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alanna Strong
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - William R Katowitz
- Division of Ophthalmology, Oculoplastic and Orbital Surgery Service, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall, Center for Human Appearance, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James A Katowitz
- Division of Ophthalmology, Oculoplastic and Orbital Surgery Service, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall, Center for Human Appearance, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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Li C, Zhang J, Li J, Qiao G, Zhan Y, Xu Y, Yang H. BACs-on-Beads Assay for the Prenatal Diagnosis of Microdeletion and Microduplication Syndromes. Mol Diagn Ther 2021; 25:339-349. [PMID: 33826125 DOI: 10.1007/s40291-021-00522-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the clinical value of BACs-on-Beads (BoBs) assay in detection of microdeletion and microduplication syndromes. METHODS A total of 6,814 cases of amniotic fluid cells collected from January 2015 to July 2020 in our hospital were analyzed by chromosomal karyotyping and BoBs assay. Fluorescence in situ hybridization (FISH) or chromosomal microarray analysis (CMA) provided further validation for the cases of microdeletion and microduplication. RESULTS Thirty microdeletion and microduplication syndromes were identified by BoBs with an incidence of ~1/227, including 22q11.2 microduplication (0.044%, 3/6814), DiGeorge I syndrome (0.044%, 3/6814), 17p11.2 microduplication (0.015%, 1/6814), Smith-Magenis syndrome (0.015%, 1/6814), 17p11.2p11.3 microduplication (0.015%, 1/6814), Williams-Beuren syndrome (0.088%, 6/6814), 7q11.2 microduplication (0.029%, 2/6814), DiGeorge II syndrome (0.015%, 1/6814), 18p11.32p11.21 microduplication (0.015%, 1/6814), Wolf-Hirschhorn syndrome (0.029%, 2/6814), 4p16.3 microduplication (0.015%, 1/6814), Langer-Giedion syndrome (0.015%, 1/6814), Miller-Dieker syndrome (0.015%, 1/6814), Cri du Chat syndrome (0.015%, 1/6814), Xp22.31 microdeletion (0.059%, 4/6814), Prader-Willi syndrome (0.015%, 1/6814). High concordance was obtained between BoBs and FISH or CMA. However, only four cases were detected by chromosomal karyotyping. CONCLUSION BoBs assay can rapidly detect microdeletion and microduplication syndromes, which compensates the shortcomings of conventional chromosomal karyotyping and greatly improves the efficiency and accuracy of prenatal diagnosis.
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Affiliation(s)
- Chunyan Li
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China
| | - Jianfang Zhang
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China
| | - Jia Li
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China
| | - Guyuan Qiao
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China
| | - Ying Zhan
- Department of Obstetrics and Gynecology, 518 Hospital of PLA, Xi'an, 710043, Shaanxi, China
| | - Ying Xu
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China
| | - Hong Yang
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, 127 West ChangLe Road, Xi'an, 710032, Shaanxi, China.
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19
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Luo X, Zhu H, Wang L, Xiao B, Fan Y, Ye H, Ying X, Qiu W, Zhang H, Han L, Gu X, Yu Y, Wang L. Chromosomal microarray analysis in fetuses with high-risk prenatal indications: A retrospective study in China. Taiwan J Obstet Gynecol 2021; 60:299-304. [PMID: 33678331 DOI: 10.1016/j.tjog.2021.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The present study aimed to determine the diagnostic value of prenatal chromosomal microarray analysis (CMA) for fetuses with several indications of being at high risk for various conditions. MATERIALS AND METHODS This retrospective analysis included 1256 pregnancies that were prenatally evaluated due to high-risk indications using invasive CMA. The indications for invasive prenatal diagnosis mainly included ultrasound anomalies, high-risk for maternal serum screening (MSS), high-risk for non-invasive prenatal tests (NIPT), family history of genetic disorders or birth defects, and advanced maternal age (AMA). The rate of clinically significant genomic imbalances between the different groups was compared. RESULTS The overall prenatal diagnostic yield was 98 (7.8%) of 1256 pregnancies. Clinically significant genomic aberrations were identified in 2 (1.5%) of 132 patients with non-structural ultrasound anomalies, 36 (12.7%) of 283 with structural ultrasound anomalies, 2 (4.5%) of 44 at high-risk for MSS, 38 (26.6%) of 143 at high-risk for NIPT, 11 (3.8%) of 288 with a family history, and 7 (2.1%) of 328 with AMA. Submicroscopic findings were identified in 29 fetuses, 19 of whom showed structural ultrasound anomalies. CONCLUSION The diagnostic yields of CMA for pregnancies with different indications greatly varied. CMA could serve as a first-tier test for structural anomalies, especially multiple anomalies, craniofacial dysplasia, urinary defects, and cardiac dysplasia. Our results have important implications for genetic counseling.
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Affiliation(s)
- Xiaomei Luo
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Hong Zhu
- Center for Prenatal Diagnosis, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lili Wang
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Bing Xiao
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yanjie Fan
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Hui Ye
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xiaomin Ying
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Wenjuan Qiu
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Huiwen Zhang
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lianshu Han
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xuefan Gu
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yongguo Yu
- Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
| | - Lei Wang
- Center for Prenatal Diagnosis, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
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Fischer M, Klopocki E. Atypical 22q11.2 Microduplication with "Typical" Signs and Overgrowth. Cytogenet Genome Res 2021; 160:659-663. [PMID: 33472199 PMCID: PMC8117256 DOI: 10.1159/000512486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
The 22q11.2 microduplication syndrome shows variable phenotypes with reduced penetrance compared to the 22q11.2 deletion syndrome. We report a woman with overgrowth and macrocephaly, mild mental retardation, heart defect, kidney anomalies, and dysmorphic features. Array-CGH analysis revealed a 246-kb duplication at the 22q11.2 region. No additional clinically significant CNVs were found. The case resembles a previously published case also showing overgrowth and macrocephaly with an almost identical 22q11.2 duplication of 252 kb.
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Affiliation(s)
- Matthias Fischer
- Department for Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany,
- Department for Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany,
| | - Eva Klopocki
- Institute of Human Genetics, Biocenter, University of Würzburg, Würzburg, Germany
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21
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Manno GC, Segal GS, Yu A, Xu F, Ray JW, Cooney E, Britt AD, Jain SK, Goldblum RM, Robinson SS, Dong J. Genotypic and phenotypic variability of 22q11.2 microdeletions – an institutional experience. AIMS MOLECULAR SCIENCE 2021; 8:257-274. [PMID: 34938854 PMCID: PMC8691803 DOI: 10.3934/molsci.2021020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
<abstract>
<p>Patients with chromosome 22q11.2 deletion syndromes classically present with variable cardiac defects, parathyroid and thyroid gland hypoplasia, immunodeficiency and velopharyngeal insufficiency, developmental delay, intellectual disability, cognitive impairment, and psychiatric disorders. New technologies including chromosome microarray have identified smaller deletions in the 22q11.2 region. An increasing number of studies have reported patients presenting with various features harboring smaller 22q11.2 deletions, suggesting a need to better elucidate 22q11.2 deletions and their phenotypic contributions so that clinicians may better guide prognosis for families. We identified 16 pediatric patients at our institution harboring various 22q11.2 deletions detected by chromosomal microarray and report their clinical presentations. Findings include various neurodevelopmental delays with the most common one being attention deficit hyperactivity disorder (ADHD), one reported case of infant lethality, four cases of preterm birth, one case with dual diagnoses of 22q11.2 microdeletion and Down syndrome. We examined potential genotypic contributions of the deleted regions.</p>
</abstract>
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Affiliation(s)
- Gabrielle C. Manno
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Gabrielle S. Segal
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Alexander Yu
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Fangling Xu
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joseph W. Ray
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Erin Cooney
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Allison D. Britt
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sunil K. Jain
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Randall M. Goldblum
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sally S. Robinson
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jianli Dong
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Correspondence:; Tel: 4097724866
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22
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Hilger AC, Dworschak GC, Reutter HM. Lessons Learned from CNV Analysis of Major Birth Defects. Int J Mol Sci 2020; 21:ijms21218247. [PMID: 33153233 PMCID: PMC7663563 DOI: 10.3390/ijms21218247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 12/25/2022] Open
Abstract
The treatment of major birth defects are key concerns for child health. Hitherto, for the majority of birth defects, the underlying cause remains unknown, likely to be heterogeneous. The implicated mortality and/or reduced fecundity in major birth defects suggest a significant fraction of mutational de novo events among the affected individuals. With the advent of systematic array-based molecular karyotyping, larger cohorts of affected individuals have been screened over the past decade. This review discusses the identification of disease-causing copy-number variations (CNVs) among individuals with different congenital malformations. It highlights the differences in findings depending on the respective congenital malformation. It looks at the differences in findings of CNV analysis in non-isolated complex congenital malformations, associated with central nervous system malformations or intellectual disabilities, compared to isolated single organ-system malformations. We propose that the more complex an organ system is, and the more genes involved during embryonic development, the more likely it is that mutational de novo events, comprising CNVs, will confer to the expression of birth defects of this organ system.
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Affiliation(s)
- Alina Christine Hilger
- Department of Pediatrics, Children’s Hospital Medical Center, University Hospital Bonn, 53127 Bonn, Germany
- Institute of Human Genetics, University Hospital Bonn, 53127 Bonn, Germany
- Institute for Anatomy and Cell Biology, University Hospital Bonn, University of Bonn, 53115 Bonn, Germany
- Correspondence: (A.C.H.); (G.C.D.); (H.M.R.); Tel.: +49-228-6885-419 (A.C.H. & G.C.D. & H.M.R.)
| | - Gabriel Clemens Dworschak
- Department of Pediatrics, Children’s Hospital Medical Center, University Hospital Bonn, 53127 Bonn, Germany
- Institute of Human Genetics, University Hospital Bonn, 53127 Bonn, Germany
- Institute for Anatomy and Cell Biology, University Hospital Bonn, University of Bonn, 53115 Bonn, Germany
- Correspondence: (A.C.H.); (G.C.D.); (H.M.R.); Tel.: +49-228-6885-419 (A.C.H. & G.C.D. & H.M.R.)
| | - Heiko Martin Reutter
- Institute of Human Genetics, University Hospital Bonn, 53127 Bonn, Germany
- Department of Neonatology and Pediatric Intensive Care, Children’s Hospital Medical Center, University Hospital Bonn, 53127 Bonn, Germany
- Correspondence: (A.C.H.); (G.C.D.); (H.M.R.); Tel.: +49-228-6885-419 (A.C.H. & G.C.D. & H.M.R.)
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23
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Sun D, Lee J, Heimall J, Jyonouchi S. Immunodeficiency in 22q11.2 duplication syndrome. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:996-998.e3. [PMID: 32949807 DOI: 10.1016/j.jaip.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/12/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Di Sun
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa.
| | - Juhee Lee
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Jennifer Heimall
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Soma Jyonouchi
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa
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