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Marszałek-Kruk BA, Myśliwiec A, Lipowicz A, Wolański W, Kulesa-Mrowiecka M, Dowgierd K. Children with Rare Nager Syndrome-Literature Review, Clinical and Physiotherapeutic Management. Genes (Basel) 2023; 15:29. [PMID: 38254920 PMCID: PMC10815867 DOI: 10.3390/genes15010029] [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: 10/29/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Nager syndrome is a rare human developmental disorder characterized by craniofacial defects including the downward slanting of the palpebral fissures, cleft palate, limb deformities, mandibular hypoplasia, hypoplasia or absence of thumbs, microretrognathia, and ankylosis of the temporomandibular joint. The prevalence is very rare and the literature describes only about a hundred cases of Nager syndrome. There is evidence of autosomal dominant and autosomal recessive inheritance for Nager syndrome, suggesting genetic heterogeneity. The majority of the described causes of Nager syndrome include pathogenic variants in the SF3B4 gene, which encodes a component of the spliceosome; therefore, the syndrome belongs to the spliceosomopathy group of diseases. The diagnosis is made on the basis of physical and radiological examination and detection of mutations in the SF3B4 gene. Due to the diversity of defects associated with Nager syndrome, patients require multidisciplinary, complex, and long-lasting treatment. Usually, it starts from birth until the age of twenty years. The surgical procedures vary over a patient's lifetime and are related to the needed function. First, breathing and feeding must be facilitated; then, oral and facial clefts should be addressed, followed by correcting eyelid deformities and cheekbone reconstruction. In later age, a surgery of the nose and external ear is performed. Speech and hearing disorders require specialized logopedic treatment. A defect of the thumb is treated by transplanting a tendon and muscle or transferring the position of the index finger. In addition to surgery, in order to maximize a patient's benefit and to reduce functional insufficiency, complementary treatments such as rehabilitation and physiotherapy are recommended. In our study, we describe eight patients of different ages with various cases of Nager syndrome. The aim of our work was to present the actual genetic knowledge on this disease and its treatment procedures.
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Affiliation(s)
| | - Andrzej Myśliwiec
- Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Sciences, Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Anna Lipowicz
- Department of Anthropology, Faculty of Biology and Animal Science, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Wojciech Wolański
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland
| | - Małgorzata Kulesa-Mrowiecka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland
| | - Krzysztof Dowgierd
- Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, Collegium Medicum, University of Warmia and Mazury, 10-561 Olsztyn, Poland
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Hennocq Q, Bongibault T, Marlin S, Amiel J, Attie-Bitach T, Baujat G, Boutaud L, Carpentier G, Corre P, Denoyelle F, Djate Delbrah F, Douillet M, Galliani E, Kamolvisit W, Lyonnet S, Milea D, Pingault V, Porntaveetus T, Touzet-Roumazeille S, Willems M, Picard A, Rio M, Garcelon N, Khonsari RH. AI-based diagnosis in mandibulofacial dysostosis with microcephaly using external ear shapes. Front Pediatr 2023; 11:1171277. [PMID: 37664547 PMCID: PMC10469912 DOI: 10.3389/fped.2023.1171277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Mandibulo-Facial Dysostosis with Microcephaly (MFDM) is a rare disease with a broad spectrum of symptoms, characterized by zygomatic and mandibular hypoplasia, microcephaly, and ear abnormalities. Here, we aimed at describing the external ear phenotype of MFDM patients, and train an Artificial Intelligence (AI)-based model to differentiate MFDM ears from non-syndromic control ears (binary classification), and from ears of the main differential diagnoses of this condition (multi-class classification): Treacher Collins (TC), Nager (NAFD) and CHARGE syndromes. Methods The training set contained 1,592 ear photographs, corresponding to 550 patients. We extracted 48 patients completely independent of the training set, with only one photograph per ear per patient. After a CNN-(Convolutional Neural Network) based ear detection, the images were automatically landmarked. Generalized Procrustes Analysis was then performed, along with a dimension reduction using PCA (Principal Component Analysis). The principal components were used as inputs in an eXtreme Gradient Boosting (XGBoost) model, optimized using a 5-fold cross-validation. Finally, the model was tested on an independent validation set. Results We trained the model on 1,592 ear photographs, corresponding to 1,296 control ears, 105 MFDM, 33 NAFD, 70 TC and 88 CHARGE syndrome ears. The model detected MFDM with an accuracy of 0.969 [0.838-0.999] (p < 0.001) and an AUC (Area Under the Curve) of 0.975 within controls (binary classification). Balanced accuracies were 0.811 [0.648-0.920] (p = 0.002) in a first multiclass design (MFDM vs. controls and differential diagnoses) and 0.813 [0.544-0.960] (p = 0.003) in a second multiclass design (MFDM vs. differential diagnoses). Conclusion This is the first AI-based syndrome detection model in dysmorphology based on the external ear, opening promising clinical applications both for local care and referral, and for expert centers.
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Affiliation(s)
- Quentin Hennocq
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
- Laboratoire ‘Forme et Croissance du Crâne’, Faculté de Médecine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Thomas Bongibault
- Imagine Institute, INSERM UMR1163, Paris, France
- Laboratoire ‘Forme et Croissance du Crâne’, Faculté de Médecine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Sandrine Marlin
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Jeanne Amiel
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Tania Attie-Bitach
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Geneviève Baujat
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Lucile Boutaud
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Georges Carpentier
- CHU Lille, Inserm, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008-Controlled Drug Delivery Systems and Biomaterial, Université de Lille, Lille, France
| | - Pierre Corre
- Department of Oral and Maxillofacial Surgery, INSERM U1229—Regenerative Medicine and Skeleton RMeS, Nantes, France
- Department of Oral and Maxillofacial Surgery, Nantes University, CHU Nantes, Nantes, France
| | - Françoise Denoyelle
- Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | | | | | - Eva Galliani
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Wuttichart Kamolvisit
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Genomics and Precision Dentistry, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Stanislas Lyonnet
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Dan Milea
- Duke-NUS Medical School Singapore, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Véronique Pingault
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Thantrira Porntaveetus
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Genomics and Precision Dentistry, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sandrine Touzet-Roumazeille
- CHU Lille, Inserm, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008-Controlled Drug Delivery Systems and Biomaterial, Université de Lille, Lille, France
| | - Marjolaine Willems
- Département de Génétique Clinique, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Institute for Neurosciences of Montpellier, INSERM, Univ Montpellier, Montpellier, France
| | - Arnaud Picard
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Marlène Rio
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | | | - Roman H. Khonsari
- Imagine Institute, INSERM UMR1163, Paris, France
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker—Enfants Malades, Assistance Publique—Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
- Laboratoire ‘Forme et Croissance du Crâne’, Faculté de Médecine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
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Kim H, Lee J, Jung SY, Yun HH, Ko JH, Lee JH. SF3B4 Depletion Retards the Growth of A549 Non-Small Cell Lung Cancer Cells via UBE4B-Mediated Regulation of p53/p21 and p27 Expression. Mol Cells 2022; 45:718-728. [PMID: 35996826 PMCID: PMC9589371 DOI: 10.14348/molcells.2022.0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/27/2022] Open
Abstract
Splicing factor B subunit 4 (SF3B4), a component of the U2-pre-mRNA spliceosomal complex, contributes to tumorigenesis in several types of tumors. However, the oncogenic potential of SF3B4 in lung cancer has not yet been determined. The in vivo expression profiles of SF3B4 in non-small cell lung cancer (NSCLC) from publicly available data revealed a significant increase in SF3B4 expression in tumor tissues compared to that in normal tissues. The impact of SF3B4 deletion on the growth of NSCLC cells was determined using a siRNA strategy in A549 lung adenocarcinoma cells. SF3B4 silencing resulted in marked retardation of the A549 cell proliferation, accompanied by the accumulation of cells at the G0/G1 phase and increased expression of p27, p21, and p53. Double knockdown of SF3B4 and p53 resulted in the restoration of p21 expression and partial recovery of cell proliferation, indicating that the p53/p21 axis is involved, at least in part, in the SF3B4-mediated regulation of A549 cell proliferation. We also provided ubiquitination factor E4B (UBE4B) is essential for p53 accumulation after SF3B4 depletion based on followings. First, co-immunoprecipitation showed that SF3B4 interacts with UBE4B. Furthermore, UBE4B levels were decreased by SF3B4 depletion. UBE4B depletion, in turn, reproduced the outcome of SF3B4 depletion, including reduction of polyubiquitinated p53 levels, subsequent induction of p53/p21 and p27, and proliferation retardation. Collectively, our findings indicate the important role of SF3B4 in the regulation of A549 cell proliferation through the UBE4B/p53/p21 axis and p27, implicating the therapeutic strategies for NSCLC targeting SF3B4 and UBE4B.
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Affiliation(s)
- Hyungmin Kim
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, Graduate School, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jeehan Lee
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Soon-Young Jung
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Hye Hyeon Yun
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jeong-Heon Ko
- Genome Editing Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Korea
| | - Jeong-Hwa Lee
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, Graduate School, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Ulhaq ZS, Soraya GV, Istifiani LA, Pamungkas SA, Tse WKF. SF3B4 Frameshift Variants Represented a More Severe Clinical Manifestation in Nager Syndrome. Cleft Palate Craniofac J 2022:10556656221089156. [PMID: 35331022 DOI: 10.1177/10556656221089156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nager syndrome (NS) is a rare disease marked with craniofacial and preaxial limb anomalies. In this report, we summarized the current evidence to determine a possible genotype-phenotype association among NS individuals. Twenty-four articles comprising of 84 NS (including 9 patients with a severe form of NS [Rodriguez syndrome]) patients were examined, of which 76% were caused by variants in SF3B4 (OMIM *605593, Splicing Factor 3B, Subunit 4). Within the SF3B4 gene, variants located in exon 3 commonly occurred (20%) from a total identified variant, while hotspot location was identified in exon 1 (12%), and primarily occurred as frameshift variants (64%). Thirty-five distinct pathogenic variants within SF3B4 gene were identified with two common sites, c.1A > G and c.1060dupC in exons 1 and 5, respectively. Although no significant genotype-phenotype association was found, it is notable that patients with frameshift SF3B4 variants and predicted to lead to nonsense-mediated RNA decay (NMD) of the transcripts tended to have a more severe clinical manifestation. Additionally, patients harboring variants in exons 2 and 3 displayed a higher proportion of cardiac malformations. Taken together, this article summarizes the pathogenic variants observed in SF3B4 and provides a possible genotype-phenotype relationship in this disease.
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Affiliation(s)
- Zulvikar Syambani Ulhaq
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia.,Department of Biochemistry, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University, Malang, Indonesia
| | - Gita Vita Soraya
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.,Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Lola Ayu Istifiani
- Department of Nutrition, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | | | - William Ka Fai Tse
- Laboratory of Developmental Disorders and Toxicology, Center for Promotion of International Education and Research, Faculty of Agriculture, Kyushu University, Fukuoka, Japan
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