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Unbalanced development and progressive repair in human early mosaic and chimeric embryos. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Natural human chimeras: A review. Eur J Med Genet 2020; 63:103971. [PMID: 32565253 DOI: 10.1016/j.ejmg.2020.103971] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/06/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
The term chimera has been borrowed from Greek mythology and has a long history of use in biology and genetics. A chimera is an organism whose cells are derived from two or more zygotes. Recipients of tissue and organ transplants are artificial chimeras. This review concerns natural human chimeras. The first human chimera was reported in 1953. Natural chimeras can arise in various ways. Fetal and maternal cells can cross the placental barrier so that both mother and child may become microchimeras. Two zygotes can fuse together during an early embryonic stage to form a fusion chimera. Most chimeras remain undetected, especially if both zygotes are of the same genetic sex. Many are discovered accidently, for example, during a routine blood group test. Even sex-discordant chimeras can have a normal male or female phenotype. Only 28 of the 50 individuals with a 46,XX/46,XY karyotype were either true hermaphrodites or had ambiguous genitalia. Blood chimeras are formed by blood transfusion between dizygotic twins via the shared placenta and are more common than was once assumed. In marmoset monkey twins the exchange via the placenta is not limited to blood but can involve other tissues, including germ cells. To date there are no examples in humans of twin chimeras involving germ cells. If human chimeras are more common than hitherto thought there could be many medical, social, forensic, and legal implications. More multidisciplinary research is required for a better understanding of this fascinating subject.
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Hershenov R, Doroski D. Twin Inc. THEORETICAL MEDICINE AND BIOETHICS 2018; 39:301-319. [PMID: 30167942 DOI: 10.1007/s11017-018-9461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper presents an account of how human spontaneous embryonic chimeras are formed. On the prevalent view in the philosophical literature, it is said that chimeras are the product of two embryos that fuse to form a new third embryo. We call this version of fusion synthesis. In contrast to synthesis, we present an alternative mechanism for chimera formation called incorporation, wherein one embryo incorporates the cells of a second embryo into its body. We argue that the incorporation thesis explains other types of chimera formation, which are better understood, and is more consistent than synthesis with what is known about embryological development. Incorporation also has different implications than synthesis and so avoids the philosophical puzzles that are often said to accompany embryonic chimera formation-puzzles which pose problems to the human embryo's persistence from fertilization to the fetal stage of human development.
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Affiliation(s)
- Rose Hershenov
- Department of Philosophy, Niagara University, Lewiston, NY, USA.
- Romanell Center for Clinical Ethics and the Philosophy of Medicine, University at Buffalo, Buffalo, NY, USA.
| | - Derek Doroski
- Department of Biology, Franciscan University at Steubenville, Steubenville, OH, USA
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Fertilization and Early Embryonic Errors. CHIMERISM 2018. [DOI: 10.1007/978-3-319-89866-7_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Serra A, Denzer F, Hiort O, Barth TF, Henne-Bruns D, Barbi G, Rettenberger G, Wabitsch M, Just W, Leriche C. Uniparental Disomy in Somatic Mosaicism 45,X/46,XY/46,XX Associated with Ambiguous Genitalia. Sex Dev 2015; 9:136-43. [PMID: 26043854 DOI: 10.1159/000430897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 11/19/2022] Open
Abstract
Disorders of sex development (DSD) affect the development of chromosomal, gonadal and/or anatomical sex. We analyzed a patient with ambiguous genitalia aiming to correlate the genetic findings with the phenotype. Blood and tissue samples from a male patient with penoscrotal hypospadias were analyzed by immunohistochemistry, karyotyping and FISH. DNA was sequenced for the AR, SRY and DHH genes, and further 26 loci in different sex chromosomes were analyzed by MLPA. The gonosomal origin was evaluated by simple tandem repeat (STR) analysis and SNP array. Histopathology revealed a streak gonad, a fallopian tube and a rudimentary uterus, positive for placental alkaline phosphatase, cytokeratin-7 and c-kit, and negative for estrogen, androgen and progesterone receptors, alpha-inhibin, alpha-1-fetoprotein, β-hCG, and oct-4. Karyotyping showed a 45,X/46,XY mosaicism, yet FISH showed both 46,XX/46,XY mosaicism (gonad and urethral plate), 46,XX (uterus and tube) and 46,XY karyotypes (rudimentary testicular tissue). DNA sequencing revealed intact sequences in SOX9, WNT4, NR0B1, NR5A1, CYP21A2, SRY, AR, and DHH. STR analysis showed only one maternal allele for all X chromosome markers (uniparental isodisomy, UPD), with a weaker SRY signal and a 4:1 ratio in the X:Y signal. Our findings suggest that the observed complex DSD phenotype is the result of somatic gonosomal mosaicism and UPD despite a normal blood karyotype. The presence of UPD warrants adequate genetic counseling for the family and frequent, lifelong, preventive follow-up controls in the patient.
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Affiliation(s)
- Alexandre Serra
- Division of Pediatric Surgery, Department of Surgery, University of Ulm, Ulm, Germany
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Nomura R, Miyai K, Okada M, Kajiwara M, Ono M, Ogata T, Onishi I, Sato M, Sekine M, Akashi T, Mizutani S, Kashimada K. A 45,X/46,XY DSD (Disorder of Sexual Development) case with an extremely uneven distribution of 46,XY cells between lymphocytes and gonads. Clin Pediatr Endocrinol 2015; 24:11-4. [PMID: 25678755 PMCID: PMC4322288 DOI: 10.1297/cpe.24.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 08/28/2014] [Indexed: 11/26/2022] Open
Abstract
In 45,X/46,XY DSDs, the proportion of the two cell lineages is uneven in different organs
and tissues, and 45,X and 46,XY cells can be found throughout the body. The gonadal
development of 45,X/46,XY patients depends on the population of 46,XY cells in the gonads
and the clinical features are variable. We had a 45,X/46,XY DSD patient whose 46,XY
population in peripheral blood was extremely low, less than 0.2%, and was not detected by
FISH analysis. However, the patient showed bilateral testicular development and more than
50% of the cells in the gonads had the 46,XY karyotype. This case suggests that a
drastically imbalanced distribution could occur in 45,X/46,XY DSD cases.
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Affiliation(s)
- Risa Nomura
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kentaro Miyai
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michiyo Okada
- Department of Endocrinology and Metabolism, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Michiko Kajiwara
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Ono
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsutomu Ogata
- Department of Endocrinology and Metabolism, National Research Institute for Child Health and Development, Tokyo, Japan ; Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Iichiro Onishi
- Department of Pathology, Graduate School, Tokyo Medical and Dental University, Tokyo Japan
| | - Mana Sato
- Department of Pathology, Graduate School, Tokyo Medical and Dental University, Tokyo Japan
| | - Masaki Sekine
- Department of Pathology, Graduate School, Tokyo Medical and Dental University, Tokyo Japan
| | - Takumi Akashi
- Department of Pathology, Graduate School, Tokyo Medical and Dental University, Tokyo Japan
| | - Shuki Mizutani
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Liao C, Yang X, Pan M, Li DZ. A 46,XY/46,XX mosaicism diagnosed at amniocentesis: another case report. Prenat Diagn 2007; 28:65-6. [DOI: 10.1002/pd.1908] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bluth MH, Reid ME, Manny N. Chimerism in the immunohematology laboratory in the molecular biology era. Transfus Med Rev 2007; 21:134-46. [PMID: 17397763 DOI: 10.1016/j.tmrv.2006.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Dual or multiple cell populations, induced by chimeras, have been the subject of many studies. This long-standing fascination with chimeras has revealed a good deal of knowledge about human inheritance. Although historically most chimeras were caused by natural events, certain current medical intervention therapies are increasing the number of situations that can lead to a mixed cell population, that is, the chimeric condition, in humans. Medical therapies such as transfusion, stem cell transplantation, kidney transplantation, and artificial insemination induce temporary and sometimes permanent chimeras. Such natural or therapeutically induced presentations of chimerism can present challenging issues to the clinical immunohematology laboratory with regard to interpretation of results and subsequent patient management. The purpose of this review was to highlight some of these chimeric states and hypothesize how testing DNA from various tissues can cause apparent discrepancies between phenotype and genotype results.
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Surti U, Hoffner L, Kolthoff M, Dunn J, Hunt J, Sniezek L, Macpherson T. Persistent gestational trophoblastic disease after an androgenetic/biparental fetal chimera: a case report and review. Int J Gynecol Pathol 2006; 25:366-72. [PMID: 16990714 DOI: 10.1097/01.pgp.0000215295.45738.ed] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present a case of a dichorionic/diamniotic twin pregnancy in which one twin presented with ultrasound findings suggestive of molar changes in the placenta. The placenta of twin A seemed to be grossly enlarged and cystic, and twin A was small for gestation. After an inevitable abortion, a detailed histological and genetic evaluation was performed on the fetus and placenta from twin A, including traditional cytogenetic techniques, microsatellite marker analysis, fluorescent in situ hybridization, and p57 immunostaining. It was determined that twin A was a chimera with a biparental XX cell line and an androgenetic XY cell line. The 2 cell lines were present in both the placenta and the fetus. The patient later developed and was treated for persistent gestational trophoblastic disease, which has been shown to have an increased risk after an androgenetic conception. Cases of mosaicism or chimerism involving an androgenetic cell line may be difficult to diagnose histologically but are critical to identify because of the increased risk for persistent gestational trophoblastic disease. Therefore, we emphasize the importance of using multiple molecular, cytogenetic, and immunohistochemical techniques when diagnosing cases involving such unusual placental abnormalities. To our knowledge, this is the first reported case of persistent gestational disease after a fetal chimera.
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MESH Headings
- Abortion, Spontaneous
- Adult
- Chimera/genetics
- Chorionic Gonadotropin, beta Subunit, Human/blood
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, X/genetics
- Chromosomes, Human, Y/genetics
- Diseases in Twins
- Female
- Fetus/pathology
- Genotype
- Humans
- Hydatidiform Mole/diagnosis
- Hydatidiform Mole/drug therapy
- Hydatidiform Mole/pathology
- In Situ Hybridization, Fluorescence
- Karyotyping
- Methotrexate/therapeutic use
- Microsatellite Repeats
- Placenta/pathology
- Polymerase Chain Reaction
- Pregnancy
- Twins
- Ultrasonography, Prenatal
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Affiliation(s)
- Urvashi Surti
- Department of Pathology, University of Pittsburgh School of Medicine, PA 15213, USA.
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Chen CP, Chern SR, Sheu JC, Lin SP, Hsu CY, Chang TY, Lee CC, Wang W, Chen HEC. Prenatal diagnosis, sonographic findings and molecular genetic analysis of a 46,XX/46,XY true hermaphrodite chimera. Prenat Diagn 2005; 25:502-6. [PMID: 15966046 DOI: 10.1002/pd.1181] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To present the prenatal diagnosis, sonographic findings and, molecular genetic analysis of a 46,XX/46,XY true hermaphrodite chimera and to review the literature. CLINICAL SUBJECT AND METHODS Amniocentesis was performed at 22 weeks' gestation because of sonographic diagnosis of ambiguous genitalia. Initial amniocentesis, repeat amniocentesis, and cordocentesis revealed a mixture of 46,XX cells and 46,XY cells. Polymorphic DNA marker analysis using the fetal and parental blood was applied to investigate the genetic origin of the chimera. A 3,625-g baby was delivered at 37 weeks' gestation with clitoromegaly, prominent labia majora, fusion of the labia, and an orifice of the urogenital sinus. A lymphangioma was noted over the right arm and was excised at age 3 days. Extraembryonic tissues and the infant's skin were cytogenetically and molecularly studied. RESULTS Initial amniocentesis, repeat amniocentesis, and cordocentesis revealed the karyotype of 46,XX[12]/46,XY[9], 46,XX[15]/46,XY[12], and 46,XX[27]/46,XY[15], respectively. The cytogenetic results of the extraembryonic tissues and skin were consistent with prenatal diagnosis. Informative sex chromosome and pericentromeric autosome markers demonstrated double paternal and single maternal genetic contributions. CONCLUSIONS Prenatal sonographic diagnosis of ambiguous genitalia should alert true hermaphroditism and prompt thorough genetic investigations. DNA marker analysis is helpful in delineation of true fetal chimerism as well as determination of its genetic origin in prenatally detected 46,XX/46,XY chromosome complement.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
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