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Polsani N, Yung T, Thomas E, Phung-Rojas M, Gupta I, Denker J, Lau K, Feng X, Ibarra B, Hopyan S, Atit RP. Mesenchymal Wnts are required for morphogenetic movements of calvarial osteoblasts during apical expansion. Development 2024; 151:dev202596. [PMID: 38814743 PMCID: PMC11234264 DOI: 10.1242/dev.202596] [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: 12/08/2023] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
Apical expansion of calvarial osteoblast progenitors from the cranial mesenchyme (CM) above the eye is integral to calvarial growth and enclosure of the brain. The cellular behaviors and signals underlying the morphogenetic process of calvarial expansion are unknown. Time-lapse light-sheet imaging of mouse embryos revealed calvarial progenitors intercalate in 3D in the CM above the eye, and exhibit protrusive and crawling activity more apically. CM cells express non-canonical Wnt/planar cell polarity (PCP) core components and calvarial osteoblasts are bidirectionally polarized. We found non-canonical ligand Wnt5a-/- mutants have less dynamic cell rearrangements and protrusive activity. Loss of CM-restricted Wntless (CM-Wls), a gene required for secretion of all Wnt ligands, led to diminished apical expansion of Osx+ calvarial osteoblasts in the frontal bone primordia in a non-cell autonomous manner without perturbing proliferation or survival. Calvarial osteoblast polarization, progressive cell elongation and enrichment for actin along the baso-apical axis were dependent on CM-Wnts. Thus, CM-Wnts regulate cellular behaviors during calvarial morphogenesis for efficient apical expansion of calvarial osteoblasts. These findings also offer potential insights into the etiologies of calvarial dysplasias.
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Affiliation(s)
- Nikaya Polsani
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Theodora Yung
- Program in Developmental and Stem Cell Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Evan Thomas
- Program in Developmental and Stem Cell Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Melissa Phung-Rojas
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Isha Gupta
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Julie Denker
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Kimberly Lau
- Program in Developmental and Stem Cell Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Xiaotian Feng
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Beatriz Ibarra
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sevan Hopyan
- Program in Developmental and Stem Cell Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Division of Orthopedics, The Hospital for Sick Children and Departments of Molecular Genetics and Surgery, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Radhika P Atit
- Department of Biology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Dermatology, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Genetics and Genome Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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2
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Lazea C, Vulturar R, Chiș A, Encica S, Horvat M, Belizna C, Damian LO. Macrocephaly and Finger Changes: A Narrative Review. Int J Mol Sci 2024; 25:5567. [PMID: 38791606 PMCID: PMC11122644 DOI: 10.3390/ijms25105567] [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: 03/14/2024] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Macrocephaly, characterized by an abnormally large head circumference, often co-occurs with distinctive finger changes, presenting a diagnostic challenge for clinicians. This review aims to provide a current synthetic overview of the main acquired and genetic etiologies associated with macrocephaly and finger changes. The genetic cause encompasses several categories of diseases, including bone marrow expansion disorders, skeletal dysplasias, ciliopathies, inherited metabolic diseases, RASopathies, and overgrowth syndromes. Furthermore, autoimmune and autoinflammatory diseases are also explored for their potential involvement in macrocephaly and finger changes. The intricate genetic mechanisms involved in the formation of cranial bones and extremities are multifaceted. An excess in growth may stem from disruptions in the intricate interplays among the genetic, epigenetic, and hormonal factors that regulate human growth. Understanding the underlying cellular and molecular mechanisms is important for elucidating the developmental pathways and biological processes that contribute to the observed clinical phenotypes. The review provides a practical approach to delineate causes of macrocephaly and finger changes, facilitate differential diagnosis and guide for the appropriate etiological framework. Early recognition contributes to timely intervention and improved outcomes for affected individuals.
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Affiliation(s)
- Cecilia Lazea
- 1st Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400370 Cluj-Napoca, Romania;
- 1st Pediatrics Clinic, Emergency Pediatric Clinical Hospital, 400370 Cluj-Napoca, Romania
| | - Romana Vulturar
- Department of Molecular Sciences, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania;
- Cognitive Neuroscience Laboratory, University Babes-Bolyai, 400015 Cluj-Napoca, Romania
- Association for Innovation in Rare Inflammatory, Metabolic, Genetic Diseases INNOROG, 30E, Făgetului St., 400497 Cluj-Napoca, Romania;
| | - Adina Chiș
- Department of Molecular Sciences, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania;
- Cognitive Neuroscience Laboratory, University Babes-Bolyai, 400015 Cluj-Napoca, Romania
- Association for Innovation in Rare Inflammatory, Metabolic, Genetic Diseases INNOROG, 30E, Făgetului St., 400497 Cluj-Napoca, Romania;
| | - Svetlana Encica
- Department of Pathology, “Niculae Stancioiu” Heart Institute Cluj-Napoca, 19-21 Calea Moților St., 400001 Cluj-Napoca, Romania;
| | - Melinda Horvat
- Department of Infectious Diseases and Epidemiology, The Clinical Hospital of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400348 Cluj-Napoca, Romania;
| | - Cristina Belizna
- UMR CNRS 6015, INSERM U1083, University of Angers, 49100 Angers, France;
- Internal Medicine Department Clinique de l’Anjou, Vascular and Coagulation Department, University Hospital Angers, 49100 Angers, France
| | - Laura-Otilia Damian
- Association for Innovation in Rare Inflammatory, Metabolic, Genetic Diseases INNOROG, 30E, Făgetului St., 400497 Cluj-Napoca, Romania;
- Department of Rheumatology, Center for Rare Musculoskeletal Autoimmune and Autoinflammatory Diseases, Emergency Clinical County Hospital Cluj, 400006 Cluj-Napoca, Romania
- CMI Reumatologie Dr. Damian, 400002 Cluj-Napoca, Romania
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3
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He(何璇) XA, Berenson A, Bernard M, Weber C, Cook LE, Visel A, Fuxman Bass JI, Fisher S. Identification of conserved skeletal enhancers associated with craniosynostosis risk genes. Hum Mol Genet 2024; 33:837-849. [PMID: 37883470 PMCID: PMC11070136 DOI: 10.1093/hmg/ddad182] [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: 07/31/2023] [Revised: 09/12/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
Craniosynostosis, defined by premature fusion of one or multiple cranial sutures, is a common congenital defect affecting more than 1/2000 infants and results in restricted brain expansion. Single gene mutations account for 15%-20% of cases, largely as part of a syndrome, but the majority are nonsyndromic with complex underlying genetics. We hypothesized that the two noncoding genomic regions identified by a GWAS for craniosynostosis contain distal regulatory elements for the risk genes BMPER and BMP2. To identify such regulatory elements, we surveyed conserved noncoding sequences from both risk loci for enhancer activity in transgenic Danio rerio. We identified enhancers from both regions that direct expression to skeletal tissues, consistent with the endogenous expression of bmper and bmp2. For each locus, we also found a skeletal enhancer that also contains a sequence variant associated with craniosynostosis risk. We examined the activity of each enhancer during craniofacial development and found that the BMPER-associated enhancer is active in the restricted region of cartilage closely associated with frontal bone initiation. The same enhancer is active in mouse skeletal tissues, demonstrating evolutionarily conserved activity. Using enhanced yeast one-hybrid assays, we identified transcription factors that bind each enhancer and observed differential binding between alleles, implicating multiple signaling pathways. Our findings help unveil the genetic mechanism of the two craniosynostosis risk loci. More broadly, our combined in vivo approach is applicable to many complex genetic diseases to build a link between association studies and specific genetic mechanisms.
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Affiliation(s)
- Xuan Anita He(何璇)
- Department of Pharmacology, Physiology & Biophysics, Boston University, 700 Albany St, W607, Boston, MA 02118, United States
- Graduate Program in Biomolecular Medicine, Boston University, 72 East Concord St, Boston, MA 02118, United States
| | - Anna Berenson
- Department of Biology, Boston University, 5 Cummington Mall, Boston, MA 02215, United States
- Program in Molecular Biology, Cell Biology, and Biochemistry, Boston University, 5 Cummington Mall, Boston, MA 02215, United States
| | - Michelle Bernard
- Department of Pharmacology, Physiology & Biophysics, Boston University, 700 Albany St, W607, Boston, MA 02118, United States
- College of Arts and Sciences, Boston University, 5 Cummington Mall, Boston, MA 02215, United States
| | - Chris Weber
- Department of Cell and Developmental Biology, University of Pennsylvania, 421 Curie Boulevard, Philadelphia, PA 19104-6058, United States
| | - Laura E Cook
- Environmental Genomics & System Biology Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720, United States
| | - Axel Visel
- Environmental Genomics & System Biology Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720, United States
- U.S. Department of Energy Joint Genome Institute, 1 Cyclotron Road, Berkeley, CA 94720, United States
- School of Natural Sciences, 5200 Lake Road, University of California Merced, Merced, CA 95343, United States
| | - Juan I Fuxman Bass
- Department of Biology, Boston University, 5 Cummington Mall, Boston, MA 02215, United States
| | - Shannon Fisher
- Department of Pharmacology, Physiology & Biophysics, Boston University, 700 Albany St, W607, Boston, MA 02118, United States
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Al-Murad BM, Radwan MA, Zaki IA, Soliman MM, Al-Shareef EM, Gaban AM, Al-Mukhlifi YM, Kefi FZ. Exploring Different Management Modalities of Nonsyndromic Craniosynostosis. Cureus 2024; 16:e60831. [PMID: 38910614 PMCID: PMC11190809 DOI: 10.7759/cureus.60831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Craniosynostosis is an atypical skull shape characterized by the premature fusion of cranial sutures. It is one of the most common congenital anomalies encountered by craniofacial surgeons, with a prevalence of one in every 2000-2500 births. It is classified into two main types: syndromic and nonsyndromic. In syndromic, the patient presents with other abnormalities involving the trunk, face, or extremities. While in nonsyndromic the only anomy is the premature fusion, which usually involves one suture; the most common subtypes are unicoronal, sagittal, bicoronal, metopic, and lambdoid. As a consequence, premature fusion before its natural time restricts the space for the brain to grow, increases intracranial pressure, causes damage to the brain tissue, and affects the development of the child. This review comprehensively provides a detailed overview of nonsyndromic craniosynostosis and aims to highlight the importance of early and accurate diagnosis, and determining the most suitable intervention, whether surgical or conservative modalities. The optimal treatment approach produces the most favorable aesthetic and functional outcomes.
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Affiliation(s)
| | | | - Ibrahim A Zaki
- General Practice of Pediatrics, Batterjee Medical College, Jeddah, SAU
| | | | | | | | - Yara M Al-Mukhlifi
- Medical School, King Saud Bin Abdualziz University for Health and Sciences, Riyadh, SAU
| | - Fatma Z Kefi
- Medical School, Batterjee Medical College, Jeddah , SAU
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5
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Wu J, Li F, Yu P, Yu C, Han C, Wang Y, Yu F, Ye L. Transcriptomic and cellular decoding of scaffolds-induced suture mesenchyme regeneration. Int J Oral Sci 2024; 16:33. [PMID: 38654018 DOI: 10.1038/s41368-024-00295-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 04/25/2024] Open
Abstract
Precise orchestration of cell fate determination underlies the success of scaffold-based skeletal regeneration. Despite extensive studies on mineralized parenchymal tissue rebuilding, regenerating and maintaining undifferentiated mesenchyme within calvarial bone remain very challenging with limited advances yet. Current knowledge has evidenced the indispensability of rebuilding suture mesenchymal stem cell niches to avoid severe brain or even systematic damage. But to date, the absence of promising therapeutic biomaterials/scaffolds remains. The reason lies in the shortage of fundamental knowledge and methodological evidence to understand the cellular fate regulations of scaffolds. To address these issues, in this study, we systematically investigated the cellular fate determinations and transcriptomic mechanisms by distinct types of commonly used calvarial scaffolds. Our data elucidated the natural processes without scaffold transplantation and demonstrated how different scaffolds altered in vivo cellular responses. A feasible scaffold, polylactic acid electrospinning membrane (PLA), was next identified to precisely control mesenchymal ingrowth and self-renewal to rebuild non-osteogenic suture-like tissue at the defect center, meanwhile supporting proper osteointegration with defect bony edges. Especially, transcriptome analysis and cellular mechanisms underlying the well-orchestrated cell fate determination of PLA were deciphered. This study for the first time cellularly decoded the fate regulations of scaffolds in suture-bony composite defect healing, offering clinicians potential choices for regenerating such complicated injuries.
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Affiliation(s)
- Jiayi Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Feifei Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peng Yu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Changhao Yu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chuyi Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yitian Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fanyuan Yu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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6
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Didziokas M, Jones D, Alazmani A, Steacy M, Pauws E, Moazen M. Multiscale mechanical characterisation of the craniofacial system under external forces. Biomech Model Mechanobiol 2024; 23:675-685. [PMID: 38217747 DOI: 10.1007/s10237-023-01799-y] [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: 09/04/2023] [Accepted: 11/23/2023] [Indexed: 01/15/2024]
Abstract
Premature fusion of craniofacial joints, i.e. sutures, is a major clinical condition. This condition affects children and often requires numerous invasive surgeries to correct. Minimally invasive external loading of the skull has shown some success in achieving therapeutic effects in a mouse model of this condition, promising a new non-invasive treatment approach. However, our fundamental understanding of the level of deformation that such loading has induced across the sutures, leading to the effects observed is severely limited, yet crucial for its scalability. We carried out a series of multiscale characterisations of the loading effects on normal and craniosynostotic mice, in a series of in vivo and ex vivo studies. This involved developing a custom loading setup as well as software for its control and a novel in situ CT strain estimation approach following the principles of digital volume correlation. Our findings highlight that this treatment may disrupt bone formation across the sutures through plastic deformation of the treated suture. The level of permanent deformations observed across the coronal suture after loading corresponded well with the apparent strain that was estimated. This work provides invaluable insight into the level of mechanical forces that may prevent early fusion of cranial joints during the minimally invasive treatment cycle and will help the clinical translation of the treatment approach to humans.
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Affiliation(s)
- Marius Didziokas
- Department of Mechanical Engineering, University College London, London, UK.
| | - Dominic Jones
- School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Ali Alazmani
- School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Miranda Steacy
- Department of Mechanical Engineering, University College London, London, UK
| | - Erwin Pauws
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Mehran Moazen
- Department of Mechanical Engineering, University College London, London, UK
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Albaugh SL, Diaz A, Wang E, Shen TC, Williams L, He TC, Reid RR. Systematic Review of Nonsyndromic Craniosynostosis: Genomic Alterations and Impacted Signaling Pathways. Plast Reconstr Surg 2024; 153:383e-396e. [PMID: 37070824 DOI: 10.1097/prs.0000000000010522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
BACKGROUND Genetic research in nonsyndromic craniosynostosis remains limited compared with syndromic craniosynostosis. This systematic review aimed to comprehensively summarize the genetic literature of nonsyndromic craniosynostosis and highlight key signaling pathways. METHODS The authors performed a systematic literature search of PubMed, Ovid, and Google Scholar databases from inception until December of 2021 using search terms related to nonsyndromic craniosynostosis and genetics. Two reviewers screened titles and abstract for relevance, and three reviewers independently extracted study characteristics and genetic data. Gene networks were constructed using Search Tool for Retrieval of Interacting Genes/Proteins (version 11) analysis. RESULTS Thirty-three articles published between 2001 and 2020 met inclusion criteria. Studies were further classified into candidate gene screening and variant identification studies ( n = 16), genetic expression studies ( n = 13), and common and rare variant association studies ( n = 4). Most studies were good quality. Using our curated list of 116 genes extracted from the studies, two main networks were constructed. CONCLUSIONS This systematic review concerns the genetics of nonsyndromic craniosynostosis, with network construction revealing TGF-β/BMP, Wnt, and NF-κB/RANKL as important signaling pathways. Future studies should focus on rare rather than common variants to examine the missing heritability in this defect and, going forward, adopt a standard definition.
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Affiliation(s)
| | - Ashley Diaz
- From the Pritzker School of Medicine, University of Chicago
| | - Esther Wang
- From the Pritzker School of Medicine, University of Chicago
| | - Timothy C Shen
- From the Pritzker School of Medicine, University of Chicago
| | - Lydia Williams
- Laboratory of Craniofacial Biology and Development, Department of Surgery, Section of Plastic and Reconstructive Surgery
| | - Tong-Chuan He
- Molecular Oncology Laboratory, Department of Surgery, Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center
| | - Russell R Reid
- Laboratory of Craniofacial Biology and Development, Department of Surgery, Section of Plastic and Reconstructive Surgery
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8
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Calandrelli R, Pilato F, Massimi L, D'Apolito G, Colosimo C. Facial skeleton dysmorphology in syndromic craniosynostosis: differences between FGFR2 and no-FGFR2-related syndromes and relationship with skull base and facial sutural patterns. Childs Nerv Syst 2023; 39:3235-3247. [PMID: 37195419 DOI: 10.1007/s00381-023-05962-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/16/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE To assess the role of FGFR2 mutations and sutural synostotic patterns on facial skeleton dysmorphology in children with syndromic craniosynostosis. METHODS Preoperative high-resolution CT images in 39 infants with syndromic craniosynostosis were evaluated. Patients were divided into infants with and without FGFR2 mutations; each group was split according to synostotic involvement of minor sutures/synchondroses: isolated or combined involvement of middle (MCF) and posterior cranial fossae (PCF). Quantitative analysis of the midface and mandible measures was performed. Each subgroup was compared with a group of age-matched healthy subjects. RESULTS Twenty-four patients with FGFR2 related syndromes were clustered in 3 subgroups: MCF + PCF (8 patients, 5.4 ± 1.75 months), MCF (8 patients, 3.62 ± 1.68 months), and PCF (8 patients, 2.75 ± 0.46 months). Fifteen no-FGFR2 patients were clustered in 2 subgroups: MCF + PCF (7 patients, 9.42 ± 0.78 months) and PCF (8 patients, 7.37 ± 2.92 months). Both FGFR2 and no-FGFR2 groups with involvement of minor sutures coursing in MCF showed more facial sutural synostoses. Children with minor suture/synchondrosis synostosis of MCF (MCF-PCF and MCF subgroups) showed altered position of glenoid fossa and mandibular inclination ([Formula: see text]), but children in the FGFR2 group had also reduced midfacial depth and maxillary length ([Formula: see text]). Children with minor suture/synchondrosis synostosis of PCF (PCF subgroups) had reduced posterior mandibular height, but those children in the FGFR2 group also showed reduced intergonion distance ([Formula: see text]). CONCLUSIONS In children with syndromic craniosynostosis, both skull base and facial suture synostosis affect facial dysmorphology/hypoplasia. FGFR2 mutations may worsen facial hypoplasia both acting on bone development and causing an earlier premature closure of facial sutures.
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Affiliation(s)
- Rosalinda Calandrelli
- Institute of Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 1, Rome, 00168, Italy.
| | - Fabio Pilato
- Unit of Neurology, Department of Medicine, Neurophysiology, Università Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Luca Massimi
- Pediatric Neurosurgery, Neurosurgery Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 1, Rome, 00168, Italy
| | - Gabriella D'Apolito
- Institute of Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 1, Rome, 00168, Italy
| | - Cesare Colosimo
- Institute of Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 1, Rome, 00168, Italy
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9
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Radu S, Jedrzejewski B, Urbinelli L. Primary Delayed Onset Craniosynostosis in a Child With ERF-Related Craniosynostosis Syndrome and Familial Cerebral Cavernous Malformation Syndrome. Cleft Palate Craniofac J 2023; 60:1321-1325. [PMID: 35313736 DOI: 10.1177/10556656221088743] [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] [Indexed: 09/21/2023] Open
Abstract
Primary delayed onset craniosynostosis is defined as premature suture fusion that developed despite clear radiographic evidence of normal postnatal calvarial configuration and patent sutures earlier in life. It is rare in the literature and typically presents as secondary synostosis. In this brief clinical study, primary delayed onset craniosynostosis is described in its unique presentation at 4 years of age with a complex genetic history including ERF-related craniosynostosis syndrome and familial cerebral cavernous malformation syndrome. Although the delayed onset clinical course of ERF-related craniosynostosis syndrome has not been well described in the literature, our review suggests that it is distinctive to ERF-related craniosynostosis and should be considered when cases present without a history of trauma, when there is a positive family history, and particularly when cases present late onset; after 1 year of age.
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Affiliation(s)
- Stephanie Radu
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Breanna Jedrzejewski
- Department of Surgery, Division of Plastic Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Leo Urbinelli
- Department of Surgery, Division of Plastic Surgery, Oregon Health & Science University, Portland, OR, USA
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10
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W Beiriger J, Zhu X, Bruce MK, Irgebay Z, Smetona J, Losee JE, Goldstein JA. Squamosal Suture Synostosis: An Under-Recognized Phenomenon. Cleft Palate Craniofac J 2023; 60:1267-1272. [PMID: 35593077 DOI: 10.1177/10556656221100675] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The squamosal suture (SQS) joins the temporal to the parietal bones bilaterally and is a poorly described site of craniosynostosis. SQS fusion is thought to occur as late as the fourth decade of life and beyond; however, we have incidentally noted its presence among our pediatric patients and hypothesize that it may occur earlier in life and more frequently than previously believed. METHODS A retrospective review of imaging performed on pediatric patients was completed to identify patients with SQS synostosis. This included a review of clinical notes as well as computed tomography (CT) images obtained by our craniofacial clinic. Relevant patient data and imaging were reviewed. RESULTS Forty-seven patients were identified with SQS synostosis, 21 were female (45%). Age at the time of radiographic diagnosis was 10.1 ± 8.4 years (range 17 days to 27 years). A majority of patients had bilateral SQS synostosis (57%), with a relatively even distribution of unilateral right (23%) versus left (19%). SQS was an isolated finding (no other suture involvement) in 15 patients (32%), all of whom were normocephalic and did not require surgical intervention. Thirty-two patients (68%) had concomitant craniosynostosis of other sutures, most commonly sagittal and coronal. Nine patients (19%) underwent surgery to correct cranial malformations-all these patients had multi-suture synostosis (P = 0.012). Twenty-seven patients (57%) had SQS synostosis diagnosed incidentally compared to 20 (43%) who were imaged with suspicion for synostosis. In those who were symptomatic, common findings included developmental delay, elevated intracranial pressure, hydrocephalus, seizures, and visual/hearing impairments. Ten patients (21%) were syndromic, the most frequent of which was Crouzon syndrome. No single pattern of calvarial malformation could be definitively described for SQS synostosis. CONCLUSION Given that most isolated SQS synostosis cases were normocephalic, asymptomatic, and discovered incidentally, it is likely that there are many cases of unidentified SQS synostosis. The significance of SQS synostosis is currently unclear, and warrants further investigation into this phenomenon, its natural course, and its potential presence in the spectrum of normal development.
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Affiliation(s)
| | - Xiao Zhu
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Zhazira Irgebay
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - John Smetona
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Joseph E Losee
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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11
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Pitirri MK, Richtsmeier JT, Kawasaki M, Coupe AP, Perrine SM, Kawasaki K. Come together over me: Cells that form the dermatocranium and chondrocranium in mice. Anat Rec (Hoboken) 2023:10.1002/ar.25295. [PMID: 37497849 PMCID: PMC10818014 DOI: 10.1002/ar.25295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
Most bone develops either by intramembranous ossification where bone forms within a soft connective tissue, or by endochondral ossification by way of a cartilage anlagen or model. Bones of the skull can form endochondrally or intramembranously or represent a combination of the two types of ossification. Contrary to the classical definition of intramembranous ossification, we have previously described a tight temporo-spatial relationship between cranial cartilages and dermal bone formation and proposed a mechanistic relationship between chondrocranial cartilage and dermal bone. Here, we further investigate this relationship through an analysis of how cells organize to form cranial cartilages and dermal bone. Using Wnt1-Cre2 and Mesp1-Cre transgenic mice, we determine the derivation of cells that comprise cranial cartilages from either cranial neural crest (CNC) or paraxial mesoderm (PM). We confirm a previously determined CNC-PM boundary that runs through the hypophyseal fenestra in the cartilaginous braincase floor and identify four additional CNC-PM boundaries in the chondrocranial lateral wall, including a boundary that runs along the basal and apical ends of the hypochiasmatic cartilage. Based on the knowledge that as osteoblasts differentiate from CNC- and PM-derived mesenchyme, the differentiating cells express the transcription factor genes RUNX2 and osterix (OSX), we created a new transgenic mouse line called R2Tom. R2Tom mice carry a tdTomato reporter gene joined with an evolutionarily well-conserved enhancer sequence of RUNX2. R2Tom mice crossed with Osx-GFP mice yield R2Tom;Osx-GFP double transgenic mice in which various stages of osteoblasts and their precursors are detected with different fluorescent reporters. We use the R2Tom;Osx-GFP mice, new data on the cell derivation of cranial cartilages, histology, immunohistochemistry, and detailed morphological observations combined with data from other investigators to summarize the differentiation of cranial mesenchyme as it forms condensations that become chondrocranial cartilages and associated dermal bones of the lateral cranial wall. These data advance our previous findings of a tendency of cranial cartilage and dermal bone development to vary jointly in a coordinated manner, promoting a role for cranial cartilages in intramembranous bone formation.
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Affiliation(s)
- M Kathleen Pitirri
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Joan T Richtsmeier
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Mizuho Kawasaki
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Abigail P Coupe
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Susan Motch Perrine
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kazuhiko Kawasaki
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
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12
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Hoshino Y, Takechi M, Moazen M, Steacy M, Koyabu D, Furutera T, Ninomiya Y, Nuri T, Pauws E, Iseki S. Synchondrosis fusion contributes to the progression of postnatal craniofacial dysmorphology in syndromic craniosynostosis. J Anat 2023; 242:387-401. [PMID: 36394990 PMCID: PMC9919486 DOI: 10.1111/joa.13790] [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: 07/12/2022] [Revised: 09/16/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
Syndromic craniosynostosis (CS) patients exhibit early, bony fusion of calvarial sutures and cranial synchondroses, resulting in craniofacial dysmorphology. In this study, we chronologically evaluated skull morphology change after abnormal fusion of the sutures and synchondroses in mouse models of syndromic CS for further understanding of the disease. We found fusion of the inter-sphenoid synchondrosis (ISS) in Apert syndrome model mice (Fgfr2S252W/+ ) around 3 weeks old as seen in Crouzon syndrome model mice (Fgfr2cC342Y/+ ). We then examined ontogenic trajectories of CS mouse models after 3 weeks of age using geometric morphometrics analyses. Antero-ventral growth of the face was affected in Fgfr2S252W/+ and Fgfr2cC342Y/+ mice, while Saethre-Chotzen syndrome model mice (Twist1+/- ) did not show the ISS fusion and exhibited a similar growth pattern to that of control littermates. Further analysis revealed that the coronal suture synostosis in the CS mouse models induces only the brachycephalic phenotype as a shared morphological feature. Although previous studies suggest that the fusion of the facial sutures during neonatal period is associated with midface hypoplasia, the present study suggests that the progressive postnatal fusion of the cranial synchondrosis also contributes to craniofacial dysmorphology in mouse models of syndromic CS. These morphological trajectories increase our understanding of the progression of syndromic CS skull growth.
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Affiliation(s)
- Yukiko Hoshino
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Office of New Drug V, Pharmaceuticals and Medical Devices Agency (PMDA), Tokyo, Japan
| | - Masaki Takechi
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mehran Moazen
- Department of UCL Mechanical Engineering, University College London, London, UK
| | - Miranda Steacy
- Institute of Child Health, Great Ormond Street, University College London, London, UK
| | - Daisuke Koyabu
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Research and Development Center for Precision Medicine, Tsukuba University, Tsukuba, Japan
| | - Toshiko Furutera
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Youichirou Ninomiya
- Research Organization of Information and Systems, National Institute of Informatics, Tokyo, Japan
| | - Takashi Nuri
- Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Erwin Pauws
- Institute of Child Health, Great Ormond Street, University College London, London, UK
| | - Sachiko Iseki
- Department of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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13
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Tabesh H, Riazi A, Mahmoodkhani M, Sharafi M, Sourani A, Mahdkhah A, Foroughi M. Surgical outcomes of calvaria reconstruction in cranial pansynostosis associated with Arnold-Chiari type 1.5 malformation, a case report. Clin Case Rep 2023; 11:e6981. [PMID: 36891239 PMCID: PMC9986723 DOI: 10.1002/ccr3.6981] [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: 04/29/2022] [Revised: 01/02/2023] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
A 6-year-old girl with persistent headaches and the visual problem was diagnosed as a delayed onset cranial pansynostosis with concurrent type 1.5 Arnold-Chiari malformation. She underwent multi-sutural reconstructive surgery and followed. The headache was greatly decreased and tonsillar-brain stem herniation and syrinx were resolved.
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Affiliation(s)
- Homayoun Tabesh
- Department of Neurosurgery School of Medicine, Isfahan University of Medical Sciences Isfahan Iran
| | - Ali Riazi
- Department of Neurosurgery School of Medicine, Isfahan University of Medical Sciences Isfahan Iran
| | - Mehdi Mahmoodkhani
- Department of Neurosurgery School of Medicine, Isfahan University of Medical Sciences Isfahan Iran
| | - Mohammad Sharafi
- Department of Neurosurgery School of Medicine, Isfahan University of Medical Sciences Isfahan Iran
| | - Arman Sourani
- Department of Neurosurgery School of Medicine, Isfahan University of Medical Sciences Isfahan Iran
| | - Ata Mahdkhah
- Department of Neurosurgery Urmia University of Medical Sciences Urmia Iran
| | - Mina Foroughi
- Isfahan Medical Students' Research Committee (IMSRC) Isfahan University of Medical Sciences Isfahan Iran
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14
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YAPIJAKIS CHRISTOS, PACHIS NIKOLAOS, SOTIRIADOU TRIANTAFYLLIA, VAILA CHRISTINA, MICHOPOULOU VASILIKI, VASSILIOU STAVROS. Molecular Mechanisms Involved in Craniosynostosis. In Vivo 2023; 37:36-46. [PMID: 36593018 PMCID: PMC9843758 DOI: 10.21873/invivo.13052] [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: 06/20/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 01/03/2023]
Abstract
Craniosynostosis refers to the early fusion of one or many cranial sutures, causing craniofacial abnormalities observed in 1:2,500 births worldwide. In most cases (85%), craniosynostosis is presented as sporadic anomaly (non-syndromic craniosynostosis), while in other cases (15%) as part of syndromes (syndromic craniosynostosis). Patients with syndromic disorder usually have more severe symptoms compared to those with single suture synostosis. Most common syndromes of craniosynostosis include Pfeiffer, Apert, Crouzon, Jackson-Weiss, Muenke and Boston type MSX2-related syndrome. The main gene mutations in craniosynostosis involve FGFR1, FGFR2, FGFR3, TWIST1 and MSX2, which encode key factors influencing cranial bone morphogenesis. The main therapeutic approaches are surgical as discussed in this review, and the type of therapy depends on the graveness of the incident.
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Affiliation(s)
- CHRISTOS YAPIJAKIS
- Unit of Orofacial Genetics, 1st Department of Pediatrics, School of Medicine, National Kapodistrian University of Athens, "Agia Sophia" Children’s Hospital, Athens, Greece,Department of Molecular Genetics, "Cephalogenetics" Center, Athens, Greece,Department of Oral Maxillofacial Surgery, School of Medicine, National Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - NIKOLAOS PACHIS
- Unit of Orofacial Genetics, 1st Department of Pediatrics, School of Medicine, National Kapodistrian University of Athens, "Agia Sophia" Children’s Hospital, Athens, Greece,Department of Molecular Genetics, "Cephalogenetics" Center, Athens, Greece
| | - TRIANTAFYLLIA SOTIRIADOU
- Unit of Orofacial Genetics, 1st Department of Pediatrics, School of Medicine, National Kapodistrian University of Athens, "Agia Sophia" Children’s Hospital, Athens, Greece
| | - CHRISTINA VAILA
- Department of Molecular Genetics, "Cephalogenetics" Center, Athens, Greece
| | | | - STAVROS VASSILIOU
- Department of Oral Maxillofacial Surgery, School of Medicine, National Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
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15
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Timberlake AT, Kiziltug E, Jin SC, Nelson-Williams C, Loring E, Allocco A, Marlier A, Banka S, Stuart H, Passos-Buenos MR, Rosa R, Rogatto SR, Tonne E, Stiegler AL, Boggon TJ, Alperovich M, Steinbacher D, Staffenberg DA, Flores RL, Persing JA, Kahle KT, Lifton RP. De novo mutations in the BMP signaling pathway in lambdoid craniosynostosis. Hum Genet 2023; 142:21-32. [PMID: 35997807 DOI: 10.1007/s00439-022-02477-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 01/18/2023]
Abstract
Lambdoid craniosynostosis (CS) is a congenital anomaly resulting from premature fusion of the cranial suture between the parietal and occipital bones. Predominantly sporadic, it is the rarest form of CS and its genetic etiology is largely unexplored. Exome sequencing of 25 kindreds, including 18 parent-offspring trios with sporadic lambdoid CS, revealed a marked excess of damaging (predominantly missense) de novo mutations that account for ~ 40% of sporadic cases. These mutations clustered in the BMP signaling cascade (P = 1.6 × 10-7), including mutations in genes encoding BMP receptors (ACVRL1 and ACVR2A), transcription factors (SOX11, FOXO1) and a transcriptional co-repressor (IFRD1), none of which have been implicated in other forms of CS. These missense mutations are at residues critical for substrate or target sequence recognition and many are inferred to cause genetic gain-of-function. Additionally, mutations in transcription factor NFIX were implicated in syndromic craniosynostosis affecting diverse sutures. Single cell RNA sequencing analysis of the mouse lambdoid suture identified enrichment of mutations in osteoblast precursors (P = 1.6 × 10-6), implicating perturbations in the balance between proliferation and differentiation of osteoprogenitor cells in lambdoid CS. The results contribute to the growing knowledge of the genetics of CS, have implications for genetic counseling, and further elucidate the molecular etiology of premature suture fusion.
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Affiliation(s)
- Andrew T Timberlake
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA.
| | - Emre Kiziltug
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Sheng Chih Jin
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA.,Department of Genetics, Washington University School of Medicine, St Louis, MO, USA
| | | | - Erin Loring
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | | | - August Allocco
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Arnaud Marlier
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Siddharth Banka
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9WL, UK.,Manchester Centre for Genomic Medicine, Health Innovation Manchester, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Helen Stuart
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9WL, UK.,Manchester Centre for Genomic Medicine, Health Innovation Manchester, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | | | - Rafael Rosa
- Clinical Genetics, UFCSPA and Irmandade da Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, RS, Brazil
| | - Silvia R Rogatto
- Neogene Laboratory, Research Center (CIPE), AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Elin Tonne
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Amy L Stiegler
- Department of Pharmacology, Yale University, New Haven, CT, USA
| | - Titus J Boggon
- Department of Pharmacology, Yale University, New Haven, CT, USA
| | - Michael Alperovich
- Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Derek Steinbacher
- Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - David A Staffenberg
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA
| | - John A Persing
- Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Kristopher T Kahle
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Broad Institute of Harvard and Massachusetts Institute of Technology, Boston, MA, USA.,Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
| | - Richard P Lifton
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA. .,Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA.
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16
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Geoffroy M, François PM, Khonsari RH, Laporte S. Paediatric skull growth models: A systematic review of applications to normal skulls and craniosynostoses. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e533-e543. [PMID: 35007781 DOI: 10.1016/j.jormas.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Craniosynostoses affect 1/2000 births and their incidence is currently increasing. Without surgery, craniosynostosis can lead to neurological issues due to restrained brain growth and social stigma due to abnormal head shapes. Understanding growth patterns is essential to develop surgical planning approaches and predict short- and long-term post-operative results. Here we provide a systematic review of normal and pathological cranial vault growth models. MATERIAL AND METHODS The systematic review of the literature identified descriptive and comprehensive skull growth models with the following criteria: full text articles dedicated to the skull vault of children under 2 years of age, without focus on molecular and cellular mechanisms. Models were analysed based on initial geometry, numerical method, age determination method and validation process. RESULTS A total of 14 articles including 17 models was reviewed. Four descriptive models were assessed, including 3 models using statistical analyses and 1 based on deformational methods. Thirteen comprehensive models were assessed including 7 finite element models and 6 diffusion models. Results from the current literature showed that successful models combined analyses of cranial vault shape and suture bone formation. DISCUSSION Growth modelling is central when assessing craniofacial architecture in young patients and will be a key factor in the development of future customized treatment strategies. Recurrent technical difficulties were encountered by most authors when generalizing a specific craniosynostosis model to all types of craniosynostoses, when assessing the role of the brain and when attempting to relate the age with different stages of growth.
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Affiliation(s)
- Maya Geoffroy
- Arts et Métiers Institute of Technology, Université Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France; Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris; 149 Rue de Sèvres, 75015 Paris, France; BONE 3D; 14 Rue Jean Antoine de Baïf, 75013 Paris, France.
| | | | - Roman Hossein Khonsari
- Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris; 149 Rue de Sèvres, 75015 Paris, France.
| | - Sébastien Laporte
- Arts et Métiers Institute of Technology, Université Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France.
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17
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Eisová S, Velemínský P, Velemínská J, Bruner E. Diploic vein morphology in normal and craniosynostotic adult human skulls. J Morphol 2022; 283:1318-1336. [PMID: 36059180 DOI: 10.1002/jmor.21505] [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: 07/11/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
Diploic veins (DV) run within the cranial diploe, where they leave channels that can be studied in osteological samples. This study investigates overall DV variability in human adults and the effects of sex, age, cranial dimensions, and dysmorphogenesis associated with craniosynostosis (CS). The morphology of macroscopic diploic channels was analyzed in a set of the qualitative and quantitative variables in computed tomography-images of crania of anatomically normal and craniosynostotic adult individuals. Macroscopic diploic channels occur most frequently in the frontal and parietal bones, often with a bilaterally symmetrical pattern. DV-features (especially DV-pattern) are characterized by high individual diversity. On average, there are 5.4 ± 3.5 large macroscopic channels (with diameters >1 mm) per individual, with a mean diameter of 1.7 ± 0.4 mm. Age and sex have minor effects on DV, and cranial proportions significantly influence DV only in CS skulls. CS is associated with changes in the DV numbers, distributions, and diameters. Craniosynostotic skulls, especially brachycephalic skulls, generally present smaller DV diameters, and dolichocephalic skulls display increased number of frontal DV. CS, associated with altered cranial dimensions, suture imbalance, increased intracranial pressure, and with changes of the endocranial craniovascular system, significantly also affects the macroscopic morphology of DV in adults, in terms of both structural (topological redistribution) and functional factors. The research on craniovascular morphology and CS may be of interest in biological anthropology, paleopathology, medicine (e.g., surgical planning), but also in zoology and paleontology.
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Affiliation(s)
- Stanislava Eisová
- Antropologické oddělení, Přírodovědecké muzeum, Národní muzeum, Prague, Czech Republic.,Katedra antropologie a genetiky člověka, Přírodovědecká fakulta, Univerzita Karlova, Prague, Czech Republic
| | - Petr Velemínský
- Antropologické oddělení, Přírodovědecké muzeum, Národní muzeum, Prague, Czech Republic
| | - Jana Velemínská
- Katedra antropologie a genetiky člověka, Přírodovědecká fakulta, Univerzita Karlova, Prague, Czech Republic
| | - Emiliano Bruner
- Programa de Paleobiología, Centro Nacional de Investigación sobre la Evolución Humana, Burgos, Spain
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18
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Chen J, Zhang P, Peng M, Liu B, Wang X, Du S, Lu Y, Mu X, Lu Y, Wang S, Wu Y. An additional whole-exome sequencing study in 102 panel-undiagnosed patients: A retrospective study in a Chinese craniosynostosis cohort. Front Genet 2022; 13:967688. [PMID: 36118902 PMCID: PMC9481236 DOI: 10.3389/fgene.2022.967688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Craniosynostosis (CRS) is a disease with prematurely fused cranial sutures. In the last decade, the whole-exome sequencing (WES) was widely used in Caucasian populations. The WES largely contributed in genetic diagnosis and exploration on new genetic mechanisms of CRS. In this study, we enrolled 264 CRS patients in China. After a 17-gene-panel sequencing designed in the previous study, 139 patients were identified with pathogenic/likely pathogenic (P/LP) variants according to the ACMG guideline as positive genetic diagnosis. WES was then performed on 102 patients with negative genetic diagnosis by panel. Ten P/LP variants were additionally identified in ten patients, increasing the genetic diagnostic yield by 3.8% (10/264). The novel variants in ANKH, H1-4, EIF5A, SOX6, and ARID1B expanded the mutation spectra of CRS. Then we designed a compatible research pipeline (RP) for further exploration. The RP could detect all seven P/LP SNVs and InDels identified above, in addition to 15 candidate variants found in 13 patients with worthy of further study. In sum, the 17-gene panel and WES identified positive genetic diagnosis for 56.4% patients (149/264) in 16 genes. At last, in our estimation, the genetic testing strategy of “Panel-first” saves 24.3% of the cost compared with “WES only”, suggesting the “Panel-first” is an economical strategy.
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Affiliation(s)
- Jieyi Chen
- Department of Plastic Surgery, Huashan Hospital, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, China
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Ping Zhang
- Center for Molecular Medicine, Pediatrics Research Institute, Children’s Hospital of Fudan University, Shanghai, China
| | - Meifang Peng
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostics & Endocrinology, Shanghai Ninth People’s Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bo Liu
- Center for Molecular Medicine, Pediatrics Research Institute, Children’s Hospital of Fudan University, Shanghai, China
| | - Xiao Wang
- Center for Molecular Medicine, Pediatrics Research Institute, Children’s Hospital of Fudan University, Shanghai, China
| | - Siyuan Du
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yao Lu
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xiongzheng Mu
- Department of Plastic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulan Lu
- Center for Molecular Medicine, Pediatrics Research Institute, Children’s Hospital of Fudan University, Shanghai, China
- *Correspondence: Yingzhi Wu, ; Sijia Wang, ; Yulan Lu,
| | - Sijia Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- *Correspondence: Yingzhi Wu, ; Sijia Wang, ; Yulan Lu,
| | - Yingzhi Wu
- Department of Plastic Surgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Yingzhi Wu, ; Sijia Wang, ; Yulan Lu,
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19
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Motch Perrine SM, Pitirri MK, Durham EL, Kawasaki M, Zheng H, Chen DZ, Kawasaki K, Richtsmeier JT. A dysmorphic mouse model reveals developmental interactions of chondrocranium and dermatocranium. eLife 2022; 11:76653. [PMID: 35704354 PMCID: PMC9259032 DOI: 10.7554/elife.76653] [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: 12/23/2021] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
The cranial endo- and dermal skeletons, which comprise the vertebrate skull, evolved independently over 470 million years ago and form separately during embryogenesis. In mammals, much of the cartilaginous chondrocranium is transient, undergoing endochondral ossification or disappearing, so its role in skull morphogenesis is not well studied and it remains an enigmatic structure. We provide complete three-dimensional (3D) reconstructions of the laboratory mouse chondrocranium from embryonic day 13.5 through 17.5 using a novel methodology of uncertainty-guided segmentation of phosphotungstic enhanced 3D microcomputed tomography images with sparse annotation. We evaluate the embryonic mouse chondrocranium and dermatocranium in 3D and delineate the effects of a Fgfr2 variant on embryonic chondrocranial cartilages and on their association with forming dermal bones using the Fgfr2cC342Y/+ Crouzon syndrome mouse. We show that the dermatocranium develops outside of and in shapes that conform to the chondrocranium. Results reveal direct effects of the Fgfr2 variant on embryonic cartilage, on chondrocranium morphology, and on the association between chondrocranium and dermatocranium development. Histologically we observe a trend of relatively more chondrocytes, larger chondrocytes, and/or more matrix in the Fgfr2cC342Y/+ embryos at all timepoints before the chondrocranium begins to disintegrate at E16.5. The chondrocrania and forming dermatocrania of Fgfr2cC342Y/+ embryos are relatively large, but a contrasting trend begins at E16.5 and continues into early postnatal (P0 and P2) timepoints, with the skulls of older Fgfr2cC342Y/+ mice reduced in most dimensions compared to Fgfr2c+/+ littermates. Our findings have implications for the study and treatment of human craniofacial disease, for understanding the impact of chondrocranial morphology on skull growth, and potentially on the evolution of skull morphology.
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Affiliation(s)
- Susan M Motch Perrine
- Department of Anthropology, The Pennsylvania State University, University Park, United States
| | - M Kathleen Pitirri
- Department of Anthropology, The Pennsylvania State University, University Park, United States
| | - Emily L Durham
- Department of Anthropology, The Pennsylvania State University, University Park, United States
| | - Mizuho Kawasaki
- Department of Anthropology, The Pennsylvania State University, University Park, United States
| | - Hao Zheng
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, United States
| | - Danny Z Chen
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, United States
| | - Kazuhiko Kawasaki
- Department of Anthropology, Pennsylvania State University, University Park, United States
| | - Joan T Richtsmeier
- Department of Anthropology, Pennsylvania State University, University Park, United States
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20
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Singh N, Heuzé Y, Holmes G. Processes and Patterns: Insights On Cranial Covariation from An Apert Syndrome Mouse Model. Dev Dyn 2022; 251:1684-1697. [PMID: 35582939 DOI: 10.1002/dvdy.498] [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: 10/17/2021] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Major cell-to-cell signaling pathways, such as the fibroblast growth factors and their four receptors (FGF/FGFR), are conserved across a variety of animal forms. FGF/FGFRs are necessary to produce several "vertebrate-specific" structures, including the vertebrate head. Here, we examine the effects of the FGFR2 S252W mutation associated with Apert syndrome on patterns of cranial integration. Our data comprise micro-computed tomography images of newborn mouse skulls, bred to express the Fgfr2 S252W mutation exclusively in either neural crest or mesoderm-derived tissues, and mice that express the Fgfr2 S252W mutation ubiquitously. RESULTS Procrustes-based methods and partial least squares analysis were used to analyze craniofacial integration patterns. We found that deviations in the direction and degree of integrated shape change across the mouse models used in our study were potentially driven by the modular variation generated by differing expression of the Fgfr2 mutation in cranial tissues. CONCLUSIONS Our overall results demonstrate that covariation patterns can be biased by the spatial distribution and magnitude of variation produced by underlying developmental-genetic mechanisms that often impact the phenotype in disproportionate ways. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Nandini Singh
- Department of Anthropology, California State University, Sacramento, CA
| | - Yann Heuzé
- Université de Bordeaux, CNRS, MC, PACEA, Pessac, France
| | - Greg Holmes
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
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21
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Nikolova S, Toneva D, Tasheva-Terzieva E, Lazarov N. Cranial morphology in metopism: A comparative geometric morphometric study. Ann Anat 2022; 243:151951. [PMID: 35523397 DOI: 10.1016/j.aanat.2022.151951] [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: 01/25/2022] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cranial sutures are active bone growth sites and any alteration in their normal formation, patency and closure influences the overall cranial morphology. This comparative study aims to establish whether the cranial shape and size are significantly modified when metopic suture persists into adulthood using geometric morphometric analyses. METHODS The sample consisted of 63 metopic and 184 non-metopic dry adult male crania. Three-dimensional polygonal models of the crania were generated using a hand-held laser scanner Creaform VIUscan. A total of 50 landmarks were digitized on the three-dimensional models and eight landmark configurations delineating the cranium and its compartments were constructed and analyzed. Geometric morphometric analyses were applied to investigate separately the size and shape differences between the metopic and non-metopic series in each of the landmark configurations. RESULTS Significant size differences were established solely in the neurocranium, but not in its total size, rather in its parts. The size modification was expressed by an enlargement of the anterior part of the neurocranium at the expense of the middle and posterior ones. All investigated landmark sets differed significantly between the series regarding the shape. In metopic series, the shape alteration was mainly in a mediolateral widening and an anteroposterior shortening contributing to a more rounded overall shape of the cranium. CONCLUSIONS The slight modification of the cranial morphology in metopism suggests that the metopic suture persistence is not an isolated variation limited to the frontal bone. It is rather a complex condition associated with a combination of specific phenotypic characteristics.
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Affiliation(s)
- Silviya Nikolova
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria.
| | - Diana Toneva
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Elena Tasheva-Terzieva
- Department of Zoology and Anthropology, Faculty of Biology, Sofia University, 1164 Sofia, Bulgaria
| | - Nikolai Lazarov
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria
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22
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Alam MK, Alfawzan AA, Srivastava KC, Shrivastava D, Ganji KK, Manay SM. Craniofacial morphology in Apert syndrome: a systematic review and meta-analysis. Sci Rep 2022; 12:5708. [PMID: 35383244 PMCID: PMC8983770 DOI: 10.1038/s41598-022-09764-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
This meta-analysis aims to compare Apert syndrome (AS) patients with non-AS populations (not clinically or genetically diagnosed) on craniofacial cephalometric characteristics (CCC) to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, an article published between 1st January 2000 to October 17th, 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to carry out this systematic review. We used the PECO system to classify people with AS based on whether or not they had distinctive CCC compared to the non-AS population. Following are some examples of how PECO has been used: People with AS are labeled P; clinical or genetic diagnosis of AS is labeled E; individuals without AS are labeled C; CCC of AS are labeled O. Using the Newcastle–Ottawa Quality-Assessment-Scale, independent reviewers assessed the articles' methodological quality and extracted data. 13 studies were included in the systematic review. 8 out of 13 studies were score 7–8 in NOS scale, which indicated that most of the studies were medium to high qualities. Six case–control studies were analyzed for meta-analysis. Due to the wide range of variability in CCC, we were only able to include data from at least three previous studies. There was a statistically significant difference in N-S-PP (I2: 76.56%; P = 0.014; CI 1.27 to − 0.28) and Greater wing angle (I2: 79.07%; P = 0.008; CI 3.07–1.17) between AS and control subjects. Cleft palate, anterior open bite, crowding in the upper jaw, and hypodontia occurred more frequently among AS patients. Significant shortening of the mandibular width, height and length is the most reported feature in AS patients. CT scans can help patients with AS decide whether to pursue orthodontic treatment alone or to have their mouth surgically expanded. The role of well-informed orthodontic and maxillofacial practitioners is critical in preventing and rehabilitating oral health issues.
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Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontics, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, Saudi Arabia.
| | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia
| | - Kumar Chandan Srivastava
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Deepti Shrivastava
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Kiran Kumar Ganji
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
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23
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Hernandez CR, Miller M, Ruiz RL. Fronto-orbital Advancement and Anterior Cranial Vault Reconstruction. Atlas Oral Maxillofac Surg Clin North Am 2022; 30:75-84. [PMID: 35256112 DOI: 10.1016/j.cxom.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Carlos R Hernandez
- Resident, Department of Oral and Maxillofacial Surgery, UT Health San Antonio, San Antonio, TX, USA
| | - Mark Miller
- Assistant Professor and Clinical Director, Department of Oral & Maxillofacial Surgery, UT Health San Antonio, San Antonio, TX, USA; Assistant Professor, UT Health San Antonio, Long School of Medicine, Department of Neurosurgery, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA; Assistant Professor, UT Health San Antonio, Department of Pediatrics, 7703 Floyd Curl Dr, San Antonio, TX, 78249, USA; Cleft and Craniofacial Team, University Health System, 4502 Medical Drive, San Antonio, TX 78229.
| | - Ramon L Ruiz
- Chief Physician Executive, Pediatric Service Line, Orlando Health Medical Group, Director, Pediatric Craniomaxillofacial Surgery, Orlando Health- Arnold Palmer Hospital for Children, Associate Professor of Surgery, University of Central Florida College of Medicine
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24
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Lesciotto KM, Tomlinson L, Leonard S, Richtsmeier JT. Embryonic and Early Postnatal Cranial Bone Volume and Tissue Mineral Density Values for C57BL/6J Laboratory Mice. Dev Dyn 2022; 251:1196-1208. [PMID: 35092111 PMCID: PMC9250594 DOI: 10.1002/dvdy.458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background Laboratory mice are routinely used in craniofacial research based on the relatively close genetic relationship and conservation of developmental pathways between humans and mice. Since genetic perturbations and disease states may have localized effects, data from individual cranial bones are valuable for the interpretation of experimental assays. We employ high‐resolution microcomputed tomography to characterize cranial bones of C57BL/6J mice at embryonic day (E) 15.5 and E17.5, day of birth (P0), and postnatal day 7 (P7) and provide estimates of individual bone volume and tissue mineral density (TMD). Results Average volume and TMD values are reported for individual bones. Significant differences in volume and TMD during embryonic ages likely reflect early mineralization of cranial neural crest‐derived and intramembranously forming bones. Although bones of the face and vault had higher TMD values during embryonic ages, bones of the braincase floor had significantly higher TMD values by P7. Conclusions These ontogenetic data on cranial bone volume and TMD serve as a reference standard for future studies using mice bred on a C57BL/6J genetic background. Our findings also highlight the importance of differentiating “control” data from mice that are presented as “unaffected” littermates, particularly when carrying a single copy of a cre‐recombinase gene. Higher average volume and density of cranial neural crest‐derived and intramembranously‐forming bones during embryonic development. Higher average density in bones of the braincase floor during early postnatal development. Ontogenetic data on cranial bone volume and TMD serve as a reference standard for mice bred on a C57BL/6J genetic background.
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Affiliation(s)
- Kate M Lesciotto
- College of Osteopathic Medicine, Sam Houston State University, Conroe, TX, USA
| | | | - Steven Leonard
- College of Medicine, Drexel University, Philadelphia, PA, USA
| | - Joan T Richtsmeier
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
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25
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Rignol G, Garcia S, Authier F, Smith K, Tosello L, Marsault R, Dellugat P, Goncalves D, Brouillard M, Stavenhagen J, Santarelli L, Czech C, Gouze E. Longitudinal Imaging of the Skull Base Synchondroses Demonstrate Prevention of a Premature Ossification After Recifercept Treatment in Mouse Model of Achondroplasia. JBMR Plus 2021; 6:e10568. [PMID: 35229060 PMCID: PMC8861980 DOI: 10.1002/jbm4.10568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 09/12/2021] [Accepted: 10/08/2021] [Indexed: 01/06/2023] Open
Affiliation(s)
- Guylene Rignol
- Rare Disease Unit Pfizer, Research and Development Nice France
| | | | | | - Kaamula Smith
- Université Côte d'Azur, CNRS, Inserm, iBV Nice France
| | | | | | - Pierre Dellugat
- Rare Disease Unit Pfizer, Research and Development Nice France
| | - Diogo Goncalves
- Rare Disease Unit Pfizer, Research and Development Nice France
| | | | | | | | - Christian Czech
- Rare Disease Unit Pfizer, Research and Development Nice France
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26
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Eisová S, Naňka O, Velemínský P, Bruner E. Craniovascular traits and braincase morphology in craniosynostotic human skulls. J Anat 2021; 239:1050-1065. [PMID: 34240418 PMCID: PMC8546506 DOI: 10.1111/joa.13506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022] Open
Abstract
Middle meningeal vessels, dural venous sinuses, and emissary veins leave imprints and canals in the endocranium, and thus provide evidence of vascular patterns in osteological samples. This paper investigates whether craniovascular morphology undergoes changes in craniosynostotic human skulls, and if specific alterations may reflect structural and functional relationships in the cranium. The analyzed osteological sample consists of adult individuals with craniosynostoses generally associated with dolichocephalic or brachycephalic proportions, and a control sample of anatomically normal adult skulls. The pattern and dominance of the middle meningeal artery, the morphology of the confluence of the sinuses, and the size and number of the emissary foramina were evaluated. Craniovascular morphology was more diverse in craniosynostotic skulls than in anatomically normal skulls. The craniosynostotic skulls often displayed enlarged occipito-marginal sinuses and more numerous emissary foramina. The craniosynostotic skulls associated with more brachycephalic morphology often presented enlarged emissary foramina, while the craniosynostotic skulls associated with dolichocephalic effects frequently displayed more developed posterior branches of the middle meningeal artery. The course and morphology of the middle meningeal vessels, dural venous sinuses, and emissary veins in craniosynostotic skulls can be related to the redistribution of growth forces, higher intracranial pressure, venous hypertension, or thermal constraints. These functional and structural changes are of interest in both anthropology and medicine, involving epigenetic traits that concern the functional and ontogenetic balance between soft and hard tissues.
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Affiliation(s)
- Stanislava Eisová
- Katedra antropologie a genetiky člověkaPřírodovědecká fakultaUniverzita KarlovaPragueCzech Republic
- Antropologické odděleníPřírodovědecké muzeum, Národní muzeumPragueCzech Republic
| | - Ondřej Naňka
- Anatomický ústav1. lékařská fakultaUniverzita KarlovaPragueCzech Republic
| | - Petr Velemínský
- Antropologické odděleníPřírodovědecké muzeum, Národní muzeumPragueCzech Republic
| | - Emiliano Bruner
- Programa de PaleobiologíaCentro Nacional de Investigación sobre la Evolución HumanaBurgosSpain
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27
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Nikolova S, Toneva D, Agre G, Lazarov N. Influence of persistent metopic suture on sagittal suture closure. Ann Anat 2021; 239:151811. [PMID: 34384857 DOI: 10.1016/j.aanat.2021.151811] [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: 06/05/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Metopic suture lies between the halves of the growing frontal bone and usually closes in early infancy. If the metopic suture fails to close it persists in adulthood and could be considered an anterior continuation of the sagittal suture (SS). This study aimed to investigate if the metopic suture persistence is related to any significant deviations from the normal SS maturation. We also aimed to elaborate linear regression models for age-at-death prediction of the metopic crania and to compare their accuracy with the models developed on the control ones. METHODS The SS was investigated in a total of 122 dry adult contemporary male crania of known age-at-death divided in a metopic series (n = 34) and a control one (n = 88). The crania were scanned and high-resolution volumetric images were generated using an industrial μCT system. The SS closure degree was assessed on cross-sectional tomograms using a scale of grades. Both series were compared and linear regression models for age-at-death prediction were elaborated. RESULTS The comparison between both series showed that the degree of SS closure differs significantly in all SS sections and bone layers and it is considerably lower in the metopic series. The elaborated linear regression models showed that the error in the age-at-death prediction of the metopic crania is almost two times bigger than that in the control. CONCLUSIONS The SS closure in metopic crania is significantly delayed compared to the control, which means that it is entirely unreliable and misleading as an indicator for age-at-death prediction.
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Affiliation(s)
- Silviya Nikolova
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria.
| | - Diana Toneva
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Gennady Agre
- Department of Artificial Intelligences and Language Technologies, Institute of Information and Communication Technologies, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Nikolai Lazarov
- Department of Anatomy and Histology, Medical University of Sofia, 1431 Sofia, Bulgaria
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28
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Katsuragi SY, Hirose E, Arai Y, Otsuki Y, Ohki S, Kobayashi H. Autopsy Case of Pfeiffer Syndrome Type 2, a Phenotype of Fibroblast Growth Factor Receptor-Associated Craniosynostosis Syndromes, with Tracheal Cartilage Sleeve and Abnormal Hyperplasia of Bronchial Cartilages. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932450. [PMID: 34366428 PMCID: PMC8363655 DOI: 10.12659/ajcr.932450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pfeiffer syndrome (PS) is a fibroblast growth factor receptor (FGFR)-associated craniosynostosis syndrome, characterized by abnormally broad and medially deviated thumbs and great toes. Tracheal cartilage sleeve (TCS) is associated with several FGFR-associated craniosynostosis syndromes, including PS. TCS is an airway malformation in which the tracheal cartilage rings fuse with each other to form a sleeve of cartilage. CASE REPORT The patient was a 4-year-old girl with PS, TCS, and abnormal hyperplasia of non-fused intrapulmonary cartilages. The patient showed cranial dysplasia on prenatal ultrasonography. At birth, a cloverleaf skull in association with hydrocephalus and digital malformations was apparent. These findings were consistent with PS type 2. The diagnosis of PS type 2 was confirmed from a genetic test detecting a FGFR2 mutation (Y340C). During the clinical course, she underwent several surgeries, including ventriculoperitoneal shunts, sequential cranioplasty surgeries, and tracheotomy due to upper airway abnormalities. At 4 years old, she died of multiple organ failure following aspiration pneumonia. The autopsy revealed that the tracheal cartilages had fused with each other, resulting in a condition called TCS, in which the cartilage rings and tracheal ligaments were absent. The lungs were poorly aerated, and the dilated bronchi had thickened walls surrounded by many cartilage fragments, mainly at the hilum. These cartilages tended to overlap at both ends, did not fuse, and were greatly altered in size and shape. CONCLUSIONS We report the results of autopsy for PS with the first histopathological findings for the lungs and other visceral organs.
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Affiliation(s)
- Shin-Ya Katsuragi
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Etsuko Hirose
- Department of Neonatology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshifumi Arai
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Shigeru Ohki
- Department of Neonatology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Hiroshi Kobayashi
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.,Department of Pathology, Tachikawa General Hospital, Nagaoka, Niigata, Japan
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29
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Salam AA, Ibbett I, Thani N. Material of Choice in Pediatric Cranioplasty. INDIAN JOURNAL OF NEUROSURGERY 2021. [DOI: 10.1055/s-0040-1716933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Abstract
Background Current evidence is lacking regarding the optimum material required for cranioplasty in the pediatric population when native bone cannot be replaced. The aim of our survey was to examine current practice in Australia and New Zealand regarding pediatric cranioplasty material.
Methods The online tool SurveyMonkey was used to survey 244 neurosurgeons in Australasia. The survey consisted of five questions concerning preference of material and donor origin for pediatric cranioplasty.
Results Twenty-two neurosurgeons (9%) participated. The results indicate that with small skull defects (< 3 cm) in patients aged 0 to 2years, conservative management with observation alone is the preferred option (65%). In patients aged 3 to 10 years, autologous donor bone was the most popular option, whereas for 11+ years, hydroxyapatite (HA) was the material of choice, followed by titanium. For defects of more than 3 cm, autologous donor bone was preferred in under 11 years. In patients older than 11 years, titanium was the preferred choice (46.67%). The preferred donor origin for autologous cranioplasty in small skull defects (< 3 cm) was split calvarial grafts for all age groups. However, 68.42% of respondents managed those under 2 years conservatively. In large skull defects (> 3 cm), the preferred donor origin was split calvarial grafts for patients older than 3 years (48.3%). In patients aged 0 to 2 years, exchange cranioplasty was the preferred option when cranioplasty was performed.
Conclusion The current practice in Australia and New Zealand is to use autologous donor bone in preference to synthetic materials for cranioplasty in children under 11 years. In children older than 11 years, hydroxyapatite and titanium are the materials of choice.
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Affiliation(s)
- Anooja Abdul Salam
- Department of Neurosurgery, Royal Hobart Hospital, Affiliated to University of Tasmania, Hobart, Tasmania, Australia
| | - Imogen Ibbett
- Department of Spine, Mater Hospital, Brisbane, Australia
| | - Nova Thani
- Department of Neurosurgery, Royal Hobart Hospital, Affiliated to University of Tasmania, Hobart, Tasmania, Australia
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30
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Menon S, Salhotra A, Shailendra S, Tevlin R, Ransom RC, Januszyk M, Chan CKF, Behr B, Wan DC, Longaker MT, Quarto N. Skeletal stem and progenitor cells maintain cranial suture patency and prevent craniosynostosis. Nat Commun 2021; 12:4640. [PMID: 34330896 PMCID: PMC8324898 DOI: 10.1038/s41467-021-24801-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/07/2021] [Indexed: 12/29/2022] Open
Abstract
Cranial sutures are major growth centers for the calvarial vault, and their premature fusion leads to a pathologic condition called craniosynostosis. This study investigates whether skeletal stem/progenitor cells are resident in the cranial sutures. Prospective isolation by FACS identifies this population with a significant difference in spatio-temporal representation between fusing versus patent sutures. Transcriptomic analysis highlights a distinct signature in cells derived from the physiological closing PF suture, and scRNA sequencing identifies transcriptional heterogeneity among sutures. Wnt-signaling activation increases skeletal stem/progenitor cells in sutures, whereas its inhibition decreases. Crossing Axin2LacZ/+ mouse, endowing enhanced Wnt activation, to a Twist1+/- mouse model of coronal craniosynostosis enriches skeletal stem/progenitor cells in sutures restoring patency. Co-transplantation of these cells with Wnt3a prevents resynostosis following suturectomy in Twist1+/- mice. Our study reveals that decrease and/or imbalance of skeletal stem/progenitor cells representation within sutures may underlie craniosynostosis. These findings have translational implications toward therapeutic approaches for craniosynostosis.
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Affiliation(s)
- Siddharth Menon
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Ankit Salhotra
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Siny Shailendra
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Ruth Tevlin
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Ryan C Ransom
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Januszyk
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Charles K F Chan
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Björn Behr
- Department of Plastic Surgery, University Hospital Bergmannsheil Bochum, Bochum, Germany
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael T Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Natalina Quarto
- Hagey Laboratory for Pediatric Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
- Dipartimento di Scienze Biomediche Avanzate, Universita' degli Studi di Napoli Federico II, Napoli, Italy.
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Evaluating the Utility of Routine Computed Tomography Scans after Cranial Vault Reconstruction for Children with Craniosynostosis. Plast Reconstr Surg 2021; 148:63e-70e. [PMID: 34181612 DOI: 10.1097/prs.0000000000008056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Postoperative computed tomography scans allow for evaluation of the structural results of cranial vault reconstruction and potential surgical concerns. The authors evaluated the clinical utility of routine postoperative scans to identify relevant surgical findings in children treated for craniosynostosis. METHODS The authors conducted a retrospective study of postoperative computed tomography reports for patients with craniosynostosis following cranial vault reconstruction during a 9-year period at their tertiary care pediatric hospital. They categorized postoperative computed tomography findings as typical, atypical, or indeterminate. Images with reported indeterminate or atypical findings were reviewed and verified by a pediatric neuroradiologist and a pediatric neurological surgeon. Clinical outcomes of patients with abnormal postoperative images were assessed with chart review for clinical relevance. RESULTS Postoperative computed tomography radiology reports for 548 operations in 506 participants were included. Most participants had single-suture craniosynostosis (89 percent), were male (64 percent), and under 1 year of age (78 percent). Surgically concerning scans were described in 52 reports (<9.5 percent), and the research team's pediatric neuroradiologist confirmed abnormal findings in 36 (6.5 percent). Potentially relevant abnormal findings included subdural blood (n = 18), subarachnoid blood (n = 4), intraparenchymal findings (n = 6), bone abnormalities (n = 5), vascular injury (n = 3), and increased ventricular size (n = 2). Most cases with abnormal findings did not require additional observation nor intervention. Only three cases (of 548; 0.55 percent) required further intervention, which included additional medical management (n = 2) and return to the operating room (n = 1). CONCLUSION Abnormal findings on routine computed tomography scans after cranial vault reconstruction are uncommon and rarely result in an urgent surgical or medical intervention. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, IV.
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Bautista G. Craniosynostosis: Neonatal Perspectives. Neoreviews 2021; 22:e250-e257. [PMID: 33795400 DOI: 10.1542/neo.22-4-e250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Craniosynostosis is the premature fusion of 1 or more sutures that normally separate the bony plates of an infant's skull and occurs in about 1 in 2,000 to 2,500 live births. Primary or congenital craniosynostoses represent the majority of cases and consist of single-suture and multisuture synostoses. Multisuture synostoses are typically associated with distinct craniofacial syndromes, including Muenke syndrome, Apert syndrome, Crouzon syndrome, and Pfeiffer syndrome, and are thus categorized under syndromic craniosynostoses. Secondary causes of craniosynostoses include metabolic or hematologic disorders that affect bone metabolism and typically present much later than primary synostoses. The severity of the deformity and the presence of increased intracranial pressure dictate the need for early surgical intervention, prompting the importance of early recognition and timely referral. Infants with craniosynostosis are also at increased risk for neurodevelopmental impairment and thus require close follow-up and monitoring. The early recognition and referral of craniosynostosis is imperative for the optimization of management and minimization of potential neurologic impairments that may develop.
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Affiliation(s)
- Geoanna Bautista
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Mattel Children's Hospital and the David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
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White HE, Goswami A, Tucker AS. The Intertwined Evolution and Development of Sutures and Cranial Morphology. Front Cell Dev Biol 2021; 9:653579. [PMID: 33842480 PMCID: PMC8033035 DOI: 10.3389/fcell.2021.653579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022] Open
Abstract
Phenotypic variation across mammals is extensive and reflects their ecological diversification into a remarkable range of habitats on every continent and in every ocean. The skull performs many functions to enable each species to thrive within its unique ecological niche, from prey acquisition, feeding, sensory capture (supporting vision and hearing) to brain protection. Diversity of skull function is reflected by its complex and highly variable morphology. Cranial morphology can be quantified using geometric morphometric techniques to offer invaluable insights into evolutionary patterns, ecomorphology, development, taxonomy, and phylogenetics. Therefore, the skull is one of the best suited skeletal elements for developmental and evolutionary analyses. In contrast, less attention is dedicated to the fibrous sutural joints separating the cranial bones. Throughout postnatal craniofacial development, sutures function as sites of bone growth, accommodating expansion of a growing brain. As growth frontiers, cranial sutures are actively responsible for the size and shape of the cranial bones, with overall skull shape being altered by changes to both the level and time period of activity of a given cranial suture. In keeping with this, pathological premature closure of sutures postnatally causes profound misshaping of the skull (craniosynostosis). Beyond this crucial role, sutures also function postnatally to provide locomotive shock absorption, allow joint mobility during feeding, and, in later postnatal stages, suture fusion acts to protect the developed brain. All these sutural functions have a clear impact on overall cranial function, development and morphology, and highlight the importance that patterns of suture development have in shaping the diversity of cranial morphology across taxa. Here we focus on the mammalian cranial system and review the intrinsic relationship between suture development and morphology and cranial shape from an evolutionary developmental biology perspective, with a view to understanding the influence of sutures on evolutionary diversity. Future work integrating suture development into a comparative evolutionary framework will be instrumental to understanding how developmental mechanisms shaping sutures ultimately influence evolutionary diversity.
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Affiliation(s)
- Heather E White
- Department of Life Sciences, Natural History Museum, London, United Kingdom.,Centre for Craniofacial and Regenerative Biology, King's College London, London, United Kingdom.,Division of Biosciences, University College London, London, United Kingdom
| | - Anjali Goswami
- Department of Life Sciences, Natural History Museum, London, United Kingdom.,Division of Biosciences, University College London, London, United Kingdom
| | - Abigail S Tucker
- Centre for Craniofacial and Regenerative Biology, King's College London, London, United Kingdom
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Mitteroecker P, Bartsch S, Erkinger C, Grunstra NDS, Le Maître A, Bookstein FL. Morphometric Variation at Different Spatial Scales: Coordination and Compensation in the Emergence of Organismal Form. Syst Biol 2021; 69:913-926. [PMID: 32011716 PMCID: PMC7440742 DOI: 10.1093/sysbio/syaa007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/27/2020] [Accepted: 01/29/2020] [Indexed: 12/16/2022] Open
Abstract
It is a classic aim of quantitative and evolutionary biology to infer genetic architecture and potential evolutionary responses to selection from the variance–covariance structure of measured traits. But a meaningful genetic or developmental interpretation of raw covariances is difficult, and classic concepts of morphological integration do not directly apply to modern morphometric data. Here, we present a new morphometric strategy based on the comparison of morphological variation across different spatial scales. If anatomical elements vary completely independently, then their variance accumulates at larger scales or for structures composed of multiple elements: morphological variance would be a power function of spatial scale. Deviations from this pattern of “variational self-similarity” (serving as a null model of completely uncoordinated growth) indicate genetic or developmental coregulation of anatomical components. We present biometric strategies and R scripts for identifying patterns of coordination and compensation in the size and shape of composite anatomical structures. In an application to human cranial variation, we found that coordinated variation and positive correlations are prevalent for the size of cranial components, whereas their shape was dominated by compensatory variation, leading to strong canalization of cranial shape at larger scales. We propose that mechanically induced bone formation and remodeling are key mechanisms underlying compensatory variation in cranial shape. Such epigenetic coordination and compensation of growth are indispensable for stable, canalized development and may also foster the evolvability of complex anatomical structures by preserving spatial and functional integrity during genetic responses to selection.[Cranial shape; developmental canalization; evolvability; morphological integration; morphometrics; phenotypic variation; self-similarity.]
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Affiliation(s)
- Philipp Mitteroecker
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria.,KLI Institute for Evolution and Cognition Research, Klosterneuburg, Austria
| | - Silvester Bartsch
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria
| | - Corinna Erkinger
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria
| | - Nicole D S Grunstra
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria.,KLI Institute for Evolution and Cognition Research, Klosterneuburg, Austria.,Mammal Collection, Natural History Museum Vienna, Vienna, Austria
| | - Anne Le Maître
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria.,Laboratoire Paléontologie Evolution Paléoécosystèmes Paléoprimatologie (PALEVOPRIM) - UMR 7262 CNRS INEE, Université de Poitiers, Poitiers, France.,Department of Palaeontology, University of Vienna, Vienna, Austria
| | - Fred L Bookstein
- Department of Evolutionary Biology, University of Vienna, Vienna, Austria.,Department of Statistics, University of Washington, Seattle, WA, USA
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Tissue-Nonspecific Alkaline Phosphatase-A Gatekeeper of Physiological Conditions in Health and a Modulator of Biological Environments in Disease. Biomolecules 2020; 10:biom10121648. [PMID: 33302551 PMCID: PMC7763311 DOI: 10.3390/biom10121648] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 12/15/2022] Open
Abstract
Tissue-nonspecific alkaline phosphatase (TNAP) is a ubiquitously expressed enzyme that is best known for its role during mineralization processes in bones and skeleton. The enzyme metabolizes phosphate compounds like inorganic pyrophosphate and pyridoxal-5′-phosphate to provide, among others, inorganic phosphate for the mineralization and transportable vitamin B6 molecules. Patients with inherited loss of function mutations in the ALPL gene and consequently altered TNAP activity are suffering from the rare metabolic disease hypophosphatasia (HPP). This systemic disease is mainly characterized by impaired bone and dental mineralization but may also be accompanied by neurological symptoms, like anxiety disorders, seizures, and depression. HPP characteristically affects all ages and shows a wide range of clinical symptoms and disease severity, which results in the classification into different clinical subtypes. This review describes the molecular function of TNAP during the mineralization of bones and teeth, further discusses the current knowledge on the enzyme’s role in the nervous system and in sensory perception. An additional focus is set on the molecular role of TNAP in health and on functional observations reported in common laboratory vertebrate disease models, like rodents and zebrafish.
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Morice A, Cornette R, Giudice A, Collet C, Paternoster G, Arnaud É, Galliani E, Picard A, Legeai-Mallet L, Khonsari RH. Early mandibular morphological differences in patients with FGFR2 and FGFR3-related syndromic craniosynostoses: A 3D comparative study. Bone 2020; 141:115600. [PMID: 32822871 DOI: 10.1016/j.bone.2020.115600] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 01/04/2023]
Abstract
Syndromic craniosynostoses are defined by the premature fusion of one or more cranial and facial sutures, leading to skull vault deformation, and midfacial retrusion. More recently, mandibular shape modifications have been described in FGFR-related craniosynostoses, which represent almost 75% of the syndromic craniosynostoses. Here, further characterisation of the mandibular phenotype in FGFR-related craniosynostoses is provided in order to confirm mandibular shape modifications, as this could contribute to a better understanding of the involvement of the FGFR pathway in craniofacial development. The aim of our study was to analyse early mandibular morphology in a cohort of patients with FGFR2- (Crouzon and Apert) and FGFR3- (Muenke and Crouzonodermoskeletal) related syndromic craniosynostoses. We used a comparative geometric morphometric approach based on 3D imaging. Thirty-one anatomical landmarks and eleven curves with sliding semi-landmarks were defined to model the shape of the mandible. In total, 40 patients (12 with Crouzon, 12 with Apert, 12 with Muenke and 4 with Crouzonodermoskeletal syndromes) and 40 age and sex-matched controls were included (mean age: 13.7 months ±11.9). Mandibular shape differed significantly between controls and each patient group based on geometric morphometrics. Mandibular shape in FGFR2-craniosynostoses was characterized by open gonial angle, short ramus height, and high and prominent symphysis. Short ramus height appeared more pronounced in Apert than in Crouzon syndrome. Additionally, narrow inter-condylar and inter-gonial distances were observed in Crouzon syndrome. Mandibular shape in FGFR3-craniosynostoses was characterized by high and prominent symphysis and narrow inter-gonial distance. In addition, narrow condylar processes affected patients with Crouzonodermoskeletal syndrome. Statistical analysis of variance showed significant clustering of Apert and Crouzon, Crouzon and Muenke, and Apert and Muenke patients (p < 0.05). Our results confirm distinct mandibular shapes at early ages in FGFR2- (Crouzon and Apert syndromes) and FGFR3-related syndromic craniosynostoses (Muenke and Crouzonodermoskeletal syndromes) and reinforce the hypothesis of genotype-phenotype correspondence concerning mandibular morphology.
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Affiliation(s)
- A Morice
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares MAFACE Fentes et Malformations Faciales, Université de Paris, Paris, France; Laboratoire 'Bases Moléculaires et Physiopathologiques des Ostéochondrodysplasies', INSERM UMR 1163, Institut Imagine, Paris, France.
| | - R Cornette
- Institut de Systématique, Evolution, Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, Sorbonne Université, Ecole Pratique des Hautes Etudes, Université des Antilles, CNRS, CP 50, 57 rue Cuvier, 75005 Paris, France
| | - A Giudice
- Università Degli Studi di Catanzaro 'Magna Graecia', Catanzaro, Italy
| | - C Collet
- BIOSCAR, INSERM U1132, Université de Paris, Hôpital Lariboisière, 75010 Paris, France; Service de Biochimie et Biologie Moléculaire, CHU-Paris-GH Saint Louis Lariboisière Widal, Paris, France
| | - G Paternoster
- Service de Neurochirurgie, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST Craniosténoses et Malformations Craniofaciales, Université de Paris, Paris, France
| | - É Arnaud
- Service de Neurochirurgie, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST Craniosténoses et Malformations Craniofaciales, Université de Paris, Paris, France
| | - E Galliani
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares MAFACE Fentes et Malformations Faciales, Université de Paris, Paris, France
| | - A Picard
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares MAFACE Fentes et Malformations Faciales, Université de Paris, Paris, France
| | - L Legeai-Mallet
- Laboratoire 'Bases Moléculaires et Physiopathologiques des Ostéochondrodysplasies', INSERM UMR 1163, Institut Imagine, Paris, France
| | - R H Khonsari
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares MAFACE Fentes et Malformations Faciales, Université de Paris, Paris, France; Laboratoire 'Bases Moléculaires et Physiopathologiques des Ostéochondrodysplasies', INSERM UMR 1163, Institut Imagine, Paris, France; Service de Neurochirurgie, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST Craniosténoses et Malformations Craniofaciales, Université de Paris, Paris, France
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Craniosynostosis: A Reversible Pathology?: Comment. J Craniofac Surg 2020; 31:2064. [PMID: 32649550 DOI: 10.1097/scs.0000000000006729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pressler MP, Hallac RR, Geisler EL, Seaward JR, Kane AA. Comparison of Head Shape Outcomes in Metopic Synostosis Using Limited Strip Craniectomy and Open Vault Reconstruction Techniques. Cleft Palate Craniofac J 2020; 58:669-677. [PMID: 33153285 DOI: 10.1177/1055665620969294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM Metopic craniosynostosis (MCS), with its trigonocephalic head shape, is often treated with either limited incision strip craniectomy (LISC) followed by helmet orthotic treatment, or open cranial vault reconstruction techniques (OCVR). There is controversy regarding resultant shape outcomes among craniofacial surgeons. Those adverse to LISC claim normal head shape is never attained, while proponents believe there is gradual correction to an equivalent outcome. This study aims to quantitate, over time, the three-dimensional (3D) head shapes in patients who have undergone LISC or OCVR intervention for MCS. METHODS Sixty-three 3D images of 26 patients with MCS were analyzed retrospectively. Head shape analyses were performed at: (1) preoperative, (2) 1-month postoperative, (3) 10 to 14 months postoperative (1 year), and (4) 2 years postoperative. Composite 3D head shapes of patients were compared at each time point. Two-dimensional (2D) standardized cross sections of the forehead were also compared. RESULTS Composite head shapes for both groups were nested, to allow visual comparison as the child's forehead grows and expands. The difference between LISC and OCVR 2D cross sections was calculated; 108.26 mm preoperatively, 127.18 mm after 1-month postoperative, 51.05 mm after 10 to 14 months postoperative, and 27.03 mm after 2 years postoperative. CONCLUSIONS This study found excellent head shape outcomes for both the LISC and OCVR techniques at 2 years of age. It also corroborates the slow and progressive improvement in head shape with the LISC technique. This study highlights the advantages of 3D photography for measurement of contour outcomes, utilizing both 2D vector and 3D whole head analytical techniques.
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Affiliation(s)
- Mark Philip Pressler
- Department of Plastic Surgery, 89063UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, 2755Children's Medical Center, Dallas, TX, USA
| | - Rami R Hallac
- Department of Plastic Surgery, 89063UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, 2755Children's Medical Center, Dallas, TX, USA
| | - Emily L Geisler
- Department of Plastic Surgery, 89063UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, 2755Children's Medical Center, Dallas, TX, USA
| | - James R Seaward
- Department of Plastic Surgery, 89063UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, 2755Children's Medical Center, Dallas, TX, USA
| | - Alex A Kane
- Department of Plastic Surgery, 89063UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, 2755Children's Medical Center, Dallas, TX, USA
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Bozkurt S, Borghi A, van de Lande LS, Jeelani NUO, Dunaway DJ, Schievano S. Computational modelling of patient specific spring assisted lambdoid craniosynostosis correction. Sci Rep 2020; 10:18693. [PMID: 33122820 PMCID: PMC7596227 DOI: 10.1038/s41598-020-75747-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Abstract
Lambdoid craniosynostosis (LC) is a rare non-syndromic craniosynostosis characterised by fusion of the lambdoid sutures at the back of the head. Surgical correction including the spring assisted cranioplasty is the only option to correct the asymmetry at the skull in LC. However, the aesthetic outcome from spring assisted cranioplasty may remain suboptimal. The aim of this study is to develop a parametric finite element (FE) model of the LC skulls that could be used in the future to optimise spring surgery. The skull geometries from three different LC patients who underwent spring correction were reconstructed from the pre-operative computed tomography (CT) in Simpleware ScanIP. Initially, the skull growth between the pre-operative CT imaging and surgical intervention was simulated using MSC Marc. The osteotomies and spring implantation were performed to simulate the skull expansion due to the spring forces and skull growth between surgery and post-operative CT imaging in MSC Marc. Surface deviation between the FE models and post-operative skull models reconstructed from CT images changed between ± 5 mm over the skull geometries. Replicating spring assisted cranioplasty in LC patients allow to tune the parameters for surgical planning, which may help to improve outcomes in LC surgeries in the future.
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Affiliation(s)
- Selim Bozkurt
- Institute of Cardiovascular Science, University College London, London, UK. .,University College London, Great Ormond Street Institute of Child Health, London, UK.
| | - Alessandro Borghi
- University College London, Great Ormond Street Institute of Child Health, London, UK.,Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
| | - Lara S van de Lande
- University College London, Great Ormond Street Institute of Child Health, London, UK.,Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
| | - N U Owase Jeelani
- University College London, Great Ormond Street Institute of Child Health, London, UK.,Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
| | - David J Dunaway
- University College London, Great Ormond Street Institute of Child Health, London, UK.,Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
| | - Silvia Schievano
- University College London, Great Ormond Street Institute of Child Health, London, UK.,Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK
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40
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Hassanein AG, Fadle KN. Assessment of the Outcome of Calvarial Vault Remodeling and Spring-Mediated Cranioplasty in the Correction of Isolated Sagittal Suture Synostosis. J Craniofac Surg 2020; 31:e747-e752. [PMID: 32890161 DOI: 10.1097/scs.0000000000006807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sagittal synostosis is the commonest form of nonsyndromic isolated craniosynostosis. Calvarial vault remodeling (CVR) and spring-mediated cranioplasty (SMC) are the commonly used correction techniques. AIM OF THE WORK To study and compare clinical and radiographic outcomes of CVR and SMC in the correction of isolated sagittal suture synostosis. METHODS A prospective cohort with the patients were divided into group; I (SMC) and II (CVR), each 15 patients. They were observed to evaluate the outcome and detect complications. RESULTS Mean operative time was 59.2 minutes in SMC and 184 minutes in CVR. Mean intraoperative blood loss was 26 mL in SMC and 64.7 mL in CVR. Intraoperative complications in SMC were dural tear in 1 patient and superior sagittal sinus injury in another patient, while in CVR 2 patients with dural tears and a 3rd with superior sagittal sinus injury. Postoperative complications in SMC were exposed spring, gaped wound, and parietal eminence elevation, while in CVR 2 patients needed blood transfusion. The mean hospital stays was 1.4 days in SMC and 4.1 days in CVR. In SMC, the relative increase in cephalic index varied between 5.5% and 8.2%, while for CVR, it varied between 5.1% and 7.9%. CONCLUSION The SMC and CVR are safe procedures, with good long-term results and significant objective changes toward normalization of the skull morphology in isolated sagittal craniosynostosis. The SMC is less invasive and associated with reduced hospital stays, decreased blood loss, and can be performed at a younger age than CVR with a lower morbidity.
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Affiliation(s)
| | - Khalid Nasser Fadle
- Neurosurgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
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Classification of Subtypes of Crouzon Syndrome Based on the Type of Vault Suture Synostosis. J Craniofac Surg 2020; 31:678-684. [PMID: 32068731 DOI: 10.1097/scs.0000000000006173] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with Crouzon syndrome develop various types of anatomic deformities due to different forms of craniosynostosis, yet they have similar craniofacial characteristics. However, exact homology is not evident. Different pathology then may be best treated by different forms of surgical technique. Therefore, precise classification of Crouzon syndrome, based on individual patterns of cranial suture involvement is needed. METHODS Ninety-five computed tomography (CT) scans (Crouzon, n = 33; control, n = 62) were included in this study. All the CT scans are divided into 4 types based on premature closure of sutures: class I = coronal and lambdoidal synostosis; class II = sagittal synostosis; class III = pansynostosis; and class IV = "Others." The CT scan anatomy was measured by Materialise software. RESULTS The class III, pansynostosis, is the most prevalent (63.6%). The classes I, III, and IV of Crouzon have significantly shortened entire anteroposterior cranial base length, with the shortest base length in class III. The external cranial measurements in class I show primarily a decreased posterior facial skeleton, while the class III presented with holistic facial skeleton reduction. Class II has the least severe craniofacial malformations, while class III had the most severe. CONCLUSION The morphology of patients with Crouzon syndrome is not identical in both cranial base and facial characteristics, especially when they associated with different subtypes of cranial suture synostosis. The classification of Crouzon syndrome proposed in this study, summarizes the differences among each subgroup of craniosynostosis suture involvement, which, theoretically, may ultimately influence both the timing and type of surgical intervention.
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What Is the Difference in Cranial Base Morphology in Isolated and Syndromic Bicoronal Synostosis? Plast Reconstr Surg 2020; 146:599-610. [DOI: 10.1097/prs.0000000000007068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dias MS, Samson T, Rizk EB, Governale LS, Richtsmeier JT. Identifying the Misshapen Head: Craniosynostosis and Related Disorders. Pediatrics 2020; 146:peds.2020-015511. [PMID: 32868470 DOI: 10.1542/peds.2020-015511] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Pediatric care providers, pediatricians, pediatric subspecialty physicians, and other health care providers should be able to recognize children with abnormal head shapes that occur as a result of both synostotic and deformational processes. The purpose of this clinical report is to review the characteristic head shape changes, as well as secondary craniofacial characteristics, that occur in the setting of the various primary craniosynostoses and deformations. As an introduction, the physiology and genetics of skull growth as well as the pathophysiology underlying craniosynostosis are reviewed. This is followed by a description of each type of primary craniosynostosis (metopic, unicoronal, bicoronal, sagittal, lambdoid, and frontosphenoidal) and their resultant head shape changes, with an emphasis on differentiating conditions that require surgical correction from those (bathrocephaly, deformational plagiocephaly/brachycephaly, and neonatal intensive care unit-associated skill deformation, known as NICUcephaly) that do not. The report ends with a brief discussion of microcephaly as it relates to craniosynostosis as well as fontanelle closure. The intent is to improve pediatric care providers' recognition and timely referral for craniosynostosis and their differentiation of synostotic from deformational and other nonoperative head shape changes.
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Affiliation(s)
- Mark S Dias
- Section of Pediatric Neurosurgery, Department of Neurosurgery and
| | - Thomas Samson
- Division of Plastic Surgery, Department of Surgery, College of Medicine and
| | - Elias B Rizk
- Section of Pediatric Neurosurgery, Department of Neurosurgery and
| | - Lance S Governale
- Lillian S. Wells Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, Florida
| | - Joan T Richtsmeier
- Department of Anthropology, College of the Liberal Arts and Huck Institutes of the Life Sciences, Pennsylvania State University, State College, Pennsylvania; and
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Nikolova S, Toneva D, Lazarov N. Squamous suture obliteration: frequency and investigation of the associated skull morphology. Anat Sci Int 2020; 96:42-54. [PMID: 32591992 DOI: 10.1007/s12565-020-00555-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 06/16/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the frequency of squamous suture (SqS) obliteration, to estimate the involvement of the major calvarial sutures and those surrounding the temporal squama, and to inspect the neuro- and basicranium for deformities. A series of 211 dry skulls of contemporary adult males were macroscopically observed. The skulls with closed SqS were scanned using an industrial µCT system. Digital morphometry of the skulls with obliterated SqS was performed by recording the 3D coordinates of anatomic landmarks and calculation of linear distances, angles and indices. Obliteration of SqS was observed in 3 (1.42%) skulls. One skull showed bilateral SqS obliteration. The other two cases were unilateral, one right-sided and one left-sided. SqS obliteration seems to be co-ordinated with the closure of the parietomastoid suture, partially related to the closure of the occipitomastoid, sphenoparietal and sphenofrontal sutures, and independent from the closure of the sphenosquamosal suture and the major calvarial sutures. No severe disproportions in the skull configuration were observed in the three investigated cases. The major differences in the complimentary hemicrania concern the parietal and occipital parts of the skull vault. Dorsum sellae erosion, an indicator for raised intracranial pressure, was observed in all three cases.
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Affiliation(s)
- Silviya Nikolova
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology With Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 25, 1113, Sofia, Bulgaria.
| | - Diana Toneva
- Department of Anthropology and Anatomy, Institute of Experimental Morphology, Pathology and Anthropology With Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 25, 1113, Sofia, Bulgaria
| | - Nikolai Lazarov
- Department of Anatomy and Histology, Medical University of Sofia, 1431, Sofia, Bulgaria
- Department of Synaptic Signaling and Communications, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113, Sofia, Bulgaria
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Di Pietro L, Barba M, Prampolini C, Ceccariglia S, Frassanito P, Vita A, Guadagni E, Bonvissuto D, Massimi L, Tamburrini G, Parolini O, Lattanzi W. GLI1 and AXIN2 Are Distinctive Markers of Human Calvarial Mesenchymal Stromal Cells in Nonsyndromic Craniosynostosis. Int J Mol Sci 2020; 21:E4356. [PMID: 32575385 PMCID: PMC7352200 DOI: 10.3390/ijms21124356] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
All skeletal bones house osteogenic stem cell niches, in which mesenchymal stromal cells (MSC) provide progenitors for tissue growth and regeneration. They have been widely studied in long bones formed through endochondral ossification. Limited information is available on the composition of the osteogenic niche in flat bones (i.e., skull vault bones) that develop through direct membranous ossification. Craniosynostosis (CS) is a congenital craniofacial defect due to the excessive and premature ossification of skull vault sutures. This study aimed at analysing the expression of GLI1, AXIN2 and THY1 in the context of the human skull vault, using nonsyndromic forms of CS (NCS) as a model to test their functional implication in the aberrant osteogenic process. The expression of selected markers was studied in NCS patients' calvarial bone specimens, to assess the in vivo location of cells, and in MSC isolated thereof. The marker expression profile was analysed during in vitro osteogenic differentiation to validate the functional implication. Our results show that GLI1 and AXIN2 are expressed in periosteal and endosteal locations within the osteogenic niche of human calvarial bones. Their expression is higher in MSC isolated from calvarial bones than in those isolated from long bones and tends to decrease upon osteogenic commitment and differentiation. In particular, AXIN2 expression was lower in cells isolated from prematurely fused sutures than in those derived from patent sutures of NCS patients. This suggests that AXIN2 could reasonably represent a marker for the stem cell population that undergoes depletion during the premature ossification process occurring in CS.
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Affiliation(s)
- Lorena Di Pietro
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
| | - Marta Barba
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
| | - Chiara Prampolini
- Dipartimento Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Sabrina Ceccariglia
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
| | - Paolo Frassanito
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
| | - Alessia Vita
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
| | - Enrico Guadagni
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
| | - Davide Bonvissuto
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
- Dipartimento Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Massimi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
- Dipartimento Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianpiero Tamburrini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
- Dipartimento Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ornella Parolini
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
| | - Wanda Lattanzi
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.D.P.); (M.B.); (S.C.); (A.V.); (E.G.); (O.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (P.F.); (D.B.); (L.M.); (G.T.)
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Lehner M, Wendling-Keim D, Kunz M, Deininger S, Zundel S, Peraud A, Mast G. On-site CAD templates reduce surgery time for complex craniostenosis repair in infants: a new method. Childs Nerv Syst 2020; 36:793-801. [PMID: 31900627 DOI: 10.1007/s00381-019-04474-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The surgical correction of craniostenosis in children is a time-consuming and taxing procedure. To facilitate this procedure, especially in infants with complex craniostenosis, we refined the computer-aided design and manufacturing technique (CAD/CAM) based on computed tomography (CT)-generated DICOM data. We used cutting guides and molding templates, which allowed the surgeon to reshape and fixate the supraorbital bar extracorporeally on a side table and to control the intracorporal fit without removing the template. METHOD AND PATIENTS To compare our traditional concept with the possibility of preoperative virtual planning (PVP) technique, the surgical treatment and courses of 16 infants with complex craniostenosis following fronto-orbital advancement (FOA) (age range 8-15 months) were analyzed in two groups (group 1: traditional, control group n = 8, group 2: CAD/CAM planned, n = 8). RESULTS While in both groups, the head accurately reshaped postoperatively during the follow-up; the CAD group 2 showed a significantly shorter operating time with a mean of 4 h 25 min compared with group 1 with a mean of 5 h 37 min (p = 0.038). Additionally, the CAD group 2 had a significantly lower volume of blood loss (380 ml vs. 575 ml mean, p = 0.047), lower blood transfusion volume (285 ml vs. 400 ml mean, p = 0.108), lower fresh frozen plasma (FFP) volume (140 ml vs. 275 ml mean, p = 0.019), shorter stay in the pediatric intensive care unit (PICU) (3 vs. 5 days mean (p = 0.002), and shorter total length of hospital stay (6 days vs. 8 days mean, p = 0.002). CONCLUSION CAD/CAM cutting guides and templates offer optimizing operative efficiency, precision, and accuracy in craniostenosis surgery in infants. As shown in this single-center observational study, the use of on-site templates significantly accelerates the reconstruction of the bandeau. The virtual 3D planning technique increases surgical precision without discernible detrimental effects.
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Affiliation(s)
- Markus Lehner
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany. .,Department of Pediatric Surgery, Children's Hospital of Lucerne, Kantonsspital Lucerne, Lucerne, Switzerland.
| | - D Wendling-Keim
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - M Kunz
- Department of Neurosurgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - S Deininger
- Department of Pediatric Surgery, Children's Hospital of Lucerne, Kantonsspital Lucerne, Lucerne, Switzerland.,Department of Neurosurgery, Section Pediatric Neurosurgery, University of Ulm, Ulm, Germany
| | - S Zundel
- Department of Pediatric Surgery, Children's Hospital of Lucerne, Kantonsspital Lucerne, Lucerne, Switzerland
| | - A Peraud
- Department of Neurosurgery, Ludwig-Maximilians-University of Munich, Munich, Germany.,Department of Neurosurgery, Section Pediatric Neurosurgery, University of Ulm, Ulm, Germany
| | - G Mast
- Department of Orofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
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Proctor MR, Meara JG. A review of the management of single-suture craniosynostosis, past, present, and future. J Neurosurg Pediatr 2019; 24:622-631. [PMID: 31786542 DOI: 10.3171/2019.7.peds18585] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Craniosynostosis is a condition in which 2 or more of the skull bones fuse prematurely. The spectrum of the disorder most commonly involves the closure of a single suture in the skull, but it can also involve syndromic diagnoses in which multiple skull bones and/or bones outside of the cranium are affected. Craniosynostosis can result in cosmetic deformity as well as potential limitations in brain growth and development, and the neurocognitive impact of the condition is just starting to be studied more thoroughly. Our knowledge regarding the genetics of this condition has also evolved substantially. In this review, the authors explore the medical and surgical advancements in understanding and treating this condition over the past century, with a focus on how the diagnosis and treatment have evolved. METHODS In this review article, the authors, who are the leaders of a craniofacial team at a major academic pediatric hospital, focus on single-suture craniosynostosis (SSC) affecting the 6 major cranial sutures and discuss the evolution of the treatment of SSC from its early history in modern medicine through the current state of the art and future trends. This discussion is based on the authors' broad experience and a comprehensive review of the literature. SUMMARY The management of SSC has evolved substantially over the past 100 years. There have been major advances in technology and medical knowledge that have allowed for safer treatment of this condition through the use of newer techniques and technologies in the fields of surgery, anesthesia, and critical care. The use of less invasive surgical techniques along with other innovations has led to improved outcomes in SSC patients. The future of SSC treatment will likely be guided by elucidation of the causes of neurocognitive delay in these children and assessment of how the timing and type of surgery can mitigate adverse outcomes.
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Affiliation(s)
| | - John G Meara
- 2Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
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Mercan E, Hopper RA, Maga AM. Cranial growth in isolated sagittal craniosynostosis compared with normal growth in the first 6 months of age. J Anat 2019; 236:105-116. [PMID: 31691965 DOI: 10.1111/joa.13085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2019] [Indexed: 01/22/2023] Open
Abstract
Sagittal craniosynostosis (SCS), the most common type of premature perinatal cranial suture fusion, results in abnormal head shape that requires extensive surgery to correct. It is important to find objective and repeatable measures of severity and surgical outcome to examine the effect of timing and technique on different SCS surgeries. The purpose of this study was to develop statistical models of infant (0-6 months old) skull growth in both normative and SCS subjects (prior to surgery). Our goal was to apply these models to the assessment of differences between these two groups in overall post-natal growth patterns and sutural growth rates as a first step to develop methods for predictive models of surgical outcome. We identified 81 patients with isolated, non-syndromic SCS from Seattle Children's Craniofacial Center patient database who had a preoperative CT exam before the age of 6 months. As a control group, we identified 117 CT exams without any craniofacial abnormalities or bone fractures in the same age group. We first created population-level templates from the CT images of the SCS and normal groups. All CT images from both groups, as well as the canonical templates of both cohorts, were annotated with anatomical landmarks, which were used in a growth model that predicted the locations of these landmarks at a given age based on each population. Using the template images and the landmark positions predicted by the growth models, we created 3D meshes for each week of age up to 6 months for both populations. To analyze the growth patterns at the suture sites, we annotated both templates with additional semi-landmarks equally spaced along the metopic, coronal, sagittal and lambdoidal cranial sutures. By transferring these semi-landmarks to meshes produced from the growth model, we measured the displacement of the bone borders and suture closure rates. We found that the growth at the metopic and coronal sutures were more rapid in the SCS cohort than in the normal cohort. The antero-posterior displacement of the semi-landmarks also indicated a more rapid growth in the sagittal plane in the SCS model than in the normal model. Statistical templates and geometric morphometrics are promising tools for understanding the growth patterns in normal and synostotic populations and to produce objective and reproducible measurements of severity and outcome. Our study is the first of its kind to quantify the bone growth for the first 6 months of life in both normal and sagittal synostosis patients.
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Affiliation(s)
- Ezgi Mercan
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA
| | - Richard A Hopper
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA.,Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA
| | - A Murat Maga
- Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, WA, USA.,Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA
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Lonsdale S, Yong R, Khominsky A, Mihailidis S, Townsend G, Ranjitkar S, Anderson PJ. Craniofacial abnormalities in a murine model of Saethre-Chotzen Syndrome. Ann Anat 2019; 225:33-41. [DOI: 10.1016/j.aanat.2019.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/19/2019] [Accepted: 05/28/2019] [Indexed: 01/23/2023]
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Lee C, Richtsmeier JT, Kraft RH. A coupled reaction-diffusion-strain model predicts cranial vault formation in development and disease. Biomech Model Mechanobiol 2019; 18:1197-1211. [PMID: 31006064 PMCID: PMC6625897 DOI: 10.1007/s10237-019-01139-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/18/2019] [Indexed: 01/16/2023]
Abstract
How cells utilize instructions provided by genes and integrate mechanical forces generated by tissue growth to produce morphology is a fundamental question of biology. Dermal bones of the vertebrate cranial vault are formed through the direct differentiation of mesenchymal cells on the neural surface into osteoblasts through intramembranous ossification. Here we join a self-organizing Turing mechanism, computational biomechanics, and experimental data to produce a 3D representative model of the growing cerebral surface, cranial vault bones, and sutures. We show how changes in single parameters regulating signaling during osteoblast differentiation and bone formation may explain cranial vault shape variation in craniofacial disorders. A key result is that toggling a parameter in our model results in closure of a cranial vault suture, an event that occurred during evolution of the cranial vault and that occurs in craniofacial disorders. Our approach provides an initial and important step toward integrating biomechanics into the genotype phenotype map to explain the production of variation in head morphology by developmental mechanisms.
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Affiliation(s)
- Chanyoung Lee
- Department of Mechanical Engineering, Pennsylvania State University, 341 Leonhard Building, University Park, PA, 16802, USA
| | - Joan T Richtsmeier
- Department of Anthropology, Pennsylvania State University, 409 Carpenter Building, University Park, PA, 16802, USA
| | - Reuben H Kraft
- Department of Mechanical and Nuclear Engineering, Pennsylvania State University, 320 Leonhard Building, University Park, PA, 16802, USA.
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
- Institute for Cyberscience, Pennsylvania State University, University Park, PA, 16802, USA.
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