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Pfitzer C, Schmitt KRL, Benson WD. Human Genetics of Hypoplastic Left Heart Syndrome. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1441:937-945. [PMID: 38884762 DOI: 10.1007/978-3-031-44087-8_60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Hypoplastic left heart syndrome (HLHS) is a severe congenital cardiovascular malformation characterized by hypoplasia of the left ventricle, aorta, and other structures on the left side of the heart. The pathologic definition includes atresia or stenosis of both the aortic and mitral valves. Despite considerable progress in clinical and surgical management of HLHS, mortality and morbidity remain concerns. One barrier to progress in HLHS management is poor understanding of its cause. Several lines of evidence point to genetic origins of HLHS. First, some HLHS cases have been associated with cytogenetic abnormalities (e.g., Turner syndrome). Second, studies of family clustering of HLHS and related cardiovascular malformations have determined HLHS is heritable. Third, genomic regions that encode genes influencing the inheritance of HLHS have been identified. Taken together, these diverse studies provide strong evidence for genetic origins of HLHS and related cardiac phenotypes. However, using simple Mendelian inheritance models, identification of single genetic variants that "cause" HLHS has remained elusive, and in most cases, the genetic cause remains unknown. These results suggest that HLHS inheritance is complex rather than simple. The implication of this conclusion is that researchers must move beyond the expectation that a single disease-causing variant can be found. Utilization of complex models to analyze high-throughput genetic data requires careful consideration of study design.
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Affiliation(s)
- Constanze Pfitzer
- Department of Congenital Heart Disease/Paediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Katharina R L Schmitt
- Department of Congenital Heart Disease/Paediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Woodrow D Benson
- Department of Pediatrics, Herma Heart Center, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
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2
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Rashkin SR, Cleves M, Shaw GM, Nembhard WN, Nestoridi E, Jenkins MM, Romitti PA, Lou XY, Browne ML, Mitchell LE, Olshan AF, Lomangino K, Bhattacharyya S, Witte JS, Hobbs CA. A genome-wide association study of obstructive heart defects among participants in the National Birth Defects Prevention Study. Am J Med Genet A 2022; 188:2303-2314. [PMID: 35451555 PMCID: PMC9283270 DOI: 10.1002/ajmg.a.62759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 01/19/2023]
Abstract
Obstructive heart defects (OHDs) share common structural lesions in arteries and cardiac valves, accounting for ~25% of all congenital heart defects. OHDs are highly heritable, resulting from interplay among maternal exposures, genetic susceptibilities, and epigenetic phenomena. A genome-wide association study was conducted in National Birth Defects Prevention Study participants (Ndiscovery = 3978; Nreplication = 2507), investigating the genetic architecture of OHDs using transmission/disequilibrium tests (TDT) in complete case-parental trios (Ndiscovery_TDT = 440; Nreplication_TDT = 275) and case-control analyses separately in infants (Ndiscovery_CCI = 1635; Nreplication_CCI = 990) and mothers (case status defined by infant; Ndiscovery_CCM = 1703; Nreplication_CCM = 1078). In the TDT analysis, the SLC44A2 single nucleotide polymorphism (SNP) rs2360743 was significantly associated with OHD (pdiscovery = 4.08 × 10-9 ; preplication = 2.44 × 10-4 ). A CAPN11 SNP (rs55877192) was suggestively associated with OHD (pdiscovery = 1.61 × 10-7 ; preplication = 0.0016). Two other SNPs were suggestively associated (p < 1 × 10-6 ) with OHD in only the discovery sample. In the case-control analyses, no SNPs were genome-wide significant, and, even with relaxed thresholds ( × discovery < 1 × 10-5 and preplication < 0.05), only one SNP (rs188255766) in the infant analysis was associated with OHDs (pdiscovery = 1.42 × 10-6 ; preplication = 0.04). Additional SNPs with pdiscovery < 1 × 10-5 were in loci supporting previous findings but did not replicate. Overall, there was modest evidence of an association between rs2360743 and rs55877192 and OHD and some evidence validating previously published findings.
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Affiliation(s)
- Sara R Rashkin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Mario Cleves
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Health Informatics Institute, Tampa, Florida, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Wendy N Nembhard
- Department of Epidemiology and Arkansas Center for Birth Defects and Prevention, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Eirini Nestoridi
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Mary M Jenkins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paul A Romitti
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Xiang-Yang Lou
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Marilyn L Browne
- Birth Defects Research Section, New York State Department of Health, Albany, New York, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA
| | - Laura E Mitchell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA
| | - Andrew F Olshan
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Sudeepa Bhattacharyya
- Bioinformatics and Data Science at University of Arkansas, Little Rock, Arkansas, USA
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Charlotte A Hobbs
- Rady Children's Institute for Genomic Medicine, San Diego, California, USA
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3
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Abstract
PURPOSE OF REVIEW Given a general lack of emphasis on the molecular underpinnings of single ventricle (SV) congenital heart diseases (CHD), our review highlights and summarizes recent advances in uncovering the genetic and molecular mechanisms in SV CHD etiology. RECENT FINDINGS While common SV-associated genetic mutations were found in key cardiac transcription factors, other mutations were sporadic. With advances in genetic sequencing technologies and animal models, more disease-associated factors have been identified to act in critical cardiac signaling pathways such as NOTCH, Wnt, and TGF signaling. Recent studies have also revealed that different cardiac lineages play different roles in disease pathogenesis. SV defects are attributed to complex combinations of genetic mutations, indicating that sophisticated spatiotemporal regulation of gene transcription networks and functional cellular pathways govern disease progression. Future studies will warrant in-depth investigations into better understanding how different genetic factors converge to influence common downstream cellular pathways, resulting in SV abnormalities.
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Morton SU, Maleyeff L, Wypij D, Yun HJ, Rollins CK, Watson CG, Newburger JW, Bellinger DC, Roberts AE, Rivkin MJ, Grant PE, Im K. Abnormal Right-Hemispheric Sulcal Patterns Correlate with Executive Function in Adolescents with Tetralogy of Fallot. Cereb Cortex 2021; 31:4670-4680. [PMID: 34009260 PMCID: PMC8408447 DOI: 10.1093/cercor/bhab114] [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: 12/31/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022] Open
Abstract
Neurodevelopmental disabilities are the most common noncardiac conditions in patients with congenital heart disease (CHD). Executive function skills have been frequently observed to be decreased among children and adults with CHD compared with peers, but a neuroanatomical basis for the association is yet to be identified. In this study, we quantified sulcal pattern features from brain magnetic resonance imaging data obtained during adolescence among 41 participants with tetralogy of Fallot (ToF) and 49 control participants using a graph-based pattern analysis technique. Among patients with ToF, right-hemispheric sulcal pattern similarity to the control group was decreased (0.7514 vs. 0.7553, P = 0.01) and positively correlated with neuropsychological testing values including executive function (r = 0.48, P < 0.001). Together these findings suggest that sulcal pattern analysis may be a useful marker of neurodevelopmental risk in patients with CHD. Further studies may elucidate the mechanisms leading to different alterations in sulcal patterning.
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Affiliation(s)
- Sarah U Morton
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Lara Maleyeff
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - David Wypij
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Hyuk Jin Yun
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Caitlin K Rollins
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | | | - Jane W Newburger
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - David C Bellinger
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Amy E Roberts
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Michael J Rivkin
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA 02115, USA
- Division of Radiology, Boston Children’s Hospital, Boston, MA 02115, USA
- Stroke and Cerebrovascular Center, Boston Children’s Hospital, Boston, MA 02115, USA
| | - P Ellen Grant
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Kiho Im
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
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5
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Grunert M, Appelt S, Grossfeld P, Sperling SR. The Needle in the Haystack-Searching for Genetic and Epigenetic Differences in Monozygotic Twins Discordant for Tetralogy of Fallot. J Cardiovasc Dev Dis 2020; 7:jcdd7040055. [PMID: 33276527 PMCID: PMC7761217 DOI: 10.3390/jcdd7040055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
Congenital heart defects (CHDs) are the most common birth defect in human with an incidence of almost 1% of all live births. Most cases have a multifactorial origin with both genetics and the environment playing a role in its development and progression. Adding an epigenetic component to this aspect is exemplified by monozygotic twins which share the same genetic background but have a different disease status. As a result, the interplay between the genetic, epigenetic and the environmental conditions might contribute to the etiology and phenotype. To date, the underlying causes of the majority of CHDs remain poorly understood. In this study, we performed genome-wide high-throughput sequencing to examine the genetic, structural genomic and epigenetic differences of two identical twin pairs discordant for Tetralogy of Fallot (TOF), representing the most common cyanotic form of CHDs. Our results show the almost identical genetic and structural genomic identity of the twins. In contrast, several epigenetic alterations could be observed given by DNA methylation changes in regulatory regions of known cardiac-relevant genes. Overall, this study provides first insights into the impact of genetic and especially epigenetic factors underlying monozygotic twins discordant for CHD like TOF.
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Affiliation(s)
- Marcel Grunert
- Cardiovascular Genetics, Charité—Universitätsmedizin Berlin, 13125 Berlin, Germany; (M.G.); (S.A.)
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10178 Berlin, Germany
| | - Sandra Appelt
- Cardiovascular Genetics, Charité—Universitätsmedizin Berlin, 13125 Berlin, Germany; (M.G.); (S.A.)
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10178 Berlin, Germany
| | - Paul Grossfeld
- Division of Cardiology, University of California San Diego, Rady’s Hospital MC 5004, San Diego, CA 92123, USA;
| | - Silke R. Sperling
- Cardiovascular Genetics, Charité—Universitätsmedizin Berlin, 13125 Berlin, Germany; (M.G.); (S.A.)
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10178 Berlin, Germany
- Department of Biology, Chemistry, and Pharmacy, Freie Universität Berlin, 14195 Berlin, Germany
- Correspondence: ; Tel.: +49-30450540123
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6
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Molecular diagnostics for congenital heart disease: a narrative review of the current technologies and applications. JOURNAL OF BIO-X RESEARCH 2020. [DOI: 10.1097/jbr.0000000000000068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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7
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Hanchard NA, Umana LA, D'Alessandro L, Azamian M, Poopola M, Morris SA, Fernbach S, Lalani SR, Towbin JA, Zender GA, Fitzgerald-Butt S, Garg V, Bowman J, Zapata G, Hernandez P, Arrington CB, Furthner D, Prakash SK, Bowles NE, McBride KL, Belmont JW. Assessment of large copy number variants in patients with apparently isolated congenital left-sided cardiac lesions reveals clinically relevant genomic events. Am J Med Genet A 2017; 173:2176-2188. [PMID: 28653806 DOI: 10.1002/ajmg.a.38309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 04/18/2017] [Accepted: 05/06/2017] [Indexed: 12/30/2022]
Abstract
Congenital left-sided cardiac lesions (LSLs) are a significant contributor to the mortality and morbidity of congenital heart disease (CHD). Structural copy number variants (CNVs) have been implicated in LSL without extra-cardiac features; however, non-penetrance and variable expressivity have created uncertainty over the use of CNV analyses in such patients. High-density SNP microarray genotyping data were used to infer large, likely-pathogenic, autosomal CNVs in a cohort of 1,139 probands with LSL and their families. CNVs were molecularly confirmed and the medical records of individual carriers reviewed. The gene content of novel CNVs was then compared with public CNV data from CHD patients. Large CNVs (>1 MB) were observed in 33 probands (∼3%). Six of these were de novo and 14 were not observed in the only available parent sample. Associated cardiac phenotypes spanned a broad spectrum without clear predilection. Candidate CNVs were largely non-recurrent, associated with heterozygous loss of copy number, and overlapped known CHD genomic regions. Novel CNV regions were enriched for cardiac development genes, including seven that have not been previously associated with human CHD. CNV analysis can be a clinically useful and molecularly informative tool in LSLs without obvious extra-cardiac defects, and may identify a clinically relevant genomic disorder in a small but important proportion of these individuals.
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Affiliation(s)
- Neil A Hanchard
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas.,USDA/ARS/Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Luis A Umana
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas
| | - Lisa D'Alessandro
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Mahshid Azamian
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas
| | - Mojisola Poopola
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas
| | - Shaine A Morris
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Susan Fernbach
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas
| | - Seema R Lalani
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey A Towbin
- Pediatric Cardiology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gloria A Zender
- Center for Cardiovascular Research, Nationwide Children's Hospital, Columbus, Ohio
| | - Sara Fitzgerald-Butt
- Center for Cardiovascular Research, Nationwide Children's Hospital, Columbus, Ohio.,Heart Center, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, Ohio State University, Columbus, Ohio
| | - Vidu Garg
- Center for Cardiovascular Research, Nationwide Children's Hospital, Columbus, Ohio.,Heart Center, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, Ohio State University, Columbus, Ohio
| | - Jessica Bowman
- Heart Center, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, Ohio State University, Columbus, Ohio
| | - Gladys Zapata
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas.,USDA/ARS/Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Patricia Hernandez
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas.,USDA/ARS/Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Cammon B Arrington
- Division of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Siddharth K Prakash
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas
| | - Neil E Bowles
- Division of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Kim L McBride
- Center for Cardiovascular Research, Nationwide Children's Hospital, Columbus, Ohio.,Heart Center, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, Ohio State University, Columbus, Ohio
| | - John W Belmont
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas.,USDA/ARS/Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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8
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Monteiro RAC, de Freitas ML, Vianna GS, de Oliveira VT, Pietra RX, Ferreira LCA, Rocha PPO, da S Gonçalves M, da C César G, de S Lima J, Medeiros PFV, Mazzeu JF, Jehee FS. Major Contribution of Genomic Copy Number Variation in Syndromic Congenital Heart Disease: The Use of MLPA as the First Genetic Test. Mol Syndromol 2017; 8:227-235. [PMID: 28878606 DOI: 10.1159/000477226] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 01/09/2023] Open
Abstract
Congenital heart disease (CHD) is the most common congenital disorder among live births. When associated with extracardiac abnormalities, it is characterized as a syndromic heart disease (syndromic CHD) and corresponds to 25% of all liveborn infants with a heart defect. The etiology in about 65% of the cases still remains unknown, and in about 35% of the patients, it is associated with genetic factors. In the present study, MLPA and SNP-array techniques were used to investigate a group of 47 patients with syndromic CHD. In total, 16 defects (34%) were identified, of which 12 (25.5%) were classified as pathogenic or probably pathogenic. The most frequent abnormalities were 22q11.2 deletion (22q11.2 deletion syndrome) and 7q11.23 deletion (Williams-Beuren syndrome). We also show that rarer malformations may be associated with syndromic CHD, such as 14q32.33 deletion as well as 17q25.3, 15q11.2 (BP1-BP2), 22q13.31, and 12p13.31 (SLC2A3) duplications. The present study demonstrates that CNVs are important causal factors and should be studied in patients with syndromic CHD. Furthermore, the use of MLPA as a first screening test was appropriate, as this less expensive technology detected 11 of the 12 pathogenic abnormalities (91.6%).
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Affiliation(s)
- Rejane A C Monteiro
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Mariana L de Freitas
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Gabrielle S Vianna
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Valdirene T de Oliveira
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Rafaella X Pietra
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Luana C A Ferreira
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Patrícia P O Rocha
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Michele da S Gonçalves
- Department of Research and Development (R & D) of the Hermes Pardini Institute, Vespasiano, Brazil
| | - Giovana da C César
- Pediatric ICU, Hospital Santa Casa de Misericórdia of Belo Horizonte, Belo Horizonte, Brazil
| | | | | | | | - Fernanda S Jehee
- Human Genetics Laboratory, Institute of Education and Research of Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
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9
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Du L, Xie HN, Huang LH, Xie YJ, Wu LH. Prenatal diagnosis of submicroscopic chromosomal aberrations in fetuses with ventricular septal defects by chromosomal microarray-based analysis. Prenat Diagn 2016; 36:1178-1184. [PMID: 27794163 DOI: 10.1002/pd.4953] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/23/2016] [Accepted: 10/24/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Liu Du
- Department of Ultrasonic Medicine; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Hong-Ning Xie
- Department of Ultrasonic Medicine; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Lin-Huan Huang
- Department of Obstetrics and Gynaecology, Fetal Medical Center; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Ying-Jun Xie
- Department of Obstetrics and Gynaecology, Fetal Medical Center; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Li-Hong Wu
- Department of Ultrasonic Medicine; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
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10
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Hanchard NA, Swaminathan S, Bucasas K, Furthner D, Fernbach S, Azamian MS, Wang X, Lewin M, Towbin JA, D'Alessandro LCA, Morris SA, Dreyer W, Denfield S, Ayres NA, Franklin WJ, Justino H, Lantin-Hermoso MR, Ocampo EC, Santos AB, Parekh D, Moodie D, Jeewa A, Lawrence E, Allen HD, Penny DJ, Fraser CD, Lupski JR, Popoola M, Wadhwa L, Brook JD, Bu'Lock FA, Bhattacharya S, Lalani SR, Zender GA, Fitzgerald-Butt SM, Bowman J, Corsmeier D, White P, Lecerf K, Zapata G, Hernandez P, Goodship JA, Garg V, Keavney BD, Leal SM, Cordell HJ, Belmont JW, McBride KL. A genome-wide association study of congenital cardiovascular left-sided lesions shows association with a locus on chromosome 20. Hum Mol Genet 2016; 25:2331-2341. [PMID: 26965164 DOI: 10.1093/hmg/ddw071] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 02/26/2016] [Indexed: 12/28/2022] Open
Abstract
Congenital heart defects involving left-sided lesions (LSLs) are relatively common birth defects with substantial morbidity and mortality. Previous studies have suggested a high heritability with a complex genetic architecture, such that only a few LSL loci have been identified. We performed a genome-wide case-control association study to address the role of common variants using a discovery cohort of 778 cases and 2756 controls. We identified a genome-wide significant association mapping to a 200 kb region on chromosome 20q11 [P= 1.72 × 10-8 for rs3746446; imputed Single Nucleotide Polymorphism (SNP) rs6088703 P= 3.01 × 10-9, odds ratio (OR)= 1.6 for both]. This result was supported by transmission disequilibrium analyses using a subset of 541 case families (lowest P in region= 4.51 × 10-5, OR= 1.5). Replication in a cohort of 367 LSL cases and 5159 controls showed nominal association (P= 0.03 for rs3746446) resulting in P= 9.49 × 10-9 for rs3746446 upon meta-analysis of the combined cohorts. In addition, a group of seven SNPs on chromosome 1q21.3 met threshold for suggestive association (lowest P= 9.35 × 10-7 for rs12045807). Both regions include genes involved in cardiac development-MYH7B/miR499A on chromosome 20 and CTSK, CTSS and ARNT on chromosome 1. Genome-wide heritability analysis using case-control genotyped SNPs suggested that the mean heritability of LSLs attributable to common variants is moderately high ([Formula: see text] range= 0.26-0.34) and consistent with previous assertions. These results provide evidence for the role of common variation in LSLs, proffer new genes as potential biological candidates, and give further insight to the complex genetic architecture of congenital heart disease.
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Affiliation(s)
- Neil A Hanchard
- Department of Molecular and Human Genetics, Department of Pediatrics
| | | | - Kristine Bucasas
- Department of Molecular and Human Genetics, Center for Statistical Genetics
| | - Dieter Furthner
- Department of Paediatrics, Children's Hospital, Linz, Austria
| | | | | | | | - Mark Lewin
- Division of Cardiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Jeffrey A Towbin
- Pediatric Cardiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | | | | | | | - Nancy A Ayres
- Division of Cardiology, Department of Pediatrics, and
| | | | - Henri Justino
- Division of Cardiology, Department of Pediatrics, and
| | | | | | | | - Dhaval Parekh
- Division of Cardiology, Department of Pediatrics, and
| | | | - Aamir Jeewa
- Division of Cardiology, Department of Pediatrics, and
| | | | - Hugh D Allen
- Division of Cardiology, Department of Pediatrics, and
| | | | - Charles D Fraser
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - James R Lupski
- Department of Molecular and Human Genetics, Department of Pediatrics
| | | | - Lalita Wadhwa
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - J David Brook
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Frances A Bu'Lock
- East Midlands Congenital Heart Centre, Glenfield Hospital, Leicester, UK
| | - Shoumo Bhattacharya
- Radcliffe Department of Medicine, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | | | - Sara M Fitzgerald-Butt
- Department of Pediatrics and Center for Cardiovascular and Pulmonary Research, The Heart Center, and
| | | | - Don Corsmeier
- Department of Pediatrics and Center for Microbial Pathogenesis, Nationwide Children's Hospital, Columbus, OH, USA
| | - Peter White
- Department of Pediatrics and Center for Microbial Pathogenesis, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kelsey Lecerf
- College of Medicine, Ohio State University, Columbus, OH, USA
| | - Gladys Zapata
- Department of Molecular and Human Genetics, Department of Pediatrics
| | | | - Judith A Goodship
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK and
| | - Vidu Garg
- Department of Pediatrics and Center for Cardiovascular and Pulmonary Research, The Heart Center, and
| | - Bernard D Keavney
- Institute of Cardiovascular Sciences, The University of Manchester, Manchester, UK
| | - Suzanne M Leal
- Department of Molecular and Human Genetics, Center for Statistical Genetics
| | - Heather J Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK and
| | - John W Belmont
- Department of Molecular and Human Genetics, Department of Pediatrics,
| | - Kim L McBride
- Department of Pediatrics and Center for Cardiovascular and Pulmonary Research,
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11
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An Y, Duan W, Huang G, Chen X, Li L, Nie C, Hou J, Gui Y, Wu Y, Zhang F, Shen Y, Wu B, Wang H. Genome-wide copy number variant analysis for congenital ventricular septal defects in Chinese Han population. BMC Med Genomics 2016; 9:2. [PMID: 26742958 PMCID: PMC4705616 DOI: 10.1186/s12920-015-0163-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/18/2015] [Indexed: 11/18/2022] Open
Abstract
Background Ventricular septal defects (VSDs) constitute the most prevalent congenital heart disease (CHD), occurs either in isolation (isolated VSD) or in combination with other cardiac defects (complex VSD). Copy number variation (CNV) has been highlighted as a possible contributing factor to the etiology of many congenital diseases. However, little is known concerning the involvement of CNVs in either isolated or complex VSDs. Methods We analyzed 154 unrelated Chinese individuals with VSD by chromosomal microarray analysis. The subjects were recruited from four hospitals across China. Each case underwent clinical assessment to define the type of VSD, either isolated or complex VSD. CNVs detected were categorized into syndrom related CNVs, recurrent CNVs and rare CNVs. Genes encompassed by the CNVs were analyzed using enrichment and pathway analysis. Results Among 154 probands, we identified 29 rare CNVs in 26 VSD patients (16.9 %, 26/154) and 8 syndrome-related CNVs in 8 VSD patients (5.2 %, 8/154). 12 of the detected 29 rare CNVs (41.3 %) were recurrently reported in DECIPHER or ISCA database as associated with either VSD or general heart disease. Fifteen genes (5 %, 15/285) within CNVs were associated with a broad spectrum of complicated CHD. Among these15 genes, 7 genes were in “abnormal interventricular septum morphology” derived from the MGI (mouse genome informatics) database, and nine genes were associated with cardiovascular system development (GO:0072538).We also found that these VSD-related candidate genes are enriched in chromatin binding and transcription regulation, which are the biological processes underlying heart development. Conclusions Our study demonstrates the potential clinical diagnostic utility of genomic imbalance profiling in VSD patients. Additionally, gene enrichment and pathway analysis helped us to implicate VSD related candidate genes. Electronic supplementary material The online version of this article (doi:10.1186/s12920-015-0163-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu An
- Institutes of Biomedical Sciences and Children's Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China. .,The State Key Laboratory of Genetic Engineering, Ministry of Education (MOE) Key Laboratory of Contemporary Anthropology, and Collaborative Innovation Center of Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200433, China. .,Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Wenyuan Duan
- Jinan Military General Hospital, Jinan, 250022, China.
| | - Guoying Huang
- Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Xiaoli Chen
- Capital Institute of Pediatrics, Beijing, 100020, China.
| | - Li Li
- Capital Institute of Pediatrics, Beijing, 100020, China.
| | - Chenxia Nie
- Department of Biology, Changzhi MedicalCollege, Changzhi, 046000, China.
| | - Jia Hou
- Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Yonghao Gui
- Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Yiming Wu
- Institutes of Biomedical Sciences and Children's Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China.
| | - Feng Zhang
- The State Key Laboratory of Genetic Engineering, Ministry of Education (MOE) Key Laboratory of Contemporary Anthropology, and Collaborative Innovation Center of Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200433, China.
| | - Yiping Shen
- Department of Laboratory Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, 02453, USA.
| | - Bailin Wu
- Institutes of Biomedical Sciences and Children's Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China. .,Children's Hospital, Fudan University, Shanghai, 201102, China. .,Department of Laboratory Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, 02453, USA.
| | - Hongyan Wang
- School of Life Sciences, Obstetrics & Gynecology Hospital, Institute of Reproduction & Development, Fudan University, Shanghai, 200032, China.
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12
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Digilio MC, Marino B. What Is New in Genetics of Congenital Heart Defects? Front Pediatr 2016; 4:120. [PMID: 27990414 PMCID: PMC5130977 DOI: 10.3389/fped.2016.00120] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/19/2016] [Indexed: 11/21/2022] Open
Abstract
Epidemiological studies, clinical observations, and advances in molecular genetics are contributing to the understanding of the etiology of congenital heart defects (CHDs). Several phenotype-genotype correlation studies have suggested that specific morphogenetic mechanisms put in motion by genes can result in a specific cardiac phenotype. The use of new technologies has increased the possibility of identification of new genes and chromosomal loci in syndromic and non-syndromic CHDs. There are a number of methods available for genetic research studies of CHDs, including cytogenetic analysis, linkage and association studies, copy number variation (CNV) and DNA micro-array analysis, and whole exome sequencing. The altered dosage of contiguous genes included inside CNVs can produce new syndromic CHDs, so that several different new genomic conditions have been identified. These include duplication 22q11.2 syndrome, distal 22q11.2 deletion syndrome, deletion and duplication 1q21.1, and deletion 1p36 syndrome. Molecular techniques such as whole exome sequencing have lead to the identification of new genes for monogenic syndromes with CHD, as for example in Adams-Oliver, Noonan, and Kabuki syndrome. The variable expressivity and reduced penetrance of CHDs in genetic syndromes is likely influenced by genetic factors, and several studies have been performed showing the involvement of modifier genes. It is not easy to define precisely the genetic defects underlying non-syndromic CHDs, due to the genetic and clinical heterogeneity of these malformations. Recent experimental studies have identified multiple CNVs contributing to non-syndromic CHD. The number of identified genes for non-syndromic CHDs is at this time limited, and each of the identified genes has been shown to be implicated only in a small proportion of CHD. The application of new technologies to specific cases of CHD and pedigrees with familial recurrence and filtering genes mapping in CNV regions can probably in the future add knowledge about new genes for non-syndromic CHDs.
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Affiliation(s)
| | - Bruno Marino
- Pediatric Cardiology, Department of Pediatrics, Sapienza University , Rome , Italy
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13
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Bellinger DC, Watson CG, Rivkin MJ, Robertson RL, Roberts AE, Stopp C, Dunbar‐Masterson C, Bernson D, DeMaso DR, Wypij D, Newburger JW. Neuropsychological Status and Structural Brain Imaging in Adolescents With Single Ventricle Who Underwent the Fontan Procedure. J Am Heart Assoc 2015; 4:e002302. [PMID: 26667085 PMCID: PMC4845289 DOI: 10.1161/jaha.115.002302] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/21/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Few studies have described the neuropsychological outcomes and frequency of structural brain or genetic abnormalities in adolescents with single ventricle who underwent the Fontan procedure. METHODS AND RESULTS In a cross-sectional, single-center study, we enrolled 156 subjects with single ventricle, mean age 14.5±2.9 years, who had undergone the Fontan procedure. Scores in the entire cohort on a standard battery of neuropsychological tests were compared with those of normative populations or to those of a group of 111 locally recruited healthy adolescents. They also underwent brain magnetic resonance imaging and were evaluated by a clinical geneticist. Genetic abnormalities were definite in 16 subjects (10%) and possible in 49 subjects (31%). Mean Full-Scale IQ was 91.6±16.8, mean Reading Composite score was 91.9±17.2, and mean Mathematics Composite score was 92.0±22.9, each significantly lower than the population means of 100±15. Mean scores on other neuropsychological tests were similarly lower than population norms. In multivariable models, risk factors for worse neuropsychological outcomes were longer total support and circulatory arrest duration at first operation, presence of a genetic abnormality, more operations and operative complications, more catheterization complications, and seizure history. The frequency of any abnormality on magnetic resonance imaging was 11 times higher among Fontan adolescents than referents (66% versus 6%); 19 (13%) patients had evidence of a stroke, previously undiagnosed in 7 patients (40%). CONCLUSIONS The neuropsychological deficits and high frequencies of structural brain abnormalities in adolescents who underwent the Fontan procedure highlight the need for research on interventions to improve the long-term outcomes in this high-risk group.
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Affiliation(s)
- David C. Bellinger
- Department of NeurologyBoston Children's HospitalBostonMA
- Department of PsychiatryBoston Children's HospitalBostonMA
- Department of NeurologyHarvard Medical SchoolBostonMA
- Department of PsychiatryHarvard Medical SchoolBostonMA
| | - Christopher G. Watson
- Department of NeurologyBoston Children's HospitalBostonMA
- Graduate Program for NeuroscienceBoston UniversityBostonMA
| | - Michael J. Rivkin
- Department of NeurologyBoston Children's HospitalBostonMA
- Department of RadiologyBoston Children's HospitalBostonMA
- Department of PsychiatryBoston Children's HospitalBostonMA
- Department of NeurologyHarvard Medical SchoolBostonMA
| | - Richard L. Robertson
- Department of RadiologyBoston Children's HospitalBostonMA
- Department of RadiologyHarvard Medical SchoolBostonMA
| | - Amy E. Roberts
- Department of CardiologyBoston Children's HospitalBostonMA
- Department of PediatricsHarvard Medical SchoolBostonMA
| | | | | | - Dana Bernson
- Department of CardiologyBoston Children's HospitalBostonMA
| | - David R. DeMaso
- Department of PsychiatryBoston Children's HospitalBostonMA
- Department of PsychiatryHarvard Medical SchoolBostonMA
| | - David Wypij
- Department of CardiologyBoston Children's HospitalBostonMA
- Department of PediatricsHarvard Medical SchoolBostonMA
- Department of BiostatisticsHarvard T. H. Chan School of Public HealthBostonMA
| | - Jane W. Newburger
- Department of CardiologyBoston Children's HospitalBostonMA
- Department of PediatricsHarvard Medical SchoolBostonMA
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14
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Glidewell SC, Miyamoto SD, Grossfeld PD, Clouthier DE, Coldren CD, Stearman RS, Geraci MW. Transcriptional Impact of Rare and Private Copy Number Variants in Hypoplastic Left Heart Syndrome. Clin Transl Sci 2015; 8:682-9. [PMID: 26534787 DOI: 10.1111/cts.12340] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hypoplastic left heart syndrome (HLHS) is a heterogeneous, lethal combination of congenital malformations characterized by severe underdevelopment of left heart structures, resulting in a univentricular circulation. The genetic determinants of this disorder are largely unknown. Evidence of copy number variants (CNVs) contributing to the genetic etiology of HLHS and other congenital heart defects has been mounting. However, the functional effects of such CNVs have not been examined, particularly in cases where the variant of interest is found in only a single patient. METHODS AND RESULTS Whole-genome SNP microarrays were employed to detect CNVs in two patient cohorts (N = 70 total) predominantly diagnosed with some form of nonsyndromic HLHS. We discovered 16 rare or private variants adjacent to or overlapping 20 genes associated with cardiovascular or premature lethality phenotypes in mouse knockout models. We evaluated the impact of selected variants on the expression of nine of these genes through quantitative PCR on cDNA derived from patient heart tissue. Four genes displayed significantly altered expression in patients with an overlapping or proximal CNV verses patients without such CNVs. CONCLUSION Rare and private genomic imbalances perturb transcription of genes that potentially affect cardiogenesis in a subset of nonsyndromic HLHS patients.
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Affiliation(s)
- Steven C Glidewell
- Human Medical Genetics and Genomics Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shelley D Miyamoto
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Paul D Grossfeld
- Department of Pediatrics, University of California, San Diego, California, USA
| | - David E Clouthier
- Human Medical Genetics and Genomics Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Robert S Stearman
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mark W Geraci
- Human Medical Genetics and Genomics Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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15
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Abstract
BACKGROUND CHD is the leading cause of mortality due to birth defects. Array comparative genomic hybridisation (aCGH) detects submicroscopic copy number changes and may improve identification of the genetic basis of CHD. METHODS This is a retrospective analysis of 1252 patients from a regional referral centre who had undergone aCGH. Of the patients, 173 had CHD. A whole-genome custom-designed oligonucleotide array with >44,000 probes was used to detect copy number changes. RESULTS Of the 1252 patients, 335 (26.76%) had abnormal aCGH results. Of the 173 patients with CHD, 50 (28.9%) had abnormal aCGH results versus 284 (26.3%) of 1079 non-cardiac patients. There were six patients with CHD who had well-described syndromes such as Wolf-Hirschhorn, trisomy 13, DiGeorge, and Williams. Of the patients with CHD, those with left-sided heart disease had the highest proportion (14/31; 45.13%) of abnormal aCGH results, followed by those with conotruncal heart disease (10/29; 34.48%), endocardial cushion defects (13/50; 26%), complex/other heart disease (12/52; 23.08%), and patent ductus arteriosus (1/11; 9.09%). CONCLUSIONS Patients with CHD are at a substantial risk of having microdeletions and microduplications. The incidence of abnormalities on aCGH analysis is higher than identified with karyotype, and identification of copy number changes may help identify the genetic basis of the specific heart defects. However, aCGH may not have a significant diagnostic yield in those with isolated CHD. Further research using larger data sets may help identify candidate genes associated with CHD.
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16
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Lahm H, Schön P, Doppler S, Dreßen M, Cleuziou J, Deutsch MA, Ewert P, Lange R, Krane M. Tetralogy of Fallot and Hypoplastic Left Heart Syndrome - Complex Clinical Phenotypes Meet Complex Genetic Networks. Curr Genomics 2015; 16:141-58. [PMID: 26069455 PMCID: PMC4460219 DOI: 10.2174/1389202916666150303232520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/28/2015] [Accepted: 03/03/2015] [Indexed: 01/06/2023] Open
Abstract
In many cases congenital heart disease (CHD) is represented by a complex phenotype and
an array of several functional and morphological cardiac disorders. These malformations will be
briefly summarized in the first part focusing on two severe CHD phenotypes, hypoplastic left heart
syndrome (HLHS) and tetralogy of Fallot (TOF). In most cases of CHD the genetic origin remains
largely unknown, though the complexity of the clinical picture strongly argues against a dysregulation which can be attributed
to a single candidate gene but rather suggests a multifaceted polygenetic origin with elaborate interactions. Consistent
with this idea, genome-wide approaches using whole exome sequencing, comparative sequence analysis of multiplex
families to identify de novo mutations and global technologies to identify single nucleotide polymorphisms, copy
number variants, dysregulation of the transcriptome and epigenetic variations have been conducted to obtain information
about genetic alterations and potential predispositions possibly linked to the occurrence of a CHD phenotype. In the second
part of this review we will summarize and discuss the available literature on identified genetic alterations linked to
TOF and HLHS.
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Affiliation(s)
- Harald Lahm
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany
| | - Patric Schön
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Center Munich, Technische Universität München, D-80636 Munich, Germany
| | - Stefanie Doppler
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany
| | - Martina Dreßen
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany
| | - Julie Cleuziou
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany
| | - Marcus-André Deutsch
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany
| | - Peter Ewert
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Center Munich, Technische Universität München, D-80636 Munich, Germany; ; DZHK (German Center for Cardiovascular Research) - partner site Munich Heart Alliance, Munich, Germany
| | - Rüdiger Lange
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany; ; DZHK (German Center for Cardiovascular Research) - partner site Munich Heart Alliance, Munich, Germany
| | - Markus Krane
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Technische Universität München, Munich Heart Alliance, D-80636 Munich, Germany; ; DZHK (German Center for Cardiovascular Research) - partner site Munich Heart Alliance, Munich, Germany
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17
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Jansen FAR, Blumenfeld YJ, Fisher A, Cobben JM, Odibo AO, Borrell A, Haak MC. Array comparative genomic hybridization and fetal congenital heart defects: a systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:27-35. [PMID: 25319878 DOI: 10.1002/uog.14695] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/10/2014] [Accepted: 10/14/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Array comparative genomic hybridization (aCGH) is a molecular cytogenetic technique that is able to detect the presence of copy number variants (CNVs) within the genome. The detection rate of imbalances by aCGH compared to standard karyotyping and 22q11 microdeletion analysis by fluorescence in-situ hybridization (FISH), in the setting of prenatally-diagnosed cardiac malformations, has been reported in several studies. The objective of our study was to perform a systematic literature review and meta-analysis to document the additional diagnostic gain of using aCGH in cases of congenital heart disease (CHD) diagnosed by prenatal ultrasound examination, with the aim of assisting clinicians to determine whether aCGH analysis is warranted when an ultrasonographic diagnosis of CHD is made, and to guide counseling in this setting. METHODS Articles in PubMed, EMBASE and Web of Science databases from January 2007 to September 2014 describing CNVs in prenatal cases of CHD were included. Search terms were: 'array comparative genomic hybridization', 'copy number variants' and 'fetal congenital heart defects'. Articles regarding karyotyping or 22q11 deletion only were excluded. RESULTS Thirteen publications (including 1131 cases of CHD) met the inclusion criteria for the analysis. Meta-analysis indicated an incremental yield of 7.0% (95% CI, 5.3-8.6%) for the detection of CNVs using aCGH, excluding aneuploidy and 22q11 microdeletion cases. Subgroup results showed a 3.4% (95% CI, 0.3-6.6%) incremental yield in isolated CHD cases, and 9.3% (95% CI, 6.6-12%) when extracardiac malformations were present. Overall, an incremental yield of 12% (95% CI, 7.6-16%) was found when 22q11 deletion cases were included. There was an additional yield of 3.4% (95% CI, 2.1-4.6%) for detecting variants of unknown significance (VOUS). CONCLUSIONS In this review we provide an overview of published data and discuss the benefits and limitations of using aCGH. If karyotyping and 22q11 microdeletion analysis by FISH are normal, using aCGH has additional value, detecting pathogenic CNVs in 7.0% of prenatally diagnosed CHD, with a 3.4% additional yield of detecting VOUS.
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Affiliation(s)
- F A R Jansen
- Leiden University Medical Center, Department of Obstetrics and Fetal Medicine, Leiden, The Netherlands
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18
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Vecoli C, Pulignani S, Foffa I, Andreassi MG. Congenital heart disease: the crossroads of genetics, epigenetics and environment. Curr Genomics 2014; 15:390-9. [PMID: 25435801 PMCID: PMC4245698 DOI: 10.2174/1389202915666140716175634] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 06/24/2014] [Accepted: 07/07/2014] [Indexed: 02/07/2023] Open
Abstract
Congenital heart diseases (CHDs) are recognized as the most common type of birth malformations. Although recent advances in pre- and neonatal diagnosis as well as in surgical procedures have reduced the morbidity and mortality for many CHD, the etiology for CHD remains undefined. In non-syndromic and isolated (without a familial history or a Mendelian inheritance) forms of CHDs, a multifactorial pathogenesis with interplay between inherited and non-inherited causes is recognized. In this paper, we discuss the current knowledge of the potential molecular mechanisms, mediating abnormal cardiac development in non-syndromic and isolated CHD, including mutations in cardiac transcription factors, the role of somatic mutations and epigenetic alterations as well as the influence of gene-environment interactions. In the near future, the advent of high-throughput genomic technologies with the integration of system biology will expand our understanding of isolated, non-syndromic CHDs for their prevention, early diagnosis and therapy.
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Affiliation(s)
| | | | - Ilenia Foffa
- CNR, Institute of Clinical Physiology, Massa, Italy
| | - Maria Grazia Andreassi
- CNR, Institute of Clinical Physiology, Pisa, Italy ; Fondazione Toscana G.Monasterio, Massa, Italy
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19
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Glessner JT, Bick AG, Ito K, Homsy J, Rodriguez-Murillo L, Fromer M, Mazaika E, Vardarajan B, Italia M, Leipzig J, DePalma SR, Golhar R, Sanders SJ, Yamrom B, Ronemus M, Iossifov I, Willsey AJ, State MW, Kaltman JR, White PS, Shen Y, Warburton D, Brueckner M, Seidman C, Goldmuntz E, Gelb BD, Lifton R, Seidman J, Hakonarson H, Chung WK. Increased frequency of de novo copy number variants in congenital heart disease by integrative analysis of single nucleotide polymorphism array and exome sequence data. Circ Res 2014; 115:884-896. [PMID: 25205790 DOI: 10.1161/circresaha.115.304458] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
RATIONALE Congenital heart disease (CHD) is among the most common birth defects. Most cases are of unknown pathogenesis. OBJECTIVE To determine the contribution of de novo copy number variants (CNVs) in the pathogenesis of sporadic CHD. METHODS AND RESULTS We studied 538 CHD trios using genome-wide dense single nucleotide polymorphism arrays and whole exome sequencing. Results were experimentally validated using digital droplet polymerase chain reaction. We compared validated CNVs in CHD cases with CNVs in 1301 healthy control trios. The 2 complementary high-resolution technologies identified 63 validated de novo CNVs in 51 CHD cases. A significant increase in CNV burden was observed when comparing CHD trios with healthy trios, using either single nucleotide polymorphism array (P=7×10(-5); odds ratio, 4.6) or whole exome sequencing data (P=6×10(-4); odds ratio, 3.5) and remained after removing 16% of de novo CNV loci previously reported as pathogenic (P=0.02; odds ratio, 2.7). We observed recurrent de novo CNVs on 15q11.2 encompassing CYFIP1, NIPA1, and NIPA2 and single de novo CNVs encompassing DUSP1, JUN, JUP, MED15, MED9, PTPRE SREBF1, TOP2A, and ZEB2, genes that interact with established CHD proteins NKX2-5 and GATA4. Integrating de novo variants in whole exome sequencing and CNV data suggests that ETS1 is the pathogenic gene altered by 11q24.2-q25 deletions in Jacobsen syndrome and that CTBP2 is the pathogenic gene in 10q subtelomeric deletions. CONCLUSIONS We demonstrate a significantly increased frequency of rare de novo CNVs in CHD patients compared with healthy controls and suggest several novel genetic loci for CHD.
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Affiliation(s)
- Joseph T Glessner
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | - Kaoru Ito
- Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Jason Homsy
- Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Laura Rodriguez-Murillo
- Mindich Child Health and Development Institute, Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Menachem Fromer
- Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Psychiatric Genomics in the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Erica Mazaika
- Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Badri Vardarajan
- Systems Biology, Columbia University Medical Center, New York, NY 10032, USA
| | - Michael Italia
- Center for Biomedical Informatics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jeremy Leipzig
- Center for Biomedical Informatics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | - Ryan Golhar
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Stephan J Sanders
- Genetics, Yale University, New Haven, CT 06520, USA.,Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Boris Yamrom
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Michael Ronemus
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Ivan Iossifov
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - A Jeremy Willsey
- Genetics, Yale University, New Haven, CT 06520, USA.,Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Matthew W State
- Genetics, Yale University, New Haven, CT 06520, USA.,Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jonathan R Kaltman
- Cardiovascular Sciences, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, MD 20892, USA
| | - Peter S White
- Center for Biomedical Informatics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Yufeng Shen
- Systems Biology, Columbia University Medical Center, New York, NY 10032, USA
| | - Dorothy Warburton
- Genetics and Development (in Medicine), Columbia University Medical Center, New York, NY 10032, USA
| | | | | | - Elizabeth Goldmuntz
- Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Bruce D Gelb
- Mindich Child Health and Development Institute, Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Richard Lifton
- Genetics, Yale University, New Haven, CT 06520, USA.,Medicine, Yale University, New Haven, CT 06520, USA
| | | | - Hakon Hakonarson
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Wendy K Chung
- Pediatrics and Medicine, Columbia University Medical Center, New York, NY 10032, USA
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White PS, Xie HM, Werner P, Glessner J, Latney B, Hakonarson H, Goldmuntz E. Analysis of chromosomal structural variation in patients with congenital left-sided cardiac lesions. ACTA ACUST UNITED AC 2014; 100:951-64. [DOI: 10.1002/bdra.23279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Peter S. White
- The Center for Biomedical Informatics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
- Department of Pediatrics; Perelman School of Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Hongbo M. Xie
- The Center for Biomedical Informatics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Petra Werner
- The Division of Cardiology; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Joseph Glessner
- The Center for Applied Genomics, Department of Pediatrics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Brande Latney
- The Division of Cardiology; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Hakon Hakonarson
- Department of Pediatrics; Perelman School of Medicine, University of Pennsylvania; Philadelphia Pennsylvania
- The Center for Applied Genomics, Department of Pediatrics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Elizabeth Goldmuntz
- Department of Pediatrics; Perelman School of Medicine, University of Pennsylvania; Philadelphia Pennsylvania
- The Division of Cardiology; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania
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Abstract
Congenital heart disease (CHD) is the most common birth defect. Despite considerable advances in care, CHD remains a major contributor to newborn mortality and is associated with substantial morbidities and premature death. Genetic abnormalities appear to be the primary cause of CHD, but identifying precise defects has proven challenging, principally because CHD is a complex genetic trait. Mainly because of recent advances in genomic technology such as next-generation DNA sequencing, scientists have begun to identify the genetic variants underlying CHD. In this article, the roles of modifier genes, de novo mutations, copy number variants, common variants, and noncoding mutations in the pathogenesis of CHD are reviewed.
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Affiliation(s)
- Bruce D Gelb
- Mindich Child Health and Development Institute and Departments of Pediatrics and Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, New York 10032
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Carey AS, Liang L, Edwards J, Brandt T, Mei H, Sharp AJ, Hsu DT, Newburger JW, Ohye RG, Chung WK, Russell MW, Rosenfeld JA, Shaffer LG, Parides MK, Edelmann L, Gelb BD. Effect of copy number variants on outcomes for infants with single ventricle heart defects. CIRCULATION. CARDIOVASCULAR GENETICS 2013; 6:444-51. [PMID: 24021551 PMCID: PMC3987966 DOI: 10.1161/circgenetics.113.000189] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Human genomes harbor copy number variants (CNVs), which are regions of DNA gains or losses. Although pathogenic CNVs are associated with congenital heart disease (CHD), their effect on clinical outcomes is unknown. This study sought to determine whether pathogenic CNVs among infants with single ventricle physiology were associated with inferior neurocognitive and somatic growth outcomes. METHODS AND RESULTS Genomic DNAs from 223 subjects of 2 National Heart, Lung, and Blood Institute-sponsored randomized clinical trials in infants with single ventricle CHD and 270 controls from The Cancer Genome Atlas project were analyzed for rare CNVs>300 kb using array comparative genomic hybridization. Neurocognitive and growth outcomes at 14 months from the CHD trials were compared among subjects with and without pathogenic CNVs. Putatively pathogenic CNVs, comprising 25 duplications and 6 deletions, had a prevalence of 13.9%, significantly greater than the 4.4% rate of such CNVs among controls. CNVs associated with genomic disorders were found in 13 cases but not in controls. Several CNVs likely to be causative of single ventricle CHD were observed, including aberrations altering the dosage of GATA4, MYH11, and GJA5. Subjects with pathogenic CNVs had worse linear growth, and those with CNVs associated with known genomic disorders had the poorest neurocognitive and growth outcomes. A minority of children with pathogenic CNVs were noted to be dysmorphic on clinical genetics examination. CONCLUSIONS Pathogenic CNVs seem to contribute to the cause of single ventricle forms of CHD in ≥10% of cases and are clinically subtle but adversely affect outcomes in children harboring them.
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Affiliation(s)
- Abigail S. Carey
- Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York
| | - Li Liang
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Jonathan Edwards
- Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York
| | - Tracy Brandt
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Hui Mei
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Andrew J. Sharp
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Daphne T. Hsu
- Pediatric Cardiology, The Children’s Hospital at Montefiore, Bronx, NY
| | | | - Richard G. Ohye
- Dept of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery, University of Michigan Medical School, Ann Arbor, MI
| | - Wendy K. Chung
- Dept of Pediatrics, Columbia University Medical Center, New York, NY
| | - Mark W. Russell
- Division of Pediatric Cardiology, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI
| | | | - Lisa G. Shaffer
- Paw Print Genetics, Genetic Veterinary Sciences, Spokane, WA
| | - Michael K. Parides
- Dept of Health Evidence & Policy, Icahn School of Medicine at Mount Sinai, New York
| | - Lisa Edelmann
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Bruce D. Gelb
- Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York
- Dept of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York
- Dept of Pediatrics, Icahn School of Medicine at Mount Sinai, New York
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Abstract
PURPOSE OF REVIEW To review recent advances in our understanding of the genetic causes of congenital heart defect (CHD). RECENT FINDINGS CHD behaves like a complex genetic trait in most instances. Recent advances in genomics have provided tools for uncovering genetic variants underlying complex traits that are now being applied to study CHD. Massively parallel DNA sequencing has shown that de-novo mutations contribute to approximately 10% of severe CHD and implicated chromatin remodeling in pathogenesis. Genome scanning methods for copy number variants continue to identify lesions underlying CHD, some predisposing to it generally and others having lesion specificity. Gene-environment interactions are being explored, primarily related to the metabolism of folate and homocysteine. Finally, studies are addressing other aspects of complexity for CHD such as mutations in cis-regulatory elements and modifying genes. SUMMARY The genetic architecture of CHD is being elaborated through the use of state-of-the-art genomic approaches. Through these scientific advances, new opportunities for preventing and ameliorating CHD and its comorbidities are anticipated.
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Andersen TA, Troelsen KDLL, Larsen LA. Of mice and men: molecular genetics of congenital heart disease. Cell Mol Life Sci 2013; 71:1327-52. [PMID: 23934094 PMCID: PMC3958813 DOI: 10.1007/s00018-013-1430-1] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/16/2013] [Accepted: 07/18/2013] [Indexed: 12/21/2022]
Abstract
Congenital heart disease (CHD) affects nearly 1 % of the population. It is a complex disease, which may be caused by multiple genetic and environmental factors. Studies in human genetics have led to the identification of more than 50 human genes, involved in isolated CHD or genetic syndromes, where CHD is part of the phenotype. Furthermore, mapping of genomic copy number variants and exome sequencing of CHD patients have led to the identification of a large number of candidate disease genes. Experiments in animal models, particularly in mice, have been used to verify human disease genes and to gain further insight into the molecular pathology behind CHD. The picture emerging from these studies suggest that genetic lesions associated with CHD affect a broad range of cellular signaling components, from ligands and receptors, across down-stream effector molecules to transcription factors and co-factors, including chromatin modifiers.
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Affiliation(s)
- Troels Askhøj Andersen
- Wilhelm Johannsen Centre for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen, Denmark
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Chang SW, Mislankar M, Misra C, Huang N, Dajusta DG, Harrison SM, McBride KL, Baker LA, Garg V. Genetic abnormalities in FOXP1 are associated with congenital heart defects. Hum Mutat 2013; 34:1226-30. [PMID: 23766104 DOI: 10.1002/humu.22366] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 06/03/2013] [Indexed: 12/20/2022]
Abstract
The etiology for the majority of congenital heart defects (CHD) is unknown. We identified a patient with unbalanced atrioventricular septal defect (AVSD) and hypoplastic left ventricle who harbored an ~0.3 Mb monoallelic deletion on chromosome 3p14.1. The deletion encompassed the first four exons of FOXP1, a gene critical for normal heart development that represses cardiomyocyte proliferation and expression of Nkx2.5. To determine whether FOXP1 mutations are found in patients with CHD, we sequenced FOXP1 in 82 patients with AVSD or hypoplastic left heart syndrome. We discovered two patients who harbored a heterozygous c.1702C>T variant in FOXP1 that predicted a potentially deleterious substitution of a highly conserved proline (p.Pro568Ser). This variant was not found in 287 controls but is present in dbSNP at a 0.2% frequency. The orthologous murine Foxp1 p.Pro596Ser mutant protein displayed deficits in luciferase reporter assays and resulted in increased proliferation and Nkx2.5 expression in cardiomyoblasts. Our data suggest that haploinsufficiency of FOXP1 is associated with human CHD.
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Affiliation(s)
- Sheng-Wei Chang
- Center for Cardiovascular and Pulmonary Research and The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA
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Abstract
Congenital heart disease (CHD) is the most common congenital anomaly in newborn babies. Cardiac malformations have been produced in multiple experimental animal models, by perturbing selected molecules that function in the developmental pathways involved in myocyte specification, differentiation, or cardiac morphogenesis. In contrast, the precise genetic, epigenetic, or environmental basis for these perturbations in humans remains poorly understood. Over the past few decades, researchers have tried to bridge this knowledge gap through conventional genome-wide analyses of rare Mendelian CHD families, and by sequencing candidate genes in CHD cohorts. Although yielding few, usually highly penetrant, disease gene mutations, these discoveries provided 3 notable insights. First, human CHD mutations impact a heterogeneous set of molecules that orchestrate cardiac development. Second, CHD mutations often alter gene/protein dosage. Third, identical pathogenic CHD mutations cause a variety of distinct malformations, implying that higher order interactions account for particular CHD phenotypes. The advent of contemporary genomic technologies including single nucleotide polymorphism arrays, next-generation sequencing, and copy number variant platforms are accelerating the discovery of genetic causes of CHD. Importantly, these approaches enable study of sporadic cases, the most common presentation of CHD. Emerging results from ongoing genomic efforts have validated earlier observations learned from the monogenic CHD families. In this review, we explore how continued use of these technologies and integration of systems biology is expected to expand our understanding of the genetic architecture of CHD.
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Affiliation(s)
- Akl C Fahed
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
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28
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GATA5 loss-of-function mutation responsible for the congenital ventriculoseptal defect. Pediatr Cardiol 2013; 34:504-11. [PMID: 22961344 DOI: 10.1007/s00246-012-0482-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 08/04/2012] [Indexed: 01/12/2023]
Abstract
The ventriculoseptal defect (VSD) is the most common form of congenital heart disease and a leading noninfectious cause of infant mortality. Growing evidence demonstrates that genetic defects are associated with congenital VSD. Nevertheless, VSD is genetically heterogeneous, and the molecular basis for VSD in an overwhelming majority of patients remains unknown. In this study, the whole coding region of GATA5, a gene encoding a zinc finger transcription factor crucial for normal cardiogenesis, was sequenced in 120 unrelated patients with VSD. The available relatives of the patient harboring the identified mutation and 200 unrelated individuals used as controls were subsequently genotyped. The causative potential of a sequence variation was evaluated by MutationTaster, and the functional effect of the mutation was characterized using a luciferase reporter assay system. As a result, a novel heterozygous GATA5 mutation, p.L199V, was identified in a patient with VSD, which was absent in 400 control chromosomes. Genetic analysis of the mutation carrier's available family members showed that the substitution co-segregated with VSD transmitted in an autosomal dominant pattern. The p.L199V variation was automatically predicted to be disease causing, and the functional analysis showed that the GATA5 p.L199V mutant protein was associated with significantly reduced transcriptional activation compared with its wild-type counterpart. To the best of the authors' knowledge, this is the first report on the link of functionally compromised GATA5 to human VSD, suggesting potential implications for the early prophylaxis and personalized treatment of VSD.
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Serra-Juhé C, Rodríguez-Santiago B, Cuscó I, Vendrell T, Camats N, Torán N, Pérez-Jurado LA. Contribution of rare copy number variants to isolated human malformations. PLoS One 2012; 7:e45530. [PMID: 23056206 PMCID: PMC3463597 DOI: 10.1371/journal.pone.0045530] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 08/21/2012] [Indexed: 11/18/2022] Open
Abstract
Background Congenital malformations are present in approximately 2–3% of liveborn babies and 20% of stillborn fetuses. The mechanisms underlying the majority of sporadic and isolated congenital malformations are poorly understood, although it is hypothesized that the accumulation of rare genetic, genomic and epigenetic variants converge to deregulate developmental networks. Methodology/Principal Findings We selected samples from 95 fetuses with congenital malformations not ascribed to a specific syndrome (68 with isolated malformations, 27 with multiple malformations). Karyotyping and Multiplex Ligation-dependent Probe Amplification (MLPA) discarded recurrent genomic and cytogenetic rearrangements. DNA extracted from the affected tissue (46%) or from lung or liver (54%) was analyzed by molecular karyotyping. Validations and inheritance were obtained by MLPA. We identified 22 rare copy number variants (CNV) [>100 kb, either absent (n = 7) or very uncommon (n = 15, <1/2,000) in the control population] in 20/95 fetuses with congenital malformations (21%), including 11 deletions and 11 duplications. One of the 9 tested rearrangements was de novo while the remaining were inherited from a healthy parent. The highest frequency was observed in fetuses with heart hypoplasia (8/17, 62.5%), with two events previously related with the phenotype. Double events hitting candidate genes were detected in two samples with brain malformations. Globally, the burden of deletions was significantly higher in fetuses with malformations compared to controls. Conclusions/Significance Our data reveal a significant contribution of rare deletion-type CNV, mostly inherited but also de novo, to human congenital malformations, especially heart hypoplasia, and reinforce the hypothesis of a multifactorial etiology in most cases.
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Affiliation(s)
- Clara Serra-Juhé
- Unitat de Genètica, Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | - Ivon Cuscó
- Unitat de Genètica, Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Teresa Vendrell
- Programa de Medicina Molecular i Genètica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Núria Camats
- Servei d'Anatomia Patològica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Núria Torán
- Servei d'Anatomia Patològica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Luis A. Pérez-Jurado
- Unitat de Genètica, Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- * E-mail:
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Bao B, Zhang L, Hu H, Yin S, Liang Z. Deletion of a single-copy DAAM1 gene in congenital heart defect: a case report. BMC MEDICAL GENETICS 2012; 13:63. [PMID: 22857009 PMCID: PMC3482563 DOI: 10.1186/1471-2350-13-63] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Accepted: 07/24/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND With an increasing incidence of congenital heart defects (CHDs) in recent years, genotype-phenotype correlation and array-based methods have contributed to the genome-wide analysis and understanding of genetic variations in the CHD population. Here, we report a copy number deletion of chromosomal 14q23.1 in a female fetus with complex congenital heart defects. This is the first description of DAAM1 gene deletion associated with congenital heart anomalies. CASE PRESENTATION Compared with the control population, one CHD fetus showed a unique copy number deletion of 14q23.1, a region that harbored DAAM1 and KIAA0666 genes. CONCLUSIONS Results suggest that the copy number deletion on chromosome 14q23.1 may be critical for cardiogenesis. However, the exact relationship and mechanism of how DAAM1 and KIAA0666 deletion contributes to the onset of CHD is yet to be determined.
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Affiliation(s)
- Bihui Bao
- Department of Gynecology and Obstetrics, South-West Hospital, Third Military Medical University, Chongqing, China
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