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Abstract
Skeletal dysplasias result from disruptions in normal skeletal growth and development and are a major contributor to severe short stature. They occur in approximately 1/5,000 births, and some are lethal. Since the most recent publication of the Nosology and Classification of Genetic Skeletal Disorders, genetic causes of 56 skeletal disorders have been uncovered. This remarkable rate of discovery is largely due to the expanded use of high-throughput genomic technologies. In this review, we discuss these recent discoveries and our understanding of the molecular mechanisms behind these skeletal dysplasia phenotypes. We also cover potential therapies, unusual genetic mechanisms, and novel skeletal syndromes both with and without known genetic causes. The acceleration of skeletal dysplasia genetics is truly spectacular, and these advances hold great promise for diagnostics, risk prediction, and therapeutic design.
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Mannelli G, Deganello A, Laganà MR, Gallo O. Spontaneous internal carotid artery rupture during neck dissection in osteogenesis imperfecta patient. Auris Nasus Larynx 2014; 42:56-8. [PMID: 25246380 DOI: 10.1016/j.anl.2014.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 05/12/2014] [Accepted: 05/24/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Several connective tissue disorders are associated with vascular wall abnormalities, including spontaneous dissection of the cervical arteries. Osteogenesis imperfecta (OI) is a hereditary disorder, with rare neurovascular complications, which potentially lead to life-threatening events. METHODS We presented a case of spontaneous internal carotid artery (ICA) rupture that occurred in a 52-year-old-woman, suffering from OI type I, and who underwent a bilateral modified radical neck dissection (mRND) plus total thyroidectomy for a T4aN1b thyroid cancer. During mRND, an ICA's spontaneous rupture occurred. RESULTS Histopathologic report suggested a structural defect of the arterial wall without cancer infiltration. The patient did not experience any neurologic complications. DISCUSSION Head and neck surgeons have to be aware about early clinical recognition of possible cervical vascular abnormalities, in patients with connective tissue disorders, potentially responsible for dramatic vascular rupture during cervical surgical procedures.
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Affiliation(s)
- Giuditta Mannelli
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy.
| | - Alberto Deganello
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy
| | - Maria Rosa Laganà
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy
| | - Oreste Gallo
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy
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Nemec SF, Cohn DH, Krakow D, Funari VA, Rimoin DL, Lachman RS. The importance of conventional radiography in the mutational analysis of skeletal dysplasias (the TRPV4 mutational family). Pediatr Radiol 2012; 42:15-23. [PMID: 21863289 DOI: 10.1007/s00247-011-2229-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 07/12/2011] [Accepted: 07/26/2011] [Indexed: 12/25/2022]
Abstract
The spondylo and spondylometaphyseal dysplasias (SMDs) are characterized by vertebral changes and metaphyseal abnormalities of the tubular bones, which produce a phenotypic spectrum of disorders from the mild autosomal-dominant brachyolmia to SMD Kozlowski to autosomal-dominant metatropic dysplasia. Investigations have recently drawn on the similar radiographic features of those conditions to define a new family of skeletal dysplasias caused by mutations in the transient receptor potential cation channel vanilloid 4 (TRPV4). This review demonstrates the significance of radiography in the discovery of a new bone dysplasia family due to mutations in a single gene.
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Affiliation(s)
- Stefan F Nemec
- International Skeletal Dysplasia Registry, Medical Genetics Institute, Cedars Sinai Medical Center, 8700 Beverly Boulevard, PACT Suite 400, Los Angeles, CA 90048, USA.
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Wainwright H, Beighton P. Visceral manifestations of hypochondrogenesis. Virchows Arch 2008; 453:203-7. [PMID: 18642028 DOI: 10.1007/s00428-008-0630-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Revised: 04/08/2008] [Accepted: 05/09/2008] [Indexed: 11/29/2022]
Abstract
Autopsy of a stillborn neonate with hypochondrogenesis revealed severe cardiac abnormalities and extensive diverticulosis of the proximal region of the small intestine. Visceral ramifications are unusual in hypochondrogenesis; they may reflect heterogeneity of the intramolecular defect in the COL2A1 gene that codes for the achondrogenesis type II-hypochondrogenesis spectrum of disorders.
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Affiliation(s)
- Helen Wainwright
- Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa.
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Lee CY, Ertel SK. Bone Graft Augmentation and Dental Implant Treatment in a Patient With Osteogenesis Imperfecta: Review of the Literature With a Case Report. IMPLANT DENT 2003; 12:291-5. [PMID: 14752964 DOI: 10.1097/01.id.0000086481.84152.42] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This case report with a review of the literature describes a patient with osteogenesis imperfecta who was treated with dental implants. To our knowledge, only one case report has been published in the English dental literature describing implant treatment in the osteogenesis imperfecta patient. The uncertainty in treatment confronted by all clinicians is the density of bone, which is essential for implant survival.
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Hicks J, De Jong A, Barrish J, Zhu SH, Popek E. Tracheomalacia in a neonate with kniest dysplasia: histopathologic and ultrastructural features. Ultrastruct Pathol 2001; 25:79-83. [PMID: 11297324 DOI: 10.1080/019131201300004726] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Kniest dysplasia is an autosomal-dominant chondrodysplastic condition characterized by disproportionate dwarfism, short trunk, small pelvis, kyphoscoliosis, short limbs, prominent joints, premature osteoarthritis, and craniofacial manifestations. The craniofacial abnormalities include tracheomalacia, midface hypoplasia, cleft palate, early onset myopia, retinal detachment, prominent eyes, and sensorineural hearing loss. Radiologic features include dumbbell-shaped femora, platyspondylia with anterior wedging of vertebral bodies, coronal clefts of thoracolumbar vertebral bodies, low broad ilia, and short tubular bones with broad metaphyses and deformed large epiphyses. This form of chondrodysplasia is associated with mutations in type II collagen splicing sequences. Mutations have been identified in the COL2A1 (type II collagen) gene between exons 12 and 24. Type II collagen is the predominant structural protein in cartilage, and mutations in this collagen account for the Kniest dysplasia phenotype. Histopathologic and ultrastructural features of epiphyseal plate cartilage have been described, but tracheal cartilage in an affected neonate has not been examined. The authors report the histopathologic and ultrastructural findings of anterior tracheal cartilage from a 35-day-old female with suspected chondrodysplasia who had tracheomalacia with airway obstruction. The tracheal cartilage was moderately cellular, but lacked cystic and myxoid changes in its matrix. The chondrocytes had abundant cytoplasmic PAS-positive inclusions. Some of these inclusions were diastase-resistant and were also highlighted on Alcian blue staining. Ultrastructural examination revealed chondrocytes with greatly dilated rough endoplasmic reticulum containing granular proteinaceous material. There were also frequent aggregates of typical glycogen. The defect in the COL2A1 gene is secondary to mutations, especially at splice junctions, and this markedly disrupts triple helix formation. The mutated type II procollagen results in intracellular retention within the chondrocytes, as abundant granular proteinaceous material within the dilated RER. A relationship is known to exist between the proportion of mutated to normal type II collagen in the matrix and the severity of the phenotype. With low levels of normal type II collagen, the phenotypic manifestations become more severe, such as in achondrogenesis type II. Both the quantity and quality of type II collagen modulates the phenotypic expression of type II collagenopathies.
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Affiliation(s)
- J Hicks
- Department of Pathology, Texas Children's Hospital, Houston 77030-2399, USA.
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Lim AL, Doyle SA, Balian G, Smith BD. Role of the pro-α2(I) COOH-terminal region in assembly of type I collagen: Truncation of the last 10 amino acid residues of pro-α2(I) chain prevents assembly of type I collagen heterotrimer. J Cell Biochem 1998. [DOI: 10.1002/(sici)1097-4644(19981101)71:2<216::aid-jcb7>3.0.co;2-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Galera MF, Patrício FRDS, Cernach MCSP, Lederman HM, Brunoni D. Clinical, genetical, radiological, and anatomopathological survey of 17 patients with lethal osteochondrodysplasias. Genet Mol Biol 1998. [DOI: 10.1590/s1415-47571998000200017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Seventeen patients thought to have lethal osteochondrodysplasias were evaluated. Diagnosis was established through clinical evaluation, radiological studies and necropsy. Genetic counseling was provided to the affected patient's families. Specific diagnosis was confirmed in 16 cases. Nosologic diagnosis was done through clinical evaluation. However, the most efficient method for verifying the diagnosis was a skeletal radiological study. This fact corroborates the orientation of the International Classification of Osteochondrodysplasias (International Working Group on Constitutional Disease of Bone, 1992) in which a radiological criterion was adopted as the most relevant for classification of osteochondrodysplasias. An anatomopathological study was also done to detect internal anomalies, and was effective in identifying abnormalities in epiphyseal growth plate in a bone fragment study. This method had low specificity, but in two cases it was especially decisive for diagnostic differentiation.
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Affiliation(s)
| | | | | | | | - Decio Brunoni
- Universidade Federal de São Paulo, Escola Paulista de Medicina
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Jacob AN, Baskaran N, Kandpal G, Narayan D, Bhargava AK, Kandpal RP. Isolation of human ear specific cDNAs and construction of cDNA libraries from surgically removed small amounts of inner ear tissues. SOMATIC CELL AND MOLECULAR GENETICS 1997; 23:83-95. [PMID: 9330637 DOI: 10.1007/bf02679968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We have used representational difference analysis (RDA) for subtractive hybridization of oligo dT primed directionally cloned cDNA libraries from human inner ear tissue and a B-lymphoblast cell line. Two rounds of subtraction-amplification, followed by differential hybridization of selected clones led to the isolation of genes which were specific to the ear. Sequence analysis of randomly chosen clones revealed the presence of a histidine rich Ca2+ binding protein, human dynamin, collagen type 1A1, collagen type 2A1, SPARC, human growth hormone, and several specific genes which had no sequence homology in the data base. Furthermore, to apply these techniques for isolating genes specific to distinct inner ear structures and/or cell types of inner ear for which the starting tissue material is limiting, we have used a modified PCR based protocol to construct representative cDNA libraries. We have characterized a cDNA library constructed from small amounts of inner ear tissues recovered by ablative surgical procedure involving labyrinthectomy. The potential application of these protocols for isolating genes involved in hearing and deafness is discussed.
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Affiliation(s)
- A N Jacob
- Fels Institute for Cancer Research and Molecular Biology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
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Reginato AJ, Passano GM, Neumann G, Falasca GF, Diaz-Valdez M, Jimenez SA, Williams CJ. Familial spondyloepiphyseal dysplasia tarda, brachydactyly, and precocious osteoarthritis associated with an arginine 75-->cysteine mutation in the procollagen type II gene in a kindred of Chiloe Islanders. I. Clinical, radiographic, and pathologic findings. ARTHRITIS AND RHEUMATISM 1994; 37:1078-86. [PMID: 8024616 DOI: 10.1002/art.1780370714] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To characterize a kindred of Chiloe Islanders with spondyloepiphyseal dysplasia tarda (SEDT), brachydactyly, precocious osteoarthritis (OA), and intraarticular calcification. METHODS Sixteen family members underwent a complete physical examination, anthropometric measurements, radiographic studies of the spine and peripheral joints, and analysis of the type II procollagen gene (COL2A1). RESULTS Seven family members presented with SEDT, brachydactyly, precocious OA, and periarticular calcification while 2 others had the same syndrome but without brachydactyly. The inheritance was autosomal dominant, and the disease cosegregated with a base substitution in the COL2A1 gene. CONCLUSION The syndrome o SEDT, precocious OA, and brachydactyly in a kindred of Chiloe Islanders is associated with a point mutation in 1 allele of the COL2A1 gene. The relationship of this type of SEDT to familial calcium pyrophosphate dihydrate deposition disease and idiopathic hip dysplasia, both endemic in Chiloe Islanders, needs to be further investigated.
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Affiliation(s)
- A J Reginato
- Rheumatology Section, Cooper Hospital University Medical Center, Camden, NJ 08103
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Abstract
With the application of molecular techniques the aetiopathogenesis of skeletal dysplasias is gradually elucidated. Recent advances show that some bone dysplasias result from defects in the biosynthesis of type II (cartilage) collagen. Clinical entities caused by mutations in the COL2A1 gene coding for type II collagen comprise achondrogenesis II, hypochondrogenesis, spondyloepiphyseal dysplasia congenita, Kniest dysplasia, Stickler arthroophthalmopathy and mild dominant spondyloarthropathy. The mutations are expressed in the heterozygous state, and inheritance of type II collagenopathies is autosomal dominant. The wide range of clinical manifestations is not well understood but characterization of the basic defect may provide clues to establish specific genotype-phenotype correlations.
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Affiliation(s)
- J Spranger
- Universitäts-Kinderklinik, Mainz, Germany
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Cole WG. Collagen genes: mutations affecting collagen structure and expression. PROGRESS IN NUCLEIC ACID RESEARCH AND MOLECULAR BIOLOGY 1994; 47:29-80. [PMID: 8016323 DOI: 10.1016/s0079-6603(08)60249-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
It is to be expected that more collagen genes will be identified and that additional heritable connective tissue diseases will be shown to arise from collagen mutations. Further progress will be fostered by the coordinated study of naturally occurring and induced heritable connective tissues diseases. In some instances, human mutations will be studied in more detail using transgenic mice, while in others, transgenic studies will be used to determine the type of human phenotype that is likely to result from mutations of a given collagen gene. Further studies of transcriptional regulation of the collagen genes will provide the prospect for therapeutic control of expression of specific collagen genes in patients with genetically determined collagen disorders as well as in a wide range of common human diseases in which abnormal formation of the connective tissues is a feature.
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Affiliation(s)
- W G Cole
- Division of Orthopaedics, Hospital for Sick Children, Toronto, Ontario, Canada
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Chan D, Taylor T, Cole W. Characterization of an arginine 789 to cysteine substitution in alpha 1 (II) collagen chains of a patient with spondyloepiphyseal dysplasia. J Biol Chem 1993. [DOI: 10.1016/s0021-9258(18)82461-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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