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Goulart MB, Vieira Neto E, Garcia DRN, Guimarães MM, de Paiva IS, de Ferran K, dos Santos NCK, Barbosa LS, de Figueiredo AF, Ribeiro MCM, Ribeiro MG. Cell Cycle Kinetics and Sister Chromatid Exchange in Mosaic Turner Syndrome. Life (Basel) 2024; 14:848. [PMID: 39063601 PMCID: PMC11278208 DOI: 10.3390/life14070848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
Turner syndrome (TS) is caused by a complete or partial absence of an X or Y chromosome, including chromosomal mosaicism, affecting 1 in 2500 female live births. Sister chromatid exchange (SCE) is used as a sensitive indicator of spontaneous chromosome instability. Cells from mosaic patients constitute useful material for SCE evaluations as they grow under the influence of the same genetic background and endogenous and exogenous factors. We evaluated the proliferation dynamics and SCE frequencies of 45,X and 46,XN cells of 17 mosaic TS patients. In two participants, the 45,X cells exhibited a proliferative disadvantage in relation to 46,XN cells after 72 h of cultivation. The analysis of the mean proliferation index (PI) showed a trend for a significant difference between the 45,X and 46,X+der(X)/der(Y) cell lineages; however, there were no intra-individual differences. On the other hand, mean SCE frequencies showed that 46,X+der(X) had the highest mean value and 46,XX the lowest, with 45,X occupying an intermediate position among the lineages found in at least three participants; moreover, there were intra-individual differences in five patients. Although 46,X+der(X)/der(Y) cell lineages, found in more than 70% of participants, were the most unstable, they had a slightly higher mean PI than the 45,X cell lineages in younger (≤17 years) mosaic TS participants. This suggests that cells with a karyotype distinct from 45,X may increase with time in mosaic TS children and adolescents.
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Affiliation(s)
- Miriam Beatriz Goulart
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
| | - Eduardo Vieira Neto
- Genetic and Genomic Medicine Division, Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Daniela R. Ney Garcia
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
| | - Marília Martins Guimarães
- Pediatric Endocrinology Service, IPPMG, UFRJ, Rio de Janeiro 21941-912, RJ, Brazil; (M.M.G.); (K.d.F.); (N.C.K.d.S.)
| | - Isaías Soares de Paiva
- Faculty of Medicine, University of Grande Rio (Unigranrio), Duque de Caxias 25071-202, RJ, Brazil;
- Faculty of Medicine, Serra dos Órgãos Educational Center (UNIFESO), Teresópolis 25964-004, RJ, Brazil
| | - Karina de Ferran
- Pediatric Endocrinology Service, IPPMG, UFRJ, Rio de Janeiro 21941-912, RJ, Brazil; (M.M.G.); (K.d.F.); (N.C.K.d.S.)
| | | | - Luciana Santos Barbosa
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
| | - Amanda F. de Figueiredo
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
| | - Maria Cecília Menks Ribeiro
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
- NUMPEX-BIO Laboratory, Campus Duque de Caxias, UFRJ, Duque de Caxias 25240-005, RJ, Brazil
| | - Márcia Gonçalves Ribeiro
- Laboratory of Genetics, Institute of Childcare and Pediatrics Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, RJ, Brazil; (M.B.G.); (D.R.N.G.); (A.F.d.F.); (M.C.M.R.); (M.G.R.)
- Medical Genetics Service, IPPMG, UFRJ, Rio de Janeiro 21941-912, RJ, Brazil
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Garg K, Zilate S. Umbilical Cord-Derived Mesenchymal Stem Cells for the Treatment of Infertility Due to Premature Ovarian Failure. Cureus 2022; 14:e30529. [PMID: 36415442 PMCID: PMC9674197 DOI: 10.7759/cureus.30529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Females belonging to the reproductive age group may face challenges regarding infertility or miscarriage due to conditions such as premature ovarian failure (POF). It is the condition that happens when a female's ovaries stop working before she is 40. The majority of the causes of POF cases are idiopathic. Other reasons include genetic disorders (Turner's syndrome, bone morphogenetic protein 15 (BMP15) mutation, galactosemia, mutation of forkhead box protein L2 (FOXL2), growth differentiation factor-9 (GDF9), mutation of luteinizing hormone (LH) and follicle-stimulating hormone receptors (FSHR), etc.), enzymatic mutation such as aromatase, autoimmune disorders (Addison's disease, vitiligo, systemic lupus erythematosus, myasthenia gravis, autoimmune thyroiditis, autoimmune polyglandular syndrome, etc.), vaccination, and environmental factors (cigarette smoking, toxins, and infections). Many attempts have been made to treat POF by various methods. Some of the methods of treatment include hormone replacement therapy (HRT), melatonin therapy, dehydroepiandrosterone (DHEA) therapy, and stem cell therapy. Stem cell therapy has proven to be the most efficient form for treating POF as compared to all other options. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) are the best among the other sources of mesenchymal stem cells (MSCs) for the treatment of POF as they have a painless extraction procedure. They have a tremendous capacity for self-repair and regeneration, which helps them in restoring degenerated ovaries. This review includes information on the causes of POF, its efficacious therapeutic approaches, and the impact of transplantation of human umbilical cord mesenchymal stem cells (hUCMSCs) as an option for the therapy of POF. Numerous studies conducted on stem cell therapy prove that it is an effective approach for the treatment of sterility.
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Dejonckheere C, Moyson C, de Zegher F, Antonio L, Van Buggenhout G, Decallonne B. Neoplasia in Turner syndrome: a retrospective cohort study in a tertiary referral centre in Belgium. Acta Clin Belg 2022; 77:86-92. [PMID: 32780684 DOI: 10.1080/17843286.2020.1805237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Patients with Turner syndrome (TS), the most common sex chromosome abnormality in women, can suffer from a variety of well-researched reproductive, cardiovascular, metabolic, and autoimmune comorbidities. Few studies investigate the neoplasia risk. We assessed the general neoplasia risk in TS women, and more specifically, the gonadoblastoma/dysgerminoma risk in the subgroup with Y chromosome mosaicism, and evaluated potential risk factors for neoplasia development, such as karyotype, metabolic and autoimmune comorbidity, and treatment with growth hormone and/or estrogen replacement. DESIGN 10-year retrospective cohort study in a tertiary referral centre in Belgium. RESULTS 105 TS women were included (median age 29; range 2-69). Six malignant tumours were detected in 5 (4.8%) patients (SIR = 0.6, 95% CI 0.2-1.0). In addition, 2 benign meningiomas were observed, resulting in 3 (2.9%) tumours of the central nervous system (CNS; SIR = 19.9, 95% CI 4.0-35.8). No breast cancer was noted. Benign neoplasms occurred in 22 women (21.0%), with skin lesions being the most frequent. All patients with Y chromosome mosaicism (n = 9; 8.6%) underwent prophylactic gonadectomy, but gonadoblastoma/dysgerminoma was not detected. A weak association was found between any tumour type and autoimmune comorbidity (r = 0.24; p = 0.02). CONCLUSION The overall malignancy risk was not increased, but a different pattern of occurrence is apparent, with an increased risk of CNS and skin tumours and a decreased breast cancer risk. Gonadoblastoma/dysgerminoma was not reported. There is a need for centralised multidisciplinary care and prospective research to unravel and predict the neoplasia risk.
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Affiliation(s)
- Cas Dejonckheere
- Faculty of Medicine, Catholic University Leuven, Leuven, Belgium
| | - Carolien Moyson
- Department of Adult Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Francis de Zegher
- Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Leen Antonio
- Department of Adult Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | | | - Brigitte Decallonne
- Department of Adult Endocrinology, University Hospitals Leuven, Leuven, Belgium
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Barbosa LG, Siviero-Miachon AA, Souza MA, Spinola-Castro AM. Recognition of the Y chromosome in Turner syndrome using peripheral blood or oral mucosa tissue. Ann Pediatr Endocrinol Metab 2021; 26:272-277. [PMID: 34634867 PMCID: PMC8749017 DOI: 10.6065/apem.2142026.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/31/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Turner syndrome is defined as total or partial loss of the second sex chromosome in a phenotypically female patient. Due to the possibility of hidden mosaicism of fragments of the Y chromosome and development of gonadoblastoma, we evaluated the presence of such fragments in 2 tissues with different embryonic origins, peripheral blood lymphocytes (mesoderm), and oral mucosal cells (ectoderm) using multiplex polymerase chain reaction. METHODS DNA samples were collected from 109 patients, and primers for the SRY, TSPY, and AMELX genes were used. RESULTS We found 14 patients (12.8%) with positive molecular markers for the Y chromosome. The study of tissues of different embryological origin showed the same degree of agreement, sensitivity, and specificity. CONCLUSION Oral mucosa cells have a simpler method of collection that is less invasive and requires less time for DNA extraction at a lower cost.
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Affiliation(s)
- Lene Garcia Barbosa
- Division of Pediatric Endocrinology, Department of Pediatrics in Federal University of Sao Paulo (UNIFESP-EPM), Sao Paulo, Brazil,Address for correspondence: Lene Garcia Barbosa Division of Pediatric Endocrinology, Department of Pediatrics in Federal University of Sao Paulo (UNIFESPEPM), Sao Paulo, Brazil,340 José de Magalhães Street, São Paulo 04026- 090, Brazil
| | | | | | - Angela Maria Spinola-Castro
- Division of Pediatric Endocrinology, Department of Pediatrics in Federal University of Sao Paulo (UNIFESP-EPM), Sao Paulo, Brazil
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Morin JP, Saltzman AF. Gonadoblastoma in Turner Syndrome: A Surprise in a Streak. Urology 2021; 154:278-280. [PMID: 33961893 DOI: 10.1016/j.urology.2021.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/14/2021] [Indexed: 11/19/2022]
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Abstract
This review describes the germ cell neoplasms that are malignant and most commonly associated with several types of gonadal dysgenesis. The most common neoplasm is gonadoblastoma, while others including dysgerminomas, yolk-sac tumors and teratomas are rare but can occur. The purpose of this review is to evaluate the incidences of these abnormalities and the circumstances surrounding these specific tumors.According to well-established methods, a PubMed systematic review was performed, to obtain relevant studies published in English and select those with the highest-quality data.Initially, the first search was performed using gonadal dysgenesis as the search term, resulting in 12,887 PubMed papers, published, from 1945 to 2017. A second search using ovarian germ cell tumors as the search term resulted in 10,473 papers, published from 1960 to 2017. Another search was performed in Medline, using germ cell neoplasia as the search term, and this search resulted in 7,560 papers that were published between 2003 to 2016, with 245 new papers assessing gonadoblastomas.The higher incidence of germ cell tumors in gonadal dysgenesis is associated with a chromosomal anomaly that leads to the absence of germ cells in these gonads and, consequently, a higher incidence of neoplasms when these tumors are located inside the abdomen. Several hypotheses suggest that increased incidence of germ cell tumors involves all or part of the Y chromosome or different genes.
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Affiliation(s)
- Mauri José Piazza
- Departamento de TocoGinecologia, Universidade Federal do Parana, Curitiba, PR, BR
- Corresponding author. E-mail:
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Identification of Y-Chromosome Sequences in Turner Syndrome. Indian J Pediatr 2016; 83:405-9. [PMID: 26634260 DOI: 10.1007/s12098-015-1929-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To investigate the presence of Y-chromosome sequences and determine their frequency in patients with Turner syndrome. METHODS The study included 23 patients with Turner syndrome from Brazil, who gave written informed consent for participating in the study. Cytogenetic analyses were performed in peripheral blood lymphocytes, with 100 metaphases per patient. Genomic DNA was also extracted from peripheral blood lymphocytes, and gene sequences DYZ1, DYZ3, ZFY and SRY were amplified by Polymerase Chain Reaction. RESULTS The cytogenetic analysis showed a 45,X karyotype in 9 patients (39.2 %) and a mosaic pattern in 14 (60.8 %). In 8.7 % (2 out of 23) of the patients, Y-chromosome sequences were found. This prevalence is very similar to those reported previously. The initial karyotype analysis of these patients did not reveal Y-chromosome material, but they were found positive for Y-specific sequences in the lymphocyte DNA analysis. CONCLUSION The PCR technique showed that 2 (8.7 %) of the patients with Turner syndrome had Y-chromosome sequences, both presenting marker chromosomes on cytogenetic analysis.
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Jung JY, Yang S, Jeong EH, Lee HC, Lee YM, Han HS, Yi KH. Mixed gonadal dysgenesis in 45,X Turner syndrome with SRY gene. Ann Pediatr Endocrinol Metab 2015; 20:226-9. [PMID: 26817010 PMCID: PMC4722163 DOI: 10.6065/apem.2015.20.4.226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/24/2015] [Accepted: 10/08/2015] [Indexed: 01/11/2023] Open
Abstract
Turner syndrome is the most common chromosomal disorder in girls. Various phenotypic features show depending upon karyotype from normal female through ambiguous genitalia to male. Usually, Turner girls containing 45,X/46,XY mosaicism, or sex-determining region Y (SRY) gene may have mixed gonadal dysgenesis with various external sexual differentiation. We experienced a short statured 45,X Turner girl with normal external genitalia. Because SRY gene was positive, laparoscopic gonadectomy was performed. The dysgenetic gonads revealed bilateral ovotesticular tissues. The authors report a mixed gonadal dysgenesis case found in clinical 45,X Turner patient with positive SRY gene. Screening for SRY gene should be done even the karyotype is 45,X monosomy and external genitalia is normal.
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Affiliation(s)
- Jae Yeop Jung
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sohyoung Yang
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eun-Hwan Jeong
- Department of Obstetrics & Gynecology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ho-Chang Lee
- Department of Anatomic Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Yong-Moon Lee
- Department of Anatomic Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Heon-Seok Han
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyung Hee Yi
- Department of Pediatrics, Wonkwang University Sanbon Medical Center, Gunpo, Korea
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de Marqui ABT, da Silva-Grecco RL, Balarin MAS. [Prevalence of Y-chromosome sequences and gonadoblastoma in Turner syndrome]. REVISTA PAULISTA DE PEDIATRIA 2015; 34:114-21. [PMID: 26525685 DOI: 10.1016/j.rpped.2015.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/26/2015] [Accepted: 06/04/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the prevalence of Y-chromosome sequences and gonadoblastoma in patients with Turner syndrome using molecular techniques. DATA SOURCE A literature search was performed in Pubmed, limiting the period of time to the years 2005 to 2014 and using the descriptors: Turner syndrome and Y sequences (n=26), and Turner syndrome and Y-chromosome material (n=27). The inclusion criteria were: articles directly related to the subject and published in English or Portuguese. Articles which did not meet these criteria and review articles were excluded. After applying these criteria, 14 papers were left. DATA SYNTHESIS the main results regarding the prevalence of Y-chromosome sequences in Turner syndrome were: 1-about 60% of the studies were conducted by Brazilian researchers; 2-the prevalence varied from 4.6 to 60%; 3-the most frequently investigated genes were SRY, DYZ3 and TSPY; 4-seven studies used only PCR, while in the remaining seven it was associated with FISH. Nine of the 14 studies reported gonadectomy and gonadoblastoma. The highest prevalence of gonadoblastoma (33%) was found in two studies. In five out of the nine papers evaluated the prevalence of gonadoblastoma was 10 to 25%; in two of them it was zero. CONCLUSIONS according to these data, molecular analysis to detect Y-chromosome sequences in TS patients is indicated, regardless of their karyotype. In patients who test positive for these sequences, gonadoblastoma needs to be investigated.
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Chapman C, Cree L, Shelling AN. The genetics of premature ovarian failure: current perspectives. Int J Womens Health 2015; 7:799-810. [PMID: 26445561 PMCID: PMC4590549 DOI: 10.2147/ijwh.s64024] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Premature ovarian failure (POF) is a common cause of infertility in women, characterized by amenorrhea, hypoestrogenism, and elevated gonadotropin levels in women under the age of 40. Many genes have been identified over the past few years that contribute to the development of POF. However, few genes have been identified that can explain a substantial proportion of cases of POF. The unbiased approaches of genome-wide association studies and next-generation sequencing technologies have identified several novel genes implicated in POF. As only a small proportion of genes influencing idiopathic POF have been identified thus far, it remains to be determined how many genes and molecular pathways may influence idiopathic POF development. However, owing to POF’s diverse etiology and genetic heterogeneity, we expect to see the contribution of several new and novel molecular pathways that will greatly enhance our understanding of the regulation of ovarian function. Future genetic studies in large cohorts of well-defined, unrelated, idiopathic POF patients will provide a great opportunity to identify the missing heritability of idiopathic POF. The identification of several causative genes may allow for early detection and would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help direct potential targets for future treatment.
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Affiliation(s)
- Chevy Chapman
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lynsey Cree
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Andrew N Shelling
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Zelaya G, López Marti JM, Marino R, Garcia de Dávila MT, Gallego MS. Gonadoblastoma in patients with Ullrich-Turner syndrome. Pediatr Dev Pathol 2015; 18:117-21. [PMID: 25535833 DOI: 10.2350/14-08-1539-oa.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ullrich-Turner syndrome (UTS) is a common chromosomal abnormality caused by partial or complete X chromosome monosomy. One half of the patients have a 45,X karyotype, whereas the remaining patients display other X chromosome anomalies. In 6% to 11% of UTS, a normal or partly deleted Y chromosome has been found. A 10% to 30% risk of developing gonadoblastoma was found in the latter patients. The aim of this study was to evaluate the prevalence of Y chromosome-derived material, the occurrence of gonadoblastoma, and the incidence of possible neoplasms in patients with UTS. Of 217 patients studied with UTS and chromosome analysis of peripheral-blood lymphocytes, Y chromosome material was found in 20 patients. Fluorescence in situ hybridization (FISH) testing was performed to characterize the structurally abnormal Y chromosome in 13 cases. Molecular analysis of the SRY gene could only be performed in 20 patients with 45,X karyotype. Two patients had the SRY genomes. Of the 20 patients with Y chromosome-derived material, 17 underwent gonadectomy. The incidence of gonadoblastoma development in our series was 35.5%. Furthermore, 1 patient also showed a pure dysgerminoma, and another showed a mixed dysgerminoma and embryonal carcinoma. We emphasize the importance of complete processing of the gonadectomy specimen, including step sections, molecular studies, and FISH, in addition to the classic cytogenetic searching for Y chromosome sequences, in patients who present with a nonmosaic 45,X karyotype. Finally, we propose to routinely collect a sample for storage in the tumor bank for future studies.
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Affiliation(s)
- Gabriela Zelaya
- 1 Department of Genetics, Laboratory of Cytogenetics, Hospital Nacional de Pediatría J.P Garrahan, Combate de los Pozos 1881 (CP 1245) Buenos Aires, Argentina
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Wong SC, Burgess T, Cheung M, Zacharin M. The prevalence of turner syndrome in girls presenting with coarctation of the aorta. J Pediatr 2014; 164:259-63. [PMID: 24172638 DOI: 10.1016/j.jpeds.2013.09.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 08/14/2013] [Accepted: 09/13/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the prevalence of Turner syndrome in girls presenting with coarctation of the aorta (CoA). STUDY DESIGN A total of 132 girls with known structural CoA was identified. Those girls who had no previous karyotype analysis performed were asked to participate in a research study in which a banded karyotype with 50-cell count was performed. RESULTS Of 132 girls with CoA, 55 (41.7%) had karyotype analysis within 6 months of cardiac diagnosis. Three girls underwent karyotyping later because of clinical concerns. Of the 74 girls with CoA who had not had a karyotype, 38 (51.4%) consented to the study. Results were available for 37 girls. All were 46,XX. Five patients with Turner syndrome were identified in the 95 girls with CoA who had karyotype analysis (4 from early karyotype and 1 diagnosed later), which translated into a minimum prevalence of 5.3% of Turner syndrome in this group of girls with CoA. In addition, one infant with a 20-cell 46,XX karyotype had features of Turner syndrome. CONCLUSION Our study demonstrated for the first time in a large cohort that 5.3% of girls presenting with CoA are found to have Turner syndrome when karyotyping is performed. Given the spectrum of preventable and treatable health problems after the diagnosis of Turner syndrome, we believe that all girls with CoA should have a karyotype analysis, ideally with at least 50-cell count, at the time of diagnosis of CoA.
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Affiliation(s)
- Sze Choong Wong
- Department of Endocrinology, The Royal Children's Hospital, Melbourne, Australia; Center for Hormone Research, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Trent Burgess
- Victorian Clinical Genetics Services Pathology, Melbourne, Australia
| | - Michael Cheung
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Margaret Zacharin
- Department of Endocrinology, The Royal Children's Hospital, Melbourne, Australia; Center for Hormone Research, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
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Cortés-Gutiérrez EI, Herrera-Bartolo R, Dávila-Rodríguez MI, Palacios-Saucedo GC, Vargas-Villarreal J, Romero-Villarreal JB. Molecular detection of cryptic Y-chromosomal material in patients with Turner syndrome. Oncol Rep 2012; 28:1205-10. [PMID: 22824904 DOI: 10.3892/or.2012.1916] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 11/28/2011] [Indexed: 11/06/2022] Open
Abstract
A systematic search for a hidden Y-chromosome mosaicism, in Turner syndrome (TS) patients is justified by the evaluation of the risk of development of germ cell tumors. In this study, we analyzed cryptic Y-chromosome derivatives by polymerase chain reaction (PCR) coupled with fluorescence in situ hybridization (FISH) using Y-specific sequences in patients with TS, and validated this methodology. Unrelated patients with TS (n=32) of Mexican mestizo ethnic origin were diagnosed using cytogenetic analysis. Clinical assessment, endocrine evaluation, karyotyping, FISH and PCR analysis of the Y-chromosomal loci were performed. We found that 9.4% (3 out of 32) patients with TS had Y-chromosome material. Two patients showed Y-chromosome by conventional cytogenetics. One patient had no Y-chromosome by initial karyotyping (45, X) but was positive by lymphocyte PCR DNA analysis of the Y-sequence-specific sex-determining region Y (SRY) gene. Our results suggest that the detection of the Y-chromosome material using sensitive methods, such as PCR coupled with FISH, should be carried out in all patients with TS and should not be limited to TS patients with cytogenetically identifiable Y-chromosome and/or virilization.
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Affiliation(s)
- Elva I Cortés-Gutiérrez
- Department of Genetics, Biomedical Research Center of Northeast (CIBIN), Mexican Institute of Social Security (IMSS), Monterrey, Nuevo León, Mexico.
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Genetic aspects of premature ovarian failure: a literature review. Arch Gynecol Obstet 2010; 283:635-43. [PMID: 21188402 DOI: 10.1007/s00404-010-1815-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Accepted: 12/08/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND The diagnosis of premature ovarian failure (POF) is based on the finding of amenorrhea before the age of 40 years associated with follicle-stimulating hormone levels in the menopausal range. It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 years and 1:1,000 women by age 30 years. POF is generally characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). METHODS Review of significant articles regarding genetic causes that are associated with POF. RESULTS Heterogeneity of POF is reflected by a variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. Changes at a single autosomal locus and many X-linked loci have been implicated in women with POF. X chromosome abnormalities (e.g., Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Many genes have been involved in POF development, among them BMP15, FMR1, FMR2, LHR, FSHR, INHA, FOXL2, FOXO3, ERα, SF1, ERβ and CYP19A1 genes. CONCLUSION Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of cases.
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Bianco B, Oliveira KC, Guedes AD, Barbosa CP, Lipay MVN, Verreschi ITN. OCT4 gonadal gene expression related to the presence of Y-chromosome sequences in Turner syndrome. Fertil Steril 2010; 94:2347-9. [PMID: 20347080 DOI: 10.1016/j.fertnstert.2010.02.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 02/10/2010] [Accepted: 02/16/2010] [Indexed: 11/16/2022]
Abstract
To show that in the dysgenetic gonads of 104 Turner syndrome patients no significant difference was found regarding the expression of the genes DAX1, FOG2, GATA4, OCT4, SF1, SRY, TSPY, WT1, and STRA8 compared with controls, except for genes OCT4, SRY, and TSPY in both gonads of a patient whose chromosomal constitution was 45,X/45,X,add(15)(p11). The expression analysis of genes OCT4, SRY, and TSPY in the dysgenetic gonads of Turner syndrome patients may allow introducing modifications in the microenvironment that could contributed to a malignant transformation process.
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Affiliation(s)
- Bianca Bianco
- Division of Endocrinology, Department of Medicine, Federal University of Sao Paulo, São Paulo, Brazil
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