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Mim RA, Soorajkumar A, Kosaji N, Rahman MM, Sarker S, Karuvantevida N, Eshaque TB, Rahaman MA, Islam A, Chowdhury MSJ, Shams N, Uddin KMF, Akter H, Uddin M. Expanding deep phenotypic spectrum associated with atypical pathogenic structural variations overlapping 15q11-q13 imprinting region. Brain Behav 2024; 14:e3437. [PMID: 38616334 PMCID: PMC11016631 DOI: 10.1002/brb3.3437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND The 15q11-q13 region is a genetic locus with genes subject to genomic imprinting, significantly influencing neurodevelopment. Genomic imprinting is an epigenetic phenomenon that causes differential gene expression based on the parent of origin. In most diploid organisms, gene expression typically involves an equal contribution from both maternal and paternal alleles, shaping the phenotype. Nevertheless, in mammals, including humans, mice, and marsupials, the functional equivalence of parental alleles is not universally maintained. Notably, during male and female gametogenesis, parental alleles may undergo differential marking or imprinting, thereby modifying gene expression without altering the underlying DNA sequence. Neurodevelopmental disorders, such as Prader-Willi syndrome (PWS) (resulting from the absence of paternally expressed genes in this region), Angelman syndrome (AS) (associated with the absence of the maternally expressed UBE3A gene), and 15q11-q13 duplication syndrome (resulting from the two common forms of duplications-either an extra isodicentric 15 chromosome or an interstitial 15 duplication), are the outcomes of genetic variations in this imprinting region. METHODS Conducted a genomic study to identify the frequency of pathogenic variants impacting the 15q11-q13 region in an ethnically homogenous population from Bangladesh. Screened all known disorders from the DECIPHER database and identified variant enrichment within this cohort. Using the Horizon analysis platform, performed enrichment analysis, requiring at least >60% overlap between a copy number variation and a disorder breakpoint. Deep clinical phenotyping was carried out through multiple examination sessions to evaluate a range of clinical symptoms. RESULTS This study included eight individuals with clinically suspected PWS/AS, all previously confirmed through chromosomal microarray analysis, which revealed chromosomal breakpoints within the 15q11-q13 region. Among this cohort, six cases (75%) exhibited variable lengths of deletions, whereas two cases (25%) showed duplications. These included one type 2 duplication, one larger atypical duplication, one shorter type 2 deletion, one larger type 1 deletion, and four cases with atypical deletions. Furthermore, thorough clinical assessments led to the diagnosis of four PWS patients, two AS patients, and two individuals with 15q11-q13 duplication syndrome. CONCLUSION Our deep phenotypic observations identified a spectrum of clinical features that overlap and are unique to PWS, AS, and Dup15q syndromes. Our findings establish genotype-phenotype correlation for patients impacted by variable structural variations within the 15q11-q13 region.
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Affiliation(s)
- Rabeya Akter Mim
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
| | - Anjana Soorajkumar
- Center for Applied and Translational Genomics (CATG)Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai HealthDubaiUAE
| | - Noor Kosaji
- Center for Applied and Translational Genomics (CATG)Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai HealthDubaiUAE
| | - Muhammad Mizanur Rahman
- Department of Paediatric NeurologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Shaoli Sarker
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
- Bangladesh Shishu Hospital and InstituteDhakaBangladesh
| | - Noushad Karuvantevida
- Center for Applied and Translational Genomics (CATG)Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai HealthDubaiUAE
| | | | - Md Atikur Rahaman
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
| | - Amirul Islam
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
- GenomeArc Inc.MississaugaOntarioCanada
| | - Mohammod Shah Jahan Chowdhury
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
- Ministry of Health and Family WelfareDhakaBangladesh
| | - Nusrat Shams
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
- National Institute of Neuroscience and HospitalDhakaBangladesh
| | - K. M. Furkan Uddin
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
| | - Hosneara Akter
- Genetics and Genomic Medicine Centre (GGMC)NeuroGen HealthcareDhakaBangladesh
| | - Mohammed Uddin
- Center for Applied and Translational Genomics (CATG)Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai HealthDubaiUAE
- GenomeArc Inc.MississaugaOntarioCanada
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Gao Y, Yang LL, Dai YL, Shen Z, Zhou Q, Zou CC. Effects of early recombinant human growth hormone treatment in young Chinese children with Prader-Willi syndrome. Orphanet J Rare Dis 2023; 18:25. [PMID: 36750945 PMCID: PMC9906936 DOI: 10.1186/s13023-023-02615-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/15/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare and multisystemic genetic disorder that is characterized by severe hypotonia, hyperphagia, short stature, and global developmental delay. Although early recombinant human growth hormone (rhGH) treatment has been proven to rescue some symptoms and bring additional benefits to PWS patients, studies in patients under 2 years old are scarce. Thus, this study aims to investigate the effectiveness and safety of rhGH treatment for young children. METHODS A total of 96 genetically confirmed Chinese PWS infants or toddlers (47 males) followed between 2013 and 2022 were retrospectively analyzed. Sixty-five infants (early treatment group) started rhGH treatment during their first year, and 31 toddlers (later treatment group) started at the age of 1-2 years. Auxological parameters, carbohydrate metabolism parameters, thyroid function, liver function, insulin-like growth factor-1 (IGF-1), and radiographs were acquired before the initiation of the treatment and every 3-6 months thereafter. Height/length, weight, and weight for height were expressed as standard deviation scores (SDSs) according to WHO child growth standards. RESULTS The mean SDS of length/height in the early treatment group was significantly higher than that in the later treatment group throughout the observation period (all P < 0.001). The change in the length SDS between the two groups at 1 year old and 4 years old was 1.50 (95% CI, 0.88-2.13) and 0.63 (95% CI, 0.16-1.10), respectively. Compared to the later treatment group, the weight SDS in the early treatment group increased by 0.94 (95% CI, 0.37-1.52) at 1 year old and 0.84 (95% CI, 0.28-1.39) at 2 years old. No statistical significance was found after 2.5 years of age. No significant differences were observed in IGF-1, incidence of liver dysfunction, hypothyroidism or spinal deformity between the two groups. CONCLUSIONS rhGH treatment improved growth and body composition in infants and toddlers. Furthermore, an early start of rhGH treatment is expected to have more efficacy than the later treatment group without an increase in adverse effects.
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Affiliation(s)
- Ying Gao
- grid.411360.1The Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051 China
| | - Li-Li Yang
- grid.411360.1The Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051 China
| | - Yang-Li Dai
- grid.411360.1The Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051 China
| | - Zheng Shen
- grid.411360.1The Children’s Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051 China
| | - Qiong Zhou
- The Children's Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051, China. .,Hangzhou children's Hospital, No. 195 Wenhui Road, Hangzhou, 310000, China.
| | - Chao-Chun Zou
- The Children's Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310051, China.
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Liu C, Zhang X, Wang J, Zhang Y, Wang A, Lu J, Huang Y, Liu S, Wu J, Du L, Yang J, Ding H, Liu L, Zhao X, Yin A. Genetic testing for Prader-Willi syndrome and Angelman syndrome in the clinical practice of Guangdong Province, China. Mol Cytogenet 2019; 12:7. [PMID: 30820248 PMCID: PMC6378742 DOI: 10.1186/s13039-019-0420-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 02/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Prader-Willi syndrome (PWS) and Angelman syndrome (AS) are clinically distinct neurodevelopmental disorders caused by absence of paternally or maternally expressed imprinted genes on chromosome 15q11.2-q13.3 region. Methods 3331 individuals was recruited from June 2013 to December 2016 under an institutional review board-approved protocol of informed consent. The methylation-specific PCR was employed as a first-tier screening test. The multiplex-fluorescent-labeled STR linkage analysis was carried out to define the underlying genetic mechanisms. The chromosomal microarray analysis was employed to identify chromosomal breakpoints in confirmed cases, and to detect other chromosomal abnormalities in undiagnosed cases. Genetic counseling and recurrence risk assessment were provided to families with affected individuals. Results The methylation-specific PCR identified 36 PWS suspected patients and 13 AS suspected patients. UBE3A sequence analysis identified another 1 patient with AS. The STR linkage analysis define the underlying genetic mechanisms. Thirty PWS patients were with paternal deletions on chromosome region 15q11-q13, 5 with isodisomic uniparental disomy and 1 with mixed segmental isodisomic/ heterodisomic uniparental disomy of maternal chromosome 15. Twelve AS patients were with maternal deletions, 1 with isodisomic uniparental disomy and 1 with UBE3A gene mutation. The chromosomal microarray analysis identified chromosomal breakpoints in confirmed cases, and detected chromosomal abnormalities in another 4 patients with clinically overlapped features but tested negative for PWS/AS. Genetic counseling was offered to all families with affected individuals. Conclusions Identifying the disorders at early age, establishing the molecular mechanisms, carrying out treatment intervention and close monitoring can significantly improve the prognosis of PWS/AS patients.
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Affiliation(s)
- Chang Liu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Xiangzhong Zhang
- 5Department of Hematology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong China
| | - Jicheng Wang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Yan Zhang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Anshi Wang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Jian Lu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Yanlin Huang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Shu Liu
- 3Children Inherited Metabolism and Endocrine Department, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Jing Wu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China
| | - Li Du
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Jie Yang
- 4Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Hongke Ding
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Ling Liu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
| | - Xin Zhao
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China
| | - Aihua Yin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010 Peoples, Republic of China.,2Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010 Guangdong China
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Yang H, Zhang M, Song H, Zhu H, Pan H. Growth patterns of Chinese patients with Prader-Willi syndrome. Congenit Anom (Kyoto) 2015; 55:173-7. [PMID: 25900037 DOI: 10.1111/cga.12111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/14/2015] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to investigate the spontaneous development of growth and weight gain of patients with Prader-Willi syndrome (PWS) in Mainland China. We retrospectively analyzed 120 cases of PWS diagnosed from 1994 to 2014 in Mainland China. Scatter diagram of the growth data was compared to standardized growth curve. The length at birth was similar to the normal population and the mean birthweight is under the 50th centile of normal population. Heights in 43% (27/62) of patients had dropped off below the 3(rd) centile of their peers after 5 years of age. Weights in 65.9% (58/88) of patients had exceeded the 97(th) centile of their peers after 3 years of age. Early obesity is obvious in 92.9% (66/71) of patients with body mass index (BMI) up the 97(th) centile of their peers from 2-3 years of age. Final mean height is 149.3 ± 11.2 cm for females (n = 7) and 146.2 ± 9.8 cm for males (n = 6), showing 11.3 cm and 26.6 cm below the average height for normal Chinese girls and boys. The growth pattern of PWS in Mainland China is comparable to those in Caucasians. Early intervention with recombinant human growth hormone is warranted considering the early onset of growth retardation and obesity.
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Affiliation(s)
- Hongbo Yang
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Mengqi Zhang
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Hongmei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Beijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Hui Pan
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
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