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Pasquali C, Basaldella F, Sala F. Updates on Intraoperative Neurophysiology During Surgery for Spinal Dysraphism. Adv Tech Stand Neurosurg 2023; 47:235-272. [PMID: 37640878 DOI: 10.1007/978-3-031-34981-2_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Spinal dysraphism is a group of disorders resulting from an embryologic failure of spinal cord development which can lead to a radicular-medullary mechanical stretch that generates vascular compromise and hypoxic-ischemic damage to the nervous structures of the conus-cauda region.Thus, the clinical relevance of the different types of spinal dysraphism is related to the possible neurologic deficits resulting from spinal cord tethering. The clinical presentation is heterogenous: from asymptomatic to very compromised patients. The indications and the time of a detethering surgery are still subject of debate, although there is an agreement on the high standards of treatment that have to be offered by the surgery. Intraoperative neurophysiology (ION) contributes to the safety of tethered cord surgery in reducing the risks of iatrogenic neurological damages.
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Affiliation(s)
- Claudia Pasquali
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy
| | - Federica Basaldella
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy
| | - Francesco Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.
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2
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Mechanics of neural tube morphogenesis. Semin Cell Dev Biol 2021; 130:56-69. [PMID: 34561169 DOI: 10.1016/j.semcdb.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 01/07/2023]
Abstract
The neural tube is an important model system of morphogenesis representing the developmental module of out-of-plane epithelial deformation. As the embryonic precursor of the central nervous system, the neural tube also holds keys to many defects and diseases. Recent advances begin to reveal how genetic, cellular and environmental mechanisms work in concert to ensure correct neural tube shape. A physical model is emerging where these factors converge at the regulation of the mechanical forces and properties within and around the tissue that drive tube formation towards completion. Here we review the dynamics and mechanics of neural tube morphogenesis and discuss the underlying cellular behaviours from the viewpoint of tissue mechanics. We will also highlight some of the conceptual and technical next steps.
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3
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Razmara E, Bitaraf A, Karimi B, Babashah S. Functions of the SNAI family in chondrocyte-to-osteocyte development. Ann N Y Acad Sci 2021; 1503:5-22. [PMID: 34403146 DOI: 10.1111/nyas.14668] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022]
Abstract
Different cellular mechanisms contribute to osteocyte development. And while critical roles for members of the zinc finger protein SNAI family (SNAIs) have been discussed in cancer-related models, there are few reviews summarizing their importance for chondrocyte-to-osteocyte development. To help fill this gap, we review the roles of SNAIs in the development of mature osteocytes from chondrocytes, including the regulation of chondro- and osteogenesis through different signaling pathways and in programmed cell death. We also discuss how epigenetic factors-including DNA methylation, histone methylation and acetylation, and noncoding RNAs-contribute differently to both chondrocyte and osteocyte development. To better grasp the important roles of SNAIs in bone development, we also review genotype-phenotype correlations in different animal models. We end with comments about the possible importance of the SNAI family in cartilage/bone development and the potential applications for therapeutic goals.
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Affiliation(s)
- Ehsan Razmara
- Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria, Australia
| | - Amirreza Bitaraf
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Behnaz Karimi
- Hematology/Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Sadegh Babashah
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
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4
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Kawachi T, Tadokoro R, Takahashi Y. Cell Lineage, Self-Renewal, and Epithelial-to-Mesenchymal Transition during Secondary Neurulation. J Korean Neurosurg Soc 2021; 64:367-373. [PMID: 33906340 PMCID: PMC8128514 DOI: 10.3340/jkns.2021.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 11/27/2022] Open
Abstract
Secondary neurulation (SN) is a critical process to form the neural tube in the posterior region of the body including the tail. SN is distinct from the anteriorly occurring primary neurulation (PN); whereas the PN proceeds by folding an epithelial neural plate, SN precursors arise from a specified epiblast by epithelial-to-mesenchymal transition (EMT), and undergo self-renewal in the tail bud. They finally differentiate into the neural tube through mesenchymal-to-epithelial transition (MET). We here overview recent progresses in the studies of SN with a particular focus on the regulation of cell lineage, self-renewal, and EMT/MET. Cellular mechanisms underlying SN help to understand the functional diversity of the tail in vertebrates.
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Affiliation(s)
- Teruaki Kawachi
- Department of Zoology, Graduate School of Science, Kyoto University, Kyoto, Japan
- Faculty of Engineering, Okayama University of Science, Okayama, Japan
| | - Ryosuke Tadokoro
- Department of Zoology, Graduate School of Science, Kyoto University, Kyoto, Japan
- Faculty of Engineering, Okayama University of Science, Okayama, Japan
| | - Yoshiko Takahashi
- Department of Zoology, Graduate School of Science, Kyoto University, Kyoto, Japan
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5
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Dworschak GC, Reutter HM, Ludwig M. Currarino syndrome: a comprehensive genetic review of a rare congenital disorder. Orphanet J Rare Dis 2021; 16:167. [PMID: 33836786 PMCID: PMC8034116 DOI: 10.1186/s13023-021-01799-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background The triad of a presacral mass, sacral agenesis and an anorectal anomaly constitutes the rare Currarino syndrome (CS), which is caused by dorsal–ventral patterning defects during embryonic development. The major causative CS gene is MNX1, encoding a homeobox protein. Main body In the majority of patients, CS occurs as an autosomal dominant trait; however, a female predominance observed, implies that CS may underlie an additional mode(s) of inheritance. Often, the diagnosis of CS is established solely by clinical findings, impacting a detailed analysis of the disease. Our combined data, evaluating more than 60 studies reporting patients with CS-associated mutations, revealed a slightly higher incidence rate in females with a female-to-male ratio of 1.39:1. Overall, MNX1 mutation analysis was successful in only 57.4% of all CS patients investigated, with no mutation detected in 7.7% of the familial and 68% of the sporadic patients. Our studies failed to detect the presence of an expressed MNX1 isoform that might explain at least some of these mutation-negative cases. Conclusion Aside from MNX1, other genes or regulatory regions may contribute to CS and we discuss several cytogenetic studies and whole-exome sequencing data that have implicated further loci/genes in its etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01799-0.
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Affiliation(s)
- Gabriel C Dworschak
- Institute of Human Genetics, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. .,Institute of Anatomy and Cell Biology, Medical Faculty, University of Bonn, 53115, Bonn, Germany. .,Department of Pediatrics, University Hospital Bonn, 53127, Bonn, Germany.
| | - Heiko M Reutter
- Institute of Human Genetics, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, 53127, Bonn, Germany
| | - Michael Ludwig
- Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 53127, Bonn, Germany
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6
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Sundaram V, Mohammed T, Rampersad S, Williams G. A rare report on 18-month survival of a dog born with multiple anomalies including atresia ani. Morphologie 2020; 105:252-258. [PMID: 33172785 DOI: 10.1016/j.morpho.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
Long term survival of animals with major congenital anomalies is very rare. This report documents the 18-month survival of a dog with multiple anomalies including atresia ani. An 18-month-old black Cocker Spaniel bitch was presented for evaluation of prolapsed glands of the third eyelid involving both the eyes. Clinical examination revealed a single perineal opening, fecal matter in the vestibule, distended abdomen, hypoplastic vulva, and the absence of a tail without any neurological deficits. Abdominal contrast radiography revealed a distended colon with fecal stasis, rectovestibular fistula, termination of the rectum as a blind pouch, lumbar scoliosis due to block vertebrae, and the presence of only two hypoplastic coccygeal vertebrae. The case was diagnosed as atresia ani type II with rectovestibular fistula, hypoplastic vulva, lumbar scoliosis, and anury, in the global context of a caudal regression syndrome. The wide aperture fistula, connected to the vestibule, undamaged spinal cord and sacrum without any neurological deficits were the favorable prognostic factors that maintained continence and allowed the dog to survive to adult life with these anomalies. Thus, an appropriate bowel management program and specialty care can improve the quality of life and longevity of this animal.
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Affiliation(s)
- V Sundaram
- Anatomy Unit, Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
| | - T Mohammed
- Anatomy Unit, Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - S Rampersad
- Anatomy Unit, Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - G Williams
- Anatomy Unit, Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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7
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Amelot A, Cretolle C, de Saint Denis T, Sarnacki S, Catala M, Zerah M. Spinal dysraphism as a new entity in V.A.C.TE.R.L syndrome, resulting in a novel acronym V.A.C.TE.R.L.S. Eur J Pediatr 2020; 179:1121-1129. [PMID: 32055959 DOI: 10.1007/s00431-020-03609-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/09/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
Anorectal malformation (ARM) is the most common symptom in VACTERL syndrome (vertebral, anal, cardiac, tracheo-esophageal fistula, renal, and limb anomalies). The association of ARM and spinal dysraphisms (DYS) is well documented. We aim to better evaluate children with VACTERL association and ARM, considering the presence or not of DYS. Between 2000 and 2015, 279 children with VACTERL associations were identified in Necker Children's Hospital, Paris. We identified 61 VACTERL children (22%) with ARM. A total of 52 VACTERL children with ARM were included. DYS were identified in 36/52 of cases (69.2%). A total of 33 (63.5%) VACTERL children presented with sphincterial dysfunction. We constated that 28/33 (84.8%) of them had DYS + (p < 0.0001). More children in ARM (DYS +) subgroup are presenting with initial urinary sphincter dysfunction (58 vs 19%, p < 0.009) than ARM (DYS -). We identified 29 lipoma filum in our series, which were not statistically associated with urinary disorders (p = 0.143).Conclusion: We propose to refine the definition of VACTERL association, by adding S as Spinal defect to include it as an integral part of this syndrome, resulting in a novel acronym V.A.C.TE.R.L.S.What is Known:• The VACTERL association: congenital anomalies of the bony vertebral column (V), anorectal malformation (A), congenital cardiopathy (C), tracheo-esophageal defects (TE), renal and urinary tract anomalies (R), and limb malformations (L).• VACTERL children needs a complete appraisal, as early as possible, to adopt the most appropriate therapeutic management.What is New:• Include spine dysraphism (DYS) as a part of this syndrome, resulting in a novel acronym V.A.C.TE.R.L.S.• The significant correlation between VACTERL/DYS and urinary dysfunction requires to investigate the spine cord prenatally.
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Affiliation(s)
- Aymeric Amelot
- Department of Pediatric Neurosurgery, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France.
| | - Célia Cretolle
- Department of Visceral Pediatric surgery, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France.,Reference center for AnoRectal and rare Pelvic anomalies MAREP, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France
| | - Timothée de Saint Denis
- Department of Pediatric Neurosurgery, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France
| | - Sabine Sarnacki
- Department of Visceral Pediatric surgery, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France.,Reference center for AnoRectal and rare Pelvic anomalies MAREP, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France
| | - Martin Catala
- cUMR7622 UPMC et CNRS, Paris cedex 05, France; dFédération de Neurologie, Groupe Hospitalier Pitié-Salpêtrière 47-83 boulevard de l'Hôpital, Paris Cedex 13, France
| | - Michel Zerah
- Department of Pediatric Neurosurgery, Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France.,Reference center for Chiari and Malformations of the Spine and the Spinal Cord C-MAVEM and Institute for Genetic Diseases IMAGINE , Necker-EM Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes, Paris, France
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8
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Rhodes RH. Congenital Spinal Lipomatous Malformations. Part 1. Spinal Lipomas, Lipomyeloceles, and Lipomyelomeningoceles. Fetal Pediatr Pathol 2020; 39:194-245. [PMID: 31342816 DOI: 10.1080/15513815.2019.1641859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Lumbosacral spinal lipomas and lipomyeloceles are usually identified in early childhood. Terminology, histopathology, and diagnosis for these malformations can be confusing. Materials and Methods: This is a PubMed review with comparison of embryology, gross, and histopathology, and reporting requisites for these and related closed spinal malformations. Results: The spinal lipoma group (congenital spinal lipomatous malformations) includes subcutaneous, transdural, intradural, and noncontiguous malformations stretching through the entire lower spinal region. This lipomyelocele trajectory overlaps the embryonic tail's caudal eminence. Histopathologically, the lipomyelocele spectrum is a heterogeneous, stereotypical set of findings encountered from dermis to spinal cord. Diagnosis requires detailed correlation of images, intraoperative inspection, and histopathology. Conclusions: Appropriate terminology and clinicopathologic correlation to arrive at a diagnosis is a critical activity shared by pathologist and clinician. Prognostic and management differences depend on specific diagnoses. Familial and genetic influences play little if any role in patient management in closed spinal malformations.
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Affiliation(s)
- Roy H Rhodes
- LSUHSC, Pathology, New Orleans, Louisiana, USA.,Rutgers Robert Wood Johnson Medical School, Pathology, New Brunswick, New Jersey, USA
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9
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Warner T, Scullen TA, Iwanaga J, Loukas M, Bui CJ, Dumont AS, Tubbs RS. Caudal Regression Syndrome-A Review Focusing on Genetic Associations. World Neurosurg 2020; 138:461-467. [PMID: 32200015 DOI: 10.1016/j.wneu.2020.03.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 12/31/2022]
Abstract
Caudal regression syndrome (CRS) represents a spectrum of clinical phenotypes with varying degrees of malformation of the lower body with involvement of structures deriving from all 3 layers of the trilaminar embryo. We review areas of active investigation in the diagnosis, etiology, epidemiology, and treatment of the disease with a focus on underlying genetics. CRS pathobiology is complex and multifactorial with a significant contribution from environmental factors as evidenced in twin studies. Contemporary genomic and genetic investigations in both human primary tissue and murine in vitro and in vivo models implicate various genes associated with caudal differentiation and neural cell migration in embryogenesis. A large number of identified targets center around the metabolic regulation of retinoic acid and its derivatives. Dysregulation of retinoic acid homeostasis has been associated with abnormal embryonic cell migration, differentiation, and organogenesis with resulting malformations and agenesis in both a laboratory and a clinical setting. There appears to be a significant overlap in potential genetic targets with CRS and other developmental syndromes with similar presentations, such as VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. CRS represents a spectrum of caudal developmental abnormalities with treatment options limited to mild and moderate expressions of disease. Continued research is necessary to further clarify mechanisms of disease pathobiology and complex polygenetic and environmental interaction. Despite this, progress has been made in identifying genetic targets and downstream effectors contributing to preclinical and clinical progression.
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Affiliation(s)
- Tyler Warner
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Tyler A Scullen
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - C J Bui
- Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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10
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Update on the Role of the Non-Canonical Wnt/Planar Cell Polarity Pathway in Neural Tube Defects. Cells 2019; 8:cells8101198. [PMID: 31590237 PMCID: PMC6829399 DOI: 10.3390/cells8101198] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/26/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
Neural tube defects (NTDs), including spina bifida and anencephaly, represent the most severe and common malformations of the central nervous system affecting 0.7–3 per 1000 live births. They result from the failure of neural tube closure during the first few weeks of pregnancy. They have a complex etiology that implicate a large number of genetic and environmental factors that remain largely undetermined. Extensive studies in vertebrate models have strongly implicated the non-canonical Wnt/planar cell polarity (PCP) signaling pathway in the pathogenesis of NTDs. The defects in this pathway lead to a defective convergent extension that is a major morphogenetic process essential for neural tube elongation and subsequent closure. A large number of genetic studies in human NTDs have demonstrated an important role of PCP signaling in their etiology. However, the relative contribution of this pathway to this complex etiology awaits a better picture of the complete genetic architecture of these defects. The emergence of new genome technologies and bioinformatics pipelines, complemented with the powerful tool of animal models for variant interpretation as well as significant collaborative efforts, will help to dissect the complex genetics of NTDs. The ultimate goal is to develop better preventive and counseling strategies for families affected by these devastating conditions.
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11
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López‐Escobar B, Wlodarczyk BJ, Caro‐Vega J, Lin Y, Finnell RH, Ybot‐González P. The interaction of maternal diabetes with mutations that affect folate metabolism and how they affect the development of neural tube defects in mice. Dev Dyn 2019; 248:900-917. [DOI: 10.1002/dvdy.92] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Beatriz López‐Escobar
- Neurodevelopment Research GroupInstitute of Biomedicine of Seville/Hospital Virgen del Rocio/US/CSIC Sevilla Spain
- Department of Nutritional SciencesDell Pediatric Research Institute, The University of Texas at Austin Austin Texas USA
| | - Bogdan J. Wlodarczyk
- Department of Nutritional SciencesDell Pediatric Research Institute, The University of Texas at Austin Austin Texas USA
- Departments of Molecular and Cellular Biology and MedicineBaylor College of Medicine Houston Texas USA
| | - Jose Caro‐Vega
- Neurodevelopment Research GroupInstitute of Biomedicine of Seville/Hospital Virgen del Rocio/US/CSIC Sevilla Spain
| | - Ying Lin
- Department of Nutritional SciencesDell Pediatric Research Institute, The University of Texas at Austin Austin Texas USA
- Departments of Molecular and Cellular Biology and MedicineBaylor College of Medicine Houston Texas USA
| | - Richard H. Finnell
- Department of Nutritional SciencesDell Pediatric Research Institute, The University of Texas at Austin Austin Texas USA
- Departments of Molecular and Cellular Biology and MedicineBaylor College of Medicine Houston Texas USA
| | - Patricia Ybot‐González
- Neurodevelopment Research GroupInstitute of Biomedicine of Seville/Hospital Virgen del Rocio/US/CSIC Sevilla Spain
- Department of Neurology and NeurofisiologyHospital Virgen de Macarena Sevilla Spain
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12
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Orman G, Tijssen MP, Seyfert D, Gassner I, Huisman TA. Ultrasound to Evaluate Neonatal Spinal Dysraphism: A First‐Line Alternative to CT and MRI. J Neuroimaging 2019; 29:553-564. [DOI: 10.1111/jon.12649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gunes Orman
- Edward B. Singleton Department of RadiologyTexas Children's Hospital and Baylor College of Medicine Houston TX
| | - Maud P.M Tijssen
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
- Department of RadiologyMaastricht University Medical Center Maastricht The Netherlands
| | - Donna Seyfert
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
| | - Ingmar Gassner
- Department of RadiologyInnsbruck Medical University Innsbruck Austria
| | - Thierry A.G.M. Huisman
- Edward B. Singleton Department of RadiologyTexas Children's Hospital and Baylor College of Medicine Houston TX
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins University School of Medicine Baltimore MD
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13
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From the primitive streak to the somitic mesoderm: labeling the early stages of chick embryos using EGFP transfection. Anat Sci Int 2018; 93:414-421. [PMID: 29427146 DOI: 10.1007/s12565-018-0429-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/16/2018] [Indexed: 10/18/2022]
Abstract
Mesoderm is derived from the primitive streak. The rostral region of the primitive streak forms the somitic mesoderm. We have previously shown the developmental origin of each level of the somitic mesoderm using DiI fluorescence labeling of the primitive streak. We found that the more caudal segments were derived from the primitive streak during the later developmental stages. DiI labeled several pairs of somites and showed the distinct rostral boundary; however, the fluorescence gradually disappeared in the caudal region. This finding can be explained in two ways: the primitive streak at a specific developmental stage is primordial of only a certain number of pairs of somites, or the DiI fluorescent dye was gradually diluted within the primitive streak by cell division. Here, we traced the development of the primitive streak cells using enhanced green fluorescent protein (EGFP) transfection. We confirmed that, the later the EGFP transfection stage, the more caudal the somites labeled. Different from DiI labeling, EGFP transfection performed at any developmental stage labeled the entire somitic mesoderm from the anterior boundary to the tail bud in 4.5-day-old embryos. Furthermore, the secondary neural tube was also labeled, suggesting that not only the somite precursor cells but also the axial stem cells were labeled.
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14
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Rossi A, Martinetti C, Morana G, Severino M, Tortora D. Diagnostic Approach to Pediatric Spine Disorders. Magn Reson Imaging Clin N Am 2017; 24:621-44. [PMID: 27417404 DOI: 10.1016/j.mric.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.
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Affiliation(s)
- Andrea Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy.
| | - Carola Martinetti
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Giovanni Morana
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Mariasavina Severino
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
| | - Domenico Tortora
- Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, Genova 16147, Italy
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15
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Kumar J, Afsal M, Garg A. Imaging spectrum of spinal dysraphism on magnetic resonance: A pictorial review. World J Radiol 2017; 9:178-190. [PMID: 28529681 PMCID: PMC5415887 DOI: 10.4329/wjr.v9.i4.178] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/15/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogeneous group of anomalies which result from faulty closure of midline structures during development. Magnetic resonance imaging (MRI) is now considered the imaging modality of choice for diagnosing these conditions. The purpose of this article is to review the normal development of spinal cord and spine and reviewing the MRI features of spinal dysraphism. Although imaging of spinal dysraphism is complicated, a systematic approach and correlation between neuro-radiological, clinical and developmental data helps in making the correct diagnosis.
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Porsch RM, Merello E, De Marco P, Cheng G, Rodriguez L, So M, Sham PC, Tam PK, Capra V, Cherny SS, Garcia-Barcelo MM, Campbell DD. Sacral agenesis: a pilot whole exome sequencing and copy number study. BMC MEDICAL GENETICS 2016; 17:98. [PMID: 28007035 PMCID: PMC5178083 DOI: 10.1186/s12881-016-0359-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/02/2016] [Indexed: 12/30/2022]
Abstract
Background Caudal regression syndrome (CRS) or sacral agenesis is a rare congenital disorder characterized by a constellation of congenital caudal anomalies affecting the caudal spine and spinal cord, the hindgut, the urogenital system, and the lower limbs. CRS is a complex condition, attributed to an abnormal development of the caudal mesoderm, likely caused by the effect of interacting genetic and environmental factors. A well-known risk factor is maternal type 1 diabetes. Method Whole exome sequencing and copy number variation (CNV) analyses were conducted on 4 Caucasian trios to identify de novo and inherited rare mutations. Results In this pilot study, exome sequencing and copy number variation (CNV) analyses implicate a number of candidate genes, including SPTBN5, MORN1, ZNF330, CLTCL1 and PDZD2. De novo mutations were found in SPTBN5, MORN1 and ZNF330 and inherited predicted damaging mutations in PDZD2 (homozygous) and CLTCL1 (compound heterozygous). Importantly, predicted damaging mutations in PTEN (heterozygous), in its direct regulator GLTSCR2 (compound heterozygous) and in VANGL1 (heterozygous) were identified. These genes had previously been linked with the CRS phenotype. Two CNV deletions, one de novo (chr3q13.13) and one homozygous (chr8p23.2), were detected in one of our CRS patients. These deletions overlapped with CNVs previously reported in patients with similar phenotype. Conclusion Despite the genetic diversity and the complexity of the phenotype, this pilot study identified genetic features common across CRS patients. Electronic supplementary material The online version of this article (doi:10.1186/s12881-016-0359-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Robert M Porsch
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | | | | | - Guo Cheng
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | | | - Manting So
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Pak C Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,Centre for Reproduction, Development, and Growth, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,State Key Laboratory of Brain and Cognitive Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Paul K Tam
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,Centre for Reproduction, Development, and Growth, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | | | - Stacey S Cherny
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.,State Key Laboratory of Brain and Cognitive Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Maria-Mercè Garcia-Barcelo
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR. .,Centre for Reproduction, Development, and Growth, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR. .,The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, People's Republic of China.
| | - Desmond D Campbell
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR. .,Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.
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Ferland CE, Sardar ZM, Abduljabbar F, Arlet V, Ouellet JA. Bilateral vascularized rib grafts to promote spinopelvic fixation in patients with sacral agenesis and spinopelvic dissociation: a new surgical technique. Spine J 2015; 15:2583-92. [PMID: 26456853 DOI: 10.1016/j.spinee.2015.08.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/03/2015] [Accepted: 08/28/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Sacral agenesis is a rare congenital disorder that may have spinopelvic instability due to sacroiliac joint malformation. Surgical indication in patients with sacral agenesis is to improve their sitting balance and protect the visceral organs. Achieving solid arthrodesis across this congenital malformation is challenging and prone to non-union. PURPOSE The purpose of this study was to describe a novel surgical technique with vascularized ribs for management of sacral agenesis and complex spinopelvic dissociation. STUDY DESIGN Retrospective study. PATIENT SAMPLE Six patients with sacral agenesis were reviewed and followed for a mean of 8.5 years after spinopelvic fusion augmented with vascularized rib graft spanning the lumbo-pelvic junction. OUTCOME MEASURES The primary outcome measure was the presence or absence of a stable spinopelvic junction and fusion across the spine-vascular rib grafts-pelvis interface. The secondary outcome measures were maintenance of pelvic obliquity, lumbosacral kyphosis, and overall sagittal balance. METHODS The surgical procedure consisted of two-stage surgeries performed 6-12 weeks apart. The first stage consisted of spinal instrumentation and correction of the deformity via a posterior approach and impaction of one of the vascularized ribs from the spine to the iliac crest. The second stage consisted of an anterior thoraco-lumbar approach for spinal fusion and the second vascularized rib spanning the spine to the iliac crest. RESULTS All six patients eventually achieved a solid spinal and spinopelvic fusion. All vascularized ribs increased in diameter over time. A high complication rate consisted mainly of spinal infections and prominent hardware requiring revision surgeries (a total of seven procedures in four patients). Two patients had decreased mobility secondary to spinopelvic surgery at last follow-up. CONCLUSIONS Spinopelvic fusion can be successfully achieved with this novel surgical technique using vascularized rib grafts. This technique allows for biological long-term maintenance of the sagittal deformity correction. Fusion across the lumbosacral junction in patients with sacral agenesis may place them at risk of losing the ability to mobilize independently. Recent lower profile implants have prevented implant-related complications.
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Affiliation(s)
- Catherine E Ferland
- Division of Orthopaedic Surgery, McGill Scoliosis and Spine Centre, McGill University Health Centre, 1650 Cedar Ave, Montreal, Quebec, H3G 1A4 Canada
| | - Zeeshan M Sardar
- Division of Orthopaedic Surgery, McGill Scoliosis and Spine Centre, McGill University Health Centre, 1650 Cedar Ave, Montreal, Quebec, H3G 1A4 Canada
| | - Fahad Abduljabbar
- Division of Orthopaedic Surgery, McGill Scoliosis and Spine Centre, McGill University Health Centre, 1650 Cedar Ave, Montreal, Quebec, H3G 1A4 Canada; Department of Orthopaedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Vincent Arlet
- Department of Orthopedics, University of Pennsylvania, Philadelphia, PA, USA
| | - Jean A Ouellet
- Division of Orthopaedic Surgery, McGill Scoliosis and Spine Centre, McGill University Health Centre, 1650 Cedar Ave, Montreal, Quebec, H3G 1A4 Canada.
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Ott E, Wendik B, Srivastava M, Pacho F, Töchterle S, Salvenmoser W, Meyer D. Pronephric tubule morphogenesis in zebrafish depends on Mnx mediated repression of irx1b within the intermediate mesoderm. Dev Biol 2015; 411:101-14. [PMID: 26472045 DOI: 10.1016/j.ydbio.2015.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/21/2015] [Accepted: 10/09/2015] [Indexed: 12/11/2022]
Abstract
Mutations in the homeobox transcription factor MNX1 are the major cause of dominantly inherited sacral agenesis. Studies in model organisms revealed conserved mnx gene requirements in neuronal and pancreatic development while Mnx activities that could explain the caudal mesoderm specific agenesis phenotype remain elusive. Here we use the zebrafish pronephros as a simple yet genetically conserved model for kidney formation to uncover a novel role of Mnx factors in nephron morphogenesis. Pronephros formation can formally be divided in four stages, the specification of nephric mesoderm from the intermediate mesoderm (IM), growth and epithelialisation, segmentation and formation of the glomerular capillary tuft. Two of the three mnx genes in zebrafish are dynamically transcribed in caudal IM in a time window that proceeds segmentation. We show that expression of one mnx gene, mnx2b, is restricted to the pronephric lineage and that mnx2b knock-down causes proximal pronephric tubule dilation and impaired pronephric excretion. Using expression profiling of embryos transgenic for conditional activation and repression of Mnx regulated genes, we further identified irx1b as a direct target of Mnx factors. Consistent with a repression of irx1b by Mnx factors, the transcripts of irx1b and mnx genes are found in mutual exclusive regions in the IM, and blocking of Mnx functions results in a caudal expansion of the IM-specific irx1b expression. Finally, we find that knock-down of irx1b is sufficient to rescue proximal pronephric tubule dilation and impaired nephron function in mnx-morpholino injected embryos. Our data revealed a first caudal mesoderm specific requirement of Mnx factors in a non-human system and they demonstrate that Mnx-dependent restriction of IM-specific irx1b activation is required for the morphogenesis and function of the zebrafish pronephros.
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Affiliation(s)
- Elisabeth Ott
- Institute for Molecular Biology/CMBI, University of Innsbruck, Technikerstr. 25, 6020 Innsbruck, Austria.
| | - Björn Wendik
- Developmental Biology, Institute Biology 1, University of Freiburg, Hauptstrasse 1, 79104 Freiburg, Germany.
| | - Monika Srivastava
- Developmental Biology, Institute Biology 1, University of Freiburg, Hauptstrasse 1, 79104 Freiburg, Germany.
| | - Frederic Pacho
- Institute for Molecular Biology/CMBI, University of Innsbruck, Technikerstr. 25, 6020 Innsbruck, Austria.
| | - Sonja Töchterle
- Institute for Molecular Biology/CMBI, University of Innsbruck, Technikerstr. 25, 6020 Innsbruck, Austria
| | - Willi Salvenmoser
- Institute of Zoology/CMBI, University of Innsbruck, Technikerstr. 25, 6020 Innsbruck, Austria.
| | - Dirk Meyer
- Institute for Molecular Biology/CMBI, University of Innsbruck, Technikerstr. 25, 6020 Innsbruck, Austria.
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Genetic evidence in planar cell polarity signaling pathway in human neural tube defects. Front Med 2013; 8:68-78. [PMID: 24307374 DOI: 10.1007/s11684-014-0308-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 10/09/2013] [Indexed: 10/25/2022]
Abstract
Neural tube defects (NTDs) are a group of birth anomalies having a profound physical, emotional, and financial effects on families and communities. Their etiology is complex, involving environmental and genetic factors that interact to modulate the incidence and severity of the developing phenotype. The planar cell polarity (PCP) pathway controls the process of convergent extension (CE) during gastrulation and neural tube closure and has been implicated in the pathogenesis of NTDs in animal models and human cohorts. This review summarizes the cumulative results of recent studies on PCP signaling pathway and human NTDs. These results demonstrate that PCP gene alterations contribute to the etiology of human NTDs.
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Steiß JO, Altinkilic B, Hamscho N, Hahn A. Akuter Harnverhalt im Kleinkindalter. Urologe A 2013; 52:1705-7. [DOI: 10.1007/s00120-013-3302-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Spinal cord malformations. HANDBOOK OF CLINICAL NEUROLOGY 2013; 112:975-91. [PMID: 23622306 DOI: 10.1016/b978-0-444-52910-7.00018-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Malformations of the spinal cord are one of the most frequent malformations. They should be clearly divided into two completely different families of malformations: open dysraphisms and occult dysraphisms. Open dysraphism mostly consists in myelomeningocele (MMC). Its incidence is 1/1000 live births with a wide variation. Folic acid supplementation has been shown to reduce its risk. In most cases, the diagnosis is done prenatally by serum screening and ultrasound and may lead to termination of pregnancy. In case of decision to continue pregnancy, surgical treatment must be achieved during the first days of life, and in 50 to 90% of cases, a ventricular shunt must be installed. The follow-up of these children must be continued throughout life looking for late complications (Chiari II and syringomyelia, vertebral problems, neuropathic bladder, tethered cord). Occult dysraphisms are a heterogeneous group of malformations. Lipomas (filum and conus) are the most frequent and their treatment remains controversial. Diastematomyelia, neurenteric cysts, dermal sinus, and more complex forms (Currarino syndrome) belong to this group. Most of them can and must be diagnosed prenatally or at birth by careful examination of the lower back for the cutaneous stigmata of the disease to decrease the risk of neurological, urological, or orthopedic permanent handicap.
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23
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Alfarra HY, Alfarra SR, Sadiq MF. Neural tube defects between folate metabolism and genetics. INDIAN JOURNAL OF HUMAN GENETICS 2012; 17:126-31. [PMID: 22345982 PMCID: PMC3276979 DOI: 10.4103/0971-6866.92082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Neural tube defects (NTDs) are the second most common severely disabling human congenital defects. Worldwide, NTDs incidence is approximately one per 1000 live births and varies between 0.78 and 12 per 1000 births in general populations. NTDs causation involves multiple genes, nutritional and environmental factors. Research in the next stage should include bigger populations and bigger studies that would be suitable to detect significant links and conclusions with relatively minor risk factors; analysis of multiple candidate genes to detect potential gene-gene interactions; detailed analysis of patient samples stratified by phenotype.
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Affiliation(s)
- Helmi Y Alfarra
- Department of Biological Sciences, Yarmouk University, Irbid, Jordan
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24
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Draaken M, Prins W, Zeidler C, Hilger A, Mughal SS, Latus J, Boemers TM, Schmidt D, Schmiedeke E, Spychalski N, Bartels E, Nöthen MM, Reutter H, Ludwig M. Involvement of the WNT and FGF signaling pathways in non-isolated anorectal malformations: sequencing analysis of WNT3A, WNT5A, WNT11, DACT1, FGF10, FGFR2 and the T gene. Int J Mol Med 2012; 30:1459-64. [PMID: 22961180 DOI: 10.3892/ijmm.2012.1124] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 08/07/2012] [Indexed: 02/07/2023] Open
Abstract
Anorectal malformations (ARMs) comprise a broad spectrum of anomalies, including anal atresia, congenital anal fistula and persistence of the cloaca. Research suggests that genetic factors play an important role in ARM development. However, few genetic variants have been identified. Embryogenesis is orchestrated by crosstalk of the wingless-type MMTV integration site family (WNT) and fibroblast growth factor (FGF) signaling pathways in a process that involves several intracellular cascades. Studies in mice have implicated several genes from these pathways in the etiology of ARMs. We performed sequencing analysis of seven of these previously reported genes in 78 patients with ARMs occurring within the context of at least one additional congenital anomaly. No associations were identified with variants in WNT3A, WNT5A, WNT11, DACT1, FGF10 or the T gene. In the FGFR2 gene, three novel heterozygous nucleotide substitutions were identified. Further investigations, including the study of family members, revealed that these variants were not causally related to the phenotype in the present ARM cohort. Mutations in the seven investigated genes may nonetheless be a cause of ARMs in rare cases. However, further studies should consider genes encoding other proteins in the WNT/FGF signaling pathways as possible candidates.
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Affiliation(s)
- Markus Draaken
- Institute of Human Genetics, University Hospital of Bonn, D-53127 Bonn, Germany
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A tail of sacral agenesis: delayed presentation of meningocele in sacral agenesis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22 Suppl 3:S311-6. [PMID: 22565805 DOI: 10.1007/s00586-012-2347-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 01/28/2012] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Sacral agenesis is a congenital condition associated with multiple orthopedic, spinal, abdominal and thoracic organ deformities. Meningocele is commonly found among patients with sacral agenesis. DESCRIPTION We present the first case in the literature describing a delayed presentation of terminal (posterior) meningocele in an adult patient born with sacral agenesis. CONCLUSION Surgical repair was performed and is the best treatment option for significantly large lesions, with postoperative CSF leak being the main complication.
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Wei X, Li H, Miao J, Zhou F, Liu B, Wu D, Li S, Wang L, Fan Y, Wang W, Yuan Z. Disturbed apoptosis and cell proliferation in developing neuroepithelium of lumbo‐sacral neural tubes in retinoic acid‐induced spina bifida aperta in rat. Int J Dev Neurosci 2012; 30:375-81. [DOI: 10.1016/j.ijdevneu.2012.03.340] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 03/26/2012] [Accepted: 03/28/2012] [Indexed: 12/17/2022] Open
Affiliation(s)
- Xiaowei Wei
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Hui Li
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Jianing Miao
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Fenghua Zhou
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Bo Liu
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Di Wu
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Shujing Li
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Lili Wang
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Yang Fan
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
| | - Weilin Wang
- Department of Pediatric SurgeryShengjing HospitalChina Medical UniversityShenyangChina
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital MalformationShengjing HospitalChina Medical UniversityShenyangChina
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Huisman TAGM, Rossi A, Tortori-Donati P. MR imaging of neonatal spinal dysraphia: what to consider? Magn Reson Imaging Clin N Am 2012; 20:45-61. [PMID: 22118592 DOI: 10.1016/j.mric.2011.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The development of the spinal canal and its contents is highly complex and involves multiple programmed anatomic and functional developmental and maturational processes. Correct and detailed knowledge about spinal malformations is essential to understand and recognize these lesions early (preferably prenatally) to counsel parents during pregnancy, to plan possible intrauterine treatments, and to make decisions about the mode of delivery and the immediate postnatal treatment. This article discusses the imaging findings of the most frequently encountered neonatal spinal malformations and correlates these findings with the relevant embryologic processes. The presented classification is based on a correlation of clinical, neuroradiologic, and embryologic data.
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Affiliation(s)
- Thierry A G M Huisman
- Division of Pediatric Radiology, Department of Radiology and Radiological Science, Johns Hopkins Hospital, Nelson, Baltimore, MD 21287-0842, USA.
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28
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Thieme R, Ramin N, Fischer S, Püschel B, Fischer B, Santos AN. Gastrulation in rabbit blastocysts depends on insulin and insulin-like-growth-factor 1. Mol Cell Endocrinol 2012; 348:112-9. [PMID: 21827825 DOI: 10.1016/j.mce.2011.07.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 07/24/2011] [Accepted: 07/24/2011] [Indexed: 11/26/2022]
Abstract
Insulin and insulin-like-growth-factor 1 (IGF1) are components of the uterine secretions. As potent growth factors they influence early embryo development. The underlying molecular mechanisms are largely unknown. Here we report on the effects of insulin and IGF1 on early gastrulation in rabbit blastocysts. We have studied blastocysts grown in vivo in metabolically healthy rabbits, in rabbits with type 1 diabetes and in vitro in the presence or absence of insulin or IGF1. Embryonic disc morphology and expression of Brachyury, Wnt3a and Wnt4 were analysed by qPCR and IHC. Pre-gastrulated blastocysts (stage 0/1) cultured with insulin or IGF1 showed a significantly higher capacity to form the posterior mesoderm and primitive streak (stage 2 and 3) than blastocysts cultured without growth factors. In gastrulating blastocysts the levels of the mesoderm-specific transcription factor Brachyury and the Wnt signalling molecules Wnt3a and Wnt4 showed a stage-specific expression pattern with Brachyury transcripts increasing from stage 0/1 to 3. Wnt4 protein was found spread over the whole embryoblast. Insulin induced Wnt3a, Wnt4 and Brachyury expression in a temporal- and stage-specific pattern. Only blastocysts cultured with insulin reached the Wnt3a, Wnt4 and Brachyury expression levels of stage 2 in vivo blastocysts, indicating that insulin is required for Wnt3a, Wnt4 and Brachyury expression during gastrulation. Insulin-induced Wnt3a and Wnt4 expression preceded Brachyury. Wnt3a-induced expression could be depleted by MEK1 inhibition (PD98059). Involvement of insulin in embryonic Wnt3a expression was further shown in vivo with Wnt3a expression being notably down regulated in stage 2 blastocysts from rabbits with type 1 diabetes. Blastocysts grown in diabetic rabbits are retarded in development, a finding which supports our current results that insulin is highly likely required for early mesoderm formation in rabbit blastocysts by inducing a distinct spatiotemporal expression profile of Wnt3a, Wnt4 and Brachyury.
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Affiliation(s)
- René Thieme
- Department of Anatomy and Cell Biology, Martin Luther University Faculty of Medicine, 06108 Halle (Saale), Germany.
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Shimokita E, Takahashi Y. Secondary neurulation: Fate-mapping and gene manipulation of the neural tube in tail bud. Dev Growth Differ 2011; 53:401-10. [DOI: 10.1111/j.1440-169x.2011.01260.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Peeters B, Benninga MA, Hennekam RC. Childhood constipation; an overview of genetic studies and associated syndromes. Best Pract Res Clin Gastroenterol 2011; 25:73-88. [PMID: 21382580 DOI: 10.1016/j.bpg.2010.12.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 12/03/2010] [Accepted: 12/13/2010] [Indexed: 01/31/2023]
Abstract
Constipation is a common problem in children but little is known about its exact pathophysiology. Environmental, behavioural but also genetic factors are thought to play a role in the aetiology of childhood constipation. We provide an overview of genetic studies performed in constipation. Until now, linkage studies, association studies and direct gene sequencing have failed to identify mutations in specific genes associated with constipation. We show that along with functional constipation, there are numerous clinical syndromes associated with childhood constipation. These syndromic forms of constipation appear to be the result of mutations in genes affecting all aspects of the normal physiology of human defecation. We stress that syndromic causes of childhood constipation should be considered in the evaluation of a constipated child.
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Affiliation(s)
- B Peeters
- Department of Paediatric Gastrointestinal Motility and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands.
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Abstract
Caudal regression syndrome is a rare congenital condition characterized by varying degrees of developmental failure ranging from a partial sacral agenesis to the absence of lumbosarcal spine, hypoplasia, or fusion of the lower extremities and visceral anomalies. This is the third case of only one of the twins involved by this syndrome described in the literature and the second case of the selective involvement in dizygotic twins. Selective involvement of only one twin suggests that factors other than hyperglycemia and 7q deletions may be involved in the pathogenesis.
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Affiliation(s)
- Zdenka Krenova
- Department of Pediatric Oncology, University Hospital, Brno, Czech Republic, EU.
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Kibar Z, Bosoi CM, Kooistra M, Salem S, Finnell RH, De Marco P, Merello E, Bassuk AG, Capra V, Gros P. Novel mutations in VANGL1 in neural tube defects. Hum Mutat 2009; 30:E706-15. [PMID: 19319979 DOI: 10.1002/humu.21026] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Neural tube defects (NTDs) are severe congenital malformations caused by failure of the neural tube to close during neurulation. Their etiology is complex involving both environmental and genetic factors. We have recently reported three mutations in the planar cell polarity gene VANGL1 associated with NTDs. The aim of the present study was to define the role of VANGL1 genetic variants in the development of NTDs in a large cohort of various ethnic origins. We identified five novel missense variants in VANGL1, p.Ser83Leu, p.Phe153Ser, p.Arg181Gln, p.Leu202Phe and p.Ala404Ser, occurring in sporadic and familial cases of spinal dysraphisms. All five variants affect evolutionary conserved residues and are absent from all controls analyzed. This study provides further evidence supporting the role of VANGL1 as a risk factor in the development of spinal NTDs.
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Affiliation(s)
- Zoha Kibar
- CHU Sainte Justine Research Center, Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC, Canada. zoha.kibar@ recherche-ste-justine.qc.ca
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Abstract
Neural tube defects (NTDs) represent a common group of severe congenital malformations of the central nervous system. They result from failure of neural tube closure during early embryonic life. Their etiology is complex, involving environmental and genetic factors that interact to modulate the incidence and severity of the developing phenotype. Despite a long history of etiologic studies, the molecular and cellular pathogenic mechanisms underlining NTDs remain poorly understood. The major epidemiologic finding in NTDs is the protective effect of perinatal folic acid supplementation that reduces their risk by 60%-70%. Genetic studies in NTDs have focused mainly on folate-related genes and identified a few significant associations between variants in these genes and an increased risk for NTDs. The candidate gene approach investigating genes involved in neurulation and inferred from animal models has faced limited success in identifying major causative genes predisposing to NTDs. However, we are witnessing a rapid and impressive progress in understanding the genetic basis of NTDs, based mainly on the development of whole genome innovative technologies and the powerful tool of animal models.
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Nagy GR, Csapó Z, Barakonyi E, Nagy B, Rigó J. Prenatal diagnosis and fetopathological investigation of dorsolumbosacral agenesis. Pathol Res Pract 2009; 205:490-3. [PMID: 19185430 DOI: 10.1016/j.prp.2008.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 11/26/2008] [Accepted: 12/02/2008] [Indexed: 11/28/2022]
Abstract
Sacral and lumbosacral spine agenesis, as characteristic signs of a rare congenital malformation--caudal regression syndrome--has been well described. However, dorsolumbosacral agenesis involving the lower thoracic, lumbar, and sacral vertebrae has rarely been reported, and prenatal diagnosis of this severe form has not been published yet. A 37-year-old woman (gravida 2, para 0) who had diabetes mellitus asked for termination of her pregnancy, because second-trimester ultrasound screening showed dorsolumbosacral agenesis of the fetus. Fetopathological examination confirmed the prenatal diagnosis and showed that the lower seven thoracic and all lumbosacral segments were absent. The noticed small "bony" structure in the lumbar region supported the idea that caudal regression syndrome can be regarded as a "multisegmental" spinal dysgenesis that involves the caudal part of the spine. Reliable prenatal diagnosis of dorsolumbosacral agenesis is possible by second-trimester ultrasound. The prenatal sonologist should always try to look for and assess abnormalities during examinations. Emphasis should be placed especially on those types that have a higher risk of being present in the fetus because of the known risk factors in the particular pregnancy. Fetopathological examination emphasized the suggestion that segmental spinal dysgenesis and caudal regression syndrome may represent two faces of a single spectrum of segmental malformations of the spine and spinal cord.
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Affiliation(s)
- Gyula Richárd Nagy
- I. Department of Obstetrics and Gynecology, Semmelweis University, Faculty of Medicine, Baross u. 27, H-1088 Budapest, Hungary.
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Pavlinkova G, Salbaum JM, Kappen C. Wnt signaling in caudal dysgenesis and diabetic embryopathy. ACTA ACUST UNITED AC 2008; 82:710-9. [PMID: 18937363 DOI: 10.1002/bdra.20495] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Congenital defects are a major complication of diabetic pregnancy, and the leading cause of infant death in the first year of life. Caudal dysgenesis, occurring up to 200-fold more frequently in children born to diabetic mothers, is a hallmark of diabetic pregnancy. Given that there is also an at least threefold higher risk for heart defects and NTDs, it is important to identify the underlying molecular mechanisms for aberrant embryonic development. METHODS We have investigated gene expression in a transgenic mouse model of caudal dysgenesis, and in a pharmacological model using situ hybridization and quantitative real-time PCR. RESULTS We identified altered expression of several molecules that control developmental processes and embryonic growth. CONCLUSIONS The results from our models point towards major implication of altered Wnt signaling in the pathogenesis of developmental anomalies associated with embryonic exposure to maternal diabetes.
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Affiliation(s)
- Gabriela Pavlinkova
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Kim T, Grobmyer SR, Liu C, Hochwald SN. Primary presacral neuroendocrine tumor associated with imperforate anus. World J Surg Oncol 2007; 5:115. [PMID: 17931412 PMCID: PMC2092435 DOI: 10.1186/1477-7819-5-115] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 10/11/2007] [Indexed: 01/07/2023] Open
Abstract
Background Presacral masses are unusual growths that have a limited differential diagnosis, typically not including neuroendocrine tumors (NETs). Classically, NETs are well-differentiated gastroenteropancreatic tumors of probable benign behavior. These tumors are associated with a typical morphologic pattern and involve the distal colon, rectum, and genitourinary tract; they are considered less aggressive, frequently asymptomatic, and rarely cause carcinoid syndrome, even when metastatic. Neuroendocrine tumors of the presacral region are extremely rare and few have been described in the literature. They have not been previously reported as being associated with imperforate anus. Case presentation We present an interesting case of a woman with a history of imperforate anus that was found to have a primary neuroendocrine tumor of the presacral region with no rectal wall involvement. Conclusion We argue that this is a primary gastroenteropancreatic neuroendocrine tumor which likely originated from cells of hindgut origin that underwent an abnormal migration during embryonic development.
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Affiliation(s)
- Tad Kim
- Division of Surgical Oncology, University of Florida, College of Medicine, Gainesville, FL 32610, USA.
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Abstract
Neural tube defects (NTDs) represent a common group of severe congenital malformations that result from failure of neural tube closure during early development. Their etiology is quite complex involving environmental and genetic factors and their underlying molecular and cellular pathogenic mechanisms remain poorly understood. Animal studies have recently demonstrated an essential role for the planar cell polarity pathway (PCP) in mediating a morphogenetic process called convergent extension during neural tube formation. Alterations in members of this pathway lead to NTDs in vertebrate models, representing novel and exciting candidates for human NTDs. Genetic studies in NTDs have focused mainly on folate-related genes based on the finding that perinatal folic acid supplementation reduces the risk of NTDs by 60-70%. A few variants in these genes have been found to be significantly associated with an increased risk for NTDs. The candidate gene approach investigating genes involved in neurulation has failed to identify major causative genes in the etiology of NTDs. Despite this history of generally negative findings, we are achieving a rapid and impressive progress in understanding the genetic basis of NTDs, based mainly on the powerful tool of animal models.
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Affiliation(s)
- Z Kibar
- CHU Sainte-Justine Research Center and Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC, Canada.
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Cai W, Zhao H, Guo J, Li Y, Yuan Z, Wang W. Retinoic acid-induced lumbosacral neural tube defects: myeloschisis and hamartoma. Childs Nerv Syst 2007; 23:549-54. [PMID: 17252267 DOI: 10.1007/s00381-006-0289-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2006] [Indexed: 10/23/2022]
Abstract
OBJECTS To observe the morphological features of the lumbosacral neural tube defects (NTDs) induced by all-trans retinoic acid (atRA) and to explore the pathogenesis of these defects. METHODS Rat embryos with lumbosacral NTDs were obtained by treating pregnant rats with administration of atRA. Rat embryos were obtained by cesarean. Fetuses were sectioned and stained with hematoxylin-eosin (H&E). Relevant structures including caudal neural tube were examined. In the atRA-treated rats, about 48% embryos showed lumbosacral NTDs. There appeared a dorsally and rostrally situated, neural-plate-like structure (myeloschisis) and a ventrally and caudally located cell mass containing multiple canals (hamartoma) in the lumbosacral NTDs induced by atRA. CONCLUSIONS Retinoic acid could disturb the notochord and tail bud development in the process of primary and secondary neurulation in rat embryos, which cause lumbosacral NTDs including myeloschisis and hamartoma. The morphology is very similar to that happens in humans.
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Affiliation(s)
- WeiSong Cai
- Congenital Malformation Lab, Pediatric Surgery, The Second Affiliated Hospital (Shengjing Hospital), China Medical University, Shenyang, 110004, People's Republic of China,
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Rossi A, Gandolfo C, Cama A, Tortori-Donati P. Congenital Malformations of the Spine, Spinal Cord, and Cranio-Cervical Junction. ACTA ACUST UNITED AC 2007. [DOI: 10.1007/978-3-540-68483-1_1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Rossi A, Gandolfo C, Morana G, Piatelli G, Ravegnani M, Consales A, Pavanello M, Cama A, Tortori-Donati P. Current Classification and Imaging of Congenital Spinal Abnormalities. Semin Roentgenol 2006; 41:250-73. [PMID: 17010690 DOI: 10.1053/j.ro.2006.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andrea Rossi
- Department of Neuroradiology, G. Gaslini Children's Research Hospital, Genova, Italy.
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Abstract
Spina bifida, anencephaly, and encephalocele are commonly grouped together and termed neural tube defects (NTD). Failure of closure of the neural tube during development results in anencephaly or spina bifida aperta but encephaloceles are possibly post-closure defects. NTD are associated with a number of other central nervous system (CNS) and non-neural malformations. Racial, geographic and seasonal variations seem to affect their incidence. Etiology of NTD is unknown. Most of the non-syndromic NTD are of multifactorial origin. Recent in vitro and in vivo studies have highlighted the molecular mechanisms of neurulation in vertebrates but the morphologic development of human neural tube is poorly understood. A multisite closure theory, extrapolated directly from mouse experiments highlighted the clinical relevance of closure mechanisms to human NTD. Animal models, such as circle tail, curly tail, loop tail, shrm and numerous knockouts provide some insight into the mechanisms of NTD. Also available in the literature are a plethora of chemically induced preclosure and a few post-closure models of NTD, which highlight the fact that CNS malformations are of hetergeneitic nature. No Mendelian pattern of inheritance has been reported. Association with single gene defects, enhanced recurrence risk among siblings, and a higher frequency in twins than in singletons indicate the presence of a strong genetic contribution to the etiology of NTD. Non-availability of families with a significant number of NTD cases makes research into genetic causation of NTD difficult. Case reports and epidemiologic studies have implicated a number of chemicals, widely differing therapeutic drugs, environmental contaminants, pollutants, infectious agents, and solvents. Maternal hyperthermia, use of valproate by epileptic women during pregnancy, deficiency and excess of certain nutrients and chronic maternal diseases (e.g. diabetes mellitus) are reported to cause a manifold increase in the incidence of NTD. A host of suspected teratogens are also available in the literature. The UK and Hungarian studies showed that periconceptional supplementation of women with folate (FA) reduces significantly both the first occurrence and recurrence of NTD in the offspring. This led to mandatory periconceptional FA supplementation in a number of countries. Encouraged by the results of clinical studies, numerous laboratory investigations focused on the genes involved in the FA, vitamin B12 and homocysteine metabolism during neural tube development. As of today no clinical or experimental study has provided unequivocal evidence for a definitive role for any of these genes in the causation of NTD suggesting that a multitude of genes, growth factors and receptors interact in controlling neural tube development by yet unknown mechanisms. Future studies must address issues of gene-gene, gene-nutrient and gene-environment interactions in the pathogenesis of NTD.
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Affiliation(s)
- Rengasamy Padmanabhan
- Department of Anatomy, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
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Vilović K, Ilijić E, Glamoclija V, Kolić K, Bocina I, Sapunar D, Saraga-Babić M. Cell death in developing human spinal cord. ACTA ACUST UNITED AC 2005; 211:1-9. [PMID: 16315061 DOI: 10.1007/s00429-005-0044-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2005] [Indexed: 10/25/2022]
Abstract
Cell death in the developing human spinal cord was investigated in 5-12 week human conceptuses using immunohistochemical and TUNEL methods. Expression of pro-apoptotic (Fas-receptor, caspase-3) and anti-apoptotic (bcl-2) markers and marker for internucleosomal fragmentation (TUNEL) were analysed in the cranial and caudal parts of the human spinal cord. In early developmental stages (5-6 weeks) of the cranial spinal cord, bcl-2 positive cells were seen in the ventricular zone and in the roof plate, while in the caudal part they were seen surrounding the central lumen. Subsequently, bcl-2 expression appeared in the basal plates of the grey matter and in the spinal ganglia, and from the seventh week on they also appeared in the intermediate horn of the grey matter. In the fetal period, bcl-2 expression appeared in the dorsal horns of the grey matter (9 weeks) but ceased in the ventricular zone (12 weeks) . In the trunk region, TUNEL-positive cells were found in ventricular and mantle zones along the whole length of the spinal cord. Caspase-3 positive cells and Fas-receptor positive cells appeared only in the grey matter of the cranial segments (head and trunk) of the spinal cord, but they were missing in the caudal parts. Caspase-3 dependant pathway, probably activated by Fas-receptor, seems to operate only in the cranial part of the human spinal cord. In the caudal (sacrococcygeal and tail) parts, cells seem to die by caspase-3 independent pathway. The interplay of pro-apoptotic and anti-apoptotic factors may be associated with cranial spinal cord morphogenesis, adjustment of cells number and selective survival of neurons, while in the caudal regions these factors cause massive cell death associated with regression of the caudal spinal cord.
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Affiliation(s)
- Katarina Vilović
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, PAK, KB Split, Spincićeva 1, 21000 Split, Croatia.
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Singer G, Schalamon J, Ainoedhofer H, Petek E, Kroisel PM, Höllwarth ME. Williams-Beuren syndrome associated with caudal regression syndrome and coagulopathy--a case report. J Pediatr Surg 2005; 40:e47-50. [PMID: 16291141 DOI: 10.1016/j.jpedsurg.2005.07.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Williams-Beuren syndrome is a genetic disorder caused by a heterozygous deletion at 7q11.23. The present report describes a female patient with Williams-Beuren syndrome combined with caudal regression syndrome and two forms of coagulopathy. Besides the typical developmental abnormalities such as mental and growth retardation, a distinctive facial appearance, and cardiovascular anomalies, our patient showed fusion of fourth and fifth lumbar vertebra and a sacrococcygeal agenesis. Blood coagulation tests revealed a deficiency of coagulation factor XI and XII. Magnetic resonance imaging angiography showed multiple vascular stenoses mainly in the abdominal aorta and its major branches as a consequence of the insufficient elastin gene. Previous reports identified a deletion of HLXB9 as a possible genetic cause of the caudal regression syndrome, which could not be identified in the present case. This unusual combination of the above-mentioned genetic disorders has not been published so far.
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Affiliation(s)
- Georg Singer
- Department of Pediatric Surgery, Medical University of Graz, 8036 Graz, Austria.
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Keegan CE, Hutz JE, Else T, Adamska M, Shah SP, Kent AE, Howes JM, Beamer WG, Hammer GD. Urogenital and caudal dysgenesis in adrenocortical dysplasia (acd) mice is caused by a splicing mutation in a novel telomeric regulator. Hum Mol Genet 2004; 14:113-23. [PMID: 15537664 DOI: 10.1093/hmg/ddi011] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Adrenocortical dysplasia (acd) is a spontaneous autosomal recessive mouse mutant with developmental defects in organs derived from the urogenital ridge. In surviving adult mutants, adrenocortical dysplasia and hypofunction are predominant features. Adults are infertile due to lack of mature germ cells, and 50% develop hydronephrosis due to ureteral hyperplasia. We report the identification of a splice donor mutation in a novel gene, which is the mouse ortholog of a newly discovered telomeric regulator. This gene (Acd) has recently been characterized as a novel component of the TRF1 protein complex that controls telomere elongation by telomerase. Characterization of Acd transcripts in mutant animals reveals two abnormal transcripts, consistent with a splicing defect. Expression of a wild-type Acd transgene in acd mutants rescues the observed phenotype. Most mutants die within 1-2 days of life on the original genetic background. Analysis of these mutant embryos reveals variable, yet striking defects in caudal specification, limb patterning and axial skeleton formation. In the tail bud, reduced expression of Wnt3a and Dll1 correlates with phenotypic severity of caudal regression. In the limbs, expression of Fgf8 is expanded in the dorsal-ventral axis of the apical ectodermal ridge and shortened in the anterior-posterior axis, consistent with the observed loss of anterior digits in older embryos. The axial skeleton of mutant embryos shows abnormal vertebral fusions in cervical, lumbar and caudal regions. This is the first report to show that a telomeric regulator is required for proper urogenital ridge differentiation, axial skeleton specification and limb patterning in mice.
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Affiliation(s)
- Catherine E Keegan
- Department of Pediatrics, Division of Genetics, University of Michigan, Ann Arbor, MI 48109-0789, USA
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Rossi A, Biancheri R, Cama A, Piatelli G, Ravegnani M, Tortori-Donati P. Imaging in spine and spinal cord malformations. Eur J Radiol 2004; 50:177-200. [PMID: 15081131 DOI: 10.1016/j.ejrad.2003.10.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2003] [Revised: 10/09/2003] [Accepted: 10/13/2003] [Indexed: 01/13/2023]
Abstract
Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.
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Affiliation(s)
- Andrea Rossi
- Department of Neuroradiology, G. Gaslini Children's Research Hospital, Largo G. Gaslini 5, I-16147 Genova, Italy.
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Rossi A, Cama A, Piatelli G, Ravegnani M, Biancheri R, Tortori-Donati P. Spinal dysraphism: MR imaging rationale. J Neuroradiol 2004; 31:3-24. [PMID: 15026728 DOI: 10.1016/s0150-9861(04)96875-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Spinal cord development occurs through the three consecutive periods of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal cord malformations derive from defects in these early embryonic stages, and are collectively called spinal dysraphisms. Spinal dysraphisms may be categorized clinically into open and closed, based on whether the abnormal nervous tissue is exposed to the environment or covered by skin. Open spinal dysraphisms include myelomeningocele and other rare abnormalities such as myelocele, hemimyelomeningocele, and hemimyelocele, and are always associated with a Chiari II malformation. Closed spinal dysraphisms are further divided into two subsets based on whether a subcutaneous mass is present in the low back. Closed spinal dysraphisms with mass comprise lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category involves abnormal notochordal development, either in the form of failed midline integration (ranging from complete dorsal enteric fistula to neurenteric cysts and diastematomyelia) or of segmental agenesis (caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging is the imaging modality of choice for evaluation of this complex group of disorders.
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Affiliation(s)
- A Rossi
- Department of Pediatric Neuroradiology, G Gaslini Children's Research Hospital, Genoa, Italy.
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Abstract
The vertebrate tail is an extension of the main body axis caudal to the anus. The developmental origin of this structure has been a source of debate amongst embryologists for the past century. Some view tail development as a continuation of the morphogenetic processes that shape the head and trunk (i.e. gastrulation). The alternative view, secondary development, holds that the tail forms in a manner similar to limb development, i.e. by secondary induction. Previous developmental studies have provided support for both views. Here I revisit these studies, describing caudal morphogenesis in select vertebrates, the associated genes and developmental defects, and, as a relevant aside, consider the developmental and evolutionary relationships of primary and secondary neurulation. I conclude that caudal development enlists both gastrulation and secondary induction, and that the application of recent high-resolution cell labelling technology may clarify how these discordant programmes interact in building the vertebrate tail.
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Jo Mauch T, Albertine KH. Urorectal septum malformation sequence: Insights into pathogenesis. THE ANATOMICAL RECORD 2002; 268:405-10. [PMID: 12420289 DOI: 10.1002/ar.10180] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We characterize the urorectal septum malformation sequence (URSMS) in discordant fetal lambs and relate it to the human syndromes with which URSMS is associated. We found abnormal external genitalia, imperforate anus, and fistulous connections between the rectum, bladder, and vagina. Discordance among the dizygous twins eliminated teratogens as a likely etiologic factor. We summarize the relevant literature and propose a molecular model for the pathogenesis of the URSMS, in which alterations in sonic hedgehog and homeobox genes lead to caudal mesodermal deficiency during blastogenesis.
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Affiliation(s)
- Teri Jo Mauch
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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