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Kalayci Yigin A, Duz MB, Seven M. Rare Findings in Cleidocranial Dysplasia Caused by RUNX Mutation. Glob Med Genet 2021; 9:23-28. [PMID: 35169780 PMCID: PMC8837417 DOI: 10.1055/s-0041-1736482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/31/2021] [Indexed: 11/06/2022] Open
Abstract
Background
Cleidocranial dysplasia (CCD, #MIM119600) is an autosomal-dominant skeletal dysplasia characterized by delayed closure of the cranial sutures, aplasia, or hypoplasia of the clavicles and dental abnormalities. These findings were accompanied by mobile and drooping shoulders, frontal and parietal bossing, hypertelorism, brachycephaly, short stature, supernumerary, and late erupting teeth. Radiographic studies can reveal involvement of multiple bones including skull, chest, pelvis, and limbs. CCD can be diagnosed with clinical and radiological evaluation and validated by molecular studies. Heterozygous loss of function
RUNX2
gene, which plays an important role in osteogenesis and differentiation of precursor cells, causes CCD phenotype.
Methods
In this article, we reported five cases from three unrelated families with CCD phenotype. All exons and exonic–intronic boundary regions of
RUNX2
gene from five patients were analyzed by polymerase chain reaction amplification and direct Sanger-sequencing.
Results
Our patients had classical CCD phenotype and we detected three different previously described mutations including c.1171C > T, IVS4 + 4delAAGT and c.676G > A. However, nail dysplasia has never been associated with these mutations. Our patients had varying degrees of nail dysplasia. Two of three mutations are related with Runt DNA-binding domain of
RUNX2
protein in Wnt signaling and c.1171C > T had effect on proline/serine/threonine-rich (PST) domain. Recently, Wnt signaling pathway was presented as a key regulator of digit and nail differentiation. Our data suggest that
RUNX2
gene may have an essential role on embryogenesis of nails, probably by protecting their integrity.
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Affiliation(s)
- Aysel Kalayci Yigin
- Department of Medical Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School, Istanbul, Turkey
| | - Mehmet Bugrahan Duz
- Department of Medical Genetics, Health Sciences University, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Seven
- Department of Medical Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School, Istanbul, Turkey
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BİSWAS A, BABU GS, RAO K, SAKTHIVEL S, CASTELİNO R. APPLICATION OF 3-D IMAGING IN A FAMILIAL CASE OF CLEIDOCRANIAL DYSPLASIA. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.668128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Matthews-Brzozowska T, Hojan-Jezierska D, Loba W, Worona M, Matthews-Brzozowski A. Cleidocranial Dysplasia-dental Disorder Treatment and Audiology Diagnosis. Open Med (Wars) 2018. [PMID: 29520374 PMCID: PMC5836532 DOI: 10.1515/med-2018-0001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A review of numerous case reports was made, in order to demonstrate the possibilities for treatment of dental disorders in patients with Cleidocranial dysplasia (CCD). In this paper, our own report, including a diagnosis of the effect on the auditory system, is presented. In addition to the triad of CCD symptoms that include hypoplastic or aplastic clavicles, impacted and supernumerary teeth, delayed closure of fontanelles and cranial sutures, impairment of the hearing system resulting in conductive hearing loss also occurs. Our own report is based on the case of a 12-year-old CCD patient, in whom Cone Beam Computed Tomography (CBCT) revealed the presence of 12 supernumerary teeth. Furthermore, a clinical examination pointed to the presence of retained deciduous teeth and a delayed eruption of permanent teeth. Orthodontic-surgical procedures were implemented, in accordance with the literature. During the course of the orthodontic treatment, a decrease in auditory sensitivity was observed, for which reason hearing tests were also performed. Conductive hearing loss was detected. As such, it is important to remember that in such cases, auditory check-ups need to be performed between the many surgical and orthodontic interventions, which usually last a few years.
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Affiliation(s)
- Teresa Matthews-Brzozowska
- Chair and Department of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Hojan-Jezierska
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, Poznan, Poland
| | - Wawrzyniec Loba
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Worona
- Students Research Group of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - Artur Matthews-Brzozowski
- Department of Oral and Maxillofacial Surgery, The University Medical Center, Groningen, The Netherlands
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Abstract
Cleidocranial dysplasia is an inherited skeletal anomaly that affects primarily the skull, clavicle, and dentition, which can occur spontaneously, but most are inherited in autosomal dominant mode. The skull findings are brachycephaly, delayed or failed closure of the fontanelles, presence of open skull sutures and multiple wormian bones with pronounced frontal bossing. The syndrome is notable for aplasia or hypoplasia of the clavicles. The neck appears long and narrow and the shoulders markedly droop. Oral manifestations exhibit a hypoplastic maxilla with high-arched palate. Crowding of teeth is produced by retention of deciduous teeth, delayed eruption of permanent teeth, and the presence of a large number of unerupted supernumerary teeth. We report a case of CCD in a 12-year-old girl who presented with an unaesthetic facial appearance, unerupted permanent dentition with hearing loss.
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Affiliation(s)
- Ramesh Candamourty
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Mahatma Gandhi Medical College and Research Institute Campus, Pillaiyarkuppam, Pondicherry, India
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Tang SY, Alliston T. Regulation of postnatal bone homeostasis by TGFβ. BONEKEY REPORTS 2013; 2:255. [PMID: 24404376 DOI: 10.1038/bonekey.2012.255] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 11/22/2012] [Indexed: 12/30/2022]
Abstract
Perhaps more so than any other tissue, bone has pivotal mechanical and biological functions. Underlying the ability of bone to execute these functions, whether providing structural support or preserving mineral homeostasis, is the dynamic remodeling of bone matrix. Cells within bone integrate multiple stimuli to balance the deposition and resorption of bone matrix. Transforming growth factor-β (TGFβ) uniquely coordinates bone cell activity to maintain bone homeostasis. TGFβ regulates the differentiation and function of both osteoblasts and osteoclasts, from lineage recruitment to terminal differentiation, to balance bone formation and resorption. TGFβ calibrates the synthesis and material quality of bone matrix and bone's responsiveness to applied mechanical loads. Therefore, by coupling the activity of bone forming and resorbing cells, and by sensing, responding to and defining physical cues, TGFβ integrates physical and biochemical stimuli to maintain bone homeostasis. Disruption of TGFβ signaling has significant consequences on bone mass and quality. Alternatively, TGFβ is a powerful lever that has the potential to yield therapeutic benefit in cases where bone homeostasis needs to be recalibrated.
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Affiliation(s)
- Simon Y Tang
- Department of Orthopaedic Surgery, School of Medicine, Washington University in St Louis , St Louis, MO, USA
| | - Tamara Alliston
- Department of Orthopaedic Surgery, School of Medicine, University of California, San Francisco , San Francisco, CA, USA
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Abstract
This article reviews some of the otolaryngologic manifestations of skeletal dysplasias. Achondroplasia is discussed most comprehensively. Skeletal dysplasias are bone and cartilage disorders that disrupt the development of the long bones, craniofacial skeleton, and vertebral column, with the most notable characteristic being short stature. Children with skeletal dysplasias have various medical problems. These children often develop head and neck manifestations of their disorders. Hearing loss, middle ear disease, and respiratory difficulties are seen in these children. Otolaryngologists must be knowledgeable about these disorders to diagnose, treat, and appropriately refer children with skeletal dysplasias.
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Yang B, Tian C, Zhang ZG, Han FC, Azem R, Yu H, Zheng Y, Jin G, Arnold JE, Zheng QY. Sh3pxd2b mice are a model for craniofacial dysmorphology and otitis media. PLoS One 2011; 6:e22622. [PMID: 21818352 PMCID: PMC3144925 DOI: 10.1371/journal.pone.0022622] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 06/26/2011] [Indexed: 11/18/2022] Open
Abstract
Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2bnee mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2bnee mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) mirrors craniofacial dysmorphology and otitis media in humans.
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Affiliation(s)
- Bin Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Cong Tian
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Zhi-guang Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- * E-mail: (QYZ); (ZgZ)
| | - Feng-chan Han
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Rami Azem
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Heping Yu
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ye Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ge Jin
- School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - James E. Arnold
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Qing Y. Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (QYZ); (ZgZ)
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Abstract
Cleidocranial dysplasia is a rare autosomal dominant condition with generalized dysplasia of bone, characterized by delayed closer of cranial sutures, hypoplastic or aplastic clavicles, short stature, dental abnormalities and a variety of other skeletal abnormalities. We present a seven-year-old female child presenting with classical features of cleidocranial dysplasia.
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Affiliation(s)
- Ramakant Dixit
- Department of Pulmonary Medicine, JLN Medical College, Ajmer and Samarpan Child Clinic, Taragarh Link Road, Ajmer, India
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Chang JL, Brauer DS, Johnson J, Chen CG, Akil O, Balooch G, Humphrey MB, Chin EN, Porter AE, Butcher K, Ritchie RO, Schneider RA, Lalwani A, Derynck R, Marshall GW, Marshall SJ, Lustig L, Alliston T. Tissue-specific calibration of extracellular matrix material properties by transforming growth factor-β and Runx2 in bone is required for hearing. EMBO Rep 2010; 11:765-71. [PMID: 20847738 DOI: 10.1038/embor.2010.135] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 08/09/2010] [Accepted: 08/11/2010] [Indexed: 01/02/2023] Open
Abstract
Physical cues, such as extracellular matrix stiffness, direct cell differentiation and support tissue-specific function. Perturbation of these cues underlies diverse pathologies, including osteoarthritis, cardiovascular disease and cancer. However, the molecular mechanisms that establish tissue-specific material properties and link them to healthy tissue function are unknown. We show that Runx2, a key lineage-specific transcription factor, regulates the material properties of bone matrix through the same transforming growth factor-β (TGFβ)-responsive pathway that controls osteoblast differentiation. Deregulated TGFβ or Runx2 function compromises the distinctly hard cochlear bone matrix and causes hearing loss, as seen in human cleidocranial dysplasia. In Runx2+/⁻ mice, inhibition of TGFβ signalling rescues both the material properties of the defective matrix, and hearing. This study elucidates the unknown cause of hearing loss in cleidocranial dysplasia, and demonstrates that a molecular pathway controlling cell differentiation also defines material properties of extracellular matrix. Furthermore, our results suggest that the careful regulation of these properties is essential for healthy tissue function.
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Affiliation(s)
- Jolie L Chang
- Department of Otolaryngology, Head and Neck Surgery, University of California at San Francisco, San Francisco, California 94143, USA
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Craniofacial and temporal bone CT findings in cleidocranial dysplasia. Pediatr Radiol 2008; 38:892-7. [PMID: 18446333 DOI: 10.1007/s00247-008-0866-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 03/13/2008] [Accepted: 03/28/2008] [Indexed: 10/22/2022]
Abstract
Cleidocranial dysplasia (CCD) is a multistructural polyostotic genetic disorder that results from mutation of the CBFA1 gene. Hearing loss is a frequent finding in CCD. We describe the CT craniofacial findings in CCD and provide a comprehensive discussion of the CT temporal bone findings in these patients.
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Segal N, Puterman M. Cleidocranial dysplasia - review with an emphasis on otological and audiological manifestations. Int J Pediatr Otorhinolaryngol 2007; 71:523-6. [PMID: 17239447 DOI: 10.1016/j.ijporl.2006.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2006] [Accepted: 11/28/2006] [Indexed: 11/21/2022]
Abstract
Cleidocranial dysplasia is a rare developmental abnormality of bone that affects both the skeleton and the temporal bone. It is genetically characterized and the clinical signs and symptoms can be diverse. Aural pathologies may be the presenting symptoms of the disease. We reviewed the up to date literature on the syndrome with an emphasis on the otological and audiological manifestation.
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Affiliation(s)
- Nili Segal
- Department of Otolaryngology, Head and Neck Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Armstrong L, Graham GE, Schimke RN, Collins DL, Kirse DJ, Costello F, Ardinger HH. The Hunter–MacDonald syndrome with expanded phenotype including risk of meningioma: An update and review. Am J Med Genet A 2007; 146A:83-92. [DOI: 10.1002/ajmg.a.31998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kisiel BM, Kostrzewa G, Wlasienko P, Kruczek A, Gajdulewicz M, Maciejak D, Wisniewska M, Ploski R, Korniszewski L. Cleidocranial dysplasia in a Polish population: high frequency of the R193X mutation. Clin Genet 2006; 70:167-9. [PMID: 16879201 DOI: 10.1111/j.1399-0004.2006.00648.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tokuc G, Boran P, Boran BO. Cleidocranial dysplasia in a mother and her daughter within the scope of neurosurgery. J Neurosurg Pediatr 2006; 104:290-2. [PMID: 16619644 DOI: 10.3171/ped.2006.104.4.290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cleidocranial dysplasia is an autosomal-dominant disorder characterized by late closure or nonclosure of the anterior fontanelle, late ossification of cranial sutures, defective clavicle, and delayed eruption of permanent teeth. In this article, two cases of cleidocranial dysplasia involving a mother and her daughter are reported, and a case management policy is suggested. The 1-year-old daughter was macrocephalic and brachycephalic, and had midface hypoplasia and hypertelorism. Plain radiographs revealed aplasia of the clavicles. Three-dimensional computerized tomography scanning demonstrated a large anterior fontanelle, a patent posterior fontanelle, and bone defects at the pterion and asterion, together with nonfused metopic and sagittal sutures. The mother was 22 years of age. She had an open anterior fontanelle, aplastic clavicles, and unerupted permanent teeth. Although it is a rare disorder, cleidocranial dysplasia should be recognized by neurosurgeons. A protective helmet can be provided in early childhood, and craniofacial remodeling can be undertaken at a later age, when the final size and shape of the skull become apparent.
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Affiliation(s)
- Gulnur Tokuc
- Second Clinic of Pediatrics, Dr Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey
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González López BS, Ortiz Solalinde C, Kubodera Ito T, Lara Carrillo E, Ortiz Solalinde E. Cleido cranial dysplasia: report of a family. J Oral Sci 2005; 46:259-66. [PMID: 15901072 DOI: 10.2334/josnusd.46.259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
A family case of Cleidocranial Dysplasia is presented. A mother and two adolescent girls were examined. In all three cases, a radiological series was performed over the entire body. Generalized dysplasia in bones, prolonged retention of primary teeth, and delayed eruption of permanent, as well as supernumerary teeth was diagnosed. The citogenetic study with GTG band showed normal 46, XX. Bilateral audiometry in the mother demonstrated a mild to moderate hypoacustic condition. Radiological findings are presented and the importance of early diagnosis is discussed.
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