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Goodwin AF, Larson JR, Jones KB, Liberton DK, Landan M, Wang Z, Boekelheide A, Langham M, Mushegyan V, Oberoi S, Brao R, Wen T, Johnson R, Huttner K, Grange DK, Spritz RA, Hallgrímsson B, Jheon AH, Klein OD. Craniofacial morphometric analysis of individuals with X-linked hypohidrotic ectodermal dysplasia. Mol Genet Genomic Med 2014; 2:422-9. [PMID: 25333067 PMCID: PMC4190877 DOI: 10.1002/mgg3.84] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/28/2014] [Accepted: 04/04/2014] [Indexed: 12/24/2022] Open
Abstract
Hypohidrotic ectodermal dysplasia (HED) is the most prevalent type of ectodermal dysplasia (ED). ED is an umbrella term for a group of syndromes characterized by missing or malformed ectodermal structures, including skin, hair, sweat glands, and teeth. The X-linked recessive (XL), autosomal recessive (AR), and autosomal dominant (AD) types of HED are caused by mutations in the genes encoding ectodysplasin (EDA1), EDA receptor (EDAR), or EDAR-associated death domain (EDARADD). Patients with HED have a distinctive facial appearance, yet a quantitative analysis of the HED craniofacial phenotype using advanced three-dimensional (3D) technologies has not been reported. In this study, we characterized craniofacial morphology in subjects with X-linked hypohidrotic ectodermal dysplasia (XLHED) by use of 3D imaging and geometric morphometrics (GM), a technique that uses defined landmarks to quantify size and shape in complex craniofacial morphologies. We found that the XLHED craniofacial phenotype differed significantly from controls. Patients had a smaller and shorter face with a proportionally longer chin and midface, prominent midfacial hypoplasia, a more protrusive chin and mandible, a narrower and more pointed nose, shorter philtrum, a narrower mouth, and a fuller and more rounded lower lip. Our findings refine the phenotype of XLHED and may be useful both for clinical diagnosis of XLHED and to extend understanding of the role of EDA in craniofacial development.
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Affiliation(s)
- Alice F Goodwin
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Jacinda R Larson
- Department of Cell Biology & Anatomy, McCaig Bone and Joint Institute, University of Calgary Calgary, Alberta, Canada ; Canadian Institutes of Health Research Training Program in Genetics, Child Development and Health, Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary Calgary, Alberta, Canada
| | - Kyle B Jones
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Denise K Liberton
- Department of Cell Biology & Anatomy, McCaig Bone and Joint Institute, University of Calgary Calgary, Alberta, Canada
| | - Maya Landan
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Zhifeng Wang
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Anne Boekelheide
- Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco San Francisco, CA
| | - Margaret Langham
- Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco San Francisco, CA
| | - Vagan Mushegyan
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Snehlata Oberoi
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA ; Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco San Francisco, CA
| | - Rosalie Brao
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | - Timothy Wen
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA
| | | | | | | | - Richard A Spritz
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine Aurora, CO
| | - Benedikt Hallgrímsson
- Department of Cell Biology & Anatomy, McCaig Bone and Joint Institute, University of Calgary Calgary, Alberta, Canada ; Alberta Children's Hospital Foundation, Institute for Child and Maternal Health, University of Calgary Calgary, Alberta, Canada
| | - Andrew H Jheon
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA ; Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco San Francisco, CA
| | - Ophir D Klein
- Program in Craniofacial and Mesenchymal Biology, University of California San Francisco San Francisco, CA ; Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco San Francisco, CA ; Institute for Human Genetics and Department of Pediatrics, University of California San Francisco San Francisco, CA
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Goodwin AF, Oberoi S, Landan M, Charles C, Massie JC, Fairley C, Rauen KA, Klein OD. Craniofacial and dental development in Costello syndrome. Am J Med Genet A 2014; 164A:1425-30. [PMID: 24668879 DOI: 10.1002/ajmg.a.36475] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 12/31/2013] [Indexed: 01/21/2023]
Abstract
Costello syndrome (CS) is a RASopathy characterized by a wide range of cardiac, musculoskeletal, dermatological, and developmental abnormalities. The RASopathies are defined as a group of syndromes caused by activated Ras/mitogen-activated protein kinase (MAPK) signaling. Specifically, CS is caused by activating mutations in HRAS. Although receptor tyrosine kinase (RTK) signaling, which is upstream of Ras/MAPK, is known to play a critical role in craniofacial and dental development, the craniofacial and dental features of CS have not been systematically defined in a large group of individuals. In order to address this gap in our understanding and fully characterize the CS phenotype, we evaluated the craniofacial and dental phenotype in a large cohort (n = 41) of CS individuals. We confirmed that the craniofacial features common in CS include macrocephaly, bitemporal narrowing, convex facial profile, full cheeks, and large mouth. Additionally, CS patients have a characteristic dental phenotype that includes malocclusion with anterior open bite and posterior crossbite, enamel hypo-mineralization, delayed tooth development and eruption, gingival hyperplasia, thickening of the alveolar ridge, and high palate. Comparison of the craniofacial and dental phenotype in CS with other RASopathies, such as cardio-facio-cutaneous syndrome (CFC), provides insight into the complexities of Ras/MAPK signaling in human craniofacial and dental development.
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Affiliation(s)
- Alice F Goodwin
- Program in Craniofacial and Mesenchymal Biology, and Division of Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco, San Francisco, California
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Jones KB, Goodwin AF, Landan M, Seidel K, Tran DK, Hogue J, Chavez M, Fete M, Yu W, Hussein T, Johnson R, Huttner K, Jheon AH, Klein OD. Characterization of X-linked hypohidrotic ectodermal dysplasia (XL-HED) hair and sweat gland phenotypes using phototrichogram analysis and live confocal imaging. Am J Med Genet A 2013; 161A:1585-93. [PMID: 23687000 DOI: 10.1002/ajmg.a.35959] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 02/09/2013] [Indexed: 11/05/2022]
Abstract
Hypohidrotic ectodermal dysplasia (HED) is the most common type of ectodermal dysplasia (ED), which encompasses a large group of syndromes that share several phenotypic features such as missing or malformed ectodermal structures, including skin, hair, sweat glands, and teeth. X-linked hypohidrotic ectodermal dysplasia (XL-HED) is associated with mutations in ectodysplasin (EDA1). Hypohidrosis due to hypoplastic sweat glands and thin, sparse hair are phenotypic features that significantly affect the daily lives of XL-HED individuals and therefore require systematic analysis. We sought to determine the quality of life of individuals with XL-HED and to quantify sweat duct and hair phenotypes using confocal imaging, pilocarpine iontophoresis, and phototrichogram analysis. Using these highly sensitive and non-invasive techniques, we demonstrated that 11/12 XL-HED individuals presented with a complete absence of sweat ducts and that none produced sweat. We determined that the thin hair phenotype observed in XL-HED was due to multiple factors, such as fewer terminal hairs with decreased thickness and slower growth rate, as well as fewer follicular units and fewer hairs per unit. The precise characterization of XL-HED phenotypes using sensitive and non-invasive techniques presented in our study will improve upon larger genotype-phenotype studies and the assessment of future therapies in XL-HED.
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Affiliation(s)
- Kyle B Jones
- Program in Craniofacial and Mesenchymal Biology, University of California, San Francisco, San Francisco, CA 94143, USA
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Goodwin AF, Oberoi S, Landan M, Charles C, Groth J, Martinez A, Fairley C, Weiss LA, Tidyman WE, Klein OD, Rauen KA. Craniofacial and dental development in cardio-facio-cutaneous syndrome: the importance of Ras signaling homeostasis. Clin Genet 2012; 83:539-44. [PMID: 22946697 DOI: 10.1111/cge.12005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 01/05/2023]
Abstract
Cardio-facio-cutaneous syndrome (CFC) is a RASopathy that is characterized by craniofacial, dermatologic, gastrointestinal, ocular, cardiac, and neurologic anomalies. CFC is caused by activating mutations in the Ras/mitogen-activated protein kinase (MAPK) signaling pathway that is downstream of receptor tyrosine kinase (RTK) signaling. RTK signaling is known to play a central role in craniofacial and dental development, but to date, no studies have systematically examined individuals with CFC to define key craniofacial and dental features. To fill this critical gap in our knowledge, we evaluated the craniofacial and dental phenotype of a large cohort (n = 32) of CFC individuals who attended the 2009 and 2011 CFC International Family Conferences. We quantified common craniofacial features in CFC which include macrocephaly, bitemporal narrowing, convex facial profile, and hypoplastic supraorbital ridges. In addition, there is a characteristic dental phenotype in CFC syndrome that includes malocclusion with open bite, posterior crossbite, and a high-arched palate. This thorough evaluation of the craniofacial and dental phenotype in CFC individuals provides a step forward in our understanding of the role of RTK/MAPK signaling in human craniofacial development and will aid clinicians who treat patients with CFC.
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Affiliation(s)
- A F Goodwin
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
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