1
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Musolf AM, Justice CM, Erdogan-Yildirim Z, Goovaerts S, Cuellar A, Shaffer JR, Marazita ML, Claes P, Weinberg SM, Li J, Senders C, Zwienenberg M, Simeonov E, Kaneva R, Roscioli T, Di Pietro L, Barba M, Lattanzi W, Cunningham ML, Romitti PA, Boyadjiev SA. Whole genome sequencing identifies associations for nonsyndromic sagittal craniosynostosis with the intergenic region of BMP2 and noncoding RNA gene LINC01428. Sci Rep 2024; 14:8533. [PMID: 38609424 PMCID: PMC11014861 DOI: 10.1038/s41598-024-58343-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Craniosynostosis (CS) is a major birth defect resulting from premature fusion of cranial sutures. Nonsyndromic CS occurs more frequently than syndromic CS, with sagittal nonsyndromic craniosynostosis (sNCS) presenting as the most common CS phenotype. Previous genome-wide association and targeted sequencing analyses of sNCS have identified multiple associated loci, with the strongest association on chromosome 20. Herein, we report the first whole-genome sequencing study of sNCS using 63 proband-parent trios. Sequencing data for these trios were analyzed using the transmission disequilibrium test (TDT) and rare variant TDT (rvTDT) to identify high-risk rare gene variants. Sequencing data were also examined for copy number variants (CNVs) and de novo variants. TDT analysis identified a highly significant locus at 20p12.3, localized to the intergenic region between BMP2 and the noncoding RNA gene LINC01428. Three variants (rs6054763, rs6054764, rs932517) were identified as potential causal variants due to their probability of being transcription factor binding sites, deleterious combined annotation dependent depletion scores, and high minor allele enrichment in probands. Morphometric analysis of cranial vault shape in an unaffected cohort validated the effect of these three single nucleotide variants (SNVs) on dolichocephaly. No genome-wide significant rare variants, de novo loci, or CNVs were identified. Future efforts to identify risk variants for sNCS should include sequencing of larger and more diverse population samples and increased omics analyses, such as RNA-seq and ATAC-seq.
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Affiliation(s)
- Anthony M Musolf
- Statistical Genetics Section, Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health (NIH), Baltimore, MD, 21224, USA
| | - Cristina M Justice
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Zeynep Erdogan-Yildirim
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Seppe Goovaerts
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Department of Electrical Engineering, ESAT-PSI, KU Leuven, Leuven, Belgium
- Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium
| | - Araceli Cuellar
- Department of Pediatrics, University of California Davis, Sacramento, CA, 95817, USA
| | - John R Shaffer
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Peter Claes
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Department of Electrical Engineering, ESAT-PSI, KU Leuven, Leuven, Belgium
- Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium
| | - Seth M Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Jae Li
- Bioinformatics Core, Genome Center, University of California Davis, Davis, CA, 95618, USA
| | - Craig Senders
- Department of Otolaryngology, Head and Neck Surgery, University of California Davis, Sacramento, CA, 95817, USA
| | - Marike Zwienenberg
- Department of Neurosurgery, University of California Davis, Sacramento, CA, 95817, USA
| | - Emil Simeonov
- Pediatric Clinic, Alexandrovska University Hospital, Medical University of Sofia, 1431, Sofia, Bulgaria
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 1431, Sofia, Bulgaria
| | - Tony Roscioli
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Lorena Di Pietro
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168, Rome, Italy
| | - Marta Barba
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168, Rome, Italy
| | - Wanda Lattanzi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168, Rome, Italy
| | - Michael L Cunningham
- Seattle Children's Craniofacial Center, Center of Developmental Biology and Regenerative Medicine and Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA, 98105, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, 52242, USA.
| | - Simeon A Boyadjiev
- Department of Pediatrics, University of California Davis, Sacramento, CA, 95817, USA
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2
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Hodapp M, Hing AV, Gallagher E, Blessing M, Cunningham ML. Isolated frontosphenoidal craniosynostosis: An argument for genetic testing. Am J Med Genet A 2023; 191:2651-2655. [PMID: 37421219 DOI: 10.1002/ajmg.a.63348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
Isolated frontosphenoidal craniosynostosis (IFSC) is a rare congenital defect defined as premature fusion of the frontosphenoidal suture in the absence of other suture fusion. Until now, IFSC was regarded as a phenomenon with an unclear genetic etiology. We have identified three cases with IFSC with underlying syndromic diagnoses that were attributable to pathogenic mutations involving FGFR3 and MN1, as well as 22q11.2 deletion syndrome. These findings suggest a genetic predisposition to IFSC may exist, thereby justifying the recommendation for genetic evaluation and testing in this population. Furthermore, due to improved imaging resolution, cases of IFSC are now readily identified. With the identification of IFSC with underlying genetic diagnoses, in combination with significant improvements in imaging resolution, we recommend genetic evaluation in children with IFSC.
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Affiliation(s)
- Matthew Hodapp
- University of Nevada, Las Vegas School of Medicine, Las Vegas, Nevada, USA
| | - Anne V Hing
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Emily Gallagher
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Matthew Blessing
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Michael L Cunningham
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
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3
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Aldawood ZA, Mancinelli L, Geng X, Yeh SCA, Di Carlo R, C. Leite T, Gustafson J, Wilk K, Yozgatian J, Garakani S, Bassir SH, Cunningham ML, Lin CP, Intini G. Expansion of the sagittal suture induces proliferation of skeletal stem cells and sustains endogenous calvarial bone regeneration. Proc Natl Acad Sci U S A 2023; 120:e2120826120. [PMID: 37040407 PMCID: PMC10120053 DOI: 10.1073/pnas.2120826120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/30/2023] [Indexed: 04/12/2023] Open
Abstract
In newborn humans, and up to approximately 2 y of age, calvarial bone defects can naturally regenerate. This remarkable regeneration potential is also found in newborn mice and is absent in adult mice. Since previous studies showed that the mouse calvarial sutures are reservoirs of calvarial skeletal stem cells (cSSCs), which are the cells responsible for calvarial bone regeneration, here we hypothesized that the regenerative potential of the newborn mouse calvaria is due to a significant amount of cSSCs present in the newborn expanding sutures. Thus, we tested whether such regenerative potential can be reverse engineered in adult mice by artificially inducing an increase of the cSSCs resident within the adult calvarial sutures. First, we analyzed the cellular composition of the calvarial sutures in newborn and in older mice, up to 14-mo-old mice, showing that the sutures of the younger mice are enriched in cSSCs. Then, we demonstrated that a controlled mechanical expansion of the functionally closed sagittal sutures of adult mice induces a significant increase of the cSSCs. Finally, we showed that if a calvarial critical size bone defect is created simultaneously to the mechanical expansion of the sagittal suture, it fully regenerates without the need for additional therapeutic aids. Using a genetic blockade system, we further demonstrate that this endogenous regeneration is mediated by the canonical Wnt signaling. This study shows that controlled mechanical forces can harness the cSSCs and induce calvarial bone regeneration. Similar harnessing strategies may be used to develop novel and more effective bone regeneration autotherapies.
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Affiliation(s)
- Zahra A. Aldawood
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA02115
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam34212, Saudi Arabia
| | - Luigi Mancinelli
- Department of Periodontics and Preventive Dentistry, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Center for Craniofacial Regeneration, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
| | - Xuehui Geng
- Department of Periodontics and Preventive Dentistry, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Center for Craniofacial Regeneration, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
| | - Shu-Chi A. Yeh
- Advanced Microscopy Program, Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA02114
| | - Roberta Di Carlo
- Department of Periodontics and Preventive Dentistry, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Center for Craniofacial Regeneration, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
| | - Taiana C. Leite
- Department of Periodontics and Preventive Dentistry, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Center for Craniofacial Regeneration, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
| | - Jonas Gustafson
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA98101
| | - Katarzyna Wilk
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Joseph Yozgatian
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Sasan Garakani
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Seyed Hossein Bassir
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA02115
| | - Michael L. Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA98101
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA98195
| | - Charles P. Lin
- Advanced Microscopy Program, Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA02114
| | - Giuseppe Intini
- Department of Periodontics and Preventive Dentistry, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Center for Craniofacial Regeneration, University of PittsburghSchool of Dental Medicine, Pittsburgh, PA15261
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA15261
- University of Pittsburgh UPMC Hillman Cancer Center, Pittsburgh, PA15232
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA15219
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4
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Quiat D, Timberlake AT, Curran JJ, Cunningham ML, McDonough B, Artunduaga MA, DePalma SR, Duenas-Roque MM, Gorham JM, Gustafson JA, Hamdan U, Hing AV, Hurtado-Villa P, Nicolau Y, Osorno G, Pachajoa H, Porras-Hurtado GL, Quintanilla-Dieck L, Serrano L, Tumblin M, Zarante I, Luquetti DV, Eavey RD, Heike CL, Seidman JG, Seidman CE. Damaging variants in FOXI3 cause microtia and craniofacial microsomia. Genet Med 2023; 25:143-150. [PMID: 36260083 PMCID: PMC9885525 DOI: 10.1016/j.gim.2022.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Craniofacial microsomia (CFM) represents a spectrum of craniofacial malformations, ranging from isolated microtia with or without aural atresia to underdevelopment of the mandible, maxilla, orbit, facial soft tissue, and/or facial nerve. The genetic causes of CFM remain largely unknown. METHODS We performed genome sequencing and linkage analysis in patients and families with microtia and CFM of unknown genetic etiology. The functional consequences of damaging missense variants were evaluated through expression of wild-type and mutant proteins in vitro. RESULTS We studied a 5-generation kindred with microtia, identifying a missense variant in FOXI3 (p.Arg236Trp) as the cause of disease (logarithm of the odds = 3.33). We subsequently identified 6 individuals from 3 additional kindreds with microtia-CFM spectrum phenotypes harboring damaging variants in FOXI3, a regulator of ectodermal and neural crest development. Missense variants in the nuclear localization sequence were identified in cases with isolated microtia with aural atresia and found to affect subcellular localization of FOXI3. Loss of function variants were found in patients with microtia and mandibular hypoplasia (CFM), suggesting dosage sensitivity of FOXI3. CONCLUSION Damaging variants in FOXI3 are the second most frequent genetic cause of CFM, causing 1% of all cases, including 13% of familial cases in our cohort.
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Affiliation(s)
- Daniel Quiat
- Department of Cardiology, Boston Children’s Hospital, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA,Department of Genetics, Harvard Medical School, Boston, MA
| | - Andrew T. Timberlake
- Hansjörg Wyss Department of Plastic and Reconstructive Surgery, NYU Langone Medical Center, New York, NY
| | | | - Michael L. Cunningham
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA,Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA
| | | | | | | | | | | | - Jonas A. Gustafson
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA
| | | | - Anne V. Hing
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA,Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA
| | | | | | - Gabriel Osorno
- Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Harry Pachajoa
- Servicio de Genética Médica, Fundación Valle del Lili, Cali, Colombia,Centro de Investigación en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
| | | | - Lourdes Quintanilla-Dieck
- Department of Otolaryngology Head and Neck Surgery, Oregon Health & Science University, Portland, OR
| | | | | | - Ignacio Zarante
- Human Genomics Institute, Pontificia Universidad Javeriana, Bogotá, Colombia,Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Daniela V. Luquetti
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA,Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA
| | - Roland D. Eavey
- Department of Otolaryngology–Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN,Correspondence and requests for materials should be addressed to Roland D. Eavey, Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center; Nashville, TN 37232. OR Carrie L. Heike, Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, WA 98105. OR Jonathan G. Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. OR Christine Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. c
| | - Carrie L. Heike
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA,Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA,Correspondence and requests for materials should be addressed to Roland D. Eavey, Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center; Nashville, TN 37232. OR Carrie L. Heike, Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, WA 98105. OR Jonathan G. Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. OR Christine Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. c
| | - Jonathan G. Seidman
- Department of Genetics, Harvard Medical School, Boston, MA,Correspondence and requests for materials should be addressed to Roland D. Eavey, Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center; Nashville, TN 37232. OR Carrie L. Heike, Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, WA 98105. OR Jonathan G. Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. OR Christine Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. c
| | - Christine E. Seidman
- Department of Genetics, Harvard Medical School, Boston, MA,Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA,Howard Hughes Medical Institute, Chevy Chase, MD,Correspondence and requests for materials should be addressed to Roland D. Eavey, Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center; Nashville, TN 37232. OR Carrie L. Heike, Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, WA 98105. OR Jonathan G. Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. OR Christine Seidman, Department of Genetics, Harvard Medical School, 77 Avenue Louis, Pasteur, Boston, MA 02115. c
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5
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Kanai SM, Heffner C, Cox TC, Cunningham ML, Perez FA, Bauer AM, Reigan P, Carter C, Murray SA, Clouthier DE. Auriculocondylar syndrome 2 results from the dominant-negative action of PLCB4 variants. Dis Model Mech 2022; 15:274705. [PMID: 35284927 PMCID: PMC9066496 DOI: 10.1242/dmm.049320] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/22/2022] [Indexed: 12/16/2022] Open
Abstract
Auriculocondylar syndrome 2 (ARCND2) is a rare autosomal dominant craniofacial malformation syndrome linked to multiple genetic variants in the coding sequence of phospholipase C β4 (PLCB4). PLCB4 is a direct signaling effector of the endothelin receptor type A (EDNRA)-Gq/11 pathway, which establishes the identity of neural crest cells (NCCs) that form lower jaw and middle ear structures. However, the functional consequences of PLCB4 variants on EDNRA signaling is not known. Here, we show, using multiple signaling reporter assays, that known PLCB4 variants resulting from missense mutations exert a dominant-negative interference over EDNRA signaling. In addition, using CRISPR/Cas9, we find that F0 mouse embryos modeling one PLCB4 variant have facial defects recapitulating those observed in hypomorphic Ednra mouse models, including a bone that we identify as an atavistic change in the posterior palate/oral cavity. Remarkably, we have identified a similar osseous phenotype in a child with ARCND2. Our results identify the disease mechanism of ARCND2, demonstrate that the PLCB4 variants cause craniofacial differences and illustrate how minor changes in signaling within NCCs may have driven evolutionary changes in jaw structure and function. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Stanley M. Kanai
- Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Timothy C. Cox
- Departments of Oral and Craniofacial Sciences and Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Michael L. Cunningham
- University of Washington, Department of Pediatrics, Division of Craniofacial Medicine and Seattle Children's Craniofacial Center, Seattle, WA 98105, USA
| | - Francisco A. Perez
- University of Washington, Department of Radiology and Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Aaron M. Bauer
- Department of Biology, Villanova University, Villanova, PA 19085, USA
| | - Philip Reigan
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Cristan Carter
- Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - David E. Clouthier
- Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA,Author for correspondence ()
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6
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Calpena E, Wurmser M, McGowan SJ, Atique R, Bertola DR, Cunningham ML, Gustafson JA, Johnson D, Morton JEV, Passos-Bueno MR, Timberlake AT, Lifton RP, Wall SA, Twigg SRF, Maire P, Wilkie AOM. Unexpected role of SIX1 variants in craniosynostosis: expanding the phenotype of SIX1-related disorders. J Med Genet 2022; 59:165-169. [PMID: 33436522 PMCID: PMC8273188 DOI: 10.1136/jmedgenet-2020-107459] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pathogenic heterozygous SIX1 variants (predominantly missense) occur in branchio-otic syndrome (BOS), but an association with craniosynostosis has not been reported. METHODS We investigated probands with craniosynostosis of unknown cause using whole exome/genome (n=628) or RNA (n=386) sequencing, and performed targeted resequencing of SIX1 in 615 additional patients. Expression of SIX1 protein in embryonic cranial sutures was examined in the Six1nLacZ/+ reporter mouse. RESULTS From 1629 unrelated cases with craniosynostosis we identified seven different SIX1 variants (three missense, including two de novo mutations, and four nonsense, one of which was also present in an affected twin). Compared with population data, enrichment of SIX1 loss-of-function variants was highly significant (p=0.00003). All individuals with craniosynostosis had sagittal suture fusion; additionally four had bilambdoid synostosis. Associated BOS features were often attenuated; some carrier relatives appeared non-penetrant. SIX1 is expressed in a layer basal to the calvaria, likely corresponding to the dura mater, and in the mid-sagittal mesenchyme. CONCLUSION Craniosynostosis is associated with heterozygous SIX1 variants, with possible enrichment of loss-of-function variants compared with classical BOS. We recommend screening of SIX1 in craniosynostosis, particularly when sagittal±lambdoid synostosis and/or any BOS phenotypes are present. These findings highlight the role of SIX1 in cranial suture homeostasis.
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Affiliation(s)
- Eduardo Calpena
- Clinical Genetics Group, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Maud Wurmser
- Institut Cochin, INSERM, CNRS, Université de Paris, Paris, France
| | - Simon J McGowan
- Centre for Computational Biology, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Rodrigo Atique
- Centro de Estudos do Genoma Humano, Universidade de São Paulo, São Paulo, Brazil
| | - Débora R Bertola
- Unidade de Genética Clínica, Instituto da Criança do Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto de Biociências, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Michael L Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, and Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, Washington, USA
| | - Jonas A Gustafson
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
| | - David Johnson
- Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jenny E V Morton
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | | | - Andrew T Timberlake
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York, USA
| | | | - Steven A Wall
- Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Stephen R F Twigg
- Clinical Genetics Group, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Pascal Maire
- Institut Cochin, INSERM, CNRS, Université de Paris, Paris, France
| | - Andrew O M Wilkie
- Clinical Genetics Group, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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7
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Lam AS, Bindschadler MD, Evans KN, Friedman SD, Blessing MS, Bly R, Cunningham ML, Egbert MA, Ettinger RE, Gallagher ER, Hopper RA, Johnson K, Perkins JA, Romberg EK, Sie KCY, Susarla SM, Zdanski CJ, Wang X, Otjen JP, Perez FA, Dahl JP. Accuracy and Reliability of 4D-CT and Flexible Laryngoscopy in Upper Airway Evaluation in Robin Sequence. Otolaryngol Head Neck Surg 2021; 166:760-767. [PMID: 34253111 DOI: 10.1177/01945998211027353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the performance of 4-dimensional computed tomography (4D-CT) in assessing upper airway obstruction (UAO) in patients with Robin sequence (RS) and compare the accuracy and reliability of 4D-CT and flexible fiber-optic laryngoscopy (FFL). STUDY DESIGN Prospective survey of retrospective clinical data. SETTING Single, tertiary care pediatric hospital. METHODS At initial and 30-day time points, a multidisciplinary group of 11 clinicians who treat RS rated UAO severity in 32 sets of 4D-CT visualizations and FFL videos (dynamic modalities) and static CT images. Raters assessed UAO at the velopharynx and oropharynx (1 = none to 5 = complete) and noted confidence levels of each rating. Intraclass correlation and Krippendorff alpha were used to assess intra- and interrater reliability, respectively. Accuracy was assessed by comparing clinician ratings with quantitative percentage constriction (QPC) ratings, calculated based on 4D-CT airway cross-sectional area. Results were compared using Wilcoxon rank-sum and signed-rank tests. RESULTS There was similar intrarater agreement (moderate to substantial) with 4D-CT and FFL, and both demonstrated fair interrater agreement. Both modalities underestimated UAO severity, although 4D-CT ratings were significantly more accurate, as determined by QPC similarity, than FFL (-1.06 and -1.46 vs QPC ratings, P = .004). Overall confidence levels were similar for 4D-CT and FFL, but other specialists were significantly less confident in FFL ratings than were otolaryngologists (2.25 and 3.92, P < .0001). CONCLUSION Although 4D-CT may be more accurate in assessing the degree of UAO in patients with RS, 4D-CT and FFL assessments demonstrate similar reliability. Additionally, 4D-CT may be interpreted with greater confidence by nonotolaryngologists who care for these patients.
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Affiliation(s)
- Austin S Lam
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Michael D Bindschadler
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Kelly N Evans
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Seth D Friedman
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Matthew S Blessing
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Randall Bly
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Michael L Cunningham
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Mark A Egbert
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA.,Division of Oral and Maxillofacial Surgery, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, Washington, USA
| | - Russell E Ettinger
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA.,Division of Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Emily R Gallagher
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Richard A Hopper
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA.,Division of Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Kaalan Johnson
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Jonathan A Perkins
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Erin K Romberg
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Kathleen C Y Sie
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Srinivas M Susarla
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA.,Division of Oral and Maxillofacial Surgery, Seattle Children's Hospital, Seattle, Washington, USA.,Division of Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Carlton J Zdanski
- Department of Otolaryngology/Head & Neck Surgery and Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Xing Wang
- Biostatistics, Epidemiology and Analytics in Research (BEAR) Core, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Jeffrey P Otjen
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Francisco A Perez
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - John P Dahl
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
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8
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Noble AR, Cunningham ML, Lam A, Wenger TL, Sie KC, Perkins JA, Dahl JP. Complex Airway Management in Patients with Tracheal Cartilaginous Sleeves. Laryngoscope 2021; 132:215-221. [PMID: 34133757 DOI: 10.1002/lary.29692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/04/2021] [Revised: 05/26/2021] [Accepted: 06/05/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS A tracheal cartilaginous sleeve (TCS) is a rare anomaly characterized by anterior fusion of tracheal cartilages. TCS is associated with syndromic craniosynostoses including Apert, Crouzon and Pfeiffer syndromes and FGFR2, FGFR3, and TWIST1 variants. This study presents a 30-year review of patients with syndromic craniosynostosis and TCS and describes diagnostic methods, genetic variants, surgical interventions, and long-term outcomes. STUDY DESIGN Retrospective, single-institution review. METHODS This review included patients with syndromic craniosynostosis and TCS treated at Seattle Children's Hospital from 1990 to 2020. Tracheostomy, genetic variants, and additional surgery were primary measures. Fisher's exact test compared need for tracheostomy in patients with proposed high-risk (FGFR2 p.W290 or FGFR2 p.C342) versus low-risk genetic variants. RESULTS Thirty patients with TCS were identified. Average age at diagnosis was 12 months (range 2-weeks to 7.9-years; standard deviation 19.8 months). Syndromes included Pfeiffer (37%), Apert (37%), and Crouzon (26%). Severe obstructive sleep apnea was present in 76% of patients. Tracheostomy was performed in 17 patients (57%); five were successfully decannulated. Additional interventions included adenotonsillectomy (57%), nasal (20%), laryngeal (17%), and craniofacial skeletal surgery (87%). All patients with Pfeiffer syndrome and FGFR2 p.W290C variants and 83% of patients with FGFR2 p.C342 variants required tracheostomy, differing from other variants (P = .02, odds ratio 33, 95% confidence interval 1.56-697.96). One patient (3%) died. CONCLUSION TCS contributes to multilevel airway obstruction in patients with syndromic craniosynostosis. Genetic testing in patients with FGFR2-related syndromic craniosynostoses may identify those at risk of TCS and facilitate early intervention. A better understanding of this patient population may foster individualized airway management strategies and improve outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Anisha R Noble
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A
| | - Michael L Cunningham
- Department of Pediatrics, Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Department of Pediatrics, Division of Craniofacial Medicine, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Seattle Children's Research Division, Seattle Children's Research Institute, Seattle, Washington, U.S.A
| | - Austin Lam
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A
| | - Tara L Wenger
- Division of Genetic Medicine, University of Washington School of Medicine, Seattle, Washington, U.S.A
| | - Kathleen C Sie
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Department of Pediatrics, Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Seattle Children's Research Division, Seattle Children's Research Institute, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A
| | - Jonathan A Perkins
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Department of Pediatrics, Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Seattle Children's Research Division, Seattle Children's Research Institute, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A
| | - John P Dahl
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Department of Pediatrics, Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Seattle Children's Research Division, Seattle Children's Research Institute, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A
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9
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Collett BR, Wallace ER, Ola C, Kartin D, Cunningham ML, Speltz ML. Do Infant Motor Skills Mediate the Association Between Positional Plagiocephaly/Brachycephaly and Cognition in School-Aged Children? Phys Ther 2020; 101:6041454. [PMID: 33340327 PMCID: PMC8525193 DOI: 10.1093/ptj/pzaa214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/26/2020] [Accepted: 11/02/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Positional plagiocephaly/brachycephaly (PPB) is associated with lower cognitive scores in school-aged children. This study tested the hypothesis that infant motor skills mediate this association. METHODS Children with a history of PPB (cases, n = 187) and without PPB (controls, n = 149) were followed from infancy through approximately 9 years of age. Infant motor skills were assessed using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3), and cognition was assessed using the Differential Ability Scales, 2nd edition (DAS-2). The Bayley-3 motor composite was examined as a mediator of the association between PPB and DAS-2 general cognitive ability (GCA) scores. In secondary analyses, mediation models were examined for the DAS-2 verbal ability, nonverbal ability, and working memory scores; models using the Bayley-3 fine versus gross motor scores also were examined. RESULTS Cases scored lower than controls on the DAS-GCA (β = -4.6; 95% CI = -7.2 to -2.0), with an indirect (mediated) effect of β = -1.5 (95% CI = -2.6 to -0.4) and direct effect of β = -3.1 (95% CI = -5.7 to -0.5). Infant motor skills accounted for approximately 33% of the case-control difference in DAS-2 GCA scores. Results were similar for other DAS-2 outcomes. Evidence of mediation was greater for Bayley-3 gross motor versus fine motor scores. CONCLUSION Infant motor skills partially mediate the association between PPB and cognition in school-aged children. Monitoring motor development and providing intervention as needed may help offset associated developmental concerns for children with PPB. IMPACT To our knowledge, this study is the first longitudinal investigation of the development of children with and without PPB from infancy through the early school years and the first to examine motor skills as a mediator of cognitive outcomes in this population. The findings highlight the importance of early motor skills for other developmental outcomes. LAY SUMMARY Infants' motor skills are related to the development of PPB and its association with later cognition. If your child has PPB, physical therapists may have an important role in assessing and providing treatment to promote motor development.
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Affiliation(s)
- Brent R Collett
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA,Address all correspondence to Dr Collett at:
| | - Erin R Wallace
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Cindy Ola
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Deborah Kartin
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Michael L Cunningham
- Department of Pediatrics, University of Washington, Seattle Children’s Craniofacial Center, Seattle, Washington, USA
| | - Matthew L Speltz
- Department of Pediatrics, University of Washington, Seattle Children’s Craniofacial Center, Seattle, Washington, USA
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10
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Lam AS, Liu CC, Deutsch GH, Rivera J, Perkins JA, Holmes G, Jabs EW, Cunningham ML, Dahl JP. Genotype-Phenotype Correlation of Tracheal Cartilaginous Sleeves and Fgfr2 Mutations in Mice. Laryngoscope 2020; 131:E1349-E1356. [PMID: 32886384 DOI: 10.1002/lary.29060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/02/2020] [Revised: 07/22/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To characterize tracheal cartilage morphology in mouse models of fibroblast growth factor receptor (Fgfr2)-related craniosynostosis syndromes. To establish relationships between specific Fgfr2 mutations and tracheal cartilaginous sleeve (TCS) phenotypes in these mouse models. METHODS Postnatal day 0 knock-in mouse lines with disease-specific genetic variations in the Fgfr2 gene (Fgfr2C342Y/C342Y , Fgfr2C342Y/+ , Fgfr2+/Y394C , Fgfr2+/S252W , and Fgfr2+/P253R ) as well as line-specific controls were utilized. Tracheal cartilage morphology as measured by gross analyses, microcomputed tomography (μCT), and histopathology were compared using Chi-squared and single-factor analysis of variance statistical tests. RESULTS A greater proportion of rings per trachea were abnormal in Fgfr2C342Y/+ tracheas (63%) than Fgfr2+/S252W (17%), Fgfr2+/P253R (17%), Fgfr2+/Y394C (12%), and controls (10%) (P < .001 for each vs. Fgfr2C342Y/+ ). TCS segments were found only in Fgfr2C342Y/C342Y (100%) and Fgfr2C342Y/+ (72%) tracheas. Cricoid and first-tracheal ring fusion was noted in all Fgfr2C342Y/C342Y and 94% of Fgfr2C342Y/+ samples. The Fgfr2C342Y/C342Y and Fgfr2C342Y/+ groups were found to have greater areas and volumes of cartilage than other lines on gross analysis and μCT. Histologic analyses confirmed TCS among the Fgfr2C342Y/C342Y and Fgfr2C342Y/+ groups, without appreciable differences in cartilage morphology, cell size, or density; no histologic differences were observed among other Fgfr2 lines compared to controls. CONCLUSION This study found TCS phenotypes only in the Fgfr2C342Y mouse lines. These lines also had increased tracheal cartilage compared to other mutant lines and controls. These data support further study of the Fgfr2 mouse lines and the investigation of other Fgfr2 variants to better understand their role in tracheal development and TCS formation. LEVEL OF EVIDENCE NA Laryngoscope, 131:E1349-E1356, 2021.
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Affiliation(s)
- Austin S Lam
- Department of Otolaryngology - Head & Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head & Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, Washington, U.S.A
| | - Carrie C Liu
- Department of Otolaryngology - Head & Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head & Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Current address: Divisions of Otolaryngology - Head and Neck Surgery, and Pediatric Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Gail H Deutsch
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Department of Pathology, Seattle Children's Hospital, Seattle, Washington, U.S.A
| | - Joshua Rivera
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, U.S.A.,Current address: Center for Personalized Cancer Therapy, University of Massachusetts, Boston, Massachusetts, U.S.A
| | - Jonathan A Perkins
- Department of Otolaryngology - Head & Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head & Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A
| | - Greg Holmes
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, U.S.A
| | - Ethylin W Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, U.S.A
| | - Michael L Cunningham
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, Washington, U.S.A.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, U.S.A
| | - John P Dahl
- Department of Otolaryngology - Head & Neck Surgery, University of Washington School of Medicine, Seattle, Washington, U.S.A.,Division of Pediatric Otolaryngology - Head & Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.,Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, U.S.A
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11
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Calpena E, Cuellar A, Bala K, Swagemakers SMA, Koelling N, McGowan SJ, Phipps JM, Balasubramanian M, Cunningham ML, Douzgou S, Lattanzi W, Morton JEV, Shears D, Weber A, Wilson LC, Lord H, Lester T, Johnson D, Wall SA, Twigg SRF, Mathijssen IMJ, Boardman-Pretty F, Boyadjiev SA, Wilkie AOM. SMAD6 variants in craniosynostosis: genotype and phenotype evaluation. Genet Med 2020; 22:1498-1506. [PMID: 32499606 PMCID: PMC7462747 DOI: 10.1038/s41436-020-0817-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Enrichment of heterozygous missense and truncating SMAD6 variants was previously reported in nonsyndromic sagittal and metopic synostosis, and interaction of SMAD6 variants with a common polymorphism nearBMP2 (rs1884302) was proposed to contribute to inconsistent penetrance. We determined the occurrence of SMAD6 variants in all types of craniosynostosis, evaluated the impact of different missense variants on SMAD6 function, and tested independently whether rs1884302 genotype significantly modifies the phenotype. METHODS We performed resequencing of SMAD6 in 795 unsolved patients with any type of craniosynostosis and genotyped rs1884302 in SMAD6-positive individuals and relatives. We examined the inhibitory activity and stability of SMAD6 missense variants. RESULTS We found 18 (2.3%) different rare damaging SMAD6 variants, with the highest prevalence in metopic synostosis (5.8%) and an 18.3-fold enrichment of loss-of-function variants comparedwith gnomAD data (P < 10-7). Combined with eight additional variants, ≥20/26 were transmitted from an unaffected parent but rs1884302 genotype did not predict phenotype. CONCLUSION Pathogenic SMAD6 variants substantially increase the risk of both nonsyndromic and syndromic presentations of craniosynostosis, especially metopic synostosis. Functional analysis is important to evaluate missense variants. Genotyping of rs1884302 is not clinically useful. Mechanisms to explain the remarkable diversity of phenotypes associated with SMAD6 variants remain obscure.
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Affiliation(s)
- Eduardo Calpena
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Araceli Cuellar
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Krithi Bala
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Sigrid M A Swagemakers
- Departments of Pathology and Bioinformatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nils Koelling
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Simon J McGowan
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Julie M Phipps
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Meena Balasubramanian
- Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Michael L Cunningham
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Sofia Douzgou
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Saint Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, UK
| | - Wanda Lattanzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jenny E V Morton
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | - Deborah Shears
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Astrid Weber
- Department of Clinical Genetics, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Louise C Wilson
- Clinical Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Helen Lord
- Oxford Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - Tracy Lester
- Oxford Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - David Johnson
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Steven A Wall
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Stephen R F Twigg
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Irene M J Mathijssen
- Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Freya Boardman-Pretty
- Genomics England, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Simeon A Boyadjiev
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Andrew O M Wilkie
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
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12
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Calpena E, Cuellar A, Bala K, Swagemakers SMA, Koelling N, McGowan SJ, Phipps JM, Balasubramanian M, Cunningham ML, Douzgou S, Lattanzi W, Morton JEV, Shears D, Weber A, Wilson LC, Lord H, Lester T, Johnson D, Wall SA, Twigg SRF, Mathijssen IMJ, Boardman-Pretty F, Boyadjiev SA, Wilkie AOM. Correction: SMAD6 variants in craniosynostosis: genotype and phenotype evaluation. Genet Med 2020; 22:1567. [PMID: 32636483 PMCID: PMC7462741 DOI: 10.1038/s41436-020-0886-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Eduardo Calpena
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Araceli Cuellar
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Krithi Bala
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Sigrid M A Swagemakers
- Departments of Pathology and Bioinformatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nils Koelling
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Simon J McGowan
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Julie M Phipps
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Meena Balasubramanian
- Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Michael L Cunningham
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Sofia Douzgou
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Saint Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, UK
| | - Wanda Lattanzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jenny E V Morton
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | - Deborah Shears
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Astrid Weber
- Department of Clinical Genetics, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Louise C Wilson
- Clinical Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Helen Lord
- Oxford Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - Tracy Lester
- Oxford Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - David Johnson
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Steven A Wall
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Stephen R F Twigg
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Irene M J Mathijssen
- Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Freya Boardman-Pretty
- Genomics England, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Simeon A Boyadjiev
- Department of Pediatrics, University of California-Davis, Sacramento, CA, USA
| | - Andrew O M Wilkie
- MRCWeatherall Institute of MolecularMedicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
- Craniofacial Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
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13
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Kett JC, Cunningham ML, Wightman A. The legacy of language: Disfigurement bias in the NICU. Acta Paediatr 2020; 109:880-882. [PMID: 32073682 DOI: 10.1111/apa.15236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/10/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Jennifer C. Kett
- Department of Pediatric Palliative Care Mary Bridge Children's Hospital Tacoma WA USA
| | - Michael L. Cunningham
- Department of Pediatrics University of Washington Seattle WA USA
- Seattle Children's Hospital Craniofacial Center Seattle WA USA
| | - Aaron Wightman
- Department of Pediatrics University of Washington School of Medicine Seattle WA USA
- Divisions of Nephrology and Bioethics and Palliative Care Treuman Katz Center for Pediatric Bioethics Seattle Children's Hospital and Research Institute Seattle WA USA
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14
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Abstract
OBJECTIVE To determine whether children with a history of positional plagiocephaly/brachycephaly (PPB) show persistent deficits in motor development. METHODS In a longitudinal cohort study, we completed follow-up assessments with 187 school-aged children with PPB and 149 participants without PPB who were originally enrolled in infancy. Primary outcomes were the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) composite scores. RESULTS Children with PPB scored lower than controls on the BOT-2. Stratified analyses indicated that differences were restricted to children who had moderate-severe PPB. No consistent differences were observed in children who had mild PPB. CONCLUSION Children who had moderate-severe PPB in infancy show persistent differences in motor function. We suggest close developmental monitoring and early intervention to address motor deficits.
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Affiliation(s)
- Brent R Collett
- Center for Child Health, Behavior, and Development (Drs Collett, Wallace, and Speltz), Seattle Children's Research Institute, Seattle, Washington; Departments of Psychiatry and Behavioral Sciences (Drs Collett and Speltz), Rehabilitation Medicine (Dr Kartin), and Pediatrics (Dr Cunningham), University of Washington, Seattle, Washington; Seattle Children's Craniofacial Center (Dr Cunningham), Seattle, Washington
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15
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Peña-Padilla C, Viramontes-Aguilar L, Tavares-Macías G, Bobadilla-Morales L, L Cunningham M, Park S, Zapata-Aldana E, Corona-Rivera JR. Pfeiffer Syndrome Type 3 and Prune Belly Anomaly in a Female: Case Report and Review. Fetal Pediatr Pathol 2019; 38:412-417. [PMID: 31002276 DOI: 10.1080/15513815.2019.1603256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Pfeiffer syndrome (PS) is an autosomal dominant entity characterized by craniosynostosis, broad thumbs, and preaxially deviated great toes. It is classified in three types depending on the severity. Type 1: Mild to moderate severity, Type 2: Severe presentation with cloverleaf skull, and Type 3: Severe craniosynostosis with prominent ocular proptosis. Association of Pfeiffer syndrome (PS) types 2 and 3 with "prune belly" anomaly has been reported in two non-related patients, one PS type 2 and one PS type 3. Case Report: we report the second case of PS type 3 in a female neonate with "prune belly" anomaly and prenatal exposure to Parvovirus B19. Conclusions: We suggest that the "prune belly" anomaly and others abdominal wall defects as omphalocele and scar-type defects may be included as a feature in PS type 2 and 3.
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Affiliation(s)
- Christian Peña-Padilla
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico
| | - Lorena Viramontes-Aguilar
- Service of Pathology, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico
| | - Gerónimo Tavares-Macías
- Service of Pathology, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico
| | - Lucina Bobadilla-Morales
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico.,Dr. Enrique Corona-Rivera Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara , Guadalajara , Jalisco , Mexico
| | | | - Sarah Park
- Craniofacial Center, Seattle Children's Hospital , Washington , USA
| | - Eugenio Zapata-Aldana
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico.,Department of Pediatrics & Child Health, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg , MB , Canada
| | - Jorge Román Corona-Rivera
- Center for Registry and Research in Congenital Anomalies (CRIAC), Service of Genetics and Cytogenetics Unit, Pediatrics Division, Dr. Juan I. Menchaca Civil Hospital of Guadalajara , Guadalajara , Jalisco , Mexico.,Dr. Enrique Corona-Rivera Institute of Human Genetics, Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara , Guadalajara , Jalisco , Mexico
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16
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Coecke S, Ahr H, Blaauboer BJ, Bremer S, Casati S, Castell J, Combes R, Corvi R, Crespi CL, Cunningham ML, Elaut G, Eletti B, Freidig A, Gennari A, Ghersi-Egea JF, Guillouzo A, Hartung T, Hoet P, Ingelman-Sundberg M, Munn S, Janssens W, Ladstetter B, Leahy D, Long A, Meneguz A, Monshouwer M, Morath S, Nagelkerke F, Pelkonen O, Ponti J, Prieto P, Richert L, Sabbioni E, Schaack B, Steiling W, Testai E, Vericat JA, Worth A. Metabolism: A Bottleneck in In Vitro Toxicological Test Development. Altern Lab Anim 2019; 34:49-84. [PMID: 16522150 DOI: 10.1177/026119290603400113] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sandra Coecke
- ECVAM, Institute for Health and Consumer Protection, European Commission Joint Research Centre, Ispra, Italy
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17
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Abstract
UNLABELLED : media-1vid110.1542/5972296741001PEDS-VA_2018-2373Video Abstract BACKGROUND: Studies have revealed an association between positional plagiocephaly and/or brachycephaly (PPB) and development, although little is known about long-term outcomes. We examined cognition and academic achievement in children with and without PPB, testing the hypothesis that children who had PPB as infants would score lower than controls. METHODS We enrolled 187 school-aged children with a history of PPB and 149 controls. Exposures were the presence or absence and severity of infancy PPB (mild, moderate to severe). Cognitive and academic outcomes were assessed by using the Differential Ability Scales, Second Edition and Wechsler Individual Achievement Test, Third Edition, respectively. RESULTS Children with PPB scored lower than controls on most scales of the Differential Ability Scales, Second Edition (standardized effect sizes [ESs] = -0.38 to -0.20) and the Wechsler Individual Achievement Test, Third Edition (ESs = -0.22 to -0.17). Analyses by PPB severity revealed meaningful differences among children with moderate to severe PPB (ESs = -0.47 to -0.23 for 8 of 9 outcomes), but few differences in children with mild PPB (ESs = -0.28 to 0.14). CONCLUSIONS School-aged children with moderate to severe PPB scored lower than controls on cognitive and academic measures; associations were negligible among children with mild PPB. The findings do not necessarily imply that these associations are causal; rather, PPB may serve as a marker of developmental risk. Our findings suggest a role for assessing PPB severity in clinical practice: providing developmental assessment and intervention for infants with more severe deformation and reassurance and anticipatory guidance for patients with mild deformation.
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Affiliation(s)
- Brent R. Collett
- Center for Child Health, Behavior, and Development and,Departments of Psychiatry and Behavioral Sciences
| | | | | | - Michael L. Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, Washington;,Pediatrics, School of Medicine, University of Washington, Seattle, Washington; and,Seattle Children’s Craniofacial Center, Seattle, Washington
| | - Matthew L. Speltz
- Center for Child Health, Behavior, and Development and,Departments of Psychiatry and Behavioral Sciences
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18
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Clarke CM, Fok VT, Gustafson JA, Smyth MD, Timms AE, Frazar CD, Smith JD, Birgfeld CB, Lee A, Ellenbogen RG, Gruss JS, Hopper RA, Cunningham ML. Single suture craniosynostosis: Identification of rare variants in genes associated with syndromic forms. Am J Med Genet A. 2018 Feb;176(2):290-300. Am J Med Genet A 2018; 176:2522. [PMID: 30537273 DOI: 10.1002/ajmg.a.38846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 04/21/2018] [Indexed: 11/06/2022]
Affiliation(s)
- C M Clarke
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - V T Fok
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - J A Gustafson
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - M D Smyth
- Washington University Department of Neurosurgery, St. Louis, Missouri.,St. Louis Children's Hospital, St. Louis, Missouri
| | - A E Timms
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - C D Frazar
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - J D Smith
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - C B Birgfeld
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - A Lee
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington.,Department of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington
| | - R G Ellenbogen
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington.,Department of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington
| | - J S Gruss
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - R A Hopper
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - M L Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
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19
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Gilbert JR, Losee JE, Mooney MP, Cray JJ, Gustafson J, Cunningham ML, Cooper GM. Genetic associations and phenotypic heterogeneity in the craniosynostotic rabbit. PLoS One 2018; 13:e0204086. [PMID: 30235265 PMCID: PMC6147457 DOI: 10.1371/journal.pone.0204086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/04/2018] [Indexed: 11/26/2022] Open
Abstract
Craniosynostosis (CS) is a disorder that involves the premature ossification of one or more cranial sutures. Our research team has described a naturally occurring rabbit model of CS with a variable phenotype and unknown etiology. Restriction-site associated DNA (RAD) sequencing is a genomic sampling method for identifying genetic variants in species with little or no existing sequence data. RAD sequencing data was analyzed using a mixed linear model to identify single nucleotide polymorphisms (SNPs) associated with disease occurrence and onset in the rabbit model of CS. SNPs achieving a genome-wide significance of p ≤ 5 x 10-8 were identified on chromosome 2 in association with disease occurrence and on chromosomes 14 and 19 in association with disease onset. Genotyping identified a coding variant in fibroblast growth factor binding protein 1 (FGFBP-1) on chromosome 2 and a non-coding variant upstream of integrin alpha 3 (ITGA3) on chromosome 19 that associated with disease occurrence and onset, respectively. Retrospective analysis of patient data revealed a significant inverse correlation between FGFBP-1 and ITGA3 transcript levels in patients with coronal CS. FGFBP-1 and ITGA3 are genes with roles in early development that warrant functional study to further understand suture biology.
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Affiliation(s)
- James R. Gilbert
- Department of Plastic Surgery, University of Pittsburgh/Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Joseph E. Losee
- Department of Plastic Surgery, University of Pittsburgh/Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mark P. Mooney
- Department of Plastic Surgery, University of Pittsburgh/Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Orthodontics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - James J. Cray
- Oral Health Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Jennifer Gustafson
- Center for Developmental Biology and Regenerative Medicine and the Craniofacial Center Seattle Children’s Hospital, Seattle, Washington, United States of America
| | - Michael L. Cunningham
- Center for Developmental Biology and Regenerative Medicine and the Craniofacial Center Seattle Children’s Hospital, Seattle, Washington, United States of America
| | - Gregory M. Cooper
- Department of Plastic Surgery, University of Pittsburgh/Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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20
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Gallagher ER, Siebold B, Collett BR, Cox TC, Aziz V, Cunningham ML. Associations between laterality of orofacial clefts and medical and academic outcomes. Am J Med Genet A 2018; 176:1037. [DOI: 10.1002/ajmg.a.38663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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21
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Abstract
Objective To recognize several conditions that result in a trapezoid head shape and review and contrast their various physical findings. Methods A detailed review of all patients seen in the Craniofacial Clinic at the Children's Hospital and Regional Medical Center in Seattle, Washington, over a 10-year period from 1991 to 2001, with the diagnosis of craniosynostosis and plagiocephaly was performed. During this period, 690 patients had a surgical correction of craniosynostosis, and 1537 patients had posterior plagiocephaly. Results and Conclusions The shape of the head when viewed from the vertex position in an axial plane can be a significant diagnostic aid when evaluating a patient with plagiocephaly. Positional molding causes the vast majority of plagiocephaly. This deformational change results in a parallelogram-shaped head. A much more rare cause of plagiocephaly is lambdoid synostosis. With premature fusion of one of the lambdoid sutures, the head takes on a very characteristic trapezoid shape when viewed from the vertex. Unilateral coronal synostosis that occurs on the same side as either posterior positional molding or unilateral lambdoid synostosis will also result in the trapezoid head shape. Furthermore, on the rare occasion when anterior and posterior deformational plagiocephaly occurs on the same side, the trapezoid head shape may be the consequence. The choice of appropriate treatment modality requires systematic evaluation of the patient with a trapezoid-shaped head to determine the etiology of the deformation.
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Affiliation(s)
- Frederick W Ehret
- Department of Surgery, Division of Plastic Surgery, University of Washington and the Children's Hospital and Regional Medical Center, Seattle, Washington 98105, USA
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22
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Gallagher ER, Siebold B, Collett BR, Cox TC, Aziz V, Cunningham ML. Associations between laterality of orofacial clefts and medical and academic outcomes. Am J Med Genet A 2017; 176:267-276. [PMID: 29232056 DOI: 10.1002/ajmg.a.38567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/13/2016] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 01/07/2023]
Abstract
Patients with oral clefts have an increased risk of other malformations, syndromes, and lower academic performance in school. Few studies have investigated if laterality of clefts is associated with medical and academic outcomes. Oral clefts have nonrandom laterality, with left-sided clefts occurring approximately twice as often as right-sided clefts. Using a retrospective study design, we examined potential associations of cleft attributes and outcomes in patients with cleft lip with or without cleft palate (CL/P) born in 2003-2010 who were treated at the Seattle Children's Craniofacial Center. The following variables were extracted from medical records: cleft type, medical history, maternal hyperglycemia, other malformations, and the need for academic support at school. We used logistic regression to examine risk of associations with outcomes of interest. Relative to patients with left-sided clefts, patients with bilateral CL/P were more likely to have a syndrome. Patients with nonsyndromic right-sided CL/P had a higher risk (OR and 95%CI: 3.5, 1.3-9.5, and 5.5, 1.9-16.0, respectively) of having other malformations and requiring academic support at school, when compared to patients with left-sided CL/P. Understanding the etiology of oral clefts is complicated, in part because both genetic and environmental factors contribute to the risk of developing a cleft. However, the different outcomes associated with cleft laterality suggest that right-sided clefts may have a distinct etiology. Using laterality to study cleft subgroups may advance our understanding of the etiology of this common birth defect.
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Affiliation(s)
- Emily R Gallagher
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Craniofacial Center, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington
| | - Babette Siebold
- Seattle Children's Craniofacial Center, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington
| | - Brent R Collett
- Seattle Children's Craniofacial Center, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington.,Child Psychiatry at Seattle Children's Hospital and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Timothy C Cox
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington
| | - Verena Aziz
- Seattle Children's Research Institute, Seattle, Washington
| | - Michael L Cunningham
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington.,Seattle Children's Craniofacial Center, University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington
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23
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Clarke CM, Fok VT, Gustafson JA, Smyth MD, Timms AE, Frazar CD, Smith JD, Birgfeld CB, Lee A, Ellenbogen RG, Gruss JS, Hopper RA, Cunningham ML. Single suture craniosynostosis: Identification of rare variants in genes associated with syndromic forms. Am J Med Genet A 2017; 176:290-300. [PMID: 29168297 DOI: 10.1002/ajmg.a.38540] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 06/20/2017] [Revised: 10/06/2017] [Accepted: 10/08/2017] [Indexed: 12/30/2022]
Abstract
We report RNA-Sequencing results on a cohort of patients with single suture craniosynostosis and demonstrate significant enrichment of heterozygous, rare, and damaging variants among key craniosynostosis-related genes. Genetic burden analysis identified a significant increase in damaging variants in ATR, EFNA4, ERF, MEGF8, SCARF2, and TGFBR2. Of 391 participants, 15% were found to have damaging and potentially causal variants in 29 genes. We observed transmission in 96% of the affected individuals, and thus penetrance, epigenetics, and oligogenic factors need to be considered when recommending genetic testing in patients with nonsyndromic craniosynostosis.
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Affiliation(s)
- Christine M Clarke
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - Vincent T Fok
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - Jennifer A Gustafson
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - Matthew D Smyth
- Washington University Department of Neurosurgery, St. Louis, Missouri.,St. Louis Children's Hospital, St. Louis, Missouri
| | - Andrew E Timms
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington
| | - Chris D Frazar
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Joshua D Smith
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Craig B Birgfeld
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - Amy Lee
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington.,Department of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington
| | - Richard G Ellenbogen
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington.,Department of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington
| | - Joseph S Gruss
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - Richard A Hopper
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Division of Craniofacial and Plastic Surgery, Seattle Children's Hospital, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| | - Michael L Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington.,Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
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24
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Aldridge K, Collett BR, Wallace ER, Birgfeld C, Austin JR, Yeh R, Feil M, Kapp-Simon KA, Aylward EH, Cunningham ML, Speltz ML. Structural brain differences in school-age children with and without single-suture craniosynostosis. J Neurosurg Pediatr 2017; 19:479-489. [PMID: 28156213 PMCID: PMC5642047 DOI: 10.3171/2016.9.peds16107] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Single-suture craniosynostosis (SSC), the premature fusion of a cranial suture, is characterized by dysmorphology of the craniofacial skeleton. Evidence to suggest that children with SSC are at an elevated risk of mild to moderate developmental delays and neurocognitive deficits is mounting, but the associations among premature suture fusion, neuroanatomy, and neurocognition are unexplained. The goals of this study were to determine 1) whether differences in the brain are present in young children with the 2 most common forms of SSC (sagittal and metopic) several years following surgical correction, and 2) whether the pattern of differences varies by affected suture (sagittal or metopic). Examination of differences in the brains of children with SSC several years after surgery may illuminate the growth trajectory of the brain after the potential constraint of the dysmorphic cranium has been relieved. METHODS The authors compared quantitative measures of the brain acquired from MR images obtained from children with sagittal or metopic craniosynostosis (n = 36) at 7 years of age to those obtained from a group of unaffected controls (n = 27) at the same age. The authors measured the volumes of the whole brain, cerebral cortex, cerebral white matter, cerebral cortex by lobe, and ventricles. Additionally, they measured the midsagittal area of the corpus callosum and its segments and of the cerebellar vermis and its component lobules. Measurements obtained from children with SSC and controls were compared using linear regression models. RESULTS No volume measures of the cerebrum or of the whole brain differed significantly between patients with SSC and controls (p > 0.05). However, ventricle volume was significantly increased in patients with SSC (p = 0.001), particularly in those with sagittal craniosynostosis (p < 0.001). In contrast, the area of the corpus callosum was significantly reduced in patients with metopic synostosis (p = 0.04), particularly in the posterior segments (p = 0.004). Similarly, the area of lobules VI-VII of the cerebellar vermis was reduced in patients with SSC (p = 0.03), with those with metopic craniosynostosis showing the greatest reduction (p = 0.01). CONCLUSIONS The lack of differences in overall brain size or regional differences in the size of the lobes of the cerebrum in children with metopic and sagittal synostosis suggests that the elevated risk of neurodevelopmental deficits is not likely to be associated with differences in the cerebral cortex. Instead, this study showed localized differences between sagittal and metopic craniosynostosis cases as compared with controls in the ventricles and in the midsagittal structures of the corpus callosum and the cerebellum. It remains to be tested whether these structural differences are associated with the increased risk for developmental delay and neurocognitive deficits in children with SSC.
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Affiliation(s)
- Kristina Aldridge
- Department of Pathology & Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri
| | - Brent R. Collett
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington,Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
| | - Erin R. Wallace
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington
| | - Craig Birgfeld
- Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
| | - Jordan R. Austin
- Department of Pathology & Anatomical Sciences, University of Missouri School of Medicine, Columbia, Missouri
| | - Regina Yeh
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Madison Feil
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Kathleen A. Kapp-Simon
- Department of Surgery, Northwestern University, Chicago, Illinois,Shriner’s Hospital for Children, Chicago, Illinois
| | - Elizabeth H. Aylward
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington,Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Michael L. Cunningham
- Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
| | - Matthew L. Speltz
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington,Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
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25
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Abstract
Craniosynostosis is the premature fusion of the calvarial sutures that is associated with a number of physical and intellectual disabilities spanning from pediatric to adult years. Over the past two decades, techniques in molecular genetics and more recently, advances in high-throughput DNA sequencing have been used to examine the underlying pathogenesis of this disease. To date, mutations in 57 genes have been identified as causing craniosynostosis and the number of newly discovered genes is growing rapidly as a result of the advances in genomic technologies. While contributions from both genetic and environmental factors in this disease are increasingly apparent, there remains a gap in knowledge that bridges the clinical characteristics and genetic markers of craniosynostosis with their signaling pathways and mechanotransduction processes. By linking genotype to phenotype, outlining the role of cell mechanics may further uncover the specific mechanotransduction pathways underlying craniosynostosis. Here, we present a brief overview of the recent findings in craniofacial genetics and cell mechanics, discussing how this information together with animal models is advancing our understanding of craniofacial development.
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Affiliation(s)
- Zeinab Al-Rekabi
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Seattle, WA, 98195, USA.,Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, 1900 9 Ave, Seattle, WA, 98101, USA
| | - Michael L Cunningham
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, 1900 9 Ave, Seattle, WA, 98101, USA.,Department of Pediatrics, Division of Craniofacial Medicine and the, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Nathan J Sniadecki
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Seattle, WA, 98195, USA.,Department of Bioengineering, University of Washington, 3720 15 Ave NE, Seattle WA, 98105, USA
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26
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Irwin RD, Boorman GA, Cunningham ML, Heinloth AN, Malarkey DE, Paules RS. Application of Toxicogenomics to Toxicology: Basic Concepts in the Analysis of Microarray Data. Toxicol Pathol 2016; 32 Suppl 1:72-83. [PMID: 15209406 DOI: 10.1080/01926230490424752] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Toxicology and the practice of pathology are rapidly evolving in the postgenomic era. Observable treatment related changes have been the hallmark of toxicology studies. Toxicogenomics is a powerful new tool that may show gene and protein changes earlier and at treatment levels below the limits of detection of traditional measures of toxicity. It may also aid in the understanding of toxic mechanisms. It is important to remember that it is only a tool and will provide meaningful results only when properly applied. As is often the case with new experimental tools, the initial utilization is driven more by the technology than application to problem solving. Toxicogenomics is interdisciplinary in nature including at a minimum, pathology, toxicology, and genomics. Most studies will require the input from the disciplines of toxicology, pathology, molecular biology, bioinformatics, biochemistry, and others depending on the types of questions being asked.
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Affiliation(s)
- Richard D Irwin
- Environmental Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, USA.
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27
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Shaffer JR, Orlova E, Lee MK, Leslie EJ, Raffensperger ZD, Heike CL, Cunningham ML, Hecht JT, Kau CH, Nidey NL, Moreno LM, Wehby GL, Murray JC, Laurie CA, Laurie CC, Cole J, Ferrara T, Santorico S, Klein O, Mio W, Feingold E, Hallgrimsson B, Spritz RA, Marazita ML, Weinberg SM. Genome-Wide Association Study Reveals Multiple Loci Influencing Normal Human Facial Morphology. PLoS Genet 2016; 12:e1006149. [PMID: 27560520 PMCID: PMC4999139 DOI: 10.1371/journal.pgen.1006149] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/08/2016] [Indexed: 11/19/2022] Open
Abstract
Numerous lines of evidence point to a genetic basis for facial morphology in humans, yet little is known about how specific genetic variants relate to the phenotypic expression of many common facial features. We conducted genome-wide association meta-analyses of 20 quantitative facial measurements derived from the 3D surface images of 3118 healthy individuals of European ancestry belonging to two US cohorts. Analyses were performed on just under one million genotyped SNPs (Illumina OmniExpress+Exome v1.2 array) imputed to the 1000 Genomes reference panel (Phase 3). We observed genome-wide significant associations (p < 5 x 10−8) for cranial base width at 14q21.1 and 20q12, intercanthal width at 1p13.3 and Xq13.2, nasal width at 20p11.22, nasal ala length at 14q11.2, and upper facial depth at 11q22.1. Several genes in the associated regions are known to play roles in craniofacial development or in syndromes affecting the face: MAFB, PAX9, MIPOL1, ALX3, HDAC8, and PAX1. We also tested genotype-phenotype associations reported in two previous genome-wide studies and found evidence of replication for nasal ala length and SNPs in CACNA2D3 and PRDM16. These results provide further evidence that common variants in regions harboring genes of known craniofacial function contribute to normal variation in human facial features. Improved understanding of the genes associated with facial morphology in healthy individuals can provide insights into the pathways and mechanisms controlling normal and abnormal facial morphogenesis. There is a great deal of evidence that genes influence facial appearance. This is perhaps most apparent when we look at our own families, since we are more likely to share facial features in common with our close relatives than with unrelated individuals. Nevertheless, little is known about how variation in specific regions of the genome relates to the kinds of distinguishing facial characteristics that give us our unique identities, e.g., the size and shape of our nose or how far apart our eyes are spaced. In this paper, we investigate this question by examining the association between genetic variants across the whole genome and a set of measurements designed to capture key aspects of facial form. We found evidence of genetic associations involving measures of eye, nose, and facial breadth. In several cases, implicated regions contained genes known to play roles in embryonic face formation or in syndromes in which the face is affected. Our ability to connect specific genetic variants to ubiquitous facial traits can inform our understanding of normal and abnormal craniofacial development, provide potential predictive models of evolutionary changes in human facial features, and improve our ability to create forensic facial reconstructions from DNA.
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Affiliation(s)
- John R. Shaffer
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Ekaterina Orlova
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Myoung Keun Lee
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Elizabeth J. Leslie
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Zachary D. Raffensperger
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carrie L. Heike
- Department of Pediatrics, Seattle Children’s Craniofacial Center, University of Washington, Seattle, Washington, United States of America
| | - Michael L. Cunningham
- Department of Pediatrics, Seattle Children’s Craniofacial Center, University of Washington, Seattle, Washington, United States of America
| | - Jacqueline T. Hecht
- Department of Pediatrics, University of Texas McGovern Medical Center, Houston, Texas, United States of America
| | - Chung How Kau
- Department of Orthodontics, University of Alabama, Birmingham, Alabama, United States of America
| | - Nichole L. Nidey
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States of America
| | - Lina M. Moreno
- Department of Orthodontics, University of Iowa, Iowa City, Iowa, United States of America
- Dows Institute, University of Iowa, Iowa City, Iowa, United States of America
| | - George L. Wehby
- Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, United States of America
| | - Jeffrey C. Murray
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States of America
| | - Cecelia A. Laurie
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Cathy C. Laurie
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Joanne Cole
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Tracey Ferrara
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Stephanie Santorico
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Mathematical and Statistical Sciences, University of Colorado, Denver, Denver, Colorado, United States of America
| | - Ophir Klein
- Department of Orofacial Sciences, University of California, San Francisco, San Francisco, California, United States of America
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Program in Craniofacial Biology, University of California, San Francisco, California, United States of America
| | - Washington Mio
- Department of Mathematics, Florida State University, Tallahassee, Florida, United States of America
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Benedikt Hallgrimsson
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- McCaig Bone and Joint Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard A. Spritz
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Mary L. Marazita
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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28
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Leslie EJ, O'Sullivan J, Cunningham ML, Singh A, Goudy SL, Ababneh F, Alsubaie L, Ch'ng GS, van der Laar IMBH, Hoogeboom AJM, Dunnwald M, Kapoor S, Jiramongkolchai P, Standley J, Manak JR, Murray JC, Dixon MJ. Expanding the genetic and phenotypic spectrum of popliteal pterygium disorders. Am J Med Genet A 2016; 167A:545-52. [PMID: 25691407 DOI: 10.1002/ajmg.a.36896] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 07/28/2014] [Accepted: 10/31/2014] [Indexed: 01/03/2023]
Abstract
The popliteal pterygia syndromes are a distinct subset of the hundreds of Mendelian orofacial clefting syndromes. Popliteal pterygia syndromes have considerable variability in severity and in the associated phenotypic features but are all characterized by cutaneous webbing across one or more major joints, cleft lip and/or palate, syndactyly, and genital malformations. Heterozygous mutations in IRF6 cause popliteal pterygium syndrome (PPS) while homozygous mutations in RIPK4 or CHUK (IKKA) cause the more severe Bartsocas-Papas syndrome (BPS) and Cocoon syndrome, respectively. In this study, we report mutations in six pedigrees with children affected with PPS or BPS. Using a combination of Sanger and exome sequencing, we report the first case of an autosomal recessive popliteal pterygium syndrome caused by homozygous mutation of IRF6 and the first case of uniparental disomy of chromosome 21 leading to a recessive disorder. We also demonstrate that mutations in RIPK4 can cause features with a range of severity along the PPS-BPS spectrum and that mutations in IKKA can cause a range of features along the BPS-Cocoon spectrum. Our findings have clinical implications for genetic counseling of families with pterygia syndromes and further implicate IRF6, RIPK4, and CHUK (IKKA) in potentially interconnected pathways governing epidermal and craniofacial development.
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Kesterke MJ, Raffensperger ZD, Heike CL, Cunningham ML, Hecht JT, Kau CH, Nidey NL, Moreno LM, Wehby GL, Marazita ML, Weinberg SM. Using the 3D Facial Norms Database to investigate craniofacial sexual dimorphism in healthy children, adolescents, and adults. Biol Sex Differ 2016; 7:23. [PMID: 27110347 PMCID: PMC4841054 DOI: 10.1186/s13293-016-0076-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/17/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although craniofacial sex differences have been extensively studied in humans, relatively little is known about when various dimorphic features manifest during postnatal life. Using cross-sectional data derived from the 3D Facial Norms data repository, we tested for sexual dimorphism of craniofacial soft-tissue morphology at different ages. Methods One thousand five hundred fifty-five individuals, pre-screened for craniofacial conditions, between 3 and 25 years of age were placed in to one of six age-defined categories: early childhood, late childhood, puberty, adolescence, young adult, and adult. At each age group, sex differences were tested by ANCOVA for 29 traditional soft-tissue anthropometric measurements collected from 3D facial scans. Additionally, sex differences in shape were tested using a geometric morphometric analysis of 24 3D facial landmarks. Results Significant (p < 0.05) sex differences were observed in every age group for measurements covering multiple aspects of the craniofacial complex. The magnitude of the dimorphism generally increased with age, with large spikes in the nasal, cranial, and facial measurements observed after puberty. Significant facial shape differences (p < 0.05) were also seen at each age, with some dimorphic features already present in young children (eye fissure inclination) and others emerging only after puberty (mandibular position). Conclusions Several craniofacial soft-tissue sex differences were already present in the youngest age group studied, indicating that these differences emerged prior to 3 years of age. The results paint a complex and heterogeneous picture, with different groups of traits exhibiting distinct patterns of dimorphism during ontogeny. The definitive adult male and female facial shape was present following puberty, but arose from numerous distinct changes taking place at earlier stages. Electronic supplementary material The online version of this article (doi:10.1186/s13293-016-0076-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew J Kesterke
- Department of Anthropology, University of Pittsburgh, Pittsburgh, PA USA
| | - Zachary D Raffensperger
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Carrie L Heike
- Department of Pediatrics, University of Washington, Seattle, WA USA
| | - Michael L Cunningham
- Department of Pediatrics, University of Washington, Seattle, WA USA ; Department of Biological Structure, University of Washington, Seattle, WA USA ; Department of Oral Biology, University of Washington, Seattle, WA USA ; Department of Pediatric Dentistry, University of Washington, Seattle, WA USA
| | - Jacqueline T Hecht
- Department of Pediatrics, University of Texas Health Science Center, Houston, TX USA
| | - Chung How Kau
- Department of Orthodontics, University of Alabama, Birmingham, AL USA
| | - Nichole L Nidey
- Department of Pediatrics, University of Iowa, Iowa City, IA USA
| | - Lina M Moreno
- Department of Orthodontics, University of Iowa, Iowa City, IA USA ; Dows Institute for Dental Research, University of Iowa, Iowa City, IA USA
| | - George L Wehby
- Department of Health Management and Policy, University of Iowa, Iowa City, IA USA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA ; Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA USA ; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA USA ; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - Seth M Weinberg
- Department of Anthropology, University of Pittsburgh, Pittsburgh, PA USA ; Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
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Al-Rekabi Z, Wheeler MM, Leonard A, Fura AM, Juhlin I, Frazar C, Smith JD, Park SS, Gustafson JA, Clarke CM, Cunningham ML, Sniadecki NJ. Activation of the IGF1 pathway mediates changes in cellular contractility and motility in single-suture craniosynostosis. J Cell Sci 2015; 129:483-91. [PMID: 26659664 DOI: 10.1242/jcs.175976] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 12/06/2015] [Indexed: 12/13/2022] Open
Abstract
Insulin growth factor 1 (IGF1) is a major anabolic signal that is essential during skeletal development, cellular adhesion and migration. Recent transcriptomic studies have shown that there is an upregulation in IGF1 expression in calvarial osteoblasts derived from patients with single-suture craniosynostosis (SSC). Upregulation of the IGF1 signaling pathway is known to induce increased expression of a set of osteogenic markers that previously have been shown to be correlated with contractility and migration. Although the IGF1 signaling pathway has been implicated in SSC, a correlation between IGF1, contractility and migration has not yet been investigated. Here, we examined the effect of IGF1 activation in inducing cellular contractility and migration in SSC osteoblasts using micropost arrays and time-lapse microscopy. We observed that the contractile forces and migration speeds of SSC osteoblasts correlated with IGF1 expression. Moreover, both contractility and migration of SSC osteoblasts were directly affected by the interaction of IGF1 with IGF1 receptor (IGF1R). Our results suggest that IGF1 activity can provide valuable insight for phenotype-genotype correlation in SSC osteoblasts and might provide a target for therapeutic intervention.
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Affiliation(s)
- Zeinab Al-Rekabi
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA 98101, USA
| | - Marsha M Wheeler
- Department of Genome Sciences, University of Washington, Seattle, WA 98105, USA
| | - Andrea Leonard
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Adriane M Fura
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Ilsa Juhlin
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Christopher Frazar
- Department of Genome Sciences, University of Washington, Seattle, WA 98105, USA
| | - Joshua D Smith
- Department of Genome Sciences, University of Washington, Seattle, WA 98105, USA
| | - Sarah S Park
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA 98101, USA
| | - Jennifer A Gustafson
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA 98101, USA
| | - Christine M Clarke
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA 98101, USA
| | - Michael L Cunningham
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA 98101, USA Division of Craniofacial Medicine and the Department of Pediatrics, University of Washington, Seattle, WA 98105, USA
| | - Nathan J Sniadecki
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
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31
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Weinberg SM, Raffensperger ZD, Kesterke MJ, Heike CL, Cunningham ML, Hecht JT, Kau CH, Murray JC, Wehby GL, Moreno LM, Marazita ML. The 3D Facial Norms Database: Part 1. A Web-Based Craniofacial Anthropometric and Image Repository for the Clinical and Research Community. Cleft Palate Craniofac J 2015; 53:e185-e197. [PMID: 26492185 DOI: 10.1597/15-199] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
With the current widespread use of three-dimensional (3D) facial surface imaging in clinical and research environments, there is a growing demand for high-quality craniofacial norms based on 3D imaging technology. The principal goal of the 3D Facial Norms (3DFN) project was to create an interactive, Web-based repository of 3D facial images and measurements. Unlike other repositories, users can gain access to both summary-level statistics and individual-level data, including 3D facial landmark coordinates, 3D-derived anthropometric measurements, 3D facial surface images, and genotypes from every individual in the dataset. The 3DFN database currently consists of 2454 male and female participants ranging in age from 3 to 40 years. The subjects were recruited at four US sites and screened for a history of craniofacial conditions. The goal of this article is to introduce readers to the 3DFN repository by providing a general overview of the project, explaining the rationale behind the creation of the database, and describing the methods used to collect the data. Sex- and age-specific summary statistics (means and standard deviations) and growth curves for every anthropometric measurement in the 3DFN dataset are provided as a supplement available online. These summary statistics and growth curves can aid clinicians in the assessment of craniofacial dysmorphology.
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32
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Homayounfar N, Park SS, Afsharinejad Z, Bammler TK, MacDonald JW, Farin FM, Mecham BH, Cunningham ML. Transcriptional analysis of human cranial compartments with different embryonic origins. Arch Oral Biol 2015; 60:1450-60. [PMID: 26188427 DOI: 10.1016/j.archoralbio.2015.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Previous investigations suggest that the embryonic origins of the calvarial tissues (neural crest or mesoderm) may account for the molecular mechanisms underlying sutural development. The aim of this study was to evaluate the differences in the gene expression of human cranial tissues and assess the presence of an expression signature reflecting their embryonic origins. METHODS Using microarray technology, we investigated global gene expression of cells from the frontal and parietal bones and the metopic and sagittal intrasutural mesenchyme (ISM) of four human foetal calvaria. qRT-PCR of a selected group of genes was done to validate the microarray analysis. Paired comparison and correlation analyses were performed on microarray results. RESULTS Of six paired comparisons, frontal and parietal compartments (distinct tissue types of calvaria, either bone or intrasutural mesenchyme) had the most different gene expression profiles despite being composed of the same tissue type (bone). Correlation analysis revealed two distinct gene expression profiles that separate frontal and metopic compartments from parietal and sagittal compartments. TFAP2A, TFAP2B, ICAM1, SULF1, TNC and FOXF2 were among differentially expressed genes. CONCLUSION Transcriptional profiles of two groups of tissues, frontal and metopic compartments vs. parietal and sagittal compartments, suggest differences in proliferation, differentiation and extracellular matrix production. Our data suggest that in the second trimester of human foetal development, a gene expression signature of neural crest origin still exists in frontal and metopic compartments while gene expression of parietal and sagittal compartments is more similar to mesoderm.
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Affiliation(s)
- Negar Homayounfar
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, 1900 - 9th Avenue, Seattle, WA 98101, United States; Department of Oral Health Sciences, Dental School, University of Washington, United States; Department of Endodontics, Prosthodontics and Operative Dentistry, School of Dentistry, University of Maryland, Baltimore, United States.
| | - Sarah S Park
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, 1900 - 9th Avenue, Seattle, WA 98101, United States
| | - Zahra Afsharinejad
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, # 100, Seattle, WA 98105-6099, United States
| | - Theodor K Bammler
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, # 100, Seattle, WA 98105-6099, United States
| | - James W MacDonald
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, # 100, Seattle, WA 98105-6099, United States
| | - Federico M Farin
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, # 100, Seattle, WA 98105-6099, United States
| | - Brigham H Mecham
- Trialomics, 1700 7th Avenue, # 116, Seattle, WA 98101, United States
| | - Michael L Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, 1900 - 9th Avenue, Seattle, WA 98101, United States; Seattle Children's Craniofacial Center, 4800 Sand Point Way NE, Seattle, WA 98105, United States
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33
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Park SS, Beyer RP, Smyth MD, Clarke CM, Timms AE, Bammler TK, Stamper BD, Mecham BH, Gustafson JA, Cunningham ML. Osteoblast differentiation profiles define sex specific gene expression patterns in craniosynostosis. Bone 2015; 76:169-76. [PMID: 25753363 PMCID: PMC4546839 DOI: 10.1016/j.bone.2015.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/18/2015] [Accepted: 03/01/2015] [Indexed: 01/25/2023]
Abstract
Single suture craniosynostosis (SSC) is the premature fusion of one calvarial suture and occurs in 1-1700-2500 live births. Congenital fusion of either the sagittal, metopic, or coronal sutures represents 95% of all cases of SSC. Sagittal and metopic synostosis have a male preponderance (3:1) while premature fusion of the coronal suture has a female preponderance (2:1). Although environmental and genetic factors contribute to SSC, the etiology of the majority of SSC cases remains unclear. In this study, 227 primary calvarial osteoblast cell lines from patients with coronal, metopic, or sagittal synostosis and unaffected controls were established and assayed for ALP activity and BrdU incorporation (n = 226) as respective measures of early stage osteoblast differentiation and proliferation. Primary osteoblast cell lines from individuals with sagittal synostosis demonstrated higher levels of ALP activity and reduced proliferation when compared to control lines. In order to address the sex differences in SSC types, the data was further stratified by sex. Osteoblasts from males and females with sagittal synostosis as well as males with metopic synostosis demonstrated higher levels of ALP activity when compared to sex matched controls, and males with sagittal or metopic synostosis demonstrated reduced levels of proliferation. In order to elucidate genes and pathways involved in these observed phenotypes, correlation analyses comparing ALP activity and proliferation to global gene expression was performed. Transcripts related to osteoblast differentiation were identified both differentially up and downregulated, correlated with ALP activity when compared to controls, and demonstrated a striking sex specific gene expression pattern. These data support that the dysregulation of osteoblast differentiation plays a role in the development of SSC and that genetic factors contribute to the observed sex related differences.
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Affiliation(s)
- Sarah S Park
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA
| | - Richard P Beyer
- University of Washington, Center for Ecogenetics and Environmental Health, Seattle, WA, USA
| | - Matthew D Smyth
- Washington University, Department of Neurosurgery and St. Louis Children's Hospital, St. Louis, MO, USA
| | - Christine M Clarke
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA
| | - Andrew E Timms
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA
| | - Theo K Bammler
- University of Washington, Center for Ecogenetics and Environmental Health, Seattle, WA, USA
| | | | | | - Jennifer A Gustafson
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA
| | - Michael L Cunningham
- Seattle Children's Research Institute, Center for Developmental Biology and Regenerative Medicine, Seattle, WA, USA; Seattle Children's Craniofacial Center, Seattle, WA, USA.
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Goss MA, Lievano F, Buchanan KM, Seminack MM, Cunningham ML, Dana A. Final report on exposure during pregnancy from a pregnancy registry for quadrivalent human papillomavirus vaccine. Vaccine 2015; 33:3422-8. [PMID: 25869893 DOI: 10.1016/j.vaccine.2015.04.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 01/21/2015] [Revised: 04/02/2015] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To better describe the safety profile of pregnancy exposures to the qHPV vaccine by acquiring and analyzing post-marketing data on pregnancy outcomes. METHODS This is a voluntary, post-marketing prenatal vaccine exposure registry. Enrollment criteria included an identifiable patient and health care provider from the United States, France, or Canada and exposure within 1 month before the date of onset of the last menstrual period or at any time during pregnancy. Outcomes of interest were pregnancy outcomes and birth defects. Prospectively reported cases were used for rate calculations. RESULTS For the 1752 prospective reports with known outcome, 1518 (86.6%) were live births, including ten twin pregnancies. Of 1527 neonates, 1444 (94.6%) had no congenital anomalies. The overall rate of spontaneous abortion was 6.7 per 100 outcomes (95% confidence interval [CI] 5.5-8.2). The prevalence of major birth defects was 2.4 per 100 live-born neonates (95% CI 1.7-3.3). There were 12 fetal deaths (0.8 per 100 outcomes, 95% CI 0.4-1.4). CONCLUSION Rates of spontaneous abortions and major birth defects were not greater than the general population rates. Although no adverse signals have been identified to date, the qHPV vaccine is not recommended for use in pregnant women.
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Affiliation(s)
| | | | | | | | - Michael L Cunningham
- University of Washington, Department of Craniofacial Medicine, Department of Pediatrics, Seattle, WA, USA
| | - Adrian Dana
- Merck Research Laboratories, West Point, PA, USA
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Maga AM, Navarro N, Cunningham ML, Cox TC. Quantitative trait loci affecting the 3D skull shape and size in mouse and prioritization of candidate genes in-silico. Front Physiol 2015; 6:92. [PMID: 25859222 PMCID: PMC4374467 DOI: 10.3389/fphys.2015.00092] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 01/09/2015] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
We describe the first application of high-resolution 3D micro-computed tomography, together with 3D landmarks and geometric morphometrics, to map QTL responsible for variation in skull shape and size using a backcross between C57BL/6J and A/J inbred strains. Using 433 animals, 53 3D landmarks, and 882 SNPs from autosomes, we identified seven QTL responsible for the skull size (SCS.qtl) and 30 QTL responsible for the skull shape (SSH.qtl). Size, sex, and direction-of-cross were all significant factors and included in the analysis as covariates. All autosomes harbored at least one SSH.qtl, sometimes up to three. Effect sizes of SSH.qtl appeared to be small, rarely exceeding 1% of the overall shape variation. However, they account for significant amount of variation in some specific directions of the shape space. Many QTL have stronger effect on the neurocranium than expected from a random vector that will parcellate uniformly across the four cranial regions. On the contrary, most of QTL have an effect on the palate weaker than expected. Combined interval length of 30 SSH.qtl was about 315 MB and contained 2476 known protein coding genes. We used a bioinformatics approach to filter these candidate genes and identified 16 high-priority candidates that are likely to play a role in the craniofacial development and disorders. Thus, coupling the QTL mapping approach in model organisms with candidate gene enrichment approaches appears to be a feasible way to identify high-priority candidates genes related to the structure or tissue of interest.
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Affiliation(s)
- A Murat Maga
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington Seattle, WA, USA ; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute Seattle, WA, USA
| | - Nicolas Navarro
- Laboratoire PALEVO, Ecole Pratique des Hautes Etudes Dijon, France ; UMR uB/CNRS 6282 - Biogéosciences, Université de Bourgogne Dijon, France
| | - Michael L Cunningham
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington Seattle, WA, USA ; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute Seattle, WA, USA
| | - Timothy C Cox
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington Seattle, WA, USA ; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute Seattle, WA, USA ; Department of Anatomy and Developmental Biology, Monash University Clayton, VIC, Australia
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Carmichael SL, Ma C, Rasmussen SA, Cunningham ML, Browne ML, Dosiou C, Lammer EJ, Shaw GM. Craniosynostosis and risk factors related to thyroid dysfunction. Am J Med Genet A 2015; 167A:701-7. [PMID: 25655789 DOI: 10.1002/ajmg.a.36953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 10/14/2014] [Accepted: 12/21/2014] [Indexed: 01/12/2023]
Abstract
Thyroid disease is a common problem among women of reproductive age but often goes undiagnosed. Maternal thyroid disease has been associated with increased risk of craniosynostosis. We hypothesized that known risk factors for thyroid disease would be associated with risk of craniosynostosis among women not diagnosed with thyroid disease. Analyses included mothers of 1,067 cases and 8,494 population-based controls who were interviewed for the National Birth Defects Prevention Study. We used multivariable logistic regression to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). After excluding women with diagnosed thyroid disease, younger maternal age (AOR 0.7, 95% CI 0.6-0.9, for <25 years versus 25-29), black or other race-ethnicity (AOR 0.3, 95% CI 0.2-0.4 and AOR 0.6, 95% CI 0.4-0.8, respectively, relative to non-Hispanic whites), fertility medications or procedures (AOR 1.5, 95% CI 1.2-2.0), and alcohol consumption (AOR 0.8, 95% CI 0.7-0.9) were associated with risk of craniosynostosis, based on confidence intervals that excluded 1.0. These associations with craniosynostosis are consistent with the direction of their association with thyroid dysfunction (i.e., younger age, black race-ethnicity and alcohol consumption are associated with reduced risk and fertility problems are associated with increased risk of thyroid disease). This study thus provides support for the hypothesis that risk factors associated with thyroid dysfunction are also associated with risk of craniosynostosis. Improved understanding of the potential association between maternal thyroid function and craniosynostosis among offspring is important given that craniosynostosis carries significant morbidity and that thyroid disease is under-diagnosed and potentially modifiable.
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Affiliation(s)
- S L Carmichael
- Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, California
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Smith J, Hing A, Clarke C, Johnson N, Perez F, Park S, Horst J, Mecham B, Maves L, Nickerson D, Cunningham M, Cunningham ML. Exome sequencing identifies a recurrent de novo ZSWIM6 mutation associated with acromelic frontonasal dysostosis. Am J Hum Genet 2014; 95:235-40. [PMID: 25105228 DOI: 10.1016/j.ajhg.2014.07.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022] Open
Abstract
Acromelic frontonasal dysostosis (AFND) is a rare disorder characterized by distinct craniofacial, brain, and limb malformations, including frontonasal dysplasia, interhemispheric lipoma, agenesis of the corpus callosum, tibial hemimelia, preaxial polydactyly of the feet, and intellectual disability. Exome sequencing of one trio and two unrelated probands revealed the same heterozygous variant (c.3487C>T [p. Arg1163Trp]) in a highly conserved protein domain of ZSWIM6; this variant has not been seen in the 1000 Genomes data, dbSNP, or the Exome Sequencing Project. Sanger validation of the three trios confirmed that the variant was de novo and was also present in a fourth isolated proband. In situ hybridization of early zebrafish embryos at 24 hr postfertilization (hpf) demonstrated telencephalic expression of zswim6 and onset of midbrain, hindbrain, and retinal expression at 48 hpf. Immunohistochemistry of later-stage mouse embryos demonstrated tissue-specific expression in the derivatives of all three germ layers. qRT-PCR expression analysis of osteoblast and fibroblast cell lines available from two probands was suggestive of Hedgehog pathway activation, indicating that the ZSWIM6 mutation associated with AFND may lead to the craniofacial, brain and limb malformations through the disruption of Hedgehog signaling.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Michael L Cunningham
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98101, USA; Department of Pediatrics, University of Washington, Seattle, WA 98195, USA; Craniofacial Center, Seattle Children's Hospital, Seattle, WA 98105, USA.
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Keppler-Noreuil KM, Sapp JC, Lindhurst MJ, Parker VER, Blumhorst C, Darling T, Tosi LL, Huson SM, Whitehouse RW, Jakkula E, Grant I, Balasubramanian M, Chandler KE, Fraser JL, Gucev Z, Crow YJ, Brennan LM, Clark R, Sellars EA, Pena LDM, Krishnamurty V, Shuen A, Braverman N, Cunningham ML, Sutton VR, Tasic V, Graham JM, Geer J, Henderson A, Semple RK, Biesecker LG. Clinical delineation and natural history of the PIK3CA-related overgrowth spectrum. Am J Med Genet A 2014; 164A:1713-33. [PMID: 24782230 PMCID: PMC4320693 DOI: 10.1002/ajmg.a.36552] [Citation(s) in RCA: 198] [Impact Index Per Article: 19.8] [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: 12/02/2013] [Accepted: 03/01/2014] [Indexed: 02/02/2023]
Abstract
Somatic mutations in the phosphatidylinositol/AKT/mTOR pathway cause segmental overgrowth disorders. Diagnostic descriptors associated with PIK3CA mutations include fibroadipose overgrowth (FAO), Hemihyperplasia multiple Lipomatosis (HHML), Congenital Lipomatous Overgrowth, Vascular malformations, Epidermal nevi, Scoliosis/skeletal and spinal (CLOVES) syndrome, macrodactyly, and the megalencephaly syndrome, Megalencephaly-Capillary malformation (MCAP) syndrome. We set out to refine the understanding of the clinical spectrum and natural history of these phenotypes, and now describe 35 patients with segmental overgrowth and somatic PIK3CA mutations. The phenotypic data show that these previously described disease entities have considerable overlap, and represent a spectrum. While this spectrum overlaps with Proteus syndrome (sporadic, mosaic, and progressive) it can be distinguished by the absence of cerebriform connective tissue nevi and a distinct natural history. Vascular malformations were found in 15/35 (43%) and epidermal nevi in 4/35 (11%) patients, lower than in Proteus syndrome. Unlike Proteus syndrome, 31/35 (89%) patients with PIK3CA mutations had congenital overgrowth, and in 35/35 patients this was asymmetric and disproportionate. Overgrowth was mild with little postnatal progression in most, while in others it was severe and progressive requiring multiple surgeries. Novel findings include: adipose dysregulation present in all patients, unilateral overgrowth that is predominantly left-sided, overgrowth that affects the lower extremities more than the upper extremities and progresses in a distal to proximal pattern, and in the most severely affected patients is associated with marked paucity of adipose tissue in unaffected areas. While the current data are consistent with some genotype-phenotype correlation, this cannot yet be confirmed.
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Affiliation(s)
- Kim M Keppler-Noreuil
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland,*Correspondence to:, Kim M. Keppler-Noreuil, M.D., National Human Genome Research Institute/NIH, 49 Convent Drive 4A83, Bethesda, MD 20892., E-mail:
| | - Julie C Sapp
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland
| | - Marjorie J Lindhurst
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland
| | - Victoria ER Parker
- The University of Cambridge Metabolic Research Laboratories, Institute of Metabolic ScienceCambridge, UK
| | - Cathy Blumhorst
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland
| | - Thomas Darling
- Department of Dermatology, Uniformed Services University of the Health SciencesBethesda, Maryland
| | - Laura L Tosi
- Division of Orthopaedic Surgery and Sports Medicine, Children's National Medical CenterWashington, District of Columbia
| | - Susan M Huson
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC)Manchester, UK
| | - Richard W Whitehouse
- Department of Radiology, Central Manchester University Hospitals NHS Foundation Trust Manchester Royal Infirmary Oxford Road ManchesterManchester, UK
| | - Eveliina Jakkula
- Department of Clinical Genetics, Helsinki University Central HospitalHelsinki, Finland
| | - Ian Grant
- Department of Plastic Surgery, Cambridge University Hospitals NHS TrustCambridge, UK
| | - Meena Balasubramanian
- Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation TrustSheffield, UK
| | - Kate E Chandler
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC)Manchester, UK
| | - Jamie L Fraser
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland
| | - Zoran Gucev
- Department of Endocrinology and Genetics, Medical Faculty SkopjeSkopje, Macedonia
| | - Yanick J Crow
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC)Manchester, UK
| | - Leslie Manace Brennan
- Medical Genetics, Kaiser Permanente Oakland, University of CaliforniaSan Francisco, California
| | - Robin Clark
- Division of Medical Genetics, Department of Pediatrics, Loma Linda University Medical CenterLoma Linda, California
| | - Elizabeth A Sellars
- Section of Genetics and Metabolism, Arkansas Children's HospitalLittle Rock, Arkansas
| | - Loren DM Pena
- Division of Genetics, Department of Pediatrics, Duke University Medical CenterDurham, North Carolina
| | | | - Andrew Shuen
- Department of Medical Genetics, McGill University Health CentreMontreal, Quebec, Canada
| | - Nancy Braverman
- Department of Human Genetics and Pediatrics, McGill University, Montreal Children's Hospital Research InstituteMontreal, Canada
| | - Michael L Cunningham
- Division of Craniofacial Medicine, University of Washington School of MedicineSeattle, Washington
| | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of MedicineHouston, Texas
| | - Velibor Tasic
- University Children's Hospital, Medical SchoolSkopje, Macedonia
| | - John M Graham
- Clinical Genetics and Dysmorphology, Department of Pediatrics, Harbor-UCLA Medical CenterLos Angeles, California
| | - Joseph Geer
- Greenwood Genetics CenterGreenwood, South Carolina
| | - Alex Henderson
- Northern Genetics Service, Newcastle Upon Tyne HospitalsNewcastle Upon Tyne, UK
| | - Robert K Semple
- The University of Cambridge Metabolic Research Laboratories, Institute of Metabolic ScienceCambridge, UK
| | - Leslie G Biesecker
- National Human Genome Research Institute, National Institutes of HealthBethesda, Maryland
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Atmosukarto I, Shapiro LG, Starr JR, Heike CL, Collett B, Cunningham ML, Speltz ML. Three-dimensional head shape quantification for infants with and without deformational plagiocephaly. Cleft Palate Craniofac J 2014; 47:368-77. [PMID: 20590458 DOI: 10.1597/09-059.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The authors developed and tested three-dimensional (3D) indices for quantifying the severity of deformational plagiocephaly (DP). DESIGN The authors evaluated the extent to which infants with and without DP (as determined by clinic referral and two experts' ratings) could be correctly classified. PARTICIPANTS Infants aged 4 to 11 months, including 154 with diagnosed DP and 100 infants without a history of DP or other craniofacial condition. After excluding participants with discrepant expert ratings, data from 90 infants with DP and 50 infants without DP were retained. MEASUREMENTS Two-dimensional (2D) histograms of surface normal vector angles were extracted from 3D mesh data and used to compute the severity scores. OUTCOME MEASURES Left posterior flattening score (LPFS), right posterior flattening score (RPFS), asymmetry score (AS), absolute asymmetry score (AAS), and an approximation of a previously described 2D measure, the oblique cranial length ratio (aOCLR). Two-dimensional histograms localized the posterior flatness for each participant. ANALYSIS The authors fit receiver operating characteristic curves and calculated the area under the curves (AUC) to evaluate the relative accuracy of DP classification using the above measures. RESULTS The AUC statistics were AAS = 91%, LPFS = 97%, RPFS = 91%, AS = 99%, and aOCLR = 79%. CONCLUSION Novel 3D-based plagiocephaly posterior severity scores provided better sensitivity and specificity in the discrimination of plagiocephalic and typical head shapes than the 2D measurements provided by a close approximation of OCLR. These indices will allow for more precise quantification of the DP phenotype in future studies on the prevalence of this condition, which may lead to improved clinical care.
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Affiliation(s)
- I Atmosukarto
- Department of Computer Science and Engineering, University of Washington, Seattle, USA
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Gordon CT, Cunniff CM, Green GE, Zechi-Ceide RM, Johnson JM, Henderson A, Petit F, Kokitsu-Nakata NM, Guion-Almeida ML, Munnich A, Cunningham ML, Lyonnet S, Amiel J. Clinical evidence for a mandibular to maxillary transformation in Auriculocondylar syndrome. Am J Med Genet A 2014; 164A:1850-3. [PMID: 24677549 DOI: 10.1002/ajmg.a.36505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/25/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Christopher T Gordon
- INSERM U1163, Hôpital Necker-Enfants Malades and Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
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Corton JC, Cunningham ML, Hummer BT, Lau C, Meek B, Peters JM, Popp JA, Rhomberg L, Seed J, Klaunig JE. Mode of action framework analysis for receptor-mediated toxicity: The peroxisome proliferator-activated receptor alpha (PPARα) as a case study. Crit Rev Toxicol 2013; 44:1-49. [PMID: 24180432 DOI: 10.3109/10408444.2013.835784] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Several therapeutic agents and industrial chemicals induce liver tumors in rodents through the activation of the peroxisome proliferator-activated receptor alpha (PPARα). The cellular and molecular events by which PPARα activators induce rodent hepatocarcinogenesis has been extensively studied and elucidated. This review summarizes the weight of evidence relevant to the hypothesized mode of action (MOA) for PPARα activator-induced rodent hepatocarcinogenesis and identifies gaps in our knowledge of this MOA. Chemical-specific and mechanistic data support concordance of temporal and dose-response relationships for the key events associated with many PPARα activators including a phthalate ester plasticizer di(2-ethylhexyl) phthalate (DEHP) and the drug gemfibrozil. While biologically plausible in humans, the hypothesized key events in the rodent MOA, for PPARα activators, are unlikely to induce liver tumors in humans because of toxicodynamic and biological differences in responses. This conclusion is based on minimal or no effects observed on growth pathways, hepatocellular proliferation and liver tumors in humans and/or species (including hamsters, guinea pigs and cynomolgous monkeys) that are more appropriate human surrogates than mice and rats at overlapping dose levels. Overall, the panel concluded that significant quantitative differences in PPARα activator-induced effects related to liver cancer formation exist between rodents and humans. On the basis of these quantitative differences, most of the workgroup felt that the rodent MOA is "not relevant to humans" with the remaining members concluding that the MOA is "unlikely to be relevant to humans". The two groups differed in their level of confidence based on perceived limitations of the quantitative and mechanistic knowledge of the species differences, which for some panel members strongly supports but cannot preclude the absence of effects under unlikely exposure scenarios.
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Cox TC, Luquetti DV, Cunningham ML. Perspectives and challenges in advancing research into craniofacial anomalies. Am J Med Genet C Semin Med Genet 2013; 163C:213-7. [PMID: 24142870 DOI: 10.1002/ajmg.c.31383] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Development of the craniofacial region is a remarkably complex and tightly orchestrated process. It is therefore not surprising that genetic and environmental insults frequently result in craniofacial anomalies. Nonetheless, our knowledge of their etiology and pathogenesis is still scarce, limiting our efforts at prevention. Furthermore, few standardized protocols have been developed to guide clinical and surgical interventions. In this Issue of the Seminars, reviews on the most recent research advances on craniofacial conditions, from genomics and epigenetics to ontology and medical care are discussed with emphasis on the most common anomalies of the craniofacial region: orofacial clefts, craniosynostosis, craniofacial microsomia, facial dysostosis, Robin sequence, jaw and dentition anomalies, and anterior neural tube defects. Phenotypic variability and the importance of detailed characterization using standardized terminology to better distinguish between phenotypes, new technologies (and their limitations) for genetic diagnosis, and the use of mouse models to study these conditions in both their complex phenotypic and genetic aspects are highlighted.
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Kido Y, Gordon CT, Sakazume S, Ben Bdira E, Dattani M, Wilson LC, Lyonnet S, Murakami N, Cunningham ML, Amiel J, Nagai T. Further characterization of atypical features in auriculocondylar syndrome caused by recessive PLCB4 mutations. Am J Med Genet A 2013; 161A:2339-46. [PMID: 23913798 DOI: 10.1002/ajmg.a.36066] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 02/19/2013] [Accepted: 05/03/2013] [Indexed: 11/08/2022]
Abstract
Auriculocondylar syndrome (ACS) is a branchial arch syndrome typically inherited in an autosomal dominant fashion. Patients with ACS display the following core symptoms with varying severity: a specific malformation of the external ear, known as a "question mark ear," micrognathia and mandibular condyle hypoplasia. Recently, phospholipase C, β 4 (PLCB4) mutations were identified as the major cause of autosomal dominant ACS, with mutations of the PLCB4 catalytic domain predicted to have a dominant negative effect. In addition, one ACS patient born to related parents harbored a homozygous partial deletion of PLCB4, and presented with ACS plus central apnea and macropenis; these features had not been previously reported in association with ACS. His parents, each with a heterozygous partial PLCB4 deletion, were phenotypically normal, suggesting autosomal recessive inheritance of ACS, with complete loss of function of PLCB4 predicted in the patient. We herein describe two brothers with ACS caused by compound heterozygous splice site mutations in PLCB4. The patients were born to the same unrelated and healthy parents, with each parent harboring one of the mutations, indicating autosomal recessive ACS. Both patients reported here had mixed apneas, gastrointestinal transit defects and macropenis, in addition to typical craniofacial features of ACS. This is the first example of ACS caused by compound heterozygous splice site mutations in PLCB4, the second autosomal recessive case of ACS confirmed by molecular analysis, and strengthens the link between complete loss of function of PLCB4 and extra-craniofacial features.
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Affiliation(s)
- Yasuhiro Kido
- Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
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Evans KN, Gruss JS, Khanna PC, Cunningham ML, Cox TC, Hing AV. Oculoauriculofrontonasal syndrome: case series revealing new bony nasal anomalies in an old syndrome. Am J Med Genet A 2013; 161A:1345-53. [PMID: 23637006 DOI: 10.1002/ajmg.a.35926] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/04/2013] [Indexed: 11/07/2022]
Abstract
Frontonasal Dysplasia (FND) and Oculo-auriculo-vertebral spectrum (OAVS) are two well-recognized clinical entities. With features of both FND and OAVS, the term oculoauriculofrontonasal syndrome (OAFNS) was coined in 1981. The OAFNS phenotype combines elements of abnormal morphogenesis of the frontonasal and maxillary process (derived from forebrain neural crest) with abnormal development of the first and second branchial arches (derived from hindbrain neural crest). We present a case series of 33 children with OAFNS ascertained from a comprehensive review of the literature and report an additional retrospective series of eight patients displaying features consistent with OAFNS. Notably, in a subset of our cases, we have observed abnormalities in nasal ossification and bony structures of the maxilla that have not previously described in OAFNS and are not seen in either FND or OAVS. We present the phenotype and novel naso-maxillary findings and explore potential etiologic and developmental pathways for OAFNS. We highlight the differences in phenotypic characteristics of OAFNS compared to OAVS and FND. These observations support the classification of OAFNS as a discrete syndrome. Further phenotypic refinements of OAFNS are needed to understand pathogenesis of this syndrome and the newly described nasal malformation may help identify the etiology.
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Affiliation(s)
- Kelly N Evans
- Department of Pediatrics, University of Washington, Seattle Children's Craniofacial Center, Seattle, Washington 98105, USA.
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Kim SD, Yagnik G, Cunningham ML, Kim J, Boyadjiev SA. MAPK/ERK Signaling Pathway Analysis in Primary Osteoblasts From Patients With Nonsyndromic Sagittal Craniosynostosis. Cleft Palate Craniofac J 2013; 51:115-9. [PMID: 23566293 DOI: 10.1597/12-136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The MAPK/ERK signaling pathway has been implicated in several craniosynostosis syndromes and represents a plausible target for therapeutic management of craniosynostosis. The causes of sagittal nonsyndromic craniosynostosis (sNSC) have not been well understood and the role that MAPK/ERK signaling cascade plays in this condition warrants an investigation. We hypothesized that MAPK-signaling is misregulated in calvarial osteoblasts derived from patients with sNSC. METHODS In order to analyze if the MAPK/ERK pathway is perturbed in sNSC, we established primary calvarial osteoblast cell lines from patients undergoing surgery for correction of this congenital anomaly. Appropriate negative and positive control cell lines were used for comparison, and we examined the levels of phosphorylated ERK by immunoblotting. RESULTS Primary osteoblasts from patients with sNSC showed no difference in ERK1/2 phosphorylation with or without FGF2 stimulation as compared with control osteoblasts. CONCLUSION Under the described test conditions, we did not observe convincing evidence that MAPK/ERK signaling contributes to the development of sNSC.
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Parsons TE, Raffensperger ZD, Hecht JT, Heike CL, Cunningham ML, Marazita ML, Weinberg SM. Shape Analysis of the Facebase 3D Facial Norms Dataset Reveals Sexual Dimorphism in Human Faces in Juveniles, Adolescents and Adults. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.519.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Carrie L Heike
- PediatricsUniversity of WashingtonSeattleWA
- PediatricsSeattle Children'sSeattleWA
| | - Michael L Cunningham
- PediatricsUniversity of WashingtonSeattleWA
- PediatricsSeattle Children'sSeattleWA
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Luquetti DV, Cox TC, Lopez-Camelo J, Dutra MDG, Cunningham ML, Castilla EE. Preferential associated anomalies in 818 cases of microtia in South America. Am J Med Genet A 2013; 161A:1051-7. [PMID: 23554119 DOI: 10.1002/ajmg.a.35888] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 01/07/2013] [Indexed: 12/28/2022]
Abstract
The etiology of microtia remains unknown in most cases. The identification of patterns of associated anomalies (i.e., other anomalies that occur with a given congenital anomaly in a higher than expected frequency), is a methodology that has been used for research into the etiology of birth defects. We conducted a study based on cases of microtia that were diagnosed from more than 5 million live (LB)- and stillbirths (SB) examined in hospitals participating in ECLAMC (Latin American Collaborative Study of Congenital Malformations) between 1967 and 2009. We identified 818 LB and SB with microtia and at least one additional non-related major congenital anomaly (cases) and 15,969 LB and SB with two or more unrelated major congenital anomalies except microtia (controls). A logistic regression analysis was performed to identify the congenital anomalies preferentially associated with microtia. Preferential associations were observed for 10 congenital anomalies, most of them in the craniofacial region, including facial asymmetry, choanal atresia, and eyelid colobomata. The analysis by type of microtia showed that for anomalies such as cleft lip and palate, macrostomia, and limb reduction defects, the frequency increased with the severity of the microtia. In contrast, for other anomalies the frequency tended to be the same across all types of microtia. Based on these results we will integrate data on the developmental pathways related to preferentially associated congenital anomalies for future studies investigating the etiology of microtia.
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Affiliation(s)
- Daniela V Luquetti
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington and Center for Tissue and Cell Sciences, Seattle Children's Research Institute, Seattle, WA, USA.
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Gordon CT, Vuillot A, Marlin S, Gerkes E, Henderson A, AlKindy A, Holder-Espinasse M, Park SS, Omarjee A, Sanchis-Borja M, Bdira EB, Oufadem M, Sikkema-Raddatz B, Stewart A, Palmer R, McGowan R, Petit F, Delobel B, Speicher MR, Aurora P, Kilner D, Pellerin P, Simon M, Bonnefont JP, Tobias ES, García-Miñaúr S, Bitner-Glindzicz M, Lindholm P, Meijer BA, Abadie V, Denoyelle F, Vazquez MP, Rotky-Fast C, Couloigner V, Pierrot S, Manach Y, Breton S, Hendriks YMC, Munnich A, Jakobsen L, Kroisel P, Lin A, Kaban LB, Basel-Vanagaite L, Wilson L, Cunningham ML, Lyonnet S, Amiel J. Heterogeneity of mutational mechanisms and modes of inheritance in auriculocondylar syndrome. J Med Genet 2013; 50:174-86. [PMID: 23315542 DOI: 10.1136/jmedgenet-2012-101331] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Auriculocondylar syndrome (ACS) is a rare craniofacial disorder consisting of micrognathia, mandibular condyle hypoplasia and a specific malformation of the ear at the junction between the lobe and helix. Missense heterozygous mutations in the phospholipase C, β 4 (PLCB4) and guanine nucleotide binding protein (G protein), α inhibiting activity polypeptide 3 (GNAI3) genes have recently been identified in ACS patients by exome sequencing. These genes are predicted to function within the G protein-coupled endothelin receptor pathway during craniofacial development. RESULTS We report eight additional cases ascribed to PLCB4 or GNAI3 gene lesions, comprising six heterozygous PLCB4 missense mutations, one heterozygous GNAI3 missense mutation and one homozygous PLCB4 intragenic deletion. Certain residues represent mutational hotspots; of the total of 11 ACS PLCB4 missense mutations now described, five disrupt Arg621 and two disrupt Asp360. The narrow distribution of mutations within protein space suggests that the mutations may result in dominantly interfering proteins, rather than haploinsufficiency. The consanguineous parents of the patient with a homozygous PLCB4 deletion each harboured the heterozygous deletion, but did not present the ACS phenotype, further suggesting that ACS is not caused by PLCB4 haploinsufficiency. In addition to ACS, the patient harbouring a homozygous deletion presented with central apnoea, a phenotype that has not been previously reported in ACS patients. CONCLUSIONS These findings indicate that ACS is not only genetically heterogeneous but also an autosomal dominant or recessive condition according to the nature of the PLCB4 gene lesion.
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Affiliation(s)
- Christopher T Gordon
- INSERM U781, Tour Lavoisier 2ème étage, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, Paris 75015, France.
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Abstract
OBJECTIVES Infants and toddlers with deformational plagiocephaly (DP) have been shown to score lower on developmental measures than unaffected children. To determine whether these differences persist, we examined development in 36-month-old children with and without a history of DP. METHODS Participants included 224 children with DP and 231 children without diagnosed DP, all of who had been followed in a longitudinal study since infancy. To confirm the presence or absence of DP, pediatricians blinded to children's case status rated 3-dimensional cranial images taken when children were 7 months old on average. The Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) was administered as a measure of child development. RESULTS Children with DP scored lower on all scales of the BSID-III than children without DP. Differences were largest in cognition, language, and parent-reported adaptive behavior (adjusted differences = -2.9 to -4.4 standard score points) and smallest in motor development (adjusted difference = -2.7). Children in the control group who did not have previously diagnosed DP but who were later rated by pediatricians to have at least mild cranial deformation also scored lower on the BSID-III than unaffected controls. CONCLUSIONS Preschool-aged children with a history of DP continue to receive lower developmental scores than unaffected controls. These findings do not imply that DP causes developmental problems, but DP may nonetheless serve as a marker of developmental risk. We encourage clinicians to screen children with DP for developmental concerns to facilitate early identification and intervention.
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Affiliation(s)
- Brent R. Collett
- Departments of Psychiatry and Behavioral Sciences,,Department of Psychiatry and Behavioral Medicine, and
| | | | - Jacqueline R. Starr
- Epidemiology, and,Department of Clinical and Translational Research, The Forsyth Institute, Cambridge, Massachusetts; and,Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Carrie L. Heike
- Pediatrics, University of Washington, Seattle, Washington;,Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
| | - Michael L. Cunningham
- Pediatrics, University of Washington, Seattle, Washington;,Seattle Children’s Craniofacial Center, Seattle Children’s Hospital, Seattle, Washington
| | - Matthew L. Speltz
- Departments of Psychiatry and Behavioral Sciences,,Department of Psychiatry and Behavioral Medicine, and
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Gallagher ER, Evans KN, Hing AV, Cunningham ML. Bathrocephaly: A Head Shape Associated with a Persistent Mendosal Suture. Cleft Palate Craniofac J 2013; 50:104-8. [DOI: 10.1597/11-153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Bathrocephaly, a deformity of the posterior skull with bulging of the midportion of the occipital bone, is often associated with a benign variant of the mendosal suture ( Mulliken and Le, 2008 ). The endochondral and membranous portions of the occipital bone converge at the mendosal suture, which normally closes during fetal life or early infancy. When it persists, it is associated with a characteristic head shape that requires no intervention. We review the clinical findings associated with postnatal persistence of the mendosal suture and discuss other factors that may be associated with bathrocephaly.
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Affiliation(s)
- Emily R. Gallagher
- Division of General Pediatrics, Medical Director, Craniofacial Program, Oregon Health and Sciences University, Portland, Oregon
| | - Kelly N. Evans
- Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle Children's Craniofacial Center, Seattle, Washington
| | - Anne V. Hing
- University of Washington School of Medicine, Seattle Children's Craniofacial Center, Seattle, Washington
| | - Michael L. Cunningham
- University of Washington School of Medicine, and Medical Director, Seattle Children's Craniofacial Center, Seattle, Washington
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