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Marchionni E, Guadagnolo D, Mastromoro G, Pizzuti A. Prenatal Genome-Wide Sequencing analysis (Exome or Genome) in detecting pathogenic Single Nucleotide Variants in fetal Central Nervous System Anomalies: systematic review and meta-analysis. Eur J Hum Genet 2024:10.1038/s41431-024-01590-2. [PMID: 38486024 DOI: 10.1038/s41431-024-01590-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/04/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
Prenatal Exome (pES) or Genome (pGS) Sequencing analysis showed a significant incremental diagnostic yield over karyotype and chromosomal microarray analysis (CMA) in fetal structural anomalies. Optimized indications and detection rates in different fetal anomalies are still under investigation. The aim of this study was to assess the incremental diagnostic yield in prenatally diagnosed Central Nervous System (CNS) anomalies. A systematic review on antenatal CNS anomalies was performed according to PRISMA guidelines, including n = 12 paper, accounting for 428 fetuses. Results were pooled in a meta-analysis fitting a logistic random mixed-effect model. The effect of interest was the incremental diagnostic rate of pES over karyotype/CMA in detecting likely pathogenic/pathogenic Single Nucleotide Variants (SNVs). A further meta-analysis adding the available pGS studies (including diagnostic coding SNVs only) and submeta-analysis on three CNS subcategories were also performed. The pooled incremental diagnostic yield estimate of pES studies was 38% (95% C.I.: [29%;47%]) and 36% (95% C.I.: [28%;45%]) when including diagnostic SNVs of pGS studies. The point estimate of the effect resulted 22% (95% C.I.: [15%;31%]) in apparently isolated anomalies, 33% (95% C.I.: [22%;46%]) in CNS-only related anomalies (≥1) and 46% (95% C.I.: [38%;55%]) in non-isolated anomalies (either ≥ 2 anomalies in CNS, or CNS and extra-CNS). Meta-analysis showed a substantial diagnostic improvement in performing Prenatal Genome-Wide Sequencing analysis (Exome or Genome) over karyotype and CMA in CNS anomalies.
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Affiliation(s)
- Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Mastromoro G, Piacentini G. Correspondence to "Dichorionic Diamniotic Twin Pairs with Complex Congenital Heart Disease". Pediatr Cardiol 2024; 45:454. [PMID: 38070025 DOI: 10.1007/s00246-023-03368-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 01/28/2024]
Affiliation(s)
- Gioia Mastromoro
- Department of Laboratory Medicine, Isola Tiberina Hospital - Gemelli Isola, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Gerardo Piacentini
- Fetal and Neonatal Cardiology Unit, Isola Tiberina Hospital - Gemelli Isola, Rome, Italy.
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Mastromoro G, Guadagnolo D, Novelli A, Torres B, Piane M, Magliozzi M, Bernardini L, Ventriglia F, Pizzuti A, Petrucci S. Prenatal CFAP53-related laterality defect: case report and review of the literature. J Matern Fetal Neonatal Med 2023; 36:2201653. [PMID: 37041101 DOI: 10.1080/14767058.2023.2201653] [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] [Indexed: 04/13/2023]
Abstract
Laterality defects include morphological anomalies with impaired left-right asymmetry induction, such as dextrocardia, situs inversus abdominis, situs inversus totalis and situs ambiguus. The different arrangement of major organs is called heterotaxy. We describe for the first time a fetus with situs viscerum inversus and azygos continuation of the inferior vena cava, due to previously unreported variants in compound heterozygosity in the CFAP53 gene, whose product is implied in cilial motility. Prenatal trio exome sequencing was performed with turn-around time during the pregnancy. The fetuses with laterality defects are suitable candidates for prenatal exome sequencing due to the emerging high diagnostic rate of this group of morphological anomalies. A timely molecular diagnosis plays a fundamental role in genetic counseling, regarding couple decisions on the ongoing pregnancy, providing recurrence risks, and in predicting possible respiratory complications due to ciliary dyskinesia.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Novelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Barbara Torres
- Laboratory of Cytogenetics, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Maria Piane
- Medical Genetics and Advanced Cell Diagnostics Unit, S. Andrea University Hospital, Rome, Italy
| | - Monia Magliozzi
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Bernardini
- Laboratory of Cytogenetics, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Flavia Ventriglia
- Maternal and Child Department, Pediatric and Neonatology Unit, Sapienza of Rome, Latina, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Division of Medical Genetics, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Simona Petrucci
- Medical Genetics and Advanced Cell Diagnostics Unit, S. Andrea University Hospital, Rome, Italy
- Division of Medical Genetics, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
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Guadagnolo D, Mastromoro G, Torres B, Marchionni E, di Palma F, Goldoni M, Cocciadiferro D, Novelli A, Bernardini L, Pizzuti A. Duplication at 19q13.32q13.33 Segregating with Neuropsychiatric Phenotype in a Three-Generation Family: Towards the Definition of a Critical Region. Genes (Basel) 2023; 14:2157. [PMID: 38136979 PMCID: PMC10742575 DOI: 10.3390/genes14122157] [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: 10/20/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Chromosomal submicroscopic imbalances represent well-known causes of neurodevelopmental disorders. In some cases, these can cause specific autosomal dominant syndromes, with high-to-complete penetrance and de novo occurrence of the variant. In other cases, they result in non-syndromic neurodevelopmental disorders, often acting as moderate-penetrance risk factors, possibly inherited from unaffected parents. We describe a three-generation family with non-syndromic neuropsychiatric features segregating with a novel 19q13.32q13.33 microduplication. The propositus was a 28-month-old male ascertained for psychomotor delay, with no dysmorphic features or malformations. His mother had Attention-Deficit/Hyperactivity Disorder and a learning disability. The maternal uncle had an intellectual disability. Chromosomal microarray analysis identified a 969 kb 19q13.32q13.33 microduplication in the proband. The variant segregated in the mother, the uncle, and the maternal grandmother of the proband, who also presented neuropsychiatric disorders. Fragile-X Syndrome testing was negative. Exome Sequencing did not identify Pathogenic/Likely Pathogenic variants. Imbalances involving 19q13.32 and 19q13.33 are associated with neurodevelopmental delay. A review of the reported microduplications allowed to propose BICRA (MIM *605690) and KPTN (MIM *615620) as candidates for the neurodevelopmental delay susceptibility in 19q13.32q13.33 copy number gains. The peculiarities of this case are the small extension of the duplication, the three-generation segregation, and the full penetrance of the phenotype.
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Affiliation(s)
- Daniele Guadagnolo
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Barbara Torres
- Medical Genetics Unit, Department of Diagnosis, Treatment and Transfusional Medicine Services, Fondazione Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, 71013 San Giovanni Rotondo (FG), Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Francesca di Palma
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Marina Goldoni
- Medical Genetics Unit, Department of Diagnosis, Treatment and Transfusional Medicine Services, Fondazione Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, 71013 San Giovanni Rotondo (FG), Italy
| | - Dario Cocciadiferro
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Laura Bernardini
- Medical Genetics Unit, Department of Diagnosis, Treatment and Transfusional Medicine Services, Fondazione Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, 71013 San Giovanni Rotondo (FG), Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Medical Genetics Unit, Department of Diagnosis, Treatment and Transfusional Medicine Services, Fondazione Casa Sollievo della Sofferenza, Istituto di Ricovero e Cura a Carattere Scientifico, 71013 San Giovanni Rotondo (FG), Italy
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Guadagnolo D, Mastromoro G, Marchionni E, Germani A, Libi F, Sadeghi S, Savio C, Petrucci S, De Marchis L, Piane M, Pizzuti A. Heterozygous Pathogenic Nonsense Variant in the ATM Gene in a Family with Unusually High Gastric Cancer Susceptibility. Biomedicines 2023; 11:2062. [PMID: 37509701 PMCID: PMC10377208 DOI: 10.3390/biomedicines11072062] [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: 06/29/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Germline pathogenic variants (PVs) in the Ataxia Telangiectasia mutated (ATM) gene (MIM* 607585) increase the risk for breast, pancreatic, gastric, and prostatic cancer and, to a reduced extent, ovarian and colon cancer and melanoma, with moderate penetrance and variable expressivity. We describe a family presenting early-onset gastric cancer and harboring a heterozygous pathogenic ATM variant. The proband had gastric cancer (age 45) and reported a sister deceased due to diffuse gastric cancer (age 30) and another sister who developed diffuse gastric cancer (age 52) and ovarian serous cancer. Next generation sequencing for cancer susceptibility genes (APC, ATM, BRD1, BRIP1, CDH1, CDK4, CDKN2A, CHEK2, EPCAM, MLH1, MRE11, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2, PTEN, RAD50, RAD51C, RAD51D, RECQL1, SMAD4, STK11, and TP53) was performed. Molecular analysis identified the truncating c.5944C>T, p.(Gln1982*) variant in the ATM (NM_000051.3; NP_000042.3) in the proband. The variant had segregated in the living affected sister and in the unaffected daughter of the deceased affected sister. Familial early-onset gastric cancer is an unusual presentation for ATM-related malignancies. Individual variants may result in different specific risks. Genotype-phenotype correlations are challenging given the low penetrance and variable expressivity. Careful family history assessments are pivotal for prevention planning and are strengthened by the availability of molecular diagnoses.
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Affiliation(s)
- Daniele Guadagnolo
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Aldo Germani
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Fabio Libi
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Soha Sadeghi
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Camilla Savio
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Simona Petrucci
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Laura De Marchis
- Department of Radiological, Oncological and Anatomopathological Science, Sapienza University of Rome, 00185 Rome, Italy
- Oncology B Unit, Department of Hematology, Dermatology and Oncology, Policlinico Umberto I Univeristy Hospital, 00161 Rome, Italy
| | - Maria Piane
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Medical Genetics Unit, Department of Diagnostic Sciences, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, School of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy
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Guadagnolo D, Mastromoro G, Hashemian NK, Orlando V, Lepri FR, D'Alberti E, Giancotti A, Novelli A, Pizzuti A. Fetal first-trimester cystic hygroma as the prenatal presenting feature of ASCC1-related Spinal Muscular Atrophy with Bone Fractures 2. J Obstet Gynaecol Can 2023:S1701-2163(23)00373-0. [PMID: 37201580 DOI: 10.1016/j.jogc.2023.05.004] [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] [Received: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Valeria Orlando
- Laboratory of Medical Genetics, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Elena D'Alberti
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Mastromoro G, Guadagnolo D, Marchionni E, Torres B, Goldoni M, Onori A, Bernardini L, De Luca A, Torrente I, Pizzuti A. Mosaic genome-wide paternal uniparental disomy after discordant results from primary fetal samples and cultured cells. Am J Med Genet A 2023; 191:1101-1106. [PMID: 36598152 DOI: 10.1002/ajmg.a.63112] [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: 02/14/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
Mosaic genome-wide paternal uniparental disomy (GWpUPD) is a rare condition in which two euploid cell lines coexist in the same individual, one with biparental content and one with genome-wide paternal isodisomy. We report a complex prenatal diagnosis with discordant results from cultured and uncultured samples. A pregnant woman was referred for placental mesenchymal dysplasia and fetal omphalocele. Karyotype, array-CGH and Beckwith-Wiedemann Syndrome (BWS) testing (methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) of 11p15) performed on amniocytes were negative. After intrauterine fetal demise, the clinical suspicion persisted and BWS MS-MLPA was repeated on cultured cells from umbilical cord and amniotic fluid, revealing a mosaicism for KvH19 hypermethylation/KCNQ1OT1:TSS:DMR hypomethylation. These results, along with microsatellite analysis of the BWS region, were consistent with mosaic paternal 11p15 isodisomy. A concurrent maternal contamination exclusion test, analyzing polymorphic microsatellite markers on multiple chromosomes, showed an imbalance in favor of paternal alleles at all examined loci on cultured amniocytes and umbilical cord samples. This led to suspicion of mosaic GWpUPD, later confirmed by SNP-array, identifying a mosaic genome-wide paternal isodisomy affecting 60% of fetal cells. The assessment of mosaic GWpUPD requires multiple approaches beyond the current established diagnostic processes, also entertaining possible low-rate mosaicism. Clinical acumen and an integrated testing approach are the key to a successful diagnosis.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Barbara Torres
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Marina Goldoni
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Annamaria Onori
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Laura Bernardini
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Alessandro De Luca
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Isabella Torrente
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
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Piceci-Sparascio F, Micale L, Torres B, Guida V, Consoli F, Torrente I, Onori A, Frustaci E, D'Asdia MC, Petrizzelli F, Bernardini L, Mancini C, Soli F, Cocciadiferro D, Guadagnolo D, Mastromoro G, Putotto C, Fontana F, Brunetti-Pierri N, Novelli A, Pizzuti A, Marino B, Digilio MC, Mazza T, Dallapiccola B, Ruiz-Perez VL, Tartaglia M, Castori M, De Luca A. Clinical variability in DYNC2H1-related skeletal ciliopathies includes Ellis-van Creveld syndrome. Eur J Hum Genet 2023; 31:479-484. [PMID: 36599940 PMCID: PMC10133340 DOI: 10.1038/s41431-022-01276-7] [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: 08/19/2022] [Revised: 11/17/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023] Open
Abstract
Deleterious variants of DYNC2H1 gene are associated with a wide spectrum of skeletal ciliopathies (SC). We used targeted parallel sequencing to analyze 25 molecularly unsolved families with different SCs. Deleterious DYNC2H1 variants were found in six sporadic patients and two monozygotic (MZ) twins. Clinical diagnoses included short rib-polydactyly type 3 in two cases, and asphyxiating thoracic dystrophy (ATD) in one case. Remarkably, clinical diagnosis fitted with EvC, mixed ATD/EvC and short rib-polydactyly/EvC phenotypes in three sporadic patients and the MZ twins. EvC/EvC-like features always occurred in compound heterozygotes sharing a previously unreported splice site change (c.6140-5A>G) or compound heterozygotes for two missense variants. These results expand the DYNC2H1 mutational repertoire and its clinical spectrum, suggesting that EvC may be occasionally caused by DYNC2H1 variants presumably acting as hypomorphic alleles.
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Affiliation(s)
- Francesca Piceci-Sparascio
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Micale
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Barbara Torres
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Valentina Guida
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Federica Consoli
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Isabella Torrente
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Annamaria Onori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Emanuela Frustaci
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maria Cecilia D'Asdia
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Francesco Petrizzelli
- Laboratory of Bioinformatics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Laura Bernardini
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Cecilia Mancini
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Fiorenza Soli
- Medical Genetic Unit, Santa Chiara Hospital APSS, Trento, Italy
| | - Dario Cocciadiferro
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital and Research Institute, IRCCS, Rome, Italy
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | | | - Nicola Brunetti-Pierri
- Department of Translational Medicine, Section of Pediatrics, Federico II University, Naples, Italy
- Telethon Institute of Genetics and Medicine, Pozzuoli, Naples, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital and Research Institute, IRCCS, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Bruno Marino
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Tommaso Mazza
- Laboratory of Bioinformatics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Bruno Dallapiccola
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Victor Luis Ruiz-Perez
- Instituto de Investigaciones Biomédicas 'Alberto Sols', CSIC-UAM, Madrid, Spain
- CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IdiPaz-UAM, Madrid, Spain
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandro De Luca
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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Squitti R, Catalli C, Gigante L, Marianetti M, Rosari M, Mariani S, Bucossi S, Mastromoro G, Ventriglia M, Simonelli I, Tondolo V, Singh P, Kumar A, Pal A, Rongioletti M. Non-Ceruloplasmin Copper Identifies a Subtype of Alzheimer’s Disease (CuAD): Characterization of the Cognitive Profile and Case of a CuAD Patient Carrying an RGS7 Stop-Loss Variant. Int J Mol Sci 2023; 24:ijms24076377. [PMID: 37047347 PMCID: PMC10094789 DOI: 10.3390/ijms24076377] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
Alzheimer’s disease (AD) is a type of dementia whose cause is incompletely defined. Copper (Cu) involvement in AD etiology was confirmed by a meta-analysis on about 6000 participants, showing that Cu levels were decreased in AD brain specimens, while Cu and non-bound ceruloplasmin Cu (non-Cp Cu) levels were increased in serum/plasma samples. Non-Cp Cu was advocated as a stratification add-on biomarker of a Cu subtype of AD (CuAD subtype). To further circumstantiate this concept, we evaluated non-Cp Cu reliability in classifying subtypes of AD based on the characterization of the cognitive profile. The stratification of the AD patients into normal AD (non-Cp Cu ≤ 1.6 µmol/L) and CuAD (non-Cp Cu > 1.6 µmol/L) showed a significant difference in executive function outcomes, even though patients did not differ in disease duration and severity. Among the Cu-AD patients, a 76-year-old woman showed significantly abnormal levels in the Cu panel and underwent whole exome sequencing. The CuAD patient was detected with possessing the homozygous (c.1486T > C; p.(Ter496Argext*19) stop-loss variant in the RGS7 gene (MIM*602517), which encodes for Regulator of G Protein Signaling 7. Non-Cp Cu as an add-on test in the AD diagnostic pathway can provide relevant information about the underlying pathological processes in subtypes of AD and suggest specific therapeutic options.
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Affiliation(s)
- Rosanna Squitti
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
- Correspondence: rosanna.squitti.fw.@fbf-isola.it or
| | - Claudio Catalli
- Osakidetza Basque Health Service, Department of Genetics, Cruces University Hospital, 48903 Barakaldo, Spain
- Neuromuscular Disorders Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Laura Gigante
- Eurofins Genoma Group, Molecular Genetics Laboratory, 00138 Rome, Italy
| | - Massimo Marianetti
- Experimental Alzheimer Center, Fatebenefratelli Roman Province, 00189 Rome, Italy
| | - Mattia Rosari
- Experimental Alzheimer Center, Fatebenefratelli Roman Province, 00189 Rome, Italy
| | - Stefania Mariani
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Serena Bucossi
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Gioia Mastromoro
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Mariacarla Ventriglia
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Ilaria Simonelli
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Vincenzo Tondolo
- Digestive and Colorectal Surgery, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
- Digestive Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Parminder Singh
- Centre for Systems Biology and Bioinformatics, Panjab University, Chandigarh 160025, India
| | - Ashok Kumar
- Centre for Systems Biology and Bioinformatics, Panjab University, Chandigarh 160025, India
| | - Amit Pal
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani 741245, India
| | - Mauro Rongioletti
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
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Mastromoro G, Romano V, Riccardi R, Orfeo L, Piacentini G. Application of 3-Dimensional Fetal Echocardiography in the Detection of Hidden Extended Ventricular Septal Defect. Circ Cardiovasc Imaging 2023:e014658. [PMID: 36876499 DOI: 10.1161/circimaging.122.014658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Italy (G.M.).,Department of Laboratory Medicine (G.M.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy
| | - Valerio Romano
- Fetal and Pediatric Cardiology Unit (V.R., R.R., L.O., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy.,Neonatology and Neonatal Intensive Care Unit (V.R., R.R., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy
| | - Riccardo Riccardi
- Fetal and Pediatric Cardiology Unit (V.R., R.R., L.O., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy.,Neonatology and Neonatal Intensive Care Unit (V.R., R.R., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy
| | - Luigi Orfeo
- Fetal and Pediatric Cardiology Unit (V.R., R.R., L.O., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy
| | - Gerardo Piacentini
- Fetal and Pediatric Cardiology Unit (V.R., R.R., L.O., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy.,Neonatology and Neonatal Intensive Care Unit (V.R., R.R., G.P.), Fatebenefratelli Isola Tiberina, Gemelli Isola Hospital, Rome, Italy
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11
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Mastromoro G, Guadagnolo D, Khaleghi Hashemian N, Bernardini L, Giancotti A, Piacentini G, De Luca A, Pizzuti A. A Pain in the Neck: Lessons Learnt from Genetic Testing in Fetuses Detected with Nuchal Fluid Collections, Increased Nuchal Translucency versus Cystic Hygroma-Systematic Review of the Literature, Meta-Analysis and Case Series. Diagnostics (Basel) 2022; 13:diagnostics13010048. [PMID: 36611340 PMCID: PMC9818917 DOI: 10.3390/diagnostics13010048] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Fetal Nuchal fluid collections can manifest with two distinct presentations attributable to the same phenotypic spectrum: increased nuchal translucency (iNT) and cystic hygroma. The prenatal detection of these findings should prompt an accurate assessment through genetic counseling and testing, including karyotype, chromosomal microarray analysis (CMA) and multigene RASopathy panel. We performed a systematic review of the literature and meta-analysis, to calculate diagnostic yields of genetic testing in fetuses with iNT and cystic hygroma. We compared the results with a cohort of 96 fetuses with these isolated findings. Fetuses with isolated NT ≥ 2.5 mm showed karyotype anomalies in 22.76% of cases and CMA presented an incremental detection rate of 2.35%. Fetuses with isolated NT ≥ 3 mm presented aneuploidies in 14.36% of cases and CMA had an incremental detection rate of 3.89%. When the isolated NT measured at least 3.5 mm the diagnostic yield of karyotyping was 34.35%, the incremental CMA detection rate was 4.1%, the incremental diagnostic rate of the RASopathy panel was 1.44% and it was 2.44% for exome sequencing. Interestingly, CMA presents a considerable diagnostic yield in the group of fetuses with NT ≥ 3.5 mm. Similarly, exome sequencing appears to show promising results and could be considered after a negative CMA result.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Department of Laboratory Medicine, Fatebenefratelli Isola Tiberina–Gemelli Isola, 00186 Rome, Italy
- Correspondence: or
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Laura Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, 71013 Foggia, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Gerardo Piacentini
- Department of Neonatology and Fetal Cardiology, Fatebenefratelli Isola Tiberina–Gemelli Isola, 00186 Rome, Italy
| | - Alessandro De Luca
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
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12
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Putotto C, Unolt M, Lambiase C, Marchetti F, Anaclerio S, Favoriti A, Tancredi G, Mastromoro G, Pugnaloni F, Liberati N, De Luca E, Tarani L, De Canditiis D, Caputo V, Bernardini L, Digilio MC, Marino B, Versacci P. Cardiac function in adolescents and young adults with 22q11.2 deletion syndrome without congenital heart disease. Eur J Med Genet 2022; 66:104651. [PMID: 36404488 DOI: 10.1016/j.ejmg.2022.104651] [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: 03/19/2021] [Revised: 09/28/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Diagnosis and treatment of 22q11.2 deletion syndrome (22q11.2DS) have led to improved life expectancy and achievement of adulthood. Limited data on long-term outcomes reported an increased risk of premature death for cardiovascular causes, even without congenital heart disease (CHD). The aim of this study was to assess the cardiac function in adolescents and young adults with 22q11.2DS without CHDs. METHODS A total of 32 patients (20M, 12F; mean age 26.00 ± 8.08 years) and a healthy control group underwent transthoracic echocardiography, including Tissue Doppler Imaging (TDI) and 2-dimensional Speckle Tracking Echocardiography (2D-STE). RESULTS Compared to controls, 22q11.2DS patients showed a significant increase of the left ventricle (LV) diastolic and systolic diameters (p = 0.029 and p = 0.035 respectively), interventricular septum thickness (p = 0.005), LV mass index (p < 0.001) and aortic root size (p < 0.001). 2D-STE analysis revealed a significant reduction of LV global longitudinal strain (p < 0.001) in 22q11.2DS than controls. Moreover, several LV diastolic parameters were significantly different between groups. CONCLUSIONS Our results suggest that an echocardiographic follow-up in 22q11.2DS patients without CHDs can help to identify subclinical impairment of the LV and evaluate a potential progression of aortic root dilation over time, improving outcomes, reducing long-term complications and allowing for a better prognosis.
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Affiliation(s)
- Carolina Putotto
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Marta Unolt
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy; Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Caterina Lambiase
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Flaminia Marchetti
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Silvia Anaclerio
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Alessandra Favoriti
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Giancarlo Tancredi
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, "Sapienza" University of Rome, Italy
| | - Flaminia Pugnaloni
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Natascia Liberati
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Enrica De Luca
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Luigi Tarani
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | | | - Viviana Caputo
- Department of Experimental Medicine, "Sapienza" University of Rome, Italy
| | - Laura Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Foggia, Italy
| | - Maria Cristina Digilio
- Rare Diseases and Medical Genetics, Department of Pediatrics, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Bruno Marino
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy
| | - Paolo Versacci
- Department of Maternal Infantile and Urological Sciences, "Sapienza" University of Rome, Italy.
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13
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Mastromoro G, Calcagni G, Vignaroli W, Anaclerio S, Pugnaloni F, Rinelli G, Secinaro A, Bordonaro V, Putotto C, Unolt M, Digilio MC, Marino B, Versacci P. Crossed pulmonary arteries: An underestimated cardiovascular variant with a strong association with genetic syndromes-A report of 74 cases with systematic review of the literature. Am J Med Genet A 2022; 188:2351-2359. [PMID: 35491976 DOI: 10.1002/ajmg.a.62763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 01/30/2021] [Revised: 03/29/2022] [Accepted: 04/09/2022] [Indexed: 11/08/2022]
Abstract
Crossed pulmonary arteries (CPAs) represent an uncommon anatomic variant, usually associated with some specific syndromes and conotruncal defects. This finding has been described in 22q11.2 Deletion Syndrome (22q11.2DS). We evaluated the correlation between CPAs and genetic diseases, in order to better define the characteristics of this variant, considered a rare anatomic pattern. An in-depth analysis of CPAs genotype-phenotype correlations was performed via a literature review. We detected 74 CPAs patients through echocardiography. Of these 74 patients, 35.1% of patients showed additional intracardiac malformations, while 29.7% showed extracardiac vascular anomalies, of which 16.2% were associated with intracardiac defects and 13.5% were not. In all, 62.2% of patients were diagnosed with genetic diseases and 52.2% of them were 22q11.2DS patients. In conclusions, CPAs represent a cardiovascular variant, which is detectable in nonsyndromic individuals, but especially in various genetic syndromes and in particular in 22q11.2DS patients. Data on the real prevalence of this morphology is lacking in literature. Knowledge of this anatomic variant is useful to interpret the unusual course of the pulmonary branches and is helpful information before cardiovascular surgical correction. Moreover, due to the strong association of CPAs with some genetic syndromes, the identification of this anatomic pattern can indicate the utility of a genetic assessment of these patients.
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Affiliation(s)
- Gioia Mastromoro
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Giulio Calcagni
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Walter Vignaroli
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Anaclerio
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Flaminia Pugnaloni
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Gabriele Rinelli
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Aurelio Secinaro
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Veronica Bordonaro
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Carolina Putotto
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Marta Unolt
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Maria Cristina Digilio
- Rare Diseases and Medical Genetics, Department of Pediatrics, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Bruno Marino
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Versacci
- Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
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14
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Germani A, Guadagnolo D, Salvati V, Micolonghi C, Mancini R, Mastromoro G, Sadeghi S, Petrucci S, Pizzuti A, Piane M. Genomic Breakpoints’ Characterization of a Large CHEK2 Duplication in an Italian Family with Hereditary Breast Cancer. Diagnostics (Basel) 2022; 12:diagnostics12071520. [PMID: 35885426 PMCID: PMC9319214 DOI: 10.3390/diagnostics12071520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/19/2022] [Indexed: 11/29/2022] Open
Abstract
CHEK2 (checkpoint kinase 2; MIM# 604373) is a tumor suppressor gene that encodes a serine threonine kinase involved in pathways such as DNA repair, cell cycle arrest, mitosis, and apoptosis. Pathogenic variants in CHEK2 contribute to a moderately increased risk of breast and other cancers. Several variant classes have been reported, either point mutations or large intragenic rearrangements. However, a significant portion of reported variants has an uncertain clinical significance. We report an intragenic CHEK2 duplication, ranging from intron 5 to intron 13, identified in an Italian family with hereditary breast cancer. Using long range PCR, with duplication-specific primers, we were able to ascertain the genomic breakpoint. We also performed a real-time PCR to assess a possible loss-of-function effect. The genomic characterization of large intragenic rearrangements in cancer susceptibility genes is important for the clinical management of the carriers and for a better classification of rare variants. The molecular definition of breakpoints allows for the prediction of the impact of the variant on transcripts and proteins, aiding in its characterization and clinical classification.
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Affiliation(s)
- Aldo Germani
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
- Correspondence:
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, 00128 Rome, RM, Italy;
| | - Caterina Micolonghi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Soha Sadeghi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
| | - Simona Petrucci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (C.M.); (G.M.); (S.S.); (A.P.)
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy
| | - Maria Piane
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, RM, Italy; (A.G.); (R.M.); (S.P.); (M.P.)
- S. Andrea University Hospital, 00189 Rome, RM, Italy
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15
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Mastromoro G, Khaleghi Hashemian N, Guadagnolo D, Giuffrida MG, Torres B, Bernardini L, Ventriglia F, Piacentini G, Pizzuti A. Chromosomal Microarray Analysis in Fetuses Detected with Isolated Cardiovascular Malformation: A Multicenter Study, Systematic Review of the Literature and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12061328. [PMID: 35741137 PMCID: PMC9221891 DOI: 10.3390/diagnostics12061328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022] Open
Abstract
Cardiovascular malformations (CVM) represent the most common structural anomalies, occurring in 0.7% of live births. The CVM prenatal suspicion should prompt an accurate investigation with fetal echocardiography and the assessment through genetic counseling and testing. In particular, chromosomal microarray analysis (CMA) allows the identification of copy number variations. We performed a systematic review and meta-analysis of the literature, studying the incremental diagnostic yield of CMA in fetal isolated CVM, scoring yields for each category of heart disease, with the aim of guiding genetic counseling and prenatal management. At the same time, we report 59 fetuses with isolated CVM with normal karyotype who underwent CMA. The incremental CMA diagnostic yield in fetuses with isolated CVM was 5.79% (CI 5.54–6.04), with conotruncal malformations showing the higher detection rate (15.93%). The yields for ventricular septal defects and aberrant right subclavian artery were the lowest (2.64% and 0.66%). Other CVM ranged from 4.42% to 6.67%. In the retrospective cohort, the diagnostic yield was consistent with literature data, with an overall CMA diagnostic yield of 3.38%. CMA in the prenatal setting was confirmed as a valuable tool for investigating the causes of fetal cardiovascular malformations.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
- Correspondence:
| | - Nader Khaleghi Hashemian
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
| | - Maria Grazia Giuffrida
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Barbara Torres
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Laura Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Flavia Ventriglia
- Department of Pediatrics, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy;
- Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Gerardo Piacentini
- Fetal and Pediatric Cardiology Unit, “San Giovanni Calibita” Fatebenefratelli Isola Tiberina Hospital, 00186 Rome, Italy;
- Neonatology and Neonatal Intensive Care Unit, “San Giovanni Calibita” Fatebenefratelli Isola Tiberina Hospital, 00186 Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
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16
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Mastromoro G, Guadagnolo D, Khaleghi Hashemian N, Marchionni E, Traversa A, Pizzuti A. Molecular Approaches in Fetal Malformations, Dynamic Anomalies and Soft Markers: Diagnostic Rates and Challenges-Systematic Review of the Literature and Meta-Analysis. Diagnostics (Basel) 2022; 12:575. [PMID: 35328129 PMCID: PMC8947110 DOI: 10.3390/diagnostics12030575] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/18/2022] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
Fetal malformations occur in 2-3% of pregnancies. They require invasive procedures for cytogenetics and molecular testing. "Structural anomalies" include non-transient anatomic alterations. "Soft markers" are often transient minor ultrasound findings. Anomalies not fitting these definitions are categorized as "dynamic". This meta-analysis aims to evaluate the diagnostic yield and the rates of variants of uncertain significance (VUSs) in fetuses undergoing molecular testing (chromosomal microarray (CMA), exome sequencing (ES), genome sequencing (WGS)) due to ultrasound findings. The CMA diagnostic yield was 2.15% in single soft markers (vs. 0.79% baseline risk), 3.44% in multiple soft markers, 3.66% in single structural anomalies and 8.57% in multiple structural anomalies. Rates for specific subcategories vary significantly. ES showed a diagnostic rate of 19.47%, reaching 27.47% in multiple structural anomalies. WGS data did not allow meta-analysis. In fetal structural anomalies, CMA is a first-tier test, but should be integrated with karyotype and parental segregations. In this class of fetuses, ES presents a very high incremental yield, with a significant VUSs burden, so we encourage its use in selected cases. Soft markers present heterogeneous CMA results from each other, some of them with risks comparable to structural anomalies, and would benefit from molecular analysis. The diagnostic rate of multiple soft markers poses a solid indication to CMA.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (N.K.H.); (E.M.); (A.T.); (A.P.)
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17
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Piacentini G, Mastromoro G, Romano V, Riccardi R, Orfeo L. Fetal echocardiographic features of absent pulmonary valve syndrome. Am J Obstet Gynecol 2022; 227:331-332. [PMID: 35216967 DOI: 10.1016/j.ajog.2022.02.023] [Citation(s) in RCA: 1] [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: 11/10/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Gerardo Piacentini
- Fetal and Pediatric Cardiology Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy; Neonatology and Neonatal Intensive Care Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy.
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Valerio Romano
- Fetal and Pediatric Cardiology Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy; Neonatology and Neonatal Intensive Care Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
| | - Riccardo Riccardi
- Fetal and Pediatric Cardiology Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy; Neonatology and Neonatal Intensive Care Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
| | - Luigi Orfeo
- Neonatology and Neonatal Intensive Care Unit, "San Giovanni Calibita" Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
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18
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Perilli L, Mastromoro G, Murciano M, Amedeo I, Avenoso F, Pizzuti A, Guido CA, Spalice A. Myoclonic Epilepsy: Case Report of a Mild Phenotype in a Pediatric Patient Expanding Clinical Spectrum of KCNA2 Pathogenic Variants. Front Neurol 2022; 12:806516. [PMID: 35178022 PMCID: PMC8844549 DOI: 10.3389/fneur.2021.806516] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/31/2021] [Indexed: 11/24/2022] Open
Abstract
We report on the rare case of a male toddler presenting with myoclonic epilepsy characterized by daily episodes of upward movements of the eyebrows, and myoclonic jerks of both head and upper limbs. In addition, the child showed speech delay, tremors, and lack of motor coordination. Next Generation Sequencing analysis (NGS) performed in trio revealed in the proband the c.889C>T de novo missense variant in the KCNA2 gene in heterozygous state. This is the first case of myoclonic epilepsy in a toddler due to a c.889C>T KCNA2 missense variant. The patient was treated with valproic acid and ethosuximide with a good clinical response. At 6 years old, follow-up revealed that the proband was seizure-free with tremors and clumsiness in movements. According to the literature, this case supports the correlation between myoclonic epilepsy and KCNA2 alterations. This evidence suggests that performing genomic testing including the KCNA2 gene in preschool patients affected by myoclonic epilepsy, especially when associated with delayed neurodevelopment. Our goal is to expand the phenotypical spectrum of this rare condition and adding clinical features following a genotype-first approach.
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Affiliation(s)
- Lorenzo Perilli
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Gioia Mastromoro
- Faculty of Medicine and Dentistry, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Manuel Murciano
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy.,Department of Emergency Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ilaria Amedeo
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Federica Avenoso
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Faculty of Medicine and Dentistry, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Cristiana Alessia Guido
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alberto Spalice
- Department of Mother and Child and Urological Sciences, Sapienza University of Rome, Rome, Italy
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19
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Piacentini G, Mastromoro G, Bottoni A, Romano V, Riccardi R, Orfeo L. Pathophysiology of coarctation of the aorta in dichorionic twins with growth discordance. Ultrasound Obstet Gynecol 2022; 59:124-125. [PMID: 34159669 DOI: 10.1002/uog.23717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Affiliation(s)
- G Piacentini
- Fetal and Pediatric Cardiology Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
- Neonatology and Neonatal Intensive Care Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
| | - G Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Bottoni
- Division of Neonatology, Department of Woman and Child Health, Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - V Romano
- Fetal and Pediatric Cardiology Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
- Neonatology and Neonatal Intensive Care Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
| | - R Riccardi
- Fetal and Pediatric Cardiology Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
- Neonatology and Neonatal Intensive Care Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
| | - L Orfeo
- Neonatology and Neonatal Intensive Care Unit, 'San Giovanni Calibita' Fatebenefratelli Isola Tiberina Hospital, Rome, Italy
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20
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Mastromoro G, De Luca A, Marchionni E, Spagnuolo A, Ventriglia F, Manganaro L, Pizzuti A. External hydrocephalus as a prenatal feature of noonan syndrome. Ann Hum Genet 2021; 85:249-252. [PMID: 34075583 DOI: 10.1111/ahg.12436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/30/2021] [Revised: 03/28/2021] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
Brain malformations have been reported in RASopathies, including postnatal external hydrocephalus, a nonobstructive form of cerebrospinal fluid accumulation around the brain. It was described in a few patients with mutations of other genes than PTPN11, such as SOS1 and SHOC2 and never in prenatal diagnosis. The aim of this case report is to describe the prenatal presentation of a fetus with Noonan syndrome (NS) and external hydrocephalus. We report on a Noonan syndrome fetus with a de novo pathogenic PTPN11 c.923A>G p.Asn308Ser mutation, showing external hydrocephalus, an extremely rare fetal finding, corpus callosum, and cerebellar vermis under the 10th centile, plus a typical NS cardiopathy. This is the first case of Noonan syndrome prenatal diagnosis in a fetus presenting with external hydrocephalus. Following pathophysiological considerations, we suggest to consider NS in the differential diagnosis of external hydrocephalus, investigating other evocative findings and considering molecular screening for mutations in NS-related genes.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Alessandro De Luca
- Ospedale Casa Sollievo della Sofferenza, Mendel Institute, San Giovanni Rotondo, Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | | | - Flavia Ventriglia
- Department of Pediatrics, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Lucia Manganaro
- Department of Radiological Science, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy.,Ospedale Casa Sollievo della Sofferenza, Mendel Institute, San Giovanni Rotondo, Italy
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21
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Scott A, Di Giosaffatte N, Pinna V, Daniele P, Corno S, D'Ambrosio V, Andreucci E, Marozza A, Sirchia F, Tortora G, Mangiameli D, Di Marco C, Romagnoli M, Donati I, Zonta A, Grosso E, Naretto VG, Mastromoro G, Versacci P, Pantaleoni F, Radio FC, Mazza T, Damante G, Papi L, Mattina T, Giancotti A, Pizzuti A, Laberge AM, Tartaglia M, Delrue MA, De Luca A. When to test fetuses for RASopathies? Proposition from a systematic analysis of 352 multicenter cases and a postnatal cohort. Genet Med 2021; 23:1116-1124. [PMID: 33568805 DOI: 10.1038/s41436-020-01093-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Recent studies have identified suggestive prenatal features of RASopathies (e.g., increased nuchal translucency [NT], cystic hygroma [CH], hydrops, effusions, congenital heart diseases [CHD], polyhydramnios, renal anomalies). Our objective is to clarify indications for RASopathy prenatal testing. We compare genotype distributions between pre- and postnatal populations and propose genotype-phenotype correlations. METHODS Three hundred fifty-two chromosomal microarray-negative cases sent for prenatal RASopathy testing between 2012 and 2019 were collected. For most, 11 RASopathy genes were tested. Postnatal cohorts (25 patients with available prenatal information and 108 institutional database genotypes) and the NSeuroNet database were used for genotypic comparisons. RESULTS The overall diagnostic yield was 14% (50/352), with rates >20% for effusions, hydrops, and CHD. Diagnostic yield was significantly improved in presence of hypertrophic cardiomyopathy (HCM), persistent or associated CH, any suggestive finding combined with renal anomaly or polyhydramnios, or ≥2 ultrasound findings. Largest prenatal contributors of pathogenic variants were PTPN11 (30%), RIT1 (16%), RAF1 (14%), and HRAS (12%), which considerably differ from their prevalence in postnatal populations. HRAS, LZTR1, and RAF1 variants correlated with hydrops/effusions, and RIT1 with prenatal onset HCM. CONCLUSION After normal chromosomal microarray, RASopathies should be considered when any ultrasound finding of lymphatic dysplasia or suggestive CHD is found alone or in association.
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Affiliation(s)
- Alexandra Scott
- Pediatrics Department, Medical Genetics Division, CHU Sainte-Justine, Montreal, QC, Canada.
| | - Niccolò Di Giosaffatte
- Medical Genetics Unit, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Valentina Pinna
- Medical Genetics Unit, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Paola Daniele
- Medical Genetics Unit, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Sara Corno
- Department of Maternal and Child Health and Urologic Science, "Sapienza" University, Policlinico Umberto I Hospital, Rome, Italy
| | - Valentina D'Ambrosio
- Department of Maternal and Child Health and Urologic Science, "Sapienza" University, Policlinico Umberto I Hospital, Rome, Italy
| | - Elena Andreucci
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Annabella Marozza
- Section of Medical Genetics, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Fabio Sirchia
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giada Tortora
- Genetics and Rare Diseases Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Daniela Mangiameli
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, Catania, Italy
| | | | - Maria Romagnoli
- Ambulatory of Medical Genetic, Azienda Usl Toscana Centro, Florence, Italy
| | | | - Andrea Zonta
- Medical Genetics Unit, Città Della Salute e Della Scienza University Hospital, Torino, Italy
| | - Enrico Grosso
- Medical Genetics Unit, Città Della Salute e Della Scienza University Hospital, Torino, Italy
| | - Valeria Giorgia Naretto
- Medical Genetics Unit, Città Della Salute e Della Scienza University Hospital, Torino, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - Paolo Versacci
- Department of Pediatrics, Università Sapienza, Rome, Italy
| | - Francesca Pantaleoni
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | | | - Tommaso Mazza
- Laboratory of Bioinformatics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Laura Papi
- Section of Medical Genetics, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, Catania, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urologic Science, "Sapienza" University, Policlinico Umberto I Hospital, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - Anne-Marie Laberge
- Pediatrics Department, Medical Genetics Division, CHU Sainte-Justine, Montreal, QC, Canada
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.
| | - Marie-Ange Delrue
- Pediatrics Department, Medical Genetics Division, CHU Sainte-Justine, Montreal, QC, Canada
| | - Alessandro De Luca
- Medical Genetics Unit, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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22
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Marchionni E, Agolini E, Mastromoro G, Guadagnolo D, Coppola G, Roggini M, Riminucci M, Novelli A, Giancotti A, Corsi A, Pizzuti A. Fetal early motor neuron disruption and prenatal molecular diagnosis in a severe BICD2-opathy. Am J Med Genet A 2021; 185:1509-1514. [PMID: 33547725 DOI: 10.1002/ajmg.a.62111] [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] [Received: 08/09/2020] [Revised: 01/09/2021] [Accepted: 01/22/2021] [Indexed: 12/15/2022]
Abstract
BICD2 (BICD Cargo Adaptor 2, MIM*609797) mutations are associated with severe prenatal-onset forms of spinal muscular atrophy, lower extremity-predominant 2B (SMALED2B MIM 618291) or milder forms with childhood-onset (SMALED2A MIM 615290). Etiopathogenesis is not fully clarified and a wide spectrum of phenotypic presentations is reported, ranging from extreme prenatal forms with adverse outcome, to slow progressive late-onset forms. We report a fetus at 22 gestational weeks with evidence of Arthrogryposis Multiplex Congenita on ultrasound, presenting with fixed extended lower limbs and flexed upper limbs, bilateral clubfoot and absent fetal movements. A trio-based prenatal Exome Sequencing was performed, disclosing a de novo heterozygous pathogenic in frame deletion (NM_015250.3: c.1636_1638delAAT; p.Asn546del) in BICD2. After pregnancy termination, quantitative analysis on NeuN immunostained spinal cord sections of the ventral horns, revealed that neuronal density was markedly reduced compared to the one of an age-matched normal fetus and an age-matched type-I Spinal Muscular Atrophy sample, used as a comparative model. The present case, the first prenatally diagnosed and neuropathologically characterized, showed an early motor neuron loss in SMALED2B, providing further insight into the pathological basis of BICD2-opathies.
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Affiliation(s)
- Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Emanuele Agolini
- Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Coppola
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Mario Roggini
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Mara Riminucci
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urologic Science, Sapienza University of Rome, Rome, Italy
| | - Alessandro Corsi
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Clinical Genomics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
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23
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Guadagnolo D, Mastromoro G, Di Palma F, Pizzuti A, Marchionni E. Prenatal Exome Sequencing: Background, Current Practice and Future Perspectives-A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11020224. [PMID: 33540854 PMCID: PMC7913004 DOI: 10.3390/diagnostics11020224] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/31/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/16/2022] Open
Abstract
The introduction of Next Generation Sequencing (NGS) technologies has exerted a significant impact on prenatal diagnosis. Prenatal Exome Sequencing (pES) is performed with increasing frequency in fetuses with structural anomalies and negative chromosomal analysis. The actual diagnostic value varies extensively, and the role of incidental/secondary or inconclusive findings and negative results has not been fully ascertained. We performed a systematic literature review to evaluate the diagnostic yield, as well as inconclusive and negative-result rates of pES. Papers were divided in two groups. The former includes fetuses presenting structural anomalies, regardless the involved organ; the latter focuses on specific class anomalies. Available findings on non-informative or negative results were gathered as well. In the first group, the weighted average diagnostic yield resulted 19%, and inconclusive finding rate 12%. In the second group, the percentages were extremely variable due to differences in sample sizes and inclusion criteria, which constitute major determinants of pES efficiency. Diagnostic pES availability and its application have a pivotal role in prenatal diagnosis, though more homogeneity in access criteria and a consensus on clinical management of controversial information management is envisageable to reach widespread use in the near future.
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Affiliation(s)
- Daniele Guadagnolo
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (G.M.); (F.D.P.); (A.P.)
| | - Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (G.M.); (F.D.P.); (A.P.)
| | - Francesca Di Palma
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (G.M.); (F.D.P.); (A.P.)
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (G.M.); (F.D.P.); (A.P.)
- Clinical Genomics Unit, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo (FG), Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (D.G.); (G.M.); (F.D.P.); (A.P.)
- Correspondence:
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24
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Mastromoro G, Guida V, Cellitti R, Cardilli V, De Luca A, Pizzuti A, Versacci P. Neonatal Marfan Syndrome by Inherited Mutation. Indian J Pediatr 2021; 88:176-177. [PMID: 32557139 DOI: 10.1007/s12098-020-03411-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/17/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Valentina Guida
- Molecular Genetics Unit, IRCCS, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Raffaella Cellitti
- Department of Pediatrics, Obstetrics and Gynecology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Viviana Cardilli
- Department of Pediatrics, Obstetrics and Gynecology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Alessandro De Luca
- Molecular Genetics Unit, IRCCS, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.,Clinical Genomics Unit, IRCCS, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Paolo Versacci
- Department of Pediatrics, Obstetrics and Gynecology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
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25
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Mastromoro G, Guadagnolo D, Giancotti A, Di Gregorio MG, Marchionni E, Vena F, Lepri FR, Bargiacchi L, Ventriglia F, Di Gioia C, Novelli A, Pizzuti A. Recurrent prenatal PIEZO1-related lymphatic dysplasia: Expanding molecular and ultrasound findings. Eur J Med Genet 2020; 64:104106. [PMID: 33227434 DOI: 10.1016/j.ejmg.2020.104106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/29/2020] [Revised: 09/24/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
Generalized lymphatic dysplasia (GLD), characterized by lymphedema, lymphangiectasias, chylothorax, effusions, represents a recognized cause of fetal hydrops. We describe for the first time recurrent pregnancies showing different ultrasound presentations of lymphatic dysplasia. The first fetus displayed diffuse subcutaneous cysts and septations while the second one presented fetal hydrops. Exome sequencing results at 18 gestational weeks in the second pregnancy showed compound heterozygosity for two novel PIEZO1 variants, afterwards detected also in the first fetus and in the heterozygous parents. Both ultrasound and genetic findings expand the current knowledge of PIEZO1-related GLD. We suggest exome sequencing in hydropic fetuses with normal cytogenetics and in pregnancies with recurrent hydrops/lymphatic dysplasia.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy.
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urologic Science, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | | | - Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Flaminia Vena
- Department of Maternal and Child Health and Urologic Science, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | | | - Lavinia Bargiacchi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Flavia Ventriglia
- Department of Pediatrics, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Cira Di Gioia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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26
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Mastromoro G, Guadagnolo D, Marchionni E, Di Palma F, Gigante L, Versacci P, Ventriglia F, Baldi M, Pizzuti A. Incidental SOS1 variant identified by non-invasive prenatal screening: Prenatal diagnosis and family clinical reassessment. Eur J Obstet Gynecol Reprod Biol 2020; 256:518-520. [PMID: 33234345 DOI: 10.1016/j.ejogrb.2020.11.003] [Citation(s) in RCA: 1] [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: 10/05/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy.
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Francesca Di Palma
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Laura Gigante
- GENOMA Group, Molecular Genetics Laboratories, Rome, Italy
| | - Paolo Versacci
- Department of Pediatrics, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Flavia Ventriglia
- Department of Pediatrics, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Marina Baldi
- GENOMA Group, Molecular Genetics Laboratories, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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Mastromoro G, Pizzuti A, Ventriglia F. Role of ductus venosus agenesis in right ventricle development. J Matern Fetal Neonatal Med 2020; 35:3110-3113. [PMID: 32842801 DOI: 10.1080/14767058.2020.1810231] [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] [Indexed: 10/23/2022]
Abstract
Ductus venosus agenesis (DVA) results from portal-umbilical and hepatic-systemic venous system connection failure. Despite a large series of DVA was reported, an accurate description of single fetus cardiac trend with hemodynamic consequences is missing. We describe two fetuses with DVA early detection, comparing right ventricle (RV) development in extrahepatic and intrahepatic drainages. In extrahepatic drainage, the RV was larger and slightly hypertrophic. In intrahepatic drainage, the RV showed reduced dimensions. Ventricle dimension differences decreased and became balanced in perinatal period. Detection of non-balanced ventricles in early second trimester should lead to sonographic follow-up. If DVA is hypothesized, it is important to identify other subdiaphragmatic connections that could alter cardiac preload and ventricle development.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Flavia Ventriglia
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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Giuffrida MG, Mastromoro G, Guida V, Truglio M, Fabbretti M, Torres B, Mazza T, De Luca A, Roggini M, Bernardini L, Pizzuti A. A new case of SMABF2 diagnosed in stillbirth expands the prenatal presentation and mutational spectrum of ASCC1. Am J Med Genet A 2019; 182:508-512. [PMID: 31880396 DOI: 10.1002/ajmg.a.61431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/15/2019] [Revised: 10/30/2019] [Accepted: 11/02/2019] [Indexed: 12/24/2022]
Abstract
Spinal muscular atrophy with congenital bone fractures 2 (SMABF2) is a rare autosomal recessive neuromuscular disorder characterized by arthrogryposis multiplex congenita and prenatal fractures of the long bones, with poor prognosis. The most affected patients present with biallelic loss-of-function nucleotide variants in ASCC1 gene, coding a subunit of the transcriptional coactivator ASC-1 complex, although the exact pathogenesis is yet unknown. This work describes the first case of SMABF2 in a stillbirth with documented evolution of the disease in the prenatal period. A microdeletion copy number variant (CNV) of about 64 Kb, involving four exons of ASCC1, was firstly detected by microarray analysis, requested for arthrogryposis and hydrops. Subsequent exome analysis disclosed a nucleotide variant of the same gene [c.1027C>T; (p. Arg343*)], resulting in the introduction of a premature termination codon. This stillbirth represents the first case of ASCC1 compound heterozygosity, due to an exonic microdeletion and a nucleotide variant, expanding the mutational spectrum of this gene. It also provides further evidence that exonic CNVs are an underestimated cause of disease-alleles and that the integrated use of the last generation genetic analysis tools, together with careful clinical evaluations, are fundamental for the characterization of rare diseases even in the prenatal setting.
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Affiliation(s)
- Maria G Giuffrida
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, Sapienza University, Policlinico Umberto I Hospital, Rome, Italy
| | - Valentina Guida
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Mauro Truglio
- Bioinformatics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Maria Fabbretti
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Barbara Torres
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Alessandro De Luca
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Mario Roggini
- Pediatrics and Child Neuropsychiatry Department, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Laura Bernardini
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy
| | - Antonio Pizzuti
- Medical Genetics Unit, Casa Sollievo della Sofferenza IRCCS Foundation, San Giovanni Rotondo, Italy.,Department of Experimental Medicine, Sapienza University, Policlinico Umberto I Hospital, Rome, Italy
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Mastromoro G, Gambardella S, Marchionni E, Campopiano R, Traversa A, Di Bonaventura C, Pizzuti A. Unusual Segregation of APP Mutations in Monogenic Alzheimer Disease. NEURODEGENER DIS 2019; 19:96-100. [PMID: 31578030 DOI: 10.1159/000502906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/29/2019] [Accepted: 08/24/2019] [Indexed: 11/19/2022] Open
Abstract
APP gene mutations causing Alzheimer disease (AD) segregate in an autosomal dominant pattern. We report on a 40-year-old woman with a severe cognitive decline starting at 36 years, while her affected relatives presented symptoms onset in the 6th decade. The proband carried an APP missense variant in homozygous state (NM_000484.4: c.2032G>A; NP_000475.1: p.Asp678Asn; rs63750064) and showed a more severe clinical picture than the other AD relatives, as regards the age of onset and the rate of disease progression. This mutation behaves as a semi-dominant trait. The very rare chance of studying APP mutations in the homozygous state demonstrates they are not always dominant and other segregation models are possible.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy,
| | | | - Enrica Marchionni
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Alice Traversa
- Fondazione IRCCS Casa Sollievo della Sofferenza, Laboratory of Clinical Genomics, San Giovanni Rotondo, Italy
| | - Carlo Di Bonaventura
- Neurology Unit, Department of Neurosciences, Mental Health, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy.,Fondazione IRCCS Casa Sollievo della Sofferenza, Laboratory of Clinical Genomics, San Giovanni Rotondo, Italy
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Mastromoro G, Capalbo A, Guido CA, Torres B, Fabbretti M, Traversa A, Giancotti A, Ventriglia F, Bernardini L, Spalice A, Pizzuti A. Small 7p22.3 microdeletion: Case report of Snx8 haploinsufficiency and neurological findings. Eur J Med Genet 2019; 63:103772. [PMID: 31568860 DOI: 10.1016/j.ejmg.2019.103772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 03/05/2019] [Revised: 09/05/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Abstract
Some cases of chromosome 7p22.3 deletions have been reported, but the genotype-phenotype correlation is still uncertain. Neurodevelopmental delay and heart anomalies have been recorded as the most recurrent defects. We describe the clinical features of a four-year-old male child with a 139 kb deletion at 7p22.3 involving SNX8 gene, inherited from a mosaic mother. The same deletion is also present in the fetus on the ongoing third pregnancy of the couple with normal fetal ultrasound assessment. The proband was prenatally diagnosed with left kidney agenesis. He does not show any congenital heart disease, but mild intellectual disability, learning and language delay, and severe behavioral problems related to the hyperactive-impulsive and inattentive area. These clinical features are also evident in other 7p22 deletions cases involving the SNX8 gene, supporting the role of this gene in neurodevelopment. Conversely, the revision of all published cases with small 7p22 deletions and the absence of heart malformations in the present family confirm that this region is involved in heart development, anyway did not confirm the role of SNX8 in cardiac phenotypes, either due to the reduced penetrance or the involvement of other candidate genes.
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Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Anna Capalbo
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Cristiana Alessia Guido
- Department of Pediatrics, Division of Child Neurology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Barbara Torres
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Maria Fabbretti
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Alice Traversa
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Antonella Giancotti
- Department of Obstetrics, Gynecology and Urologic Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Flavia Ventriglia
- Department of Pediatrics, Pediatric Cardiology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Laura Bernardini
- Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - Alberto Spalice
- Department of Pediatrics, Division of Child Neurology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy; Medical Genetics Unit, IRCCS Mendel Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy.
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31
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Motta M, Giancotti A, Mastromoro G, Chandramouli B, Pinna V, Pantaleoni F, Di Giosaffatte N, Petrini S, Mazza T, D'Ambrosio V, Versacci P, Ventriglia F, Chillemi G, Pizzuti A, Tartaglia M, De Luca A. Clinical and functional characterization of a novel RASopathy-causing SHOC2 mutation associated with prenatal-onset hypertrophic cardiomyopathy. Hum Mutat 2019; 40:1046-1056. [PMID: 31059601 DOI: 10.1002/humu.23767] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/26/2019] [Accepted: 04/17/2019] [Indexed: 12/17/2022]
Abstract
SHOC2 is a scaffold protein mediating RAS-promoted activation of mitogen-activated protein kinase (MAPK) signaling in response to extracellular stimuli. A recurrent activating mutation in SHOC2 (p.Ser2Gly) causes Mazzanti syndrome, a RASopathy characterized by features resembling Noonan syndrome and distinctive ectodermal abnormalities. A second mutation (p.Met173Ile) supposed to cause loss-of-function was more recently identified in two individuals with milder phenotypes. Here, we report on the third RASopathy-causing SHOC2 mutation (c.807_808delinsTT, p.Gln269_His270delinsHisTyr), which was found associated with prenatal-onset hypertrophic cardiomyopathy. Structural analyses indicated a possible impact of the mutation on the relative orientation of the two SHOC2's leucine-rich repeat domains. Functional studies provided evidence of its activating role, revealing enhanced binding of the mutant protein to MRAS and PPP1CB, and increased signaling through the MAPK cascade. Differing from SHOC2 S2G , SHOC2 Q269_H270delinsHY is not constitutively targeted to the plasma membrane. These data document that diverse mechanisms in SHOC2 functional dysregulation converge toward MAPK signaling upregulation.
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Affiliation(s)
- Marialetizia Motta
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urologic Science, Policlinico Umberto I Hospital, "Sapienza" University, Rome, Italy
| | - Gioia Mastromoro
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | | | - Valentina Pinna
- Molecular Genetics Unit, Fondazione Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy
| | - Francesca Pantaleoni
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Niccolò Di Giosaffatte
- Molecular Genetics Unit, Fondazione Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy
| | - Stefania Petrini
- Confocal Microscopy Core Facility, Research Laboratories, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, Fondazione Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy
| | - Valentina D'Ambrosio
- Department of Maternal and Child Health and Urologic Science, Policlinico Umberto I Hospital, "Sapienza" University, Rome, Italy
| | - Paolo Versacci
- Department of Pediatrics, Università Sapienza, Rome, Italy
| | | | | | - Antonio Pizzuti
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Alessandro De Luca
- Molecular Genetics Unit, Fondazione Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy
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Mastromoro G, Calcagni G, Versacci P, Putotto C, Chinali M, Lambiase C, Unolt M, Pelliccione E, Anaclerio S, Caprio C, Cioffi S, Bilio M, Baban A, Drago F, Digilio MC, Marino B, Baldini A. Left pulmonary artery in 22q11.2 deletion syndrome. Echocardiographic evaluation in patients without cardiac defects and role of Tbx1 in mice. PLoS One 2019; 14:e0211170. [PMID: 30933971 PMCID: PMC6443172 DOI: 10.1371/journal.pone.0211170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 01/07/2019] [Accepted: 03/18/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction and hypothesis Patients with 22q11 deletion syndrome (22q11.2DS) present, in about 75% of cases, typical patterns of cardiac defects, with a particular involvement on the ventricular outflow tract and great arteries. However, in this genetic condition the dimensions of the pulmonary arteries (PAs) never were specifically evaluated. We measured both PAs diameter in patients with 22q11.2DS without cardiac defects, comparing these data to a normal control group. Moreover, we measured the PAs diameter in Tbx1 mutant mice. Finally, a cell fate mapping in Tbx1 mutants was used to study the expression of this gene in the morphogenesis of PAs. Methods We evaluated 58 patients with 22q11.2DS without cardiac defects. The control group consisted of 54 healthy subjects, matched for age and sex. All cases underwent a complete transthoracic echocardiography. Moreover, we crossed Tbx1+/- mice and harvested fetuses. We examined the cardiovascular phenotype of 8 wild type (WT), 37 heterozygous (Tbx1+/-) and 6 null fetuses (Tbx1-/-). Finally, we crossed Tbx1Cre/+mice with R26RmT-mG Cre reporter mice to study Tbx1 expression in the pulmonary arteries. Results The echocardiographic study showed that the mean of the LPA/RPA ratio in 22q11.2DS was smaller (0.80 ± 0.12) than in controls (0.97 ± 0.08; p < 0.0001). Mouse studies resulted in similar data as the size of LPA and RPA was not significantly different in WT embryos, but in Tbx1+/- and Tbx1-/- embryos the LPA was significantly smaller than the RPA in both mutants (P = 0.0016 and 0.0043, respectively). We found that Tbx1 is expressed near the origin of the PAs and in their adventitia. Conclusions Children with 22q11.2DS without cardiac defects show smaller LPA compared with healthy subjects. Mouse studies suggest that this anomaly is due to haploinsufficiency of Tbx1. These data may be useful in the clinical management of children with 22q11.2DS and should guide further experimental studies as to the mechanisms underlying PAs development.
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Affiliation(s)
- Gioia Mastromoro
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Giulio Calcagni
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Paolo Versacci
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Marcello Chinali
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | | | - Marta Unolt
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Elena Pelliccione
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Silvia Anaclerio
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Cinzia Caprio
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, CNR, Naples, Italy
| | - Sara Cioffi
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, CNR, Naples, Italy
| | - Marchesa Bilio
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, CNR, Naples, Italy
| | - Anwar Baban
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Fabrizio Drago
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Maria Cristina Digilio
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Bruno Marino
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
- * E-mail: (AB); (BM)
| | - Antonio Baldini
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, CNR, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
- * E-mail: (AB); (BM)
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