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Ji L, Li J, Liu D, Qiao Y, Zhao W, Liu Y, Zheng S. RUNX2 mutation inhibits the cellular senescence of dental follicle cells via ERK signalling pathway. Oral Dis 2024; 30:1337-1349. [PMID: 37154397 DOI: 10.1111/odi.14607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/24/2023] [Accepted: 04/22/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to explore the regulatory effect of RUNX2 mutation on dental follicle cells (DFCs) senescence and clarify the underlying mechanism. This study aimed to explore the basis for a novel mechanism of delayed permanent tooth eruption in cleidocranial dysplasia (CCD) patients. MATERIALS AND METHODS Dental follicles were collected from a CCD patient and healthy controls. Senescence-associated β-galactosidase (SA-β-gal) staining, Ki67 staining, cell cycle assays, and senescence-related gene and protein expression assays were performed to assess DFCs senescence. Western blotting was performed to detect the activation of mitogen-activated protein kinase (MAPK) signalling pathways, and the molecular mechanism underlying RUNX2 regulating in DFCs senescence was explored. RESULTS RUNX2 mutation inhibited the cellular senescence of DFCs from the CCD patient compared with healthy controls. Ki67 staining showed that mutant RUNX2 promoted DFCs proliferation, and cell cycle assays revealed that the healthy control-derived DFCs arrested at G1 phase. RUNX2 mutation significantly downregulated senescence-associated gene and protein expression. RUNX2 mutation suppressed ERK signalling pathway activation, an ERK inhibitor decreased healthy control-derived DFCs senescence, and an ERK activator promoted CCD patient-derived DFCs senescence. CONCLUSIONS RUNX2 mutation delayed DFCs senescence through the ERK signalling pathway, which may be responsible for delayed permanent tooth eruption in CCD patients.
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Affiliation(s)
- LingLi Ji
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Jie Li
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Dandan Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Yanchun Qiao
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Weiwei Zhao
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Yang Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
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Schröder A, Örs T, Byeon YO, Cieplik F, Proff P, Kirschneck C, Paddenberg E. Impact of Mechanical Strain and Nicotinamide on RUNX2-Deficient Osteoblast Mimicking Cleidocranial Dysplasia. Int J Mol Sci 2023; 24:16581. [PMID: 38068903 PMCID: PMC10705976 DOI: 10.3390/ijms242316581] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
Cleidocranial dysplasia (CCD) is a rare genetic defect caused by a heterozygous mutation of runt-related transcription factor 2 (RUNX2), which is important for osteoblast and skeletal development. RUNX2-deficiency causes extra- and intra-oral malformations that often require orthodontic treatment. Nicotinamide (NAM) affects bone remodelling processes. As these are crucial for orthodontic therapy, NAM could improve orthodontic treatment in CCD patients. This study investigates the effect of NAM in control and RUNX2-deficient osteoblasts under mechanical strain mimicking orthodontic treatment. First, the optimal NAM concentration and the differences in the expression profile of control and RUNX2-deficient osteoblasts were determined. Subsequently, osteoblasts were exposed to tensile and compressive strain with and without NAM, and the expression of genes critically involved in bone remodelling was investigated. NAM increased the expression of bone remodelling genes. RUNX2-deficient osteoblasts expressed more receptor activator of NFkB ligand (RANKL) and interleukin-6 (IL6), but less colony-stimulating factor-1 (CSF1). Most of the positive effects of NAM on bone remodelling genes were impaired by mechanical loading. In conclusion, NAM stimulated osteoblast differentiation by increasing the expression of RUNX2 and regulated the expression of osteoclastogenic factors. However, the positive effects of NAM on bone metabolism were impaired by mechanical loading and RUNX2 deficiency.
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Affiliation(s)
- Agnes Schröder
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany; (T.Ö.); (Y.-O.B.); (P.P.); (E.P.)
| | - Talia Örs
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany; (T.Ö.); (Y.-O.B.); (P.P.); (E.P.)
| | - Ye-Oun Byeon
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany; (T.Ö.); (Y.-O.B.); (P.P.); (E.P.)
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany; (T.Ö.); (Y.-O.B.); (P.P.); (E.P.)
| | | | - Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany; (T.Ö.); (Y.-O.B.); (P.P.); (E.P.)
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Cao X, Lenk GM, Meisler MH. Altered phenotypes due to genetic interaction between the mouse phosphoinositide biosynthesis genes Fig4 and Pip4k2c. G3 (Bethesda) 2023; 13:jkad007. [PMID: 36691351 PMCID: PMC10411592 DOI: 10.1093/g3journal/jkad007] [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] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023]
Abstract
Loss-of-function mutations of FIG4 are responsible for neurological disorders in human and mouse that result from reduced abundance of the signaling lipid PI(3,5)P2. In contrast, loss-of-function mutations of the phosphoinositide kinase PIP4K2C result in elevated abundance of PI(3,5)P2. These opposing effects on PI(3,5)P2 suggested that we might be able to compensate for deficiency of FIG4 by reducing expression of PIP4K2C. To test this hypothesis in a whole animal model, we generated triallelic mice with genotype Fig 4-/-, Pip4k2c+/-; these mice are null for Fig 4 and haploinsufficient for Pip4k2c. The neonatal lethality of Fig 4 null mice in the C57BL/6J strain background was rescued by reduced expression of Pip4k2c. The lysosome enlargement characteristic of Fig 4 null cells was also reduced by heterozygous loss of Pip4k2c. The data demonstrate interaction between these two genes, and suggest that inhibition of the kinase PIPK4C2 could be a target for treatment of FIG4 deficiency disorders such as Charcot-Marie-Tooth Type 4J and Yunis-Varón Syndrome.
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Affiliation(s)
- Xu Cao
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Guy M Lenk
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Miriam H Meisler
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
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4
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Lenk GM, Meisler MH. Chloroquine corrects enlarged lysosomes in FIG4 null cells and reduces neurodegeneration in Fig4 null mice. Mol Genet Metab 2022; 137:382-387. [PMID: 36434903 PMCID: PMC10364190 DOI: 10.1016/j.ymgme.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
Loss-of-function mutations of FIG4 impair the biosynthesis of PI(3,5)P2 and are responsible for rare genetic disorders including Yunis-Varón Syndrome and Charcot-Marie-Tooth Disease Type 4 J. Cultured cells deficient in FIG4 accumulate enlarged lysosomes with hyperacidic pH, due in part to impaired regulation of lysosomal ion channels and elevated intra-lysosomal osmotic pressure. We evaluated the effects of the FDA approved drug chloroquine, which is known to reduce lysosome acidity, on FIG4 deficient cell culture and on a mouse model. Chloroquine corrected the enlarged lysosomes in FIG4 null cells. In null mice, addition of chloroquine to the drinking water slowed progression of the disorder. Growth and mobility were dramatically improved during the first month of life, and spongiform degeneration of the nervous system was reduced. The median survival of Fig4 null mice was increased from 4 weeks for untreated mutants to 8 weeks with chloroquine treatment (p < 0.009). Chloroquine thus corrects the lysosomal swelling in cultured cells and ameliorates Fig4 deficiency in vivo. The improved phenotype of mice with complete loss of Fig4 suggests that chloroquine could be beneficial FIG2 in partial loss-of-function disorders such as Charcot-Marie-Tooth Type 4 J.
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Affiliation(s)
- Guy M Lenk
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, United States of America.
| | - Miriam H Meisler
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI 48109, United States of America
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Chen Y, Gu H, Tang G, Li R. [Analysis of clinical phenotype and genetic variant in a Chinese pedigree affected with cleidocranial dysplasia]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2022; 39:1247-1251. [PMID: 36317212 DOI: 10.3760/cma.j.cn511374-20211024-00845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To analyze the clinical features and pathogenic variant in a Chinese pedigree affected with cleidocranial dysplasia (CCD). METHODS Clinical data of 8 patients from the pedigree was collected, including physical examination and X-ray images of head, face, spine, limbs, and mouth. Peripheral blood samples were collected from 6 affected members for the extraction of genomic DNA. The proband and other 3 patients were subjected to trio-whole exome sequencing. Candidate variant was verified by Sanger sequencing of the other 2 affected members from the pedigree. RESULTS This pedigree has included 22 members (8 affected) from four generations. Genetic testing revealed that the proband has harbored a novel pathogenic variant of the RUNX2 gene [NM_001024630: c.1268_1277del (p.P425Afs*56)], which was inherited from her mother and carried by all affected members in the pedigree. The same variant was not detected among the unaffected members, suggesting co-segregation with the phenotype. CONCLUSION The c.1268_1277del (p.P425Afs*56) variant of the RUNX2 gene probably underlay the pathogenesis of CCD in this pedigree. Genetic testing has facilitated the definite diagnosis and enabled prenatal diagnosis.
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Affiliation(s)
- Yinhua Chen
- Department of Child Health Care, the Affiliated Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, China.
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Mestre VF, Spoladori IC, Osiak LB, Paiva WJM, Ferreira de Lima RL, Silveira BC, Salles MJS. Clinical, radiographic, and genetic observations in 2 families with cleidocranial dysplasia. Gen Dent 2022; 70:59-66. [PMID: 35749249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The clinical, radiographic, and molecular alterations in 7 individuals belonging to 2 families with clinical characteristics of cleidocranial dysplasia (CCD) were investigated. The patients underwent karyotype and genetic sequencing examinations. Cytogenetic analysis did not demonstrate any alterations. The next-generation sequencing technique employed for the molecular analysis revealed sequence variations in the RUNX2 gene: c.568C>T (p.Arg190Trp) in exon 4 in family A and c.1205del (p.Pro402Argfs*82) in exon 9 in family B. Incomplete closure of anterior fontanels, hypoplastic clavicles, and dental changes were observed in all 7 patients. Uncommon clinical findings, such as partial hearing loss and bilateral clavicular agenesis, were noted in some patients. According to the literature consulted, this is the first time that the total absence of the pubic bone in a study subject is being reported. The variable expression among individuals of the same family and between families A and B suggests the absence of a genotype-phenotype relationship. Early diagnosis allows the dentist to minimize the effects of changes associated with CCD by monitoring and providing appropriate treatment, and the identification of genetic sequence variations enables appropriate family genetic counseling.
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Zhang Y, Duan X. A Novel 90-kbp Deletion of RUNX2 Associated with Cleidocranial Dysplasia. Genes (Basel) 2022; 13:1128. [PMID: 35885911 PMCID: PMC9322484 DOI: 10.3390/genes13071128] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia caused by runt-related transcription factor 2 (RUNX2) mutations. In addition to the regular missense, small or large fragment deletions are the common mutation types of RUNX2. This study aimed to find the rules of deletions in RUNX2. The clinical information of one Chinese CCD family was collected. Genomic DNA was extracted for whole-exome sequencing (WES). Bioinformatics analyzed the pathogenicity of the variants. Polymerase chain reaction (PCR) and Sanger sequencing were carried out using specific primers. RT-PCR and Q-PCR were also used to detect the mRNA level of RUNX2. The CCD studies related with deletions in RUNX2 from 1999 to 2021 from HGMD and PubMed were collected and analyzed for the relationship between the phenotypes and the length of deleted fragments. The proband presented typical CCD features, including delayed closure of cranial sutures, clavicle dysplasia, abnormal teeth. WES, PCR with specific primers and Sanger sequencing revealed a novel heterozygous 90-kbp deletion in RUNX2 (NG_008020.2 g.103671~193943), which caused a substitution (p.Asn183Ile) and premature termination (p.Asp184*). In addition, the mRNA expression of RUNX2 was decreased by 75.5% in the proband. Herein, 31 types of deletions varying from 2 bp to 800 kbp or covering the whole gene of RUNX2 were compared and the significant phenotypic difference was not found among these deletions. The CCD phenotypes were related with the final effects of RUNX2 mutation instead of the length of deletion. WES has the defects in identifying large indels, and direct PCR with specific primers and Sanger sequencing could make up for the shortcoming.
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Affiliation(s)
| | - Xiaohong Duan
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China;
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Barbosa Lima R, de Souza Furtado TC, Nelson-Filho P, Assed Bezerra da Silva R, Wanderley Garcia Paula-Silva F, Kitazono de Carvalho F, Mussolino de Queiroz A. RUNX2 Nonsense Mutation Associated with Cleidocranial Dysplasia with Unusual Dental Features. J Dent Child (Chic) 2022; 89:126-129. [PMID: 35986479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Purpose: The purpose of this case report is to describe a RUNX2 nonsense mutation associated with cleidocranial dysplasia (CCD) with unusual dental features. The patient was a 12-year-old Brazilian girl who sought dental care due to over-retention of primary teeth and absence of erupted permanent teeth. Clinical and radiographic examinations revealed multiple impacted permanent teeth, a prominent cingulum of the permanent impacted maxillary incisors and enamel defects (hypoplasia and hypomineralization) in addition to skeletal abnormalities. No supernumerary teeth were present. The diagnostic hypothesis of CCD was raised and the patient was refer- red to the genetic medical service, where the diagnosis was cofirmed. After RUNX2 genetic screening, including polymerase chain reaction and sequencing of both DNA strands, a heterozygous nonsense mutation was identified in exon 2 (c.193 C>T [Q65X]). This article reports unusual dental features in a patient with CCD.
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Affiliation(s)
- Ricardo Barbosa Lima
- Dr. Lima is a graduate student, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Taíssa Cássia de Souza Furtado
- Dr. Furtado is a graduate student, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Paulo Nelson-Filho
- Dr. Nelson-Filho is a professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Raquel Assed Bezerra da Silva
- Dr. da Silva is a professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Francisco Wanderley Garcia Paula-Silva
- Dr. Paula-Silva is an associate professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fabrício Kitazono de Carvalho
- Dr. de Carvalho is an assistant professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Alexandra Mussolino de Queiroz
- Dr. de Queiroz is a professor, Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil;,
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Zhou B, Zheng W, Hu J, Wang O, Jiang Y, Xia W, Xing X, Li M. [Identification of c.196C>T nonsense RUNX2 variant in a Chinese patient with cleidocranial dysplasia]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2022; 39:526-529. [PMID: 35598271 DOI: 10.3760/cma.j.cn511374-20210119-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To detect the genetic variant of a child with cleidocranial dysplasia (CCD) and to find out the causation of the illness. METHODS Gene variant was identified by the second generation targeted sequencing and Sanger sequencing. RESULTS The gene sequencing revealed that the RUNX2 gene had c.196C>T(p.Glu66*) nonsense variant, which was predicted to be a pathogenic variant according to the ACMG guidelines(PVS1+PS2). CONCLUSION The variant of c.196C > T in the RUNX2 gene may be the cause of the child with CCD, and the novel variant enriches the RUNX2 gene variant spectrum.
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Affiliation(s)
- Bingna Zhou
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
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Koduru Laxmi S, Misra SR, Panda S, Mohanty N. Marie-Sainton syndrome (cleidocranial dysplasia): early diagnosis is the key. BMJ Case Rep 2022; 15:e248673. [PMID: 35228252 PMCID: PMC8886401 DOI: 10.1136/bcr-2021-248673] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sushmita Koduru Laxmi
- Oral Medicine and Radiology, Siksha O Anusandhan University Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Satya Ranjan Misra
- Oral Medicine and Radiology, Siksha O Anusandhan University Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Saurav Panda
- Periodontics, Siksha O Anusandhan University Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Neeta Mohanty
- Oral Maxillofacial Pathology and Microbiology, Siksha O Anusandhan University Institute of Dental Sciences, Bhubaneswar, Odisha, India
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Inchingolo AD, Patano A, Coloccia G, Ceci S, Inchingolo AM, Marinelli G, Malcangi G, Montenegro V, Laudadio C, Palmieri G, Bordea IR, Ponzi E, Orsini P, Ficarella R, Scarano A, Lorusso F, Dipalma G, Corsalini M, Gentile M, Venere DD, Inchingolo F. Genetic Pattern, Orthodontic and Surgical Management of Multiple Supplementary Impacted Teeth in a Rare, Cleidocranial Dysplasia Patient: A Case Report. Medicina (Kaunas) 2021; 57:medicina57121350. [PMID: 34946295 PMCID: PMC8709258 DOI: 10.3390/medicina57121350] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/30/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
Background: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 (CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth. Materials and Methods: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue. Results: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics. Conclusions: The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Valentina Montenegro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Claudia Laudadio
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
| | - Emanuela Ponzi
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Paola Orsini
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Romina Ficarella
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Mattia Gentile
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
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12
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Yang L, Lu G, Shen W, Chen W, Lu H, Zhang G, Yuan S, Zheng S, Ren J. Whole-exome sequencing of a novel initiation codon mutation in RUNX2 in a Chinese family with cleidocranial dysplasia. Medicine (Baltimore) 2021; 100:e27746. [PMID: 34766588 PMCID: PMC8589230 DOI: 10.1097/md.0000000000027746] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 10/25/2021] [Indexed: 01/05/2023] Open
Abstract
Cleidocranial dysplasia (CCD) is mainly attributable to a variant of runt-related transcription factor 2 (RUNX2) on chromosome 6p21. CCD is an autosomal dominant skeletal disorder characterized by open/delayed closure of fontanels, clavicular hypoplasia, retention of deciduous teeth, and supernumerary permanent teeth. The aim of this study was to investigate potentially pathogenic mutations in 2 Chinese families. Genomic DNA was obtained from peripheral blood lymphocytes, and whole exome sequencing and Sanger sequencing were performed to detect gene variants. Real-time quantitative PCR was performed to determine the mRNA expression level of RUNX2 in the proband of family 1. Silico algorithms and conservation analyses were used to evaluate the functional impact. We identified a novel initiation codon mutation (c.2T>C) and a previously reported mutation (c.569G>A). Familial co-segregation verified an autosomal-dominant inheritance pattern. Our findings demonstrated that the novel mutation c.2T>C causes CCD. Quantitative real-time PCR suggested that downregulated RUNX2 levels and haploinsufficiency in RUNX2 lead to CCD. These results extend the spectrum of RUNX2 mutations in CCD patients and can be used for genetic consultation and prenatal diagnosis.
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Affiliation(s)
- Liyuan Yang
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Genqi Lu
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Wenjing Shen
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Wenjing Chen
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Haiyan Lu
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Guozhong Zhang
- College of Forensic Medicine, Hebei Medical University, Shijiazhuang, PR China
| | - Shuo Yuan
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | | | - Jiabao Ren
- Department of Prosthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
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13
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McClure PK, Franzone JM, Herzenberg JE. Congenital Pseudarthrosis of the Tibia Associated With Cleidocranial Dysostosis: Case Report and Literature Review. JBJS Case Connect 2021; 11:01709767-202112000-00042. [PMID: 34735385 DOI: 10.2106/jbjs.cc.21.00451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CASE We describe a case of 2 individually rare diseases existing comorbidly in the form of congenital pseudarthrosis of the tibia (CPT) coincident with cleidocranial dysostosis and provide a review of the literature, including the sole preexisting documented coincidence. CONCLUSION Understanding, treatment, and surgical protocol of CPT have changed considerably since this comorbidity was last reported. Updates include synostosis, periosteal grafting, the use of bone morphogenetic protein, and bisphosphonates. Our case varies from the previous in associated disorder and family history. The relationship between CBFA1 and RUNX2 genes may hold the key, but further study is needed.
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Affiliation(s)
- Philip K McClure
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Jeanne M Franzone
- Department of Orthopaedic Surgery, AI Dupont Hospital for Children, Wilmington, Delaware
| | - John E Herzenberg
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
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14
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Dalle Carbonare L, Antoniazzi F, Gandini A, Orsi S, Bertacco J, Li Vigni V, Minoia A, Griggio F, Perduca M, Mottes M, Valenti MT. Two Novel C-Terminus RUNX2 Mutations in Two Cleidocranial Dysplasia (CCD) Patients Impairing p53 Expression. Int J Mol Sci 2021; 22:ijms221910336. [PMID: 34638677 PMCID: PMC8508986 DOI: 10.3390/ijms221910336] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
Cleidocranial dysplasia (CCD), a dominantly inherited skeletal disease, is characterized by a variable phenotype ranging from dental alterations to severe skeletal defects. Either de novo or inherited mutations in the RUNX2 gene have been identified in most CCD patients. Transcription factor RUNX2, the osteogenic master gene, plays a central role in the commitment of mesenchymal stem cells to osteoblast lineage. With the aim to analyse the effects of RUNX2 mutations in CCD patients, we investigated RUNX2 gene expression and the osteogenic potential of two CCD patients' cells. In addition, with the aim to better understand how RUNX2 mutations interfere with osteogenic differentiation, we performed string analyses to identify proteins interacting with RUNX2 and analysed p53 expression levels. Our findings demonstrated for the first time that, in addition to the alteration of downstream gene expression, RUNX2 mutations impair p53 expression affecting osteogenic maturation. In conclusion, the present work provides new insights into the role of RUNX2 mutations in CCD patients and suggests that an in-depth analysis of the RUNX2-associated gene network may contribute to better understand the complex molecular and phenotypic alterations in mutant subjects.
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Affiliation(s)
- Luca Dalle Carbonare
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
| | - Franco Antoniazzi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37100 Verona, Italy; (F.A.); (A.G.)
| | - Alberto Gandini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37100 Verona, Italy; (F.A.); (A.G.)
| | - Silvia Orsi
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
| | - Jessica Bertacco
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy;
| | - Veronica Li Vigni
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
| | - Arianna Minoia
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
| | - Francesca Griggio
- Centro Piattaforme Tecnologiche, University of Verona, 37100 Verona, Italy;
| | - Massimiliano Perduca
- Biocrystallography Lab, Department of Biotechnology, University of Verona, 37134 Verona, Italy;
| | - Monica Mottes
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy;
| | - Maria Teresa Valenti
- Department of Medicine, University of Verona, 37100 Verona, Italy; (L.D.C.); (S.O.); (J.B.); (V.L.V.); (A.M.)
- Correspondence: ; Tel.: +39-045-812-8450
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15
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Papadopoulou A, Bountouvi E, Sideri V, Moutsatsou P, Skarakis NS, Doulgeraki A, Karachaliou FE. Parietal aplasia and hypophosphatasia in a child harboring a novel mutation in RUNX2 and a likely pathogenic variant in TNSALP. Bone 2021; 146:115904. [PMID: 33647526 DOI: 10.1016/j.bone.2021.115904] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/03/2021] [Accepted: 02/23/2021] [Indexed: 11/30/2022]
Abstract
Cleidocranial dysplasia is a dominantly inherited skeletal dysplasia resulting from inherited or spontaneous mutations of Runt-related transcription factor 2 gene (RUNX2). It represents a clinical continuum typically characterized by wide calvarial sutures, clavicular hypoplasia and dental abnormalities. CDD has been rarely associated with skeletal and biochemical features that mimic hypophosphatasia. We report clinical, biochemical and molecular profile of a 3-year-old female with CCD, presented in utero with large cranial defects. She displayed severe parietal dysplasia, wide cranial sutures, clavicular abnormalities and biochemical features of hypophospatasia (HHP). She was preliminary diagnosed with benign perinatal HHP, harboring a likely pathogenic heterozygous TNSALP variant (p.Ser181Leu) inherited by the mother, who also displayed low levels of ALP. Asfotase alfa was introduced for a six-month-period with rather positive impact on cranial ossification. Nevertheless, focal skeletal disease (cranium and clavicles) and absence of clinical symptoms in the mother, carrier of the same genetic variant, posed diagnosis into question and further genetic analysis detected the novel spontaneous frameshift mutation c.1191delC (p.Phe398Leufs*86) in RUNX2 gene, establishing the CCD diagnosis. Although genotype-phenotype correlations are difficult, p.Phe398Leufs*86 appears to be associated with a severe cranial phenotype and absence of parietal bones, similarly to other adjacent frameshift/splicing mutations. The TNSALP variant (p.Ser181Leu) may contributed to patient's final phenotype, as well as to maternal low ALP levels. However, since low ALP levels have been also reported in few CCD patients with no alterations in TNSALP gene, studies to elucidate RUNX2 and TNSALP interactions could shed more light on differential diagnosis between CCD and HHP, CCD appropriate therapy and genetic counselling. ACCESSION NUMBER: (SUB8185506).
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Affiliation(s)
- Anna Papadopoulou
- Third Department of Pediatrics, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece; Department of Clinical Biochemistry, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece.
| | - Evangelia Bountouvi
- Third Department of Pediatrics, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece
| | - Vassiliki Sideri
- Third Department of Pediatrics, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece
| | - Paraskevi Moutsatsou
- Department of Clinical Biochemistry, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece
| | - Nikitas Spyridon Skarakis
- Department of Clinical Biochemistry, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece; Department of Endocrinology and Diabetes Center, "G. Gennimatas", General Hospital of Athens, Athens, Greece
| | - Artemis Doulgeraki
- Department of Bone and Mineral Metabolism, Institute of Child Health, Athens, Greece
| | - Fotini Eleni Karachaliou
- Third Department of Pediatrics, National & Kapodistrian University of Athens, University General Hospital "Attikon", Medical School, Athens, Greece
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16
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Ooki A, Onodera S, Saito A, Oguchi A, Murakawa Y, Sakamoto T, Sueishi K, Nishii Y, Azuma T. CAGE-seq analysis of osteoblast derived from cleidocranial dysplasia human induced pluripotent stem cells. Bone 2020; 141:115582. [PMID: 32795676 DOI: 10.1016/j.bone.2020.115582] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
Non-coding RNAs (ncRNAs) comprise a major portion of transcripts and serve an essential role in biological processes. Although the importance of major transcriptomes in osteogenesis has been extensively studied, the function of ncRNAs in human osteogenesis remains unclear. Previously, we developed hiPSCs from patients with cleidocranial dysplasia (CCD) caused by runt-related transcription factor 2 (RUNX2) haploinsufficiency. To gain insight into ncRNAs in osteogenesis, we surveyed differential ncRNA expression profiling and promoter differences of RUNX2 using patient-specific iPSCs and cap analysis gene expression (CAGE) technology to define the promoter landscape. Revertant iPSCs (Rev1 iPSCs) edited by CRISPR/Cas9 system to harbor mutation-corrected RUNX2 exhibited increased proximal promoter expression of RUNX2, while CCD iPSCs did not. We identified 2271 ncRNA genes with altered expression levels before and after differentiation, 31 of which showed at least 20-fold higher expression in Rev1 iPSCs. Bioinformatic analysis also categorized AC007392.3, LINC00379, RP11-122D10.1, and RP11-90J7.2 as enhancer regulatory regions, and HOXA-AS2, MIR219-2, and RP11-834C11.3 as dyadic regulatory regions of these ncRNAs. In addition, two miRNAs, termed MIR199A2 and MIR152, were found to have high enrichment of osteogenic-related terms. Upon further examination of the role of MIR152 on osteoblast differentiation, we found that MIR152 knockdown induced upregulation of ALP and COL1A1 in Saos-2 cells. Thus, ncRNAs were found to regulate the osteogenic differentiation potentials of hiPSCs that are used for bone regeneration and repair owing to their differentiation potentials. These data allow understanding ncRNA profiles of hiPSCs during osteogenesis.
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Affiliation(s)
- Akio Ooki
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Shoko Onodera
- Department of Biochemistry, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Akiko Saito
- Department of Biochemistry, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Akiko Oguchi
- Division of Genomic Technologies, RIKEN Center for Life Science Technologies, Yokohama, Kanagawa 230-0045, Japan; RIKEN Preventive Medicine and Diagnosis Innovation Program, Yokohama, Kanagawa 230-0045, Japan
| | - Yasuhiro Murakawa
- Division of Genomic Technologies, RIKEN Center for Life Science Technologies, Yokohama, Kanagawa 230-0045, Japan; RIKEN Preventive Medicine and Diagnosis Innovation Program, Yokohama, Kanagawa 230-0045, Japan
| | - Teruo Sakamoto
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kenji Sueishi
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Yasushi Nishii
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Toshifumi Azuma
- Department of Biochemistry, Tokyo Dental College, Tokyo 101-0061, Japan; Oral Health Science Center, Tokyo Dental College, Tokyo 101-0061, Japan.
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17
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Lerusse J, Kaux JF. [The Pierre Marie-Sainton syndrome or cleidocranial dysplasia]. Rev Med Liege 2020; 75:639-643. [PMID: 33030838] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Pierre-Marie Sainton syndrome or cleidocranial dysplasia is a rare congenital malformation due to a mutation in the RUNX2 gene, causing disruption in osteoblastic maturation, which results in various skeletal, dental and endocrine abnormalities. These various disorders may also have otorhinolaryngology and psychological consequences. We report the case of a patient with this rare birth defect.
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Affiliation(s)
- J Lerusse
- Service de Médecine physique et Réadaptation, CHU Liège, Belgique
| | - J F Kaux
- Service de Médecine physique et Réadaptation, CHU Liège, Belgique
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18
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Kim JM, Yang YS, Park KH, Ge X, Xu R, Li N, Song M, Chun H, Bok S, Charles JF, Filhol-Cochet O, Boldyreff B, Dinter T, Yu PB, Kon N, Gu W, Takarada T, Greenblatt MB, Shim JH. A RUNX2 stabilization pathway mediates physiologic and pathologic bone formation. Nat Commun 2020; 11:2289. [PMID: 32385263 PMCID: PMC7210266 DOI: 10.1038/s41467-020-16038-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/10/2020] [Indexed: 12/21/2022] Open
Abstract
The osteoblast differentiation capacity of skeletal stem cells (SSCs) must be tightly regulated, as inadequate bone formation results in low bone mass and skeletal fragility, and over-exuberant osteogenesis results in heterotopic ossification (HO) of soft tissues. RUNX2 is essential for tuning this balance, but the mechanisms of posttranslational control of RUNX2 remain to be fully elucidated. Here, we identify that a CK2/HAUSP pathway is a key regulator of RUNX2 stability, as Casein kinase 2 (CK2) phosphorylates RUNX2, recruiting the deubiquitinase herpesvirus-associated ubiquitin-specific protease (HAUSP), which stabilizes RUNX2 by diverting it away from ubiquitin-dependent proteasomal degradation. This pathway is important for both the commitment of SSCs to osteoprogenitors and their subsequent maturation. This CK2/HAUSP/RUNX2 pathway is also necessary for HO, as its inhibition blocked HO in multiple models. Collectively, active deubiquitination of RUNX2 is required for bone formation and this CK2/HAUSP deubiquitination pathway offers therapeutic opportunities for disorders of inappropriate mineralization.
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Affiliation(s)
- Jung-Min Kim
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Yeon-Suk Yang
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kwang Hwan Park
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Xianpeng Ge
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ren Xu
- State Key Laboratory of Cellular Stress Biology, Xiamen University, Fujian, China
| | - Na Li
- State Key Laboratory of Cellular Stress Biology, Xiamen University, Fujian, China
| | - Minkyung Song
- Department of integrative biotechnology, Sungkyunkwan University, Suwon, South Korea
| | - Hyunho Chun
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Seoyeon Bok
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Julia F Charles
- Department of Orthopedics and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Odile Filhol-Cochet
- INSERM U1036, pour le Vivant/Biologie du Cancer et de l'Infection, Commissariat à l'Énergie Atomique et aux Énerigies Alternatives Grenoble, Grenoble, France
| | | | - Teresa Dinter
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul B Yu
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ning Kon
- Institute of Cancer Genetics, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Wei Gu
- Institute of Cancer Genetics, College of Physicians and Surgeons of Columbia University, New York, NY, USA
- Department of Pathology and Cell Biology, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Takeshi Takarada
- Department of Regenerative Science, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Matthew B Greenblatt
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Jae-Hyuck Shim
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
- Li Weibo Institute for Rare Diseases Research, University of Massachusetts Medical School, Worcester, MA, USA.
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19
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Zimmermann M, Schuster S, Boesch S, Korenke GC, Mohr J, Reichbauer J, Kernstock C, Kotzot D, Spahlinger V, Schüle-Freyer R, Schöls L. FIG4 mutations leading to parkinsonism and a phenotypical continuum between CMT4J and Yunis Varón syndrome. Parkinsonism Relat Disord 2020; 74:6-11. [PMID: 32268254 DOI: 10.1016/j.parkreldis.2020.03.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Charcot-Marie-Tooth disease type 4J (CMT4J) originates from mutations in the FIG4 gene and leads to distal muscle weakness. Two null alleles of FIG4 cause Yunis Varón syndrome with severe central nervous system involvement, cleidocranial dysmorphism, absent thumbs and halluces and early death. OBJECTIVES To analyse the phenotypic spectrum of FIG4-related disease and explore effects of residual FIG4 protein. METHODS Phenotyping of five new patients with FIG4-related disease. Western Blot analyses of FIG4 from patient fibroblasts. RESULTS Next generation sequencing revealed compound heterozygous variants in FIG4 in five patients. All five patients presented with peripheral neuropathy, various degree of dysmorphism and a central nervous system involvement comprising Parkinsonism in 3/5 patients, cerebellar ataxia (1/5), spasticity of lower limbs (1/5), epilepsy (1/5) and/or cognitive deficits (2/5). Onset varied between the first and the seventh decade. There was no residual FIG4 protein detectable in fibroblasts of the four analysed patients. CONCLUSION This study extends the phenotypic spectrum of FIG4-related disease to Parkinsonism as a feature and demonstrates new phenotypes on a continuum between CMT4J and Yunis Varón syndrome.
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Affiliation(s)
- Milan Zimmermann
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany.
| | - Stefanie Schuster
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Sylvia Boesch
- Department of Neurology, Medical University, Christoph-Probst-Platz 52, 6020, Innsbruck, Austria
| | - G Christoph Korenke
- Department of Neuropediatrics, University of Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Germany
| | - Julia Mohr
- Center for Genomics and Transcriptomics (CeGaT) GmbH and Practice for Human Genetics, Paul-Ehrlich-Straße 23, 72076, Tübingen, Germany
| | - Jennifer Reichbauer
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Christoph Kernstock
- University Eye Hospital, Center for Ophthalmology, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Germany
| | - Dieter Kotzot
- Institute of Human Genetics, Medical University Innsbruck, Christoph-Probst-Platz 52, 6020, Innsbruck, Austria; Division of Clinical Genetics, Department of Pediatrics, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Veronika Spahlinger
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Rebecca Schüle-Freyer
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurology and Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
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Mitomo K, Matsunaga S, Kitamura K, Nakamura T, Saito A, Komori T, Muramatsu T, Yamaguchi A. Sphenoid bone hypoplasia is a skeletal phenotype of cleidocranial dysplasia in a mouse model and patients. Bone 2019; 120:176-186. [PMID: 30391578 DOI: 10.1016/j.bone.2018.10.028] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022]
Abstract
Cleidocranial dysplasia (CCD) is an autosomal dominant disorder caused by heterozygous mutations in RUNX2. Affected individuals exhibit delayed maturation or hypoplasia in various bones, mainly including those formed by intramembranous ossification. Although several reports described deformation of the sphenoid bone in CCD patients, details of the associated changes have not been well documented. Most parts of the sphenoid bone are formed by endochondral ossification; however, the medial pterygoid process is formed by intramembranous ossification associated with secondary cartilage. We first investigated histological changes in the medial pterygoid process during different developmental stages in Runx2+/+ and Runx2+/- mice, finding that mesenchymal cell condensation of the anlage of this structure was delayed in Runx2+/- mice as compared with that in Runx2+/+ mice. Additionally, in Runx2+/+ mice, Osterix-positive osteoblastic cells appeared at the upper region of the anlage of the medial pterygoid process, and bone trabeculae appeared to associate with subsequent secondary cartilage formation. By contrast, few Osterix-positive osteoblastic cells appeared at the upper region of the anlage of the medial pterygoid process, and no bone trabeculae appeared thereafter in Runx2+/- mice. At more advanced embryonic stages, endochondral ossification occurred at the lower part of the medial pterygoid process in both Runx2+/+ and Runx2+/- mice. After birth, well-developed bone trabeculae occupied two-thirds of the cranial side of the medial pterygoid process, and cartilage appeared beneath these bones in Runx2+/+ mice, whereas thin trabecular bone appeared at the center of the cartilage of the medial pterygoid process in Runx2+/- mice. In adult mice, the body and medial pterygoid processes of the sphenoid bone comprised mature bones in both Runx2+/+ and Runx2+/- mice, although the axial length of the medial pterygoid processes was apparently lower in Runx2+/-mice as compared with that in Runx2+/+mice based on histological and micro-computed tomography (CT) examinations. Moreover, medical-CT examination revealed that in CCD patients, the medial pterygoid process of sphenoid bone was significantly shorter relative to that in healthy young adults. These results demonstrated that the medial pterygoid process of the sphenoid bone specifically exhibited hypoplasia in CCD.
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Affiliation(s)
- Keisuke Mitomo
- Department of Operative Dentistry, Cariology and Dental Pulp Biology, Tokyo Dental College, Tokyo, Japan; Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan
| | - Satoru Matsunaga
- Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan; Department of Anatomy, Tokyo Dental College, Tokyo, Japan; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Kei Kitamura
- Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan; Department of Histology, Tokyo Dental College, Tokyo, Japan
| | - Takashi Nakamura
- Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan; Department of Biochemistry, Tokyo Dental College, Tokyo, Japan
| | - Akiko Saito
- Department of Biochemistry, Tokyo Dental College, Tokyo, Japan
| | - Toshihisa Komori
- Department of Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Muramatsu
- Department of Operative Dentistry, Cariology and Dental Pulp Biology, Tokyo Dental College, Tokyo, Japan; Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Akira Yamaguchi
- Tokyo Dental College Research Branding Project, Tokyo Dental College, Tokyo, Japan; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
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Liu Y, Wang Y, Sun X, Zhang X, Wang X, Zhang C, Zheng S. RUNX2 mutation reduces osteogenic differentiation of dental follicle cells in cleidocranial dysplasia. Mutagenesis 2018; 33:203-214. [PMID: 29947791 DOI: 10.1093/mutage/gey010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 06/01/2018] [Indexed: 01/09/2023] Open
Abstract
Disturbed permanent tooth eruption is common in cleidocranial dysplasia (CCD), a skeletal disorder caused by heterozygous mutation of RUNX2, but the mechanism underlying is still unclear. As it is well known that dental follicle cells (DFCs) play a critical role in tooth eruption, the changed biological characteristics of DFCs might give rise to disturbance of permanent tooth eruption in CCD patients. Thus, primary DFCs from one CCD patient and normal controls were collected to investigate the effect of RUNX2 mutation on the bone remodeling activity of DFCs and explore the mechanism of impaired permanent tooth eruption in this disease. Conservation and secondary structure analysis revealed that the RUNX2 mutation (c.514delT, p.172fs) found in the present CCD patient was located in the highly conserved RUNT domain and converted the structure of RUNX2. After osteogenic induction, we found that the mineralised capacity of DFCs and the expression of osteoblast-related genes, including RUNX2, ALP, OSX, OCN and Col Iα1, in DFCs was severely interfered by the RUNX2 mutation found in CCD patients. To investigate whether the osteogenic deficiency of DFCs from the CCD patient can be rescued by RUNX2 restoration, we performed 'rescue' experiments. Surprisingly, the osteogenic deficiency and the abnormal expression of osteoblast-associated genes in DFCs from the CCD patient were almost rescued by overexpression of wild-type RUNX2 using lentivirus. All these findings indicate that RUNX2 mutation can reduce the osteogenic capacity of DFCs through inhibiting osteoblast-associated genes, thereby disturbing alveolar bone formation, which serves as a motive force for tooth eruption. This effect may provide valuable explanations and implications for the mechanism of delayed permanent tooth eruption in CCD patients.
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Affiliation(s)
- Yang Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - Yixiang Wang
- Central Laboratory, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - Xiangyu Sun
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - Xianli Zhang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
- Department of Stomatology, Xuanwu Hospital Capital Medical University, Xicheng District, Beijing, PR China
| | - Xiaozhe Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - Chenying Zhang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
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Ha SW, Jung YJ, Bae HS, Ryoo HM, Cho IS, Baek SH. Characterization of dental phenotype in patients with cleidocranial dysplasia using longitudinal data. Angle Orthod 2018; 88:416-424. [PMID: 29664332 DOI: 10.2319/092617-647.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate the characteristics of the dental phenotype in patients with cleidocranial dysplasia (CCD) using longitudinal data. MATERIALS AND METHODS Twelve unrelated Korean CCD patients were observed using a longitudinal series of radiographs and clinical photographs. Statistical analysis was performed on the dental phenotypic data. RESULTS Although dysplasia of the clavicles, open fontanelle, and wormian bone were observed in all 12 patients, delayed fusion of the mandibular symphysis was found in four patients. One patient did not have a supernumerary tooth (ST). However, 62 STs were found in 11 patients (mean, 5.6 per patient; range of ST emergence, 5 years 6 months-14 years 8 months; developing position, occlusal to the permanent incisors, canines, and premolars and distal and apical to the permanent molars). The mandibular premolar region was the most frequent area of ST development (50.0%, P < .001). All 12 patients showed impacted permanent teeth (IPT), including one patient without ST (mean, 17.8 per patient). Impaction occurred most frequently in the mandibular premolar region and least frequently in the maxillary molar region (93.8% vs 39.6%, P < .01). The ratio of spontaneous eruption of IPT after removal of retained deciduous teeth and/or ST was highest for the maxillary and mandibular incisors (all 54.6%) and lowest for the mandibular canines and premolars (26.7% and 28.9%, respectively); however, the difference was not significant. CONCLUSIONS The emergence time and development position of ST and the root development of IPT should be considered to determine the timing for the removal of ST and forced eruption of IPT.
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Qian Y, Zhang Y, Wei B, Zhang M, Yang J, Leng C, Ge Z, Xu X, Sun M. A novel Alu-mediated microdeletion in the RUNX2 gene in a Chinese patient with cleidocranial dysplasia. J Genet 2018; 97:137-143. [PMID: 29666333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cleidocranial dysplasia (CCD; OMIM: 119600) is a rare autosomal dominant skeletal dysplasia caused by RUNX2 gene mutations. The present study described a sporadic case with CCD. The clinical data of the proband with CCD was reported and genetic analysis was performed. The proband presented with typical CCD features including supernumerary impacted teeth, bilateral clavicle dysplasia, delayed closure of cranial sutures, and short stature; while his hands were normal. Sequencing analysis of the entire coding region of the RUNX2 gene revealed no pathogenic changes; however, copy-number analysis with the Affymetrix HD array found ~500 kb genomicmicrodeletion. Real-time quantitative PCR validated this microdeletion in the 1-4 exons of the RUNX2 gene. The junction point of the breaking DNA was located in the directly oriented AluSz6 and AluSx repetitive elements, indicating that this microdeletion might be generated through an Alu-Alu mediated mechanism. In addition, this microdeletion existed in 21.8% of the asymptomatic mother's peripheral blood cells, demonstrating that the mosaicism was not associated with CCD phenotypes. In summary, a pathogenic microdeletion in the RUNX2 gene located on chromosome 6 was responsible for CCD.
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Affiliation(s)
- Yunzhu Qian
- Center of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, People's Republic of China.
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Zhang X, Liu Y, Wang X, Sun X, Zhang C, Zheng S. Analysis of novel RUNX2 mutations in Chinese patients with cleidocranial dysplasia. PLoS One 2017; 12:e0181653. [PMID: 28738062 PMCID: PMC5524338 DOI: 10.1371/journal.pone.0181653] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/05/2017] [Indexed: 11/22/2022] Open
Abstract
Cleidocranial dysplasia (CCD) is an autosomal dominant inheritable skeletal disorder characterized by cranial dysplasia, clavicle hypoplasia and dental abnormalities. This disease is mainly caused by heterozygous mutations in RUNX2, a gene that encodes an osteoblast-specific transcription factor. In the present study, mutational analyses of RUNX2 gene were performed on four unrelated Chinese patients with CCD. Four different RUNX2 mutations were detected in these patients, including one nonsense mutation (c.199C>T p.Q67X) and three missense mutations (c.338T>G p.L113R, c.557G>C p.R186T and c.673C>T p.R225W). Among them, two mutations (c.199C>T p.Q67X and c.557G>C p.R186T) were novel and the other two had been reported in previous literatures. Except for Q67X mutation located in the Q/A domain, other three mutations were clustered within the highly conserved Runt domain. Green fluorescent protein (GFP) and RUNX2 fusion protein analyses in vitro showed that nuclear accumulation of RUNX2 protein was disturbed by Q67X mutation, while the other two mutations (c.338T>G p.L113R and c.557G>C p.R186T) had no effects on the subcellular distribution of RUNX2. Luciferase reporter assay demonstrated that all the three novel RUNX2 mutations significantly reduced the transactivation activity of RUNX2 on osteocalcin promoter. Our findings enrich the evidence of molecular genetics that the mutations of RUNX2 gene are responsible for CCD.
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Affiliation(s)
- Xianli Zhang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Yang Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Xiaozhe Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Xiangyu Sun
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Chenying Zhang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
- * E-mail: (SGZ); (CYZ)
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
- * E-mail: (SGZ); (CYZ)
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Wu LZ, Xu XY, Liu YF, Ge X, Wang XJ. Expansion of polyalanine tracts in the QA domain may play a critical role in the clavicular development of cleidocranial dysplasia. J Genet 2015; 94:551-3. [PMID: 26440098 DOI: 10.1007/s12041-015-0551-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Li-Zheng Wu
- State Key Laboratory of Military Stomatology, Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China.
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Bouyahia O, Ben Rebeh R, Bel Hadj I, Boukthir S, Sammoud A. Cleidocranial dysplasia: family cases. Tunis Med 2015; 93:478. [PMID: 26757508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Guo YW, Chiu CY, Liu CL, Jap TS, Lin LY. Novel mutation of RUNX2 gene in a patient with cleidocranial dysplasia. Int J Clin Exp Pathol 2015; 8:1057-1062. [PMID: 25755819 PMCID: PMC4348862] [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] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 12/24/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Cleidocranial dysplasia is a rare hereditary skeletal disorder due to heterozygous loss of function mutations in the RUNX2 gene that encodes runt-related transcription factor 2 (RUNX2). Here we report a 52 year-old woman with cleidocranial dysplasia due to a novel RUNX2 mutation. CASE DESCRIPTION A 52 year-old Han Chinese woman presented with short stature and skeletal dysplasia that was first noted during early childhood. She was 153 cm in height and 40 kg in weight. Her skull was deformed with hypertelorism, midface hypoplasia, protrusion of chin, and dental abnormalities. Radiological examination revealed shortened clavicles and depressed skull bone and that were consistent with the clinical diagnosis of cleidocranial dysplasia. There was no family history of a similar skeletal disorder. We sequenced the RUNX2 gene and discovered a novel heterozygous mutation in exon 3 (c.476 del G, p.G159fs175X) that is predicted to cause a frameshift and premature termination that leads to the loss of the final 347 amino acid residues. This severely truncated protein is expected to be inactive. LITERATURE REVIEW RUNX2 gene controls osteoblast differentiation and chondrocyte maturation. Around 90 RUNX2 mutations have been discovered in patients with cleidocranial dysplasia. CLINICAL RELEVANCE We identified a case of cleidocranial dysplasia due to a novel mutation of RUNX2 gene at exon 3 (c.476 del G).
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Affiliation(s)
- Ya-Wun Guo
- Department of Internal Medicine, Taipei City HospitalZhongxing Branch, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalTaipei, ROC. 112, Taiwan
| | - Chih-Yang Chiu
- Department of Pathology and Laboratory Medicine, Taipei Veterans General HospitalTaipei, Taiwan
| | - Chien-Lin Liu
- Department of Orthopaedics and Traumatology, Taipei Veterans General HospitalTaipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of MedicineROC. 112, Taiwan
| | - Tjin-Shing Jap
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalTaipei, ROC. 112, Taiwan
- Faculty of Medicine, National Yang-Ming University School of MedicineROC. 112, Taiwan
| | - Liang-Yu Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General HospitalTaipei, ROC. 112, Taiwan
- Faculty of Medicine, National Yang-Ming University School of MedicineROC. 112, Taiwan
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McGee-Lawrence ME, Carpio LR, Bradley EW, Dudakovic A, Lian JB, van Wijnen AJ, Kakar S, Hsu W, Westendorf JJ. Runx2 is required for early stages of endochondral bone formation but delays final stages of bone repair in Axin2-deficient mice. Bone 2014; 66:277-86. [PMID: 24973690 PMCID: PMC4125446 DOI: 10.1016/j.bone.2014.06.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/13/2014] [Accepted: 06/18/2014] [Indexed: 11/19/2022]
Abstract
Runx2 and Axin2 regulate skeletal development. We recently determined that Axin2 and Runx2 molecularly interact in differentiating osteoblasts to regulate intramembranous bone formation, but the relationship between these factors in endochondral bone formation was unresolved. To address this, we examined the effects of Axin2 deficiency on the cleidocranial dysplasia (CCD) phenotype of Runx2(+/-) mice, focusing on skeletal defects attributed to improper endochondral bone formation. Axin2 deficiency unexpectedly exacerbated calvarial components of the CCD phenotype in the Runx2(+/-) mice; the endocranial layer of the frontal suture, which develops by endochondral bone formation, failed to mineralize in Axin2(-/-):Runx2(+/-) mice, resulting in a cartilaginous, fibrotic and larger fontanel than observed in Runx2(+/-) mice. Transcripts associated with cartilage development (e.g., Acan, miR140) were expressed at higher levels, whereas blood vessel morphogenesis transcripts (e.g., Slit2) were suppressed in Axin2(-/-):Runx2(+/-) calvaria. Cartilage maturation was impaired, as primary chondrocytes from double mutant mice demonstrated delayed differentiation and produced less calcified matrix in vitro. The genetic dominance of Runx2 was also reflected during endochondral fracture repair, as both Runx2(+/-) and double mutant Axin2(-/-):Runx2(+/-) mice had enlarged fracture calluses at early stages of healing. However, by the end stages of fracture healing, double mutant animals diverged from the Runx2(+/-) mice, showing smaller calluses and increased torsional strength indicative of more rapid end stage bone formation as seen in the Axin2(-/-) mice. Taken together, our data demonstrate a dominant role for Runx2 in chondrocyte maturation, but implicate Axin2 as an important modulator of the terminal stages of endochondral bone formation.
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Affiliation(s)
| | | | | | | | | | | | | | - Wei Hsu
- University of Rochester Medical Center, Rochester, NY, USA
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Chen T, Hou J, Hu LL, Gao J, Wu BL. A novel small deletion mutation in RUNX2 gene in one Chinese family with cleidocranial dysplasia. Int J Clin Exp Pathol 2014; 7:2490-2495. [PMID: 24966961 PMCID: PMC4069909] [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] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 04/27/2014] [Indexed: 06/03/2023]
Abstract
Cleidocranial dysplasia (CCD) is a skeletal dysplasia with autosomal-dominant inheritance. The runt related transcription factor 2 (RUNX2) gene is the only gene in which mutations are known to cause CCD. We report identification of a novel small deletions mutation in the RUNX2 gene in a Chinese family with CCD. A 29-year-old female was diagnosed as proband of CCD based on the clinical findings, which show delayed closure of the fontanels, hypoplastic or aplastic clavicles and dental anomalies. Similar dental and skeletal symptoms were also observed in the other three affected individuals. We prepared genomic DNA from all four affected individuals, unaffected individual from her family members, as well as 100 unrelated healthy controls. PCR was conducted using the above genomic DNA as template and the RUNX2 gene-specific primers. The PCR product was subjected to direct sequencing and the sequence was compared to that of RUNX2 gene within the NCBI database. We detected a small deletion CCTA from nucleotide 635 to nucleotide 638 in exon 3 of RUNX2 gene of the proband. This will lead to the introduction of a translational stop codon at codon 220, resulting in a truncated RUNX2 protein, and therefore within the runt domain of the RUNX2 protein. We detected the same mutation in the the other three affected individuals, and did not detect any mutation in the unaffected family members or the 100 unrelated healthy controls, demonstrating that this is a novel missense mutation in RUNX2 gene and therefore, contributes to the molecular diagnosis of CCD.
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Affiliation(s)
- Ting Chen
- Department of Stomatology, Nanfang Hospital, College of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Jin Hou
- Department of Stomatology, Nanfang Hospital, College of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Ling-Ling Hu
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Jie Gao
- Department of Stomatology, Nanfang Hospital, College of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Bu-Ling Wu
- Department of Stomatology, Nanfang Hospital, College of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, China
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Oosterkamp BCM, Ockeloen CW, Carels CEL, Kuijpers-Jagtman AM. [Tooth eruption disturbances and syndromes]. Ned Tijdschr Tandheelkd 2014; 121:233-238. [PMID: 24881265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the tooth eruption mechanism, various disturbances can appear as a result of gene mutations, a consequence of which can be that tooth eruption does not occur. There are 5 syndromes which involve the complete failure of several or even all teeth to erupt, specifically: cleidocranial dysplasia, Gardner's syndrome, osteopetrosis, mucopolysaccharidosis and GAPO syndrome. Some are very rare and will seldom be encountered in a dental practice, but they show how vulnerable the tooth eruption mechanism is. Dentists are generally the ones who identify a tooth eruption problem in a patient. Since syndromes can be associated with other disorders, additional investigation by a clinical geneticist is always important when a syndrome is suspected.
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Matsushita M, Kitoh H, Kaneko H, Mishima K, Itoh Y, Tokita Y, Ishiguro N. A novel in-frame deletion of the RUNX2 gene causes a classic form of cleidocranial dysplasia. J Bone Miner Metab 2014; 32:96-9. [PMID: 23558979 DOI: 10.1007/s00774-013-0456-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 02/28/2013] [Indexed: 11/30/2022]
Abstract
The runt-related transcription factor 2 (RUNX2) is a physiological regulatory gene implicated in the development of cleidocranial dysplasia (CCD). Molecular analysis of the RUNX2 gene in a 2-year-old boy with a diagnosis of CCD demonstrated a heterozygous in-frame 9-bp deletion (c.593_601delCCTTGACCA, corresponding to the amino-acid deletion p.ΔTLT198_200). Transcription activity of the ΔTLT198_200 mutant decreased in a similar degree to that of the L199F mutant, which was previously reported in the case with classic CCD. Atomic model assessment demonstrated that the ΔTLT198_200 mutation abolished the heterodimerization of the RUNX2 protein with the partner subunit, polyomavirus enhancer-binding protein 2β (PEBP2β). Destruction of RUNX2/PEBP2β heterodimerization activity appears to impair the function of the RUNX2 protein and cause the disease.
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Affiliation(s)
- Masaki Matsushita
- Departments of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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32
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Jiang T, Jiang X, Zhang Y. [Mutation analysis of the RUNX2 gene in a family with cleidocranial dysplasia]. Hua Xi Kou Qiang Yi Xue Za Zhi 2013; 31:522-525. [PMID: 24298808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To analyze the mutations of the RUNX2 gene in a family with cleidocranial dysplasia (CCD). METHODS The general health status of family members with CCD was investigated through propositus verification method. Oral specialized examination and radiological examination were performed. The peripheral venous blood of the proband and her parents and sisters was collected. Genomic DNA was extracted, and the RUNX2 gene from this DNA was amplified by polymerase chain reaction (PCR). DNA sequences were analyzed with the Blastn program. RESULTS After Blastn analysis, heterozygous C to T transition mutation at nucleotide 568 occurred in exon 2, which converted arginine to tryptophane at codon 190 (c.568C>T, CGG-->TGG). CONCLUSION RUNX2 gene is responsible for the CCD in the Chinese family under study. The c.568C>T mutation is the molecular basis of the CCD in the family.
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Affiliation(s)
- Tao Jiang
- General Department, Jinan Stomatological Hospital, Jinan 250001, China
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Callea M, Fattori F, Yavuz I, Bertini E. A new phenotypic variant in cleidocranial dysplasia (CCD) associated with mutation c.391C>T of the RUNX2 gene. BMJ Case Rep 2012; 2012:bcr1220115422. [PMID: 23220435 PMCID: PMC4542990 DOI: 10.1136/bcr-12-2011-5422] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The RUNX2 gene is a physiological regulatory gene implicated in the development of cleidocranial dysplasia (CCD). A 13-month-old child presented with clinical features of CCD. At the age of 3 years the diagnosis was corroborated by clinical genetic assessment and DNA analysis, revealing a missense mutation p.R131C (c.391C>T) in RUNX2. At the age of 8 years the child was found to have a unique dental phenotype, represented by lack of supernumerary teeth and congenital absence of one tooth. A simple therapeutic approach was adopted, consisting of interceptive orthodontic treatment. The presence of this specific missense mutation in RUNX2, associated with the lack of typical supernumerary teeth may suggest a phenotype-genotype association.
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Affiliation(s)
- Michele Callea
- Institute for Maternal and Child Health--IRCCS Burlo Garofolo, Trieste, Italy.
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Morrison NA, Stephens AA, Osato M, Polly P, Tan TC, Yamashita N, Doecke JD, Pasco J, Fozzard N, Jones G, Ralston SH, Sambrook PN, Prince RL, Nicholson GC. Glutamine repeat variants in human RUNX2 associated with decreased femoral neck BMD, broadband ultrasound attenuation and target gene transactivation. PLoS One 2012; 7:e42617. [PMID: 22912713 PMCID: PMC3418257 DOI: 10.1371/journal.pone.0042617] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 07/09/2012] [Indexed: 12/28/2022] Open
Abstract
RUNX2 is an essential transcription factor required for skeletal development and cartilage formation. Haploinsufficiency of RUNX2 leads to cleidocranial displaysia (CCD) a skeletal disorder characterised by gross dysgenesis of bones particularly those derived from intramembranous bone formation. A notable feature of the RUNX2 protein is the polyglutamine and polyalanine (23Q/17A) domain coded by a repeat sequence. Since none of the known mutations causing CCD characterised to date map in the glutamine repeat region, we hypothesised that Q-repeat mutations may be related to a more subtle bone phenotype. We screened subjects derived from four normal populations for Q-repeat variants. A total of 22 subjects were identified who were heterozygous for a wild type allele and a Q-repeat variant allele: (15Q, 16Q, 18Q and 30Q). Although not every subject had data for all measures, Q-repeat variants had a significant deficit in BMD with an average decrease of 0.7SD measured over 12 BMD-related parameters (p = 0.005). Femoral neck BMD was measured in all subjects (-0.6SD, p = 0.0007). The transactivation function of RUNX2 was determined for 16Q and 30Q alleles using a reporter gene assay. 16Q and 30Q alleles displayed significantly lower transactivation function compared to wild type (23Q). Our analysis has identified novel Q-repeat mutations that occur at a collective frequency of about 0.4%. These mutations significantly alter BMD and display impaired transactivation function, introducing a new class of functionally relevant RUNX2 mutants.
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Affiliation(s)
- Nigel A Morrison
- School of Medical Sciences, Griffith University, Southport, Australia.
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Gardham A, Forsythe E, Goulden N. One in 10 million: a case of cleidocranial dysplasia and acute lymphoblastic leukaemia--more than just a coincidence? Clin Dysmorphol 2012; 21:170-171. [PMID: 22569278 DOI: 10.1097/mcd.0b013e32835431fd] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alice Gardham
- NW Thames Regional Genetics Service, Harrow, Middlesex Institute of Child Health, London Department of Haematology and Oncology, Great Ormond Street Hospital, London, UK
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Diaconescu S, Păduraru G, Vâscu AM, Burlea M. [Pierre Marie-Sainton cleidocranial dysplasia]. Rev Med Chir Soc Med Nat Iasi 2011; 115:341-348. [PMID: 21870721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The paper presents a family with hereditary transmitted Marie-Sainton dysplasia affecting the father and his both children. This is a rare syndrome presenting an autosomal pattern of inheritance, characterized by a generalized defect in both membranous and endochondral bone formation resulting in clavicular aplasia, delayed ossification of the fontanelles and the sutures of the skull and prolonged retention of deciduous dentition with delayed eruption of the permanent teeth. The diagnosis is suggested by more or less complete clinical picture and confirmed by multiple radiological explorations (skull, thorax, spinal column, pelvis) and genetical examination. The genetic mutation for cleidocranial dysplasia (CCD) is found on chromosome six and is called CBFA1 (short for core biding factor al or RUNX2) and is the only gene known to be associated with CCD. The normal version of CBFA1 acts to induce osteoblasts which are the type of cells that lay down bone. Although associated psychosocial disorders can occur, the prognosis and life expectancy of this condition are favorable being conditioned however by the complexity of orthodontic procedures which are determinant for these patients life quality.
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Affiliation(s)
- Smaranda Diaconescu
- Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi, Facultatea de Medicină, Clinica a V-a Pediatrie-Gastroenterologie
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Wang GX, Ma LX, Xu WF, Song FL, Sun RP. [Clinical and image features, and identification of pathogenic gene mutation of two cleidocranial dysplasia families]. Zhonghua Er Ke Za Zhi 2010; 48:834-838. [PMID: 21215027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Cleidocranial dysplasia (CCD) is a dominantly inherited skeletal dysplasia caused by mutations in the osteoblast-specific transcription factor-encoding gene, core binding factor α1 (CBFA1). Over 90 mutations in CBFA1 gene have been published to date in 500 independent cases of CCD, including missense mutations, deletions, insertions, frameshift, and splice mutations. However, mutational screening of the CBFA1 gene is still far from saturation, and more novel mutations will be identified to enrich the insights into the molecular basis for the pathogenesis of CCD. The aim of this study was to explore the clinical and image features and detect the mutations of CBFA1 gene in two CCD families. METHOD In this study, the clinical features were investigated in two CCD families, radiological and CT examinations regarding osseous malformation were carried out over the entire body of these patients with CCD. Blood (2 ml) was drawn from all affected individuals, unaffected family members and one hundred unrelated normal controls, Genomic DNA was extracted from whole blood with PureGene DNA extraction kit and PCR was performed with eight pairs of PCR primers for exons 0 to 7 of the CBFA1 gene. The mutations of CBFA1 gene were screened in these two CCD families. RESULT (1) The clinical features of patients with CCD include delayed closure of fontanelles, frontal bossing, dysplasia of clavicles, late tooth eruption, and other skeletal anomalies. X-ray and CT examination showed the bulging calvarium, patent fontanelles, wide cranial sutures, multiple Wormian bones, dental dysplasia or aplasia of clavicles. (2) Two mutations were identified, one is novel missense mutation (c.1259C > T[p.T420I]) in CBFA1 gene exon 7, other (c.577C > T[p.R193X]) was reported in Chinese cases with CCD for the first time. CONCLUSION (1) The clinical and image features of patients in two CCD families include delayed closure of fontanelles, frontal bossing, dysplasia of clavicles, late tooth eruption, and other skeletal anomalies. (2) The T420I and R193X mutations of CBFA1 were reported, expanding the spectrum of CBFA1 mutations causing CCD.
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Affiliation(s)
- Guang-xin Wang
- Department of Paediatrics, Qilu Hospital of Shandong University, Jinan 250012, China
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38
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Suresh SS. A family with cleidocranial dysplasia and crossed ectopic kidney in one child. Acta Orthop Belg 2009; 75:521-527. [PMID: 19774820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cleidocranial dysplasia or dysostosis (CCD) is a condition characterised by failure of membranous ossification resulting in absence or pseudarthrosis of the clavicle, open fontanelles, wormian bones and supernumerary teeth. The aetiology though not completely known is thought to be due to a CBFA1 (core binding factor activity 1) gene defect on the short arm of chromosome 6p21. CBFA1 is essential for differentiation of stem cells into osteoblasts, so any defect in this gene will cause defects in membranous and endochondral bone formation. Since the first description, over 700 cases have been reported in literature. The authors report a family with mother and her four sons affected with CCD and Crossed Renal Ectopia (CRE) in one child, which has not been reported in CCD before.
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Cunningham ML, Seto ML, Hing AV, Bull MJ, Hopkin RJ, Leppig KA. Cleidocranial dysplasia with severe parietal bone dysplasia: C-terminal RUNX2 mutations. ACTA ACUST UNITED AC 2009; 76:78-85. [PMID: 16463420 DOI: 10.1002/bdra.20231] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cleidocranial dysplasia (CCD) is an autosomal-dominant skeletal dysplasia syndrome that is characterized by widely patent calvarial sutures, clavicular hypoplasia, supernumerary teeth, and short stature. CCD is caused by mutations in the transcription factor RUNX2, which is known to function as a major regulator of bone differentiation. Despite the characterization of 67 unique mutations in 97 individual cases, and the availability of animal models, no obvious genotype-phenotype correlation has emerged. METHODS We describe 3 new cases that were ascertained on the basis of a severe calvarial phenotype, that were associated with 3 novel mutations in the C-terminal region of RUNX2 distal to the DNA-binding runt domain. In addition, a review of all previously described cases was undertaken in an effort to standardize mutation nomenclature, characterize the position of known mutations relative to the runt domain, and explore the hypothesis that C-terminal mutations that preserve the runt domain may lead to more-severe craniofacial phenotypes. RESULTS Upon mutational analysis of RUNX2, we identified either frameshift or splice-site mutations that affect the C-terminal region of the resultant protein distal to the runt domain. CONCLUSIONS In the context of previously described mutations, these cases suggest that C-terminal mutations that preserve the DNA-binding runt domain while disrupting the SMAD 1,2,3,5 binding domain and the nuclear matrix targeting signal may be responsible for the severe phenotype observed.
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Affiliation(s)
- Michael L Cunningham
- Children's Craniofacial Center, Children's Hospital and Regional Medical Center, Seattle, Washington 98195-6320, USA.
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40
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Xuan D, Li S, Zhang X, Hu F, Lin L, Wang C, Zhang J. Mutations in the RUNX2 gene in Chinese patients with cleidocranial dysplasia. Ann Clin Lab Sci 2008; 38:15-24. [PMID: 18316777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cleidocranial dysplasia (CCD) is an autosomal dominant inheritable skeletal disease caused by heterozygous mutations in an osteoblast-specific transcription factor, RUNX2. Mutational analyses of RUNX2 were done on 4 unrelated Chinese patients with CCD. One nonsense and 3 missense mutations were detected, including one novel mutation, a heterozygous G to C transition mutation at nucleotide 475 in exon 2, which converts glycine to arginine at codon 159 (G159R). Two mutations, R225W and R391X, were reported in Chinese patients with CCD for the first time. Our findings show that R225 mutations interfere with nuclear accumulation of RUNX2 protein, and that a lack of nuclear RUNX2 protein accumulation is at least one of the causes of haploinsufficiency in these cases. Body stature was significantly reduced in the 3 male and 1 female cases. The cases all had malformations of the tarsometatarsal joints. In 1 case, the humeroulnar joints and humeroradial joints were abnormal, and the elbow looked like a triangle. The data suggest that an impaired runt domain contributes to the short stature of CCD patients. We postulate that RUNX2 influences joint formation by affecting the differentiation pathways of chondrocytes and osteoblasts.
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Affiliation(s)
- Dongying Xuan
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulevard, Guangzhou, 510280, China
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Baumert U, Golan I, Driemel O, Reichert TE, Reicheneder C, Muessig D, Rose E. [Cleidocranial dysplasia. Description and analysis of a patient cohort]. ACTA ACUST UNITED AC 2007; 10:385-93. [PMID: 17051365 DOI: 10.1007/s10006-006-0029-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cleidocranial dysplasia (CCD) is a rare dysplasia of bony and dental tissue. Characteristic are typical craniofacial and dental findings including morphological anomalies. CCD is possibly the only general syndrome that can be diagnosed based on the dental findings alone. CCD correlates with mutations in the RUNX2 gene. PURPOSE The present interdisciplinary study correlates phenotypic findings with genetic variations in the corresponding gene. PATIENTS AND METHODS The coding sequence of the RUNX2 gene from 31 CCD patients from 20 families was analyzed using molecular genetic methods including polymerase chain reaction and direct sequencing. The craniofacial and dental findings of each patient were evaluated according to a standardized scoring scheme and tested with homogeneity analysis for general phenotypic findings. RESULTS Several mutations of the RUNX2 gene were identified. Depending on the mutation type, they showed different distribution patterns within the gene coinciding with the functional domains of the gene product. With homogeneity analysis of the phenotype cardinal (especially dental findings) and minor findings (pneumatization disturbances, Wormian bones) were identified. In combination with the genetic data, the statistical analysis showed that loss-of-function mutations of the RUNX2 gene result in a milder markedness of the CCD phenotype than gain-of-function or decrease-of-function mutations. CONCLUSIONS We found that type and location of a specific mutation within the RUNX2 gene might have an impact on the expressivity of CCD. Due to the limited sampling size this hypothesis must be verified by investigations in larger patient groups.
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Affiliation(s)
- U Baumert
- AG Kraniofaziale Genetik/Tissue Engineering, BioPark Regensburg, Zentrum für Medizinische Biotechnologie, Josef-Engert-Strasse 9, 93051 Regensburg, Germany.
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Abstract
Cleidocranial dysplasia (CCD) is typically an autosomal dominant condition. The possibility of alternative causes, such as an autosomal recessive form or germ line mosaicism, have been suggested in some families with CCD, but not proven. We present a family consisting of a mother having three sons affected with CCD. One of the affected boys is a half brother to the other two affected children. The diagnosis of CCD was confirmed by DNA analysis of the RUNX2 gene in all three of the boys in blood; however, initial DNA testing in the mother's blood did not detect the presence of a RUNX2 mutation in the mother. Further testing through heteroduplex analysis applying high-resolution melting analysis followed by subcloning detected low-level mosaicism in DNA isolated from maternal blood and buccal swab, confirming low-level mosaicism in somatic cells. We present the first case of confirmed germ line mosaicism in CCD.
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Affiliation(s)
- T Pal
- Department of Pediatrics, All Children's Hospital, College of Medicine, The University of South Florida, St Petersburg, Florida 33612, USA.
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43
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Segal N, Puterman M. Cleidocranial dysplasia - review with an emphasis on otological and audiological manifestations. Int J Pediatr Otorhinolaryngol 2007; 71:523-6. [PMID: 17239447 DOI: 10.1016/j.ijporl.2006.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2006] [Accepted: 11/28/2006] [Indexed: 11/21/2022]
Abstract
Cleidocranial dysplasia is a rare developmental abnormality of bone that affects both the skeleton and the temporal bone. It is genetically characterized and the clinical signs and symptoms can be diverse. Aural pathologies may be the presenting symptoms of the disease. We reviewed the up to date literature on the syndrome with an emphasis on the otological and audiological manifestation.
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Affiliation(s)
- Nili Segal
- Department of Otolaryngology, Head and Neck Surgery, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Matheny CJ, Speck ME, Cushing PR, Zhou Y, Corpora T, Regan M, Newman M, Roudaia L, Speck CL, Gu TL, Griffey SM, Bushweller JH, Speck NA. Disease mutations in RUNX1 and RUNX2 create nonfunctional, dominant-negative, or hypomorphic alleles. EMBO J 2007; 26:1163-75. [PMID: 17290219 PMCID: PMC1852839 DOI: 10.1038/sj.emboj.7601568] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [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: 05/11/2006] [Accepted: 01/02/2007] [Indexed: 12/29/2022] Open
Abstract
Monoallelic RUNX1 mutations cause familial platelet disorder with predisposition for acute myelogenous leukemia (FPD/AML). Sporadic mono- and biallelic mutations are found at high frequencies in AML M0, in radiation-associated and therapy-related myelodysplastic syndrome and AML, and in isolated cases of AML M2, M5a, M3 relapse, and chronic myelogenous leukemia in blast phase. Mutations in RUNX2 cause the inherited skeletal disorder cleidocranial dysplasia (CCD). Most hematopoietic missense mutations in Runx1 involve DNA-contacting residues in the Runt domain, whereas the majority of CCD mutations in Runx2 are predicted to impair CBFbeta binding or the Runt domain structure. We introduced different classes of missense mutations into Runx1 and characterized their effects on DNA and CBFbeta binding by the Runt domain, and on Runx1 function in vivo. Mutations involving DNA-contacting residues severely inactivate Runx1 function, whereas mutations that affect CBFbeta binding but not DNA binding result in hypomorphic alleles. We conclude that hypomorphic RUNX2 alleles can cause CCD, whereas hematopoietic disease requires more severely inactivating RUNX1 mutations.
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Affiliation(s)
| | - Maren E Speck
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
| | - Patrick R Cushing
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
| | - Yunpeng Zhou
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
| | - Takeshi Corpora
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
| | - Michael Regan
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
| | - Miki Newman
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
| | - Liya Roudaia
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
| | - Caroline L Speck
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
| | - Ting-Lei Gu
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
| | - Stephen M Griffey
- Comparative Pathology Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - John H Bushweller
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
- Department of Chemistry, University of Virginia, Charlottesville, VA, USA
| | - Nancy A Speck
- Department of Biochemistry, Dartmouth Medical School, Hanover, NH, USA
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Balaton G, Tarján I, Balaton P, Barabási Z, Gyulai Gál S, Nagy K, Vajó Z. [Orthodontic and oral surgery therapy in cleidocranial dysplasia]. Fogorv Sz 2007; 100:17-21. [PMID: 17444132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A cleidocranial dysplasia is an autosomal dominant inherited condition consisting of generalized skeletal disorder. Associated dental signs are present in 93,5%; failure of tooth eruption with multiple supernumerary teeth, dilaceration of roots, crown germination, microdontia, high arched palate, midface hypoplasia, high gonion angle. The molecular- genetic analysis revealed a missense mutation in the CBFA1 gene located on chromosome 6p21, which is considered to be etiological factor for CCD. Orthodontic and oral surgery therapy of a 13 year-old child with CCD was performed due to aesthetic and functional problems. The supernumerary germs were removed and the teeth were aligned with orthodontic appliances. Temporary functional rehabilitation was solved with partial denture. The presented case and the literature data support the importance of early diagnosis of CCD. The good collaboration of the orthodontic and maxillo-facial surgery specialists help achieve the correct rehabilitation of the patient.
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Lo Muzio L, Tetè S, Mastrangelo F, Cazzolla AP, Lacaita MG, Margaglione M, Campisi G. A novel mutation of gene CBFA1/RUNX2 in cleidocranial dysplasia. Ann Clin Lab Sci 2007; 37:115-20. [PMID: 17522365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia characterised by abnormal clavicles, patent sutures and fontanelles, supernumerary teeth, short stature, and a variety of other skeletal changes. The disease gene is CBFA1/RUNX2, which is mapped to chromosome 6p21. Inactivation of the CBFA1/RUNX2 gene by mutations is involved in the skeletal defects that occur in patients with CCD. CBFA1/RUNX2 controls the differentiation of precursor cells into osteoblasts and is essential for membranous as well as endochondral bone formation. In this study of a 14-yr-old boy with typical CCD phenotype, the authors found a novel CBFA1/RUNX2 gene mutation. All of the amplified segments from the patient's CBFA1/RUNX2 gene were identical to those obtained in controls, except for the one spanning the exon 7 and intron/exon boundary regions. Direct sequencing of the PCR product showed a heterozygous T-to-A transition mutation at nucleotide 1182 in exon 7, leading to Y394X mutation. The predicted protein product lacks 128 amino acids, including part of the PST domain. Identification of this novel mutation constitutes a further step in elucidating the pathogenesis of this autosomal disorder.
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Affiliation(s)
- Lorenzo Lo Muzio
- Department of Surgical Sciences, University of Foggia, Foggia, Italy.
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Kisiel BM, Kostrzewa G, Wlasienko P, Kruczek A, Gajdulewicz M, Maciejak D, Wisniewska M, Ploski R, Korniszewski L. Cleidocranial dysplasia in a Polish population: high frequency of the R193X mutation. Clin Genet 2006; 70:167-9. [PMID: 16879201 DOI: 10.1111/j.1399-0004.2006.00648.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hecht J, Seitz V, Urban M, Wagner F, Robinson PN, Stiege A, Dieterich C, Kornak U, Wilkening U, Brieske N, Zwingman C, Kidess A, Stricker S, Mundlos S. Detection of novel skeletogenesis target genes by comprehensive analysis of a Runx2(-/-) mouse model. Gene Expr Patterns 2006; 7:102-12. [PMID: 16829211 DOI: 10.1016/j.modgep.2006.05.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2006] [Revised: 05/26/2006] [Accepted: 05/29/2006] [Indexed: 01/06/2023]
Abstract
Runx2 is an essential factor for skeletogenesis and heterozygous loss causes cleidocranial dysplasia in humans and a corresponding phenotype in the mouse. Homozygous Runx2-deficient mice lack hypertrophic cartilage and bone. We compared the expression profiles of E14.5 wildtype and Runx2(-/-) murine embryonal humeri to identify new transcripts potentially involved in cartilage and bone development. Seventy-one differentially expressed genes were identified by two independent oligonucleotide-microarray hybridizations and quantitative RT-PCR experiments. Gene Ontology analysis demonstrated an enrichment of the differentially regulated genes in annotations to terms such as extracellular, skeletal development, and ossification. In situ hybridization on E15.5 limb sections was performed for all 71 differentially regulated genes. For 54 genes conclusive in situ hybridization results were obtained and all of them showed skeletal expression. Co-expression with Runx2 was demonstrated for 44 genes. While 41 of the 71 differentially expressed genes have a known role in bone and cartilage, we identified 21 known genes that have not yet been implicated in skeletal development and 9 entirely new transcripts. Expression in the developing skeleton was demonstrated for 21 of these genes.
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Affiliation(s)
- J Hecht
- Max Planck Institute for Molecular Genetics, Ihnestr. 73, 14195 Berlin,Germany
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Abstract
Oral anomalies and dental treatment in a patient with cleidocranial dysplasia (referred to the dental clinic at the age of 40 years) are presented. Five supernumerary teeth were found in the patient: three in the maxilla in the area of molars and two in the mandibula in the area of premolars. Therapy included surgical exposure of impacted teeth in combination with removal of supernumerary teeth.
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Affiliation(s)
- Aneta Olszewska
- Department of Pediatric Dentistry, University of Medical Sciences, Bukowska 70, 60-812 Poznań, Poland
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Baumert U, Golan I, Redlich M, Aknin JJ, Muessig D. Clarification of data reported in “Cleidocranial Dysplasia: Molecular Genetic Analysis and Phenotypic-Based Description of a Middle European Patient Group” (AJMG 139A:78–85). Am J Med Genet A 2006; 140:1030. [PMID: 16575894 DOI: 10.1002/ajmg.a.31182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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