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1.
Int J Mol Sci ; 24(15)2023 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-37569667

RESUMEN

Microcephalic Osteodysplastic Primordial Dwarfism type II (MOPDII) represents the most common form of primordial dwarfism. MOPD clinical features include severe prenatal and postnatal growth retardation, postnatal severe microcephaly, hypotonia, and an increased risk for cerebrovascular disease and insulin resistance. Autosomal recessive biallelic loss-of-function genomic variants in the centrosomal pericentrin (PCNT) gene on chromosome 21q22 cause MOPDII. Over the past decade, exome sequencing (ES) and massive RNA sequencing have been effectively employed for both the discovery of novel disease genes and to expand the genotypes of well-known diseases. In this paper we report the results both the RNA sequencing and ES of three patients affected by MOPDII with the aim of exploring whether differentially expressed genes and previously uncharacterized gene variants, in addition to PCNT pathogenic variants, could be associated with the complex phenotype of this disease. We discovered a downregulation of key factors involved in growth, such as IGF1R, IGF2R, and RAF1, in all three investigated patients. Moreover, ES identified a shortlist of genes associated with deleterious, rare variants in MOPDII patients. Our results suggest that Next Generation Sequencing (NGS) technologies can be successfully applied for the molecular characterization of the complex genotypic background of MOPDII.


Asunto(s)
Enanismo , Microcefalia , Osteocondrodisplasias , Humanos , Femenino , Embarazo , Microcefalia/genética , Exoma/genética , Transcriptoma , Retardo del Crecimiento Fetal/genética , Enanismo/genética , Osteocondrodisplasias/genética , Genotipo , Mutación
2.
Cancers (Basel) ; 15(7)2023 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-37046605

RESUMEN

CRC is an adult-onset carcinoma representing the third most common cancer and the second leading cause of cancer-related deaths in the world. EO-CRC (<45 years of age) accounts for 5% of the CRC cases and is associated with cancer-predisposing genetic factors in half of them. Here, we describe the case of a woman affected by BWSp who developed EO-CRC at age 27. To look for a possible molecular link between BWSp and EO-CRC, we analysed her whole-genome genetic and epigenetic profiles in blood, and peri-neoplastic and neoplastic colon tissues. The results revealed a general instability of the tumor genome, including copy number and methylation changes affecting genes of the WNT signaling pathway, CRC biomarkers and imprinted loci. At the germline level, two missense mutations predicted to be likely pathogenic were found in compound heterozygosity affecting the Cystic Fibrosis (CF) gene CFTR that has been recently classified as a tumor suppressor gene, whose dysregulation represents a severe risk factor for developing CRC. We also detected constitutional loss of methylation of the KCNQ1OT1:TSS-DMR that leads to bi-allelic expression of the lncRNA KCNQ1OT1 and BWSp. Our results support the hypothesis that the inherited CFTR mutations, together with constitutional loss of methylation of the KCNQ1OT1:TSS-DMR, initiate the tumorigenesis process. Further somatic genetic and epigenetic changes enhancing the activation of the WNT/beta-catenin pathway likely contributed to increase the growth advantage of cancer cells. Although this study does not provide any conclusive cause-effect relationship between BWSp and CRC, it is tempting to speculate that the imprinting defect of BWSp might accelerate tumorigenesis in adult cancer in the presence of predisposing genetic variants.

3.
J Matern Fetal Neonatal Med ; 36(1): 2205985, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37100787

RESUMEN

Short-rib thoracic dysplasia 3 with or without polydactyly (OMIM # 613091) represents a clinical spectrum encompassing a heterogeneous group of skeletal dysplasias associated with homozygous or compound heterozygous mutations of DYNC2H1. We describe the case of a couple with two consecutive therapeutic abortions due to a diagnosis of short-rib thoracic dysplasia mutations. In the first pregnancy, the diagnosis has been made at 21 weeks. In the second one, an accurate and early ultrasound examination allowed a diagnosis at 12 weeks. DYNC2H1 mutations were confirmed in both cases. In this report, we underline the importance of an ultrasound evaluation at the end of the first trimester of pregnancy in the detection of early signs of skeletal dysplasias. An early prenatal diagnosis of a short-rib skeletal dysplasia, such as for other severe skeletal dysplasias, is critical to offer a couple the chance of a weighted, informed, and less traumatic decision about the continuation of the pregnancy.


Asunto(s)
Osteocondrodisplasias , Síndrome de Costilla Pequeña y Polidactilia , Embarazo , Femenino , Humanos , Síndrome de Costilla Pequeña y Polidactilia/diagnóstico , Síndrome de Costilla Pequeña y Polidactilia/genética , Diagnóstico Prenatal , Ultrasonografía , Osteocondrodisplasias/diagnóstico por imagen , Osteocondrodisplasias/genética , Costillas , Ultrasonografía Prenatal , Dineínas Citoplasmáticas/genética
4.
Eur J Pediatr ; 181(1): 171-187, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34232366

RESUMEN

Kabuki syndrome (KS) is a well-recognized disorder characterized by postnatal growth deficiency, dysmorphic facial features, skeletal anomalies, and intellectual disability. The syndrome is caused by KMT2D gene mutations or less frequently KDM6A gene mutations or deletions. We report a systematic evaluation of KS patients from Campania region of Italy; data were also compared with literature ones. We collected data of 15 subjects (8 males and 7 females with age range 10-26 years; mean age 16.9 years) with confirmed diagnosis of KS, representing the entire cohort of patients from Campania Region. Each patient performed biochemical testing and instrumental investigation. Neuro-intellectual development, cranio-facial dysmorphisms, and multisystem involvement data were collected retrospectively. For each category, type of defects and frequency of the anomalies were analyzed. Our observation shows that KS patients from Campania region have some particular and previously underscored, neurological and immunological findings. We found high prevalence of EEG's abnormalities (43%) and MRI brain abnormalities (60%). Microcephaly resulted more common in our series (33%), if compared with major cohorts described in literature. Biochemical features of immunodeficiency and autoimmune diseases including thyroid autoimmunity, polyserositis, and vitiligo were observed with high prevalence (54.5%). Low immunoglobulins levels were a frequent finding. Lymphocyte class investigation showed significantly reduced CD8 levels in one patient.Conclusions: These data confirm great heterogeneity of clinical manifestations in KS and suggest to introduce further clinical diagnostic criteria in order to perform a correct and precocious diagnosis. What is Known • Kabuki syndrome is characterized by growth deficiency, dysmorphic facial features, skeletal anomalies, and intellectual disability • Immune dysfunction is a common finding but autoimmune diseases are rarely seen • Neurological features are common What is New • Some particular facial features could help gestalt diagnosis (hypertelorism, broad nasal bridge, micrognathia, tooth agenesis, cutaneous haemangiomas and strabismus) • Higher prevalence of autoimmune disorders than previously reported • Particular neurological features are present in this cohort (EEG and MRI brain abnormalities).


Asunto(s)
Anomalías Múltiples , Enfermedades Hematológicas , Enfermedades Vestibulares , Anomalías Múltiples/diagnóstico , Anomalías Múltiples/epidemiología , Anomalías Múltiples/genética , Adolescente , Adulto , Niño , Cara/anomalías , Femenino , Enfermedades Hematológicas/epidemiología , Humanos , Masculino , Estudios Retrospectivos , Enfermedades Vestibulares/diagnóstico , Enfermedades Vestibulares/epidemiología , Adulto Joven
5.
J Pediatr Genet ; 10(3): 245-249, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34504730

RESUMEN

Inverted duplications deletions are rare, complex, and nonrecurrent chromosomal rearrangements associated with a variable phenotype. In this case report, we described the phenotype and genotype of a 14-week-old male fetus, who was aborted after discovery of multiple anomalies (septal cystic hygroma, open abdominal wall, and a nonidentifiable lower limb). At autopsy, fluorescence in situ hybridization and array comparative genomic hybridization identified an inverted duplication with terminal deletion of 4p [46,XY,der(4)del(p16.3)dup(4)(p15.2p16.3)]. Only five genotypically similar cases have been reported, and we hope our case contribution will add meaningful to the body of knowledge.

6.
Ital J Pediatr ; 42(1): 65, 2016 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-27411491

RESUMEN

BACKGROUND: Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. This study aimed to update the prevalence and to identify possible determinants of preconception folic acid supplement use in Italian women. METHODS: The study was based on cross-sectional data from seven maternity clinics located in six Italian regions from January to June, 2012. Data on maternal characteristics and supplement use were collected for 2,189 women using a self-administered questionnaire. RESULTS: Preconception folic acid use was reported by 23.5 % (n = 515) of the participants. Of these, 479 (93 %) women had taken folic acid supplements on a daily basis as recommended by the health authorities. Women who both had intended their pregnancy and had requested a preconception health visit to a doctor/gynecologist were substantially more likely than the reference group to initiate folic acid supplementation before their pregnancy (48.6 versus 4.8 %). Preconception folic acid use was also associated with higher maternal age, higher education, marriage/cohabitation, lower parity, infertility treatments, and chronic disease. CONCLUSIONS: Data from seven maternity clinics located in six Italian regions indicate that preconception folic acid supplement use in many Italian women is low. Women who do not plan their pregnancy or do not request a preconception health visit to their doctor have among the lowest prevalence of preconception folic acid use. Improving folate status in these and other supplemental non-users may have important disease preventive effects.


Asunto(s)
Ácido Fólico/administración & dosificación , Defectos del Tubo Neural/prevención & control , Atención Preconceptiva , Adulto , Estudios Transversales , Suplementos Dietéticos , Femenino , Humanos , Italia , Prevalencia , Encuestas y Cuestionarios
7.
Ital J Pediatr ; 40: 91, 2014 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-25416843

RESUMEN

OBJECTIVES: Adequate preconception maternal health care is essential to reduce the risk of unwanted pregnancy outcomes and complications. Still, many women are exposed to a number of unhealthy risk factors both before and early in pregnancy. This study aimed to estimate the prevalence of a number of important preconception risk factors using data from a recent multicenter study in Italy. METHODS: The study was based on cross-sectional data from seven maternity clinics located in six different regions in Italy during the period January - June, 2012. Data on maternal preconception risk factors and characteristics were collected from 1,892 women who delivered healthy children and 320 women who were pregnant in the first trimester. RESULTS: About 97% of the women (n =2,212) were exposed to one or more preconception risk factors. The overall prevalence of the most essential maternal risk factors was as follows: 41% had a age ≥35 years, 36% mistimed or did not intend their pregnancy, 58% did not request a preconception health visit to their doctor, 76% did not use folic acid supplements before pregnancy, 26% smoked at the last menstrual period, 19% had a body mass index ≥25 kg/m2 before pregnancy, and 10% suffered from pregestational chronic diseases. The prevalence of certain variables varied between the maternity clinics. CONCLUSIONS: Many Italian women are exposed to a number of preconception risk factors that have been associated with adverse pregnancy complications and outcomes. More effective intervention programs to improve preconception health in Italian women are strongly needed.


Asunto(s)
Estado de Salud , Conducta Materna , Adolescente , Adulto , Instituciones de Atención Ambulatoria , Índice de Masa Corporal , Enfermedad Crónica/epidemiología , Estudios Transversales , Femenino , Ácido Fólico/uso terapéutico , Humanos , Italia/epidemiología , Persona de Mediana Edad , Atención Preconceptiva/estadística & datos numéricos , Embarazo , Embarazo no Planeado , Factores de Riesgo , Fumar/epidemiología , Encuestas y Cuestionarios , Complejo Vitamínico B/uso terapéutico , Adulto Joven
8.
Prenat Diagn ; 34(11): 1093-8, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24916896

RESUMEN

OBJECTIVES: The aim of this study is to describe the prenatal diagnosis and epidemiology of multicystic kidney dysplasia (MCKD). METHODS: The study is based on routinely collected data from a European database of major congenital anomalies including 13 registries with cases born in 1997-2006 and covering 1 458 552 births. RESULTS: There were 601 MCKD cases giving an overall prevalence of 4.12 per 10 000 births with regional variation. In live births, 87% of cases had an isolated renal anomaly and 13% had associated major nonrenal anomalies (chromosomal, syndrome or other major anomalies). For the cases with isolated renal anomalies, 51/386 (11%) and 7/386 (2%) choose to terminate the pregnancy or resulted in an intrauterine fetal death, respectively. The prenatal detection rate was 88% in both unilateral and bilateral cases. Birth outcome differed with 92% of unilateral MCKD cases being liveborn compared with 33% of bilateral MCKD cases. For unilateral MCKD cases, 84% had an isolated renal anomaly compared with 51% of bilateral MCKD cases (p < 0.001). CONCLUSIONS: Cases with unilateral MCKD are mainly liveborn, and only 16% have associated major malformations or a syndrome. Cases with bilateral MCKD are often associated with nonrenal major congenital anomalies or part of a syndrome, and only one third of bilateral MCKD cases in this study were liveborn. Prenatal detection rate of MCKD was high for both unilateral and bilateral cases. © 2014 John Wiley & Sons, Ltd.


Asunto(s)
Riñón Displástico Multiquístico/diagnóstico , Riñón Displástico Multiquístico/epidemiología , Diagnóstico Prenatal , Anomalías Múltiples/epidemiología , Europa (Continente)/epidemiología , Femenino , Muerte Fetal , Edad Gestacional , Humanos , Recién Nacido , Nacimiento Vivo/epidemiología , Masculino , Embarazo , Diagnóstico Prenatal/estadística & datos numéricos , Prevalencia , Sistema de Registros/estadística & datos numéricos , Mortinato/epidemiología
9.
Hum Mutat ; 35(7): 841-50, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24633898

RESUMEN

Kabuki syndrome (KS) is a multiple congenital anomalies syndrome characterized by characteristic facial features and varying degrees of mental retardation, caused by mutations in KMT2D/MLL2 and KDM6A/UTX genes. In this study, we performed a mutational screening on 303 Kabuki patients by direct sequencing, MLPA, and quantitative PCR identifying 133 KMT2D, 62 never described before, and four KDM6A mutations, three of them are novel. We found that a number of KMT2D truncating mutations result in mRNA degradation through the nonsense-mediated mRNA decay, contributing to protein haploinsufficiency. Furthermore, we demonstrated that the reduction of KMT2D protein level in patients' lymphoblastoid and skin fibroblast cell lines carrying KMT2D-truncating mutations affects the expression levels of known KMT2D target genes. Finally, we hypothesized that the KS patients may benefit from a readthrough therapy to restore physiological levels of KMT2D and KDM6A proteins. To assess this, we performed a proof-of-principle study on 14 KMT2D and two KDM6A nonsense mutations using specific compounds that mediate translational readthrough and thereby stimulate the re-expression of full-length functional proteins. Our experimental data showed that both KMT2D and KDM6A nonsense mutations displayed high levels of readthrough in response to gentamicin treatment, paving the way to further studies aimed at eventually treating some Kabuki patients with readthrough inducers.


Asunto(s)
Anomalías Múltiples/genética , Cara/anomalías , Enfermedades Hematológicas/genética , Enfermedades Vestibulares/genética , Anomalías Múltiples/tratamiento farmacológico , Línea Celular , Codón sin Sentido/efectos de los fármacos , Estudios de Cohortes , Análisis Mutacional de ADN , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Expresión Génica , Regulación de la Expresión Génica/efectos de los fármacos , Estudios de Asociación Genética , Gentamicinas/farmacología , Gentamicinas/uso terapéutico , Haploinsuficiencia , Enfermedades Hematológicas/tratamiento farmacológico , Histona Demetilasas/genética , Proteínas de Homeodominio/genética , Humanos , Mutación , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Degradación de ARNm Mediada por Codón sin Sentido , Proteínas Nucleares/genética , Sitios de Empalme de ARN , Análisis de Secuencia de ADN , Transcripción Genética , Enfermedades Vestibulares/tratamiento farmacológico
10.
Hum Mutat ; 33(4): 665-73, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22190451

RESUMEN

Dominant missense mutations in FLNB, encoding the actin-cross linking protein filamin B (FLNB), cause a broad range of skeletal dysplasias with varying severity by an unknown mechanism. Here these FLNB mutations are shown to cluster in exons encoding the actin-binding domain (ABD) and filamin repeats surrounding the flexible hinge 1 region of the FLNB rod domain. Despite being positioned in domains that bind actin, it is unknown if these mutations perturb cytoskeletal structure. Expression of several full-length FLNB constructs containing ABD mutations resulted in the appearance of actin-containing cytoplasmic focal accumulations of the substituted protein to a degree that was correlated with the severity of the associated phenotypes. In contrast, study of mutations leading to substitutions in the FLNB rod domain that result in the same phenotypes as ABD mutations demonstrated that with only one exception disease-associated substitutions, surrounding hinge 1 demonstrated no tendency to form actin-filamin foci. The exception, a substitution in filamin repeat 6, lies within a region previously implicated in filamin-actin binding. These data are consistent with mutations in the ABD conferring enhanced actin-binding activity but suggest that substitutions affecting repeats near the flexible hinge region of FLNB precipitate the same phenotypes through a different mechanism.


Asunto(s)
Actinas/metabolismo , Proteínas Contráctiles/genética , Proteínas Contráctiles/metabolismo , Citoplasma/metabolismo , Proteínas de Microfilamentos/genética , Proteínas de Microfilamentos/metabolismo , Anomalías Musculoesqueléticas/genética , Mutación , Osteocondrodisplasias/genética , Sitios de Unión , Enanismo/genética , Facies , Filaminas , Humanos , Secuencias Repetitivas de Ácidos Nucleicos , Índice de Severidad de la Enfermedad
11.
Am J Med Genet C Semin Med Genet ; 157C(4): 262-73, 2011 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-22002952

RESUMEN

Acardia is a severe, complex malformation of monozygotic twinning, but beyond clinical case series, very few epidemiologic data are available. The goals of this study were to assess the epidemiologic characteristics of acardia from birth defect registries in the International Clearinghouse for Birth Defects Surveillance and Research (Clearinghouse), and compare these findings to current literature. The study included 17 surveillance programs of the Clearinghouse representing 23 countries from North and South America, Europe, China, and Australia. Anonymized individual records with clinical and demographic data were reviewed centrally by clinical geneticists. A literature search was performed. A total of 164 cases of acardia were reported from an underlying cohort of 21.2 million births. Of these, 23% were elective pregnancy terminations. Rates did not vary significantly by maternal age. For many cases, information on pregnancy exposures and genetic testing was missing. However, these limited data did not suggest high rates of chronic illnesses (diabetes, seizure disorders) or lifestyle factors such as smoking. One case had trisomy 13. Major malformations were reported in 2.4% of co-twins. With some basic assumptions, the total prevalence of acardia was estimated at 1 in 50,000-70,000 births, and 1 in 200-280 monozygotic twins. In summary, acardia is a dramatic, probably underreported, and incompletely understood malformation. Studies on its epidemiology and etiology are challenging and still rare. An international collaboration of epidemiologists, clinicians, and geneticists is necessary to understand the etiology, pathogenesis, and occurrence of this severe malformation complex.


Asunto(s)
Anencefalia/epidemiología , Enfermedades en Gemelos/epidemiología , Cardiopatías Congénitas/epidemiología , Cooperación Internacional , Vigilancia de la Población/métodos , Gemelos Monocigóticos , Adulto , Américas/epidemiología , Anencefalia/patología , Australia/epidemiología , China/epidemiología , Anomalías Congénitas/epidemiología , Anomalías Congénitas/patología , Enfermedades en Gemelos/genética , Enfermedades en Gemelos/patología , Estudios Epidemiológicos , Europa (Continente)/epidemiología , Femenino , Cardiopatías Congénitas/patología , Humanos , Recién Nacido , Masculino , Edad Materna , Embarazo , Embarazo Múltiple , Prevalencia , Sistema de Registros , Adulto Joven
12.
Orphanet J Rare Dis ; 6: 38, 2011 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-21658225

RESUMEN

BACKGROUND: Kabuki syndrome (Niikawa-Kuroki syndrome) is a rare, multiple congenital anomalies/mental retardation syndrome characterized by a peculiar face, short stature, skeletal, visceral and dermatoglyphic abnormalities, cardiac anomalies, and immunological defects. Recently mutations in the histone methyl transferase MLL2 gene have been identified as its underlying cause. METHODS: Genomic DNAs were extracted from 62 index patients clinically diagnosed as affected by Kabuki syndrome. Sanger sequencing was performed to analyze the whole coding region of the MLL2 gene including intron-exon junctions. The putative causal and possible functional effect of each nucleotide variant identified was estimated by in silico prediction tools. RESULTS: We identified 45 patients with MLL2 nucleotide variants. 38 out of the 42 variants were never described before. Consistently with previous reports, the majority are nonsense or frameshift mutations predicted to generate a truncated polypeptide. We also identified 3 indel, 7 missense and 3 splice site. CONCLUSIONS: This study emphasizes the relevance of mutational screening of the MLL2 gene among patients diagnosed with Kabuki syndrome. The identification of a large spectrum of MLL2 mutations possibly offers the opportunity to improve the actual knowledge on the clinical basis of this multiple congenital anomalies/mental retardation syndrome, design functional studies to understand the molecular mechanisms underlying this disease, establish genotype-phenotype correlations and improve clinical management.


Asunto(s)
Anomalías Múltiples/genética , Anomalías Múltiples/patología , Análisis Mutacional de ADN , Proteínas de Unión al ADN/genética , Enfermedades Hematológicas/genética , Enfermedades Hematológicas/patología , Proteínas de Neoplasias/genética , Enfermedades Vestibulares/genética , Enfermedades Vestibulares/patología , Anomalías Múltiples/diagnóstico , Niño , Preescolar , Codón sin Sentido/genética , Estudios de Cohortes , Discapacidades del Desarrollo/genética , Cara/anomalías , Cara/patología , Femenino , Mutación del Sistema de Lectura/genética , Estudios de Asociación Genética , Humanos , Discapacidad Intelectual/genética , Masculino , Fenotipo , Análisis de Secuencia de ADN
13.
Am J Med Genet A ; 149A(11): 2452-6, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19839044

RESUMEN

We report on a 3-year-old boy with prenatal onset of proportionate dwarfism, postnatal severe microcephaly, high forehead with receded hairline, sparse scalp hair, beaked nose, mild retrognathia and hypotonia diagnosed at birth as Seckel syndrome. At age 3 years, he became paralyzed due to a cerebrovascular malformation. Based on the clinical and radiological features showing evidence of skeletal dysplasia, the diagnosis was revised to Majewski osteodysplastic primordial dwarfism type II (MOPD II) syndrome. Western blot analysis of the patient's lymphoblastoid cell line lysate showed the absence of the protein pericentrin. Subsequent molecular analysis identified a novel homozygous single base insertion (c.1527_1528insA) in exon 10 of the PCNT gene, which leads to a frameshift (Treo510fs) and to premature protein truncation. PCNT mutations must be considered diagnostic of MOPD II syndrome. A possible role of pericentrin in the development of cerebral vessels is suggested.


Asunto(s)
Antígenos/genética , Enanismo/complicaciones , Enanismo/diagnóstico , Mutación/genética , Síndrome de Costilla Pequeña y Polidactilia/complicaciones , Síndrome de Costilla Pequeña y Polidactilia/diagnóstico , Adulto , Secuencia de Bases , Western Blotting , Huesos/diagnóstico por imagen , Encéfalo/patología , Estudios de Casos y Controles , Preescolar , Análisis Mutacional de ADN , Diagnóstico Diferencial , Enanismo/diagnóstico por imagen , Femenino , Humanos , Lactante , Recién Nacido , Angiografía por Resonancia Magnética , Masculino , Datos de Secuencia Molecular , Embarazo , Radiografía , Síndrome de Costilla Pequeña y Polidactilia/diagnóstico por imagen , Síndrome
14.
Cleft Palate Craniofac J ; 45(5): 525-32, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18788868

RESUMEN

OBJECTIVES: To identify preferential associations between oral clefts (CL = cleft lip only, CLP = cleft lip with cleft palate, CP = cleft palate) and nonoral cleft anomalies, to interpret them on clinical grounds, and, based on the patterns of associated defects, to establish whether CL and CLP are different conditions. DESIGN AND SETTINGS: Included were 1416 cleft cases (CL = 131, CLP = 565, CP = 720), among 8304 live- and stillborn infants with multiple congenital anomalies, from 6,559,028 births reported to the International Clearinghouse for Birth Defects Surveillance and Research by 15 registries between 1994 and 2004. Rates of associated anomalies were established, and multinomial logistic regressions applied to identify significant associations. RESULTS: Positive associations with clefts were observed for only a few defects, among which anencephaly, encephaloceles, club feet, and ear anomalies were the most outstanding. Anomalies negatively associated with clefts included congenital heart defects, VATER complex (vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia), and spina bifida. CONCLUSION: The strong association between all types of clefts and anencephaly seems to be attributable to cases with disruptions; the association between CP and club feet seems to be attributable to conditions with fetal akinesia. Some negative associations may depend on methodologic factors, while others, such as clefts with VATER components or clefts with spina bifida, may depend on biological factors. The different patterns of defects associated with CL and CLP, indicating different underlying mechanisms, suggest that CL and CLP reflect more than just variable degrees of severity, and that distinct pathways might be involved.


Asunto(s)
Anomalías Múltiples/epidemiología , Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Anencefalia/epidemiología , Ano Imperforado/epidemiología , Pie Equinovaro/epidemiología , Anomalías Congénitas/epidemiología , Oído/anomalías , Encefalocele/epidemiología , Salud Global , Cardiopatías Congénitas/epidemiología , Humanos , Recién Nacido , Riñón/anomalías , Vigilancia de la Población , Sistema de Registros/estadística & datos numéricos , Disrafia Espinal/epidemiología , Columna Vertebral/anomalías , Mortinato/epidemiología , Fístula Traqueoesofágica/epidemiología
15.
Am J Med Genet A ; 143A(22): 2733-7, 2007 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-17937430

RESUMEN

Chromosomal abnormalities may cause autism by disrupting a gene or by providing a permissive genetic environment for mutations elsewhere in the genome to become expressed as autism. We report here on a patient with an apparently balanced de novo translocation of chromosomes 1q and 5q. He presented with minor dysmorphic features and renal malformations, mental retardation, and autism. Further characterization of the chromosomal rearrangement by FISH revealed a deletion in chromosome 1 from q23.3 to q24.2 corresponding to a region of rising interest in the research of autism susceptibility genes. The array-CGH technique gave better resolution of the breakpoints and the size of the deletion was calculated to be 4.97 Mb.


Asunto(s)
Trastorno Autístico/genética , Cromosomas Humanos Par 1 , Cromosomas Humanos Par 5 , Cromosomas , Translocación Genética , Anomalías Múltiples , Humanos , Hibridación Fluorescente in Situ , Lactante , Discapacidad Intelectual , Masculino
16.
Eur J Med Genet ; 50(4): 301-8, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17591464

RESUMEN

Microdeletions of Xp22.3 can result in contiguous gene syndromes, showing the variable association of apparently unrelated clinical manifestations such as ichthyosis, chondrodysplasia punctata, hypogonadotropic hypogonadism, anosmia, ocular albinism, short stature and mental retardation. We report on a boy with ichthyosis, dysmorphic features and mental retardation with ADHD. The patient was born at term after a pregnancy complicated by threatened abortion; decreased fetal movements and low estriol serum levels were reported during the last trimester. The boy was referred to us at the age of 13 years. He presented with aggressive and hyperactive behavior. He had dry hair, a flat face, bilateral lens opacities, a small nose with hypoplastic tip, alae nasi and nares, a high-arched palate with a very small cleft, mixed dentition with 7 unerupted permanent teeth, left sensorineural and right mixed hearing loss with a calcified plaque of the tympanic membrane, marked shortness of terminal phalanges of hands and feet, ichthyosis of trunk and limbs. The genomic interval between AFM248th5 and KAL1 was investigated. PCR analysis showed a deletion in Xp22.3, with the distal breakpoint between the marker AFM248th5 and PABX and the proximal one between DXS278 and KAL1. Array-CGH and FISH analysis confirmed the interstitial deletion (of about 5.5 Mb) and refined the breakpoints. We discuss the phenotype of our patient in relationship to the deleted segment and the possibility of mental retardation and ADHD genes in the region.


Asunto(s)
Anomalías Múltiples/genética , Trastorno por Déficit de Atención con Hiperactividad/genética , Condrodisplasia Punctata/genética , Deleción Cromosómica , Cromosomas Humanos X , Ictiosis/genética , Discapacidad Intelectual/genética , Adolescente , Análisis Citogenético , Proteínas de la Matriz Extracelular/genética , Marcadores Genéticos , Humanos , Masculino , Proteínas del Tejido Nervioso/genética , Fenotipo
17.
J Med Genet ; 44(1): e60, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17209130

RESUMEN

BACKGROUND: Chromosome 13q deletion is associated with varying phenotypes, which seem to depend on the location of the deleted segment. Although various attempts have been made to link the 13q deletion intervals to distinct phenotypes, there is still no acknowledged consensus correlation between the monosomy of distinct 13q regions and specific clinical features. METHODS: 14 Italian patients carrying partial de novo 13q deletions were studied. Molecular-cytogenetic characterisation was carried out by means of array-comparative genomic hybridisation (array-CGH) or fluorescent in situ hybridisation (FISH). RESULTS: Our 14 patients showed mental retardation ranging from profound-severe to moderate-mild: eight had central nervous system (CNS) anomalies, including neural tube defects (NTDs), six had eye abnormalities, nine had facial dysmorphisms and 10 had hand or feet anomalies. The size of the deleted regions varied from 4.2 to 75.7 Mb. CONCLUSION: This study is the first systematic molecular characterisation of de novo 13q deletions, and offers a karyotype-phenotype correlation based on detailed clinical studies and molecular determinations of the deleted regions. Analyses confirm that patients lacking the 13q32 band are the most seriously affected, and critical intervals have been preliminarily assigned for CNS malformations. Dose-sensitive genes proximal to q33.2 may be involved in NTDs. The minimal deletion interval associated with the Dandy-Walker malformation (DWM) was narrowed to the 13q32.2-33.2 region, in which the ZIC2 and ZIC5 genes proposed as underlying various CNS malformations are mapped.


Asunto(s)
Anomalías Múltiples/genética , Deleción Cromosómica , Cromosomas Humanos Par 13/genética , Adolescente , Adulto , Proteínas Portadoras/genética , Niño , Preescolar , Trastornos de los Cromosomas , Proteínas de Unión al ADN , Síndrome de Dandy-Walker/genética , Síndrome de Dandy-Walker/patología , Síndrome de Dandy-Walker/fisiopatología , Femenino , Humanos , Hibridación Fluorescente in Situ , Lactante , Recién Nacido , Cariotipificación , Masculino , Proteínas Nucleares , Hibridación de Ácido Nucleico/métodos , Fenotipo , Factores de Transcripción/genética
18.
J Bone Miner Res ; 21(12): 1828-35, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17002563

RESUMEN

UNLABELLED: The analysis of 236 Italian patients with Paget's bone disease showed higher clinical severity and greater frequency of neoplastic degeneration among patients who live or descend from individuals living in the Campania region (southern Italy). A prevalent involvement of the spine and the skull, the sites preferentially involved in giant cell tumors complicating Paget's disease, was also shown in familial cases from this geographical region. INTRODUCTION: The Campania region in southern Italy has been recently indicated as a high prevalence area for Paget's disease of bone (PDB), and most pagetic families with multiple occurrence of neoplasms in affected members were from this geographical region. MATERIALS AND METHODS: We evaluated the PDB epidemiological characteristics in 125 patients from Campania in comparison with 111 patients from other Italian regions. Twenty-three patients from Campania and 26 patients from other Italian areas had at least one first-degree relative affected by PDB (familial cases). The remaining patients made up the sporadic cases. RESULTS: Among subjects from Campania, the patients in the familial group tended to come from larger families and showed at diagnosis higher serum total alkaline phosphatase, larger extension of disease, and earlier mean age with respect to patients with PDB of the sporadic group. The skull, spine, and humerus were the sites preferentially involved in the familial cases. In contrast, no such differences were observed between familial and sporadic PDB cases among patients from the other geographical areas, except for a lower age at diagnosis. An increased PDB clinical severity was finally observed in the PDB cohort from Campania in comparison with patients from other Italian regions. Neoplastic degeneration of pagetic bones (osteosarcoma and giant cell tumor) was exclusively observed in patients with polyostotic PDB from Campania. CONCLUSIONS: We showed a higher clinical severity of PDB with occurrence of neoplastic degeneration in the high prevalence area of Campania, with its maximum expression in cases with familial disease. This peculiar pattern might be traced to genetic predisposition and/or to the abnormal impact of a still undefined environmental trigger.


Asunto(s)
Osteítis Deformante/epidemiología , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Ambiente , Femenino , Predisposición Genética a la Enfermedad/epidemiología , Tumores de Células Gigantes/epidemiología , Tumores de Células Gigantes/etiología , Tumores de Células Gigantes/genética , Humanos , Italia , Masculino , Persona de Mediana Edad , Osteítis Deformante/complicaciones , Osteítis Deformante/genética , Osteosarcoma/epidemiología , Osteosarcoma/etiología , Osteosarcoma/genética , Prevalencia
19.
Anal Bioanal Chem ; 383(3): 398-403, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16205894

RESUMEN

Cd-bound phytochelatins (Cd-PCs) have been synthesised by incubation of Phaeodactylum tricornutum cell cultures with Cd and purified by size-exclusion chromatography-UV-Vis. These complexes, which were identified in previous work, have now been used as model substances to develop and optimise ion-pair chromatography (IPC) coupled to inductively coupled plasma-mass spectrometry (ICP-MS) for analysis of Cd-PCs. Subsequent analysis of samples taken from Silene vulgaris plants cultivated under heavy metal stress conditions revealed Cd signals but no Cd-PC signals. By use of isotopically enriched (116)Cd-PCs the sample preparation steps were verified to determine the stability of the analytes. We observed species transformation between Cd-PCs and other unidentified Cd complexes. Consequently, the kinetic and thermodynamic lability of Cd-PCs are decisive factors in their detection.


Asunto(s)
Cadmio/metabolismo , Eucariontes/química , Eucariontes/metabolismo , Glutatión/biosíntesis , Glutatión/química , Cadmio/química , Extractos Celulares , Cromatografía en Gel , Glutatión/aislamiento & purificación , Glutatión/metabolismo , Espectrometría de Masas , Fitoquelatinas , Silene/química , Silene/metabolismo
20.
Physiol Genomics ; 23(2): 150-8, 2005 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-16046620

RESUMEN

Autosomal recessive mandibuloacral dysplasia [mandibuloacral dysplasia type A (MADA); Online Mendelian Inheritance in Man (OMIM) no. 248370] is caused by a mutation in LMNA encoding lamin A/C. Here we show that this mutation causes accumulation of the lamin A precursor protein, a marked alteration of the nuclear architecture and, hence, chromatin disorganization. Heterochromatin domains are altered or completely lost in MADA nuclei, consistent with the finding that heterochromatin-associated protein HP1beta and histone H3 methylated at lysine 9 and their nuclear envelope partner protein lamin B receptor (LBR) are delocalized and solubilized. Both accumulation of lamin A precursor and chromatin defects become more severe in older patients. These results strongly suggest that altered chromatin remodeling is a key event in the cascade of epigenetic events causing MADA and could be related to the premature-aging phenotype.


Asunto(s)
Huesos Faciales/anomalías , Heterocromatina/metabolismo , Membrana Nuclear/metabolismo , Adolescente , Adulto , Estudios de Casos y Controles , Homólogo de la Proteína Chromobox 5 , Proteínas Cromosómicas no Histona/metabolismo , Femenino , Fibroblastos/citología , Fibroblastos/patología , Fibroblastos/ultraestructura , Histonas/metabolismo , Humanos , Lamina Tipo A/metabolismo , Masculino , Persona de Mediana Edad , Membrana Nuclear/ultraestructura , Proteínas Nucleares/metabolismo , Precursores de Proteínas/metabolismo , Receptores Citoplasmáticos y Nucleares/metabolismo , Coloración y Etiquetado , Receptor de Lamina B
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