Maternal Steroid Hormone Levels in Early Pregnancy and Autism in the Offspring: A Population-Based, Nested Case-Control Study.

BACKGROUND: A role for prenatal steroid hormones in the etiology of autism has been proposed, but evidence is conflicting. METHODS: Here, we examined serum levels of maternal estradiol, testosterone, 17-hydroxyprogesterone (OHP), and cortisol from the first trimester of gestation (mean = 10.1 weeks) in relation to the odds of diagnosed autism with and without co-occurring intellectual disability (ID) in the offspring (n = 118 autism with ID, n = 249 autism without ID, n = 477 control). Levels of maternal hormones were measured using highly sensitive liquid chromatography tandem mass spectrometry, standardized according to gestational timing of sample collection, and analyzed with restricted cubic spline logistic regression models adjusting for child's sex and maternal health, demographic, and socioeconomic factors. RESULTS: We observed significant nonlinear associations between maternal estradiol, 17-OHP, and cortisol with autism, which varied with the presence of co-occurring ID. Compared to mean levels, lower levels of estradiol were associated with higher odds of autism with ID (odds ratio for concentrations 1 SD below the mean = 1.66; 95% CI, 1.24-2.11), while higher cortisol levels were associated with lower odds (odds ratio for 1 SD above the mean = 0.55; 95% CI, 0.36-0.88). In contrast, higher 17-OHP was associated with increased odds of autism without ID (odds ratio for 1 SD above the mean = 1.49; 95% CI, 1.11-1.99). We observed no evidence for interaction with sex of the child. CONCLUSIONS: These findings support the notion that the maternal steroid hormonal environment in early pregnancy may contribute to autism, but also emphasize the complex relationship between early-life steroid exposure and autism.

Label free quantitative proteomic profiling of serum samples of intellectually disabled young patients revealed dysregulation of complement coagulation and cholesterol cascade systems.

Intellectual disability is a heterogeneous disorder, diagnosed using intelligence quotient (IQ) score criteria. Currently, no specific clinical test is available to diagnose the disease and its subgroups due to inadequate understanding of the pathophysiology. Therefore, current study was designed to explore the molecular mechanisms involved in disease perturbation, and to identify potential biomarkers for disease diagnosis and prognosis. A total of 250 participants were enrolled in this study, including 200 intellectually disabled (ID) subjects from the subgroups (mild, moderate, and severe) with age and gender matched healthy controls (n = 50). Initially, IQ testing score and biochemical profile of each subject was generated, followed by label-free quantitative proteomics of subgroups of IQ and healthy control group through nano-LC/MS- mass spectrometry. A total of 310 proteins were identified, among them198 proteins were common among all groups. Statistical analysis (ANOVA) of the subgroups of ID showed 142 differentially expressed proteins, in comparison to healthy control group. From these, 120 proteins were found to be common among all subgroups. The remaining 22 proteins were categorized as exclusive proteins found only in disease subgroups. Furthermore, the hierarchical cluster analysis (HCL) of common significant proteins was also performed, followed by PANTHER protein classification and GO functional enrichment analysis. Results provides that the datasets of differentially expressed proteins, belong to the categories of immune / defense proteins, transfer carrier proteins, apolipoproteins, complement proteins, protease inhibitors, hemoglobin proteins etc., they are known to involvein immune system, and complement and coagulation pathway cascade and cholesterol metabolism pathway. Exclusively expressed 22 proteins were found to be disease stage specific and strong PPI network specifically those that have significant role in platelets activation and degranulation, such as Filamin A (FLNA). Furthermore, to validate the mass spectrometric findings, four highly significant proteins (APOA4, SAP, FLNA, and SERPING) were quantified by ELISA in all the study subjects. AUROC analysis showed a significant association of APOA4 (0.830), FLNA (0.958), SAP (0.754) and SERPING (0.600) with the disease. Apolipoprotein A4 (APOA4) has a significant role in cholesterol transport, and in modulation of glucose and lipid metabolism in the CNS. Similarly, FLNA has a crucial role in the nervous system, especially in the functioning of synaptic network. Therefore, both APOA4, and FLNA proteins represent good potential for candidate biomarkers for the diagnosis and prognosis of the intellectual disability. Overall, serum proteome of ID patients provides valuable information of proteins/pathways that are altered during ID progression.

Síndrome Schinzel-Giedion: nueva mutación en SETBP1 / Schinzel-Giedion syndrome: A new mutation in SETBP1

El síndrome Schinzel-Giedion (SSG) (#MIM 269150) es una enfermedad genética infrecuente, caracterizada por dismorfia cráneo-facial específica, anomalías congénitas múltiples y discapacidad intelectual grave. La mayoría de los pacientes fallece en los primeros años de vida. Se debe a mutaciones en el gen SETBP1, habiéndose descrito a la fecha un reducido número de pacientes con confirmación molecular. Presentamos a un paciente de 4 años con SSG asociado a la mutación c.2608G>T (p.Gly870Cys) en el gen SETBP1, no descrita previamente. Se revisan las características clínicas de esta enfermedad y su diagnóstico diferencial. Los rasgos dismórficos son muy característicos en el SSG. Su reconocimiento clínico es fundamental para alcanzar un diagnóstico precoz, planificar un correcto seguimiento y ofrecer asesoramiento genético familiar adecuado. A la fecha, este es el decimoséptimo paciente ublicado con mutación en el gen SETBP1, primero en España, contribuyendo a ampliar el conocimiento clínico y molecular de esta entidad

Schinzel-Giedion syndrome (SGS) (#MIM 269150) is a rare genetic disorder characterized by very marked craniofacial dysmorphism, multiple congenital anomalies and severe intellectual disability. Most affected patients die in early childhood. SETBP1 was identified as the causative gene, but a limited number of patients with molecular confirmation have been reported to date. The case is reported of a 4 and a half year-old male patient, affected by SGS. SETBP1 sequencing analysis revealed the presence of a non-previously described mutation: c.2608G>T (p.Gly870Cys). The clinical features and differential diagnosis of this rare condition are reviewed. Dysmorphic features are strongly suggestive of SGS. Its clinical recognition is essential to enable an early diagnosis, a proper follow-up, and to provide the family with genetic counseling. To date, this is the seventeenth SGS patient published with SETBP1 mutation, and the first in Spain, helping to widen clinical and molecular knowledge of the disease

Tamiz neonatal para hipotiroidismo congénito. Experiencia en el Laboratorio Regional del Sureste / Neonatal screening for congenital hypothyroidism. Experience in the Southeast Regional Laboratory

Introducción. Se presenta en este artículo los resultados del Programa para Prevención de Retraso Mental por Hipotiroidismo Congénito del Laboratorio Regional del Suereste. El objetivo del estudio fue mostrar la frecuencia de este problema en las muestras enviadas por los hospitales de Yucatán, Campeche, Quintana Roo, Chiapas, Tabasco y Oaxaca; asimismo, se describen algunos problemas y dificultades realcionados con éste. Material y métodos. Se estudiaron 58,154 muestras de sangre de niños en edades comprendidas desde el nacimiento hasta los 3 meses de edad, durante el período de enero de 1993 a diciembre de 1995. Resultados. Se detectó 20 casos de hipotiroidismo congénito, lo cual dio una incidencia de 1 caso en 2,907 recién nacidos tamizados. Conclusión. La incidencia fue menor a la reportada en estudios efectuados en México; asimismo, se identificaron algunos problemas relacionados con la toma de la muestras y los seguimientos de los casos sospechosos