Tyson Christine, Qiao Ying, Harvard Chansonette, Liu Xudong, Bernier Francois P, McGillivray Barbara, Farrell Sandra A, Arbour Laura, Chudley Albert E, Clarke Lorne, Gibson William, Dyack Sarah, McLeod Ross, Costa Teresa, Vanallen Margot I, Yong Siu-Li, Graham Gail E, Macleod Patrick, Patel Millan S, Hurlburt Jane, Holden Jeanette Ja, Lewis Suzanne Me, Rajcan-Separovic Evica
Department of Pathology and Laboratory Medicine and Child and Family Research Institute (CFRI), UBC, Vancouver, BC, Canada.
Mol Cytogenet. 2008 Nov 11;1:23. doi: 10.1186/1755-8166-1-23.
BACKGROUND: Jacobsen syndrome is a rare contiguous gene disorder that results from a terminal deletion of the long arm of chromosome 11. It is typically characterized by intellectual disability, a variety of physical anomalies and a distinctive facial appearance. The 11q deletion has traditionally been identified by routine chromosome analysis. Array-based comparative genomic hybridization (array-CGH) has offered new opportunities to identify and refine chromosomal abnormalities in regions known to be associated with clinical syndromes. RESULTS: Using the 1 Mb BAC array (Spectral Genomics), we screened 70 chromosomally normal children with idiopathic intellectual disability (ID) and congenital abnormalities, and identified five cases with submicroscopic abnormalities believed to contribute to their phenotypes. Here, we provide detailed molecular cytogenetic descriptions and clinical presentation of two unrelated subjects with de novo submicroscopic deletions within chromosome bands 11q24-25. In subject 1 the chromosome rearrangement consisted of a 6.18 Mb deletion (from 128.25-134.43 Mb) and an adjacent 5.04 Mb duplication (from 123.15-128.19 Mb), while in subject 2, a 4.74 Mb interstitial deletion was found (from 124.29-129.03 Mb). Higher resolution array analysis (385 K Nimblegen) was used to refine all breakpoints. Deletions of the 11q24-25 region are known to be associated with Jacobsen syndrome (JBS: OMIM 147791). However, neither of the subjects had the typical features of JBS (trigonocephaly, platelet disorder, heart abnormalities). Both subjects had ID, dysmorphic features and additional phenotypic abnormalities: subject 1 had a kidney abnormality, bilateral preauricular pits, pectus excavatum, mild to moderate conductive hearing loss and behavioral concerns; subject 2 had macrocephaly, an abnormal MRI with delayed myelination, fifth finger shortening and squaring of all fingertips, and sensorineural hearing loss. CONCLUSION: Two individuals with ID who did not have the typical clinical features of Jacobsen syndrome were found to have deletions within the JBS region at 11q24-25. Their rearrangements facilitate the refinement of the JBS critical region and suggest that a) deletion of at least 3 of the 4 platelet function critical genes (ETS-1, FLI-1 and NFRKB and JAM3) is necessary for thrombocytopenia; b) one of the critical regions for heart abnormalities (conotruncal heart defects) may lie within 129.03 - 130.6 Mb; c) deletions of KCNJ1 and ADAMTS15 may contribute to the renal anomalies in Jacobsen Syndrome; d) the critical region for MRI abnormalities involves a region from 124.6 - 129.03 Mb. Our results reiterate the benefits of array-CGH for description of new phenotype/genotype associations and refinement of previously established ones.
背景:雅各布森综合征是一种罕见的连续性基因疾病,由11号染色体长臂末端缺失所致。其典型特征为智力残疾、多种身体异常及独特的面部外观。传统上,11q缺失通过常规染色体分析来识别。基于微阵列的比较基因组杂交技术(array-CGH)为识别和细化已知与临床综合征相关区域的染色体异常提供了新机会。 结果:我们使用1 Mb细菌人工染色体阵列(Spectral Genomics)对70名染色体正常但患有特发性智力残疾(ID)和先天性异常的儿童进行了筛查,确定了5例存在亚微观异常的病例,这些异常被认为与他们的表型有关。在此,我们提供了两名无关个体的详细分子细胞遗传学描述和临床表现,这两名个体在染色体带11q24 - 25内存在新生亚微观缺失。在个体1中,染色体重排包括一个6.18 Mb的缺失(从128.25 - 134.43 Mb)和一个相邻的5.04 Mb重复(从123.15 - 128.19 Mb),而在个体2中,发现了一个4.74 Mb的间质缺失(从124.29 - 129.03 Mb)。使用更高分辨率的阵列分析(385 K Nimblegen)来细化所有断点。已知11q24 - 25区域的缺失与雅各布森综合征(JBS:OMIM 147791)相关。然而,这两名个体均不具有JBS的典型特征(三角头畸形、血小板疾病、心脏异常)。两名个体均有智力残疾、畸形特征及其他表型异常:个体1有肾脏异常、双侧耳前凹、漏斗胸、轻度至中度传导性听力损失及行为问题;个体2有巨头畸形、MRI显示髓鞘形成延迟异常、第五指缩短及所有指尖呈方形,以及感音神经性听力损失。 结论:发现两名患有智力残疾但不具有雅各布森综合征典型临床特征的个体在11q24 - 25的JBS区域存在缺失。他们的重排有助于细化JBS关键区域,并表明:a)血小板减少症至少需要4个血小板功能关键基因(ETS - 1、FLI - 1、NFRKB和JAM3)中的3个缺失;b)心脏异常(圆锥动脉干心脏缺陷)的关键区域之一可能位于129.03 - 130.6 Mb之间;c)KCNJ和ADAMTS15的缺失可能导致雅各布森综合征中的肾脏异常;d)MRI异常关键区域涉及124.至129.03 Mb区域。我们的结果重申了array-CGH在描述新的表型/基因型关联及细化先前已确定的关联方面的益处。
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