Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA.
J Med Genet. 2010 Nov;47(11):777-81. doi: 10.1136/jmg.2009.075903. Epub 2010 Oct 4.
Congenital diaphragmatic hernia (CDH) can occur in isolation or in association with other abnormalities. We hypothesised that some cases of non-isolated CDH are caused by novel genomic disorders.
In a cohort of >12, 000 patients referred for array comparative genomic hybridisation testing, we identified three individuals-two of whom had CDH--with deletions involving a ∼2.3 Mb region on chromosome 15q25.2. Two additional patients with deletions of this region have been reported, including a fetus with CDH. Clinical data from these patients suggest that recurrent deletions of 15q25.2 are associated with an increased risk of developing CDH, cognitive deficits, cryptorchidism, short stature and possibly Diamond-Blackfan anaemia (DBA). Although no known CDH-associated genes are located on 15q25.2, four genes in this region--CPEB1, AP3B2, HOMER2 and HDGFRP3--have been implicated in CNS development/function and may contribute to the cognitive deficits seen in deletion patients. Deletions of RPS17 may also predispose individuals with 15q25.2 deletions to DBA and associated anomalies.
Individuals with recurrent deletions of 15q25.2 are at increased risk for CDH and other birth defects. A high index of suspicion should exist for the development of cognitive defects, anaemia and DBA-associated malignancies in these individuals.
先天性膈疝 (CDH) 可孤立发生,也可与其他异常并存。我们假设,一些非孤立性 CDH 病例是由新的基因组疾病引起的。
在一个超过 12000 名患者的队列中,这些患者被转介进行阵列比较基因组杂交检测,我们发现了 3 名个体——其中 2 名患有 CDH——他们的 15q25.2 染色体上存在涉及约 2.3 Mb 区域的缺失。已有 2 例报道了该区域缺失的患者,包括一名患有 CDH 的胎儿。这些患者的临床数据表明,15q25.2 的重复缺失与增加发生 CDH、认知缺陷、隐睾、身材矮小和可能的 Diamond-Blackfan 贫血(DBA)的风险相关。虽然 15q25.2 上没有已知的 CDH 相关基因,但该区域的 4 个基因——CPEB1、AP3B2、HOMER2 和 HDGFRP3——已被牵连到 CNS 发育/功能中,可能导致缺失患者的认知缺陷。RPS17 的缺失也可能使 15q25.2 缺失的个体易患 DBA 和相关异常。
反复发生 15q25.2 缺失的个体患 CDH 和其他出生缺陷的风险增加。这些个体应高度怀疑出现认知缺陷、贫血和 DBA 相关恶性肿瘤。