Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, "Aldo Moro" University of Bari, Bari, Italy,
Eur J Pediatr. 2014 Mar;173(3):277-83. doi: 10.1007/s00431-014-2267-9. Epub 2014 Jan 25.
Abnormalities of the sex chromosomes (47, XXY, 47 XYY, 45,X/46,XY mosaicism) are frequently associated with Autism Spectrum Disorders (ASD), but the male predisposition to these disorders has not been clearly explained. Previously, the role of the X chromosome was considered important in the ASD mainly because autistic symptoms were detected in genetic syndromes involving X chromosome (fragile X syndrome, Rett syndrome, Klinefelter syndrome). Instead, few studies have analyzed the possible role of the Y chromosome in the ASD. This study explores the role of the Y chromosome in ASD through a systematic literature review about the association between ASD and XYY syndrome and a description of two new cases with this association. The literature review considered studies published in peer-reviewed journals, included in the MEDLINE and PubMed databases, that examined the association between ASD and XYY syndrome. Few studies reported the occurrence of ASD in children with XYY karyotype and the majority of them did not reported a well-defined autism diagnostic category associated with an extra Y chromosome, but several clinical conditions that are generically described as language and social impairment.
This study underlines the underestimated role of the Y chromosome in ASD, and we postulate that all the ASD associated with the XYY karyotype may presumably fall within mild degree of ASD as in our cases.
性染色体异常(47,XXY、47,XYY、45,X/46,XY 嵌合体)常与自闭症谱系障碍(ASD)相关,但男性易患这些疾病的原因尚未得到明确解释。此前,X 染色体的作用被认为在 ASD 中很重要,主要是因为在涉及 X 染色体的遗传综合征中发现了自闭症症状(脆性 X 综合征、雷特综合征、克莱恩费尔特综合征)。相反,很少有研究分析 Y 染色体在 ASD 中的可能作用。本研究通过系统地回顾关于 ASD 与 XYY 综合征之间关联的文献,以及描述两例具有这种关联的新病例,探讨了 Y 染色体在 ASD 中的作用。文献综述考虑了发表在同行评议期刊上的研究,这些研究被纳入 MEDLINE 和 PubMed 数据库,以检查 ASD 与 XYY 综合征之间的关联。很少有研究报告 XYY 核型儿童发生 ASD,而且大多数研究没有报告与额外的 Y 染色体相关的明确的自闭症诊断类别,但有几种临床情况通常被描述为语言和社交障碍。
本研究强调了 Y 染色体在 ASD 中的作用被低估,我们假设所有与 XYY 核型相关的 ASD 可能都属于我们病例中的轻度 ASD。