Service de Génétique Médicale, CHU Nantes, France.
Service de Génétique Médicale, CHBA Vannes, France.
Am J Med Genet A. 2019 Jun;179(6):993-1000. doi: 10.1002/ajmg.a.61113. Epub 2019 Mar 19.
This report presents two families with interstitial 11q24.2q24.3 deletion, associated with malformations, hematologic features, and typical facial dysmorphism, observed in Jacobsen syndrome (JS), except for intellectual disability (ID). The smallest 700 Kb deletion contains only two genes: FLI1 and ETS1, and a long noncoding RNA, SENCR, narrowing the minimal critical region for some features of JS. Consistent with recent literature, it adds supplemental data to confirm the crucial role of FLI1 and ETS1 in JS, namely FLI1 in thrombocytopenia and ETS1 in cardiopathy and immune deficiency. It also supports that combined ETS1 and FLI1 haploinsufficiency explains dysmorphic features, notably ears, and nose anomalies. Moreover, it raises the possibility that SENCR, a long noncoding RNA, could be responsible for limb defects, because of its early role in endothelial cell commitment and function. Considering ID and autism spectrum disorder, which are some of the main features of JS, a participation of ETS1, FLI1, or SENCR cannot be excluded. But, considering the normal neurodevelopment of our patients, their role would be either minor or with an important variability in penetrance. Furthermore, according to literature, ARHGAP32 and KIRREL3 seem to be the strongest candidate genes in the 11q24 region for other Jacobsen patients.
本报告介绍了两个具有 11q24.2q24.3 间质缺失的家族,这些缺失与畸形、血液学特征和典型的面部发育不良有关,与雅各布森综合征(JS)一致,但不伴有智力障碍(ID)。最小的 700 Kb 缺失仅包含两个基因:FLI1 和 ETS1,以及一个长非编码 RNA,SENCR,这缩小了一些 JS 特征的最小关键区域。与最近的文献一致,它增加了补充数据来证实 FLI1 和 ETS1 在 JS 中的关键作用,即 FLI1 在血小板减少症和 ETS1 在心脏病和免疫缺陷中。它还支持 ETS1 和 FLI1 杂合不足可以解释发育不良特征,特别是耳朵和鼻子异常。此外,由于其在血管内皮细胞承诺和功能中的早期作用,它提出了长非编码 RNA SENCR 可能导致肢体缺陷的可能性。考虑到 ID 和自闭症谱系障碍,这是 JS 的一些主要特征,ETS1、FLI1 或 SENCR 的参与不能排除。但是,考虑到我们患者的正常神经发育,它们的作用要么很小,要么在穿透性方面存在很大的可变性。此外,根据文献,ARHGAP32 和 KIRREL3 似乎是 11q24 区域中其他雅各布森患者的最强候选基因。
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