Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Int J Mol Sci. 2019 Jun 14;20(12):2914. doi: 10.3390/ijms20122914.
The 15q11.2 BP1-BP2 microdeletion (Burnside-Butler) syndrome is an emerging disorder that encompasses four genes (, and ). When disturbed, these four genes can lead to cognitive impairment, language and/or motor delay, psychiatric/behavioral problems (attention-deficit hyperactivity, autism, dyslexia, schizophrenia/paranoid psychosis), ataxia, seizures, poor coordination, congenital anomalies, and abnormal brain imaging. This microdeletion was reported as the most common cytogenetic finding when using ultra-high- resolution chromosomal microarrays in patients presenting for genetic services due to autism with or without additional clinical features. Additionally, those individuals with Prader-Willi or Angelman syndromes having the larger typical 15q11-q13 type I deletion which includes the 15q11.2 BP1-BP2 region containing the four genes, show higher clinical severity than those having the smaller 15q11-q13 deletion where these four genes are intact. Two of the four genes (i.e., and ) are expressed in the brain and encode magnesium transporters. Magnesium is required in over 300 enzyme systems that are critical for multiple cellular functions, energy expenditure, protein synthesis, DNA transcription, and muscle and nerve function. Low levels of magnesium are found in those with seizures, depression, and acute or chronic brain diseases. Anecdotally, parents have administered magnesium supplements to their children with the 15q11.2 BP1-BP2 microdeletion and have observed improvement in behavior and clinical presentation. These observations require more attention from the medical community and should include controlled studies to determine if magnesium supplements could be a treatment option for this microdeletion syndrome and also for a subset of individuals with Prader-Willi and Angelman syndromes.
15q11.2 BP1-BP2 微缺失(Burnside-Butler)综合征是一种新兴疾病,涉及四个基因(UBE3A、MKRN3、NIPA1 和 MAGT1)。当这些基因受到干扰时,可能导致认知障碍、语言和/或运动迟缓、精神/行为问题(注意力缺陷多动障碍、自闭症、阅读障碍、精神分裂症/偏执型精神病)、共济失调、癫痫发作、运动协调能力差、先天性异常和异常的脑成像。当使用超高分辨率染色体微阵列对因自闭症且伴有或不伴有其他临床特征而就诊于遗传科的患者进行检测时,这种微缺失是最常见的细胞遗传学发现。此外,那些患有 Prader-Willi 或 Angelman 综合征且具有较大的典型 15q11-q13 型 I 缺失(包括包含四个基因的 15q11.2 BP1-BP2 区域)的个体,其临床严重程度高于那些具有较小的 15q11-q13 缺失(其中四个基因完整)的个体。四个基因中的两个(即 UBE3A 和 MAGT1)在大脑中表达并编码镁转运体。镁在超过 300 种酶系统中发挥作用,这些酶系统对多种细胞功能、能量消耗、蛋白质合成、DNA 转录以及肌肉和神经功能至关重要。在癫痫、抑郁和急性或慢性脑部疾病患者中发现镁水平较低。有传言称,父母给患有 15q11.2 BP1-BP2 微缺失的孩子补充镁后,其行为和临床表现有所改善。这些观察结果需要引起医学界的更多关注,并且应该包括对照研究,以确定镁补充剂是否可以作为这种微缺失综合征的治疗选择,以及是否可以作为 Prader-Willi 和 Angelman 综合征的一部分患者的治疗选择。