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卡兰诺综合征:一种罕见先天性疾病的全面遗传学综述。

Currarino syndrome: a comprehensive genetic review of a rare congenital disorder.

机构信息

Institute of Human Genetics, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Institute of Anatomy and Cell Biology, Medical Faculty, University of Bonn, 53115, Bonn, Germany.

出版信息

Orphanet J Rare Dis. 2021 Apr 9;16(1):167. doi: 10.1186/s13023-021-01799-0.

Abstract

BACKGROUND

The triad of a presacral mass, sacral agenesis and an anorectal anomaly constitutes the rare Currarino syndrome (CS), which is caused by dorsal-ventral patterning defects during embryonic development. The major causative CS gene is MNX1, encoding a homeobox protein.

MAIN BODY

In the majority of patients, CS occurs as an autosomal dominant trait; however, a female predominance observed, implies that CS may underlie an additional mode(s) of inheritance. Often, the diagnosis of CS is established solely by clinical findings, impacting a detailed analysis of the disease. Our combined data, evaluating more than 60 studies reporting patients with CS-associated mutations, revealed a slightly higher incidence rate in females with a female-to-male ratio of 1.39:1. Overall, MNX1 mutation analysis was successful in only 57.4% of all CS patients investigated, with no mutation detected in 7.7% of the familial and 68% of the sporadic patients. Our studies failed to detect the presence of an expressed MNX1 isoform that might explain at least some of these mutation-negative cases.

CONCLUSION

Aside from MNX1, other genes or regulatory regions may contribute to CS and we discuss several cytogenetic studies and whole-exome sequencing data that have implicated further loci/genes in its etiology.

摘要

背景

由肛门前直肠畸形、骶骨发育不全和骶前肿物组成三联征的罕见 Currarino 综合征(CS),是由胚胎发育过程中背腹模式缺陷引起的。主要的 CS 致病基因是 MNX1,编码同源盒蛋白。

主要内容

在大多数患者中,CS 是常染色体显性遗传;然而,女性发病率较高,表明 CS 可能存在其他遗传方式。通常,CS 的诊断仅通过临床发现确定,影响了对疾病的详细分析。我们综合评估了 60 多项研究 CS 相关突变患者的数据,结果显示女性发病率略高,女性与男性的比例为 1.39:1。总体而言,MNX1 突变分析仅成功检测到 57.4%的 CS 患者,在 7.7%的家族性和 68%的散发性患者中未检测到突变。我们的研究未能检测到表达的 MNX1 异构体的存在,这至少可以解释部分无突变的病例。

结论

除了 MNX1,其他基因或调控区域可能导致 CS,我们讨论了一些细胞遗传学研究和全外显子组测序数据,这些数据提示了其发病机制中的其他基因/基因座。

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