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1p36 缺失综合征:回顾与分析表型,结合新的 86 例患者队列的进一步特征描述

1p36 deletion syndrome: Review and mapping with further characterization of the phenotype, a new cohort of 86 patients.

机构信息

Service de Génétique, CRMR AnDDI-Rares, CHU Reims, Reims, France.

Centre de Référence des Malformations et Maladies Congénitales du Cervelet, Département de Génétique et Embryologie Médicale, APHP, Hôpital Trousseau, Paris, France.

出版信息

Am J Med Genet A. 2023 Feb;191(2):445-458. doi: 10.1002/ajmg.a.63041. Epub 2022 Nov 11.

Abstract

Chromosome 1p36 deletion syndrome (1p36DS) is one of the most common terminal deletion syndromes (incidence between 1/5000 and 1/10,000 live births in the American population), due to a heterozygous deletion of part of the short arm of chromosome 1. The 1p36DS is characterized by typical craniofacial features, developmental delay/intellectual disability, hypotonia, epilepsy, cardiomyopathy/congenital heart defect, brain abnormalities, hearing loss, eyes/vision problem, and short stature. The aim of our study was to (1) evaluate the incidence of the 1p36DS in the French population compared to 22q11.2 deletion syndrome and trisomy 21; (2) review the postnatal phenotype related to microarray data, compared to previously publish prenatal data. Thanks to a collaboration with the ACLF (Association des Cytogénéticiens de Langue Française), we have collected data of 86 patients constituting, to the best of our knowledge, the second-largest cohort of 1p36DS patients in the literature. We estimated an average of at least 10 cases per year in France. 1p36DS seems to be much less frequent than 22q11.2 deletion syndrome and trisomy 21. Patients presented mainly dysmorphism, microcephaly, developmental delay/intellectual disability, hypotonia, epilepsy, brain malformations, behavioral disorders, cardiomyopathy, or cardiovascular malformations and, pre and/or postnatal growth retardation. Cardiac abnormalities, brain malformations, and epilepsy were more frequent in distal deletions, whereas microcephaly was more common in proximal deletions. Mapping and genotype-phenotype correlation allowed us to identify four critical regions responsible for intellectual disability. This study highlights some phenotypic variability, according to the deletion position, and helps to refine the phenotype of 1p36DS, allowing improved management and follow-up of patients.

摘要

1p36 缺失综合征(1p36DS)是最常见的末端缺失综合征之一(美国人群中活产儿发病率为 1/5000 至 1/10000),是由于 1 号染色体短臂部分的杂合性缺失所致。1p36DS 的特征是典型的颅面特征、发育迟缓/智力残疾、肌张力低下、癫痫、心肌病/先天性心脏病、脑异常、听力损失、眼睛/视力问题和身材矮小。我们研究的目的是:(1)评估 1p36DS 在法国人群中的发病率与 22q11.2 缺失综合征和 21 三体的比较;(2)根据微阵列数据回顾出生后表型,与之前发表的产前数据进行比较。通过与 ACLF(法国细胞遗传学家协会)的合作,我们收集了 86 名患者的数据,据我们所知,这是文献中第二大 1p36DS 患者队列。我们估计法国每年至少有 10 例病例。1p36DS 似乎比 22q11.2 缺失综合征和 21 三体要少见得多。患者主要表现为发育异常、小头畸形、发育迟缓/智力残疾、肌张力低下、癫痫、脑畸形、行为障碍、心肌病或心血管畸形以及出生前和/或出生后生长迟缓。心脏异常、脑畸形和癫痫在远端缺失中更为常见,而在近端缺失中,小头畸形更为常见。定位和基因型-表型相关性分析使我们能够确定四个导致智力残疾的关键区域。本研究根据缺失位置突出了一些表型变异性,并有助于细化 1p36DS 的表型,从而改善患者的管理和随访。

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