Maternal uniparental disomy 14 dissection of the phenotype with respect to rare autosomal recessively inherited traits, trisomy mosaicism, and genomic imprinting

Dieter Kotzot
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引用次数: 74

Abstract

The phenotype of maternal uniparental disomy of chromosome 14 (upd(14)mat) is characterized by pre and postnatal growth retardation, early onset of puberty, joint laxity, motor delay, and minor dysmorphic features of the face, hands, and feet. Based on a clinical analysis of 24 cases extracted from the literature the phenotype of upd(14)mat was dissected with respect to each symptom’s most likely primary causative: trisomy mosaicism, rare autosomal recessively inherited traits, and the impact of known imprinted genes located on chromosome 14q32. As a result, primary factors are confined placental mosaicism for prenatal growth retardation and one or more imprinted genes, which contribute to the reduced final height by accelerated skeletal maturation. As a secondary effect the latter might also cause early onset of puberty. Other secondary effects might be postnatal adaptation problems associated with neurological deficits such as muscular hypotonia due to premature delivery and reduced birthweight and most dysmorphic features as a consequence of subtle skeletal abnormalities and muscular hypotonia. Considering the rarity of traits such as cleft palate, trisomy mosaicism in the fetus is more likely causative than homozygosity of autosomal recessively inherited mutations. Totally, the variable phenotype of upd(14)mat is mainly the consequence of trisomy mosaicism and genomic imprinting. Rare traits might be due to homozygosity of autosomal recessively inherited mutations.

与罕见常染色体隐性遗传性状、三体嵌合体和基因组印记相关的母体单亲二体14的表型解剖
母亲14号染色体单亲二体(upd(14)mat)的表型特征是产前和产后生长迟缓,青春期早发,关节松弛,运动迟缓,面部,手和脚的轻微畸形特征。根据从文献中提取的24例临床分析,对upd(14)mat的表型进行了解剖,分析了每种症状最可能的主要病因:三体嵌合,罕见的常染色体隐性遗传性状,以及位于染色体14q32上的已知印迹基因的影响。因此,主要因素是产前生长迟缓的受限胎盘嵌合和一个或多个印记基因,它们通过加速骨骼成熟来降低最终身高。作为次要影响,后者也可能导致青春期提前。其他继发性影响可能是与神经功能缺陷相关的产后适应问题,如早产和出生体重减少引起的肌肉张力不足,以及由于细微的骨骼异常和肌肉张力不足引起的大多数畸形特征。考虑到罕见的特征,如腭裂,胎儿的三体嵌合体比常染色体隐性遗传突变的纯合性更有可能导致。总的来说,upd(14)mat的可变表型主要是三体嵌合和基因组印迹的结果。罕见性状可能是由于常染色体隐性遗传突变的纯合性。
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