Prevalence of Edwards' syndrome. Clustering and seasonal variation?

Summary The incidence of Edwards' syndrome was found to be 1 per 4857 newborn children of 34000 consecutively newborn children in two Danish counties. Six of the 7 cases were born during the months of February through April.The incidence was high compared with the expected incidence of Edwards' syndrome of approximately 1 per 10000. This might be due to clustering in the area studied during the period 1967 to 1973.The finding of variations in incidence of children with Edwards' syndrome in different parts of the world, as well as the finding of seasonal variation in birth of such children, indicates that some of the etiological factors of nondisjunction of chromosome 18 are of an environmental nature.     

Down's syndrome: an atheroma-free model?

Postmortem examination of five institutionalised patients with Down''s syndrome (DS) aged 40-66 years showed a complete absence of atheroma, while a similar number of mental defectives with DS were found to have mild or severe atheroma. Previous investigation of risk factors for atheroma in 70 patients with DS and 70 age-and sex-matched mental defectives living in the same institution showed significantly lower systolic and diastolic blood pressures in the DS group, with the exception of systolic pressure in men under 40. Fasting serum cholesterol and triglyceride concentrations were similar in the two groups, but triglyceride concentrations were significantly lower than in normal people without a history of vascular disease. These unexplained observations may be relevant in further studies of the pathogenesis of atheroma.     

On the origin of the supernumerary chromosome in autosomal trisomies — with special reference to Down's syndrome

Summary The differential staining methods for chromosomes have led to the demonstration of more chromosomal polymorphisms. Not rarely, these polymorphisms allow in autosomal trisomies the detection of parental origin of the supernumerary chromosome. In addition, the malsegregation may be ascribed to 1st or 2nd meiotic division in informative families.This approach of analyzing possible causes of trisomies is subject to a considerable bias. Trisomic phenotypes are twice as frequent for 2nd meiotic errors than for 1st meiotic errors. Also, rare chromosome variants seldom occur in matings where malsegregation in 1st meiotic division can be detected. In the present paper this bias is analyzed mathematically on the family as well as on the population level.From this mathematical analysis and from the data in the literature we conclude that Down's syndrome as a whole is caused about 5–10 times more often by a malsegregation in 1st meiotic than by an error in 2nd meiotic division.Mainly from experimental studies in rodents, causes for errors in 1st and 2nd meiotic division are becoming apparent. They are summarized in the context of the results of the present paper.Human population cytogenetics, a subject originated by Court Brown, has not, as yet, required mathematics at all unless we include—as I think we may correctly—the exact study of such variables as parental age and chromosomal measurements. L. S. Penrose (1970)We dedicate this paper to Professor Emeritus P. E. Becker, M.D., with our best wishes for his retirement.     

A survey on maternal age and karyotype in Down's syndrome in Japan, 1947–1975

Summary Data on karyotype and maternal age of 1954 cases of Down's syndrome were analyzed to see if the rate of chromosome mutations leading to this abnormality has been enhanced during the last 20 years. Comparison of the data for patients born in 1947–1960 with those in 1961–1975 revealed little change with time in the proportions of cases due to different karyotypes, the overwhelming majority being of 21 trisomy type in both periods. However, there has been a remarkable decline in the mean maternal age from 33.1 years to 29.7 years as well as in the variance from 50.5 to 29.4. While the rate of decline in the variance was almost the same as that for all births occurring in the same periods, the decline in the mean maternal age was much greater for the patients than for all births, suggesting that the rate of nondisjunction might have increased in younger rather than in older mothers. However, when the risk of brearing a child with Down's syndrome for mothers aged 40–44 is taken as unity, no evidence was found for an increase with time in the relative risk for younger mothers. Moreover, results of surveys made in 1960 and thereafter in different parts of Japan indicate that the crude incidence rate of Down's syndrome at birth has been around 0.10%, giving no indication of an upward trend. These findings are discussed with reference to the serious environmental pollution, including possible genetic hazards, with which Japan has been faced since the 1960s.     

Maternal levels of pregnancy-specific β1 (SP-1) are elevated in pregnancies affected by Down's syndrome

Summary Concentrations of pregnancy-specific ₁-glycoprotein (SP-1) were measured in maternal blood and amniotic fluid of patients with a trisomic fetus and compared with that of a cytogenetically normal fetus at weeks 16–19 of pregnancy. The SP-1 concentrations were significantly elevated in the sera of women with a Down's syndrome fetus, whereas amniotic fluid levels were only slightly increased. It is suggested that high levels of maternal SP-1 in the second trimester of pregnancy may be a valuable indicator in the prenatal detection of fetal trisomy 21.     

Design,synthesis, and biological evaluation of a novel series of peripheral-selective noradrenaline reuptake inhibitors—Part 2

Peripherally selective inhibition of noradrenaline reuptake is a novel mechanism for the treatment of stress urinary incontinence to overcome adverse effects associated with central action. Herein, we describe our medicinal chemistry approach to discover peripheral-selective noradrenaline reuptake inhibitors to avert the risk of P-gp-mediated DDI at the blood–brain barrier. We observed that steric shielding of the hydrogen-bond acceptors and donors (HBA and HBD) of compound 1 reduced the multidrug resistance protein 1 (MDR1) efflux ratio; however, the resulting compound 6, a methoxyacetamide derivative, was mainly metabolized by CYP2D6 and CYP2C19 in the in vitro phenotyping study, implying the risk of PK variability based on the genetic polymorphism of the CYPs. Replacement of the hydrogen atom with a deuterium atom in a strategic, metabolically hot spot led to compound 13, which was mainly metabolized by CYP3A4. To our knowledge, this study represents the first report of the effect of deuterium replacement for a major metabolic enzyme. The compound 13, N-{[(6S,7R)-7-(4-chloro-3-fluorophenyl)-1,4-oxazepan-6-yl]methyl}-2-[(2H³)methyloxy]acetamide hydrochloride, which exhibited peripheral NET selective inhibition at tested doses in rats, increased urethral resistance in a dose-dependent manner.     

Phosphonic acid analogue of forfenicine — synthesis, antibacterial activity and degradation byPseudomonas fluorescens

Summary Phosphonic acid analogue of forfenicine, amino (p-formylbenzyl)-phosphonic acid, was synthesized and evaluated as antibacterial agent. As indicated by disc diffusion test this compound was found to inhibit significantly the growth ofBacillus subtilis andStaphylococcus aureus and moderately the growth ofEscherichia coli. Resistance ofPseudomonas fluorescens to the action of the aminophosphonate may result from the ability of the strain to degrade this compound.     

Design,synthesis and anticancer activities of hybrids of indole and barbituric acids—Identification of highly promising leads

By combining the structural features of indole and barbituric acid, new hybrid molecules were designed and synthesized. Evaluations of these molecules over 60 cell line panel of human cancer cells have identified two molecules with significant anticancer activities. Dockings of two active molecules in the active sites of COX-2, thymidylate synthase and ribonucleotide reductase indicate their strong interactions with these enzymes.     

A novel,stereospecific synthesis of β-D-glucopyranosyl phosphate

In alkaline solution, periodate ions form complexes with three consecutive hydroxyl groups in an axial-equatorial-axial arrangement but not with three syn-axial hydroxyl groups. Borate ions form complexes with three syn-axial hydroxyl groups but not with the axeqax sequence. Accordingly, cis-inositol gives a 1,2,3-periodate and a 1,3,5-borate complex. Cations form complexes with either type of conformation, but complex formation provides little energy towards achieving it by ring inversion. Lanthanide ions have been used to establish the sites of complex formation.     

Down's syndrome in Wallonia (South Belgium), 1971–1978: Cytogenetics and incidence

Summary During the 8 year-period 1971–1978 inclusive, 268 newborn with Down's syndrome (DS) were ascertained in Wallonia (South Belgium). The chromosomes of all patients were analyzed. A standard trisomy 21 was observed in 259 cases (96.6%) and translocations in seven (2.6%). One mosaic (0.4%) and one case with a 47,XX,+21,5 p-karyotype (0.4%) were also found. The overall incidence at birth for the 8 year-period was of 0.123%. However, the comparison of the 2 four-year periods 1971–1974 and 1975–1978 showed an increased incidence in mothers below 35 during the second period, reaching a statistical significant level in Charleroi, and industrial and densely populated area of the region (Fisher's exact test: P=0.016<0.025). Young women have now become the principal source of DS patients in Wallonia. This change from the previous pattern happened abruptly in 1975, and strongly suggests that one or more persisting factors relating tomeiotic non-disjunction of chromosome 21 are operating in this region since 1974, and affecting DS births from 1975 onwards.     

Interaction of human β-defensin 2 (HBD2) with glycosaminoglycans

Human β-defensin 2 (HBD2) is a member of the defensin family of antimicrobial peptides that plays important roles in the innate and adaptive immune system of both vertebrates and invertebrates. In addition to their direct bactericidal action, defensins are also involved in chemotaxis and Toll-like receptor activation. In analogy to chemokine/glycosaminoglycan (GAG) interactions, GAG-defensin complexes are likely to play an important role in chemotaxis and in presenting defensins to their receptors. Using a gel mobility shift assay, we found that HBD2 bound to a range of GAGs including heparin/heparan sulfate (HS), dermatan sulfate (DS), and chondroitin sulfate. We used NMR spectroscopy of (15)N-labeled HBD2 to map the binding sites for two GAG model compounds, a heparin/HS pentasaccharide (fondaparinux sodium; FX) and enzymatically prepared DS hexasaccharide (DSdp6). We identified a number of basic amino acids that form a common ligand binding site, which indicated that these interactions are predominantly electrostatic. The dissociation constant of the [DSdp6-HBD2] complex was determined by NMR spectroscopy to be 5 ± 5 μM. Binding of FX could not be quantified because of slow exchange on the NMR chemical shift time scale. FX was found to induce HBD2 dimerization as evidenced by the analysis of diffusion coefficients, (15)N relaxation, and nESI-MS measurements. The formation of FX-bridged HBD2 dimers exhibited features of a cooperative binding mechanism. In contrast, the complex with DSdp6 was found to be mostly monomeric.     

Method for the synthesis of phosphinic acids from hypophosphites V. The synthesis of pseudo-α,α-dipeptides

Summary. Neurolathyrisim is a motor neuron disease characterized by spastic paraparesis in the hind legs, and is caused by grass pea, Lathyrus sativus, which contains the excitotoxic amino acid, 3-N-oxalyl-L-2,3-diaminopropanoic acid (L--ODAP), an -amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-type glutamatergic receptor agonist. In an attempt to make a useful model of this disease, the CNS distribution and toxicity of L--ODAP was studied in rat neonates after parenteral administration. L--ODAP was detected in the spinal cord as well as in the pons/medulla oblongata, though only small amounts in the latter. Repeated injection of L--ODAP resulted in rats with paraparesis of the legs, though at a low incidence rate of 0.032. These paralyzed rats displayed the severe atrophy of the ventral root of the lumbar cord as well as degenerations of motor neuron. The rats were useful models for the study of motor neuron degeneration in the spinal cord.     

The effect of β,β′-iminodipropionitrile treatment and alloxan diabetes on the glycosaminoglycans of the rat retina and aorta

• 1.1. The glycosaminoglycans from normal and alloxan-diabetic rat aorta and retina, with and without prior incubation with ³⁵SO₄²⁻, the glycosaminoglycans of β,β′-iminodipropionitrile-treated rat aorta and retina and the glycosaminoglycans from isolated human and bovine retinal vascular systems have been quantitatively separated by chromatography on cetylpyridinium chloride/cellulose columns.
• 2.2. Significant increases in the chondroitin sulphate content of both tissues were observed in alloxan diabetes, based on hexosamine determinations and ³⁵SO₄²⁻ uptake.
• 3.3. A significant increase in the ‘neutral’ fraction was observed in the retina, but not in the aorta, after β,β′-iminodipropionitrile treatment.
• 4.4. The neutral fraction constituted 83 and 86% of the total hexosamine of isolated human and bovine retinal microvascular systems compared with 60% in the rat aorta.

     

Molecular genetics of preeclampsia and HELLP syndrome — A review

Preeclampsia is characterised by new onset hypertension and proteinuria and is a major obstetrical problem for both mother and foetus. Haemolysis elevated liver enzymes and low platelets (HELLP) syndrome is an obstetrical emergency and most cases occur in the presence of preeclampsia. Preeclampsia and HELLP are complicated syndromes with a wide variety in severity of clinical symptoms and gestational age at onset. The pathophysiology depends not only on periconceptional conditions and the foetal and placental genotype, but also on the capability of the maternal system to deal with pregnancy. Genetically, preeclampsia is a complex disorder and despite numerous efforts no clear mode of inheritance has been established. A minor fraction of HELLP cases is caused by foetal homozygous LCHAD deficiency, but for most cases the genetic background has not been elucidated yet. At least 178 genes have been described in relation to preeclampsia or HELLP syndrome. Confined placental mosaicism (CPM) is documented to cause early onset preeclampsia in some cases; the overall contribution of CPM to the occurrence of preeclampsia has not been adequately investigated yet. This article is part of a Special Issue entitled: Molecular Genetics of Human Reproductive Failure.     

Modelling the reaction course of N-acetylneuraminic acid synthesis from N-acetyl-d-glucosamine—new strategies for the optimisation of neuraminic acid synthesis

In this work, a model describing the complete enzyme catalysed synthesis of N-acetylneuraminic acid (Neu5Ac) from N-acetyl-d-glucosamine (GlcNAc) is presented. It includes the combined reaction steps of epimerisation from GlcNAc to N-acetyl-d-mannosamine (ManNAc) and the aldol condensation of ManNAc with sodium pyruvate yielding Neu5Ac. The model is expedient to predict the reaction course for various initial and feed concentrations and therefore to calculate reaction times and yields. The equilibrium constants calculated from the kinetic constants via the Haldane relationship correspond with experimental values very well (0.26 calculated and 0.24 experimental value for the epimerisation, 27.4 l mol⁻¹ calculated and 28.7 l mol⁻¹ experimental for the aldol condensation). The actual relevance of the model is shown by a scale-up. Using the model, an optimisation of reaction conditions in consideration of different targets is possible. Exemplarily, it is presented how the optimal ratio of the two enzymes in the reaction can be determined and how the composition of the reaction solution in a fed-batch reactor can be designed to meet downstream processing needs.     

A familial tetraphocomelia syndrome involving limb deformities,cleft lip,cleft palate,and associated anomalies —A new syndrome

Summary This paper reports a rare malformation syndrome which is observed in two sibs (brother and sister) of a family. It consists of nearly symmetric reductive defects of the limbs, flexon contractures of various joints, cleft lip and cleft palate, multiple minor abnormalities including capillary hemangioma of the forehead, hypoplastic cartilages of ears and nose, micrognathia, intrauterine growth retardation, and possibly mental retardation. Chromosomes of both parents and propositi are normal. Genetic data suggest autosomal recessive inheritance.     

The effect of isoniazid,carbutamide, propamidine and pentamidine on the activity and synthesis of β-galactosidase,and the synthesis of transaminases in Escherichia coli,strain 15, mutant M2

• 1.1. The amount of valine/glutamic acid and aspartic acid/glutamic acid transaminases in resting cells of Escherichia coli, 15, M₂, is not affected by growing the cultures in 10⁻³M isoniazid, 10⁻⁴M carbutamide, 5·10⁻⁵M pentamidine or 10⁻⁵M propamidine.
• 2.2. The amount of β-galactosidase formed in resting cells of E. coli, 15, M₂, is not affected when cultures are grown in 10⁻³M isoniazid, 10⁻⁴M carbutamide or 10⁻⁵M pentamidine. The amount of this enzyme formed in the logarithmic phase of growth is lower in carbutamide and pentamidine grown cells than in control cultures.
• 3.3. The β-galactosidase activity of cell-free extracts of E. coli, 15, M₂, is 75% and 99% inhibited by 3.3·10⁻³M propamidine and pentamidine respectively. The inhibition is competitive. Isoniazid and carbutamide at the same concentration are without effect on the activity of β-galactosidase.