一个短指(趾)少指(趾)节畸形家系的调查

本文报道了一短指(趾)少指(趾)节畸形苗族家系的调查结果。该家系中患者双手、双足第一指(趾)近节指(趾)骨变短粗,第二、三、四、五指(趾)中节指(趾)骨缺如,属于遗传性短指(趾)畸形的BellA-1型。患者手纹与贵州正常苗族人有较大差异。该家系父系正常,母系4代共调查75人,发现患者22人(男13人,女9人)。系谱分析表明,该畸形属常染色体显性遗传。     

双手双足并指(趾)多指(趾)多掌(蹠)骨畸形家系的分析

遗传性多指并指畸形国内已有报道,均属常染色体显性遗传。我们发现了一个呈性连锁显性遗传的双手双足并指(趾)多指(趾)多掌(蹠)骨畸形的家系,现报告如下。 一、家系调查 先证者罗××,女,25岁,其家系成员分布在怀化市及郊区公社,世代务农,家系中无     

双手双足并指（趾）多指（趾）多掌（？）骨畸形家系的分析

遗传性多指并指畸形国内已有报道［11.27,均 属常染色体显性遗传。我们发现了一个呈性连 锁显性遗传的双手双足并指（趾）多指（趾）多掌 （班）骨畸形的家系,现报告如下。     

短指/趾的分子遗传学研究进展

短指/趾(Brachydactyly, BD)是指(趾)骨和/或掌(跖)骨短小、缺失或融合导致的手/足先天畸形, 是一组以骨发育障碍为特征的肢体畸形疾病。BD可单独出现, 也可作为综合征的一种体征, 还可伴随其他的手/足畸形如并指/趾、多指/趾、短缺畸形和指/趾骨关节融合出现。绝大多数单纯型BD呈常染色体显性遗传, 存在表现度不同和外显不全。大多数单纯型BD和一些综合征型BD的致病基因缺陷已经被鉴定。BMP (Bone morphogenetic protein)通路参与正常指/趾发育, 且已知的BD致病基因直接或间接参与该通路。文章综述了BD分子遗传学研究方面的新进展, 将有助于BD致病机制的研究和基因诊疗的开展。     

一个并指（趾）缺指（趾）家系的遗传分析

本文报道一个并指（趾）缺指（趾）家系。该家系2代4人患有并指（趾）缺指（趾）,同时伴有掌（跖）骨缺少。经过遗传分析,认为该畸形属常染色体显性遗传。 Abstract:A family with syndactyly and adactylism was reported in this paper.There are four sufferers,suffering from syndactyly and adactylism,with the lack of metacarpus and metatarsus in two generations.According to genetic analysis,this disease is caused by autosomal dominant inheritance.     

多指畸形的遗传性调查

调查了5个多指（趾）畸形的家系,在56人中有患者9人。该征的主要临床特征是：在拇指（趾）或小指（趾）的掌指（趾）上生有一赘生指（趾）,也有发育不全者只有残迹悬于皮肤蒂上。据调查统计,何氏家系与刘氏家系提示多指畸形系常染色体显性遗传。其他3个家系则与何、刘二家系相悖,究其原因,还有待于积累更丰富的资料来证实。     

苗族Grebe-Quelce-Salgado型软骨成长不全家族

本文报道我国首次在云南省屏边苗族自治县发现的Grebe-Quelce-Salgado型软骨成长不全家族。共有6例患者,现存活2例。患者为特殊的短肢侏儒,头和躯干基本正常,短肢畸形越向肢骨远端越趋严重,各指(趾)仅为芽状突起,且为多指(趾)。患者指纹几乎全为斗纹。集合家系数据再次证实,本症为常染色体隐性遗传,杂合子肢骨呈表现不一的轻度畸形。     

短指(趾)症及指(趾)骨发育的分子调控机制

短指(趾)症(brachydactyly, BD)是一类指(趾)骨或掌(跖)骨的异常缩短或缺失而造成的手/足畸形病变。从临床表型上短指(趾)症可以分为单纯型短指(趾)症以及包含短指(趾)症状的综合征,其中单纯型短指(趾)症又分为5种类型:BDA、BDB、BDC、BDD和BDE,而每一类型又分为不同的亚型。作为一类重要的分子疾病家族,随着对每种短指(趾)症的深入研究,大多数单纯型短指(趾)症和部分综合征的致病基因及其分子机制逐渐被发现。虽然短指(趾)症在表型上高度多样化,但在分子水平上这些致病基因主要影响Hedgehog、NOTCH、WNT和BMP等信号传导通路。这些信号传导通路组成了一个复杂的信号调控网络,在指(趾)骨及关节的不同发育阶段发挥着不同的作用,其中BMP信号传导通路扮演着至为关键的角色。本文在目前对短指(趾)症的分类基础上,详细综述了短指(趾)症相关致病基因及所影响的信号通路等方面的最新进展,旨在探讨指(趾)骨形成的分子机制,以期为短指(趾)症的临床诊断以及人类骨骼发育的分子调控机制研究提供参考。     

一先天性并指中国家系的遗传学研究

先天性并指(syndactyly)是一种以手脚发育异常为主要症状的常染色体显性遗传性疾病。I临床症状主要为手指间由蹼相连。其中I、Ⅱ、Ⅲ型先天性并指分别定位于2q34～36、2q31～q32和6q21～23．2。并指多指(synpoly-dactyly;SPD)为Ⅱ型并指(syndactyly,typeⅡ),通常情况下多为第3、4手指和第4、5脚趾受累,两指(趾)间由蹼相连接,不能分离。目前认为本病致病基因为HOXD13,定位于2q31～q32。HOXD13位于HOXD基因簇中。HOXD基因簇中的9个同源基因(HOXD1,-D3,-D4,-D8,-D9,-D10,-D11,-D12,-D13)根据其距着丝粒的远近,按由远到近的顺序在染色体上依次排列。HOXD基因簇中不同基因或其上游调控因子的重复或缺失都可能影响手指关节的发育,从而造成指(趾)数目或形态的异常。作者对湖南怀化地区一出生后即发现双手并指,双足并趾畸形患儿的常染色体显性先天性并指多指家系进行了连锁分析。结果显示,在SPD遗传基因座2q31～q32发现紧密连锁(两点间最大LOD：6．78;θ=0．00)。多点连锁分析最大LOD值为7．02。本家系单倍型分析遗传区间从D2s2302到D2s315之间,间距为20．61cM。我们对HOXD13基因的编码区,内含子-外显子交接区,和部分启动子区域进行序列分析未发现突变。结果证明了在中国人群中存在Ⅱ型并指的遗传位点,并表明该家系致病基因有可能为HOXD13基因相临近的其他基因。     

一先天性多趾并指(趾)系谱分析

本文对一多趾兼有并指(趾)家系的调查分析,从Ⅰ_2开始传递,连续四代出患者14人,男7、女7,患者均属杂合体。对多指(趾)并指(趾)畸形遗传方式进行了分析讨论。     

Granulomatous skin lesions complicating Varicella infection in a patient with Rothmund-Thomson syndrome and immune deficiency: case report

Acro-cardio-facial syndrome (ACFS) is a rare genetic disorder characterized by split-hand/split-foot malformation (SHFM), facial anomalies, cleft lip/palate, congenital heart defect (CHD), genital anomalies, and mental retardation. Up to now, 9 patients have been described, and most of the reported cases were not surviving the first days or months of age. The spectrum of defects occurring in ACFS is wide, and both interindividual variability and clinical differences among sibs have been reported. The diagnosis is based on clinical criteria, since the genetic mechanism underlying ACFS is still unknown. The differential diagnosis includes other disorders with ectrodactyly, and clefting conditions associated with genital anomalies and heart defects. An autosomal recessive pattern of inheritance has been suggested, based on parental consanguinity and disease's recurrence in sibs in some families. The more appropriate recurrence risk of transmitting the disease for the parents of an affected child seems to be up to one in four. Management of affected patients includes treatment of cardiac, respiratory, and feeding problems by neonatal pediatricians and other specialists. Prognosis of ACFS is poor.     

Split-hand/foot malformation - molecular cause and implications in genetic counseling

Split-hand/foot malformation (SHFM) is a congenital limb defect affecting predominantly the central rays of the autopod and occurs either as an isolated trait or part of a multiple congenital anomaly syndrome. SHFM is usually sporadic, familial forms are uncommon. The condition is clinically and genetically heterogeneous and shows mostly autosomal dominant inheritance with variable expressivity and reduced penetrance. To date, seven chromosomal loci associated with isolated SHFM have been described, i.e., SHFM1 to 6 and SHFM/SHFLD. The autosomal dominant mode of inheritance is typical for SHFM1, SHFM3, SHFM4, SHFM5. Autosomal recessive and X-linked inheritance is very uncommon and have been noted only in a few families. Most of the known SHFM loci are associated with chromosomal rearrangements that involve small deletions or duplications of the human genome. In addition, three genes, i.e., TP63, WNT10B, and DLX5 are known to carry point mutations in patients affected by SHFM. In this review, we focus on the known molecular basis of isolated SHFM. We provide clinical and molecular information about each type of abnormality as well as discuss the underlying pathways and mechanism that contribute to their development. Recent progress in the understanding of SHFM pathogenesis currently allows for the identification of causative genetic changes in about 50 % of the patients affected by this condition. Therefore, we propose a diagnostic flow-chart helpful in the planning of molecular genetic tests aimed at identifying disease causing mutation. Finally, we address the issue of genetic counseling, which can be extremely difficult and challenging especially in sporadic SHFM cases.     

病理性近视的家系研究

为了探讨我国病理性近视的遗传模式,对90个病理性近视大家系进行了分离分析。简单分离分析采用先验法和SEGRAN-B软件,进行拟合优度卡方检验,比较实际分离比与理论分离比的符合程度;复合分离分析运用SAGE-REGD软件进行孟德尔遗传模型(主基因、显性、隐性、共显性)和非孟德尔遗传模型(非传递、环境、一般)的拟合。结果显示,婚配类型为A*N的家系符合常染色体显性遗传,散发概率为13．8％,婚配类型为N*N的家系符合常染色体隐性遗传,散发概率为16．3％,但常染色体显性遗传不能除外,复合分离分析接受孟德尔遗传的显性、隐性、共显性和主基因模型,共显性模型的可能性最大,基因频率为0．21442999。因此,我国病理性近视存在常染色体显性和隐性遗传模式,并有一定比例的散发病例,具有遗传异质性。     

Localization of the genetic defect in familial adenomatous polyposis within a small region of chromosome 5

Familial adenomatous polyposis (FAP), a Mendelian disorder that includes familial polyposis coli (FPC) and Gardner syndrome (GS), has an autosomal dominant mode of inheritance. It is characterized by hundreds to thousands of adenomatous polyps that can progress to carcinoma of the colon, suggesting that the gene that harbors the FAP germ-line mutation may play an important role in the somatic genetic pathway to colon cancer. The defect responsible for FAP was recently mapped to the long arm of chromosome 5 by linkage between the FPC phenotype and a locus defined by DNA probe pC11p11 (D5S71), located at 5q21-22. Because an important next step in the paradigm for identification of a disease gene is to obtain a more precise localization, we isolated and mapped by linkage six additional polymorphic DNA markers in the FAP region. Subsequent linkage analysis in six pedigrees, three having the FPC phenotype and three segregating GS, placed the FAP locus very close to a new marker, YN5.48 (D5S81), that is approximately 17 centimorgans distal to C11p11 on the genetic map. The analysis revealed no evidence of genetic heterogeneity between the two phenotypes, a question that had not been clearly resolved by the earlier studies. The new set of markers in the near vicinity of the FAP locus represents a further step toward isolation of the genetic defect and provides the opportunity for preclinical diagnosis of risk status for colon cancer among individuals in families that are segregating adenomatous polyposis.     

Normal uracil-DNA glycosylase activity in Bloom's syndrome cells

Cells from patients with Bloom's syndrome, a rare human disease with autosomal recessive mode of inheritance, exhibit cytological abnormalities involving DNA metabolism. Bloom's syndrome is characterized by a greatly increased cancer frequency which may reflect a specific defect in DNA repair and replication. Evidence has recently been presented of the existence in Bloom's syndrome of an abnormality of the DNA ligase involved in semiconservative DNA replication. Another abnormality, in the excision-repair pathway of Bloom's syndrome cells, is reportedly due to an aberrant immunological reactivity of the DNA-repair enzyme uracil-DNA glycosylase. In this investigation we show, however, that the catalytic activity of uracil-DNA glycosylase appears to be normal in Bloom's syndrome lymphoblastoid cells.     

The load and diversity of hereditary diseases in four raions of Rostov oblast

The results of a medical genetic survey of the population of four raions (176535 individuals) of Rostov oblast (Dubovsky, Zimovnikovsky, Myasnikovsky, and Krasnosulinsky raions) are presented. The load of autosomal dominant (AD), autosomal recessive (AR), and X-linked hereditary diseases for urban and rural population was calculated, and the diversity of monogenic hereditary diseases (MHD) was reviewed. The nosological spectrum of MHD constituted 117 diseases (63 diseases with AD inheritance; 38, with AR inheritance; and 16, with X-linked inheritance). The analysis showed that the incidence of MHD among the population of Rostov oblast was 1: 336. Considerable differentiation in the prevalence rates of MHD (AD, AR, and X-linked pathologies) among certain raions was revealed.     

Autosomal recessive inheritance of goiter in Dutch goats

The inheritance of congenital goiter due to a thyroglobulin synthesis defect in a strain of Dutch goats has been studied by Mendelian and biochemical methods. Mendelian analysis of 301 matings, resulting in 591 kids, showed an autosomal recessive mode of inheritance. A restriction fragment length polymorphism (RFLP) in the thyroglobulin gene also was used to confirm the recessive mode of inheritance of the defect. In a pedigree consisting of 27 goats, spanning four generations, the genotype determined by RFLP study was in accordance with the observed phenotype and the autosomal inheritance of the defect. Although phenotypically no differences were detected between normal and heterozygous animals, the use of RFLPs allowed the diagnosis of the three genotypes.     

Autosomal recessive cerebellar ataxias

Autosomal recessive cerebellar ataxias (ARCA) are a heterogeneous group of rare neurological disorders involving both central and peripheral nervous system, and in some case other systems and organs, and characterized by degeneration or abnormal development of cerebellum and spinal cord, autosomal recessive inheritance and, in most cases, early onset occurring before the age of 20 years. This group encompasses a large number of rare diseases, the most frequent in Caucasian population being Friedreich ataxia (estimated prevalence 2–4/100,000), ataxia-telangiectasia (1–2.5/100,000) and early onset cerebellar ataxia with retained tendon reflexes (1/100,000). Other forms ARCA are much less common. Based on clinicogenetic criteria, five main types ARCA can be distinguished: congenital ataxias (developmental disorder), ataxias associated with metabolic disorders, ataxias with a DNA repair defect, degenerative ataxias, and ataxia associated with other features. These diseases are due to mutations in specific genes, some of which have been identified, such as frataxin in Friedreich ataxia, α-tocopherol transfer protein in ataxia with vitamin E deficiency (AVED), aprataxin in ataxia with oculomotor apraxia (AOA1), and senataxin in ataxia with oculomotor apraxia (AOA2). Clinical diagnosis is confirmed by ancillary tests such as neuroimaging (magnetic resonance imaging, scanning), electrophysiological examination, and mutation analysis when the causative gene is identified. Correct clinical and genetic diagnosis is important for appropriate genetic counseling and prognosis and, in some instances, pharmacological treatment. Due to autosomal recessive inheritance, previous familial history of affected individuals is unlikely. For most ARCA there is no specific drug treatment except for coenzyme Q10 deficiency and abetalipoproteinemia.     

Segregation analyses of the index fingerprint

Segregation analyses have been performed on both the ridge count and the pattern type (arch vs. nonarch) of the index fingerprints in a sample of 422 families. These analyses suggest a dominant autosomal major gene for arch and a recessive autosomal gene for low ridge count on the index finger. In both cases, multifactorial inheritance has to be taken into account. However, by testing different hypotheses, it turns out that the penetrance of arch trait is low (70%), and that the transmission parameters of the ridge count trait, although they are significant, diverge from the expected Mendelian values.     

Congenital stenosis of the aqueduct of Sylvius transmitted in an autosomal recessive mode (5 cases in 2 families)

The authors report 5 cases of congenital hydrocephalus due to isolated stenosis of the aqueduct of Sylvius. In the first three cases (2 brothers and 1 sister) ventriculograms showed apparent obstruction of the aqueduct. A valve shunting was necessary at 1 month of age in cases 1 and 2, at 3 years of age in case 3. In cases 4 and 5 (1 brother and 1 sister) ultrasonic prenatal diagnosis showed ventriculomegaly and pregnancies were interrupted respectively at 31 and 28 weeks of gestational age. The pedigree of the families suggests that the inheritance of this abnormality is autosomal recessive. Such an inheritance is very unusual and confirms the difficulty of genetic counseling facing the first occurrence of hydrocephalus with stenosis of the aqueduct of Sylvius in a family. The prenatal diagnosis is based on fetal ultrasonic examination and may be obtained late in the pregnancy leading to therapeutic and ethical tricky decisions.