Caracterización de variantes genómicas. Aplicación de nuevas tecnologías al estudio del retraso mental.

[spa] Estudios recientes han permitido estimar que aproximadamente un 5% del genoma consiste en duplicaciones segmentarias (DS), secuencias de entre 1-100 kb con un nivel de similitud de más del 95% (Eichler, 2001). Las regiones flanqueadas por duplicaciones segmentarias son susceptibles de sufrir reordenamientos mediante recombinación homóloga no alélica y se ha hipotetizado que estas regiones representan puntos calientes de inestabilidad genómica propensos a variación en número de copia (CNVs). Esta variación estructural (deleciones, duplicaciones e inversiones) representa una fuerza mutacional infravalorada en la contribución a las enfermedades genéticas, y en particular en los loci susceptibles a retraso mental. La aparición de nuevas tecnologías como los arrays de CGH o el MLPA permiten el análisis de alta resolución para la identificación de alteraciones genéticas y variaciones en número de copia a nivel de todo el genoma. La aplicación de estas tecnologías ha permitido, recientemente, establecer la implicación de microdeleciones y microduplicaciones en diversas enfermedades genéticas, como por ejemplo el retraso mental (RM). Las técnicas convencionales (cariotipo, FISH, CGH o PCR) de las que disponemos actualmente para el estudio de enfermedades genéticas como el retraso mental no son los suficientemente sensibles para la detección de reordenamientos submicroscópicos. Disponiendo de la tecnología y el material adecuado, es posible la caracterización molecular nuevas variantes geonómicas en retraso mental. Debido a la gran cantidad de casos de RM en los que se desconoce su etiología, el objetivo principal de esta tesis ha sido la caracterización de variantes genómicas responsables de RM aplicando nuevas tecnologías: aCGH del cromosoma X y MLPA. El MLPA se basa en la detección simultánea del número de copias de una secuencia específica mediante la hibridación genómica del DNA con una mezcla de sondas específicas. La cantidad relativa del producto amplificado se correlaciona con el número de copias de la secuencia diana de esa sonda. Por otro lado, los arrays de CGH permiten detectar reordenamientos cromosómicos desequilibrados de <1 Mb. Con el uso de clones genómicos distribuidos de forma que cubran la totalidad del cromosoma X se puede generar un array específico que permitirá obtener un cariotipo molecular de este cromosoma a nivel de 100kb, lo que permitirá detectar microdeleciones, microduplicaciones e inversiones del cromosoma X. Esta parte del proyecto que incluye tanto el diseño, la construcción y validación del array como la hibridación de las muestras se realiza de forma coordinada con el Centro de Regulación de Barcelona (CRG).Para este estudio se seleccionaron pacientes procedentes de familias con herencia compatible con un RM ligado al cromosoma X. Estas familias procedían del Departamento de Bioquímica y Genética Molecular del Hospital Clínico de Barcelona y del grupo GIRMOGEN (Grupo Investigación Retraso Mental de Origen Genético). A todos ellos se les había realizado previamente un cariotipo, se había descartado la expansión del triplete CGG el gen FMR1, responsable del Síndrome del X frágil y no se habían detectado reordenamientos subteloméricos. Gracias a la aplicación de estas tecnologías hemos identificado y caracterización de nuevas variantes genómicas implicadas en RM (11,5%). La detección de reordenamientos cripticos en pacientes afectos de estas enfermedades nos ha permitido establecer una correlación genotipo/fentipo e identificar nuevos genes y mecanismos implicados en el desarrollo del RM.[eng] "CARACTERIZATION OF GENOMIC VARIANTS. APLICATION OF NEW TECHONOLOGIES TO THE STUDY OF MENTAL RETARDATION" TEXT:Mental Retardation (RM) is a common disorder affecting 1-3% of general population. X-linked MR represents and important group inside MR. Nowadays OMIM lists 359 entries about XLMR although only 44 X-linked genes are known to cause XLMR (syndromic and non-syndromic). On the other hand, subtelomeric rearrangements comprise 5-7% of MR with unknown genetic origin. There are few reports about submicroscopic rearrangements that affect X chromosome due to the difficulties that implicate these studies. CGHarray (array-based comparative genomic hibridization) measures submicroscopic DNA copy number changes and allows the simultaneous high-resolution mapping of these changes onto the genome sequence. With the construction and application of a specific CGH microarray, it will be possible to characterize different molecular variants inside this chromosome in those cases of MRLX without molecular diagnosis. On the other hand, MLPA is based in the simultaneous detection of the number of copies of a specific sequence through hybridization of genomic DNA with a mixture of specific probes. The main objective of the present project is to identify submicroscopic duplications and deletions affecting chromosome X in patients with non-syndromic. For this study we selected patients from families with an inheritance consistent with an XLMR. These families came from the Department of Biochemistry and Molecular Genetics at the Hospital Clinical of Barcelona and the GIRMOGEN group (Research Group for Mental Retardation of Genetic Origin). The application of new techonolgies such as MLPA o aCGH has led to the identification of new rearrangements in the X chromosome responsible for MR (11,5%). The detection of cryptic rearrangements in MR patients has enabled us to establish a gentype/phenotype correlation and to identify new genes and mechanisms involved in the development of MR

Lethal congenital contracture syndrome 11: A case report and literature review

Lethal congenital contracture syndrome 11 (LCCS11) is caused by homozygous or compound heterozygous variants in the GLDN gene on chromosome 15q21. GLDN encodes gliomedin, a protein required for the formation of the nodes of Ranvier and development of the human peripheral nervous system. We report a fetus with ultrasound alterations detected at 28 weeks of gestation. The fetus exhibited hydrops, short long bones, fixed limb joints, absent fetal movements, and polyhydramnios. The pregnancy was terminated and postmortem studies confirmed the prenatal findings: distal arthrogryposis, fetal growth restriction, pulmonary hypoplasia, and retrognathia. The fetus had a normal chromosomal microarray analysis. Exome sequencing revealed two novel compound heterozygous variants in the GLDN associated with LCCS11. This manuscript reports this case and performs a literature review of all published LCCS11 cases

Severe neurocognitive and growth disorders due to variation in THOC2, an essential component of nuclear mRNA export machinery

Highly conserved TREX-mediated mRNA export is emerging as a key pathway in neuronal development and differentiation. TREX subunit variants cause neurodevelopmental disorders (NDDs) by interfering with mRNA export from the cell nucleus to the cytoplasm. Previously we implicated four missense variants in the X-linked THOC2 gene in intellectual disability (ID). We now report an additional six affected individuals from five unrelated families with two de novo and threematernally inherited pathogenic or likely pathogenic variants in THOC2 extending the genotypic and phenotypic spectrum. These comprise three rare missense THOC2 variants that affect evolutionarily conserved amino acid residues and reduce protein stability and two with canonical splice-site THOC2 variants that result in C-terminally truncated THOC2 proteins.We present detailed clinical assessment and functional studies on a de novo variant in a female with an epileptic encephalopathy and discuss an additional four families with rare variants in THOC2 with supportive evidence for pathogenicity. Severe neurocognitive features, including movement and seizure disorders, were observed in this cohort. Taken together our data show that even subtle alterations to the canonical molecular pathways such asmRNAexport, otherwise essential for cellular life, can be compatible with life, but lead to NDDs in human

The Contribution of QF-PCR and pathology studies in the diagnosis of diandric triploidy/partial mole

Objective: the aim of our study was to assess the contribution of quantitative fluorescent polymerase chain reaction (QF-PCR) and pathology studies in the diagnosis of diandric triploidies/partial hydatidiform moles. Methods: this study included all fet al triploidies diagnosed by QF-PCR in chorionic villi or amniotic fluid in the 2 centers of BCNatal in which a maternal saliva sample was used to establish its parental origin. Pathology studies were performed in products of conception and concordance between a partial hydatidiform mole diagnosis and the finding of a diandric triploidy was assessed. Results: among 46 fetal triploidies, found in 13 ongoing pregnancies and in 33 miscarriages, there were 26 (56%) diandric triploidies. Concordant molecular (diandric triploidy) and pathology results (partial mole) were achieved in 14 cases (54%), while in 6 cases (23%) pathology studies were normal, and in the remaining 6 cases (23%) pathology studies could not be performed because miscarriage was managed medically. Conclusions: diandric triploidy is associated with partial hydatidiform mole and its diagnosis is crucial to prevent the development of persistent trophoblastic disease. QF-PCR analysis in chorionic villi or amniotic fluid provides a more accurate diagnosis of the parental origin of triploidy than the classical pathology studie