A Specific Mutation in the Distant Sonic Hedgehog (SHH) Cis-Regulator (ZRS) Causes Werner Mesomelic Syndrome(WMS) While Complete ZRS Duplications Underlie Haas Type Polysyndactyly and Preaxial Polydactyly (PPD) With or Without Triphalangeal Thumb
Wieczorek, Dagmar; Pawlik, Barbara; Yun Li; Akarsu, Nurten A; Caliebe, Almuth; May, Klaus J. W; Schweiger, Bernd; Vargas, Fernando R; Balci, Sevim; Gillessen-Kaesbach, Gabriele; Wollnik, Bernd.
Hum Mutat
; 31(1): 81-89, 2010. ilus, tab
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ABSTRACT Werner mesomelic syndrome (WMS) is anautosomal dominant disorder with unknown molecularetiology characterized by hypo- or aplasia of the tibiae inaddition to the preaxial polydactyly (PPD) of the handsand feet and/or five-fingered hand with absence ofthumbs. We show that point mutations of a specificnucleotide within the sonic hedgehog (SHH) regulatoryregion (ZRS) cause WMS. In a previously unpublishedWMS family, we identified the causative G4A transitionat position 404 of the ZRS, and in six affected familymembers of a second WMS family we found a 404G4Cmutation of the ZRS. The 404G4A ZRS mutation isknown as the Cuban mutation of PPD type II (PPD2).Interestingly, the index patient of that family had tibialhypoplasia as well. These data provide the first evidencethat WMS is caused by a specific ZRS mutation, whichleads to strong ectopic SHH expression. In contrast, weshow that complete duplications of the ZRS region leadto type Haas polysyndactyly or triphalangeal thumbpolysyndactylysyndrome, but do not affect lower limbdevelopment. We suggest the term ZRS-associatedsyndromes and a clinical subclassification for thecontinuum of limb malformations caused by differentmolecular alterations of the ZRS.(AU)
Biblioteca responsable:
BR440.1
Ubicación: BR440.1
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