Association of chromosome 22q11 deletion with isolated anomalies of aortic arch laterality and branching.

OBJECTIVES: The purpose of this study was to determine the frequency of chromosome 22q11 deletions in patients with isolated anomalies of the aortic arch and its branches. BACKGROUND: Chromosome 22q11 deletions are often present in patients with certain forms of congenital cardiovascular disease, including tetralogy of Fallot, truncus arteriosus and interruption of the aortic arch. Among patients with these anomalies, chromosome 22q11 deletion is more common in those with abnormal aortic arch laterality or branching. METHODS: We studied 66 patients with isolated anomalies of the aortic arch and no associated intracardiac defects for deletions within chromosome 22q11, using fluorescence in situ hybridization with the cosmid probe N25 (D22S75). Arch anomalies included: double aortic arch (n = 22); right aortic arch with aberrant left subclavian artery (n = 28); right aortic arch with mirror-image branching and a vascular ring formed by a left-sided ductus from the descending aorta (n = 5); right aortic arch with mirror-image branching and no vascular ring (n = 4); and left aortic arch with aberrant right subclavian artery (n = 7). In addition, four patients had a cervical aortic arch, four had aortic coarctation and six had hypoplasia/atresia of the proximal pulmonary arteries. RESULTS: Chromosome 22q11 deletions were found in 16 patients (24%) across the full spectrum of anomalies studied. Among the morphologic variables analyzed, only hypoplasia/atresia of the proximal pulmonary arteries correlated with the deletion (p = 0.03). Among patients with a double arch, the frequency of chromosome 22q11 deletion was higher in those with an atretic minor arch than it was in those with a patent minor arch (p = 0.02). CONCLUSIONS: Chromosome 22q11 deletion is associated with isolated anomalies of laterality or branching of the aortic arch in 24% of cases in our series. These findings should alert the clinician to consider deletion screening in patients with isolated anomalies of the aortic arch.

Expression of members of the bcl-2 gene family in the immature rat ovary: equine chorionic gonadotropin-mediated inhibition of granulosa cell apoptosis is associated with decreased bax and constitutive bcl-2 and bcl-xlong messenger ribonucleic acid levels.

The loss of ovarian follicles through atresia, which accounts for greater than 99% of postnatal female germ cell depletion, is mediated through apoptotic cell death. Although recent data have shown that apoptosis in granulosa cells of ovarian follicles can be hormonally manipulated, the molecular mechanisms responsible for transducing external signals remain to be elucidated. Herein we have characterized changes in the expression of the bcl-2 protooncogene (an inhibitor of apoptosis), the bax gene (an inducer of apoptosis), and the bcl-x gene (which encodes both bcl-xlong, an inhibitor of apoptosis, and bcl-xshort, an inducer of apoptosis) during gonadotropin-stimulated follicular development in vivo and during atresia of antral follicles incubated in vitro. Complementary DNA fragments corresponding to rat bcl-2, rat bax, and rat bcl-x coding sequences were obtained by the reverse transcription-polymerase chain reaction (RT-PCR) technique using total RNA prepared from immature rat ovaries. Northern blot analysis of steady-state bcl-2, bax, and bcl-x messenger RNA (mRNA) levels in total RNA prepared from ovaries of immature rats before and after in vivo priming with 10 IU equine CG (eCG) revealed that eCG-induced follicular growth and survival were associated with a relatively constitutive level of bcl-2 and bcl-x expression but markedly reduced levels of bax mRNA (29 +/- 5% of saline-treated control animals). Using the RT-PCR technique coupled with Southern blot hybridization analysis to distinguish the long vs. short forms of bcl-x (which differ in size by 189 base pairs), it was determined that bcl-xlong was the predominant message expressed by granulosa cells of eCG-primed ovaries. The eCG-mediated decrease in bax expression, coupled with a maintenance of bcl-2 and bcl-xlong mRNA levels, were associated with a pronounced reduction in the extent of granulosa cell apoptosis. In contrast, the induction of apoptosis in a homogeneous population of healthy antral follicles by incubation in vitro without tropic support was associated with an significant increase in bax mRNA levels to 220 +/- 10% of those detected in freshly isolated, healthy follicles. Moreover, bcl-xlong message levels were significantly reduced in follicles incubated for 24 h to 69 +/- 4% of those levels detected in freshly isolated, healthy follicles. However, no significant change in the level of bcl-2 mRNA was detected.(ABSTRACT TRUNCATED AT 250 WORDS)