Two different phenotypes of fetuses with chromosomal triploidy: correlation with parental origin of the extra haploid set

Triploidy is a condition in which there is over-representation of one parental genome. Recent work in experimental mouse embryo-genesis suggests that the parental origin of the extra genome in triploidy may have specific effects on both embryonic/fetal phenotype and placental development due to an "imprinting" effect. We studied 19 human triploid fetuses and discerned 2 distinct fetal phenotypes, as well as the previously described placental phenotypes, which correlate with the parental origin of the extra haploid set. Although these findings suggest that in human triploids the parental origin of the extra haploid set is important in determination of both fetal and placental phenotype it is not clear to what degree placental development and function affect the resultant fetal phenotype.     

Analysis of the spectrum of malformations in human fetuses of the second and third trimester of pregnancy with human triploidy

Triploidy is constituted by an extra haploid set of chromosomes for a total of 69 chromosomes in humans. A "parent-of-origin" effect has been demonstrated by analysis of cytogenetic polymorphisms of triploidy pregnancies. Two distinct phenotypes of human triploid fetuses have been recognized according to the parental origin of the extra haploid set. The first one or triploidy of diandric type occurs when the extra haploid set of chromosomes arises from the father, the second one or triploidy of digynic type occurs when the extra haploid set of chromosomes arises from the mother. Diandric fetuses appear relatively well grown with a large placenta, while digynic fetuses show intrauterine growth retardation with a small placenta. Autopsy archive data files (1982-1998) of the Institute of Pathology, University of Heidelberg (Germany) were examined for fetuses with triploidy. We found 12 well-studied triploid fetuses (gestational age: 20 to 32 weeks). Eleven fetuses corresponded to the digynic type of triploidy and one fetus corresponded to the diandric type of triploidy. The spectrum of external malformations included a dysmorphic face (broad root of the nose, exophthalmos, low-set ears, micro-/retrognathia, microgenia, median cleft lip and/or palate, gnathoschisis, macroglossia), encephalocele, spina bifida, syndactyly, club or rocker-bottom feet, pes equino-valgus. More common internal malformations included ventricular septum defect of the heart, abnormal lobation of the lungs, and renal disease (agenesis, cysts).     

Maternal origin of extra haploid set of chromosomes in third trimester triploid fetuses

Twenty-six highly polymorphic markers were used to determine the origin of the extra haploid chromosome set in 6 triploid fetuses of type II phenotype. All had reached the third trimester of pregnancy. The extra set was maternal in origin in all cases, supporting previous research indicating longer in utero survival of maternally-derived triploid fetuses. These findings provide evidence for an instance of genomic imprinting in humans. © 1995 Wiley-Liss, Inc.     

Digynic triploid infant surviving for 46 days

We report on a triploid infant who survived for 46 days. She had severe intrauterine growth retardation, relative macrocephaly, and a small, noncystic placenta, which are manifestations compatible with type II phenotype. Cultured amniotic fluid cells, skin fibroblasts, cord blood, and peripheral blood lymphocytes all showed a nonmosaic 69,XXX karyotype. Analysis of chromosomal heteromorphisms and microsatellite DNA polymorphisms in the infant and her parents indicated that the extra haploid set in the infant resulted from nondisjunction at maternal second meiosis. Postzygotic, mitotic nondisjunction was ruled out because of the presence of both homozygous and heterozygous markers of maternal origin. A search of the literature demonstrated five triploid infants, including the girl we described, who survived 4 weeks or more, and the parental origin of whose triploidy was studied: four were digynic and one was diandric. These findings support the notion that type II triploids are digynic in parental origin and that they survive longer than type I, diandric triploids.     

Parental origin of triploidy and D and G trisomy in spontaneous abortions.

A cytogenetic study of 15 triploid spontaneous abortuses, 12 trisomic abortuses, and their parents was carried out using the Q-banding technique. Polymorphic regions in abortus chromosomes were compared to corresponding regions of parental chromosomes to determine the origin of the extra chromosomes. Using marker chromosomes it was found that 7 triploids and only one trisomy were informative. Three triploids arose by failure to shed the second polar body during oogenesis. One triploid arose by dispermy. The other three triploids inherited an extra haploid set of chromosomes from the father, either by dispermy or by failure of the second meiotic division during spermatogenesis. The only informative trisomy, a trisomy 22, inherited the extra 22 from the mother. Chromosome polymorphisms are useful in determining the parental origin of extra chromosomes in certain cases.     

Parental origin of the extra haploid chromosome set in triploidies diagnosed prenatally

The parental origin of the additional chromosome complement in a total of 17 cases of triploidy was determined mainly using highly polymorphic microsatellites. Maternal origin of the triploidy was demonstrated in most cases. To the best of our knowledge, this is the first systematic evaluation of the parental origin of chromosome sets in fetuses who survived until a cytogenetic diagnosis was established. In contrast to previous investigations this study documented a predominance of maternal origin of the extra haploid set mainly due to longer survival time for digynic triploidies. The concept of 2 distinct fetal phenotypes in triploidy is clearly supported by this study. © 1995 Wiley-Liss, Inc.     

Alpha-1-antitrypsin protease inhibitor (Pi) phenotypes in Down''s syndrome patients and their parents

Alpha-1-antitrypsin was examined in the serum from 121 Down's syndrome families. Variant phenotypes (non-M) were increased in frequency in parents (15%) and in their affected children (19%) compared to frequencies of 8-10% in two control groups (p less than 0.001). Variant parental Pi phenotypes were found in 19 mothers and 10 fathers of Down's patients. Parental origin of the extra chromosome 21 was known in 34 families and was maternal in 26 instances. In seven families where parental origin of the extra chromosome was known, a variant Pi phenotype was inherited from the parent contributing the extra chromosome in four families and from the parent not contributing the extra chromosome in three families, indicating that there is no simple correlation between the Pi variant and nondisjunction. The increase in Pi variant in Down's syndrome families was independent of maternal age.     

Origin of triploidy in spontaneous abortuses

Fourteen triploid spontaneous abortuses were studied cytogenetically by sequential Q and C banding and the marker chromosomes were compared with those of the parents. The abortuses comprised all triploid cases in a series of 288 consecutive abortuses of the first 16 weeks of pregnancy occurring in one hospital. In 12 of the triploids the origin of the extra haploid set was conclusively determined, revealing six cases of dispermy, five failures in the first maternal and one failure in the first paternal meiotic division. The results were combined with those of five other studies comprising a total of 48 informative cases. Non-reduction in the second meiotic division seems to be of little or no significance in the origin of human triploidy. Dispermy is the predominant source, accounting for 40--50% of the triploid spontaneous abortuses. Non-reduction in the first meiotic division of the father seems to be the second-most frequent source although in the present material the corresponding maternal non-reduction is much more common.     

Clinical details, cytogenic studies,and cellular physiology of a 69, XXX fetus, with comments on the biological effect of triploidy in man.

A triploid fetus, 69, XXX, aborted spontaneously at 26 weeks' gestation. It had multiple abnormalities including syndactyly of the hands and feet single palmar creases, hypoplasia of the adrenals and ovaries, hypertrophy of thigh muscles, and abnormalities of the brain. The placenta was large and showed hydatidiform degeneration. The pregnancy had been complicated by acute dyspnoea, pre-eclampsia, and postpartum haemorrhage. Detailed cytogenetic studies, using banding and fluorescence techniques, were performed on fetus and parents. Meiotic studies were made on the fetal ovaries. Muscle cell differentiation and electrophysiological relationships of cultured skin fibriblasts were examined in an attempt to study the way in which the extra haploid set of chromosomes exerts its effect on the phenotype. The antenatal diagnosis of late triploidy is discussed. The finding that 25 per cent of late triploids have spina bifida is further evidence that meningomyelocele has a genetic component and strongly suggests that this results from chromosomal imbalance or a regulatory gene disturbance.     

Confirmation of prenatal diagnosis of sex chromosome mosaicism

Prenatal diagnosis of mosaicism causes problems in interpretation and in genetic counselling. Part of the difficulty with any prenatal diagnosis of mosaicism is interpretation of results without knowing the exact origin, embryonic or extraembryonic, of the abnormal cell line. To confuse the issue in cases of prenatal diagnosis of 45,X/46,XY mosaicism is the recent demonstration that a diagnosis of 45,X/46,XY made prenatally is not necessarily associated with the same phenotype as when diagnosed postnatally. We present two cases of prenatal diagnosis of sex chromosome mosaicism (45,X/46,XY and 45,X/47,XYY). Posttermination examination of the phenotypically normal male fetuses and their placentas established that the placenta was the most likely source of the 45,X cell line. An approach to confirming the prenatal diagnosis of sex chromosome mosaicism and establishing its origin utilizing detailed cytogenetic examination of both fetus and placenta is suggested.     

Chromosome investigations in early life. II. Human preimplantation embryos

Cytogenetic analysis of 68 human embryos at the 2-to 8-cellstage was performed according to Tarkowski's technique. Sixteenper cent of diploid embryos showed abnormalities, essentiallydiploid/haploid or triploid/haploid mosaicism. Considering theaspect of the embryos, 11% of healthy looking and 19% of fragmentedembryos were chromosomally abnormal without, however, any statisticalsignificance in this small series. Only 46.7% of the tripronucleatefertilized eggs showed a triploid chromosome complement. In20% of the cases, however, diploid metaphases were found, andin the last 30% a triploid/diploid mosaicism. One per cent ofthe oocytes displayed a single pronucleus, and the resultingembryos contained haploid sets of chromosomes suggesting a parthogeneticactivation. The overall rate of chromosome abnormalities, including16/ of abnormal diploid eggs, 6/ of polyploid and 1/ of haploidembryos, thus reaches 23/ in this series.     

Variable clinical expression of mosaic trisomy 16 in the newborn infant

Trisomy 16 is common in embryos and fetuses aborted early during development. Mosaicism for trisomy 16 is sometimes encountered during prenatal diagnosis, particularly with chorionic villi biopsy specimens, and, until recently, was thought to be confined to the placenta. However, recently, several liveborn infants with trisomy 16 mosaicism have been described. We report on an additional liveborn infant with trisomy 16 mosaicism and compare the clinical findings with those of the previously reported cases in an attempt to delineate a mosaic trisomy 16 syndrome. Cytogenetic analysis from our patient showed that there was a different proportion of abnormal cells in different tissues and that the anomaly was undetectable in blood lymphocyte cultures. This observation was consistent with some of the previous reports. DNA analysis of parents and child was carried out using a polymorphic dinucleotide marker that maps to the long arm of chromosome 16. This analysis showed that the extra chromosome 16 in the infant was maternal in origin and suggested that the nondisjunction was probably a first meiotic division error. Our results suggest that an investigation of multiple tissues is required before concluding that mosaicism is confined to the placenta. We conclude that a finding of trisomy 16 mosaicism at prenatal diagnosis should be regarded with extreme caution. This diagnosis may be associated with a highly variable phenotype that may occasionally be compatible with extrauterine life. © 1993 Wiley-Liss, Inc.     

Triploidy, partial mole and dispermy. An investigation of 12 cases

Twelve triploid abortuses were investigated to determine the origin of the additional haploid set and were retrospectively examined for the development of partial hydatidiform mole. Eight out of ten suitable triploids were diagnosed as partial mole. Dispermy was indicated as the cause of triploidy in 6 informative cases of which 3 were also partial moles. However, one diandric triploid had no features of partial mole. The problem of maternal cell contamination in triploids and the difficulty of diagnosing partial moles on pathological grounds alone are discussed.     

Overexpression of connexin43 alters the mutant phenotype of midgestational wnt-1 null mice resulting in recovery of the midbrain and cerebellum

The midbrain-hindbrain (MHB) junction plays a key role in the patterning of the embryonic neural tube and the formation of brain structures such as the cerebellum. The mitogen wnt-1 is critical for cerebellar development, as evidenced by the lack of MHB region and cerebellar formation in the wnt-1 null embryo. We have generated wnt-1 null embryos overexpressing the gap junction gene connexin43 by crossing wnt-1 null heterozygotes into the CMV43 mouse line. We have confirmed that these mice show an increase in gap junctional communication by dye coupling analysis. Two-thirds of wnt-1 null CMV43(+) mouse embryos at E18.5 have a cerebellum. In addition, changes in the wnt-1 null phenotype in mouse embryos overexpressing connexin43 are observed as early as E9.5. At this stage, one-quarter of wnt-1 null CMV43(+) embryos display extra or expanded tissue present at the MHB boundary (a wnt-1 null enlarged phenotype). In situ hybridization studies conducted on these embryos have indicated no changes in the expression of embryonic brain positional markers in this region. We conclude from these studies that overexpression of the connexin43 gap junction restores cerebellar formation by compensating for the loss of wnt-1.     

Clinical and molecular studies in full trisomy 22: Further delineation of the phenotype and review of the literature

Trisomy 22 is commonly found among spontaneous abortions, second in frequency of occurrence only to trisomy 16. Most earlier reports of surviving trisomy 22 cases in the literature are thought to represent the product of unbalanced 11;22 translocations or the result of undetected mosaicism, since this condition is thought to manifest early embryonic or fetal lethality. We present two strikingly similar cases of non-mosaic trisomy 22 surviving to late gestation. In this paper we emphasize the unique phenotype of this trisomy which included intrauterine growth retardation, microcephaly, broad flat nasal bridge with epicanthal folds and ocular hypertelorism, microtia, variable cleft palate, webbed neck, congenital heart defects involving anomalous great vessels, anorectal and renal anomalies, and hypoplastic distal digits with thumb anomalies. We also explore why some cases survive to late gestation. Confined placental mosaicism, a frequent finding in other lethal trisomies, has been ruled out in one of the cases. Molecular studies done to assess the parental origin of the extra chromosome in the other case showed that the non-disjunction originated during maternal meiosis II. Parental origin of the extra chromosome does not seem to play a role in late survival for trisomy 22. © 1995 Wiley-Liss, Inc.     

Studies of non-disjunction in trisomies 2, 7, 15, and 22: does the parental origin of trisomy influence placental morphology?

Recently, there have been several molecular studies of trisomic fetuses and liveborns which have examined the parent and meiotic stage of origin of nondisjunction. However, little is known about the possible phenotypic effects of the origin of trisomy. For trisomic spontaneous abortions, no distinct phenotype has been described, although some have been reported to have features, such as trophoblastic hyperplasia, similar to hydatidiform moles. In the present report, we describe molecular and histological studies of spontaneous abortions with trisomies 2, 7, 15, or 22, conditions occasionally linked to trophoblastic hyperplasia. Our results provide strong evidence for chromosome specific mechanisms of nondisjunction, with trisomy 2 having a high frequency of paternally derived cases and trisomy 7 typically originating postzygotically. In studies correlating parental origin of trisomy with phenotype, we found no difference in the proportion of cases with trophoblastic hyperplasia, fetal tissue, nucleated red blood cells, or hydropic villi among paternally or maternally derived trisomies 2, 7, 15, or 22. However, paternally derived trisomies tended to abort earlier than maternally derived trisomies. This suggests that parental origin might affect the developmental stage at which abortion occurs but not other features of placental phenotype.     

The effect of heterologous antisera on embryonic development. XIII. Lack of effect of antisera to alpha fetoprotein

This investigation was carried out to determine whether heterologous antisera to alpha fetoprotein (AFP) are embryotoxic to developing rat embryos. Homogeneous rat AFP was isolated and antisera directed against this glycoprotein were produced in rabbits, horse and goat. The effect of the antisera on embryonic development was examined by injecting the antisera intraperitoneally into pregnant rats on the ninth, eleventh and thirteenth days of gestation. The results demonstrated that there was no evidence of increased incidence of fetal abnormalities in 472 surviving fetuses of 42 injected rats. There was no evidence of increase embryonic death or retardation of intrauterine growth following administration of the antisera on the ninth, eleventh and thirteenth days of gestation. The localization of the injected antisera was examined by the indirect immunofluorescent method. The results showed that the heterologous AFP antibodies localized specifically in the visceral yolk sac placenta. No antibody localization was observed in the embryo proper or the chorioallantoic placenta. It is speculated that the localization of AFP antibodies in the visceral yolk sac does not interfere with the embryotrophic function of the visceral yolk sac placenta.     

Parental origin and mechanisms of formation of triploidy: a study of 25 cases

Triploidy is one of the most frequently observed chromosome abnormalities in spontaneous abortions in humans. The parental origin of the additional chromosome set is known to have a major impact on the phenotype of the foetuses and to result in differences in size and structure of the placenta. Early studies based on cytogenetic polymorphisms indicated a preponderant diandric origin of the triploidies; such detection method, however, is known to be prone to error. Other studies revealed a predominant digynic origin in cases with longer intrauterine survival. It is now thought that, to some extent, a detection bias in favour of cases with associated partial hydatidiform moles may account for the high incidences of diandric cases reported in some studies. Furthermore, depending on the gestational age of the cases analysed there may indeed be differences in the proportion of diandric and digynic triploidies. We investigated the parental origin and mechanisms of formation of triploidy in a group of 25 probands with gestational ages ranging from 8 to 37 weeks. DNA samples were extracted from foetal material and from blood samples of the parents, and were analysed using microsatellite markers. The parental origin of the triploidies was found to be maternal in 20 cases and paternal in 5. Regarding the digynic cases, an error at meiosis I was inferred in 10 cases, whereas in the other half an error occurred at meiosis II. All five diandric cases included in this study were found to be due to dispermy. No significant differences in the average maternal ages were found amongst the different subgroups of patients.     

Trisomy and chromosome size changes in hybrid trypanosomes from a genetic cross between Trypanosoma brucei rhodesiense and T. b. brucei.

Further analysis of hybrid clones from an experimental cross of Trypanosoma brucei rhodesiense 058 and T. b. brucei 196 shows 2 of the hybrid clones to have DNA contents about 1.5 times parental values. This represents over 40,000 kb of extra DNA. Comparison of the molecular karyotypes of parental and progeny trypanosomes shows that the bulk of the extra DNA constitutes chromosomes greater than 1 Mb in size, although a small proportion can be accounted for by an increased number of mini-chromosomes. The 2 hybrid clones have 3 alleles at several loci for housekeeping genes as shown by RFLP and isoenzyme analysis. Trisomy of the chromosome carrying phosphoglycerate kinase and tubulin genes and that carrying the phospholipase C gene was demonstrated by analysis of molecular karyotypes. These chromosomes appear prone to substantial size alterations associated with genetic exchange. Our results for one of the hybrid clones are completely consistent with it being triploid and the product of fusion of haploid and diploid nuclei.     

The chromosome constitution of human preimplantation embryos fertilized in vitro

The chromosome constitution of five haploid, 178 diploid and11 triploid embryos fertilized in vitro was determined afterfixation on day 2 or day 3 of development. Karyotype analysisof 178 diploid embryos revealed abnormalities in 40 (22.5%)cases: 34 (19.1%) aneuploids, four (2.2%) mosaic embryos andtwo (1.1%) structural anomalies were identified. The majorityof aneuploid karyotypes (28/34) involved a single chromosomebut six embryos had aneuploidy of two or three chromosomes.The E group was most frequently involved in aneuploid karyotypes(10/23 hyperdiploid embryos) and trisomy 16, the most commonsingle anomaly in diploid embryos, was detected in 2.2% (4/178)of cases. Only one case of sex chromosome monosomy was identified.An excess of female karyotypes was detected in abnormal cases(sex ratio 0.48); this ratio was significantly (p< 0.05)different from that observed in normal cases (74: 64, XY: XX).The incidence of aneuploidy increased with maternal age butthis did not reach statistical significance. Embryo morphologyand growth rate, assessed by embryo development rating (EDR),did not distinguish between normal (mean score 7.9; mean EDR96.1) and aneuploid (mean score 8.1; mean EDR, 92.1) embryos.Numbers of hyperploid (n = 17) and hypoploid (n= 11) embryos(non-mosaic cases involving single chromosomes) were not statisticallydifferent. The relative proportions of chromosomes involvedin trisomic karyotypes showed a remarkable similarity to thepattern in spontaneous abortions. Pronuclear status was an unreliablepredictor of ploidy. Small numbers of karyotyped triploid embryosrevealed equal proportions of XXX, XXY and XYY embryos