Prenatal diagnosis of mosaicism for trisomy 12 in a single colony at amniocentesis in a pregnancy with a favorable outcome

ObjectiveWe present prenatal diagnosis of mosaicism for trisomy 12 in a single colony at amniocentesis with a favorable outcome.Case reportA 36-year-old woman underwent amniocentesis at 18 weeks of gestation because of advanced maternal age. Amniocentesis revealed a karyotype of 47,XY,+12[1]/46,XY[14]. In 15 colonies of cultured amniocytes, all three cells in one colony had the karyotype of 47,XY,+12, while the rest 14 colonies had the karyotype of 46,XY. The parental karyotypes were normal. Prenatal ultrasound findings were unremarkable. Polymorphic DNA marker analysis using the DNAs extracted from cultured amniocytes and parental bloods excluded uniparental disomy (UPD) 12. At 37 weeks of gestation, a healthy 2,828-g male baby was delivered with no phenotypic abnormality. The cord blood had a karyotype of 46,XY in 40/40 lymphocytes. Postnatal interphase fluorescence in situ hybridization (FISH) analysis on buccal cells and urinary cells revealed normal signals in 72/72 buccal cells, and trisomy 12 signals in 1/47 (2.1%) urinary cells compared with 0% (0/75 cells) of trisomy 12 signals in the normal control.ConclusionMosaicism for trisomy 12 in a single colony at amniocentesis without UPD 12 and fetal ultrasound abnormalities can be associated with a favorable outcome.     

Evaluation of the developmental competence and chromosomal compliment of mouse oocytes derived from in-vitro growth and maturation of preantral follicles

Purpose To evaluate the developmental potential and aneuploidy rates of in-vitro versus in-vivo grown and matured mouse oocytes. Methods Mice were superovulated to obtain in-vivo matured oocytes. Mouse preantral follicles were also mechanically isolated and cultured in-vitro. In-vitro fertilization (IVF) was performed and fertilization, cleavage, and morula/blastocyst formation rates were compared between groups. Cytogenetic analysis was used to compare oocyte aneuploidy rates and aneuploidy characteristics in the developing embryos. Results In-vivo oocyte maturation resulted in higher IVF fertilization, cleavage, and morula/blastocyst formation rates versus in-vitro follicle culture (96.4% versus 78.5%, p < 0.001; 95.3% versus 77.4%, p < 0.001; 94.1% versus 76.9%, p < 0.001). Total aneuploidy rates were higher in embryos derived from in-vitro matured oocytes versus those grown in-vivo (4.0% versus 1.3%, p < 0.05). Conclusions Results indicate a reduced developmental competency of in-vitro matured oocytes. The data also highlight an increased susceptibility to meiotic errors in early stage follicles undergoing in vitro culture. Capsule Impaired developmental capacity and errors in proper chromosome segregation are observed in mouse oocytes generated from in-vitro preantral follicle culture versus those developed in-vivo.     

Noninvasive prenatal detection of fetal sex chromosome abnormalities using the semiconductor sequencing platform (SSP) in Southern China

BackgroundNoninvasive prenatal testing (NIPT) has been widely used to screen for fetal aneuploidies, including fetal sex chromosome aneuploidies (SCAs). However, there is less information on the performance of NIPT in detecting SCAs.MethodsA cohort of 47,800 pregnancies was recruited to review the high-risk NIPT results for SCAs. Cell-free fetal DNA (cffDNA) was extracted and sequenced. All NIPT high-risk cases were recommended to undergo invasive prenatal diagnosis for karyotyping analysis and chromosome microarray analysis (CMA).ResultsA total of 238 high-risk cases were detected by NIPT, including 137 cases of 45,X, 27 cases of 47,XXX, and 74 cases of 47,XYY/47,XXY. Prenatal diagnosis, including karyotyping analysis and CMA, was available in 170 cases. The positive predictive value (PPV) was 30.00% for 45,X, 70.58% for 47,XXX, and 81.13% for 47,XYY/47,XXY. In addition, 13 cases of sex chromosome mosaicism and 9 cases of sex chromosome CNVs were incidentally found in this study.ConclusionOur study showed that NIPT was reliable for screening SCAs based on a large sample, and it performed better in predicting sex chromosome trisomies than monosomy X. Our study will provide an important reference for clinical genetic counseling and further processing of the results.     

辅助生殖技术中嵌合胚胎的发生机制及结局

随着胚胎植入前遗传学检测（preimplantation genetic test，PGT）的应用及其诊断方法的不断进步，嵌合胚胎作为整倍体胚胎、非整倍体胚胎以外的第三种胚胎类型，在移植前胚胎中的检出率越来越高。胚胎嵌合可导致流产、死产和遗传异常风险的增加，但也可发育为健康活产儿。嵌合胚胎在染色体异常类型、异常细胞比例和嵌合部位等方面存在很大差异性，为其移植的选择带来了巨大挑战，也使其移植后的结局具有极大未知性。减数分裂形成配子时发生的错误，将导致非整倍体胚胎的形成；而受精卵形成后细胞的有丝分裂错误，产生了嵌合胚胎。理解嵌合胚胎形成机制，了解其检出率及影响因素、发育结局，对避免错误地丢弃具有发育潜力的胚胎至关重要。     

Novel non-identical MECP2 mutations in Rett syndrome family: a rare presentation

Introduction

Rett syndrome (RS), an X-linked neurodevelopmental disorder and the common cause of mental retardation in females, is caused by methyl CpG binding protein 2 (MECP2) gene mutations with a frequency of more than 95% in classical Rett patients. Majority of RS cases are sporadic but few familial cases caused by either skewed X-chromosome inactivation in healthy female carriers or mosaicism in male carriers are also reported. Most of the times, the mutation carried in a family is the same as found in affected child.

Methods and results

Here we report a unique family carrying non-identical MECP2 mutations in exon 2 wherein the proband with classical RS was carrying a de-novo early truncating frameshift mutation while her asymptomatic mother was carrying a missense mutation, both predicted as pathogenic mutations.

Conclusions

These findings further validate the importance of MECP2 mutation screening in parents of all mutation positive patients and careful evaluation of the pathogenicity of the mutation found in asymptomatic carriers before providing genetic counseling to the family. The results also propose the role of other factors including other gene mutations, environmental and epigenetics factors in modifying the expression of MECP2 mutations.     

Mitochondrial dysfunction and pathology in bipolar disorder and schizophrenia

Bipolar disorder (BPD) and schizophrenia (SZ) are severe psychiatric illnesses with a combined prevalence of 4%. A disturbance of energy metabolism is frequently observed in these disorders. Several pieces of evidence point to an underlying dysfunction of mitochondria: (i) decreased mitochondrial respiration; (ii) changes in mitochondrial morphology; (iii) increases in mitochondrial DNA (mtDNA) polymorphisms and in levels of mtDNA mutations; (iv) downregulation of nuclear mRNA molecules and proteins involved in mitochondrial respiration; (v) decreased high-energy phosphates and decreased pH in the brain; and (vi) psychotic and affective symptoms, and cognitive decline in mitochondrial disorders. Furthermore, transgenic mice with mutated mitochondrial DNA polymerase show mood disorder-like phenotypes. In this review, we will discuss the genetic and physiological components of mitochondria and the evidence for mitochondrial abnormalities in BPD and SZ. We will furthermore describe the role of mitochondria during brain development and the effect of current drugs for mental illness on mitochondrial function. Understanding the role of mitochondria, both developmentally as well as in the ailing brain, is of critical importance to elucidate pathophysiological mechanisms in psychiatric disorders.     

SCN1A mutation mosaicism in a family with severe myoclonic epilepsy in infancy

PURPOSE: To investigate the genetic background of familial severe myoclonic epilepsy in infancy (SMEI) cases. METHODS: We performed mutation analyses of the sodium-channel gene SCN1A in two Japanese brothers with clinical features of SMEI and their parents, who had no history of febrile and epileptic seizures. RESULTS: Each patient showed nucleotide changes (c.[730G>T; 735G>T; 736A>T]) in the coding exon 6 of SCN1A that led to a truncation of the channel protein. Their father showed no mutations, but their mother showed the same mutation in a subpopulation of lymphocytes. CONCLUSIONS: The maternal mosaicism explains the identical SCN1A mutations in the two brothers. This highlights the importance of investigating parental mosaicism even in sporadic SMEI cases.     

Methylation analysis and developmental profile of two individuals with Angelman syndrome due to mosaic imprinting defects

Angelman syndrome (AS) is a severe neurodevelopmental disorder caused by loss of expression of the maternally-inherited UBE3A on chromosome 15q11.2. In AS due to a chromosomal deletion that encompasses UBE3A, paternal uniparental disomy of chromosome 15, or imprinting defects (ImpD), the SNRPN locus is unmethylated, while in neurotypical individuals, it is ～50% methylated. We present the developmental profile of two adults with mild AS assessed using standardized behavioral and neurodevelopmental measures. Both had intellectual disability with unusually advanced verbal communication skills compared to other individuals with AS. Methylation of the SNRPN locus was examined using Methylation Specific Quantitative Melt Analysis (MS-QMA) in different tissues at one time point for participant A (22 years) and two time points for participant B (T1: 22 years, T2: 25 years), and these levels were compared to a typical AS cohort. While participant A showed methylation levels comparable to the typical AS cohort, participant B showed methylation mosaicism in all tissues at both time points and changes in methylation levels from T1 to T2. AS should be considered in individuals with intellectual disability and verbal speech who may not have the typical symptoms of AS.     

Catch them if you are aware: PTEN postzygotic mosaicism in clinically suspicious patients with PTEN Hamartoma Tumour Syndrome and literature review

PTEN germline variants cause PTEN Hamartoma Tumour Syndrome (PHTS). Of individuals fulfilling diagnostic criteria, 41–88% test negative for PTEN germline variants, while mosaicism could be an explanation. Here we describe two individuals with PTEN mosaicism. First, a 21-year-old female presented with macrocephaly and a venous malformation. Next generation sequencing analysis on her venous malformation identified the mosaic pathogenic PTEN variant c.493-2A>G (23%). This variant was initially missed in blood due to low frequency (<1%), but detected in buccal swab (21%). Second, a 13-year-old male presented with macrocephaly, language developmental delay, behavioral problems, and an acral hyperkeratotic papule. Targeted PTEN analysis identified the mosaic pathogenic variant c.284C>T (11%) in blood, which was confirmed via buccal swab. These two cases suggest that PTEN mosaicism might be more common than currently reported. PTEN mosaicism awareness is important to enable diagnosis, which facilitates timely inclusion in cancer surveillance programs improving prognosis and life expectancy.     

一例TSC2基因低比例突变嵌合体基因学分析

目的: 对一例临床表现不典型的结节性硬化症（TSC）患者进行基因突变分析以明确诊断。方法: 收集一例临床上拟诊TSC的患者及其父母的外周血,通过全外显子组测序技术对先证者TSC1和TSC2基因的全部外显子及其侧翼序列进行测序,确定候选致病突变位点,同时对先证者及其父母的外周血DNA进行Sanger测序验证,并用液滴数字PCR技术确定先证者体细胞中该突变嵌合比例。结果: 先证者的TSC2基因第11号外显子存在c.1096G>T（p.E366*）杂合无义突变,为微小突变峰,突变比例未高于其突变阈值,不排除嵌合体的可能。液滴数字PCR结果提示,先证者为c.1096G>T点突变嵌合体,嵌合比例为14%。结论: 先证者TSC2基因发生体细胞镶嵌突变,c.1096G>T可能是该TSC患者的致病原因。液滴数字PCR有助于体细胞镶嵌突变嵌合体的确诊。