BACKGROUND: Axenfeld-Rieger syndrome (ARS) is characterised by typical anterior segment anomalies, with or without systemic features. The discovery of causative genes identified ARS subtypes with distinct phenotypes, but our understanding is incomplete, complicated by the rarity of the condition. METHODS: Genetic and phenotypic characterisation of the largest reported ARS cohort through comprehensive genetic and clinical data analyses. RESULTS: 128 individuals with causative variants in PITX2 or FOXC1, including 81 new cases, were investigated. Ocular anomalies showed significant overlap but with broader variability and earlier onset of glaucoma for FOXC1-related ARS. Systemic anomalies were seen in all individuals with PITX2-related ARS and the majority of those with FOXC1-related ARS. PITX2-related ARS demonstrated typical umbilical anomalies and dental microdontia/hypodontia/oligodontia, along with a novel high rate of Meckel diverticulum. FOXC1-related ARS exhibited characteristic hearing loss and congenital heart defects as well as previously unrecognised phenotypes of dental enamel hypoplasia and/or crowding, a range of skeletal and joint anomalies, hypotonia/early delay and feeding disorders with structural oesophageal anomalies in some. Brain imaging revealed highly penetrant white matter hyperintensities, colpocephaly/ventriculomegaly and frequent arachnoid cysts. The expanded phenotype of FOXC1-related ARS identified here was found to fully overlap features of De Hauwere syndrome. The results were used to generate gene-specific management plans for the two types of ARS. CONCLUSION: Since clinical features of ARS vary significantly based on the affected gene, it is critical that families are provided with a gene-specific diagnosis, PITX2-related ARS or FOXC1-related ARS. De Hauwere syndrome is proposed to be a FOXC1opathy.
- MeSH
- abnormality očí * genetika diagnóza MeSH
- forkhead transkripční faktory genetika MeSH
- homeodoménové proteiny * genetika MeSH
- lidé MeSH
- mutace MeSH
- přední segment oční abnormality MeSH
- transkripční faktory genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
Four members of a three-generation Czech family with early-onset chorioretinal dystrophy were shown to be heterozygous carriers of the n.37C>T in MIR204. The identification of this previously reported pathogenic variant confirms the existence of a distinct clinical entity caused by a sequence change in MIR204. Chorioretinal dystrophy was variably associated with iris coloboma, congenital glaucoma, and premature cataracts extending the phenotypic range of the condition. In silico analysis of the n.37C>T variant revealed 713 novel targets. Additionally, four family members were shown to be affected by albinism resulting from biallelic pathogenic OCA2 variants. Haplotype analysis excluded relatedness with the original family reported to harbour the n.37C>T variant in MIR204. Identification of a second independent family confirms the existence of a distinct MIR204-associated clinical entity and suggests that the phenotype may also involve congenital glaucoma.
- MeSH
- glaukom * komplikace genetika MeSH
- iris abnormality MeSH
- katarakta * genetika vrozené MeSH
- kolobom * komplikace genetika MeSH
- lidé MeSH
- mikro RNA * MeSH
- mutace MeSH
- rodokmen MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Microphthalmia, anophthalmia, and coloboma (MAC) spectrum disease encompasses a group of eye malformations which play a role in childhood visual impairment. Although the predominant cause of eye malformations is known to be heritable in nature, with 80% of cases displaying loss-of-function mutations in the ocular developmental genes OTX2 or SOX2, the genetic abnormalities underlying the remaining cases of MAC are incompletely understood. This study intended to identify the novel genes and pathways required for early eye development. Additionally, pathways involved in eye formation during embryogenesis are also incompletely understood. This study aims to identify the novel genes and pathways required for early eye development through systematic forward screening of the mammalian genome. RESULTS: Query of the International Mouse Phenotyping Consortium (IMPC) database (data release 17.0, August 01, 2022) identified 74 unique knockout lines (genes) with genetically associated eye defects in mouse embryos. The vast majority of eye abnormalities were small or absent eyes, findings most relevant to MAC spectrum disease in humans. A literature search showed that 27 of the 74 lines had previously published knockout mouse models, of which only 15 had ocular defects identified in the original publications. These 12 previously published gene knockouts with no reported ocular abnormalities and the 47 unpublished knockouts with ocular abnormalities identified by the IMPC represent 59 genes not previously associated with early eye development in mice. Of these 59, we identified 19 genes with a reported human eye phenotype. Overall, mining of the IMPC data yielded 40 previously unimplicated genes linked to mammalian eye development. Bioinformatic analysis showed that several of the IMPC genes colocalized to several protein anabolic and pluripotency pathways in early eye development. Of note, our analysis suggests that the serine-glycine pathway producing glycine, a mitochondrial one-carbon donator to folate one-carbon metabolism (FOCM), is essential for eye formation. CONCLUSIONS: Using genome-wide phenotype screening of single-gene knockout mouse lines, STRING analysis, and bioinformatic methods, this study identified genes heretofore unassociated with MAC phenotypes providing models to research novel molecular and cellular mechanisms involved in eye development. These findings have the potential to hasten the diagnosis and treatment of this congenital blinding disease.
- MeSH
- abnormality očí * genetika MeSH
- anoftalmie * genetika MeSH
- embryonální vývoj genetika MeSH
- fenotyp MeSH
- kolobom * genetika MeSH
- lidé MeSH
- mikroftalmie * genetika MeSH
- myši knockoutované MeSH
- myši MeSH
- oči MeSH
- savci MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
The possible complications of anophthalmic eye sockets can occur due to many different pathomechanisms. A differentiation is made between allergic, infectious, inflammatory or mechanical causes. This article gives an overview on the different etiologies of socket complications with their pathophysiology and treatment options.
- MeSH
- anoftalmie * MeSH
- enukleace oka MeSH
- lidé MeSH
- následná péče MeSH
- orbita MeSH
- orbitální implantáty * škodlivé účinky MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- abnormality očí chirurgie etiologie klasifikace patologie terapie MeSH
- blefaritida etiologie patofyziologie patologie terapie MeSH
- blefaroptóza chirurgie etiologie klasifikace patologie terapie MeSH
- dítě MeSH
- kolobom etiologie patologie MeSH
- lidé MeSH
- nádory očního víčka etiologie klasifikace patologie terapie MeSH
- nemoci očních víček * chirurgie etiologie klasifikace patologie terapie vrozené MeSH
- nemoci slzného ústrojí * diagnóza klasifikace patofyziologie patologie terapie MeSH
- oční víčka abnormality anatomie a histologie fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- albinismus oční klasifikace patologie MeSH
- aniridie etiologie klasifikace patologie terapie MeSH
- choroideremie etiologie patologie MeSH
- dědičné nemoci očí etiologie klasifikace patologie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- hormony kůry nadledvin aplikace a dávkování klasifikace škodlivé účinky MeSH
- imunomodulační látky aplikace a dávkování klasifikace škodlivé účinky MeSH
- lidé MeSH
- nádory duhovky klasifikace patologie terapie MeSH
- nemoci uvey * etiologie klasifikace patologie vrozené MeSH
- uvea abnormality anatomie a histologie MeSH
- uveitida diagnóza etiologie farmakoterapie klasifikace komplikace patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- abnormality očí klasifikace MeSH
- amblyopie etiologie terapie MeSH
- dítě MeSH
- implantace nitrooční čočky MeSH
- katarakta * diagnóza epidemiologie etiologie klasifikace patologie MeSH
- lidé MeSH
- nemoci oční čočky * etiologie klasifikace patologie vrozené MeSH
- oční čočka abnormality anatomie a histologie MeSH
- oftalmologické chirurgické výkony metody škodlivé účinky trendy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- abnormality očí * diagnóza klasifikace komplikace patologie terapie MeSH
- dědičné dystrofie rohovky diagnóza klasifikace komplikace patologie terapie MeSH
- dědičné nemoci očí diagnóza klasifikace komplikace patologie terapie MeSH
- degenerativní myopie diagnóza komplikace terapie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- oči anatomie a histologie patologie MeSH
- odchlípení sítnice etiologie klasifikace terapie MeSH
- retina abnormality anatomie a histologie patologie MeSH
- retinální dystrofie diagnóza klasifikace patologie terapie MeSH
- retinální teleangiektázie diagnóza komplikace terapie MeSH
- retinopatie nedonošených diagnóza klasifikace komplikace patofyziologie terapie MeSH
- sklivec abnormality anatomie a histologie patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- abnormality očí * diagnóza etiologie klasifikace patologie MeSH
- anoftalmie diagnóza etiologie klasifikace patologie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- encefalokéla diagnóza etiologie klasifikace patologie MeSH
- kolobom diagnóza klasifikace patologie MeSH
- lidé MeSH
- mikroftalmie diagnóza etiologie klasifikace patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- abnormality očí MeSH
- lidé MeSH
- oči - fyziologické jevy MeSH
- oči * anatomie a histologie embryologie imunologie inervace MeSH
- oční nemoci vrozené MeSH
- oftalmologie dějiny MeSH
- okulomotorické svaly anatomie a histologie fyziologie MeSH
- optické jevy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH