Trisomy 21

Prenatal diagnosis of fetal trisomies is usually performed by cytogenetic analysis from amniotic fluid. This requires lengthy laboratory procedures and high costs and is unsuitable for large-scale screening of pregnant women. An alternative method, which is rapid and inexpensive and may potentially be suitable for diagnosing trisomies even from single fetal cells, is the fluorescent polymerase chain reaction (F-PCR) using polymorphic small tandem repeats (STRs). In this paper we present data demonstrating that fluorescent PCR amplification of STRs can be used for rapid diagnosis of trisomy 21, trisomy 18, and trisomy 13 and can be successfully applied to both prenatal diagnosis and diagnosis of single cells. This study also reports significant numbers of prenatal diagnoses using quantitative fluorescent PCR. We believe that further studies of greater numbers of samples will determine the absolute reliability of this technique. These results also provide a model for trisomy diagnosis...

Clinical and cytogenetic data of two related patients, both trisomic for the segment 4q27→qter, are reported. Familial studies determined that the mothers of the two probands were carriers of the same balanced translocation between chromosomes 4 and 18. Altogether, two partial trisomies 4q, five balanced karyotypes, and one 45,XO karyotype were found in the family. The 18 cases reported to date are reviewed with respect ot the karyotype-phenotype correlation.

Periodontal disease is highly prevalent in Down syndrome (DS) individuals and is a significant cause of tooth loss in these individuals. Alterations in the immune system associated with poor oral hygiene, normally observed in these patients, are important contributing factors for the increased susceptibility to periodontal disease. The etiology of periodontal disease in DS is complex and more recently much focus has been placed in understanding the immune response alterations resulting from this genetic disorder. The purpose of this paper is to review the literature on the immunological alterations observed in Down syndrome patients and their relationship to periodontal disease. The increased incidence of periodontal disease in DS subjects relates to its genetic background. The reduced ability of the immune system to properly eliminate periodontal pathogens may be the main reason behind the increased susceptibility to periodontitis. Evaluation, treatment and monitoring of these patients as early as during the primary dentition can reduce the morbidity associated with periodontal disease.

This project investigates different aspects of craniofacial phenotypes exhibited in individuals with Down syndrome (DS), siblings of individuals with DS, and typically developing sibling pairs. A human sample (4-12 yrs.) consisting of 3D facial surface images (n = 55 for four separate samples: i.e. n = 220 overall) was used to explore developmental instability of the face and patterns of facial covariation between individuals with DS, their siblings, and typically developing sibling pairs. Morphometric analyses were used to infer how gene-dosage imbalance, caused by trisomy 21, is affecting DS craniofacial development. Overall we found increased fluctuating asymmetry in the faces of individuals with DS, which provides evidence for the "amplified developmental instability" model put forth by Shapiro (1975, 1983). However, the patterns of differences that we found suggest specific disruptions to regions of the face during craniofacial development rather than the generalized disruptions described by Shapiro under the amplified developmental instability model. Additionally, the results of our investigation found that covariation of facial metrics is different in DS individuals and in DS siblings relative to typically developing siblings. Based on differences in the pattern and strength of integration within and between facial regions in the DS and DS sibling samples, we put forth an "aneuploid conception model" to explain why facial integration is lowest in DS siblings and strengthened in DS relative to DS siblings.

In addition to the human-based analyses, micro-computed tomography (µCT) scans and morphometric analysis were employed to evaluate a complete genetic mouse model for DS - the Ts1Yey mouse. Morphometric comparison of craniofacial measures for Ts1Yey mice and euploid littermates (n = 12 for each sample) was done to determine if this model exhibits craniofacial differences similar to differences seen in humans with DS and in previously established DS mouse models. Overall, our results validate this mouse model for use in craniofacial DS investigations.

AimTo review systematically the neurodevelopmental characteristics of individuals with sex chromosome trisomies (SCTs).MethodA bibliographic search identified English-language articles on SCTs. The focus was on studies unbiased by clinical referral, with power of at least 0.69 to detect an effect size of 1.0.ResultsWe identified 35 articles on five neonatally identified samples that had adequate power for our review. An additional 11 studies were included where cases had been identified for reasons other than neurodevelopmental concerns. Individuals with an additional X chromosome had mean IQs that were within broadly normal limits but lower than the respective comparison groups, with verbal IQ most affected. Cognitive outcomes were poorest for females with XXX. Males with XYY had normal-range IQs, but all three SCT groups (XXX, XXY, and XYY) had marked difficulties in speech and language, motor skills, and educational achievement. Nevertheless, most adults with SCTs lived independently. Less evidence was available for brain structure and for attention, social, and psychiatric outcomes. Within each group there was much variation.InterpretationIndividuals with SCTs are at risk of cognitive and behavioural difficulties. However, the evidence base is slender, and further research is needed to ascertain the nature, severity, and causes of these difficulties in unselected samples.

A 22-week stillborn fetus with 47,XXX karyotype had lower mesodermal defects consisting of irregular fusion of the sacral vertebrae, anal agenesis, multicystic dysplasia of a horseshoe kidney, a single umbilical artery, dysplastic ovaries, and uterine hypoplasia. This case provides additional evidence for an association between trisomy X and genitourinary defects including lower mesodermal defects sequence.

A 22-week stillborn fetus with 47,XXX karyotype had lower mesodermal defects consisting of irregular fusion of the sacral vertebrae, anal agenesis, multicystic dysplasia of a horseshoe kidney, a single umbilical artery, dysplastic ovaries, and uterine hypoplasia. This case provides additional evidence for an association between trisomy X and genitourinary defects including lower mesodermal defects sequence.