Nörokütan Hastalıklarda Genetik ve Genetik Danışmanlık
Özet
Nörokutan hastalıklar, genellikle genetik kökenli olup cilt ve merkezi sinir sistemini etkileyen heterojen bir hastalık grubudur. Tanıda klinik bulguların yanı sıra aile öyküsü ve moleküler genetik testler kritik rol oynamaktadır. Nörofibromatozis tip 1, tip 2, tüberoskleroz kompleksi ve Sturge-Weber sendromu gibi yaygın örneklerde, genetik temellerin ve sinyal yolaklarının aydınlatılması, doğru teşhis ve tedavi yaklaşımları için elzemdir. Genetik danışmanlık, özellikle sporadik vakalarda ve kalıtsal risklerin belirlenmesinde önemli bir süreçtir.
Neurocutaneous diseases are a heterogeneous group of disorders, typically genetic in origin, that primarily affect the skin and the central nervous system. Precise diagnosis and management rely on clinical findings combined with comprehensive genetic testing and detailed family histories. Understanding the molecular mechanisms and signaling pathways, such as those involved in neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome, is essential for guiding accurate diagnostic and therapeutic approaches. Genetic counseling plays a vital role in identifying inheritance patterns and providing risk assessments, particularly in cases involving new mutations or somatic mosaicism.
Referanslar
Becker B, Strowd RE, 3rd. Phakomatoses. Dermatol Clin. 2019;37(4):583-606.
Rosser T. Neurocutaneous Disorders. Continuum (Minneap Minn). 2018;24(1, Child Neurology):96-129.
Aoki Y, Niihori T, Inoue S, Matsubara Y. Recent advances in RASopathies. Journal of human genetics. 2016;61(1):33-9.
Curatolo P, Moavero R. mTOR Inhibitors in Tuberous Sclerosis Complex. Curr Neuropharmacol. 2012;10(4):404-15.
Williams VC, Lucas J, Babcock MA, Gutmann DH, Korf B, Maria BL. Neurofibromatosis type 1 revisited. Pediatrics. 2009;123(1):124-33.
Hyman SL, Arthur Shores E, North KN. Learning disabilities in children with neurofibromatosis type 1: subtypes, cognitive profile, and attention-deficit-hyperactivity disorder. Dev Med Child Neurol. 2006;48(12):973-7.
Korf BR. Plexiform neurofibromas. American journal of medical genetics. 1999;89(1):31-7.
Jett K, Friedman JM. Clinical and genetic aspects of neurofibromatosis 1. Genetics in medicine : official journal of the American College of Medical Genetics. 2010;12(1):1-11.
National Institutes of Health Consensus Development Conference Statement: neurofibromatosis. Bethesda, Md., USA, July 13-15, 1987. Neurofibromatosis. 1988;1(3):172-8.
Howe KL, Achuthan P, Allen J, Allen J, Alvarez-Jarreta J, Amode MR, et al. Ensembl 2021. Nucleic acids research. 2021;49(D1):D884-D91.
Friedman JM. Neurofibromatosis 1. 1998 Oct 2 [Updated 2019 Jun 6]. In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1109/.
Upadhyaya M. NF1 gene structure and NF1 genotype/phenotype correlations. Neurofibromatoses. 16: Karger Publishers; 2008. p. 46-62.
Trovo-Marqui AB, Tajara EH. Neurofibromin: a general outlook. Clinical genetics. 2006;70(1):1-13.
Denayer E, de Ravel T, Legius E. Clinical and molecular aspects of RAS related disorders. Journal of medical genetics. 2008;45(11):695-703.
Cichowski K, Jacks T. NF1 tumor suppressor gene function: narrowing the GAP. Cell. 2001;104(4):593-604.
Carey JC, Baty BJ, Johnson JP, Morrison T, Skolnick M, Kivlin J. The genetic aspects of neurofibromatosis. Annals of the New York Academy of Sciences. 1986;486:45-56.
Pasmant E, Vidaud M, Vidaud D, Wolkenstein P. Neurofibromatosis type 1: from genotype to phenotype. Journal of medical genetics. 2012;49(8):483-9.
Brems H, Chmara M, Sahbatou M, Denayer E, Taniguchi K, Kato R, et al. Germline loss-of-function mutations in SPRED1 cause a neurofibromatosis 1-like phenotype. Nature genetics. 2007;39(9):1120-6.
Victor FC. Segmental neurofibromatosis. Dermatology online journal. 2005;11(4):20.
Ruggieri M, Huson SM. The clinical and diagnostic implications of mosaicism in the neurofibromatoses. Neurology. 2001;56(11):1433-43.
Dang JD, Cohen PR. Segmental neurofibromatosis and malignancy. Skinmed. 2010;8(3):156-9.
Evans DG, Bowers N, Burkitt-Wright E, Miles E, Garg S, Scott-Kitching V, et al. Comprehensive RNA Analysis of the NF1 Gene in Classically Affected NF1 Affected Individuals Meeting NIH Criteria has High Sensitivity and Mutation Negative Testing is Reassuring in Isolated Cases With Pigmentary Features Only. EBioMedicine. 2016;7:212-20.
Valero MC, Martín Y, Hernández-Imaz E, Hernández AM, Meleán G, Valero AM, et al. A highly sensitive genetic protocol to detect NF1 mutations. The Journal of Molecular Diagnostics. 2011;13(2):113-22.
Sabbagh A, Pasmant E, Imbard A, Luscan A, Soares M, Blanche H, et al. NF1 molecular characterization and neurofibromatosis type I genotype-phenotype correlation: the French experience. Hum Mutat. 2013;34(11):1510-8.
Rojnueangnit K, Xie J, Gomes A, Sharp A, Callens T, Chen Y, et al. High Incidence of Noonan Syndrome Features Including Short Stature and Pulmonic Stenosis in Patients carrying NF1 Missense Mutations Affecting p.Arg1809: Genotype-Phenotype Correlation. Hum Mutat. 2015;36(11):1052-63.
Upadhyaya M, Huson SM, Davies M, Thomas N, Chuzhanova N, Giovannini S, et al. An absence of cutaneous neurofibromas associated with a 3-bp inframe deletion in exon 17 of the NF1 gene (c.2970-2972 delAAT): evidence of a clinically significant NF1 genotype-phenotype correlation. Am J Hum Genet. 2007;80(1):140-51.
Pasmant E, Sabbagh A, Spurlock G, Laurendeau I, Grillo E, Hamel MJ, et al. NF1 microdeletions in neurofibromatosis type 1: from genotype to phenotype. Hum Mutat. 2010;31(6):E1506-18.
Pasmant E, Sabbagh A, Masliah-Planchon J, Haddad V, Hamel MJ, Laurendeau I, et al. Detection and characterization of NF1 microdeletions by custom high resolution array CGH. The Journal of molecular diagnostics : JMD. 2009;11(6):524-9.
Trevisson E, Forzan M, Salviati L, Clementi M. Neurofibromatosis type 1 in two siblings due to maternal germline mosaicism. Clinical genetics. 2014;85(4):386-9.
Upadhyaya M, Majounie E, Thompson P, Han S, Consoli C, Krawczak M, et al. Three different pathological lesions in the NF1 gene originating de novo in a family with neurofibromatosis type 1. Human genetics. 2003;112(1):12-7.
Merker VL, Murphy TP, Hughes JB, Muzikansky A, Hughes MR, Souter I, et al. Outcomes of preimplantation genetic diagnosis in neurofibromatosis type 1. Fertility and sterility. 2015;103(3):761-8 e1.
van Minkelen R, van Bever Y, Kromosoeto JN, Withagen-Hermans CJ, Nieuwlaat A, Halley DJ, et al. A clinical and genetic overview of 18 years neurofibromatosis type 1 molecular diagnostics in the Netherlands. Clinical genetics. 2014;85(4):318-27.
Evans DG, Moran A, King A, Saeed S, Gurusinghe N, Ramsden R. Incidence of vestibular schwannoma and neurofibromatosis 2 in the North West of England over a 10-year period: higher incidence than previously thought. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2005;26(1):93-7.
Asthagiri AR, Parry DM, Butman JA, Kim HJ, Tsilou ET, Zhuang Z, et al. Neurofibromatosis type 2. Lancet. 2009;373(9679):1974-86.
Ardern-Holmes S, Fisher G, North K. Neurofibromatosis Type 2. J Child Neurol. 2017;32(1):9-22.
Evans DG. Neurofibromatosis 2 [Bilateral acoustic neurofibromatosis, central neurofibromatosis, NF2, neurofibromatosis type II]. Genetics in medicine : official journal of the American College of Medical Genetics. 2009;11(9):599-610.
Trofatter JA, MacCollin MM, Rutter JL, Murrell JR, Duyao MP, Parry DM, et al. A novel moesin-, ezrin-, radixin-like gene is a candidate for the neurofibromatosis 2 tumor suppressor. Cell. 1993;75(4):826.
Knudson AG, Jr. Mutation and cancer: statistical study of retinoblastoma. Proceedings of the National Academy of Sciences of the United States of America. 1971;68(4):820-3.
Rong R, Surace EI, Haipek CA, Gutmann DH, Ye K. Serine 518 phosphorylation modulates merlin intramolecular association and binding to critical effectors important for NF2 growth suppression. Oncogene. 2004;23(52):8447-54.
Lee JY, Kim H, Ryu CH, Kim JY, Choi BH, Lim Y, et al. Merlin, a tumor suppressor, interacts with transactivation-responsive RNA-binding protein and inhibits its oncogenic activity. The Journal of biological chemistry. 2004;279(29):30265-73.
Parry DM, Eldridge R, Kaiser-Kupfer MI, Bouzas EA, Pikus A, Patronas N. Neurofibromatosis 2 (NF2): clinical characteristics of 63 affected individuals and clinical evidence for heterogeneity. American journal of medical genetics. 1994;52(4):450-61.
Evans DG, Trueman L, Wallace A, Collins S, Strachan T. Genotype/phenotype correlations in type 2 neurofibromatosis (NF2): evidence for more severe disease associated with truncating mutations. Journal of medical genetics. 1998;35(6):450-5.
Baser ME, Friedman JM, Aeschliman D, Joe H, Wallace AJ, Ramsden RT, et al. Predictors of the risk of mortality in neurofibromatosis 2. Am J Hum Genet. 2002;71(4):715-23.
Patronas NJ, Courcoutsakis N, Bromley CM, Katzman GL, MacCollin M, Parry DM. Intramedullary and spinal canal tumors in patients with neurofibromatosis 2: MR imaging findings and correlation with genotype. Radiology. 2001;218(2):434-42.
Smith MJ, Higgs JE, Bowers NL, Halliday D, Paterson J, Gillespie J, et al. Cranial meningiomas in 411 neurofibromatosis type 2 (NF2) patients with proven gene mutations: clear positional effect of mutations, but absence of female severity effect on age at onset. Journal of medical genetics. 2011;48(4):261-5.
Evans DG, Bowers N, Huson SM, Wallace A. Mutation type and position varies between mosaic and inherited NF2 and correlates with disease severity. Clinical genetics. 2013;83(6):594-5.
Smith MJ, Urquhart JE, Harkness EF, Miles EK, Bowers NL, Byers HJ, et al. The Contribution of Whole Gene Deletions and Large Rearrangements to the Mutation Spectrum in Inherited Tumor Predisposing Syndromes. Hum Mutat. 2016;37(3):250-6.
Evans DG. Neurofibromatosis 2. 1998 Oct 14 [Updated 2018 Mar 15]. In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1201/.
Parry DM, MacCollin MM, Kaiser-Kupfer MI, Pulaski K, Nicholson HS, Bolesta M, et al. Germ-line mutations in the neurofibromatosis 2 gene: correlations with disease severity and retinal abnormalities. Am J Hum Genet. 1996;59(3):529-39.
Evans DG, Huson SM, Donnai D, Neary W, Blair V, Teare D, et al. A genetic study of type 2 neurofibromatosis in the United Kingdom. I. Prevalence, mutation rate, fitness, and confirmation of maternal transmission effect on severity. Journal of medical genetics. 1992;29(12):841-6.
Evans DG, Kalamarides M, Hunter-Schaedle K, Blakeley J, Allen J, Babovic-Vuskanovic D, et al. Consensus recommendations to accelerate clinical trials for neurofibromatosis type 2. Clinical cancer research : an official journal of the American Association for Cancer Research. 2009;15(16):5032-9.
Verlinsky Y, Rechitsky S, Verlinsky O, Chistokhina A, Sharapova T, Masciangelo C, et al. Preimplantation diagnosis for neurofibromatosis. Reprod Biomed Online. 2002;4(3):218-22.
O'Callaghan FJ, Shiell AW, Osborne JP, Martyn CN. Prevalence of tuberous sclerosis estimated by capture-recapture analysis. Lancet. 1998;351(9114):1490.
Northrup H, Krueger DA, International Tuberous Sclerosis Complex Consensus G. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 Iinternational Tuberous Sclerosis Complex Consensus Conference. Pediatr Neurol. 2013;49(4):243-54.
van Slegtenhorst M, de Hoogt R, Hermans C, Nellist M, Janssen B, Verhoef S, et al. Identification of the tuberous sclerosis gene TSC1 on chromosome 9q34. Science. 1997;277(5327):805-8.
European Chromosome 16 Tuberous Sclerosis C. Identification and characterization of the tuberous sclerosis gene on chromosome 16. Cell. 1993;75(7):1305-15.
Crino PB, Nathanson KL, Henske EP. The tuberous sclerosis complex. The New England journal of medicine. 2006;355(13):1345-56.
Marcotte L, Crino PB. The neurobiology of the tuberous sclerosis complex. Neuromolecular Med. 2006;8(4):531-46.
Li J, Kim SG, Blenis J. Rapamycin: one drug, many effects. Cell Metab. 2014;19(3):373-9.
Henske EP, Jozwiak S, Kingswood JC, Sampson JR, Thiele EA. Tuberous sclerosis complex. Nat Rev Dis Primers. 2016;2:16035.
Dabora SL, Jozwiak S, Franz DN, Roberts PS, Nieto A, Chung J, et al. Mutational analysis in a cohort of 224 tuberous sclerosis patients indicates increased severity of TSC2, compared with TSC1, disease in multiple organs. Am J Hum Genet. 2001;68(1):64-80.
Sancak O, Nellist M, Goedbloed M, Elfferich P, Wouters C, Maat-Kievit A, et al. Mutational analysis of the TSC1 and TSC2 genes in a diagnostic setting: genotype--phenotype correlations and comparison of diagnostic DNA techniques in Tuberous Sclerosis Complex. European journal of human genetics : EJHG. 2005;13(6):731-41.
Tyburczy ME, Dies KA, Glass J, Camposano S, Chekaluk Y, Thorner AR, et al. Mosaic and Intronic Mutations in TSC1/TSC2 Explain the Majority of TSC Patients with No Mutation Identified by Conventional Testing. PLoS genetics. 2015;11(11):e1005637.
Northrup H, Koenig MK, Pearson DA, Au KS. Tuberous Sclerosis Complex. 1999 Jul 13 [Updated 2020 Apr 16]. In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1220/.
Qin W, Kozlowski P, Taillon BE, Bouffard P, Holmes AJ, Janne P, et al. Ultra deep sequencing detects a low rate of mosaic mutations in tuberous sclerosis complex. Human genetics. 2010;127(5):573-82.
Au KS, Williams AT, Roach ES, Batchelor L, Sparagana SP, Delgado MR, et al. Genotype/phenotype correlation in 325 individuals referred for a diagnosis of tuberous sclerosis complex in the United States. Genetics in medicine : official journal of the American College of Medical Genetics. 2007;9(2):88-100.
Numis AL, Major P, Montenegro MA, Muzykewicz DA, Pulsifer MB, Thiele EA. Identification of risk factors for autism spectrum disorders in tuberous sclerosis complex. Neurology. 2011;76(11):981-7.
Kothare SV, Singh K, Chalifoux JR, Staley BA, Weiner HL, Menzer K, et al. Severity of manifestations in tuberous sclerosis complex in relation to genotype. Epilepsia. 2014;55(7):1025-9.
Yang P, Cornejo KM, Sadow PM, Cheng L, Wang M, Xiao Y, et al. Renal cell carcinoma in tuberous sclerosis complex. Am J Surg Pathol. 2014;38(7):895-909.
Strizheva GD, Carsillo T, Kruger WD, Sullivan EJ, Ryu JH, Henske EP. The spectrum of mutations in TSC1 and TSC2 in women with tuberous sclerosis and lymphangiomyomatosis. American journal of respiratory and critical care medicine. 2001;163(1):253-8.
Henske EP, Scheithauer BW, Short MP, Wollmann R, Nahmias J, Hornigold N, et al. Allelic loss is frequent in tuberous sclerosis kidney lesions but rare in brain lesions. Am J Hum Genet. 1996;59(2):400-6.
Chan JA, Zhang H, Roberts PS, Jozwiak S, Wieslawa G, Lewin-Kowalik J, et al. Pathogenesis of tuberous sclerosis subependymal giant cell astrocytomas: biallelic inactivation of TSC1 or TSC2 leads to mTOR activation. J Neuropathol Exp Neurol. 2004;63(12):1236-42.
Rose VM, Au KS, Pollom G, Roach ES, Prashner HR, Northrup H. Germ-line mosaicism in tuberous sclerosis: how common? Am J Hum Genet. 1999;64(4):986-92.
Schwartz RA, Fernandez G, Kotulska K, Jozwiak S. Tuberous sclerosis complex: advances in diagnosis, genetics, and management. J Am Acad Dermatol. 2007;57(2):189-202.
Comi AM. Sturge-Weber syndrome. Handb Clin Neurol. 2015;132:157-68.
Thomas-Sohl KA, Vaslow DF, Maria BL. Sturge-Weber syndrome: a review. Pediatr Neurol. 2004;30(5):303-10.
Shirley MD, Tang H, Gallione CJ, Baugher JD, Frelin LP, Cohen B, et al. Sturge-Weber syndrome and port-wine stains caused by somatic mutation in GNAQ. The New England journal of medicine. 2013;368(21):1971-9.
Harbour JW. The genetics of uveal melanoma: an emerging framework for targeted therapy. Pigment Cell Melanoma Res. 2012;25(2):171-81.
Nguyen V, Hochman M, Mihm MC, Jr., Nelson JS, Tan W. The Pathogenesis of Port Wine Stain and Sturge Weber Syndrome: Complex Interactions between Genetic Alterations and Aberrant MAPK and PI3K Activation. International journal of molecular sciences. 2019;20(9).
Zallmann M, Mackay MT, Leventer RJ, Ditchfield M, Bekhor PS, Su JC. Retrospective review of screening for Sturge-Weber syndrome with brain magnetic resonance imaging and electroencephalography in infants with high-risk port-wine stains. Pediatr Dermatol. 2018;35(5):575-81.
Dies KA, Sahin M. Genetics of neurocutaneous disorders: basic principles of inheritance as they apply to neurocutaneous syndromes. Handb Clin Neurol. 2015;132:3-8.
Hildebrand MS, Harvey AS, Malone S, Damiano JA, Do H, Ye Z, et al. Somatic GNAQ mutation in the forme fruste of Sturge-Weber syndrome. Neurol Genet. 2018;4(3):e236.
Sujansky E, Conradi S. Outcome of Sturge-Weber syndrome in 52 adults. American journal of medical genetics. 1995;57(1):35-45.