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2015 ; 6
(3
): 110-34
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Mechanisms of Origin, Phenotypic Effects and Diagnostic Implications of Complex
Chromosome Rearrangements
#MMPMID26732513
Poot M
; Haaf T
Mol Syndromol
2015[Sep]; 6
(3
): 110-34
PMID26732513
show ga
Complex chromosome rearrangements (CCRs) are currently defined as structural
genome variations that involve more than 2 chromosome breaks and result in
exchanges of chromosomal segments. They are thought to be extremely rare, but
their detection rate is rising because of improvements in molecular cytogenetic
technology. Their population frequency is also underestimated, since many CCRs
may not elicit a phenotypic effect. CCRs may be the result of fork stalling and
template switching, microhomology-mediated break-induced repair,
breakage-fusion-bridge cycles, or chromothripsis. Patients with chromosomal
instability syndromes show elevated rates of CCRs due to impaired DNA
double-strand break responses during meiosis. Therefore, the putative functions
of the proteins encoded by ATM, BLM, WRN, ATR, MRE11, NBS1, and RAD51 in
preventing CCRs are discussed. CCRs may exert a pathogenic effect by either (1)
gene dosage-dependent mechanisms, e.g. haploinsufficiency, (2) mechanisms based
on disruption of the genomic architecture, such that genes, parts of genes or
regulatory elements are truncated, fused or relocated and thus their interactions
disturbed - these mechanisms will predominantly affect gene expression - or (3)
mixed mutation mechanisms in which a CCR on one chromosome is combined with a
different type of mutation on the other chromosome. Such inferred mechanisms of
pathogenicity need corroboration by mRNA sequencing. Also, future studies with in
vitro models, such as inducible pluripotent stem cells from patients with CCRs,
and transgenic model organisms should substantiate current inferences regarding
putative pathogenic effects of CCRs. The ramifications of the growing body of
information on CCRs for clinical and experimental genetics and future treatment
modalities are briefly illustrated with 2 cases, one of which suggests KDM4C
(JMJD2C) as a novel candidate gene for mental retardation.