Detailed analysis of X chromosome inactivation in a 49,XXXXX pentasomy

Moraes, Cardoso, Moura, Moreira, Menezes, Llerena, Seuánez

Description

Pentasomy X (49,XXXXX) has been associated with a severe clinical condition, presumably resulting from failure or disruption of X chromosome inactivation. Here we report that some human X chromosomes from a patient with 49,XXXXX pentasomy were functionally active following isolation in inter-specific (human-rodent) cell hybrids. A comparison with cytogenetic and molecular findings provided evidence that more than one active X chromosome was likely to be present in the cells of this patient, accounting for her abnormal phenotype. Results 5-bromodeoxyuridine (BrdU)-pulsed cultures showed different patterns among late replicating X chromosomes suggesting that their replication was asynchronic and likely to result in irregular inactivation. Genotyping of the proband and her mother identified four maternal and one paternal X chromosomes in the proband. It also identified the paternal X chromosome haplotype (P), indicating that origin of this X pentasomy resulted from two maternal, meiotic non-disjunctions. Analysis of the HUMANDREC region of the androgen receptor ( AR ) gene in the patient's mother showed a skewed inactivation pattern, while a similar analysis in the proband showed an active paternal X chromosome and preferentially inactivated X chromosomes carrying the 173 AR allele. Analyses of 33 cell hybrid cell lines selected in medium containing hypoxanthine, aminopterin and thymidine (HAT) allowed for the identification of three maternal X haplotypes (M1, M2 and MR) and showed that X chromosomes with the M1, M2 and P haplotypes were functionally active. In 27 cell hybrids in which more than one X haplotype were detected, analysis of X inactivation patterns provided evidence of preferential inactivation. Conclusion Our findings indicated that 12% of X chromosomes with the M1 haplotype, 43.5% of X chromosomes with the M2 haplotype, and 100% of the paternal X chromosome (with the P haplotype) were likely to be functionally active in the proband's cells, a finding indicating that disruption of X inactivation was associated to her severe phenotype.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2009
• Nombre de lectures: 37
• Langue: English

Extrait

BioMed CentralMolecular Cytogenetics
Open AccessResearch
Detailed analysis of X chromosome inactivation in a 49,XXXXX
pentasomy
1 2,3 1 2LuciaMMoraes , Leila CA Cardoso , Vera LS Moura , Miguel AM Moreira ,
2,3 1 2,3Albert N Menezes , Juan C Llerena Jr and Héctor N Seuánez*
1 2Address: Medical Genetics Department, Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, Brazil, Genetics Division, Instituto Nacional de
3Câncer, Rio de Janeiro, Brazil and Department of Genetics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Email: Lucia M Moraes - [e-mail]; Leila CA Cardoso - [e-mail]; Vera LS Moura - [e-mail];
Miguel AM Moreira - [e-mail]; Albert N Menezes - [e-mail]; Juan C Llerena - [e-mail];
Héctor N Seuánez* - [e-mail]
* Corresponding author
Published: 7 October 2009 Received: 12 August 2009
Accepted: 7 October 2009
Molecular Cytogenetics 2009, 2:20 doi:10.1186/1755-8166-2-20
This article is available from: http://www.molecularcytogenetics.org/content/2/1/20
© 2009 Moraes et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Pentasomy X (49,XXXXX) has been associated with a severe clinical condition,
presumably resulting from failure or disruption of X chromosome inactivation. Here we report that
some human X chromosomes from a patient with 49,XXXXX pentasomy were functionally active
following isolation in inter-specific (human-rodent) cell hybrids. A comparison with cytogenetic and
molecular findings provided evidence that more than one active X chromosome was likely to be
present in the cells of this patient, accounting for her abnormal phenotype.
Results: 5-bromodeoxyuridine (BrdU)-pulsed cultures showed different patterns among late
replicating X chromosomes suggesting that their replication was asynchronic and likely to result in
irregular inactivation. Genotyping of the proband and her mother identified four maternal and one
paternal X chromosomes in the proband. It also identified the paternal X chromosome haplotype
(P), indicating that origin of this X pentasomy resulted from two maternal, meiotic
nondisjunctions. Analysis of the HUMANDREC region of the androgen receptor (AR) gene in the
patient's mother showed a skewed inactivation pattern, while a similar analysis in the proband
showed an active paternal X chromosome and preferentially inactivated X chromosomes carrying
the 173 AR allele. Analyses of 33 cell hybrid cell lines selected in medium containing hypoxanthine,
aminopterin and thymidine (HAT) allowed for the identification of three maternal X haplotypes
(M1, M2 and MR) and showed that X chromosomes with the M1, M2 and P haplotypes were
functionally active. In 27 cell hybrids in which more than one X haplotype were detected, analysis
of X inactivation patterns provided evidence of preferential inactivation.
Conclusion: Our findings indicated that 12% of X chromosomes with the M1 haplotype, 43.5% of
X chromosomes with the M2 haplotype, and 100% of the paternal X chromosome (with the P
haplotype) were likely to be functionally active in the proband's cells, a finding indicating that
disruption of X inactivation was associated to her severe phenotype.
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Background Results
Pentasomy X (49,XXXXX) is a rare chromosome abnor- Cytogenetic analysis, X chromosome replication and
parental origin of X chromosomesmality, first described in a 2-year-old girl [1], with less
than 30 cases reported in the literature [2-30] and only The proband showed a 49,XXXXX karyotype in all cells
one in a patient of 15 years of age [25]. The characteristic without evidence of mosaicism (Figure 2).
5-bromodeoxphenotype associated with a 49,XXXXX karyotype is more yuridine (BrdU)-pulsed cultures showed clear patterns of
severe than in X trisomies and tetrasomies [25,31], includ- asynchronic replication of the proband's X chromosomes
ing severe mental retardation with delayed speech devel- (Figure 3); in all cells one early replicating X chromosome
opment, short stature, coarse facial features, osseous and was identified, together with four late replicating X
chroarticular abnormalities, congenital heart defects and skel- mosomes showing different replication patterns.
Replicaetal and limb abnormalities. The actual incidence of pen- tion patterns were classified as "early replicating" (e), "late
tasomy X is unknown but may be comparable to replicating" (l) and "very late replicating" (vl) according
49,XXXXY, occurring in 1/85,000 males [31]. to Sarto [35]. The observed proportion of cells showing
different number of X replication patterns accounted for
In normal, 46,XX females, X chromosome inactivation is 31% with 1e/2l/2vl, 23% with 1e/3l/1vl, 17% with 1e/1l/
usually random [32], consequently to which every X chro- 3vl, and 29% with 1e/4vl.
mosome may be inactivated in a given cell during early
development; once inactivated, this state is stably main- Molecular analysis of five X-linked polymorphic loci in
tained and transmitted to all clonal descendants [33,34]. the proband and her mother (Table 1) allowed for the
Lyon's hypothesis [32] postulated that in patients with X unequivocal identification of the parental origin of the X
chromosome polysomies, X chromosome inactivation chromosomes in the proband who carried four maternal
was expected to be random and only one X chromosome X chromosomes and one paternal X chromosome; this
would remain functionally active. However, in patients last one with a 173-108-199-206-141 (P) haplotype.
with a 49,XXXXY chromosome constitution, the late
replicating X chromosomes showed different patterns of rep- Preferential inactivation of X chromosomes
lication, suggesting that X inactivation was likely to be less The methylation status of X chromosomes, assayed in the
HUMANDREC region of the human androgen receptorefficient than in 46,XX females, and accounting for the
presence of more than one active X chromosome in some gene (AR), showed a skewed pattern of inactivation in the
cells [35,36]. Furthermore, analysis of histone H4 acetyla- proband's mother because one AR allelic fragment of 173
tion in a group of patients with 49,XXXXX, 49,XXXXY, bp was preferentially amplified with respect to the other
48,XXXY and 47,XXX karyotypes showed alterations in of 179 bp (Figure 4). Similar analysis in the proband
deacetylation of histone H4 once the inactive state was showed that two maternal AR alleles were amplified (173
established [37]. These alterations might have affected the and 179); the 173 allele showing a preferential
amplificaoutcome in determining the number and the choice of tion with respect to allele 179, and lack of amplification
which X chromosomes were deacetylated, probably due to of the paternal 199 allele (Figure 5). These results
indithe presence of more than one X chromosome undergoing cated (i) a preferential inactivation of maternal X
chromoinactivation. These results suggested that supernumerary somes containing the 173 allele in the proband; (ii) the
X chromosomes might be associated to abnormal pheno- possibility that her maternal chromosomes with the 179
types due to excess of X active regions or to increased asyn- allele might be incompletely inactivated, and (iii) an
chronism of X chromosome replication, mainly in active paternal X chromosome.
patients with four or five X chromosomes.
Inactivation of X chromosomes present in somatic cell
hybridsIn this paper, we analyzed the origin of an X chromosome
pentasomy in a patient (Figure 1) with a 49,XXXXX kary- The segregation of the proband's X chromosomes in a
+ otype and the inactivation status of her X chromosomes. panel of 51 HPRT1 cell hybrid lines was informative for
This was carried out by analysing chromosome replication analysing the functional status of each individual X
chroin Budr-pulsed cultures, the methylation status of the mosome. Cell hybrids cloned in the same Petri dish were
HUMANDREC region in the patient, her mother, and in X included only when they showed different molecular
patchromosomes present in cell hybrids previously selected terns; this was considered evidence that clones were
differin HAT (hypoxanthine-aminopterin-thymidine) ent from one another. Conversely, when cell hybrids
medium. cloned in the same Petri dish showed an identical
molecular pattern only one of them was included because we
could not prove that they were different from one
another. Table 2 lists the molecular patterns of 33 cell
hybrid lines. Human-specific amplification patterns were
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Figure 1Frontal (A) and side (B) view of patient's face
Frontal (A) and side (B) view of patient's face. Note flat profile, ocular hypertelorism, upslanting palpebral fissures,
epicanthic folds, flat nasal bridge, low-set ears, retrognathism and micrognathia. (C) Ha