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Research on the mechanisms of subtelomeric rearrangements in monosomy 1p36, extension of the spectrum of phenotypic and behavioral variability, diferential diagnosis and characterization of a critical region for obesity

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Author(s):
Carla Sustek D'Angelo
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Instituto de Biociências (IBIOC/SB)
Defense date:
Examining board members:
Celia Priszkulnik Koiffmann; Chong Ae Kim; Maria Isabel de Souza Aranha Melaragno; Angela Maria Vianna Morgante; Carla Rosenberg
Advisor: Celia Priszkulnik Koiffmann
Abstract

Subtelomeric abnormalities are an important cause of mental retardation and birth defects. The mechanisms involved in the formation of subtelomeric rearrangements are now beginning to be elucidated. Breakpoint sequencing analysis of 1p36 rearrangements has revealed prevalence of different nonexclusive recombination-repair mechanisms. Rearrangements of 1p36 are the most frequently detected subtelomeric abnormalities and include different-sized simple terminal deletions, derivative chromosomes, interstitial deletions and complex rearrangements. These rearrangements have been reported to result in the specific pattern of malformation and neurodevelopmental disabilities that characterizes monosomy 1p36 syndrome. Thus far, no genes have been conclusively determined to be causative. Besides, it is still not known if a mechanism of haploinsufficiency or position effect that influences phenotype expression in this commonest terminal deletion syndrome. Obesity and hyperphagia have been reported to occur in ~15% of cases. We have used multiplex ligation-dependent probe amplification (MLPA) to screen for monosomy 1p36 in a group of 154 hyperphagic and obese, PWS negative patients and in a separate group of 83 patients sent to investigate a variety of other conditions. The MLPA strategy used allowed the identification of a diversity of rearrangements in nine subjects. In order to gain further insights into the mechanisms of chromosome breakage, repair, and stabilization mediating subtelomeric rearrangements in humans, we have used cell lines containing constitutional rearrangements of 1p36 of six patients. Cloning of the breakpoint junctions in a complex rearrangement and three non-reciprocal translocations revealed similarities at the junctions that suggest NHEJ as the most likely mechanism of DNA repair that generated these rearrangements. Additionally, two apparently pure terminal deletions were also investigated and the refinement of the breakpoint regions identified two distinct genomic intervals ~25-kb apart, each containing a series of 1p36 specific segmental duplications with 90-98% identity. These segmental duplications might have been stimulated or used as substrate for a recombination-repair mechanism. Our work reinforces the association between monosomy 1p36 and obesity and hyperphagia, and further suggests that these features might be usually associated with an atypical/mild phenotype in addition to a submicroscopic deletion of ~2 to 3 Mb in size. We suggest the use of MLPA as an alternative method for high-throughput detection and delineation of rearrangements at 1p36. (AU)