medgenМедицинская генетикаMedical Genetics2073-7998Publishing House «Genius Media» LLC10.25557/2073-7998.2021.02.39-48medgen-1877Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHМежхромосомная инсерция (11;2): анализ сегрегации в четырех поколениях семьи и клиническая характеристика сегментных анеусомий в потомствеInterchromosomal insertion (11;2): analysis of segregation in 4 generation of the family and characterization of segmental monoand trisomy phenotype in offspringРумянцеваН. В.RumiantsavaN. V.rumiantseva@inbox.ruХурсО. М.KhursO. M.noemail@neicon.ruНаумчикИ. В.NaumchikI. V.noemail@neicon.ruНовиковаИ. В.NovikovaI. V.noemail@neicon.ruВенчиковаН. А.VenchikovaN. A.noemail@neicon.ruГосударственное учреждение «Республиканский научно-практический центр «Мать и дитя» Министерства здравоохранения Республики Беларусь (ГУ «РНПЦ «Мать и дитя» МЗ Республики Беларусь)РоссияRepublican Scientific Practical Centre «Mother and Child», Ministry of Health of Belarus RepublicRussian Federation2021250620212023948Copyright © Румянцева Н.В., Хурс О.М., Наумчик И.В., Новикова И.В., Венчикова Н.А., 20212021Румянцева Н.В., Хурс О.М., Наумчик И.В., Новикова И.В., Венчикова Н.А.Rumiantsava N.V., Khurs O.M., Naumchik I.V., Novikova I.V., Venchikova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medgen-journal.ru/jour/article/view/1877

Межхромосомная инсерция - редкий вариант сбалансированной перестройки, когда интерстициальный фрагмент одной хромосомы встраивается в другую негомологичную хромосому. Носители инсерций имеют нормальный фенотип и фертильность, но повышенный риск как спонтанных абортов (СА), так и рождения детей с хромосомным дисбалансом. Цель исследования: оценить сегрегацию хромосом у носителей межхромосомной инсерции ins(11;2)(q21;q31.1q32.3) для уточнения риска наследования потомством несбалансированного набора хромосом, провести анализ фенотипических проявлений при сегментных моно- и трисомии 2q31.1q32.3. Представлены клинико-цитогенетические данные носителей межхромосомной ins(11;2)(q21;q31.1q32.1) с длиной инсертированного фрагмента 0,8-0,9% гаплоидной длины аутосом. У 6 носителей зарегистрировано 15 беременностей, из которых 47% завершилось неблагополучным исходом: удельный вес СА составил 20%, в 1 случае диагностирована неразвивающаяся беременность (кариотип плода 46,XY), унаследованный дисбаланс установлен у 3 потомков. Распределение вариантов с кариотипами нормальный : сбалансированная инсерция : der(2) : der(11) составило 3:6:1:1, эмпирический риск образования зигот с хромосомным дисбалансом - 18% (2/11). Данные сравнительного анализа проявлений моносомии 2q31.1q32.1 (2 представленных родственника) и моносомии 2q31q33 (18 ранее описанных живорожденных пациентов) демонстрируют высокую степень фенотипического сходства. Фенотипические признаки у двух пациентов с der(2)ins(11;2) соответствуют симптомокомплексу, который рассматривается клинически очерченным синдромом моносомии 2q31q32. Наличие эктродактилии у 2 детей подтверждает связь порока с утратой генов, локализованных в сегменте 2q31.1. Результаты анализа репродуктивных исходов в представленной семье и описанных в литературе случаев демонстрируют возможность рождения потомства как с моно-, так и с трисомией 2q31q32, и позволяют оценивать риски повторного рождения детей с данными сегментными анеусомиями на уровне 30-40%, а вероятность СА - в 20-33%. У плода с трисомией 2q31.1q32.3 отмечены неспецифические признаки аутосомного дисбаланса. Микроцефалия, расщелина неба/губы и неба, эктродактилия являются основными диагностическими маркерами патологии плода, значимыми для пренатальной УЗ диагностики.

Interchromosomal insertion is a rare balanced chromosomal rearrangement that occur when an interstitial segment of one chromosome is translocated into another non-homologous chromosome. Carriers of insertions display normal phenotype and fertility, but have an increased risks of spontaneous abortions (SA) and viable offspring with inherited chromosomal imbalance. The aim of study: to assess the interchromosomal ins(11;2)(q21;q31.1q32.3) segregation to determine the genetic risk of inheriting an unbalanced karyotype by the outcome; to analyze segmental mono- and trisomy 2q31.1q32.3 phenotypic manifestations.Family with reproductive failure history was investigated using a clinical, genealogical, ultrasound, cytogenetical (GTG-banding) and morphological methods. Risks of reproductive loss and aneusomic offspring birth were calculated. The outcome prognosis and prenatal diagnostics results were discussed. Clinical, cytogenetical and reproductive history data of carriers ins(11;2) (q21;q31.1q32.3) were presented. The size of insertional segment is about 0,8-0,9% haploid autosomal length (HAL). Outcomes of 15 pregnancies of 6 carriers were as follows: rate of miscarries - 20%, one miscarriage - fetus with karyotype 46,XY, 3 cases - chromosomal imbalance. The segregation ratio for normal:balanced:der(2):der(11) is 3:6:1:1; the empirical risk for forming aneuploid zygotes is 18% (2/11). Segmental monosomy 2q31.1q32.1 phenotypic features in 2 presented patients are similar with clinical signs of 18 previously reported live-born children with monosomy 2q31q33. Ectrodactyly in 2 our patients confirms association of malformation with 2q31.1 region loss. The presented and reported cases data illustrate a possibility of giving birth of offspring with segmental monosomy as well as trisomy 2q31q32, risk of viable offspring with inherited imbalance may be estimated as 30-40%, spontaneous abortions rate - 20-33%. Fetus with trisomy 2q31.1q32.3 showed unspecific signs of autosomal imbalance. Pattern of phenotypical features reported in 2 relatives with der(2)ins(11;2) correlates with clinically recognizable monosomy 2q31q32 syndrome. Microcephaly, cleft palate/cleft lip and palate, ectrodactyly are the main diagnostic markers of fetal pathology which can be identified using prenatal ultrasound investigation.

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The authors declare that there are no conflicts of interest present.