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Molecular and Genetic Studies in Neurocutaneous Syndromes

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Neurobiology".

Deadline for manuscript submissions: closed (24 November 2023) | Viewed by 3933

Special Issue Editor

Department of Medical Genetics, Medical School, University of Pécs, 7624 Pécs, Hungary
Interests: molecular genetics and genomics; next generation sequencing; rare diseases; genetic testing; neurocutaneous syndromes; copy number variations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Neurocutaneous syndromes are a heterogeneous group of rare genetic disorders affecting primarily the skin, the central and peripheral nervous systems and the eye. Clinical manifestations in other organs such as the heart, vessels, lungs, kidneys, endocrine glands and bones may also be present. Moreover, there is an increased risk of tumour formation in many of these syndromes. Most common forms of these syndromes are neurofibromatosis and tuberous sclerosis, which are also known as hamartoma syndromes. Due to intensive research, genes involved in the pathogenesis of these syndromes have been annotated and their functions have been partially discovered; however, the underlying reasons for the neoplastic formations are not yet fully understood. Moreover, strong phenotypic variability can be observed even within families carrying the same germline mutation, suggesting the involvement of modifier genes or epigenetic factors in the disease pathogenesis. The diversity of disease manifestations is apparent; however, they share one common feature, namely, the dysregulation of the mTORC1 signalling pathway. Therefore, targeting the mTOR pathway supposed to be a promising therapy approach in the treatment of these syndromes. The genetic heterogeneity of these syndromes makes diagnosis challenging. The disease-causing genetic variations could range from small-scale mutations to various large structural variations, including copy-number variations. A certain number of mutations are of de novo origin, and somatic mosaicism further nuances the clinical picture.  

The aim of this Special Issue is to collect original and review articles reporting recent findings related to the genetic defects and pathomechanisms underlying neurocutaneous syndromes, particularly hamartoma syndromes (neurofibromatosis and tuberous sclerosis). Molecular studies with promising therapeutic approaches are also welcome. 

Dr. Judit Bene
Guest Editor

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Published Papers (3 papers)

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11 pages, 1231 KiB  
Article
Identification of an NF1 Microdeletion with Optical Genome Mapping
by Gergely Büki, Anna Bekő, Csaba Bödör, Péter Urbán, Krisztina Németh, Kinga Hadzsiev, György Fekete, Hildegard Kehrer-Sawatzki and Judit Bene
Int. J. Mol. Sci. 2023, 24(17), 13580; https://doi.org/10.3390/ijms241713580 - 1 Sep 2023
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Abstract
Neurofibromatosis type 1 (NF1) is a clinically heterogeneous neurocutaneous disorder inherited in autosomal dominant manner. Approximately 5–10% of the cases are caused by NF1 microdeletions involving the NF1 gene and its flanking regions. Microdeletions, which lead to more severe clinical manifestations, can be [...] Read more.
Neurofibromatosis type 1 (NF1) is a clinically heterogeneous neurocutaneous disorder inherited in autosomal dominant manner. Approximately 5–10% of the cases are caused by NF1 microdeletions involving the NF1 gene and its flanking regions. Microdeletions, which lead to more severe clinical manifestations, can be subclassified into four different types (type 1, 2, 3 and atypical) according to their size, the genomic location of the breakpoints and the number of genes included within the deletion. Besides the prominent hallmarks of NF1, patients with NF1 microdeletions frequently exhibit specific additional clinical manifestations like dysmorphic facial features, macrocephaly, overgrowth, global developmental delay, cognitive disability and an increased risk of malignancies. It is important to identify the genes co-deleted with NF1, because they are likely to have an effect on the clinical manifestation. Multiplex ligation-dependent probe amplification (MLPA) and microarray analysis are the primary techniques for the investigation of NF1 microdeletions. However, based on previous research, optical genome mapping (OGM) could also serve as an alternative method to identify copy number variations (CNVs). Here, we present a case with NF1 microdeletion identified by means of OGM and demonstrate that this novel technology is a suitable tool for the identification and classification of the NF1 microdeletions. Full article
(This article belongs to the Special Issue Molecular and Genetic Studies in Neurocutaneous Syndromes)
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11 pages, 3124 KiB  
Article
Superimposed Mosaicism in the Form of Extremely Extended Segmental Plexiform Neurofibroma Caused by a Novel Pathogenic Variant in the NF1 Gene
by Klára Veres, Judit Bene, Kinga Hadzsiev, Miklós Garami, Sára Pálla, Rudolf Happle, Márta Medvecz and Zsuzsanna Zsófia Szalai
Int. J. Mol. Sci. 2023, 24(15), 12154; https://doi.org/10.3390/ijms241512154 - 29 Jul 2023
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Abstract
Plexiform neurofibromas occurring in approximately 20–50% of all neurofibromatosis type-1 (NF1) cases are histologically benign tumors, but they can be fatal due to compression of vital structures or transformation to malignant sarcomas or malignant peripheral nerve sheath tumors. All sizeable plexiform neurofibromas are [...] Read more.
Plexiform neurofibromas occurring in approximately 20–50% of all neurofibromatosis type-1 (NF1) cases are histologically benign tumors, but they can be fatal due to compression of vital structures or transformation to malignant sarcomas or malignant peripheral nerve sheath tumors. All sizeable plexiform neurofibromas are thought to result from an early second mutation giving rise to a loss of heterozygosity of the NF1 gene. In this unusual case, a 12-year-old girl presented with a rapidly growing, extremely extensive plexiform neurofibroma with segmental distribution over the entire right arm, extending to the right chest wall and mediastinum, superimposed on classic cutaneous lesions of NF1. After several surgical interventions, the patient was efficiently treated with an oral selective MEK inhibitor, selumetinib, which resulted in a rapid reduction of the tumor volume. Molecular analysis of the NF1 gene revealed a c.2326-2 A>G splice-site mutation in the clinically unaffected skin, peripheral blood sample, and plexiform neurofibroma, which explains the general clinical symptoms. Furthermore, a novel likely pathogenic variant, c.4933dupC (p.Leu1645Profs*7), has been identified exclusively in the girl’s plexiform neurofibromas. This second-hit mutation can explain the extremely extensive segmental involvement. Full article
(This article belongs to the Special Issue Molecular and Genetic Studies in Neurocutaneous Syndromes)
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11 pages, 4509 KiB  
Case Report
Three-Year Follow-Up after Intrauterine mTOR Inhibitor Administration for Fetus with TSC-Associated Rhabdomyoma
by Anita Maász, Tímea Bodó, Ágnes Till, Gábor Molnár, György Masszi, Gusztáv Labossa, Zsuzsanna Herbert, Judit Bene and Kinga Hadzsiev
Int. J. Mol. Sci. 2023, 24(16), 12886; https://doi.org/10.3390/ijms241612886 - 17 Aug 2023
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Abstract
Tuberous sclerosis complex (TSC) is a multisystem disorder characterized by seizures, neuropsychiatric disorders, and tumors of the heart, brain, skin, lungs, and kidneys. We present a three-year follow-up of a patient with TSC-associated rhabdomyoma detected in utero. Genetic examination of the fetus and [...] Read more.
Tuberous sclerosis complex (TSC) is a multisystem disorder characterized by seizures, neuropsychiatric disorders, and tumors of the heart, brain, skin, lungs, and kidneys. We present a three-year follow-up of a patient with TSC-associated rhabdomyoma detected in utero. Genetic examination of the fetus and the parents revealed a de novo variant in the TSC2 gene (c.3037delG, p.Asp1013IlefsTer3). Oral everolimus was initiated in the pregnant mother to regress the fetal tumor, which was successful. To the best of our knowledge, there is very little information regarding the use of everolimus therapy during pregnancy. West-syndrome was diagnosed when the proband was four months old. The symptoms were well-manageable, however temporarily. Therapy-resistant focal seizures were frequent. The patient had good vitals and was under regular cardiological control, showed a balanced circulation, and did not require any medication. Subependymal giant cell astrocytoma (SEGA) identified by regular neuroimaging examinations remained unchanged, which may be a consequence of early intrauterine treatment. Early detection of the pathogenic TSC2 variant, followed by in utero administration of everolimus and early vigabatrin therapy, allowed the detection of a milder developmental delay of the proband. Our study emphasizes how early genetic testing and management of epilepsy are pivotal for proper neurodevelopmental impacts and therapeutic strategies. Full article
(This article belongs to the Special Issue Molecular and Genetic Studies in Neurocutaneous Syndromes)
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