Reflections on the pathogenesis of Down syndrome
- PMID: 2149972
- DOI: 10.1002/ajmg.1320370707
Reflections on the pathogenesis of Down syndrome
Abstract
Present efforts to identify, isolate, and characterize in molecular terms the "consensus" segment of 21q sufficient to cause most of the major and some of the most characteristic minor manifestations of Down syndrome will soon provide answers to many questions. However, we think that a reductionist approach to explain the Down syndrome phenotype in a "linear" manner from the DNA sequence of the segment will be doomed to failure from the outset because of the open, complex, nonlinear, hierarchical nature of morphogenetic systems. Neo-Darwinism is under strong attack; most genetic changes accumulated over time may very well be of neutral effect, and detailed studies in several related groups of vertebrate species has shown that molecular and organismal evolution are largely independent of one another. It has been pointed out recently that biology lacks a theory of ontogenetic and phylogenetic development, and that a purely "genocentric" view of biology at the expense of the complexly hierarchical intrinsic epigenetic attributes of developmental systems is "out of focus with respect to ... biological organization and morphogenesis," and may be "a residue of nineteenth century romantic idealism." Down syndrome impresses us as a paradigm of increased developmental variability due to a deceleration of the rate of development (neoteny) with many anomalies of incomplete morphogenesis (vestigia), atavisms, increased morphometric variability with many decreased means, increased variances, and increased fluctuating asymmetry. These abnormalities, together with highly increased risk of prenatal death and postnatal morbidity, impaired growth, and abnormal CNS and gonadal structure and function characteristic of most aneuploidy syndromes, suggest to us that the pathogenesis of Down syndrome is best viewed in terms of the mechanisms of speciation. Transgenic experiment involving sequential or overlapping pieces of "the consensus segment" on distal 21q22.1-22.3 may help decide to what extent the Down syndrome phenotype can be resolved into the additive effect of several pleiotropic oligogenes with epistatic interaction or the indirect secondary "mass" effect of a specific segment of 21q with epistatic interaction involving multiple loci on 21q and other chromosomes.
Similar articles
-
Clinical, cytogenetic, and molecular evaluation of a patient with partial trisomy 21 (21q11-q22) lacking the classical Down syndrome phenotype.Am J Med Genet Suppl. 1990;7:110-4. doi: 10.1002/ajmg.1320370722. Am J Med Genet Suppl. 1990. PMID: 2149936
-
The consequences of chromosome imbalance.Am J Med Genet Suppl. 1990;7:31-7. doi: 10.1002/ajmg.1320370706. Am J Med Genet Suppl. 1990. PMID: 2149968 Review.
-
Maternal balanced translocation (4;21) leading to an offspring with partial duplication of 4q and 21q without phenotypic manifestations of Down syndrome.Genet Couns. 2007;18(2):217-26. Genet Couns. 2007. PMID: 17710874
-
A de novo duplication of chromosome 21q22.11→qter associated with Down syndrome: prenatal diagnosis, molecular cytogenetic characterization and fetal ultrasound findings.Taiwan J Obstet Gynecol. 2011 Dec;50(4):492-8. doi: 10.1016/j.tjog.2011.10.016. Taiwan J Obstet Gynecol. 2011. PMID: 22212323
-
Prenatal diagnosis of partial monosomy 18p(18p11.2-->pter) and trisomy 21q(21q22.3-->qter) with alobar holoprosencephaly and premaxillary agenesis.Prenat Diagn. 2001 May;21(5):346-50. doi: 10.1002/pd.63. Prenat Diagn. 2001. PMID: 11360273 Review.
Cited by
-
The Influence of trisomy 21 on facial form and variability.Am J Med Genet A. 2017 Nov;173(11):2861-2872. doi: 10.1002/ajmg.a.38464. Epub 2017 Sep 21. Am J Med Genet A. 2017. PMID: 28941128 Free PMC article.
-
Modeling neurodevelopmental disorders using human pluripotent stem cells.Stem Cell Rev Rep. 2014 Aug;10(4):494-511. doi: 10.1007/s12015-014-9507-2. Stem Cell Rev Rep. 2014. PMID: 24728983 Review.
-
Theories of schizophrenia: a genetic-inflammatory-vascular synthesis.BMC Med Genet. 2005 Feb 11;6:7. doi: 10.1186/1471-2350-6-7. BMC Med Genet. 2005. PMID: 15707482 Free PMC article. Review.
-
The innate immune system stimulating cytokine GM-CSF improves learning/memory and interneuron and astrocyte brain pathology in Dp16 Down syndrome mice and improves learning/memory in wild-type mice.Neurobiol Dis. 2022 Jun 15;168:105694. doi: 10.1016/j.nbd.2022.105694. Epub 2022 Mar 18. Neurobiol Dis. 2022. PMID: 35307513 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Medical