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==Aetiology==
==Aetiology==


Different genetic mechanisms lead to different clinical phenotypes of AS. The most common genetic mechanism leading to AS is the deletion or re-arrangement of maternal chromosome at locus 15q11.2-q13, accounting 60-75% of AS occurrences. This leads to more severe clinical phenotypes of microcephaly, motor difficulties, seizures and impaired speech development. The next most common genetic mechanism is mutation in the ''UBE3A'' gene responsible for 10% of AS cases and paternal uniparental disomy and mutation in the imprinting centre (IC), both accounting 2-5% of AS observed.  
Different genetic mechanisms lead to different clinical phenotypes of AS. The most common genetic mechanism leading to AS is the deletion or re-arrangement of maternal chromosome at locus 15q11.2-q13, accounting 60-75% of AS occurrences.<ref><pubmed>19455185</pubmed></ref> This leads to more severe clinical phenotypes of microcephaly, motor difficulties, seizures and impaired speech development. The next most common genetic mechanism is mutation in the ''UBE3A'' gene responsible for 10% of AS cases and paternal uniparental disomy and mutation in the imprinting centre (IC), both accounting 2-5% of AS observed.<ref><pubmed>19455185</pubmed></ref>
 
AS is caused by the 4 major genetic mechanisms mentioned above and are thus divided into Classes I to IV based on their underlying genetic mechanism. AS patients with the clinical features of AS but no cytogenetic or molecular abnormality in Chromosome 15q11.2-13 are grouped under Class V (summarised in table below). <ref><pubmed>10364509</pubmed></ref>


AS is caused by the 4 major genetic mechanisms mentioned above and are thus divided into Classes I to IV based on their underlying genetic mechanism. AS patients with the clinical features of AS but no cytogenetic or molecular abnormality in Chromosome 15q11.2-13 are grouped under Class V (summarised in table below).





Revision as of 15:45, 7 September 2011

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1721745/pdf/v089p0F436.pdf--Sang Lee 21:32, 17 August 2011 (EST)


Identify a review and a research article related to your group topic.

This research article showed genotype-phenotype correlations in Angelman Syndrome (AS). They have concluded that deletion patients had worse developmental outcomes than non deletion patients. Abstract at PMID 20729760

This review article is really comprehensive and gives a good background knowledge of AS. Astract at PMID 20445456

--z3291643 21:37, 10 August 2011 (EST)


Timeline

Year Notes
1965 First reported by Dr Harry Angelman- Initially called this disorder “Happy Puppet Syndrome”
1980s First reports of AS reaches US and research into the disorder being at the University of Florisa under the direction of Dr. Charles Williams.
1987 Discovery of a genetic marker for AS – an absent genetic code on chromosome 15
1997 The cause of AS discovered by Dr. Joseph Wagstaff and Dr. Arthur Beaudet – mutation or deletion in the UBE3A gene.
Current Four different genetic abnormalities for AS confirmed by genetic testing; Deletion, Uniparental Disomy (UPD), Imprinting and UBE3A mutation.

--Sang Lee 23:22, 1 September 2011 (EST)


Aetiology

Different genetic mechanisms lead to different clinical phenotypes of AS. The most common genetic mechanism leading to AS is the deletion or re-arrangement of maternal chromosome at locus 15q11.2-q13, accounting 60-75% of AS occurrences.[1] This leads to more severe clinical phenotypes of microcephaly, motor difficulties, seizures and impaired speech development. The next most common genetic mechanism is mutation in the UBE3A gene responsible for 10% of AS cases and paternal uniparental disomy and mutation in the imprinting centre (IC), both accounting 2-5% of AS observed.[2]

AS is caused by the 4 major genetic mechanisms mentioned above and are thus divided into Classes I to IV based on their underlying genetic mechanism. AS patients with the clinical features of AS but no cytogenetic or molecular abnormality in Chromosome 15q11.2-13 are grouped under Class V (summarised in table below). [3]


Class Mechanism Diagnostic Tests Frequency
Ia De novo deletion High resolution cytogenetics FISH 60-75%
Ib Deletion due to chromosome rearrangement High resolution cytogenetics FISH <1%
II Paternal uniparental disomy RFLP analysis 2%
IIIa Imprinting defect with IC mutation Screening of IC for mutations is positive 2%
IIIb Imprinting defect withouth IC mutation Screening of IC for mutations is negative 2%
IIIc Mosaic imprinting defect Screening of IC for mutations is usually negative ?
IV UBE3A mutation Screening of UBE3A for mutations 5-10%
V No identifiable genetic abnormality Consider other diagnoses 5-26%
Adapted from Smith JC, et al. Angelman syndrome: a review of the clinical and genetic aspects. J Med Genet 2003;40:87-95


Pathogenesis

Chromosome 15 became associated with AS in the 1980s after the observation of many AS patients harboring microdeletions of 15q11.2-15q13. [4] The last decade has shed even more light in the aetiology of AS,as Kishino and Matsuura first identified UBE3A as the causative gene for AS in 1997. [5] [6] Although the function of UBE3A is known (encodes for a ubiuitin ligase enzyme),its function in the development of the nervous system and the process of UBE3A mutation leading to cognitive impairment in AS patients is still vague. [7] Despite the uncertain progression of UBE3A mutation and the neurological abnormalities characteristic of AS, animal models have illustrated the vital role of UBE3A in the normal functioning of the brain. This can be exemplified by a study which utilized a mouse model with target inactivation of the gene UBE3A resulting in the manifestation of classical features of AS. [8] In addition, the fact that imprinting of UBE3A takes place on ly in specific brain regions (cerebellum, olfactory tracts and the hippocampus) confirms the hypothesis that the loss of this gene would be detrimental in the cognitive development. [9] It is also known that UBE3A plays an important role in synaptic transmission, but exactly how it does so is still not completely understood.[10]

As briefly mentioned above, UBE3A is a member of the E3 ubiquitin ligase family of enzymes, responsible for the addition of ubiquitin to the target protein for degradation of the ubiquitinated protein. These processes are required for normal human cognitive function.[11] In this way synaptic protein Arc(activity-regulated cytoskeleton-associated protein) is degraded to control synaptic function. Arc is a target protein of UBE3A in dendritic spines found in the hippocampal neurons.[12] Deletion UBE3A leads to the accumulation of Arc in neurons leading to trafficking of AMPA receptors, resulting in impaired cognitive functions.[13]

UBE3A ubiqutylation consists of: 1. Activation of ubiquitin by E1 enzyme 2. E1 ezyme transfers ubiquitin to E2 enzyme 3. E2 enzyme transfers ubiquitin to UBE3A 4. UBE3A attaches activated ubiquitin to target protein which is then polyubiquitylated and degraded by 26S proteosome. [14]


Animal models

Phenotype-Genotype correlations

Pathophysiology

Glossary

Imprint: Genomic imprinting

References

  1. <pubmed>19455185</pubmed>
  2. <pubmed>19455185</pubmed>
  3. <pubmed>10364509</pubmed>
  4. <pubmed>15668046</pubmed>
  5. <pubmed>8988171</pubmed>
  6. <pubmed>8988172</pubmed>
  7. <pubmed>20211139</pubmed>
  8. <pubmed>11895368</pubmed>
  9. <pubmed>20398390</pubmed>
  10. <pubmed>9808466</pubmed>
  11. <pubmed>9808466</pubmed>
  12. <pubmed>20668179</pubmed>
  13. <pubmed>20211139</pubmed>
  14. <pubmed>20668179</pubmed>