Warsaw breakage syndrome

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Warsaw breakage syndrome
Other namesWABS [1]

Warsaw breakage syndrome (Warsaw syndrome, WABS) is a rare genetic condition. Fewer than 10 cases have been reported by 2018. [2] Its clinical manifestations affect several organ systems, and includes microcephaly and severe growth retardation among others.

Contents

Presentation

Presentation include: [3] [4]

Israeli Health Ministry describes the condition manifestation as "characterized by smaller than average head circumference (microcephaly) as early as the embryonic stage, intrauterine growth restriction (IUGR) as well as postnatal growth restriction (dwarfism). Furthermore, patients born with this condition experience hearing impairments, moderate to significant developmental delays, skeletal disorders and heart disorders (40%), as well as disorders to various body systems such as the renal and urogenital systems. In some patients, blood tests indicate increased chromosome fragility. Some fetuses die in utero (intrauterine fetal demise)." [5]

Genetics

This condition is caused by mutations in the DDX11 gene. [4] [6]

DDX11 mutation that causes WABS is described at US National Library of Medicine: [7]

The DDX11 gene provides instructions for making an enzyme called ChlR1. This enzyme functions as a helicase. Helicases are enzymes that attach (bind) to DNA and temporarily unwind the two spiral strands (double helix) of the DNA molecule. This unwinding is necessary for copying (replicating) DNA in preparation for cell division, and for repairing damaged DNA and any errors that are made when DNA is copied. In addition, after DNA is copied, ChlR1 plays a role in ensuring proper separation of each chromosome during cell division. By helping repair errors in DNA and ensuring proper DNA replication, the ChlR1 enzyme is involved in maintaining the stability of a cell's genetic information. DDX11 gene mutations severely reduce or completely eliminate ChlR1 enzyme activity. As a result, the enzyme cannot bind to DNA and cannot unwind the DNA strands to help with DNA replication and repair. A lack of functional ChlR1 impairs cell division and leads to an accumulation of DNA damage. This DNA damage can appear as breaks in the DNA, giving the condition its name. It is unclear how these problems in DNA maintenance lead to the specific abnormalities characteristic of Warsaw breakage syndrome.

This gene encodes an iron-sulfur containing DNA helicase that belongs to the Fe–S DNA helicases. [3] This protein interacts with the 9-1-1 checkpoint complex protein.[ citation needed ]

The inheritance pattern is autosomal recessive. [2] [5] Condition is very rare, but its prevalence in Ashkenazi Jews population is about 1/50. [5] [7]

Differential diagnosis

The DDX should be based on the following:[ citation needed ]

Treatment

There is no known curative treatment for this condition presently. Management is supportive. [4]

History

This condition was first described in 2010. [8]

Related Research Articles

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References

  1. "OMIM Entry - # 613398 - WARSAW BREAKAGE SYNDROME; WABS". omim.org. Retrieved 29 October 2019.
  2. 1 2 Alkhunaizi, Ebba; Shaheen, Ranad; Bharti, Sanjay Kumar; et al. (November 2018). "Warsaw breakage syndrome: Further clinical and genetic delineation". American Journal of Medical Genetics Part A. 176 (11): 2404–2418. doi:10.1002/ajmg.a.40482. PMC   6289708 . PMID   30216658.
  3. 1 2 Pisani, Francesca M. (5 December 2019). "Spotlight on Warsaw Breakage Syndrome". The Application of Clinical Genetics. 12: 239–248. doi: 10.2147/TACG.S186476 . PMC   6901054 . PMID   31824187.
  4. 1 2 3 Alkhunaizi, Ebba; Brosh, Robert M.; Alkuraya, Fowzan S.; Chitayat, David (1993). "Warsaw Syndrome". GeneReviews. University of Washington, Seattle. PMID   31169992 . Retrieved 9 April 2023.
  5. 1 2 3 "Warsaw Breakage Syndrome". GOV.IL. Retrieved 9 April 2023.
  6. "DDX11 gene: MedlinePlus Genetics". medlineplus.gov. Retrieved 9 April 2023.
  7. 1 2 "Warsaw breakage syndrome: MedlinePlus Genetics". medlineplus.gov. Retrieved 9 April 2023.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  8. van der Lelij, Petra; Chrzanowska, Krystyna H.; Godthelp, Barbara C.; Rooimans, Martin A.; Oostra, Anneke B.; Stumm, Markus; Zdzienicka, Małgorzata Z.; Joenje, Hans; de Winter, Johan P. (February 2010). "Warsaw Breakage Syndrome, a Cohesinopathy Associated with Mutations in the XPD Helicase Family Member DDX11/ChlR1". The American Journal of Human Genetics. 86 (2): 262–266. doi:10.1016/j.ajhg.2010.01.008. PMC   2820174 . PMID   20137776.