Abstract

AbstractThe effects of DNA repair and transcription genes in human prenatal life have never been studied. Trichothiodystrophy (TTD) is a rare (affected frequency of 10^-6^) recessive disorder caused by mutations in genes involved in the nucleotide excision repair (NER) pathway and in transcription. Based on our clinical observations, we conducted a genetic epidemiologic study to investigate gestational outcomes associated with TTD. We compared pregnancies resulting in TTD-affected offspring (N=24) with respect to abnormalities in their antenatal and neonatal periods to pregnancies resulting in their unaffected siblings (N=18), accounting for correlation, and to population reference values. Significantly higher incidence of several severe gestational complications was noted in TTD-affected pregnancies. Gestational complications were noted in nearly all pregnancies resulting in TTD-affected offspring with XPD and TTDN1, but not TTD-A, gene mutations. Abnormal placental development may explain the constellation of observed complications; therefore, we hypothesize that some TTD genes play an important role in normal placental and fetal development. We investigated this hypothesis by analyzing the expression patterns of TTD genes. Expression of TTDA was strongly negatively correlated (r=-0.7,P<0.0001) with gestational age, while XPD, XPB and TTDN1 were consistently expressed from 14 to 40 weeks gestation. *Conclusion:* Our results indicate an important role for XPD, XPB and TTDN1 gene products during normal human placental and fetal development.

Highlights

  • INTRODUCTIONTTD is rare (affected frequency of 1 in 106 in Europe) autosomal recessive disorder of DNA repair

  • Compared to reference values from general obstetrical population, pregnancies that resulted in TTD-affected infants were significantly more likely to be complicated by hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome (RR=35.7, P=0.0002), elevated mid-trimester maternal serum human chorionic gonadotropin levels (RR=14.3, P

  • Our results indicate an important role for XPD, XPB and TTDN1 gene products during normal human placental and fetal development

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Summary

INTRODUCTION

TTD is rare (affected frequency of 1 in 106 in Europe) autosomal recessive disorder of DNA repair. Photosensitive TTD caused by mutations in XPD (ERCC2) and XPB (ERCC3) which code for the two helicase subunits of transcription factor TFIIH and TTD-A (TFB5) which codes for the 10th subunit of TFIIH. TFIIH has various roles in several pathways including nucleotide excision repair (NER), basal transcription and activated transcription. Non-photosensitive TTD has been associated with mutations in TTDN1 (C7ORF11), a gene of unknown function. Mutations in genes coding for other NER proteins may Lead to other NER disorders besides TTD: Xeroderma Pigmentosum [XPA – XPG, XPV]. Based on clinical observations by Dr Moslehi, we designed a genetic epidemiologic study to investigate pregnancy and gestational outcomes associated with TTD in order to test the hypothesis of involvement of TTD genes in human fetal development

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