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'''Numerical''' chromosome abnormalities are '''deviations from the normal number of chromosomes'''. These deviations can refer to individual chromosomes, both in the sense of "plus" (supernumerary chromosome, extranumerary chromosome) and in the sense of "minus" (missing chromosome, missing chromosomes). The entire haploid set of chromosomes may also be multiplied. Unlike structural chromosome aberrations, chromosomes are not structurally altered in numerical aberrations. A number of numerical abnormalities are incompatible with life (all autosomal monosomies, most trisomies, polyploidy) and those that allow survival usually cause severe syndromes.  
'''Numerical''' chromosome abnormalities are '''deviations from the normal number of chromosomes'''. These deviations can refer to individual chromosomes, both in the sense of "plus" (supernumerary chromosome, extranumerary chromosome) and in the sense of "minus" (missing chromosome, missing chromosomes). The entire haploid set of chromosomes may also be multiplied. Unlike structural chromosome aberrations, chromosomes are not structurally altered in numerical aberrations. A number of numerical abnormalities are incompatible with life (all autosomal monosomies, most trisomies, polyploidy) and those that allow survival usually cause severe syndromes.  


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=== Trisomy ===
=== Trisomy ===
[[File:21 trisomy - Down syndrome.png|left|thumb|255x255px|21 trisomy - Down syndrome]]
Trisomies are caused by nondisjunction, i.e. an error in the separation of homologous chromosomes in the 1st meiotic division, or chromatides in the 2nd meiotic division. The risk of this error, i.e. the occurrence of trisomy, depends significantly on the age of the mother, at the age of 25 the woman is roughly twice the population risk and then increases dramatically with age. The risk of this error is associated with the fact that meiotic division in a woman begins already during embryonic development, then is stopped and continues only at the time of sexual maturity. The age of fathers plays a role only from 50 years.  
Trisomies are caused by nondisjunction, i.e. an error in the separation of homologous chromosomes in the 1st meiotic division, or chromatides in the 2nd meiotic division. The risk of this error, i.e. the occurrence of trisomy, depends significantly on the age of the mother, at the age of 25 the woman is roughly twice the population risk and then increases dramatically with age. The risk of this error is associated with the fact that meiotic division in a woman begins already during embryonic development, then is stopped and continues only at the time of sexual maturity. The age of fathers plays a role only from 50 years.  


If errors in the number of chromosomes occur during meiotic division and an abnormal gamete is fertilized (in the case of nondisjunction, a disomic gamete is formed - it has an extra chromosome and a nullisomic gamete - it does not have the given chromosome), the error then occurs in all cells of the individual. If the error occurs postzygotic during the mitotic division of the zygote, a so-called mosaic occurs, where two or more cell lines with different karyotypes are present.  
If errors in the number of chromosomes occur during meiotic division and an abnormal gamete is fertilized (in the case of nondisjunction, a disomic gamete is formed - it has an extra chromosome and a nullisomic gamete - it does not have the given chromosome), the error then occurs in all cells of the individual. If the error occurs postzygotic during the mitotic division of the zygote, a so-called mosaic occurs, where two or more cell lines with different karyotypes are present.
[[File:Down Syndrome karyotype.png|thumb|226x226px|Down Syndrome karyotype]]
 
Most autosomal trisomies do not allow survival, only an individual can be born with trisomy 21, 18, 13, patients with trisomy 21 survive to adulthood. One more trisomy allows survival, trisome 8, but it always occurs in a mosaic with a predominance of the normal celly line i live births.  
Most autosomal trisomies do not allow survival, only an individual can be born with trisomy 21, 18, 13, patients with trisomy 21 survive to adulthood. One more trisomy allows survival, trisome 8, but it always occurs in a mosaic with a predominance of the normal celly line i live births.  


=== Monozomie ===
=== Monosomy ===
Monozomie vznikají nondisjunkcí a oplozením abnormální – nulizomické gamety. Dalším mechanismem, kterým vzniká pouze monozomie, je opoždění chromozomu v anafázi a jeho nezačlenění do dceřiného jádra. Oba mechanismy mohou nastat v meióze, nebo postzygoticky při mitotickém dělení zygoty. Jedinou monozomií, která dovoluje přežití, je monozomie X, monozomie autozomů bychom našli jen v spontánních potratech.
Monosomies arise from nondisjunction and fertilization of an abnormal - nullisomic gamete. Another mechanism by which only monosomy arises is the delay of the chromosome in anaphase and its non-incorporation into the daughter nucleus. Both mechanisms can occur in meiosis, or postzygotic during mitotic division of the zygote. The only monosomy that allows survival is monosomy X, monosomy of autosomes we would only find in spontaneous abortions.


== Polyploidie ==
== Polyploidy ==
Polyploidie je zmnožení chromozomální sady, u triplodie je 69 chromozomů, tedy trojnásobek haploidní sady (3n), u tetraplodie 92 chromozomů – čtyřnásobek haploidní sady (4n).
Polyploidy is the multiplication of the chromosomal set, in triploidy there are 69 chromosomes, i.e. three time the haploid ste (3n), in tetraploidy 92 chromosomes - four times the haploid set (4n).  


=== Triploidie ===
=== Triploidy ===
[[Soubor:Triploidie.jpg|thumb|150px|Triploidie]]
[[File:Triploidie.jpg|thumb|Triploidy]]
Triploidie je letální genetická konstituce, výjimečně se jedinec s triploidií narodí, ale umírá záhy po porodu. Triploidie je nejčastěji způsobena poruchou [[fertilizace]], tzv. dispermií (oplození vajíčka dvěma spermiemi), méně často je důsledkem splynutí abnormální neredukované gamety (vzniklé nodisjunkcí všech chromozomálních párů) a gamety normální. [[Fenotyp]] abnormálního produktu závisí na tom, zda nadpočetná sada chromozomů je otcovského původu (částečná mola) nebo mateřského původu (produkt nemolární). Tato situace (odlišný fenotyp v závislosti na rodičovském původu nadpočetné sady chromozomů) je způsobena imprintingem genů, který se projeví už na začátku embryonálního vývoje (aktivní otcovské [[alely]] určitých [[gen]]ů jsou zodpovědné za vývoj obalů, aktivní mateřské alely dalších genů za vývoj vlastního embrya). Pokud vzájemná funkce imprintovaných genů není vyvážená, jako není např. u triploidie, vzniká patologický produkt.
Triploidy is a lethal genetic constitution, rarely an individual is born with triploidy but dies soon after birth. Triploidy is most often caused by a fertilization disorder, so-called dispermia (fertilization of an egg by two sperm), less often it is the result of the fusion of an abnormal unreduced gamete (created by nondisjunction of all chromosomal pairs) and a normal gamete. The phenotype of the abnormal product depends on whether the supernumerary set of chromosomes is of paternal origin (partial moles) or maternal origin (nonmolar product). This situation (a different phenotype depending on the parental origin of the supernumerary set of chromosomes) is caused by gene imprinting, which manifests itself at the beginning of embryonic development (active paternal alleles of certain genes are responsible for the development of the membranes, active maternal alleles of other genes for the development of the embryo itself). if the mutual function of the imprinted genes is not balanced, as is the case with triploidy, for example, a pathological product is produced.


=== Tetraploidie ===
=== Tetraploidy ===
Tetraploidie je letální genetická konstituce, kdy počet chromozomů u jedince je 92 (4n). Tetraploidie vzniká endoreduplikací, tj. rozdělením chromozomů, bez rozdělení buňky.
Tetraploidy is a lethal genetic constitution where the number of chromosomes in an individual is 92 (4n). Tetraploidy results from endoreduplication, i.e. division of chromosomes, without cell division.


== Numerické aberace autozomů ==
== Numerical aberrations of autosomes ==


=== Downův syndrom ===
=== Down's syndrome ===
{{Podrobnosti|Downův syndrom}}
{{Details|Down syndrome}}


'''Downův syndrom''' (DS) patří mezi nejznámější [[syndrom]]y způsobené [[Chromozomální abnormality|chromozomální abnormalitou]].
'''Down's syndrome''' (DS) is one of the most well-known syndromes caused by a chromosomal abnormality.  


Jde o nejčastější syndrom způsobený trizomií chromozomu u živě narozených (konkrétně trizomií chromozomu 21) a nejčastější vrozenou příčinou '''mentální retardace'''. Dalšími charakteristickými klinickými příznaky jsou '''[[vrozené srdeční vady|vrozené vady srdce]]''', svalová '''hypotonie''' a '''typický vzhled''' (oči s kožní řasou – ''epikantem'' a nahoru směřujícími očními štěrbinami), dále opičí rýha, klinodaktylie 5. prstu aj. U novorozenců je nápadný velký, plazivý jazyk. Kromě větší náchylnosti k infekcím mají též zvýšené riziko nádorových onemocnění, zvl. leukémie. To je způsobeno tím, že trizomické buňky jsou mnohem citlivější na efekt mutagenů a karcinogenů. I když toto postižení dovoluje přežití, velká část (asi ¾) všech vzniklých trizomií 21 se potrácí.
It is the most common syndrome caused by trisomy of a chromosome in live births (specifically trisomy of chromosome 21) and the most common congenital cause of '''mental retardation'''. Other characteristic clinical symptoms are '''congenital heart defects''', muscle '''hypotonia''' and a '''typical appearance''' (eyes with a skin fold - ''epicantherum'' - and upward-facing eye slits), as well as a monkey furrow, clinodactyly of the 5th finger, etc. In newborns, a large, crawling tongue is noticeable. In addition to greater susceptibility to infections, they also have an increased risk of cancer, especially leukemia. This is due to the fact that trisomic cells are much more sensitive to the effect of mutagnes and carcinogens. Although this is impairment allows survival, a large proportion (about  ¾) of all resulting trisomies 21 are aborted.  


Asi u 4 % pacientů narozených s Downovým syndromem je třetí, nadbytečný chromozom 21 translokován na některý z akrocentrických chromozomů (tzv. translokační forma trizomie způsobená Robertsonskou traslokací). Zatímco riziko volné trizomie závisí na věku matky (riziko nondisjunkce), riziko translokační formy trizomie na věku rodičů nezávisí, ale v případě translokační formy asi v polovině případů bývá jeden z rodičů nosičem balancované podoby translokace a hrozí riziko pro potomstvo, které může zdědit tuto translokaci v nebalancované podobě. Pokud je rodič nosičem tzv. homologní fúze obou 21. chromozomů, riziko DS nebo potratu je dokonce 100 %. U nehomologní robertsonské fúze je riziko podstatně nižší, avšak nosičství balancované aberace je vždy důvodem k prenatální cytogenetické diagnostice.
In about 4 % of patients born with Down syndrome, the third, the redundant chromosome 21 is translocated to one of the acrocentric chromosomes (the so-called translocation form of trisome caused by Robertsonian translocation). While the risk of free trisomy depends on the age of the mother (nondisjunction risk), the risk of the translocation form of trisomy does not depend on the age of the parents, but in the case of the translocation form, in about half of the cases one of the parents is a carrier of the balanced form of the translocation and there is a risk for the offspring who may inherit this translocation in unbalanced form. If the parent is a carrier of the so-called homologous fusion of both 21 st chromosomes, the risk of DS or miscarriage is even 100 %. In non-homologous Robertsonian fusion, the risk is considerable lower, but carrying a balanced aberration is always a reason for prenatal cytogenetic diagnosis.  


Malé procento pacientů s DS má mozaikovou formu trizomie, vzniklou postzygotickou ztrátou chromozomu 21 z trizomické zygoty nebo postzygotickou nondisjunkcí při dělení normální zygoty.
A small percenatge of DS patients have a mosaic form of trisomy, resulting from postzygotic loss of chromosome 21 from a trisomic zygote or postyzygotic nondisjunction during division of a normal zygote.  


Díky moderním metodám [[Prenatální diagnostika|prenatální diagnostiky]] lze tento syndrom v drtivé většině případů diagnostikovat již v průběhu těhotenství. Indikacemi k prenatální cytogenetické diagnostice, které vedou k záchytu numerických chromozomálních změn, je vyšší věk matky, atypický biochemický skríning, abnormalita na ultrazvuku včetně drobných morfologických odchylek. Samozřejmě nosičství balancované Robertsonské translokace je rovněž indikací k tomuto vyšetření.
Thanks to modern methods of prenatal diagnosis, this syndrome can be diagnosed in the overwhelming majority of cases already during pregnancy. Indications for prenatal cytogenetic diagnosis, which lead to the detection of numerical chromosomal changes, are older age of the mother, atypical biochemical screening, abnormality on ultrasound, including minor morphological deviations. Of course, carrying a balanced Roberstonian translocation is also an indication for this examination.  


=== Edwardsův syndrom ===
=== Edwards syndrome ===
{{Podrobnosti|Edwardsův syndrom}}
{{Details|Edwards syndrome}}


'''Edwardsův syndrom''' (ES) je způsoben trizomií 18. chromozomu.
'''Edwards syndrome''' (ES) is caused by trisomy od 18th chromosome. j


Z klinických příznaků je nápadná flekční deformita prstů (ukazováček a 5. prst překrývají ostatní prsty), atypická facies s mikrognacií, prominující záhlaví, těžká růstová retardace, vrozené vady srdce a ledvin, hypotonie.  
From the clinical symptoms, there is a noticeable flexion deformity of the fingers (the index finger and the 5th finger overlap the other fingers), atypical facies with micrognathia, prominent head, severe growth retardation, congenital defects of the heart and kidneys, hypotonia.


Průměrná délka přežití je asi 2 měsíce, zcela výjimečně pacient přežívá 1 rok, ale naprostá většina všech vzniklých trizomií 18 je potracena.
The average length of survival is about 2 moths, quite exceptionally the patient survives 1 year, but the vas majority of all resulting trisomies 18 are aborted.  


=== Patauův syndrom ===
=== Patau syndrome ===
{{Podrobnosti|Patauův syndrom}}
{{Details|Patau syndrome}}


'''Patauův syndrom''' (PS) je způsoben trizomií 13. chromozomu.
'''Patau syndrome''' (PS) is cause by trisomy 13.


Z projevů je nápadná mikrocefalie, svažující se čelo, hypertelorizmus, mikroftalmie ev. anoftalmie nebo kyklopie, rozštěp rtu a patra, mikrognacie, může být polydaktylie. Postižení mají vrozené vývojové vady mozku (holoprozencefalie), srdeční vady a vady dalších orgánů.
Manifestations include microcephaly, sloping forehead, hypertelorism, microphthalmia and even anophthalmi or cyclopia, cleft lip and palate, micrognathia, may be polydactyly. Those affected have congenital developmental defects of the brain (holoprosencephaly), heart defects and defects of other organs.  


Postižení umírají většinou během prvního měsíce života. Je známa též translokační forma trizomie 13. Většina všech vzniklých trizomií 13 se potrácí.
Affected people usually die within the first month of life. A translocation form of trisomy 13 is also known. The majority of all resulting trisomies 13 are aborted.  


== Numerické aberace gonozomů ==
== Numerical aberrations of gonosomes ==


=== Turnerův syndrom ===
=== Turner syndrome ===
{{Podrobnosti|Turnerův syndrom}}
{{Details|Turner syndrome}}


'''Turnerův syndrom''' (TS) je způsoben nejčastěji monozomií [[chromosom X|chromozomu X]] ([[Lidský karyotyp|karyotyp]] '''45,X'''), případně různými [[Strukturní chromozomové aberace|strukturními aberacemi]] (například delecí na X chromozomu apod.). Numerické i strukturní změny se mohou vyskytovat i v mozaice. Klasickými projevy jsou: '''nízký vzrůst''', '''ovariální dysgeneze''' spojená se sterilitou, u některých pacientek se vyskytuje kožní řasa (''pterygium colli''). Intelekt nebývá narušen. U novorozenců je časný lymfedém na končetinách, který by měl sigalizovat podezření na TS a indikaci cytogenetického vyšetření. Možná je úprava fenotypu pomocí růstového hormonu a hormonální substituční terapie.  
'''Turner syndrome''' (TS) is most often caused by monosomy of the X chromosome (karyotype '''45,X'''), or by various structural aberrations (for example, a deletion on the X chromosome, etc.). Numerical and structural changes can also occur in a mosaic. Classic manifestations are: '''short stature, ovarian dysgenesis''' associated with sterility, in some patients there is a skin fold (''pterygium colli''). Intelect is not impaired. In newborns, there is early lymphedema on the limbs, which should signal the suspicion of TS and the indication of cytogenetic examination. Phenotype modification with growth hormone and hormone replacement therapy is possible.


V případě strukturní aberace, tzv. izochromozomu pro dlouhá ramena X chromozomu, fenotyp pacientky odpovídá TS, ale pacientka může být fertilní, stejně jako v případě delece krátkých ramen X chromozomu. Pokud je zachována tzv. kritická oblast na dlouhých ramenech X chromozomu, fertilita bývá zachována. Naopak delece nebo zlom v této kritické oblasti (při vzniku X/autozomální translokace) vede ke gonadální dysgenezi, i když fenotyp pacientky neodpovídá TS. Mozaiky jsou u TS velmi časté, při ztrátě chromozomu se ztrácí nejen X, ale může být i velmi časná ztráta [[chromozom Y|Y chromozomu]] (častěji se ztrácí otcovský gonozom). Pokud je mozaika 45,X/46,XY hrozí riziko malignizace gonády.
In the case of a structural aberration, the so-called isochromosome for the long arms of the X chromosome, the patient's phenotype corresponds to TS, but the patient can be fertile, as in the case of deletion of the short arms of the X chromosome. If the so-called critical region on the long arms of the X chromosome is preserved, fertility is preserved. Conversely, a deletion or a break in this critical region (when an X / autosomal translocation occurs) leads to gonadal dysgenesis, even if the patient's phenotype does not correspond to TS. Mosaics are very common in TS, when a chromosome is lost, not only the X is loste, but there can also be a very early loss of the Y chromosome (the paternal gonosome is more often lost). If the mosaic is 45,X/46,XY, there is a risk of malignancy of the gonad.  
   
   
Je zajímavé, že až 99% všech vzniklých monozomií X je potraceno. Je předpoklad, že ty monozomie, které přežívají, jsou ve skutečnosti mozaiky, i když často diagnostikované jako plné monozomie X.
It is interesting that up to 99 % of all resulting X monosomies are aborted. It is assumed that thoso monosomies that survive are actually mosaics, although often diagnosed as full X monosomies.  


=== Klinefelterův syndrom ===
=== Klinefelter syndrome ===
{{Podrobnosti|Klinefelterův syndrom}}
{{Details|Klinefelter syndrome}}
[[Soubor:Klinefelter's_syndrome.jpg|náhled|319x319pixelů|Typický vzhled jedince s ''Klinefelterovým syndromem.'']]
[[File:Klinefelter's syndrome.jpg|thumb|The symptoms of Klinefelter's syndrome in a human male]]  
'''Klinefelterův syndrom''' (KS) je důsledkem přítomnosti nadpočetného chromozomu X u muže. Nejčastěji je způsoben karyotypem '''47,XXY''', možné jsou i varianty s více chromozomy X (48,XXXY či 49,XXXXY), které mají výraznější manifestaci. Existují i mozaikové formy. Hlavními příznaky jsou: '''neplodnost''' (azoospermie), '''hypogonadizmus''', průměrný až vysoký vzrůst, dlouhé končetiny, řídké ochlupení, gynekomastie. V případě karyotypu 49,XXXXY je pacient retardován a fenotyp připomíná Downův syndrom s tím rozdílem, že pacient s KS je na rozdíl od pacientů s DS vysokého vzrůstu.


=== Syndrom 47,XXX ===
'''Klinefelter syndrome''' (KS) results from the presence of an extra X chromosome in a male. It is most often caused by karyotype '''47,XXY''', variants with more X chromosomes (48,XXXY or 49,XXXXY) are also possible, which have a more pronounced manifestation. There are also mosaic forms. The main symptoms are: '''infertility''' (azoospermia), '''hypogonadism''', average to tall height, long limbs, sparse hair, gynecomastia. In the case of the 49,XXXXY karyotype, the patient is retarded and the phenotype resembles Down syndrome, with the difference that the KS patient is tall, unlike the DS patient.   
{{Podrobnosti|Syndrom 47,XXX}}


Trizomie chromozomu X, nazývaná též '''syndrom tří X''' (a dříve „Superfemale syndrom“). Jak již napovídá název – je způsoben karyotypem '''47,XXX''', možný je i výskyt v mozaice. Velmi vzácně se může vyskytnout i karyotyp 48,XXXX či 49,XXXXX, tyto případy mají odlišnou a výraznější manifestaci. Samotný syndrom 47,XXX nemá výrazný klinický obraz, některé ženy jsou vyšetřovány kvůli '''infertilitě'''. Snížená fertilita by byla v případě mozaiky 45,X/47,XXX. Jinak žena 47,XXX fertilní být může, ale některé její gamety mohou být abnormální. Mohou se vyskytnout menší problémy psychosociálního rázu, například problémy s učením, uvádí se i zvýšený sklon k schizofrenii.
=== Syndrome 47,XXX ===
{{Details|Syndrome 47,XXX}}


=== Syndrom 47,XYY ===
X chromosome trisomy, also called '''three X syndrome''' (and formerly "Superfemale syndrome"). As the name already suggests - it is caused by kayrotype '''47,XXX''', it can also occur in mosaic. Karyotype 48,XXXX or 49,XXXXX can also occur very rarely, these cases have a different and more pronounced manifestation. The 47,XXX syndrome itself does not have a distinct clinical picture, come women are examined for '''infertility'''. Reduced fertility would be in the case of mosaic 45,X/47,XXX. Otherwise, a 47,XXX woman may be fertile, but some of her gametes may be abnormal. Minor problems of a psychosocial nature may occur, for example learning problems and an increased tendency to schizophrenia is also reported. 
{{Podrobnosti|Syndrom 47,XYY}}


Tento syndrom je způsoben přítomností dvou a více [[chromosom Y|chromozomů Y]] v karyotypu, nejčastěji přímo karyotypem '''47,XYY'''. Dříve se tento syndrom označoval jako „Supermale“ – tento termín se dnes již nepoužívá. Muži mohou mít '''vyšší postavu''', dříve se předpokládalo, že muži se dvěma Y mají větší sklon k agresivitě, to se však nepotvrdilo. V populaci existují zcela normální muži s dvěma Y v buňkách.
=== Syndrome 47,XYY ===
<noinclude>
{{Details|Syndrome 47,XYY}}


== Odkazy ==
This syndrome is caused by the presence of two or more Y chromosomes in the karyotype, most often the karyotype '''47,XYY'''. Previously, this syndrome was referred to as "Supermale" - a term that is no longer used today. Males can be '''taller''', it was previously thought that males with two Ys were more aggresive,but this has not been confirmed. There are completely normal men in the population with two Ys in their cells. 
=== Související články ===
== Links ==
* [[Chromozomální abnormality]]
=== Related articles ===
** [[Strukturní chromozomové aberace]]
* [[Chromosomal abnormalities]]
** [[Získané chromozomální aberace]]
** [[Structural chromosome aberrations]]
* [[Chromozomové aberace v etiologii neoplázií|Chromozomové aberace v etiologie neoplázií]]
** [[Acquired chromosomal aberrations]]
* [[Nádorová cytogenetika]]
* [[Chromosome aberrations in the etiology of neoplasia|Chromosome aberrations in the etiology of neoplasia]]
* [[Mozaika|Chromozomální mozaika]]
* [[Tumor cytogenetics]]
* [[Mosaic|Chromosomal mosaicism]]


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|publisher = Triton
|místo = Praha
|year = 2004
|vydavatel = Triton
|rok = 2004
|rozsah=
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|isbn = 80-7254-475-6
|isbn = 80-7254-475-6
|strany =  
|pages =  
|url =  
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* {{Citace
* {{Cite
|typ = web
|type = web
|korporace =  
|corporation =  
|příjmení1 = Šípek
|surname1 = Šípek
|jméno1 = Antonín
|name1 = Antonín
|kolektiv = ne
|others = no
|název = Genetika
|source_name = Genetika
|url = http://www.genetika-biologie.cz/chromozomove-aberace
|url = http://www.genetika-biologie.cz/chromozomove-aberace
|citováno = 30. 5. 2009
|cited = 30. 5. 2009
}}
}}
</noinclude>
[[Category:Genetics]]
 
[[Category:Paediatrics]]
[[Kategorie:Genetika]]
[[Category:Obstetrics]]
[[Kategorie:Pediatrie]]
[[Kategorie:Porodnictví]]

Latest revision as of 23:18, 24 November 2023

Numerical chromosome abnormalities are deviations from the normal number of chromosomes. These deviations can refer to individual chromosomes, both in the sense of "plus" (supernumerary chromosome, extranumerary chromosome) and in the sense of "minus" (missing chromosome, missing chromosomes). The entire haploid set of chromosomes may also be multiplied. Unlike structural chromosome aberrations, chromosomes are not structurally altered in numerical aberrations. A number of numerical abnormalities are incompatible with life (all autosomal monosomies, most trisomies, polyploidy) and those that allow survival usually cause severe syndromes.

Aneuploidies[edit | edit source]

Aneuploidies are such changes in the number of chromosomes where there is one extra chromosome, i.e. trisomy (2n+1), or 1 chromosome is missing - monosomy (2n-1).

Trisomy[edit | edit source]

21 trisomy - Down syndrome

Trisomies are caused by nondisjunction, i.e. an error in the separation of homologous chromosomes in the 1st meiotic division, or chromatides in the 2nd meiotic division. The risk of this error, i.e. the occurrence of trisomy, depends significantly on the age of the mother, at the age of 25 the woman is roughly twice the population risk and then increases dramatically with age. The risk of this error is associated with the fact that meiotic division in a woman begins already during embryonic development, then is stopped and continues only at the time of sexual maturity. The age of fathers plays a role only from 50 years.

If errors in the number of chromosomes occur during meiotic division and an abnormal gamete is fertilized (in the case of nondisjunction, a disomic gamete is formed - it has an extra chromosome and a nullisomic gamete - it does not have the given chromosome), the error then occurs in all cells of the individual. If the error occurs postzygotic during the mitotic division of the zygote, a so-called mosaic occurs, where two or more cell lines with different karyotypes are present.

Down Syndrome karyotype

Most autosomal trisomies do not allow survival, only an individual can be born with trisomy 21, 18, 13, patients with trisomy 21 survive to adulthood. One more trisomy allows survival, trisome 8, but it always occurs in a mosaic with a predominance of the normal celly line i live births.

Monosomy[edit | edit source]

Monosomies arise from nondisjunction and fertilization of an abnormal - nullisomic gamete. Another mechanism by which only monosomy arises is the delay of the chromosome in anaphase and its non-incorporation into the daughter nucleus. Both mechanisms can occur in meiosis, or postzygotic during mitotic division of the zygote. The only monosomy that allows survival is monosomy X, monosomy of autosomes we would only find in spontaneous abortions.

Polyploidy[edit | edit source]

Polyploidy is the multiplication of the chromosomal set, in triploidy there are 69 chromosomes, i.e. three time the haploid ste (3n), in tetraploidy 92 chromosomes - four times the haploid set (4n).

Triploidy[edit | edit source]

Triploidy

Triploidy is a lethal genetic constitution, rarely an individual is born with triploidy but dies soon after birth. Triploidy is most often caused by a fertilization disorder, so-called dispermia (fertilization of an egg by two sperm), less often it is the result of the fusion of an abnormal unreduced gamete (created by nondisjunction of all chromosomal pairs) and a normal gamete. The phenotype of the abnormal product depends on whether the supernumerary set of chromosomes is of paternal origin (partial moles) or maternal origin (nonmolar product). This situation (a different phenotype depending on the parental origin of the supernumerary set of chromosomes) is caused by gene imprinting, which manifests itself at the beginning of embryonic development (active paternal alleles of certain genes are responsible for the development of the membranes, active maternal alleles of other genes for the development of the embryo itself). if the mutual function of the imprinted genes is not balanced, as is the case with triploidy, for example, a pathological product is produced.

Tetraploidy[edit | edit source]

Tetraploidy is a lethal genetic constitution where the number of chromosomes in an individual is 92 (4n). Tetraploidy results from endoreduplication, i.e. division of chromosomes, without cell division.

Numerical aberrations of autosomes[edit | edit source]

Down's syndrome[edit | edit source]

Searchtool right.svg For more information see Down syndrome.

Down's syndrome (DS) is one of the most well-known syndromes caused by a chromosomal abnormality.

It is the most common syndrome caused by trisomy of a chromosome in live births (specifically trisomy of chromosome 21) and the most common congenital cause of mental retardation. Other characteristic clinical symptoms are congenital heart defects, muscle hypotonia and a typical appearance (eyes with a skin fold - epicantherum - and upward-facing eye slits), as well as a monkey furrow, clinodactyly of the 5th finger, etc. In newborns, a large, crawling tongue is noticeable. In addition to greater susceptibility to infections, they also have an increased risk of cancer, especially leukemia. This is due to the fact that trisomic cells are much more sensitive to the effect of mutagnes and carcinogens. Although this is impairment allows survival, a large proportion (about ¾) of all resulting trisomies 21 are aborted.

In about 4 % of patients born with Down syndrome, the third, the redundant chromosome 21 is translocated to one of the acrocentric chromosomes (the so-called translocation form of trisome caused by Robertsonian translocation). While the risk of free trisomy depends on the age of the mother (nondisjunction risk), the risk of the translocation form of trisomy does not depend on the age of the parents, but in the case of the translocation form, in about half of the cases one of the parents is a carrier of the balanced form of the translocation and there is a risk for the offspring who may inherit this translocation in unbalanced form. If the parent is a carrier of the so-called homologous fusion of both 21 st chromosomes, the risk of DS or miscarriage is even 100 %. In non-homologous Robertsonian fusion, the risk is considerable lower, but carrying a balanced aberration is always a reason for prenatal cytogenetic diagnosis.

A small percenatge of DS patients have a mosaic form of trisomy, resulting from postzygotic loss of chromosome 21 from a trisomic zygote or postyzygotic nondisjunction during division of a normal zygote.

Thanks to modern methods of prenatal diagnosis, this syndrome can be diagnosed in the overwhelming majority of cases already during pregnancy. Indications for prenatal cytogenetic diagnosis, which lead to the detection of numerical chromosomal changes, are older age of the mother, atypical biochemical screening, abnormality on ultrasound, including minor morphological deviations. Of course, carrying a balanced Roberstonian translocation is also an indication for this examination.

Edwards syndrome[edit | edit source]

Searchtool right.svg For more information see Edwards syndrome.

Edwards syndrome (ES) is caused by trisomy od 18th chromosome. j

From the clinical symptoms, there is a noticeable flexion deformity of the fingers (the index finger and the 5th finger overlap the other fingers), atypical facies with micrognathia, prominent head, severe growth retardation, congenital defects of the heart and kidneys, hypotonia.

The average length of survival is about 2 moths, quite exceptionally the patient survives 1 year, but the vas majority of all resulting trisomies 18 are aborted.

Patau syndrome[edit | edit source]

Searchtool right.svg For more information see Patau syndrome.

Patau syndrome (PS) is cause by trisomy 13.

Manifestations include microcephaly, sloping forehead, hypertelorism, microphthalmia and even anophthalmi or cyclopia, cleft lip and palate, micrognathia, may be polydactyly. Those affected have congenital developmental defects of the brain (holoprosencephaly), heart defects and defects of other organs.

Affected people usually die within the first month of life. A translocation form of trisomy 13 is also known. The majority of all resulting trisomies 13 are aborted.

Numerical aberrations of gonosomes[edit | edit source]

Turner syndrome[edit | edit source]

Searchtool right.svg For more information see Turner syndrome.

Turner syndrome (TS) is most often caused by monosomy of the X chromosome (karyotype 45,X), or by various structural aberrations (for example, a deletion on the X chromosome, etc.). Numerical and structural changes can also occur in a mosaic. Classic manifestations are: short stature, ovarian dysgenesis associated with sterility, in some patients there is a skin fold (pterygium colli). Intelect is not impaired. In newborns, there is early lymphedema on the limbs, which should signal the suspicion of TS and the indication of cytogenetic examination. Phenotype modification with growth hormone and hormone replacement therapy is possible.

In the case of a structural aberration, the so-called isochromosome for the long arms of the X chromosome, the patient's phenotype corresponds to TS, but the patient can be fertile, as in the case of deletion of the short arms of the X chromosome. If the so-called critical region on the long arms of the X chromosome is preserved, fertility is preserved. Conversely, a deletion or a break in this critical region (when an X / autosomal translocation occurs) leads to gonadal dysgenesis, even if the patient's phenotype does not correspond to TS. Mosaics are very common in TS, when a chromosome is lost, not only the X is loste, but there can also be a very early loss of the Y chromosome (the paternal gonosome is more often lost). If the mosaic is 45,X/46,XY, there is a risk of malignancy of the gonad.

It is interesting that up to 99 % of all resulting X monosomies are aborted. It is assumed that thoso monosomies that survive are actually mosaics, although often diagnosed as full X monosomies.

Klinefelter syndrome[edit | edit source]

Searchtool right.svg For more information see Klinefelter syndrome.
The symptoms of Klinefelter's syndrome in a human male

Klinefelter syndrome (KS) results from the presence of an extra X chromosome in a male. It is most often caused by karyotype 47,XXY, variants with more X chromosomes (48,XXXY or 49,XXXXY) are also possible, which have a more pronounced manifestation. There are also mosaic forms. The main symptoms are: infertility (azoospermia), hypogonadism, average to tall height, long limbs, sparse hair, gynecomastia. In the case of the 49,XXXXY karyotype, the patient is retarded and the phenotype resembles Down syndrome, with the difference that the KS patient is tall, unlike the DS patient.

Syndrome 47,XXX[edit | edit source]

Searchtool right.svg For more information see Syndrome 47,XXX.

X chromosome trisomy, also called three X syndrome (and formerly "Superfemale syndrome"). As the name already suggests - it is caused by kayrotype 47,XXX, it can also occur in mosaic. Karyotype 48,XXXX or 49,XXXXX can also occur very rarely, these cases have a different and more pronounced manifestation. The 47,XXX syndrome itself does not have a distinct clinical picture, come women are examined for infertility. Reduced fertility would be in the case of mosaic 45,X/47,XXX. Otherwise, a 47,XXX woman may be fertile, but some of her gametes may be abnormal. Minor problems of a psychosocial nature may occur, for example learning problems and an increased tendency to schizophrenia is also reported.

Syndrome 47,XYY[edit | edit source]

Searchtool right.svg For more information see Syndrome 47,XYY.

This syndrome is caused by the presence of two or more Y chromosomes in the karyotype, most often the karyotype 47,XYY. Previously, this syndrome was referred to as "Supermale" - a term that is no longer used today. Males can be taller, it was previously thought that males with two Ys were more aggresive,but this has not been confirmed. There are completely normal men in the population with two Ys in their cells.

Links[edit | edit source]

Related articles[edit | edit source]

References[edit | edit source]

  • PRITCHARD, Dorian J. – KORF, Bruce R.. Základy lékařské genetiky. 1.. edition. Galén, 2007. 182 s. pp. ISBN 978-80-7262-449-2.
  • NUSSBAUM, R. L. – MCINNES, R. R. – WILLARD, H. W.. Klinická genetika (Thompson&Thompson). 6. edition. Triton, 2004. ISBN 80-7254-475-6.