Molecular Genetic Analysis of Congenital Diaphragmatic Hernia

描述(由申请人提供)：我们的总体目标是确定人类横隔疝的遗传原因。横隔膜是由肌肉和肌腱组成的组织，将胸部和腹部分开。如果横隔膜没有正常形成，可能会导致腹壁内容物突出或突出到胸腔内。横隔式疝气很常见，每2500例活产和死产中就有1例发生。横隔式疝气是一种破坏性的先天缺陷，与之相关的死亡率和发病率非常高。关于横隔膜疝气的遗传原因我们知之甚少，因此我们想要发现哪些基因在决定哪些婴儿容易患上腹股沟疝气方面起着重要作用。我们使用了一种名为阵列比较基因组杂交的技术来识别横隔疝患者中新的、微小的染色体缺失。这些缺失的区域包含正常横隔膜发育所需的基因。我们希望进一步发展这项研究，并使用相同的技术继续筛查患有横隔疝的患者的染色体缺失。我们还想确定缺失区域中的哪些基因参与了横隔膜的发育。为此，我们建议确定缺失区域中的哪些基因在小鼠横隔膜中表达，因为我们假设在小鼠横隔膜中表达的基因也将在人类横隔膜中表达。然后，我们将根据基因表达和公布的基因表达和功能数据，编制一份横隔疝候选基因清单。我们将在一大批横隔疝患者中对候选基因进行测序。我们的目的是检测导致疝气的基因，以改善患者咨询，并促进我们对这种出生缺陷的发病机制的理解。与公共卫生的相关性这个项目旨在提高我们对一种常见的出生缺陷--先天性横隔疝--的遗传原因的了解。增加我们对导致一些人而不是其他人受到影响的基因的了解，将使我们能够优化对有关家庭的治疗和管理，从而可能有助于降低婴儿死亡率和发病率。

DESCRIPTION (provided by applicant): Our overall goal is to identify the genetic causes of diaphragmatic hernia in humans. The diaphragm is a tissue composed of muscle and tendon that separates the chest and abdomen. If the diaphragm does not form normally, a hernia or protrusion of the abdominal contents into the chest can result. Diaphragmatic hernias are common and occur in 1 in 2500 live- and stillbirths. A diaphragmatic hernia is a devastating birth defect, and the mortality and morbidity associated with the hernias is very high. Little is known about the genetic causes of diaphragmatic hernia, and we therefore would like to discover which genes are important in determining which babies is susceptible to developing a hernia. We have used a technique called array comparative genomic hybridization to identify new, small chromosome deletions in patients with diaphragmatic hernias. These deleted regions contain genes that are needed for normal diaphragm development. We would like to develop this research further and use the same technique to continue to screen patients with diaphragmatic hernias for chromosome deletions. We would also like to determine which of the genes in the deleted regions are involved in diaphragm development. To do this, we propose to determine which of the genes from the deleted regions are expressed in the mouse diaphragm, as we hypothesize that the genes expressed in the mouse diaphragm will also be expressed in the human diaphragm. We will then compile a list of candidate genes for diaphragmatic hernias based on gene expression and published data on gene expression and function. We will sequence the candidate genes in a large cohort of patients with diaphragmatic hernias. Our purpose is to detect the genes that cause the hernias to improve patient counseling and to advance our understanding of the pathogenesis of this birth defect. Relevance to Public Health This project is directed at improving our understanding of the genetic causes of a common birth defect, congenital diaphragmatic hernia. An increase in our knowledge about the genes that cause some individuals to be affected and not others will allow us to optimize treatment and management for the families concerned and thus may help to reduce infant mortality and morbidity.