ChromosOmics - Database
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- BASIC INFORMATION ON sSMC -
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What are sSMC? | ||||||||||||||||||||||||||||
sSMC "can be defined as small structurally abnormal chromosomes that occur in addition to the normal 46 chromosomes" {80} "The term (small) 'supernumerary marker chromosome' (=sSMC) has been used to refer to any unidentifiable marker chromosome and clearly covers a diverse range of cytogenetic abnormalities" {3} "Such an 'accessory' chromosome of unknown origin is referred as a marker chromosome (mar), using the standardized human chromosome nomenclature (Paris Conference 1971), and they comprise a mixed collection of structurally rearranged chromosome regions" {2}. Up to 2004 it was still worth what was stated in 1987 {14-15} and 1992 {16; 42}, respectively: "For humans there are at present no uniform criteria that enable precise distinction of supernumerary chromosomes from other extra structurally abnormal chromosome" {14} Several attempts have been made to correlate specific marker chromosomes with a clinical picture. This has resulted in the description of a few specific syndromes, e.g. i(18p)-syndrome, i(9p)-syndrome, the Pallister-Killian syndrome = i(12p)-syndrome and the cat-eye syndrome. However, most markers have not been fully characterized {16; 44}. I.e. sSMC are a morphologically heterogeneous group of structural abnormal chromosomes: different types of inverted duplicated chromosomes, minute chromosomes and ring chromosomes can be detected (see Figure below). Thus, the description of sSMC as ‘markers’, makes sense and should be maintained, even after their identification by molecular cytogenetics. We suggested the following cytogenetic definition of sSMC {see as well 120-121} sSMC are structurally abnormal chromosomes that cannot be identified unambiguously by conventional banding cytogenetics alone, and are equal in size or smaller than a chromosome 20 of the same metaphase spread (see Fig. 1). sSMC can be present 1) in a karyotype of 46 normal chromosomes, (2) in a numerically abnormal karyotype (like Turner- or Down-syndrome) or (3) in a structurally abnormal but balanced karyotype (e.g. Robertsonian translocation or ring chromosome formation. In contrast, a SMC larger than chromosome 20 usually can be identified based on chromosome-banding. Even though cases with isochromosome 5p, 8p and 9p are not included in the group of sSMC according to that definition, they are included in this page. What else? At least minute sSMC evolve by trisomic rescue as recently shown in two cases {112-113}. If among sSMC B-chromosomes are hidden is discussed in the literature {162} - also how B-chromosomes behave in general {199}. Also there are, like human sSMC(15) being candidtae for human B-chrs., sicentric B-chrs. e.g. in Maize {201}. An acrocentric inv dup shaped sSMC was found in an Asian elefant family {200}. Also their way of formation may be related to Howel Joly Body formation {164} sSMC might be helpful as gene vectors in future {171} sSMC can be found as de novo events in tumor cells, but constitutional, inherited or de novo sSMC do not cause cancer! {see this web page chromosme-specific sites - sSMC found in tumors} sSMC should not be mixed up with double minutes (cancer associated extrachromosomal double dot like DNA containing mainly oncogene-amplification), or also not with 'markers' as described by Dr. Hit Kishore Goswami, Bhopal, India in several papers {193-196}. |
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When was the first sSMC described? | ||||||||||||||||||||||||||||
In 1961 Ilberry et al. {28} describe a 2 year old boy with epicanthic fold, slightly protuberant tongue who had a karyotype 47,XY,+mar[53]/46,XY[16]de novo. The sSMC was a "centric particle" of about the same size as 17p. This paper was not well-recognized and thus, the work of Froland et al. {8} is often mentioned as first description of sSMC. The latter describe a boy with various congenital defects and a karyotype 47,XY,+mar; the sSMC is metacentric and of comparable size as #21 - and turned out to be a tetrasomy 18p {72}. However, the case reported by Froland et al. (1963) was indeed only the third described sSMC-case, as in 1962 there was an additional report of Ellis et al. {106}. |
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Euchromatin presence on an sSMC | ||||||||||||||||||||||||||||
Euchromatin is genetic relevant
material and to be distigished from heterochromatin.
The latter does not include any genes.
sSMC may consist of both: eu- and heterochromatin. Strikingly euchromatin can be present on an sSMC and must not cause any harm in the carrier. It depends which exact genetic imbalance was induced. Thus, a detailed sSMC characterization is necessary esp. in prenatal cases!! Euchromatin was / can be detected or excluded on sSMC by different methods: Replication banding {49} C-bands {58-59}DA/DAPI staining for characterization of chromosome 15 - however, its abilities have been questioned {60-63; 75} Rx-FISH {50} microdissection and reverse painting (e.g. {51}) FISH using locus specific probes (e.g. {52}) association of sSMC with centromeric regions - the more heterochromatin they consist of the better they associate {82-87} array-CGH studies (e.g. {173}) NGS (e.g. {184}) |
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Mosaicism in sSMC | ||||||||||||||||||||||||||||
Mosaicism in sSMC carriers is present in slightly over 50% of the cases {172}. Interestingly, non-acrocentric derived sSMC show much more frequently mosaicism than acrocentric ones. sSMC can be present in different mosaic rates, which may go below 5% of the studied cells. Also cryptic mosaicism can be present and mosaics may be differently expressed in different tissues of the body. Even though in the overwhelming majority of the cases somatic sSMC mosaicism has no direct clinical effects, there are also cases with altered clinical outcomes due to mosaicism. Also clinically important is the fact that a de novo sSMC, even present in mosaic, may be a hint on uniparental disomy (UPD). {172} Mosaicism in phenotypically normal sSMC carriers: 61.9% {42} or 52.3% {43} Mosaicism in phenotypically abnormal sSMC carriers: 56.6% {42} or 56.3% {43} Mosaicism in a fetus with sSMC showing a big variation of cells with and without sSMC (see table below). Thus, cultured amniocytic fluid, chorion or fetal blood is not necessarily representative for the fetus as a whole. {165}
Development of mosaicism during lifetime: In {88} it was postulated that the percentage of cells with sSMC decrease during lifetime - especially in sSRC cases. In {64} a case is described with a sSRC with a karyotype 48,XX,+rx2/47,XX+r/47,XX,+r(doublering)/46,XX; here at birth a mosaicism of 0%/77.9%/2.3%/19.8% was described; at 5.5y the patient had a mosaicism of 0.9%/46.6%/4.4%/49.1%. This confirms that theory. In {96} the authors describe a case with a larger supernumerary marker chromosome which disappeared during the first 6 months of lifetime completely from peripheral blood. It was present first in 6/22 cells (day 12) and declined over 3/57 (day 23) and 2/70 (month 9) to 0/100 (16 months and 2 years). In parts there are confusing examples for mosaicism:
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sSMC and uniparental disomy (UPD) | ||||||||||||||||||||||||||||
Small supernumerary maker chromosomes (sSMC) and uniparental disomy (UPD) is rare, combination of both are rarely encountered. Accordingly only 46 sSMC cases with UPD are reported. Irrespective of its rareness, UPD has to be considered especially in prenatal cases with sSMC. Here we reviewed all sSMC cases with UPD (sSMCU+) and compared them to sSMC without UPD (sSMCU-). It resulted in following correlations: i) every sSMC, irrespective of its chromosomal origin maybe principally connected with UPD, ii) mixed hetero- and iso UPD (hUPD/iUPD) can be observed most oftenly in sSMCU+ cases followed by complete iUPD, complete hUPD and segmental iUPD. iii) UPD of chromosomes #6, #7, #14, #15, #16 and #20 are most often reported in sSMCU+, iv) maternal UPD was approximately nine times more frequent than paternal, v) if mosaic with a normal cell line, acrocentric derived sSMC had three times higher chances of occurence than its corrosponding non-mosaic sSMC cases , vi) UPD in connection with a parentally inherited sSMC is, if existent at all, a rare event, vii) The gender type and shape of sSMC had no effect on UPD formation. Overall, sSMCU+ cases may have a story to tell about ‘chromosome number control mechanisms’ in early embryogenesis. {174} |
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Synonyms for sSMC | ||||||||||||||||||||||||||||
Unfortunately sSMC are reported in
the literature under a lot of synonyms, which
makes finding of all relevant reports not that
easy.
Here a collection of designations given during the last years:
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Frequency of sSMC | ||||||||||||||||||||||||||||
___________________________________________ Frequency of sSMC in newborn Overall, in newborn cases the rate is 0.044% {157} some examples from literature: 0.026% (16 in 59952 newborn infants) {1 here are taken together: 17-18, 22-27} 0.024% ( 4 in 16395 newborn infants) {2} 0.123% ( 8 in 6500 newborn infants) {3} 0.040% ( 3 in 7536 newborn infants) {4-6 taken together according to 3} 0.054% ( 6 in 11148 newborn infants) {7} 0.069% (24 in 34910 newborn infants) {19; 62} 0.027% ( 4 in 14835 newborn infants) {98} 0.219% ( 4 in 1830 newborn infants) {125} 0.000% ( 0 in 930 newborn infants) {126} 0.027% ( 1 in 3665 newborn infants) {143} According to {142} sSMC occur - in 27.7% of aborted fetuses (9/46 cases) but only - in 9.2% (7/76 cases) of term births ___________________________________________ Frequency of sSMC in prenatal cases Overall, in prenatal cases the rate is 0.075% {157} In Ref. {153} 20 sSMC were found in 15792 prenatal cases. The cases were studied due to + advanced maternal age [54.16%], + increased risk acc. to triple test [19.27%], + pathologic ultrasound finding [14.26%], or others In Ref {177} 8 sSMC were found in 10125 prenatal cases in Turkey. In Ref {187} 59 sSMC were found in 68087 prenatal cases in Taiwan. According to {16} the higher rate of cases with sSMC in prenatal compared to newborn can be due to (1) the bias caused by the maternal age effect in prenatal series, (2) the fact that prenatal diagnosis is sometimes performed due to known or suspected fetal pathology, and/or (3) severely affected fetuses may result in miscarriages and will therefore not be included among newborns. According to {142} - a study done in 1997 + ~50% of pregnancies with sSMC were terminated; + 4.4% of the remaining pregnancies ended with stillbirth or spontaneous abortion; + the rest of the children wer born clinically normal. According to {116} - a study done in 2004 + 20% of pregnancies with cytogenetic aberrations (419 cases) are terminated; + 31% of the cases with de novo sSMC are selectively terminated! According to {166} - a study done in 2003: + in 7/7 inherited sSMC pregnancy continued in 8/17 pregnancies with de novo sSMC pregnancy was terminated + i.e. ~50% were terminated in this Italian study According to {158} an sSMC was present in 1/13 pregnancies with exomphalos. According to {159} an sSMC was present in 1/70 pregnancies with cleft palate. In {181} sSMC found in infertile are reviewed. ___________________________________________ Frequency of sSMC in mentally retarded Overall, in mentally retarded patients the rate is 0.288% {157} one single center study found a rate of 0.118% (in 32,930 patients karyotyped in the Belgium center for Human Genetics between 1966 and 1981) {48} ___________________________________________ Frequency of sSMC subfertile people Overall, in sub fertile people the rate for male and female together is 0.125% {157} but it differs with 0.165% in male versus 0.022% in female. In Ref. 69 it is suggested that sSMC could disrupt human spermatogenesis In {142} the influence of sSMC on non-disjunction is discussed. 644 cases with autosomal sSMC collected in that page by 13.Nov. 2004 were specified by their gender: 322/644 where male an 322/644 female. ___________________________________________ Frequency of sSMC if sSMC is de novo Overall, 70% of sSMC are de novo {157} 77% of sSMC are de novo (172 in 241 cases) - 16% maternally, 7% paternally inherited {151}. According to {53; 94} no discernibly increase risk for fetal abnormalities if sSMC is also present in a phenotypically normal parent. According to this page (12/06/2005) 918/1872 de novo; 111/1872 inherited 943/1872 no information available; i.e. de novo → 89.2%; inherited → 10,8%. This reflects the ascertainment bias present in the sSMC cases collectable on this page. But: 66/111 sSMC cases are of maternal origin; 39/111 are of paternal origin 6 familial → concordance with {151} 0.125% (3 in 2,400 adult healthy persons; 2 of the 3 cases were familial) had a de novo sSMC {29} ___________________________________________ Frequency of sSMC if sSMC is acrocentric derived Overall, 70% of sSMC are acrocentric derived {157} 86% (i.e. in 38 of 44 cases) {2} 81% (i.e. in 17 of 20 cases) {16} 45% with satellites (i.e. 14 of 31 cases) {16} 68% (i.e. in 26 of 38 cases) {46} among mentally retarded 50% with satellites (i.e. 27 of 54 cases) {91} ___________________________________________ Frequency of sSMC of one single UK facility (Dr. Crollas group {147}) 137 patients with sSMC 37% with abnormal phenotype 7% couples with reproductive difficulties 47% antenatal diagnosis 9% miscellaneous 59% mosaics 41% no mosaics 70% de novo 19% maternal origin 11% paternal origin (of 109 of the cases) 36% derived from non-acrocentrics (of 112 cases studied by FISH) 35% derived from #15 9% from #22 sSMC(15) appearance seems to be associated with advanced maternal age. In China in 74,266 samples (pre and postnatals) 75 sSMC (0,1%) were found {189} in a very mixed group of patients. ___________________________________________ Frequency of sSMC if ring chromosome shaped 10% (i.e. 3 of 31 cases) {16} 60% of case with sSRC are associated with an abnormal phenotype {77} Apart from the shape a ring is characterized by: "the detection of anaphase bridges and micronuclei in the monolayer fibroblast culture" {64} sSRC per definition do not have telomeric sequences {78; 79} Ring chromosomes can also have telomeric sequences {169} ___________________________________________ |
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sSMC-formation | ||||||||||||||||||||||||||||
Overall, little is known on sSMC formation. What we know is: - sSMC may form from each chromosome (see this collection) - inherited sSMC mainly derive from maternal origin {175} - de novo sSMC often form by trisomic rescue {112-113} - sSMC formation seems to be different according to sSMC shape (see below) - in {183} a rolling circle mechansism is suggested sSMC-formation in:
___________________________________________ inverted duplication shape For formation of inv dup shaped sSMC several models were proposed {1-7}. The most plausible of those is that an intra- {8} or interchromosomal U-type exchange of homologous chromosomes takes place, resulting from a crossover mistake of chromatids during meiosis {1}. U-type exchange seems to be a more general mechanism of isochromosome formation, which was found in tumor cells, as well {9-10}. A mechanism resembling {8} or being identical to intrachromosomal U-type exchange was proven yet for neocentric inv dup formation, where it could even be the primary mechanism of formation {8;11}. Also, this kimd of formation must take place in all cases with inv dup sSMC derived from the Y-chromosome in Turner-syndrome karyotype carriers {12}. Due to different heteromorphisms present on the two cetromeric and/or pericentric regions of some reported centric inv dup shaped sSMC, interchromosomal origin was proven exemplarily there {13-14}. Also evidence was provided that this kind of U-type exchange may predominantly happen in maternal meiosis {10;13}. It was postulated that similar breakpoints in 15q are involved not only in centric inv dup shaped sSMC formation, but also in other rearrangements {16}. N.B.: Inverted duplicated shaped sSMC can also form after ‘ring opening’ and inverted duplication of a centric minute. For present knowledge on centromeric activity in dicentric sSMC see {15}. Model of formation Inverted duplicated shaped sSMC form by U-type exchange mechanism. b = break; n = neocentromere formation can happen. References for section inv dup formation
ring shape Several possibilities how ring shaped sSMC may evolve were proposed. First, such kind of sSMC can be formed in association with a deletion of a part of the chromosome. This leads to a balanced situation in the carrier and is known as McClintock-mechanism {1}. Clinical problems only arise if exclusively the sSMC or the derivative chromsome from which the sSMC was cut out are passed to a carrier’s child, as then a chromosomal imbalance - either partial trisomy or partial monosomy - is present. In such ring shaped sSMC parts of the centromere can be included, leaving two centric chromosome fragments one of which forms a small ring, or a neocentromere is formed within the ring shaped sSMC {2} or the derivative. Second, ring formation has been proposed in connection with an inverted duplication as due to a U-type reunion between broken sister chromatids {3}. This kind of ring was only rarely reported for sSMC yet, and if so it was observed in ‘larger’ sSMC or SMC {4}. This might be connected with steric problems this mechanism may face in sSMC. Third, for the overwhelming majority of ring shaped sSMC a ring formation starting from a centric minute is suggested, which during karyotypic evolution acquires the ring shape, maybe to become more stable {5}. N.B.: The formation of double ringsis well known and frequently observed. It is thought to be due to a sister chromatid exchange with a normal centromere division {6}. A ring shaped sSMC can form as follows: 1) In a balanced karyotype parts of the sSMC’s sister-chromosome are excised and stabilized by ring formation (McClintock-mechanism). Either the ring shaped sSMC and the derivative chromosome share the centromeric region (1-1), or a neocentromere (n) is formed on sSMC (1-2) or the derivative (not depicted). 2) Ring formation can be due to an intrachromosomal U-type exchange. 3) A ring shaped sSMC can evolve from a centric minute shaped sSMC. References for section ring formation
centric minute shape Different mechanisms of centric minute sSMC formation, including trisomic and monosomic rescue, post fertilization errors and gamete complementation, have been proposed in literature. Mosaicism resulting in one cell line with sSMC and one with a trisomy provided evidence for functional trisomic rescue as a real existing mechanism {1-2}. In implanted embryos the rate of trisomies was estimated to be 16% {3}, however, no data is available how many of them undergo trisomic rescue events. Up to present no pathways or enzymes involved in the processes of trisomic or monosomic rescue formation are known. N.B.: Centric minute shaped sSMC can also form by ‘ring opening’. Also formation of a centric minute shaped sSMC was reported together with partial deletion due to dicentric intermediate {4}. References for section centric minute formation
for as side effect of inv dup sSMC formation see here and {1}. for as ring chromosomes due to McClintock mechanism see here. ___________________________________________ neocentric sSMC Really, mainly inv dup and ring shaped neocentric sSMC are reported {1}. However, there are also hints on centric minute shaphed neocentrics. References for neocentric formation
complex sSMC Complex rearranged sSMC {1 , 3} are only identifiable as such after molecular (cytogenetic) analysis. In cytogenetic analysis they look like centric minute, ring or inverted duplicated shaped. The majority of complex rearranged sSMC are constituted by the cases with Emanuel syndrome {2}. The carriers of this special derivative chromosome #22 (der(22)t(11;22)(q23;q11)) normally inherit it from a parent who has a balanced translocation t(11;22)(q23;q11). A person or better an embryo having a karyotype 46,XN,der(22)(11;22)(q23;q11) is not viable. Thus, patients with ES have had either to double their only chromosome #22 during early embryogenesis, or gamete complementation must have taken place. Complex sSMC besides ES (for review see {1}) either derive from one single, from two, or even from three different chromosomes. Models how they form are not available yet, even though copy number variant regions are thought to be causative for rearrangements. In cases when a complex sSMC may result from a parental balanced translocation some insights into their meiotic behaviour are available {4}. References for complex sSMC formation
multiple sSMC Multiple sSMC derive from a different chromosomal subset as single sSMC. Besides, they have also another distribution of shapes as centric sSMC in general. While in single sSMC there is a difference in shape distribution distinguishing acrocentric from non-acrocentric derived ones, this is not the case in multiple sSMC. Also, centric minute shaped ones are most frequent in multiple sSMC followed by ring and inverted duplication. Thus, Beverstock et al. (2003) {1} suggested correctly that the formation of multiple sSMC of different chromosomal origin is based on some other mechanism as those discussed above for single sSMC. Daniel and Malafiej (2003) {2} proposed multiple sSMC may originate from transfection of chromosomes into the zygote derived from one or more superfluous haploid pronuclei that would normally be degraded. Also, rescue of a triploid zygote could be the reason for multiple sSMC. However, no studies are available supporting any of these ideas. References for multiple sSMC
Discontinous Discontinous sSMC are known since ~2000s, but where suggested to be rather exceptions than the rule. Since recognition that chromothripsis maybe involved in sSMC formation more discontinous sSMC are recogniced and reported, Still it is not clear yet what is the exact percentage of such sSMC {1-3}. References for discontinous sSMC
McClintock "In one of her seminal contributions Barbara McClintock describes the mechanism leading to the formation of ring/deleted chromosomes in maize and the aberrant mitotic behaviour leading to 'variable mutant characteristics'. This mechanism, a break within the centromere together with a break in either the long or the short arm, creating a small ring, has been called "centromere misdivision"; these authors propose that this be referred to as "the McClintock mechanism". McClintock also describes pachytene configurations in microsporocytes, showing that although the normal, deleted and ring chromosomes may synapse, the ring is also seen with the centromeric region attached to a non-homologous bivalent." (cited from Mantzouratou et al., Molecular Cytogenetics 2009, 2:3) - see also here ___________________________________________ Pseudo-McClintock It turned out that similar to McClintock mechanism with ring chromosome formation, there are cases which seem to evolve by a related mechnaism, called pseudo-McClintock mechansim. |
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