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Yang Q, Liu S, Ruan J, Sun B, Chen X, Lai X. Establishment of human induced pluripotent stem cell line BAFYi001-A from a patient with Edwards syndrome. Stem Cell Res 2025; 86:103735. [PMID: 40375407 DOI: 10.1016/j.scr.2025.103735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2025] [Revised: 04/08/2025] [Accepted: 05/10/2025] [Indexed: 05/18/2025] Open
Abstract
Edwards' syndrome (trisomy 18) is a genetic disorder characterized by the presence of an extra chromosome 18. A specific induced pluripotent stem cell (iPSC) line, named BAFYi001-A, was generated from the umbilical cord-derived mesenchymal stromal cells (UC-MSCs) of a patient with Edwards syndrome using an integration-free Sendai virus method. This line expresses markers for identifying undifferentiated hiPSCs, trilineage differentiation potential, and genetic fidelity in the context of trisomy 18. Therefore, this cell line serves as a reliable in vitro model for investigating the pathogenesis of Edward syndrome.
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Affiliation(s)
- Qingqing Yang
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Simin Liu
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Jing Ruan
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Bo Sun
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Xiaoyan Chen
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China.
| | - Xingqiang Lai
- Maternal-Fetal Medicine Institute, Department of Obstetrics and Gynaecology, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China.
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Zanin A, Patti M, Rosato I, Divisic A, Rusalen F, Maghini I, Agosto C, Benini F. Early assessment of clinical complexity and home care in patients affected by trisomy 13 and 18. Eur J Pediatr 2025; 184:194. [PMID: 39937286 PMCID: PMC11821786 DOI: 10.1007/s00431-025-06020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/23/2025] [Accepted: 01/29/2025] [Indexed: 02/13/2025]
Abstract
PURPOSE Trisomy 13 and 18 consist of a recurrent pattern of multiple congenital anomalies. The aim of this study was to analyze the clinical characteristics and disease trajectory of a cohort of children with trisomy 13 and 18 followed up by an Italian pediatric palliative care service. METHODS A single-center retrospective observational study was conducted examining the medical records of patients with trisomy 13 and 18 seen in the Pediatric Palliatives Care (PPC) center of the University Hospital of Padua from 2007 to 2022. RESULTS Seventeen patients were included in the analysis. All were born alive; four children are still alive and only three (23%) died at home. All presented high care complexity, as estimated by ACCAPED index (median 86, range 38-129). The median time to receive care from PPC was 3 months (0-108). All patients' parents shared an advance care plan with the PPC team: 13/17 patients (76%) accepted a do not resuscitate (DNR) order. Approximately 12% of patients received at least one surgery. The trend of survival compared with other cohorts reported in the literature does not appear to differ significantly after the initial stages. CONCLUSIONS The possible recognition of an early evolution toward medical complexity and the availability of home care resources and programs are crucial factors in the management of these children. These indices could become a driving factor in the definition of new outcomes that are more patient-oriented, in addition to mortality. WHAT IS KNOWN • Trisomy 13 and 18 are serious genetic conditions with high mortality rates. In the last years medical interventions including surgery are being offered more frequently, though the appropriateness of these interventions is still debated. WHAT IS NEW • The study emphasizes the crucial role of early referral to specialized pediatric palliative care teams and the coordination they provide enabling families to care for their children at home, even with complex medical needs.
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Affiliation(s)
- Anna Zanin
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Matteo Patti
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Isabella Rosato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Antuan Divisic
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Francesca Rusalen
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Irene Maghini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Caterina Agosto
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Franca Benini
- Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy.
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Visconti D, Esposito V, Brugnoli F, Gallitelli V, Corsano B, Papacci P, Pellegrino M, De Santis M, Lanzone A, Noia G. Trisomy 18 and the possibility of choice: The importance of Perinatal Hospice's support. Eur J Pediatr 2025; 184:141. [PMID: 39821650 PMCID: PMC11739207 DOI: 10.1007/s00431-025-05970-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/27/2024] [Accepted: 01/03/2025] [Indexed: 01/19/2025]
Abstract
Trisomy 18 is a severe aneuploidy associated with multiple malformations and a poor prognosis. The diagnosis is typically made prenatally, leading to a high rate of pregnancy terminations. The aim of this study is to demonstrate that even though the prognosis is heterogeneous, prolonged survival is possible and these children are an enrichment for their families after all. A retrospective, descriptive and monocentric study was conducted on fetuses diagnosed with trisomy 18, evaluated between March 2017 and June 2023 at our Institution. The objective was to investigate the natural history of trisomy 18 and the psychological impact on parents who choose to carry the pregnancy on, through a retrospective data collection and the use of a questionnaire. Sixteen couples with a diagnosis of trisomy 18 were cared for within the Perinatal Hospice Pathway during the study period. Cardiac defects were identified in 93.7% of cases, structural abnormalities in 71.4%, respiratory defects in 14.3% of the fetuses, while genitourinary defects affected nearly half of the study population. The survival rate was typically less than one day, however two babies survived for more than four years. All couples reported being satisfied with their decision to continue the pregnancy and would do so again if given the opportunity.Conclusions: despite the severity of the diagnosis, couples may choose to continue the pregnancy and give birth. Our study shows that trisomy 18 is not merely a lethal condition and the Perinatal Hospice plays a crucial role in supporting these families.
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Affiliation(s)
- D Visconti
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - V Esposito
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - F Brugnoli
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy.
| | - V Gallitelli
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - B Corsano
- Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Papacci
- Neonatal Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - M Pellegrino
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - M De Santis
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - A Lanzone
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
| | - G Noia
- Unit of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
- Department of Women and Child Health, Women Health Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Gemelli 8, Rome, Italy
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Schlosser MP, MacPherson MJ, Castro-Codesal M, Mack C, Sue-Milne K, Wren T, Shapka L, Kung JY, van Manen M. Liveborn children with trisomy 18: A scoping review. J Neonatal Perinatal Med 2024; 17:733-749. [PMID: 40016985 DOI: 10.1177/19345798241302276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2025]
Abstract
BACKGROUND There have been an increasing number of publications related to trisomy 18 associated with a shift in the philosophy of care. The objective of this review is to understand the scope of contemporary literature informing the care of children born alive with trisomy 18. METHODS Included was peer-reviewed, primary literature in MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library from 2012 to 2023 reporting outcomes of children born alive with trisomy 18. Data extraction involved descriptive statistics of the types of studies, and an inductive thematic analysis of the questions addressed by the studies. RESULTS Of 4628 records identified, 229 met inclusion criteria. Key themes were organized around the domains: What is trisomy 18? What are the chances of survival with trisomy 18? What can be done to improve the chances of survival with trisomy 18? How do children with trisomy 18 die? Do surgical interventions provide a benefit? Are there non-surgical options? What knowledge is informing medical management? How is life described for children with trisomy 18? What are children with trisomy 18 like as babies and as they get older? What is life like for families caring for children with trisomy 18? CONCLUSIONS A sizeable number of publications grouped trisomy 18 with other syndromes. Relatively few showed the longitudinal evolution of medical issues associated with trisomy 18, nor did they unfold the clinical heterogeneity of this population. This review shows the limited knowledge base guiding decision-making and care for children born alive with trisomy 18.
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Affiliation(s)
| | | | | | | | | | - Tara Wren
- Alberta Health Services, Edmonton, AB, Canada
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Qin Y, Touch K, Sha M, Sun Y, Zhang S, Wu J, Wu Y, Feng L, Chen S, Xiao J. The chromosomal characteristics of spontaneous abortion and its potential associated copy number variants and genes. J Assist Reprod Genet 2024; 41:1285-1296. [PMID: 38668959 PMCID: PMC11143157 DOI: 10.1007/s10815-024-03119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/02/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE This study aimed to investigate the correlation between chromosomal abnormalities in spontaneous abortion with clinical features and seek copy number variations (CNVs) and genes that might be connected to spontaneous abortion. METHODS Over 7 years, we used CNV-seq and STR analysis to study POCs, comparing chromosomal abnormalities with clinical features and identifying critical CNVs and genes associated with spontaneous abortion. RESULTS Total chromosomal variants in the POCs were identified in 66.8% (2169/3247) of all cases, which included 45.2% (1467/3247) numerical abnormalities and 21.6% (702/3247) copy number variants (CNVs). Chromosome number abnormalities, especially aneuploidy abnormalities, were more pronounced in the group of mothers aged ≥ 35 years, the early miscarriage group, and the chorionic villi group. We further analyzed 212 pathogenic and likely pathogenic CNVs in 146 POCs as well as identified 8 statistically significant SORs through comparison with both a healthy population and a group of non-spontaneously aborted fetuses. Our analysis suggests that these CNVs may play a crucial role in spontaneous abortion. Furthermore, by utilizing the RVIS score and MGI database, we identified 86 genes associated with spontaneous abortion, with particular emphasis on PARP6, ISLR, ULK3, FGFRL1, TBC1D14, SCRIB, and PLEC. CONCLUSION We found variability in chromosomal abnormalities across clinical features, identifying eight crucial copy number variations (CNVs) and multiple key genes that may be linked to spontaneous abortion. This research enhances the comprehension of genetic factors contributing to spontaneous abortion.
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Affiliation(s)
- Yu Qin
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Koksear Touch
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Menghan Sha
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanan Sun
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Shunran Zhang
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Jianli Wu
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Yuanyuan Wu
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Ling Feng
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China
| | - Suhua Chen
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China.
| | - Juan Xiao
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, Hubei, China.
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Marçola L, Zoboli I, Polastrini RTV, Barbosa SMDM, Falcão MC, Gaiolla PDV. Patau and Edwards Syndromes in a University Hospital: beyond palliative care. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023053. [PMID: 38088680 PMCID: PMC10712940 DOI: 10.1590/1984-0462/2024/42/2023053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/15/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To describe the newborn population with Patau (T13) and Edwards Syndrome (T18) with congenital heart diseases that stayed in the Intensive Care Unit (ICU) of a quaternary care hospital complex, regarding surgical and non-surgical medical procedures, palliative care, and outcomes. METHODS Descriptive case series conducted from January/2014 to December/2018 through analysis of records of patients with positive karyotype for T13 or T18 who stayed in the ICU of a quaternary hospital. Descriptive statistics analysis was applied. RESULTS 33 records of eligible patients were identified: 27 with T18 (82%), and 6 T13 (18%); 64% female and 36% male. Eight were preterm infants with gestational age between 30-36 weeks (24%), and only 4 among the 33 infants had a birth weight >2500 g (12%). Four patients underwent heart surgery and one of them died. Intrahospital mortality was 83% for T13, and 59% for T18. The majority had other malformations and underwent other surgical procedures. Palliative care was offered to 54% of the patients. The median hospitalization time for T18 and T13 was 29 days (range: 2-304) and 25 days (13-58), respectively. CONCLUSIONS Patients with T13 and T18 have high morbidity and mortality, and long hospital and ICU stays. Multicentric studies are needed to allow the analysis of important aspects for creating protocols that, seeking therapeutic proportionality, may bring better quality of life for patients and their families.
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Affiliation(s)
- Ligia Marçola
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil
| | - Ivete Zoboli
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil
| | | | | | - Mário Cícero Falcão
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil
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