ABSTRACT. Hemifacial microsomia is the second congenital malformation in prevalence, after cleft lip and palate, and is described as a congenital alteration of the first and second branchial arches. As a condition of wide spectrum, its characteristics are expressed in many different INTRODUCCIÓNLa microsomía hemifacial (MHF) corresponde a un espectro de malformaciones congénitas craneofaciales caracterizadas por la hipoplasia de los tejidos derivados embriológicamente del primer y el segundo arcos branquiales. Su manifestación es altamente variable, presentando defectos incluso a nivel cardiaco, vertebral y del sistema nervioso central.Es la segunda malformación craneofacial más común después de la fisura de labio y paladar, con una incidencia estimada de 1/5.600 nacidos vivos. 1 Se presenta unilateral en un 70% de los casos, y cuando aparece en forma bilateral, se presenta en forma asimétrica, afectando más a un lado que otro. 2Al ser una alteración compleja y heterogénea, los pacientes con alteraciones pertenecientes a este espectro han recibido distintos diagnósticos, como Síndrome de Goldenhar, espectro óculo-aurículo-vertebral, síndrome del primer y el segundo arcos branquiales, microsomía craneofacial, entre otros. Aún no se ha establecido un criterio diagnóstico común para dicha entidad. 3Su patogénesis obedece a un carácter heterogéneo explicado por diferentes teorías. 4 Una de ellas es la propuesta por Poswillo, para quien la causa sería una disrupción vascular que produce una hemorragia durante la formación embriológica de la arteria estapedial, lo que se asocia con alteraciones en el desarrollo del primer y el segundo arcos branquiales. El tamaño del hematoma y la lesión del tejido resultante explicarían la morfología y las diferentes variaciones de MHF en los modelos experimentales, ya que, a mayor tamaño, mayores alteraciones en el desarrollo de estos arcos branquiales. 5 Otra de las teorías es la postulada por Johnston, 6 para quien el factor causal sería una alteración en la migración de las células de la cresta neural hacia la formación del ganglio trigeminal. Esta falta en la migración, y por ende la ausencia de interacción entre las células de la cresta neural y el mesénquima celular, también se ha asociado a otros problemas observados en pacientes con MHF, como la microdoncia y la hipodoncia, 7 la fisura palatina y problemas cardiacos. 8 INTRODUCTIONHemifacial microsomia (HFM) corresponds to a spectrum of congenital craniofacial malformations characterized by hypoplasia of tissues embryologically originating from the first and second branchial arches. Its expression is highly variable, even with defects of heart, spine, and central nervous system.It is the second most common craniofacial malformation after cleft lip and palate, with an estimated incidence of 1/5,600 births. 1 It appears one-sided in 70% of cases, and its bilateral form is usually asymmetrical, affecting one side more than the other. 2 As a complex heterogeneous alteration, patients showing its wide manifestations have received...
Body-mass index (BMI) is a well-known marker of adiposity across all ages. The genetic architecture of BMI has been thoroughly studied among adults. In contrast, there are a few genome-wide association studies (GWAS) on children. Further, GWAS on children have been performed almost exclusively in Europeans at single ages. We aimed to better understand the genetic architecture of BMI trajectory across ages and how BMI is affected by Native American genetic ancestry. We performed cross-sectional and longitudinal GWAS for BMI-related traits on 904 admixed Chilean children with mostly European and Mapuche Native American genetic ancestry. We focused on BMI and two traits that occur at the minimum of the childhood BMI growth trajectory, namely, age at adiposity rebound (Age-AR) and BMI at adiposity rebound (BMI-AR). We found several variants in the immune gene HLA-DQB3 that are strongly associated with BMI at ages 1.5-2.5 years old, but not at other ages. We also identified a variant in the sex-determining gene DMRT1 significantly associated with Age-AR (P = 9.8 * 10e-9). Further, BMI was significantly higher in Mapuche than in European children at all ages between 5.5 and 16.5 years old, but not before. Finally, Age-AR was significantly lower (P = 0.013) by 1.64 years in the Mapuche children compared with Europeans.
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