MTHFR gene polymorphism and associated nutritional deficiency in the etiology and pathogenesis of Down syndrome

Abstract

Background: Our aim was to evaluate the influence of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism on maternal risk for Down syndrome (DS) and observe the impact of this polymorphism on folate, homocysteine, and vitamin B 12 concentrations and their association with pregnancy outcome in addition to malformations in DS offspring. Results: The prevalence of MTHFR gene polymorphism at 677 positions in mothers of DS children (DSM) (n = 118) was compared with control mothers (CM) who were age matched with normal children and no history of spontaneous abortion (SA) (n = 118). The MTHFR gene polymorphism was detected using the PCR-RFLP method. MN frequency was measured by CBMN assay and folate; homocysteine and vitamin B 12 were measured using the biochemical analyzer. All statistical analyses were carried out using the chi-square test and t test by using GraphPad Prism 7.0 software. Heterozygous (C/T) genotype was highly significant (p < 0.001) in DSM occurring at 64.4 %, while only 33% CM showed C/T genotype, with an odds ratio of 4.1. Significantly lower levels of folate (p < 0.01), vitamin B 12 (p < 0.001), and higher levels of homocysteine (p < 0.01) were found in DSM compared to CM. The MN frequency was highly significant (p < 0.001) in DSM with C/T genotype when compared to CM. Within DSM, significantly higher (p < 0.001) MN frequencies were observed in DSM with C/T genotype than DSM with C/C genotype. This shows the susceptibility of chromosome malsegregation leading to DS in these women. In addition, the frequency of SA in DSM with C/T genotype was significantly higher (p < 0.01). The DS children showed significantly higher rates of congenital heart defect, preterm birth and low birth weight when mother had C/T genotype. Conclusion: The present study supports the association of MTHFR C677T with DS risk and the above mentioned associated abnormalities in the child. We suggest that identification of MTHFR genotype and adequate folate and vitamin B 12 intake during the preconception and pregnancy period could help protect against congenital malformations and improving pregnancy outcome.

Methylenetetrahydrofolate Reductase Dimer Configuration as a Risk Factor for Maternal Meiosis I-Derived Trisomy 21

“…Additionally, associations between MTHFR gene polymorphisms and formation of micronucleus in peripheral lymphocytes of mothers with a DS child were observed. Such results support the hypothesis that polymorphisms in the MTHFR gene could be a maternal risk factor for genetic instability [26,27].…”

Maternal MTHFR 677C>T, 1298A>C gene polymorphisms and risk of offspring aneuploidy

“…An increased risk of offspring aneuploidy in the combination of two maternal MTHFR gene poly- to offspring aneuploidy. 1,23 Research on this topic become of increasing interest worldwide, but the presented results are conflicting and with large variations among populations.…”

“…Unlike individual case-control studies showing conflicting outcomes within different geographic populations, 1,2,10,11,13,[15][16][17][18][26][27][28][29][30][31][32] several meta-analyzes conducted over the past decade have highlighted a significant association between MTHFR 677C>T maternal polymorphism and Down syndrome risk in offspring. 19,24,25,33,34 Using different genetic models, a stable association was shown for MTHFR 677C>T maternal polymorphism in Caucasians, which concurs with our results.…”

“…An improper chromosome segregation, leading to aneuploidy, mainly occurs (95%) in maternal, primarily meiosis I. 1,2 The most frequent aneuploidies in live births are free trisomy 21 and sex chromosome aneuploidies, while other autosomal trisomies are unviable, with the exception of trisomy 13 and 18, which are rarely observed in live births. 3,4 Despite detrimental clinical consequences and extensive research, the cellular and molecular mechanisms involved in chromosome non-disjunction are still poorly understood.…”

“…13 and 18. An improper chromosome segregation, leading to aneuploidy, mainly occurs (95%) in maternal, primarily meiosis I 1,2 . The most frequent aneuploidies in live births are free trisomy 21 and sex chromosome aneuploidies, while other autosomal trisomies are unviable, with the exception of trisomy 13 and 18, which are rarely observed in live births 3,4 .…”