title: A case of autism with an interstitial deletion on 4q leading to hemizygosity for genes encoding for glutamine and glycine neurotransmitter receptor sub-units (AMPA 2, GLRA3, GLRB) and neuropeptide receptors NPY1R, NPY5R.
abstract: BACKGROUND
  Autism is a pervasive developmental disorder characterized by a triad of deficits: qualitative impairments in social interactions, communication deficits, and repetitive and stereotyped patterns of behavior. Although autism is etiologically heterogeneous, family and twin studies have established a definite genetic basis. The inheritance of idiopathic autism is presumed to be complex, with many genes involved; environmental factors are also possibly contributory. The analysis of chromosome abnormalities associated with autism contributes greatly to the identification of autism candidate genes.
  
  
  METHODS
  We describe a child with autistic disorder and an interstitial deletion on chromosome 4q. This child first presented at 12 months of age with developmental delay and minor dysmorphic features. At 4 years of age a diagnosis of Pervasive Developmental Disorder was made. At 11 years of age he met diagnostic criteria for autism. Cytogenetic studies revealed a chromosome 4q deletion. The karyotype was 46, XY del 4 (q31.3-q33). Here we report the clinical phenotype of the child and the molecular characterization of the deletion using molecular cytogenetic techniques and analysis of polymorphic markers. These studies revealed a 19 megabase deletion spanning 4q32 to 4q34. Analysis of existing polymorphic markers and new markers developed in this study revealed that the deletion arose on a paternally derived chromosome. To date 33 genes of known or inferred function are deleted as a consequence of the deletion. Among these are the AMPA 2 gene that encodes the glutamate receptor GluR2 sub-unit, GLRA3 and GLRB genes that encode glycine receptor subunits and neuropeptide Y receptor genes NPY1R and NPY5R.
  
  
  CONCLUSIONS
  The deletion in this autistic subject serves to highlight specific autism candidate genes. He is hemizygous for AMPA 2, GLRA3, GLRB, NPY1R and NPY5R. GluR2 is the major determinant of AMPA receptor structure. Glutamate receptors maintain structural and functional plasticity of synapses. Neuropeptide Y and its receptors NPY1R and NPY5R play a role in hippocampal learning and memory. Glycine receptors are expressed in very early cortical development. Molecular cytogenetic studies and DNA sequence analysis in other patients with autism will be necessary to confirm that these genes are involved in autism.
authors.affiliation: Department of Pediatrics, University of California, Irvine, Irvine, CA, USA. subhs@yahoo.com
authors.forename: Subhadra
authors.initials: S
authors.lastname: Ramanathan
authors.forename: Abigail
authors.initials: A
authors.lastname: Woodroffe
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Flodman
authors.forename: Lee Z
authors.initials: LZ
authors.lastname: Mays
authors.forename: Mona
authors.initials: M
authors.lastname: Hanouni
authors.forename: Charlotte B
authors.initials: CB
authors.lastname: Modahl
authors.forename: Robin
authors.initials: R
authors.lastname: Steinberg-Epstein
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Bocian
authors.forename: M Anne
authors.initials: MA
authors.lastname: Spence
authors.forename: Moyra
authors.initials: M
authors.lastname: Smith
mesh_terms: D001321:Autistic Disorder / Q000175:diagnosis / Q000235:genetics*; D002872:Chromosome Deletion; D002894:Chromosomes, Human, Pair 4; D020732:Cytogenetic Analysis; D005819:Genetic Markers; D006801:Humans; D007223:Infant; D007806:Language Disorders / Q000175:diagnosis; D008297:Male; D018895:Microsatellite Repeats; D011110:Polymorphism, Genetic; D021122:Protein Subunits / Q000235:genetics; D018091:Receptors, AMPA / Q000235:genetics; D018009:Receptors, Glycine / Q000235:genetics; D017476:Receptors, Neuropeptide Y / Q000235:genetics; D017981:Receptors, Neurotransmitter / Q000235:genetics*
chemical_list: C114561:GLRB protein, human; D005819:Genetic Markers; D021122:Protein Subunits; D018091:Receptors, AMPA; D018009:Receptors, Glycine; D017476:Receptors, Neuropeptide Y; D017981:Receptors, Neurotransmitter; C097212:neuropeptide Y-Y1 receptor; C100568:neuropeptide Y5 receptor; C104722:glutamate receptor ionotropic, AMPA 2