title: Identification of dosage-sensitive genes in fetuses referred with severe isolated congenital diaphragmatic hernia.
abstract: OBJECTIVE
  Congenital diaphragmatic hernia (CDH) is a fetal abnormality affecting diaphragm and lung development with a high mortality rate despite advances in fetal and neonatal therapy. CDH may occur either as an isolated defect or in syndromic form for which the prognosis is worse. Although conventional karyotyping and, more recently, chromosomal microarrays support a substantial role for genetic factors, causal genes responsible for isolated CDH remain elusive. We propose that chromosomal microarray analysis will identify copy number variations (CNVs) associated with isolated CDH.
  
  
  METHODS
  We perform a prospective genome-wide screen for CNVs using chromosomal microarrays on 75 fetuses referred with apparently isolated CDH, six of which were later reclassified as non-isolated CDH.
  
  
  RESULTS
  The results pinpoint haploinsufficiency of NR2F2 as a cause of CDH and cardiovascular malformations. In addition, the 15q25.2 and 16p11.2 recurrent microdeletions are associated with isolated CDH. By using gene prioritisation and network analysis, we provide strong evidence for several novel dosage-sensitive candidate genes associated with CDH.
  
  
  CONCLUSIONS
  Chromosomal microarray analysis detects submicroscopic CNVs associated with isolated CDH or CDH with cardiovascular malformations.
authors.affiliation: Centre for Human Genetics, KU Leuven/University Hospital Leuven, Leuven, Belgium.
authors.forename: P D
authors.initials: PD
authors.lastname: Brady
authors.forename: P
authors.initials: P
authors.lastname: DeKoninck
authors.forename: J P
authors.initials: JP
authors.lastname: Fryns
authors.forename: K
authors.initials: K
authors.lastname: Devriendt
authors.forename: J A
authors.initials: JA
authors.lastname: Deprest
authors.forename: J R
authors.initials: JR
authors.lastname: Vermeesch
mesh_terms: D002869:Chromosome Aberrations; D055028:Comparative Genomic Hybridization / Q000379:methods; D056915:DNA Copy Number Variations; D005260:Female; D005333:Fetus / Q000378:metabolism; D018628:Gene Dosage; D050437:Genes, Developmental; D056726:Genetic Association Studies; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000235:genetics; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007621:Karyotyping / Q000379:methods; D020411:Oligonucleotide Array Sequence Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000379:methods; D012720:Severity of Illness Index