Cited by 276Craniofacial Disorders and Treatmentsdental development and anomaliesBone Metabolism and Diseases

A Genetic-Pathophysiological Framework for Craniosynostosis

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Twigg, Stephen R.F., Wilkie, Andrew O.M.·2015·The American Journal of Human Genetics

Abstract

Craniosynostosis, the premature fusion of one or more cranial sutures of the skull, provides a paradigm for investigating the interplay of genetic and environmental factors leading to malformation. Over the past 20 years molecular genetic techniques have provided a new approach to dissect the underlying causes; success has mostly come from investigation of clinical samples, and recent advances in high-throughput DNA sequencing have dramatically enhanced the study of the human as the preferred "model organism." In parallel, however, we need a pathogenetic classification to describe the pathways and processes that lead to cranial suture fusion. Given the prenatal onset of most craniosynostosis, investigation of mechanisms requires more conventional model organisms; principally the mouse, because of similarities in cranial suture development. We present a framework for classifying genetic causes of craniosynostosis based on current understanding of cranial suture biology and molecular and developmental pathogenesis. Of note, few pathologies result from complete loss of gene function. Instead, biochemical mechanisms involving haploinsufficiency, dominant gain-of-function and recessive hypomorphic mutations, and an unusual X-linked cellular interference process have all been implicated. Although few of the genes involved could have been predicted based on expression patterns alone (because the genes play much wider roles in embryonic development or cellular homeostasis), we argue that they fit into a limited number of functional modules active at different stages of cranial suture development. This provides a useful approach both when defining the potential role of new candidate genes in craniosynostosis and, potentially, for devising pharmacological approaches to therapy.

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Crossref · 10.1016/j.ajhg.2015.07.006

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  • Environmental influences, including in utero mechanical constraints, maternal health conditions, medication exposure, and other prenatal risk factors, have been proposed as contributing factors particularly in non-syndromic cases.

    “Environmental influences have also been proposed as contributing factors, particularly in non-syndromic cases. These include in utero mechanical constraints, maternal health conditions, medication exposure, and other prenatal risk factors [1, 2, 11, 22–25].”

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Authors
Twigg, S. R. F., & Wilkie, A. O. M.
Affiliations
John Radcliffe Hospital (GB)
Corresponding author
Wilkie, Andrew O.M.
Venue
The American Journal of Human Genetics
Publisher
Elsevier BV
Published
2015-09
Volume
97
Issue
3
Pages
359-377
ISSN
0002-9297 (ISSN-L)
OpenAlex
W1929611763
Cited by
276
References
156
Citations by year
2026: 24 · 2025: 21 · 2024: 26 · 2023: 29 · 2022: 25 · 2021: 25 · 2020: 24 · 2019: 26 · 2018: 25 · 2017: 26 · 2016: 23 · 2015: 2
FWCI
3.25
Type
journal article
Language
en
Open access
Locations
  • The American Journal of Human Genetics (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Wellcome Trust (102731/Z/13/Z, 102731)
  • National Institute for Health and Care Research
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › dental development and anomalies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords
craniosynostosis, cranial sutures, premature suture fusion, genetic pathogenesis, haploinsufficiency, gain-of-function mutations, hypomorphic mutation, mouse model
MeSH terms
Animals, Brain, Cranial Sutures, Craniosynostoses, Humans, Models, Biological, Osteogenesis, Phenotype, Risk Factors, Cell Lineage, Mice

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