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DOWN SYNDROME 
GROUP:38 
NAME:PUGAZHENTHI RAVICHANDAR
WHICH CHROMOSOME ARE RESPONSIBLE 
FOR THIS DISORDER? 
-MAINLY caused by trisomy of chromosome 21 in 
which there is an meitic disjunction in 
chromosome 21 
-a patient with down syndrome has a 47 
chromosomes instead of 46 in which there is an 
extra s number of short segment of acrocentric 
chromosome . 
-acrocentric - a chromosome in which the 
centromere is located near the end of an 
chromosome.humans normally have 5 pairs of 
acrocentric chromosomes
WHO HAS THE GREATER CHANCE FOR 
ACQUIRING THIS DISORDER? 
.INCREASED MATERNAL AGE 
.MOST SEVERE IN MONOZYGOTIC TWINS WHO SHARE SAME ALLES IN 
THEIR GENES 
-LESS PREVEALENT IN DIZYGOTIC TWINS WHO HAS DIFFERENT ALEELS 
IN THEIR GENES. 
ALLES-any of the alternative forms of a gene that may occur 
at a given locus
HISTORY OF THIS DISORDER 
 -THIS SYNDROME WAS DISCOVERED CLINICALLY BY LANGDON 
DOWN IN 1866 ITS CAUSE REMAINED MYSTERY FOR MANY YEARS 
 ITS MAIN CAUSE WAS DETERMINED IN 1930 AND DOWN 
SYNDROME BECOME THE FIRST CHROMOSOMAL ABNORMAL 
DISORDER to be discovered.
phenotypical abnormalities or structural 
variations caused by down syndrome 
 down syndrome can be diagonised at birth or shortly after birth. 
 the first sign of abnormality in infant is hypotonia in which there 
is a state of low muscle tone which causes the reduction in 
tension or resistance to stretch in a muscle .
-identified mainly by dysmorphic features that differ among each 
individual in which there is an difference in the bodily 
structure related mainly due to the congenital disorder, 
genetic diseases or birth defect 
-infants with very short height and brachycephaly-short skull 
and flat occipat region 
-infants have flat ears 
-the mouth is open often showing protruding tongue 
-brushfield spots on the iris of the eye
-abnormal palbepral fissures and epicanthal folds 
-the hands are shor and broad and often with a single palmar 
crease or simian crease -the fifth digit is incurved or 
clinodactyl
• -down syndrome mainly causes mental retardation by 
the end of first year 
-the intelligence qutioent(iq) is usulally 30%to 60% 
-many children with the down syndrome develop to 
happy and self reliant person inspite of their limitations 
-congenital heart diseases occurs one third in patients 
with the down syndrome. 
- 
Duodenal atresia is the congenital absence or complete 
closure of a portion of the lumen of the duodenum. It 
causes increased levels of amniotic fluid during 
pregnancy (polyhydramnios) and intestinal obstruction in 
newborn babies.
-A tracheoesophageal fistula (TEF) is a congenital or acquired 
communication between the trachea and esophagus. TEFs often 
lead to severe and fatal pulmonary complications. 
-these phenotypes result mainly due to the overespreesion of genes 
in the chromosome 21 which can overexoressed in brain and heart 
samples 
-it does not occur in euploid individuals-having an exact multiple of 
the haploid number of chromosomes. 
diagnosis 
-it can be diagnised by determining the genes in chromosome 21 
which causes abnormal phenotype in an individual.
diagnosis 
-it can be diagnised by determining the genes 
in chromosome 21 which causes abnormal 
phenotype in an individual. 
-estimating maternal ages provide usefull 
information 
-diagonised mainly by chorionic villus sampling 
and amnicensitosis 
amniocensitosis-the
• amniocensitosis-the sampling of 
amniotic fluid using a hollow needle 
inserted into the uterus, to screen for 
developmental abnormalities in a 
fetus.
-in all maternal ages there is some loss of 
amniotic fluid and at the the end of 
pregnancy there is an great loss of amnitic 
fluid- the loss of amniotic fluid can be 
usually observed at 11th week to 16th week 
which causes sponatneous abortion
-nearly all down syndrome patients develops alzeimer diseases 
at earlier age than the typical age at onset 
-the risk of having child at maternal age increaseses and the 
meoitic erros during trisomy 21 increases after the maternal age 
of 30 
-the error occuring durin maternal meiosis is 90% which are 
usually in meiosis 1 and the error ocurring during paternal 
meisosis is 10% usually during meiosis 2 which are essential for 
recurrence of risk
-only 20%to 25% of trisomy conceptuses survive at birth. 
-although this survived child develops congenital heart in disorder 
-one fourth of the infants die due to heart defects before their 1st 
birthday 
-there is an chance of 15 fold increase in leukaemia 
-premature infants also develop dementia(loss of memmory) which are 
similar to alzeimer diseases (AD) and neurofibrillary tangles and 
plaques 
-
clinical manifestations: 
-it is not difficult to identify this disorder and the karyotyping test gives us 
conformation test to genetic counseling 
-the specific abnormal karyotype responsible for down syndrome usually has an 
little effetct of phenotype
why maternal aging causes down 
syndrome? 
-as we get older our egg cells become older 
-this aged egg cells has less ability to 
overcome meiotic non disjunction of 
chromosomes 
-the age for ocurrance of down syndrome is 
30 to 45 years of age where the primary 
oocytes are in prophase after first meiotic 
division
what is robertsonian translocation ? 
--it is a type of rearrangement involving two 
acrocentric chromosomes which fuse near the 
centromere with the long arm of an another 
chromosome with the loss of short arms -the 
resulting chromosome has a balanced karyotype is 45 
which are metacentric 
-there are 5 pairs of acrocentric chromosomes in 
human which has large number of genes encoding 
ribosomal RNA
.ROBERTSONIAN TRANSLOCATION- may be either psudocentric 
or monocnetric 
pseudocentric-without centromere 
monocentric-having a single centromere 
-the acrocentric chromosome combinations is found 
in chromosome 14q21q and 13q14q -carriers 
female have high risk of transmiting this 
translocation segment to affected child in an 
trisomy 21 
-
-a carrier for robertsonian translocation invloves acrocentric 
chromosome 14 and 21 
there are three types of gametes result from robertsonian translocation 
which are balance ,non-blanced and one is having normal chromosome 
21 which accounts for 1in 3 in down syndrome
RISK OF DOWN SYNDROME: 
-THE RECUURANCE OF RISK IN FAMILY IS ABOUT 1% 
OVERALL 
-THE RISK IS ABOUT 1.4% MOTHER YOUNGER THAN 30 
YEARS WHICH ARE ALSO CAUSED BY MATERNAL 
ANXIETY DOES NOT INCREASE THE RISK OF HAVING 
DOWN SYNDROME CHILD 
-down syndrome can be detected prenatlly by 
cytogenetically or comparitive hybridisation in involves 
analysis of chorionic villus or amniotic fluid cells by 
comparative genome hybridisation(CGH) .SAMPLINNG 
OF FETAL CELLS will cause loss of fetal tissue
-the population incidence of the down syndrome in live births 
is 
currently 
estimated to be about 1 in 800 of all births in older mother. 
-at about the age of 30 the recurrance of risk is 1 in 25omy is 
birth in mother 
-the risk of translocation or partial trisomy is unrelated to 
maternal age 
-the paternal age have no appearance of risk. 
-in us and canada 50% of pregnant women is 35 years of old 
undergoes prenatal diagnosis but only 1% in fetuses where 
found to have trisomy in 21 
-circulation of fetal cells in maternal blood can also be 
determined
21q 21q translocation 
- a 21q21q chromosome consists of two chromosome 21 long 
arms 
-An isochromosome is a chromosome that has lost one of its 
arms and replaced it with an exact copy of the other arm 
- monosomy 21 is rarely visible but it can be det ected by 
postzygotically where there is an extra dose of chromosomal 
material or lack of chromosome 21 at all 
-now this trisomy 21 disorder is also found in animals like tiger
mosacicsm- when a person has 
chromosomal abnormality is usualy present 
in all cell 
-2 or more chromosomal compelments is 
found in an individual.this is called 
mosaiscism which can be either nummerical 
or structural. 
-about 2% down syndrome patients are 
mosaic 
-the phenotype may be milder than 
trisomy21 but there isvariation of 
phenotypes differed from 21 chromosome 
trisomy in embryo durin early development. 
-the mildly affected patients are less 
diagonised by karyotype
partial trisomy 21: 
-down syndrome can be diagonised in a patient of long arm of 
chromosome 21 which are present in triplicate or 3 copies 
-it is not identified by cytogenetically and can be rarely 
identified 
-by knowing what regions are triplicated in an chromosome 21 
which are responsible for specific phenotype 
-by knowing what regions have been triplicated before appearing 
phenotype 
-the chromosome 21 contains only few genes 
-the most succesfull detection in down syndrome is the heart 
defect region on chromosome 21 in 40% of down syndrome 
patients
CURRENT INVESTIGATION 
-sorting out specific genes in chromosome 21 which are 
responsible for down syndrome phenotype is a focus of current 
investigation which uses mouse as a model. 
-mice engineered contain extra chromosome 21 or even copy of 
an entire human chromosome 21 which can show phenotypical 
abnormalities such as in behaviour,brain function and cardiac 
dvelopment 
-nowadays mice is the potential promise for genetic diseases 
research
down syndrome 2

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down syndrome 2

  • 1. DOWN SYNDROME GROUP:38 NAME:PUGAZHENTHI RAVICHANDAR
  • 2. WHICH CHROMOSOME ARE RESPONSIBLE FOR THIS DISORDER? -MAINLY caused by trisomy of chromosome 21 in which there is an meitic disjunction in chromosome 21 -a patient with down syndrome has a 47 chromosomes instead of 46 in which there is an extra s number of short segment of acrocentric chromosome . -acrocentric - a chromosome in which the centromere is located near the end of an chromosome.humans normally have 5 pairs of acrocentric chromosomes
  • 3. WHO HAS THE GREATER CHANCE FOR ACQUIRING THIS DISORDER? .INCREASED MATERNAL AGE .MOST SEVERE IN MONOZYGOTIC TWINS WHO SHARE SAME ALLES IN THEIR GENES -LESS PREVEALENT IN DIZYGOTIC TWINS WHO HAS DIFFERENT ALEELS IN THEIR GENES. ALLES-any of the alternative forms of a gene that may occur at a given locus
  • 4.
  • 5. HISTORY OF THIS DISORDER  -THIS SYNDROME WAS DISCOVERED CLINICALLY BY LANGDON DOWN IN 1866 ITS CAUSE REMAINED MYSTERY FOR MANY YEARS  ITS MAIN CAUSE WAS DETERMINED IN 1930 AND DOWN SYNDROME BECOME THE FIRST CHROMOSOMAL ABNORMAL DISORDER to be discovered.
  • 6. phenotypical abnormalities or structural variations caused by down syndrome  down syndrome can be diagonised at birth or shortly after birth.  the first sign of abnormality in infant is hypotonia in which there is a state of low muscle tone which causes the reduction in tension or resistance to stretch in a muscle .
  • 7. -identified mainly by dysmorphic features that differ among each individual in which there is an difference in the bodily structure related mainly due to the congenital disorder, genetic diseases or birth defect -infants with very short height and brachycephaly-short skull and flat occipat region -infants have flat ears -the mouth is open often showing protruding tongue -brushfield spots on the iris of the eye
  • 8. -abnormal palbepral fissures and epicanthal folds -the hands are shor and broad and often with a single palmar crease or simian crease -the fifth digit is incurved or clinodactyl
  • 9. • -down syndrome mainly causes mental retardation by the end of first year -the intelligence qutioent(iq) is usulally 30%to 60% -many children with the down syndrome develop to happy and self reliant person inspite of their limitations -congenital heart diseases occurs one third in patients with the down syndrome. - Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum. It causes increased levels of amniotic fluid during pregnancy (polyhydramnios) and intestinal obstruction in newborn babies.
  • 10. -A tracheoesophageal fistula (TEF) is a congenital or acquired communication between the trachea and esophagus. TEFs often lead to severe and fatal pulmonary complications. -these phenotypes result mainly due to the overespreesion of genes in the chromosome 21 which can overexoressed in brain and heart samples -it does not occur in euploid individuals-having an exact multiple of the haploid number of chromosomes. diagnosis -it can be diagnised by determining the genes in chromosome 21 which causes abnormal phenotype in an individual.
  • 11. diagnosis -it can be diagnised by determining the genes in chromosome 21 which causes abnormal phenotype in an individual. -estimating maternal ages provide usefull information -diagonised mainly by chorionic villus sampling and amnicensitosis amniocensitosis-the
  • 12. • amniocensitosis-the sampling of amniotic fluid using a hollow needle inserted into the uterus, to screen for developmental abnormalities in a fetus.
  • 13. -in all maternal ages there is some loss of amniotic fluid and at the the end of pregnancy there is an great loss of amnitic fluid- the loss of amniotic fluid can be usually observed at 11th week to 16th week which causes sponatneous abortion
  • 14. -nearly all down syndrome patients develops alzeimer diseases at earlier age than the typical age at onset -the risk of having child at maternal age increaseses and the meoitic erros during trisomy 21 increases after the maternal age of 30 -the error occuring durin maternal meiosis is 90% which are usually in meiosis 1 and the error ocurring during paternal meisosis is 10% usually during meiosis 2 which are essential for recurrence of risk
  • 15. -only 20%to 25% of trisomy conceptuses survive at birth. -although this survived child develops congenital heart in disorder -one fourth of the infants die due to heart defects before their 1st birthday -there is an chance of 15 fold increase in leukaemia -premature infants also develop dementia(loss of memmory) which are similar to alzeimer diseases (AD) and neurofibrillary tangles and plaques -
  • 16. clinical manifestations: -it is not difficult to identify this disorder and the karyotyping test gives us conformation test to genetic counseling -the specific abnormal karyotype responsible for down syndrome usually has an little effetct of phenotype
  • 17. why maternal aging causes down syndrome? -as we get older our egg cells become older -this aged egg cells has less ability to overcome meiotic non disjunction of chromosomes -the age for ocurrance of down syndrome is 30 to 45 years of age where the primary oocytes are in prophase after first meiotic division
  • 18. what is robertsonian translocation ? --it is a type of rearrangement involving two acrocentric chromosomes which fuse near the centromere with the long arm of an another chromosome with the loss of short arms -the resulting chromosome has a balanced karyotype is 45 which are metacentric -there are 5 pairs of acrocentric chromosomes in human which has large number of genes encoding ribosomal RNA
  • 19.
  • 20. .ROBERTSONIAN TRANSLOCATION- may be either psudocentric or monocnetric pseudocentric-without centromere monocentric-having a single centromere -the acrocentric chromosome combinations is found in chromosome 14q21q and 13q14q -carriers female have high risk of transmiting this translocation segment to affected child in an trisomy 21 -
  • 21. -a carrier for robertsonian translocation invloves acrocentric chromosome 14 and 21 there are three types of gametes result from robertsonian translocation which are balance ,non-blanced and one is having normal chromosome 21 which accounts for 1in 3 in down syndrome
  • 22. RISK OF DOWN SYNDROME: -THE RECUURANCE OF RISK IN FAMILY IS ABOUT 1% OVERALL -THE RISK IS ABOUT 1.4% MOTHER YOUNGER THAN 30 YEARS WHICH ARE ALSO CAUSED BY MATERNAL ANXIETY DOES NOT INCREASE THE RISK OF HAVING DOWN SYNDROME CHILD -down syndrome can be detected prenatlly by cytogenetically or comparitive hybridisation in involves analysis of chorionic villus or amniotic fluid cells by comparative genome hybridisation(CGH) .SAMPLINNG OF FETAL CELLS will cause loss of fetal tissue
  • 23. -the population incidence of the down syndrome in live births is currently estimated to be about 1 in 800 of all births in older mother. -at about the age of 30 the recurrance of risk is 1 in 25omy is birth in mother -the risk of translocation or partial trisomy is unrelated to maternal age -the paternal age have no appearance of risk. -in us and canada 50% of pregnant women is 35 years of old undergoes prenatal diagnosis but only 1% in fetuses where found to have trisomy in 21 -circulation of fetal cells in maternal blood can also be determined
  • 24. 21q 21q translocation - a 21q21q chromosome consists of two chromosome 21 long arms -An isochromosome is a chromosome that has lost one of its arms and replaced it with an exact copy of the other arm - monosomy 21 is rarely visible but it can be det ected by postzygotically where there is an extra dose of chromosomal material or lack of chromosome 21 at all -now this trisomy 21 disorder is also found in animals like tiger
  • 25. mosacicsm- when a person has chromosomal abnormality is usualy present in all cell -2 or more chromosomal compelments is found in an individual.this is called mosaiscism which can be either nummerical or structural. -about 2% down syndrome patients are mosaic -the phenotype may be milder than trisomy21 but there isvariation of phenotypes differed from 21 chromosome trisomy in embryo durin early development. -the mildly affected patients are less diagonised by karyotype
  • 26. partial trisomy 21: -down syndrome can be diagonised in a patient of long arm of chromosome 21 which are present in triplicate or 3 copies -it is not identified by cytogenetically and can be rarely identified -by knowing what regions are triplicated in an chromosome 21 which are responsible for specific phenotype -by knowing what regions have been triplicated before appearing phenotype -the chromosome 21 contains only few genes -the most succesfull detection in down syndrome is the heart defect region on chromosome 21 in 40% of down syndrome patients
  • 27. CURRENT INVESTIGATION -sorting out specific genes in chromosome 21 which are responsible for down syndrome phenotype is a focus of current investigation which uses mouse as a model. -mice engineered contain extra chromosome 21 or even copy of an entire human chromosome 21 which can show phenotypical abnormalities such as in behaviour,brain function and cardiac dvelopment -nowadays mice is the potential promise for genetic diseases research