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Epigenetic Causes of Overgrowth Syndromes

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ENDOCRINE SOC
DOI: 10.1210/clinem/dgad420

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tall stature; epigenetic modifications; histone; methylation; WNT signaling

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Human overgrowth disorders are characterized by excessive prenatal and/or postnatal growth of various tissues. Multiple monogenic overgrowth syndromes result from variants in epigenetic regulators. In this review, the genetics of these overgrowth disorders are discussed, along with possible common underlying mechanisms by which epigenetic pathways regulate human body size.
Human overgrowth disorders are characterized by excessive prenatal and/or postnatal growth of various tissues. These disorders often present with tall stature, macrocephaly, and/or abdominal organomegaly and are sometimes associated with additional phenotypic abnormalities such as intellectual disability and increased cancer risk. As the genetic etiology of these disorders have been elucidated, a surprising pattern has emerged. Multiple monogenic overgrowth syndromes result from variants in epigenetic regulators: variants in histone methyltransferases NSD1 and EZH2 cause Sotos syndrome and Weaver syndrome, respectively, variants in DNA methyltransferase DNMT3A cause Tatton-Brown-Rahman syndrome, and variants in chromatin remodeler CHD8 cause an autism spectrum disorder with overgrowth. In addition, very recently, a variant in histone reader protein SPIN4 was identified in a new X-linked overgrowth disorder. In this review, we discuss the genetics of these overgrowth disorders and explore possible common underlying mechanisms by which epigenetic pathways regulate human body size.

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