Subscribe to RSS
DOI: 10.1055/s-0042-1759531
Meckel Syndrome: A Clinical and Molecular Overview
Authors

Abstract
Meckel syndrome (MKS) is a lethal, autosomal recessive, congenital syndrome caused by mutations in genes that encode proteins structurally or functionally related to the primary cilium. MKS is a malformative syndrome, most commonly characterized by occipital meningoencephalocele, polycystic kidney disease, liver fibrosis, and post- and (occasionally) preaxial polydactyly. To date, more than 10 genes are known to constitute the molecular background of MKS, displaying genetic heterogeneity. Individuals with MKS may resemble some phenotypic features of Joubert syndrome and related disorders, thus making diagnostic setting quite challenging. Here, we systematically reviewed the main clinical and genetic characteristics of MKS and its role among ciliopathies.
Author Contributions
Conceptualization: G. V., M. S.
Investigation: G. F., V. S.
Resources: F. C.
Data curation: A. M., I. C.
Writing - original draft preparation: P. V. C.
Writing - review and editing: M. T., G. D. R., G. I.
Supervision: F. C.
All authors have read and agreed to the published version of the manuscript.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.
Publication History
Received: 22 August 2022
Accepted: 27 October 2022
Article published online:
05 December 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1
Salonen R.
The Meckel syndrome: clinicopathological findings in 67 patients. Am J Med Genet 1984;
18 (04) 671-689
Reference Ris Wihthout Link
- 2
Hartill V,
Szymanska K,
Sharif SM,
Wheway G,
Johnson CA.
Meckel-Gruber syndrome: an update on diagnosis, clinical management, and research
advances. Front Pediatr 2017; 5: 244
Reference Ris Wihthout Link
- 3
Valente EM,
Logan CV,
Mougou-Zerelli S.
et al.
Mutations in TMEM216 perturb ciliogenesis and cause Joubert, Meckel and related syndromes.
Nat Genet 2010; 42 (07) 619-625
Reference Ris Wihthout Link
- 4
Consugar MB,
Kubly VJ,
Lager DJ.
et al.
Molecular diagnostics of Meckel-Gruber syndrome highlights phenotypic differences
between MKS1 and MKS3. Hum Genet 2007; 121 (05) 591-599
Reference Ris Wihthout Link
- 5
Delous M,
Baala L,
Salomon R.
et al.
The ciliary gene RPGRIP1L is mutated in cerebello-oculo-renal syndrome (Joubert syndrome
type B) and Meckel syndrome. Nat Genet 2007; 39 (07) 875-881
Reference Ris Wihthout Link
- 6
Iannicelli M,
Brancati F,
Mougou-Zerelli S.
et al;
International JSRD Study Group.
Novel TMEM67 mutations and genotype-phenotype correlates in meckelin-related ciliopathies.
Hum Mutat 2010; 31 (05) E1319-E1331
Reference Ris Wihthout Link
- 7
Dawe HR,
Smith UM,
Cullinane AR.
et al.
The Meckel-Gruber syndrome proteins MKS1 and meckelin interact and are required for
primary cilium formation. Hum Mol Genet 2007; 16 (02) 173-186
Reference Ris Wihthout Link
- 8
Kyttälä M,
Tallila J,
Salonen R.
et al.
MKS1, encoding a component of the flagellar apparatus basal body proteome, is mutated
in Meckel syndrome. Nat Genet 2006; 38 (02) 155-157
Reference Ris Wihthout Link
- 9
Williams CL,
Li C,
Kida K.
et al.
MKS and NPHP modules cooperate to establish basal body/transition zone membrane associations
and ciliary gate function during ciliogenesis. J Cell Biol 2011; 192 (06) 1023-1041
Reference Ris Wihthout Link
- 10
Shi X,
Garcia III G,
Van De Weghe JC.
et al.
Super-resolution microscopy reveals that disruption of ciliary transition-zone architecture
causes Joubert syndrome. Nat Cell Biol 2017; 19 (10) 1178-1188
Reference Ris Wihthout Link
- 11
Hsiao YC,
Tong ZJ,
Westfall JE,
Ault JG,
Page-McCaw PS,
Ferland RJ.
Ahi1, whose human ortholog is mutated in Joubert syndrome, is required for Rab8a localization,
ciliogenesis and vesicle trafficking. Hum Mol Genet 2009; 18 (20) 3926-3941
Reference Ris Wihthout Link
- 12
Abdelhamed ZA,
Wheway G,
Szymanska K.
et al.
Variable expressivity of ciliopathy neurological phenotypes that encompass Meckel-Gruber
syndrome and Joubert syndrome is caused by complex de-regulated ciliogenesis, Shh
and Wnt signalling defects. Hum Mol Genet 2013; 22 (07) 1358-1372
Reference Ris Wihthout Link
- 13
Aydin Ozturk P,
Asena M,
Katar S,
Ozturk U.
Meckel-Gruber syndrome: a case who lived for 5 months. Pediatr Neurosurg 2019; 54
(04) 277-280
Reference Ris Wihthout Link
- 14
Sergi C,
Adam S,
Kahl P,
Otto HF.
Study of the malformation of ductal plate of the liver in Meckel syndrome and review
of other syndromes presenting with this anomaly. Pediatr Dev Pathol 2000; 3 (06) 568-583
Reference Ris Wihthout Link
- 15
Chen CP.
Meckel syndrome: genetics, perinatal findings, and differential diagnosis. Taiwan
J Obstet Gynecol 2007; 46 (01) 9-14
Reference Ris Wihthout Link
- 16
Ferrante MI,
Zullo A,
Barra A.
et al.
Oral-facial-digital type I protein is required for primary cilia formation and left-right
axis specification. Nat Genet 2006; 38 (01) 112-117
Reference Ris Wihthout Link
- 17
Barker AR,
Thomas R,
Dawe HR.
Meckel-Gruber syndrome and the role of primary cilia in kidney, skeleton, and central
nervous system development. Organogenesis 2014; 10 (01) 96-107
Reference Ris Wihthout Link
- 18
Paetau A,
Salonen R,
Haltia M.
Brain pathology in the Meckel syndrome: a study of 59 cases. Clin Neuropathol 1985;
4 (02) 56-62
Reference Ris Wihthout Link
- 19
Pavlidou E,
Salpietro V,
Phadke R.
et al.
Pontocerebellar hypoplasia type 2D and optic nerve atrophy further expand the spectrum
associated with selenoprotein biosynthesis deficiency. Eur J Paediatr Neurol 2016;
20 (03) 483-488
Reference Ris Wihthout Link
- 20
Accogli A,
Iacomino M,
Pinto F.
et al.
Novel AMPD2 mutation in pontocerebellar hypoplasia, dysmorphisms, and teeth abnormalities. Neurol
Genet 2017; 3 (05) e179
Reference Ris Wihthout Link
- 21
Pinchefsky EF,
Accogli A,
Shevell MI,
Saint-Martin C,
Srour M.
Developmental outcomes in children with congenital cerebellar malformations. Dev Med
Child Neurol 2019; 61 (03) 350-358
Reference Ris Wihthout Link
- 22
Pustorino G,
Spano M,
Sgro DL.
et al.
Status gelasticus associated with levetiracetam as add-on treatment. Epileptic Disord
2007; 9 (02) 186-189
Reference Ris Wihthout Link
- 23
Sepulveda W,
Sebire NJ,
Souka A,
Snijders RJM,
Nicolaides KH.
Diagnosis of the Meckel-Gruber syndrome at eleven to fourteen weeks' gestation. Am
J Obstet Gynecol 1997; 176 (02) 316-319
Reference Ris Wihthout Link
- 24
Nizard J,
Bernard JP,
Ville Y.
Fetal cystic malformations of the posterior fossa in the first trimester of pregnancy.
Fetal Diagn Ther 2005; 20 (02) 146-151
Reference Ris Wihthout Link
- 25
Khurana S,
Saini V,
Wadhwa V,
Kaur H.
Meckel-Gruber syndrome: ultrasonographic and fetal autopsy correlation. J Ultrasound
2017; 20 (02) 167-170
Reference Ris Wihthout Link
- 26
Manara R,
D'Agata L,
Rocco MC.
et al;
Menkes Working Group in the Italian Neuroimaging Network for Rare Diseases.
Neuroimaging changes in Menkes disease, part 1. AJNR Am J Neuroradiol 2017; 38 (10)
1850-1857
Reference Ris Wihthout Link
- 27
Chao A,
Wong AM,
Hsueh C,
Chang YL,
Wang TH.
Integration of imaging and pathological studies in Meckel-Gruber syndrome. Prenat
Diagn 2005; 25 (03) 267-268
Reference Ris Wihthout Link
- 28
Quintero RA,
Abuhamad A,
Hobbins JC,
Mahoney MJ.
Transabdominal thin-gauge embryofetoscopy: a technique for early prenatal diagnosis
and its use in the diagnosis of a case of Meckel-Gruber syndrome. Am J Obstet Gynecol
1993; 168 (05) 1552-1557
Reference Ris Wihthout Link
- 29
Tassano E,
Accogli A,
Pavanello M.
et al.
Interstitial 9p24.3 deletion involving only DOCK8 and KANK1 genes in two patients
with non-overlapping phenotypic traits. Eur J Med Genet 2016; 59 (01) 20-25
Reference Ris Wihthout Link
- 30
Friedman J,
Smith DE,
Issa MY.
et al.
Biallelic mutations in valyl-tRNA synthetase gene VARS are associated with a progressive
neurodevelopmental epileptic encephalopathy. Nat Commun 2019; 10 (01) 707
Reference Ris Wihthout Link
- 31
Tortora D,
Severino M,
Accogli A.
et al.
Moyamoya vasculopathy in PHACE syndrome: six new cases and review of the literature.
World Neurosurg 2017; 108: 291-302
Reference Ris Wihthout Link
- 32
Sartori S,
Polli R,
Bettella E.
et al.
Pathogenic role of the X-linked cyclin-dependent kinase-like 5 and aristaless-related
homeobox genes in epileptic encephalopathy of unknown etiology with onset in the first
year of life. J Child Neurol 2011; 26 (06) 683-691
Reference Ris Wihthout Link
- 33
Ruggieri M,
Polizzi A,
Schepis C.
et al.
Cutis tricolor: a literature review and report of five new cases. Quant Imaging Med Surg 2016; 6
(05) 525-534
Reference Ris Wihthout Link
- 34
Salpietro V,
Lin W,
Delle Vedove A.
et al;
SYNAPS Study Group.
Homozygous mutations in VAMP1 cause a presynaptic congenital myasthenic syndrome.
Ann Neurol 2017; 81 (04) 597-603
Reference Ris Wihthout Link
- 35
Lambacher NJ,
Bruel AL,
van Dam TJ.
et al.
TMEM107 recruits ciliopathy proteins to subdomains of the ciliary transition zone
and causes Joubert syndrome. Nat Cell Biol 2016; 18 (01) 122-131
Reference Ris Wihthout Link
- 36
Edvardson S,
Shaag A,
Zenvirt S.
et al.
Joubert syndrome 2 (JBTS2) in Ashkenazi Jews is associated with a TMEM216 mutation.
Am J Hum Genet 2010; 86 (01) 93-97
Reference Ris Wihthout Link
- 37
Karmous-Benailly H,
Martinovic J,
Gubler MC.
et al.
Antenatal presentation of Bardet-Biedl syndrome may mimic Meckel syndrome. Am J Hum
Genet 2005; 76 (03) 493-504
Reference Ris Wihthout Link
- 38
Sang L,
Miller JJ,
Corbit KC.
et al.
Mapping the NPHP-JBTS-MKS protein network reveals ciliopathy disease genes and pathways.
Cell 2011; 145 (04) 513-528
Reference Ris Wihthout Link
- 39
McCaffrey MJ.
Trisomy 13 and 18: Selecting the road previously not taken. Am J Med Genet C Semin
Med Genet 2016; 172 (03) 251-256
Reference Ris Wihthout Link
- 40
Nowaczyk MJ,
Irons MB.
Smith-Lemli-Opitz syndrome: phenotype, natural history, and epidemiology. Am J Med
Genet C Semin Med Genet 2012; 160C (04) 250-262
Reference Ris Wihthout Link
- 41
Di Rosa G,
Deodato F,
Loupatty FJ.
et al.
Hypertrophic cardiomyopathy, cataract, developmental delay, lactic acidosis: a novel
subtype of 3-methylglutaconic aciduria. J Inherit Metab Dis 2006; 29 (04) 546-550
Reference Ris Wihthout Link
- 42
Mee L,
Honkala H,
Kopra O.
et al.
Hydrolethalus syndrome is caused by a missense mutation in a novel gene HYLS1. Hum
Mol Genet 2005; 14 (11) 1475-1488
Reference Ris Wihthout Link
- 43
Kaur A,
Dhir SK,
Goyal G,
Mittal N,
Goyal RK.
Senior Loken syndrome. J Clin Diagn Res 2016; 10 (11) SD03-SD04
Reference Ris Wihthout Link
- 44
Guilmatre A,
Legallic S,
Steel G.
et al.
Type I hyperprolinemia: genotype/phenotype correlations. Hum Mutat 2010; 31 (08) 961-965
Reference Ris Wihthout Link
- 45
Miraglia Del Giudice M,
Maiello N,
Decimo F.
et al.
Airways allergic inflammation and L. reuterii treatment in asthmatic children. J Biol
Regul Homeost Agents 2012; 26 (1, suppl): S35-S40
Reference Ris Wihthout Link
- 46
Zollo M,
Ahmed M,
Ferrucci V.
et al.
PRUNE is crucial for normal brain development and mutated in microcephaly with neurodevelopmental
impairment. Brain 2017; 140 (04) 940-952
Reference Ris Wihthout Link
- 47
Salpietro V,
Chimenz R,
Arrigo T,
Ruggieri M.
Pediatric idiopathic intracranial hypertension and extreme childhood obesity: a role
for weight gain. J Pediatr 2013; 162 (05) 1084
Reference Ris Wihthout Link
- 48
Lionetti E,
Francavilla R,
Castellazzi AM.
et al.
Probiotics and Helicobacter pylori infection in children. J Biol Regul Homeost Agents
2012; 26 (1, suppl): S69-S76
Reference Ris Wihthout Link
- 49
Niccolini F,
Mencacci NE,
Yousaf T.
et al.
PDE10A and ADCY5 mutations linked to molecular and microstructural basal ganglia pathology.
Mov Disord 2018; 33 (12) 1961-1965
Reference Ris Wihthout Link
- 50
Salpietro V,
Zollo M,
Vandrovcova J.
et al;
SYNAPS Study Group.
The phenotypic and molecular spectrum of PEHO syndrome and PEHO-like disorders. Brain
2017; 140 (08) e49
Reference Ris Wihthout Link
- 51
Granata F,
Morabito R,
Mormina E.
et al.
3T double inversion recovery magnetic resonance imaging: diagnostic advantages in
the evaluation of cortical development anomalies. Eur J Radiol 2016; 85 (05) 906-914
Reference Ris Wihthout Link
- 52
Salpietro V,
Ruggieri M.
Pseudotumor cerebri pathophysiology: the likely role of aldosterone. Headache 2014;
54 (07) 1229
Reference Ris Wihthout Link
- 53
Pavone P,
Briuglia S,
Falsaperla R.
et al.
Wide spectrum of congenital anomalies including choanal atresia, malformed extremities,
and brain and spinal malformations in a girl with a de novo 5.6-Mb deletion of 13q12.11-13q12.13.
Am J Med Genet A 2014; 164A (07) 1734-1743
Reference Ris Wihthout Link
- 54
Salpietro V,
Efthymiou S,
Manole A.
et al.
A loss-of-function homozygous mutation in DDX59 implicates a conserved DEAD-box RNA
helicase in nervous system development and function. Hum Mutat 2018; 39 (02) 187-192
Reference Ris Wihthout Link
- 55
Ghosh SG,
Becker K,
Huang H.
et al.
Biallelic mutations in ADPRHL2, encoding ADP-ribosylhydrolase 3, lead to a degenerative
pediatric stress-induced epileptic ataxia syndrome. [published correction appears
in Am J Hum Genet. 2018;103(5):826] [published correction appears in Am J Hum Genet.
2021;108(12):2385] Am J Hum Genet 2018; 103 (03) 431-439
Reference Ris Wihthout Link
- 56
Efthymiou S,
Salpietro V,
Malintan N.
et al;
SYNAPS Study Group.
Biallelic mutations in neurofascin cause neurodevelopmental impairment and peripheral
demyelination. Brain 2019; 142 (10) 2948-2964
Reference Ris Wihthout Link
- 57
Pizzino G,
Irrera N,
Galfo F.
et al.
Effects of the antagomiRs 15b and 200b on the altered healing pattern of diabetic
mice. Br J Pharmacol 2018; 175 (04) 644-655
Reference Ris Wihthout Link