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Ataxia telangiectasia

Ataxia-telangiectasia (AT) (Boder-Sedgwick syndrome or Louis-Bar syndrome) is a primary immunodeficiency disorder that occurs in an estimated incidence of 1 in 40,000 to 1 in 300,000 births (Lederman, 2000). Telangiectasias are small, red 'spider' veins. These typically appear on the surface of the ears and cheeks or in the corners of the eyes in patients with AT. The 'ataxia' part of the name refers to the difficulty patients with AT have walking. At early age, the child's walking becomes wobbley, at teens handicapped-bound and at the early 20s, it becomes fatal. more...

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AT is characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, progressive cerebellar dysfunction, and recurrent sinopulmonary infections secondary to progressive immunological and neurological dysfunction (Boder, 1958). AT patients are significantly predisposed to cancer, particularly lymphomas and leukemia. Other manifestations of the disease include sensitivity to ionizing radiation (Taylor et al., 1975), premature aging, and hypogonadism (Regueiro et al., 2000). AT has been a major interest of scientists since the 1960's because it may yield an insight into numerous other major health problems, such as cancer, neurological disease, immunodeficiency, and aging (Lederman, 2000).

The responsible gene in AT, ataxia-telangiectasia mutated (ATM), was discovered in 1995 by Savitsky et al., a team led by Yosef Shiloh of Tel Aviv University in Israel. Researchers linked the hyper-sensitivity of AT patients to ionizing radiation (IR) and predisposition to cancer to "chromosomal instability, abnormalities in genetic recombination, and defective signaling to programmed cell death and several cell cycle checkpoints activated by DNA damage"; (Canman, 1998). Earlier observations predicted that the gene altered in AT played a role in DNA damage recognition. These predictions were confirmed when a single gene on chromosome 11 (11q 22-23) was discovered (Savitsky et al., 1995, Gatti et al., 1982). Since its discovery, the protein product of the ATM gene has been shown to be a part of eukaryotic cell cycle control, DNA repair, and DNA recombination (Lavin, 2004).

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Germline Mutations Of The Ataxia-Telangiectasia Gene As A Risk Factor For Radiation-Associated Breast Cancer - ATM
From Life Sciences & Biotechnology Update, 11/1/00

This (Sloan-Kettering Institute for Cancer Research) work involves Ataxia-Telangiectasia (AT), which is an autosomal recessive disorder characterized by neurologic and other abnormalities as well as an approximately 100-fold increase in cancer incidence. A single gene, ATM, appears to be mutated in the majority of AT families. ATM functions as a central component of the cellular response to DNA damage. It has been postulated that heterozygotes for ATM mutations have an increased susceptibility to radiation-induced breast cancer.

To test this hypothesis, a study is performed to test the frequency of ATM mutations in woman with breast cancer after therapeutic radiation therapy for Hodgkin's disease. Cases are compared to matched controls treated for Hodgkin's disease with no breast cancer. No truncating mutations of ATM are observed in either group, and no difference is found in the rate of missense mutations (37% controls vs 21% cases). Some missense mutations are observed at polymorphic (>1%) frequencies. Further studies analyzing the frequencies of these mutations in the general population, as well as functional studies, will be necessary to resolve their potential role as susceptibility alleles for lymphoid cancers.

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