Behavioral profile of adults with Prader-Willi syndrome : correlations with individual and environmental variables

Background: Maladaptive behavior has been reported as a phenotypical feature in Prader–Willi syndrome (PWS). It severely limits social adaptation and the quality of life of children and adults with the syndrome. Different factors have been linked with the intensity and form of these behavioral disturbances but there is no consensus about the cause. Consequently, there is still controversy regarding management strategies and there is a need for new data. Methods: The behavior of 100 adults with PWS attending a dedicated center was assessed using the Developmental Behavior Checklist for Adults (DBC-A) and the PWS-specific Hyperphagia Questionnaire. The DBC-A was completed separately by trained caregivers at the center and relatives or caregivers in a natural setting. Genotype, gender, age, degree of obesity and cognitive impairment were analyzed as variables with a hypothetical influence on behavioral features. Results: Patients showed a relatively high rate of behavioral disturbances other than hyperphagia. Disruptive and social relating were the highest scoring DBC-A subscales whereas anxiety/antisocial and self-absorbed were the lowest. When hospital caregiver and natural caregiver scores were compared, scores for the latter were higher for all subscales except for disruptive and anxiety/antisocial. These effects of institutional management were underlined. In the DBC-A, 22 items have descriptive indications of PWS behavior and were used for further comparisons and correlation analysis. In contrast to previous reports, rates of disturbed behavior were lower in patients with a deletion genotype. However, the behavioral profile was similar for both genotypes. No differences were found in any measurement when comparing type I and type II deletions. The other analyzed variables showed little relevance. Conclusions: Significant rates of behavioral disorders were highlighted and their typology described in a large cohort of adults with PWS. The deletion genotype was related to a lower severity of symptoms. Some major behavioral problems, such as hyperphagia, may be well controlled if living circumstances are adapted to the specific requirements of individuals with PWS.

miRNA polymorphisms are associated with risk of developing chronic lymphocytic leukemia

Chronic Lymphocytic Leukemia (CLL) is the most frequent leukemia of adults in Western countries and shows a ~8.5-fold increased relative risk in first-degree relatives. Up to date several studies have identified low-penetrance susceptibility alleles in CLL. Nevertheless, these studies scarcely study regions that do not encode proteins such as microRNAs (miRNAs). Abnormalities in miRNAs, as altered expression patterns and mutations, have been described in CLL, suggesting their implication in the development of the disease. Polymorphisms in these miRNAs may deregulate miRNAs expression levels and affect to the miRNA function. However, despite accumulating evidence that inherited genetic variation in miRNA genes can contribute to the predisposition for CLL, the role of these in the risk of CLL has not been extensively studied. Therefore, the aim of this study was to find new genetic markers of risk to CLL. To that end, we made a systematic search for SNPs in miRNAs and miRNAs deregulated in CLL and genotyped 213 polymorphisms in 401 samples of Spanish individuals. The literature search resulted in more than 100 miRNAs deregulated in CLL and 43 polymorphisms studied in the disease. Out of 213 genotyped SNPs, 13 showed to be significantly associated with CLL risk. rs2682818 in pre-mature miR618 was the most significant result, with 0.49 fold decreased risk to CLL. Interestingly, a previous study associated this SNP with an increased risk of developing follicular lymphoma. Secondly, rs10173558 SNP in mir- 1302-4 showed the highest risk association, with a 5.24 fold increased risk, but there were no previous works studying it. Finally, rs61992671 in miR412, previously associated with CLL risk, showed also association in our sample. In conclusion, we find 13 alleles which could contribute to the risk of CLL. However, new large-scale studies including functional analyses will be needed to validate our findings.