Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case

Abstract Background In this study we aimed to describe the morphological and pathogenetic differences between tracheal agenesis and tracheal atresia, which are not clearly distinguished from each other in the literature, and to contribute thereby to the understanding and management of these conditio...

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Main Authors: Mateja Pfeifer, Helga Rehder, Maria Gerykova Bujalkova, Christine Bartsch, Barbara Fritz, Cordula Knopp, Björn Beckers, Frank Dohle, Matthias Meyer-Wittkopf, Roland Axt-Fliedner, Alexander V. Beribisky, Manuel Hofer, Franco Laccone, Katharina Schoner
Format: Article
Language:English
Published: BMC 2024-03-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-024-03106-z
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author Mateja Pfeifer
Helga Rehder
Maria Gerykova Bujalkova
Christine Bartsch
Barbara Fritz
Cordula Knopp
Björn Beckers
Frank Dohle
Matthias Meyer-Wittkopf
Roland Axt-Fliedner
Alexander V. Beribisky
Manuel Hofer
Franco Laccone
Katharina Schoner
author_facet Mateja Pfeifer
Helga Rehder
Maria Gerykova Bujalkova
Christine Bartsch
Barbara Fritz
Cordula Knopp
Björn Beckers
Frank Dohle
Matthias Meyer-Wittkopf
Roland Axt-Fliedner
Alexander V. Beribisky
Manuel Hofer
Franco Laccone
Katharina Schoner
author_sort Mateja Pfeifer
collection DOAJ
description Abstract Background In this study we aimed to describe the morphological and pathogenetic differences between tracheal agenesis and tracheal atresia, which are not clearly distinguished from each other in the literature, and to contribute thereby to the understanding and management of these conditions. Both tracheal agenesis and tracheal atresia represent rare disorders of still unknown aetiology that cannot be detected by prenatal ultrasound. If the affected foetuses survive until birth these conditions result in respiratory failure and in futile attempts to rescue the infant’s life. Results Autopsies and genetic analyses, including singleton or trio exome sequencing, were performed on five neonates/foetuses with tracheal agenesis and three foetuses with tracheal atresia. Tracheal agenesis was characterized by absence of the sublaryngeal trachea and presence of a bronchooesophageal fistula and by pulmonary isomerism and occurred as an isolated malformation complex or as part of a VACTERL association. Special findings were an additional so-called ‘pig bronchus’ and a first case of tracheal agenesis with sirenomelia. Tracheal atresia presenting with partial obliteration of its lumen and persistence of a fibromuscular streak resulted in CHAOS. This condition was associated with normal lung lobulation and single, non-VACTERL type malformations. Trio ES revealed a novel variant of MAPK11 in one tracheal agenesis case. Its involvement in tracheooesophageal malformation is herein discussed, but remains hypothetical. Conclusion Tracheal agenesis and tracheal atresia represent different disease entities in terms of morphology, pathogenesis and accompanying anomalies due to a primary developmental and secondary disruptive possibly vascular disturbance, respectively.
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spelling doaj.art-a27bc7de37c240fbb01c3dfa427cba1f2024-03-17T12:38:06ZengBMCOrphanet Journal of Rare Diseases1750-11722024-03-0119111110.1186/s13023-024-03106-zTracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one caseMateja Pfeifer0Helga Rehder1Maria Gerykova Bujalkova2Christine Bartsch3Barbara Fritz4Cordula Knopp5Björn Beckers6Frank Dohle7Matthias Meyer-Wittkopf8Roland Axt-Fliedner9Alexander V. Beribisky10Manuel Hofer11Franco Laccone12Katharina Schoner13Institute of Medical Genetics, Medical University of ViennaInstitute of Medical Genetics, Medical University of ViennaInstitute of Medical Genetics, Medical University of ViennaInstitute of Forensic Medicine, University of ZürichInstitute of Human Genetics, Philipps-University of MarburgInstitute of Human Genetics, RWTHChildren’s Hospital St. LouiseDepartment of Pediatrics, Children’s Center Bethel, University BielefeldDepartment of Gynecology and Obstetrics, University Clinic OldenburgDivision of Prenatal Medicine and Fetal Therapy, University Hospital GiessenInstitute of Medical Genetics, Medical University of ViennaInstitute of Medical Genetics, Medical University of ViennaInstitute of Medical Genetics, Medical University of ViennaInstitute of Pathology, Fetal Pathology, Philipps-University of MarburgAbstract Background In this study we aimed to describe the morphological and pathogenetic differences between tracheal agenesis and tracheal atresia, which are not clearly distinguished from each other in the literature, and to contribute thereby to the understanding and management of these conditions. Both tracheal agenesis and tracheal atresia represent rare disorders of still unknown aetiology that cannot be detected by prenatal ultrasound. If the affected foetuses survive until birth these conditions result in respiratory failure and in futile attempts to rescue the infant’s life. Results Autopsies and genetic analyses, including singleton or trio exome sequencing, were performed on five neonates/foetuses with tracheal agenesis and three foetuses with tracheal atresia. Tracheal agenesis was characterized by absence of the sublaryngeal trachea and presence of a bronchooesophageal fistula and by pulmonary isomerism and occurred as an isolated malformation complex or as part of a VACTERL association. Special findings were an additional so-called ‘pig bronchus’ and a first case of tracheal agenesis with sirenomelia. Tracheal atresia presenting with partial obliteration of its lumen and persistence of a fibromuscular streak resulted in CHAOS. This condition was associated with normal lung lobulation and single, non-VACTERL type malformations. Trio ES revealed a novel variant of MAPK11 in one tracheal agenesis case. Its involvement in tracheooesophageal malformation is herein discussed, but remains hypothetical. Conclusion Tracheal agenesis and tracheal atresia represent different disease entities in terms of morphology, pathogenesis and accompanying anomalies due to a primary developmental and secondary disruptive possibly vascular disturbance, respectively.https://doi.org/10.1186/s13023-024-03106-zTracheal agenesisTracheal atresiaCongenital high airway obstruction sequence (CHAOS)VACTERL associationSirenomeliaMAPK11 variant
spellingShingle Mateja Pfeifer
Helga Rehder
Maria Gerykova Bujalkova
Christine Bartsch
Barbara Fritz
Cordula Knopp
Björn Beckers
Frank Dohle
Matthias Meyer-Wittkopf
Roland Axt-Fliedner
Alexander V. Beribisky
Manuel Hofer
Franco Laccone
Katharina Schoner
Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
Orphanet Journal of Rare Diseases
Tracheal agenesis
Tracheal atresia
Congenital high airway obstruction sequence (CHAOS)
VACTERL association
Sirenomelia
MAPK11 variant
title Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
title_full Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
title_fullStr Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
title_full_unstemmed Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
title_short Tracheal agenesis versus tracheal atresia: anatomical conditions, pathomechanisms and causes with a possible link to a novel MAPK11 variant in one case
title_sort tracheal agenesis versus tracheal atresia anatomical conditions pathomechanisms and causes with a possible link to a novel mapk11 variant in one case
topic Tracheal agenesis
Tracheal atresia
Congenital high airway obstruction sequence (CHAOS)
VACTERL association
Sirenomelia
MAPK11 variant
url https://doi.org/10.1186/s13023-024-03106-z
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