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1
Inheritance
2
Pathophys.
16
Phenotypes
22
Pathograph
1
Genes
10
Treatments
2
Subtypes
5
References
1
Deep Research
👪

Inheritance

1
Autosomal dominant inheritance HP:0000006
Reported cases are caused by heterozygous activating PTDSS1 variants that typically arise de novo.
Autosomal dominant inheritance
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"LMS is caused by activating de novo heterozygous mutations in PTDSS1, encoding phosphatidylserine synthase 1 (PSS1)."
This full-text disease description supports dominant disease causation by heterozygous activating PTDSS1 variants.

Subtypes

2
Classic PTDSS1-related LMHD
Classic PTDSS1-related Lenz-Majewski hyperostotic dysplasia presents in infancy with cutis laxa, prominent cutaneous veins, craniofacial dysmorphism, digit anomalies, early-onset osteosclerosis, severe growth deficiency, and significant developmental delay.
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Individuals with classic PTDSS1-related LMHD typically presents in infancy with cutis laxa, prominent cutaneous veins, characteristic craniofacial features (disproportionately large head, broad forehead, delayed closure of the fontanelles, hypertelorism, large floppy ears, nasal obstruction /..."
GeneReviews defines the classic PTDSS1-related LMHD presentation.
Attenuated PTDSS1-related LMHD
Attenuated PTDSS1-related Lenz-Majewski hyperostotic dysplasia has milder cutaneous involvement, slower hyperostosis progression, normal stature, and preserved or mildly affected development.
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Attenuated PTDSS1-related LMHD is characterized by minimal or mild cutis laxa, slower progression of hyperostosis, preserved or mildly affected development, and normal stature."
GeneReviews defines the attenuated PTDSS1-related LMHD presentation.

Pathophysiology

2
PTDSS1 gain-of-function phosphatidylserine biosynthesis dysregulation
Activating PTDSS1 variants increase phosphatidylserine synthase activity and impair feedback regulation by phosphatidylserine, establishing the primary biochemical lesion in Lenz-Majewski syndrome. Excess phosphatidylserine may promote pathologic mineralization by binding calcium in matrix vesicles and nucleating hydroxyapatite crystal formation.
PTDSS1 link
phosphatidylserine biosynthetic process link
Show evidence (2 references)
PMID:29341480 SUPPORT Human Clinical
"This disorder called Lenz-Majewski syndrome (LMS) is associated with gain of function mutations in PTDSS1, encoding an enzyme involved in phospholipid biosynthesis."
This directly supports PTDSS1 gain of function with disturbed phospholipid biosynthesis as the initiating molecular mechanism.
PMID:25363158 SUPPORT Human Clinical
"In vitro, these PTDSS1 mutations were gain-of-function and increased PTDS production. Notably, PTDS binds calcium within matrix vesicles to engender hydroxyapatite crystal formation, and may enhance mesenchymal stem cell differentiation leading to osteogenesis."
This supports the gain-of-function phosphatidylserine-to-bone-mineralization mechanism that deepens the primary PTDSS1 pathophysiology node.
Progressive hyperostotic skeletal dysplasia
The downstream skeletal disease is marked by excessive bone growth, generalized hyperostosis, and progressive deformity that drives severe short stature and brachydactyly.
ossification link
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes."
This directly supports progressive hyperostotic skeletal dysplasia as the pathological event linking PTDSS1 dysfunction to brachydactyly and severe short stature.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Lenz-Majewski hyperostotic dwarfism Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

16
Ear 1
Sensorineural hearing impairment Sensorineural hearing impairment (HP:0000407)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"His progressive cranial bone deformity was associated with profound deafness."
This directly supports severe hearing impairment as a clinical consequence of the progressive cranial hyperostotic disease.
Eye 1
Hypertelorism Hypertelorism (HP:0000316)
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"characteristic craniofacial features (disproportionately large head, broad forehead, delayed closure of the fontanelles, hypertelorism, large floppy ears, nasal obstruction / choanal atresia, macrostomia, thin vermilion of the lips, dental enamel hypoplasia, and prognathism or retrognathia)"
GeneReviews lists hypertelorism among characteristic craniofacial features.
Head and Neck 5
Cranial hyperostosis Cranial hyperostosis (HP:0004437)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"Clinical features of LMS include craniotubular hyperostosis, loose skin, progeroid appearance, marked growth failure, and moderate to severe intellectual disability."
This directly supports craniotubular hyperostosis as a cardinal skeletal phenotype; the selected HPO term captures the cranial component of the generalized hyperostotic process.
Abnormal facial shape Abnormal facial shape (HP:0001999)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes."
This directly supports facial dysmorphism as an early and distinctive phenotype of Lenz-Majewski hyperostotic dwarfism.
Wide mouth Wide mouth (HP:0000154)
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"characteristic craniofacial features (disproportionately large head, broad forehead, delayed closure of the fontanelles, hypertelorism, large floppy ears, nasal obstruction / choanal atresia, macrostomia, thin vermilion of the lips, dental enamel hypoplasia, and prognathism or retrognathia)"
GeneReviews lists macrostomia among characteristic craniofacial features.
Enamel hypoplasia Enamel hypoplasia (HP:0006297)
Show evidence (1 reference)
PMID:40993826 SUPPORT Human Clinical
"Intraoral and radiographic examinations demonstrated enamel hypoplasia, taurodontism, delayed eruption of permanent teeth, a horizontally positioned upper lateral incisor, and a large follicular cyst in the maxilla."
This directly supports enamel hypoplasia in the oral phenotype.
Taurodontia Taurodontia (HP:0000679)
Show evidence (1 reference)
PMID:40993826 SUPPORT Human Clinical
"Intraoral and radiographic examinations demonstrated enamel hypoplasia, taurodontism, delayed eruption of permanent teeth, a horizontally positioned upper lateral incisor, and a large follicular cyst in the maxilla."
This directly supports taurodontia in the oral phenotype.
Integument 2
Cutis laxa Cutis laxa (HP:0000973)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"We provide here molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability."
This case series directly identifies cutis laxa as a core disease phenotype.
Progeroid facial appearance Progeroid facial appearance (HP:0005328)
Show evidence (1 reference)
PMID:40993826 SUPPORT Human Clinical
"Clinical evaluation revealed moderate intellectual disability, cutis laxa, a progeroid facial appearance, and pronounced prognathism."
This case report documents progeroid facial appearance in molecularly confirmed LMS.
Limbs 2
Brachydactyly Brachydactyly (HP:0001156)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes."
This directly supports brachydactyly as an early and characteristic phenotype.
Syndactyly Syndactyly (HP:0001159)
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"brachydactyly and syndactyly of the digits, early-onset osteosclerosis (involving the skull, spine, diaphyses of the long bones, clavicles, and ribs), severe growth deficiency, and significant developmental delays."
GeneReviews lists syndactyly of the digits in classic PTDSS1-related LMHD.
Nervous System 4
Intellectual disability Intellectual disability (HP:0001249)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"We provide here molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability."
The disease-defining series directly includes intellectual disability in the core phenotype.
Hydrocephalus Hydrocephalus (HP:0000238)
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Additional features can include genitourinary anomalies in males, inguinal hernia, ophthalmologic manifestations, hearing loss, and hydrocephalus."
GeneReviews lists hydrocephalus as an additional feature.
Obstructive sleep apnea Obstructive sleep apnea (HP:0002870)
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"treatment of respiratory difficulty and obstructive sleep apnea per otolaryngologist and/or pulmonologist; careful airway evaluation prior to surgical procedures;"
GeneReviews management guidance documents obstructive sleep apnea as a clinically relevant manifestation.
Seizure Seizure (HP:0001250)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"Generalized seizures without fever started at 4 years and were responsive to antiepileptic drugs."
This directly supports seizure as an additional neurologic manifestation of Lenz-Majewski hyperostotic dwarfism.
Growth 1
Short stature Short stature (HP:0004322)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes."
Severe dwarfism in the disease-defining series supports short stature as a major growth phenotype.
🧬

Genetic Associations

1
PTDSS1 (Gain of function mutation)
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"LMS is caused by activating de novo heterozygous mutations in PTDSS1, encoding phosphatidylserine synthase 1 (PSS1)."
This directly supports activating PTDSS1 variants as the molecular basis of the disorder.
💊

Treatments

10
Supportive multidisciplinary care
Action: supportive care MAXO:0000950
Ongoing orthopedic and dental or maxillofacial follow-up is recommended to manage the progressive skeletal complications of the disorder.
Target Phenotypes: Cranial hyperostosis Abnormal facial shape
Show evidence (1 reference)
PMID:29341480 SUPPORT Human Clinical
"Consequently periodic consultations with the orthopedic surgeon and the dentist or the maxillofacial surgeon are recommended."
This directly supports supportive multidisciplinary management for the progressive skeletal and craniofacial complications of the disorder.
Mobility and developmental therapies
Action: physical therapy MAXO:0000011
Physical therapy, occupational therapy, mobility devices, developmental supports, and individualized education planning are used for skeletal, motor, and developmental manifestations.
Target Phenotypes: Short stature Intellectual disability
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Treatment of skeletal manifestations per orthopedist; consider physical therapy, occupational therapy, and assisted devices for mobility; decompression of cervical spine stenosis as needed; treatment of hydrocephalus as needed per neurosurgeon; treatment of respiratory difficulty and obstructive..."
GeneReviews supports mobility, developmental, and education-directed management.
Brain and spine MRI surveillance
Action: MRI of the brain MAXO:0000427
Brain and spine MRI is used as needed to monitor for hydrocephalus and craniovertebral or spine complications.
Target Phenotypes: Hydrocephalus
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Growth assessment and orthopedic evaluation annually or as determined by the orthopedist to monitor joint and skeletal manifestations; brain and spine MRI as needed; assess for manifestations of sleep apnea at each visit; polysomnography as needed; dental evaluation with frequency per dentist;..."
GeneReviews supports brain and spine MRI surveillance as needed.
Neurosurgical management of hydrocephalus or cervical stenosis
Action: surgical procedure on nervous system MAXO:0000946
Neurosurgical care is used for hydrocephalus or cervical spine stenosis when clinically indicated.
Target Phenotypes: Hydrocephalus
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Treatment of skeletal manifestations per orthopedist; consider physical therapy, occupational therapy, and assisted devices for mobility; decompression of cervical spine stenosis as needed; treatment of hydrocephalus as needed per neurosurgeon;"
GeneReviews supports neurosurgical treatment for hydrocephalus and cervical stenosis when needed.
Sleep apnea screening and polysomnography
Action: polysomnography MAXO:0000915
Respiratory and sleep-apnea surveillance includes visit-based screening and polysomnography when indicated.
Target Phenotypes: Obstructive sleep apnea
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Growth assessment and orthopedic evaluation annually or as determined by the orthopedist to monitor joint and skeletal manifestations; brain and spine MRI as needed; assess for manifestations of sleep apnea at each visit; polysomnography as needed; dental evaluation with frequency per dentist;..."
GeneReviews supports sleep-apnea assessment at each visit and polysomnography as needed.
Dental evaluation and enamel care
Action: clinical assessment MAXO:0000487
Dental surveillance and treatment address enamel hypoplasia, taurodontia, eruption delay, malocclusion, and related oral complications.
Target Phenotypes: Enamel hypoplasia Taurodontia
Show evidence (2 references)
PMID:41818602 SUPPORT Human Clinical
"treatment of dental enamel hypoplasia per dentist; standard treatments for genitourinary anomalies, delayed puberty, inguinal hernia, vision issues, and hearing loss;"
GeneReviews supports dentist-directed treatment of dental enamel hypoplasia.
PMID:40993826 SUPPORT Human Clinical
"It underscores the importance of early dental assessment and multidisciplinary care in managing LMS."
The dental case report supports early dental assessment and multidisciplinary oral care.
Ophthalmology surveillance
Action: eye examination MAXO:0001155
Ophthalmology evaluation monitors vision and other ophthalmologic manifestations.
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"dental evaluation with frequency per dentist; ophthalmology evaluation with frequency per ophthalmologist; audiology evaluation as needed; monitor developmental progress, educational needs, and family needs at each visit."
GeneReviews supports ophthalmology surveillance.
Audiology evaluation
Action: audiologist evaluation MAXO:0000734
Audiology evaluation is used as needed to assess and manage hearing loss.
Target Phenotypes: Sensorineural hearing impairment
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"dental evaluation with frequency per dentist; ophthalmology evaluation with frequency per ophthalmologist; audiology evaluation as needed; monitor developmental progress, educational needs, and family needs at each visit."
GeneReviews supports audiology evaluation as needed.
Craniovertebral junction precautions
Action: supportive care MAXO:0000950
Extreme neck extension or flexion should be avoided when craniovertebral junction stenosis is present, and cervical spine imaging should precede general anesthesia.
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"Activities/procedures that involve extreme neck extension and flexion in individuals with craniovertebral junction stenosis."
GeneReviews identifies extreme neck flexion and extension as circumstances to avoid.
Genetic counseling
Action: genetic counseling MAXO:0000079
Genetic counseling addresses autosomal dominant de novo inheritance, low-but-nonzero sib recurrence risk from possible gonadal mosaicism, and reproductive options.
Show evidence (1 reference)
PMID:41818602 SUPPORT Human Clinical
"PTDSS1-related LMHD is an autosomal dominant disorder. All probands reported to date with PTDSS1-related LMHD whose parents have undergone molecular genetic testing have had the disorder as the result of a de novo PTDSS1 pathogenic variant."
GeneReviews provides inheritance and recurrence-risk context for genetic counseling.
🔬

Biochemical Markers

1
Hyperphosphoserinuria (INCREASED)
Context: Urinary amino acid quantitation can show elevated phosphoserine, providing a biochemical readout of the PTDSS1/phosphatidylserine biosynthesis branch.
Pathograph Readouts
Readout Of PTDSS1 gain-of-function phosphatidylserine biosynthesis dysregulation Positive Diagnostic
Elevated urinary phosphoserine supports increased phosphatidylserine pathway flux in LMHD.
Show evidence (1 reference)
PMID:25363158 SUPPORT Human Clinical
"Urinary amino acid quantitation revealed a greater than sixfold elevation of phosphoserine."
This supports hyperphosphoserinuria as a biochemical finding in molecularly confirmed LMHD.
{ }

Source YAML

click to show
name: Lenz-Majewski hyperostotic dwarfism
creation_date: "2026-04-15T17:35:00Z"
updated_date: "2026-04-15T23:05:00Z"
description: >-
  Lenz-Majewski hyperostotic dwarfism is an ultra-rare PTDSS1-related skeletal
  dysplasia characterized by activating heterozygous variants in PTDSS1,
  progressive hyperostotic bone disease, cutis laxa, marked growth failure,
  brachydactyly, craniofacial dysmorphism, and intellectual disability.
category: Mendelian
parents:
- hereditary disease
has_subtypes:
- name: Classic
  display_name: Classic PTDSS1-related LMHD
  description: >-
    Classic PTDSS1-related Lenz-Majewski hyperostotic dysplasia presents in
    infancy with cutis laxa, prominent cutaneous veins, craniofacial
    dysmorphism, digit anomalies, early-onset osteosclerosis, severe growth
    deficiency, and significant developmental delay.
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Individuals with classic PTDSS1-related LMHD typically presents in infancy
      with cutis laxa, prominent cutaneous veins, characteristic craniofacial
      features (disproportionately large head, broad forehead, delayed closure
      of the fontanelles, hypertelorism, large floppy ears, nasal obstruction /
      choanal atresia, macrostomia, thin vermilion of the lips, dental enamel
      hypoplasia, and prognathism or retrognathia), brachydactyly and syndactyly
      of the digits, early-onset osteosclerosis (involving the skull, spine,
      diaphyses of the long bones, clavicles, and ribs), severe growth
      deficiency, and significant developmental delays.
    explanation: GeneReviews defines the classic PTDSS1-related LMHD presentation.
- name: Attenuated
  display_name: Attenuated PTDSS1-related LMHD
  description: >-
    Attenuated PTDSS1-related Lenz-Majewski hyperostotic dysplasia has milder
    cutaneous involvement, slower hyperostosis progression, normal stature, and
    preserved or mildly affected development.
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Attenuated PTDSS1-related LMHD is characterized by minimal or mild cutis
      laxa, slower progression of hyperostosis, preserved or mildly affected
      development, and normal stature.
    explanation: GeneReviews defines the attenuated PTDSS1-related LMHD presentation.
disease_term:
  preferred_term: Lenz-Majewski hyperostotic dwarfism
  term:
    id: MONDO:0007892
    label: Lenz-Majewski hyperostotic dwarfism
inheritance:
- name: Autosomal dominant inheritance
  inheritance_term:
    preferred_term: Autosomal dominant inheritance
    term:
      id: HP:0000006
      label: Autosomal dominant inheritance
  description: >-
    Reported cases are caused by heterozygous activating PTDSS1 variants that
    typically arise de novo.
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      LMS is caused by activating de novo heterozygous mutations in PTDSS1, encoding phosphatidylserine synthase 1 (PSS1).
    explanation: >-
      This full-text disease description supports dominant disease causation by
      heterozygous activating PTDSS1 variants.
pathophysiology:
- name: PTDSS1 gain-of-function phosphatidylserine biosynthesis dysregulation
  description: >-
    Activating PTDSS1 variants increase phosphatidylserine synthase activity and
    impair feedback regulation by phosphatidylserine, establishing the primary
    biochemical lesion in Lenz-Majewski syndrome. Excess phosphatidylserine may
    promote pathologic mineralization by binding calcium in matrix vesicles and
    nucleating hydroxyapatite crystal formation.
  genes:
  - preferred_term: PTDSS1
    term:
      id: hgnc:9587
      label: PTDSS1
  biological_processes:
  - preferred_term: phosphatidylserine biosynthetic process
    term:
      id: GO:0006659
      label: phosphatidylserine biosynthetic process
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      This disorder called Lenz-Majewski syndrome (LMS) is associated with gain of function mutations in PTDSS1, encoding an enzyme involved in phospholipid biosynthesis.
    explanation: >-
      This directly supports PTDSS1 gain of function with disturbed phospholipid
      biosynthesis as the initiating molecular mechanism.
  - reference: PMID:25363158
    reference_title: "Lenz-Majewski hyperostotic dwarfism with hyperphosphoserinuria from a novel mutation in PTDSS1 encoding phosphatidylserine synthase 1."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In vitro, these PTDSS1 mutations were gain-of-function and increased PTDS
      production. Notably, PTDS binds calcium within matrix vesicles to engender
      hydroxyapatite crystal formation, and may enhance mesenchymal stem cell
      differentiation leading to osteogenesis.
    explanation: >-
      This supports the gain-of-function phosphatidylserine-to-bone-mineralization
      mechanism that deepens the primary PTDSS1 pathophysiology node.
  downstream:
  - target: Hyperphosphoserinuria
    description: Increased phosphatidylserine biosynthesis can be reflected by elevated urinary phosphoserine.
  - target: Progressive hyperostotic skeletal dysplasia
    description: Excess phosphatidylserine and abnormal mineralization drive the progressive skeletal dysplasia branch of disease.
  - target: Cutis laxa
    description: PTDSS1-driven phospholipid dysregulation is upstream of the cutis laxa phenotype.
  - target: Intellectual disability
    description: PTDSS1-driven multisystem developmental dysfunction contributes to intellectual disability.
- name: Progressive hyperostotic skeletal dysplasia
  description: >-
    The downstream skeletal disease is marked by excessive bone growth,
    generalized hyperostosis, and progressive deformity that drives severe short
    stature and brachydactyly.
  biological_processes:
  - preferred_term: ossification
    term:
      id: GO:0001503
      label: ossification
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes.
    explanation: >-
      This directly supports progressive hyperostotic skeletal dysplasia as the
      pathological event linking PTDSS1 dysfunction to brachydactyly and severe
      short stature.
  downstream:
  - target: Short stature
    description: Progressive skeletal dysplasia leads to severe dwarfism and short stature.
  - target: Brachydactyly
    description: The skeletal dysplasia branch produces early brachydactyly.
  - target: Cranial hyperostosis
    description: Excess bone formation causes progressive cranial and skull-base hyperostosis.
  - target: Abnormal facial shape
    description: Progressive craniofacial skeletal remodeling drives the characteristic facial dysmorphism.
  - target: Sensorineural hearing impairment
    description: Progressive cranial bone deformity is associated with profound hearing loss.
phenotypes:
- name: Cutis laxa
  category: Connective tissue
  description: >-
    Loose, redundant, wrinkled skin is a defining early feature and places the
    disorder within the congenital cutis laxa spectrum.
  phenotype_term:
    preferred_term: Cutis laxa
    term:
      id: HP:0000973
      label: Cutis laxa
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We provide here molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability.
    explanation: >-
      This case series directly identifies cutis laxa as a core disease
      phenotype.
- name: Short stature
  category: Growth
  description: >-
    Severe growth failure with disproportionate dwarfism is a major consequence
    of the hyperostotic skeletal dysplasia.
  phenotype_term:
    preferred_term: Short stature
    term:
      id: HP:0004322
      label: Short stature
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes.
    explanation: >-
      Severe dwarfism in the disease-defining series supports short stature as a
      major growth phenotype.
- name: Brachydactyly
  category: Musculoskeletal
  description: >-
    Short fingers are among the earliest skeletal clues to the diagnosis.
  phenotype_term:
    preferred_term: Brachydactyly
    term:
      id: HP:0001156
      label: Brachydactyly
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes.
    explanation: >-
      This directly supports brachydactyly as an early and characteristic
      phenotype.
- name: Syndactyly
  category: Musculoskeletal
  description: >-
    Cutaneous syndactyly and bony digital fusion are part of the digit anomaly
    spectrum in PTDSS1-related LMHD.
  phenotype_term:
    preferred_term: Syndactyly
    term:
      id: HP:0001159
      label: Syndactyly
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      brachydactyly and syndactyly of the digits, early-onset osteosclerosis
      (involving the skull, spine, diaphyses of the long bones, clavicles, and
      ribs), severe growth deficiency, and significant developmental delays.
    explanation: GeneReviews lists syndactyly of the digits in classic PTDSS1-related LMHD.
- name: Cranial hyperostosis
  category: Musculoskeletal
  description: >-
    Progressive craniotubular hyperostosis is a defining skeletal feature of
    Lenz-Majewski hyperostotic dwarfism.
  phenotype_term:
    preferred_term: Craniotubular hyperostosis
    term:
      id: HP:0004437
      label: Cranial hyperostosis
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Clinical features of LMS include craniotubular hyperostosis, loose skin, progeroid appearance, marked growth failure, and moderate to severe intellectual disability.
    explanation: >-
      This directly supports craniotubular hyperostosis as a cardinal skeletal
      phenotype; the selected HPO term captures the cranial component of the
      generalized hyperostotic process.
- name: Abnormal facial shape
  category: Craniofacial
  description: >-
    Characteristic facial dysmorphism is an early and persistent component of
    the syndrome.
  phenotype_term:
    preferred_term: Abnormal facial shape
    term:
      id: HP:0001999
      label: Abnormal facial shape
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes.
    explanation: >-
      This directly supports facial dysmorphism as an early and distinctive
      phenotype of Lenz-Majewski hyperostotic dwarfism.
- name: Progeroid facial appearance
  category: Craniofacial
  description: A prematurely aged facial appearance is reported in the craniofacial phenotype.
  phenotype_term:
    preferred_term: Progeroid facial appearance
    term:
      id: HP:0005328
      label: Progeroid facial appearance
  evidence:
  - reference: PMID:40993826
    reference_title: "Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Clinical evaluation revealed moderate intellectual disability, cutis laxa,
      a progeroid facial appearance, and pronounced prognathism.
    explanation: This case report documents progeroid facial appearance in molecularly confirmed LMS.
- name: Hypertelorism
  category: Craniofacial
  description: Hypertelorism is part of the characteristic craniofacial pattern.
  phenotype_term:
    preferred_term: Hypertelorism
    term:
      id: HP:0000316
      label: Hypertelorism
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      characteristic craniofacial features (disproportionately large head,
      broad forehead, delayed closure of the fontanelles, hypertelorism, large
      floppy ears, nasal obstruction / choanal atresia, macrostomia, thin
      vermilion of the lips, dental enamel hypoplasia, and prognathism or
      retrognathia)
    explanation: GeneReviews lists hypertelorism among characteristic craniofacial features.
- name: Wide mouth
  category: Craniofacial
  description: Macrostomia or wide mouth is part of the characteristic craniofacial pattern.
  phenotype_term:
    preferred_term: Macrostomia
    term:
      id: HP:0000154
      label: Wide mouth
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      characteristic craniofacial features (disproportionately large head,
      broad forehead, delayed closure of the fontanelles, hypertelorism, large
      floppy ears, nasal obstruction / choanal atresia, macrostomia, thin
      vermilion of the lips, dental enamel hypoplasia, and prognathism or
      retrognathia)
    explanation: GeneReviews lists macrostomia among characteristic craniofacial features.
- name: Enamel hypoplasia
  category: Craniofacial
  description: Dental enamel hypoplasia is a recurring oral manifestation requiring dental care.
  phenotype_term:
    preferred_term: Enamel hypoplasia
    term:
      id: HP:0006297
      label: Enamel hypoplasia
  evidence:
  - reference: PMID:40993826
    reference_title: "Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Intraoral and radiographic examinations demonstrated enamel hypoplasia,
      taurodontism, delayed eruption of permanent teeth, a horizontally
      positioned upper lateral incisor, and a large follicular cyst in the
      maxilla.
    explanation: This directly supports enamel hypoplasia in the oral phenotype.
- name: Taurodontia
  category: Craniofacial
  description: Taurodontia has been documented as part of the expanding dental phenotype.
  phenotype_term:
    preferred_term: Taurodontia
    term:
      id: HP:0000679
      label: Taurodontia
  evidence:
  - reference: PMID:40993826
    reference_title: "Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Intraoral and radiographic examinations demonstrated enamel hypoplasia,
      taurodontism, delayed eruption of permanent teeth, a horizontally
      positioned upper lateral incisor, and a large follicular cyst in the
      maxilla.
    explanation: This directly supports taurodontia in the oral phenotype.
- name: Intellectual disability
  category: Neurologic
  description: >-
    Intellectual disability develops as part of the core neurodevelopmental
    syndrome.
  phenotype_term:
    preferred_term: Intellectual disability
    term:
      id: HP:0001249
      label: Intellectual disability
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We provide here molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability.
    explanation: >-
      The disease-defining series directly includes intellectual disability in
      the core phenotype.
- name: Sensorineural hearing impairment
  category: Otolaryngologic
  description: >-
    Profound hearing loss can occur as part of the progressive cranial
    hyperostotic phenotype.
  phenotype_term:
    preferred_term: Sensorineural hearing impairment
    term:
      id: HP:0000407
      label: Sensorineural hearing impairment
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      His progressive cranial bone deformity was associated with profound deafness.
    explanation: >-
      This directly supports severe hearing impairment as a clinical consequence
      of the progressive cranial hyperostotic disease.
- name: Hydrocephalus
  category: Neurologic
  description: Hydrocephalus is a reported neurologic complication that requires surveillance and neurosurgical management when present.
  phenotype_term:
    preferred_term: Hydrocephalus
    term:
      id: HP:0000238
      label: Hydrocephalus
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Additional features can include genitourinary anomalies in males,
      inguinal hernia, ophthalmologic manifestations, hearing loss, and
      hydrocephalus.
    explanation: GeneReviews lists hydrocephalus as an additional feature.
- name: Obstructive sleep apnea
  category: Respiratory
  description: Obstructive sleep apnea can occur and should be screened for during surveillance.
  phenotype_term:
    preferred_term: Obstructive sleep apnea
    term:
      id: HP:0002870
      label: Obstructive sleep apnea
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      treatment of respiratory difficulty and obstructive sleep apnea per
      otolaryngologist and/or pulmonologist; careful airway evaluation prior to
      surgical procedures;
    explanation: GeneReviews management guidance documents obstructive sleep apnea as a clinically relevant manifestation.
- name: Seizure
  category: Neurologic
  description: >-
    Generalized seizures have been reported in Lenz-Majewski hyperostotic
    dwarfism.
  phenotype_term:
    preferred_term: Seizure
    term:
      id: HP:0001250
      label: Seizure
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Generalized seizures without fever started at 4 years and were responsive to antiepileptic drugs.
    explanation: >-
      This directly supports seizure as an additional neurologic manifestation
      of Lenz-Majewski hyperostotic dwarfism.
biochemical:
- name: Hyperphosphoserinuria
  presence: INCREASED
  context: >-
    Urinary amino acid quantitation can show elevated phosphoserine, providing
    a biochemical readout of the PTDSS1/phosphatidylserine biosynthesis branch.
  biomarker_term:
    preferred_term: phosphoserine
    term:
      id: CHEBI:15811
      label: O-phospho-L-serine
  readouts:
  - target: PTDSS1 gain-of-function phosphatidylserine biosynthesis dysregulation
    relationship: READOUT_OF
    direction: POSITIVE
    endpoint_context: DIAGNOSTIC
    interpretation: Elevated urinary phosphoserine supports increased phosphatidylserine pathway flux in LMHD.
  evidence:
  - reference: PMID:25363158
    reference_title: "Lenz-Majewski hyperostotic dwarfism with hyperphosphoserinuria from a novel mutation in PTDSS1 encoding phosphatidylserine synthase 1."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Urinary amino acid quantitation revealed a greater than sixfold elevation
      of phosphoserine.
    explanation: This supports hyperphosphoserinuria as a biochemical finding in molecularly confirmed LMHD.
genetic:
- name: PTDSS1
  association: Gain of function mutation
  gene_term:
    preferred_term: PTDSS1
    term:
      id: hgnc:9587
      label: PTDSS1
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      LMS is caused by activating de novo heterozygous mutations in PTDSS1, encoding phosphatidylserine synthase 1 (PSS1).
    explanation: >-
      This directly supports activating PTDSS1 variants as the molecular basis
      of the disorder.
diagnosis:
- name: PTDSS1 molecular genetic testing
  description: >-
    Molecular testing is used to confirm the diagnosis by identifying a
    heterozygous pathogenic PTDSS1 variant in the appropriate clinical context.
  diagnosis_term:
    preferred_term: molecular genetic testing
    term:
      id: MAXO:0000533
      label: molecular genetic testing
    qualifiers:
    - predicate:
        preferred_term: has participant
        term:
          id: RO:0000057
          label: has participant
      value:
        preferred_term: PTDSS1
        term:
          id: hgnc:9587
          label: PTDSS1
  results: Heterozygous activating or likely activating PTDSS1 variant.
  evidence:
  - reference: PMID:40993826
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      We report a 13-year-old male diagnosed with Lenz-Majewski Syndrome (LMS) through whole exome sequencing, which identified a heterozygous de novo PTDSS1 variant (c.284G>A; p.R95Q), not previously documented in LMS cases.
    explanation: >-
      This directly supports molecular confirmation of LMS by identification of
      a heterozygous pathogenic PTDSS1 variant.
- name: Radiographic skeletal assessment
  description: >-
    Radiographic imaging documents the characteristic progressive osteosclerosis
    and hyperostotic skeletal dysplasia pattern.
  diagnosis_term:
    preferred_term: radiograph imaging procedure
    term:
      id: MAXO:0000595
      label: radiograph imaging procedure
  results: Progressive osteosclerosis and hyperostosis involving skull, spine, long bones, clavicles, and ribs.
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The diagnosis of PTDSS1-related LMHD is established in a proband with
      characteristic clinical and imaging findings and a heterozygous
      pathogenic gain-of-function variant in PTDSS1 identified by molecular
      genetic testing.
    explanation: GeneReviews establishes imaging findings as part of the diagnostic basis.
  - reference: PMID:29341480
    reference_title: Cutis laxa and excessive bone growth due to de novo mutations in PTDSS1.
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Bone X-rays showed structural changes to all bones, with sclerosis mainly
      in the skull and vertebra, hip dislocation, turricephaly, mildly delayed
      ossification and thickness of the long bone diaphyses.
    explanation: Patient radiographs support the characteristic osteosclerotic skeletal pattern.
- name: Urinary phosphoserine quantitation
  description: Urinary amino acid testing can identify hyperphosphoserinuria as a biochemical clue.
  diagnosis_term:
    preferred_term: clinical laboratory procedure
    term:
      id: MAXO:0000006
      label: clinical laboratory procedure
  results: Elevated urinary phosphoserine.
  evidence:
  - reference: PMID:25363158
    reference_title: "Lenz-Majewski hyperostotic dwarfism with hyperphosphoserinuria from a novel mutation in PTDSS1 encoding phosphatidylserine synthase 1."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Urinary amino acid quantitation revealed a greater than sixfold elevation
      of phosphoserine.
    explanation: This supports urinary phosphoserine quantitation as a biochemical diagnostic readout.
treatments:
- name: Supportive multidisciplinary care
  description: >-
    Ongoing orthopedic and dental or maxillofacial follow-up is recommended to
    manage the progressive skeletal complications of the disorder.
  treatment_term:
    preferred_term: supportive care
    term:
      id: MAXO:0000950
      label: supportive care
  target_phenotypes:
  - preferred_term: Cranial hyperostosis
    term:
      id: HP:0004437
      label: Cranial hyperostosis
  - preferred_term: Abnormal facial shape
    term:
      id: HP:0001999
      label: Abnormal facial shape
  evidence:
  - reference: PMID:29341480
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Consequently periodic consultations with the orthopedic surgeon and the dentist or the maxillofacial surgeon are recommended.
    explanation: >-
      This directly supports supportive multidisciplinary management for the
      progressive skeletal and craniofacial complications of the disorder.
- name: Mobility and developmental therapies
  description: >-
    Physical therapy, occupational therapy, mobility devices, developmental
    supports, and individualized education planning are used for skeletal,
    motor, and developmental manifestations.
  treatment_term:
    preferred_term: physical therapy
    term:
      id: MAXO:0000011
      label: physical therapy
  target_phenotypes:
  - preferred_term: Short stature
    term:
      id: HP:0004322
      label: Short stature
  - preferred_term: Intellectual disability
    term:
      id: HP:0001249
      label: Intellectual disability
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Treatment of skeletal manifestations per orthopedist; consider physical
      therapy, occupational therapy, and assisted devices for mobility;
      decompression of cervical spine stenosis as needed; treatment of
      hydrocephalus as needed per neurosurgeon; treatment of respiratory
      difficulty and obstructive sleep apnea per otolaryngologist and/or
      pulmonologist; careful airway evaluation prior to surgical procedures;
      supportive therapies for those with developmental delays; individualized
      education plan for learning disorders and school performance issues;
      treatment of dental enamel hypoplasia per dentist; standard treatments
      for genitourinary anomalies, delayed puberty, inguinal hernia, vision
      issues, and hearing loss; consider dermatology referral for cosmetic
      concerns due to cutis laxa.
    explanation: GeneReviews supports mobility, developmental, and education-directed management.
- name: Brain and spine MRI surveillance
  description: Brain and spine MRI is used as needed to monitor for hydrocephalus and craniovertebral or spine complications.
  treatment_term:
    preferred_term: MRI of the brain
    term:
      id: MAXO:0000427
      label: MRI of the brain
  target_phenotypes:
  - preferred_term: Hydrocephalus
    term:
      id: HP:0000238
      label: Hydrocephalus
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Growth assessment and orthopedic evaluation annually or as determined by
      the orthopedist to monitor joint and skeletal manifestations; brain and
      spine MRI as needed; assess for manifestations of sleep apnea at each
      visit; polysomnography as needed; dental evaluation with frequency per
      dentist; ophthalmology evaluation with frequency per ophthalmologist;
      audiology evaluation as needed; monitor developmental progress,
      educational needs, and family needs at each visit.
    explanation: GeneReviews supports brain and spine MRI surveillance as needed.
- name: Neurosurgical management of hydrocephalus or cervical stenosis
  description: Neurosurgical care is used for hydrocephalus or cervical spine stenosis when clinically indicated.
  treatment_term:
    preferred_term: surgical procedure on nervous system
    term:
      id: MAXO:0000946
      label: surgical procedure on nervous system
  target_phenotypes:
  - preferred_term: Hydrocephalus
    term:
      id: HP:0000238
      label: Hydrocephalus
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Treatment of skeletal manifestations per orthopedist; consider physical
      therapy, occupational therapy, and assisted devices for mobility;
      decompression of cervical spine stenosis as needed; treatment of
      hydrocephalus as needed per neurosurgeon;
    explanation: GeneReviews supports neurosurgical treatment for hydrocephalus and cervical stenosis when needed.
- name: Sleep apnea screening and polysomnography
  description: Respiratory and sleep-apnea surveillance includes visit-based screening and polysomnography when indicated.
  treatment_term:
    preferred_term: polysomnography
    term:
      id: MAXO:0000915
      label: polysomnography
  target_phenotypes:
  - preferred_term: Obstructive sleep apnea
    term:
      id: HP:0002870
      label: Obstructive sleep apnea
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Growth assessment and orthopedic evaluation annually or as determined by
      the orthopedist to monitor joint and skeletal manifestations; brain and
      spine MRI as needed; assess for manifestations of sleep apnea at each
      visit; polysomnography as needed; dental evaluation with frequency per
      dentist; ophthalmology evaluation with frequency per ophthalmologist;
      audiology evaluation as needed; monitor developmental progress,
      educational needs, and family needs at each visit.
    explanation: GeneReviews supports sleep-apnea assessment at each visit and polysomnography as needed.
- name: Dental evaluation and enamel care
  description: Dental surveillance and treatment address enamel hypoplasia, taurodontia, eruption delay, malocclusion, and related oral complications.
  treatment_term:
    preferred_term: clinical assessment
    term:
      id: MAXO:0000487
      label: clinical assessment
  target_phenotypes:
  - preferred_term: Enamel hypoplasia
    term:
      id: HP:0006297
      label: Enamel hypoplasia
  - preferred_term: Taurodontia
    term:
      id: HP:0000679
      label: Taurodontia
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      treatment of dental enamel hypoplasia per dentist; standard treatments
      for genitourinary anomalies, delayed puberty, inguinal hernia, vision
      issues, and hearing loss;
    explanation: GeneReviews supports dentist-directed treatment of dental enamel hypoplasia.
  - reference: PMID:40993826
    reference_title: "Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      It underscores the importance of early dental assessment and
      multidisciplinary care in managing LMS.
    explanation: The dental case report supports early dental assessment and multidisciplinary oral care.
- name: Ophthalmology surveillance
  description: Ophthalmology evaluation monitors vision and other ophthalmologic manifestations.
  treatment_term:
    preferred_term: eye examination
    term:
      id: MAXO:0001155
      label: eye examination
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      dental evaluation with frequency per dentist; ophthalmology evaluation
      with frequency per ophthalmologist; audiology evaluation as needed;
      monitor developmental progress, educational needs, and family needs at
      each visit.
    explanation: GeneReviews supports ophthalmology surveillance.
- name: Audiology evaluation
  description: Audiology evaluation is used as needed to assess and manage hearing loss.
  treatment_term:
    preferred_term: audiologist evaluation
    term:
      id: MAXO:0000734
      label: audiologist evaluation
  target_phenotypes:
  - preferred_term: Sensorineural hearing impairment
    term:
      id: HP:0000407
      label: Sensorineural hearing impairment
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      dental evaluation with frequency per dentist; ophthalmology evaluation
      with frequency per ophthalmologist; audiology evaluation as needed;
      monitor developmental progress, educational needs, and family needs at
      each visit.
    explanation: GeneReviews supports audiology evaluation as needed.
- name: Craniovertebral junction precautions
  description: >-
    Extreme neck extension or flexion should be avoided when craniovertebral
    junction stenosis is present, and cervical spine imaging should precede
    general anesthesia.
  treatment_term:
    preferred_term: supportive care
    term:
      id: MAXO:0000950
      label: supportive care
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Activities/procedures that involve extreme neck extension and flexion in
      individuals with craniovertebral junction stenosis.
    explanation: GeneReviews identifies extreme neck flexion and extension as circumstances to avoid.
- name: Genetic counseling
  description: >-
    Genetic counseling addresses autosomal dominant de novo inheritance,
    low-but-nonzero sib recurrence risk from possible gonadal mosaicism, and
    reproductive options.
  treatment_term:
    preferred_term: genetic counseling
    term:
      id: MAXO:0000079
      label: genetic counseling
  evidence:
  - reference: PMID:41818602
    reference_title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      PTDSS1-related LMHD is an autosomal dominant disorder. All probands
      reported to date with PTDSS1-related LMHD whose parents have undergone
      molecular genetic testing have had the disorder as the result of a de novo
      PTDSS1 pathogenic variant.
    explanation: GeneReviews provides inheritance and recurrence-risk context for genetic counseling.
differential_diagnoses: []
clinical_trials: []
references:
- reference: PMID:41818602
  title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia."
  tags:
  - GeneReviews
  findings: []
- reference: url:https://www.ncbi.nlm.nih.gov/books/n/gene/ptdss1-lmhd/
  title: "PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia - GeneReviews - NCBI Bookshelf"
  tags:
  - GeneReviews
  findings: []
- reference: PMID:25363158
  title: "Lenz-Majewski hyperostotic dwarfism with hyperphosphoserinuria from a novel mutation in PTDSS1 encoding phosphatidylserine synthase 1."
  findings: []
- reference: PMID:29341480
  title: "Cutis laxa and excessive bone growth due to de novo mutations in PTDSS1."
  findings: []
- reference: PMID:40993826
  title: "Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report."
  findings: []
datasets: []
📚

References & Deep Research

References

5
PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia.
No top-level findings curated for this source.
PTDSS1-Related Lenz-Majewski Hyperostotic Dysplasia - GeneReviews - NCBI Bookshelf
No top-level findings curated for this source.
Lenz-Majewski hyperostotic dwarfism with hyperphosphoserinuria from a novel mutation in PTDSS1 encoding phosphatidylserine synthase 1.
No top-level findings curated for this source.
Cutis laxa and excessive bone growth due to de novo mutations in PTDSS1.
No top-level findings curated for this source.
Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report.
No top-level findings curated for this source.

Deep Research

1
Asta
Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Lenz-Majewski hyperostotic dwarfism. Core disease mechanisms, molecular an...
Asta Scientific Corpus Retrieval 17 citations 2026-04-15T12:04:31.731177

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of Lenz-Majewski hyperostotic dwarfism. Core disease mechanisms, molecular an...

This report is retrieval-only and is generated directly from Asta results.

  • Papers retrieved: 17
  • Snippets retrieved: 20

Relevant Papers

[1] Clinical and Oral Manifestations in a Patient with Lenz-Majewski Syndrome: A Rare Case Report

  • Authors: Merve Bayram, B. B. Akgöl, E. Çetin, Gulsum Ceylan
  • Year: 2025
  • Venue: BMC Oral Health
  • URL: https://www.semanticscholar.org/paper/ff954bf6dd8137f84aa3260205107bb17d260de6
  • DOI: 10.1186/s12903-025-06785-7
  • PMID: 40993826
  • PMCID: 12462183
  • Summary: A 13-year-old male diagnosed with Lenz-Majewski Syndrome is reported through whole exome sequencing, which identified a heterozygous de novo PTDSS1 variant (c.284G > A; p.R95Q), not previously documented in LMS cases, and novel dental findings—particularly taurodontism—in association with a previously unreported PTDSS1 variant are documents.
  • Evidence snippets:
  • Snippet 1 (score: 0.551) > Lenz-Majewski Syndrome (LMS), also referred to as Lenz-Majewski hyperostotic dwarfism, is a rare genetic disorder characterized by a constellation of clinical features, including skeletal dysplasia, craniofacial abnormalities, and intellectual disability. The syndrome is primarily caused by gain-of-function mutations in the Phosphatidylserine Synthase 1 (PTDSS1) gene, which encodes phosphatidylserine synthase 1, an enzyme involved in phospholipid biosynthesis. The clinical presentation of LMS is diverse, with skeletal abnormalities being one of its most prominent features. Patients typically exhibit generalized craniotubular hyperostosis, which leads to progressive skeletal sclerosis and dwarfism [1][2][3]. > The dysplastic changes in the bones are often accompanied by distinctive craniofacial features such as brachycephaly, midface hypoplasia, and a prominent forehead [4]. Oral and dental manifestations in LMS patients include dental enamel dysplasia [4][5][6], and delayed dental eruption [2,4]. Dental enamel dysplasia, a common finding, is characterized by abnormal enamel formation that increases susceptibility to caries and other dental complications [4]. Additionally, delayed tooth eruption is commonly reported, often necessitating early dental interventions to manage potential complications, such as malocclusion or spacing issues [7]. The pathophysiology underlying these dental anomalies is likely linked to the broader developmental disruptions caused by PTDSS1 mutations. The enzyme encoded by PTDSS1 plays a crucial role in lipid metabolism, and its dysregulation can affect cellular processes involved in the development and maintenance of dental tissues [1][2][3]. > LMS is characterized by progressive hyperostosis of craniofacial bones, particularly the skull base and jawbones, which contributes to prognathism and may result in misaligned dentition [1][2][3][4]8].

[2] Cutis laxa and excessive bone growth due to de novo mutations in PTDSS1

  • Authors: J. Piard, J. Lespinasse, M. Vlčková, M. A. Mensah, S. Iurian et al.
  • Year: 2018
  • Venue: American Journal of Medical Genetics. Part a
  • URL: https://www.semanticscholar.org/paper/17ab7d7bdc0c1b44591dcc5816bd11ed88f3ad55
  • DOI: 10.1002/ajmg.a.38604
  • PMID: 29341480
  • PMCID: 5838527
  • Citations: 14
  • Influential citations: 5
  • Summary: Molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability are provided and it is illustrated that LMS is an unequivocal cuti laxa syndrome and expands the clinical and molecular spectrum of this group of disorders.
  • Evidence snippets:
  • Snippet 1 (score: 0.511) > The cutis laxa syndromes are multisystem disorders that share loose redundant inelastic and wrinkled skin as a common hallmark clinical feature. The underlying molecular defects are heterogeneous and 13 different genes have been involved until now, all of them being implicated in elastic fiber assembly. We provide here molecular and clinical characterization of three unrelated patients with a very rare phenotype associating cutis laxa, facial dysmorphism, severe growth retardation, hyperostotic skeletal dysplasia, and intellectual disability. This disorder called Lenz–Majewski syndrome (LMS) is associated with gain of function mutations in PTDSS1, encoding an enzyme involved in phospholipid biosynthesis. This report illustrates that LMS is an unequivocal cutis laxa syndrome and expands the clinical and molecular spectrum of this group of disorders. In the neonatal period, brachydactyly and facial dysmorphism are two early distinctive signs, later followed by intellectual disability and hyperostotic skeletal dysplasia with severe dwarfism allowing differentiation of this condition from other cutis laxa phenotypes. Further studies are needed to understand the link between PTDSS1 and extra cellular matrix assembly.

[3] Insights into Natural History, Phenotypic, and Molecular Spectrum in a Large Cohort of Osteosclerotic Disorders

  • Authors: Dilek Uludağ Alkaya, Esra Usluer, Zeynep Alp Ünkar, Ali Şeker, Ibrahim Adaletli et al.
  • Year: 2025
  • Venue: Calcified Tissue International
  • URL: https://www.semanticscholar.org/paper/65a0ff0631a0d8ea601a4611820af34f267383b8
  • DOI: 10.1007/s00223-025-01366-w
  • PMID: 40198394
  • PMCID: 11978542
  • Citations: 1
  • Summary: Clinical and radiologic findings improved over time in PHOAR1 patients, whereas they progressed in JPD-5 and trichothiodystrophy-1 patients, and intra- and interfamilial clinical differences were observed in CMD, CED, JPD-5, and GHDD.
  • Evidence snippets:
  • Snippet 1 (score: 0.440) > During follow-up, the patient developed significant difficulty walking and severe hip joint pain at the age of 8.5 years, similar to the previously reported patient [37]. We clearly observed joint stiffness and also sclerosis of the skull, vertebrae and pelvis, which is the characteristic feature of the disease progressing with age, similar to the few patients reported [38]. > Lenz-Majewski hyperostotic dwarfism showed typical clinical findings in one of our patients, including severe prenatal short stature, a dismorphic face, and radiologic features such as short or absent metacarpals and phalanges, diaphyseal thickening, and metaphyseal hypostosis [5,39]. To date, only twenty patients have been documented, 12 of whom received molecular confirmation [40]. > Heterozygosity for a COL1A1 mutation was found in the lung tissue of a fetus with a severe form of prenatal cortical hyperostosis [41]. In our cohort, one fetus was diagnosed with perinatal Caffey disease with typical clinical, radiologic, and histopathologic findings. > Melorheostosis often presents with a classic "dripping candle wax" radiographic appearance. Despite no pathogenic variant detected through exome sequencing, recent studies link melorheostosis to somatic mutations, particularly in the MAP2K1, which plays a crucial role in the RAS-MAPK signaling pathway, implicated in bone remodeling and sclerosis [9]. Our patient, in whom we could not detect mutations in the blood, had unilateral camptodactyly and hyperostosis, which are typical features of the syndrome, as well as dripping waxy lesions on radiographs. The absence of a detectable variant in blood DNA is not unexpected in melorheostosis, as somatic mutations are typically restricted to the affected tissue. This highlights the mosaic nature of the condition and indicates that genetic testing of affected tissue may be required to identify the underlying mutation.
  • Snippet 2 (score: 0.422) > Based on the clinical and radiologic evaluations, nine patients were diagnosed with primary hypertrophic osteoarthropathy type 1, three with primary hypertrophic osteoarthropathy type 2, five with Juvenile Paget's disease-5, four with craniometaphyseal dysplasia, four with Camurati-Engelmann disease, three with Ghosal hematodiaphyseal dysplasia, two with sclerosteosis-1, one with trichothiodystrophy-1, one with Lenz-Majewski hyperostotic dwarfism, one with Caffey disease, and one with melorheostosis. The clinical features of the patients according to the different phenotypes are compared in Table S1. The detailed clinical and radiological features are summarized in Table S2.
  • Snippet 3 (score: 0.410) > Patient 33, diagnosed with Lenz-Majewski hyperostotic dwarfism, was a 6-month-old girl with developmental delay, feeding difficulties, hypotonia and facial dysmorphism including macrocephaly, flattened and broad nasal bridge, hypertelorism, anteverted nostrils, and micrognathia (Fig. 4f). Other features included sagging and wrinkled skin, brachydactyly, partial syndactyly, and rocker bottom feet (Fig. 4g). Radiologic examinations revealed short phalanges, increased bone density in the long bones (Fig. 4h), and hypoplasia of the 5th metatarsal.
  • Snippet 4 (score: 0.369) > Sclerosing bone dysplasias are a heterogeneous group of disorders characterized by increased bone density [1,2]. In the 2023 revised nosology of genetic skeletal disorders, these conditions are categorized into two main groups based on the underlying pathogenic mechanism: Osteopetrosis and related osteoclast disorders, and osteosclerotic disorders [3]. Osteopetrosis and related osteoclastic disorders (group 24) result from impaired bone resorption due to defects in the number or function of osteoclasts while osteosclerotic disorders are mainly caused by excessive bone formation Dilek Uludağ Alkaya and Esra Usluer are joint first authors. > or disruptions in bone remodeling [1]. Osteosclerotic disorders, classified as group 25, combine the previously distinct subcategories of neonatal osteosclerotic dysplasias and other sclerosing bone disorders [3]. This group encompasses various diseases, including sclerosteosis-1, Juvenile Paget's disease (JPD)-5, Ghosal hematodiaphyseal dysplasia (GHDD), primary hypertrophic osteoarthropathy (PHOAR) types 1 and 2, caused by biallelic mutations in SOST/LRP4, TNFRSF11B, TBXAS1, and HPGD/SLCO2A1, as well as craniometaphyseal dysplasia (CMD) and Camurati-Engelmann disease (CED), caused by monoallelic mutations of ANKH and TGFB1, respectively [1][2][3]. Extremely rare osteosclerotic disorders also include Caffey disease, Lenz-Majewski hyperostotic dwarfism, trichothiodystrophy-1 with axial osteosclerosis, and melorheostosis which are caused by mutations in COL1A1, PTDSS1, ERCC2, and MAP2K1, respectively [4][5][6].

[4] New therapeutic targets in rare genetic skeletal diseases

  • Authors: M. Briggs, Peter A. Bell, M. Wright, K. A. Pirog
  • Year: 2015
  • Venue: Expert Opinion on Orphan Drugs
  • URL: https://www.semanticscholar.org/paper/1363107f71ae6d2d60abca471cddf3da5d13644b
  • DOI: 10.1517/21678707.2015.1083853
  • PMID: 26635999
  • PMCID: 4643203
  • Citations: 37
  • Influential citations: 1
  • Summary: An overview of disease mechanisms that are shared amongst groups of different GSDs and potential therapeutic approaches that are under investigation are described to generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.429) > proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e. chondrocyte) to the abnormal extracellular environment is also important for disease progression as illustrated by several GSDs discussed in this review. > It is important that 'omics'-based approaches and technologies are systematically applied to the study of rare GSDs so that definitive reference profiles and disease signatures are generated for each phenotype. These can then be used in a Systems Biology approach to identify both common and dissimilar pathological signatures and disease mechanisms. This approach is entirely dependent upon relevant in vitro and in vivo models (and also novel 'disease-mechanism phenocopies' [107]) for testing new diagnostic and prognostic tools and for determining the molecular mechanisms that underpin the pathophysiology so that effective therapeutic treatments can be developed and validated. This approach will eventually lead to personalized treatments and care strategies centred on shared disease mechanisms with the use of relevant biomarkers to monitor the efficacy of treatment and disease progression. > It is vital that all relevant stakeholders are involved from the outset in defining the appropriate outcomes of any potential therapeutic regime. The perceptions of a successful therapy can differ widely between the clinical academic community and the relevant patient-support groups and it is vital that there is engagement on all these issues. > In summary, the identification of causative genes and mutations for GSDs over the last 20 years, coupled with the generation and in-depth analysis of a plethora of relevant cell and mouse models, has derived new knowledge on disease mechanisms and suggested potential therapeutic targets. The fast-evolving hypothesis that clinically disparate diseases can share common disease mechanisms is a powerful concept that will generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.

[5] A Roadmap to Gene Discoveries and Novel Therapies in Monogenic Low and High Bone Mass Disorders

  • Authors: M. Formosa, D. Bergen, C. Gregson, A. Maurizi, A. Kämpe et al.
  • Year: 2021
  • Venue: Frontiers in Endocrinology
  • URL: https://www.semanticscholar.org/paper/be13ff3ea01dc5719f2c63b2cbf5d9f77bafd659
  • DOI: 10.3389/fendo.2021.709711
  • PMID: 34539568
  • PMCID: 8444146
  • Citations: 21
  • Summary: The monogenic forms of rare low and high rare bone Mass disorders known to date are described, a roadmap to unravel the genetic determinants of monogenic rare bone mass disorders is provided, using proper phenotyping and genotyping methods are provided, and different genetic validation approaches paving the way for future treatments are described.
  • Evidence snippets:
  • Snippet 1 (score: 0.418) > Skeletal development is regulated by numerous genetic factors that guide the growth, modeling and remodeling of skeletal structures starting in early fetal development and continuing throughout life. These processes are crucial for attainment of normal height, skeletal patterning, bone shape, and mobility, but also for maintenance of normal bone mass and fracture resistance. Defects in the involved genes result in a large and heterogeneous group of disorders, collectively called skeletal dysplasias, in which the primary features are confined to the skeleton. More than 460 different forms of skeletal dysplasia, most of them monogenic, have been recognized (1). They are estimated to affect approximately 1/5,000 children (2,3), and can have distinct clinical manifestations and course. Clinical outcomes range in severity from neonatal lethality to only mild growth retardation, deformity or fracture risk. Diagnosis is based on growth pattern and other clinical characteristics, skeletal imaging, bone density testing, biochemical diagnostics, and genetic tests. Although the genetic basis has been described and mutations in the responsible genes identified in a significant proportion of these conditions, for several distinct skeletal dysplasia phenotypes the genetic cause is still not known (1). > Within this large group of genetic skeletal disorders, monogenic disorders affecting bone mass comprise an expanding subgroup (1,4). This includes disorders with low bone mass and skeletal fragility, and disorders leading to increased bone mass, both commonly associated with extraskeletal complications (5,6). Due to significant variability in severity, diagnosis can be challenging. Importantly, the underlying molecular genetic mechanisms for these disorders remain inadequately explored and, in several entities, the causative genetic defect, and underlying cellular and molecular pathophysiology are still uncharacterized. > The various skeletal dysplasia delineated to date have provided important information about the molecular pathways governing skeletal health both in these conditions and in the general population, underscoring the significance of new gene discoveries not only for the individuals affected by the monogenic rare bone mass disorder, but also more widely to the musculoskeletal research field (7). Indeed, the large wealth of data generated from monogenic and polygenic bone mass disorders, frailty and other musculoskeletal traits, have led

[6] Changes in Serum Proteomic Profiles at Different Stages of Pregnancy Toxemia in Goats

  • Authors: M. Uzti̇mür, C. N. Ünal, Gurler Akpinar
  • Year: 2025
  • Venue: Journal of Veterinary Internal Medicine
  • URL: https://www.semanticscholar.org/paper/4b9c488b5dbd65d7b26fd2ad9aed70e8c4b59942
  • DOI: 10.1111/jvim.70139
  • PMID: 40492724
  • PMCID: 12150350
  • Summary: Understanding the serum proteome profiles of goats with pregnancy toxemia might help identify the proteomes and pathways responsible for the development of this disease and improve diagnosis and treatment.
  • Evidence snippets:
  • Snippet 1 (score: 0.412) > The pathophysiology and progression of this disease are not fully understood. > Traditional biomedical research has focused on the analysis of single genes, proteins, metabolites, or metabolic pathways in diseases. This molecular reductionist approach is based on the assumption that identifying genetic variations and molecular components will lead to new treatments for diseases [13][14][15][16]. However, many diseases are complex and multifactorial, and in order to determine the phenotype of such diseases, it is necessary to understand the changes that occur in more than one gene, pathway, protein, or metabolite at the cellular, tissue, and organismal levels [17][18][19]. Therefore, in recent years, proteomics, as one field of multi-omics technologies, has helped in evaluating the complex pathogenetic mechanisms of different diseases from a broad perspective and has made substantial contributions [20,21]. In veterinary medicine, proteomic analysis of metabolic diseases such as ketosis [16], hypocalcemia [22], and fatty liver [23] in dairy cows has contributed valuable insights for the definition of new pathophysiological pathways and new diagnosis and treatment protocols for these diseases. The proteomic approach can contribute importantly to a broad and detailed understanding of the changes that occur at the organismal level associated with the increase in BHBA concentration in goats with pregnancy toxemia. Our aim was to evaluate the serum protein profiles of goats with SPT or CPT using proteomic techniques to determine the proteomic profiles of these animals and to identify the relevant pathophysiological mechanisms.

[7] 18O-assisted dynamic metabolomics for individualized diagnostics and treatment of human diseases

  • Authors: E. Nemutlu, Song Zhang, N. Juranic, A. Terzic, S. Macura et al.
  • Year: 2012
  • Venue: Croatian Medical Journal
  • URL: https://www.semanticscholar.org/paper/880f053c7f060db4b990e447d0a22c4b69372ddb
  • DOI: 10.3325/cmj.2012.53.529
  • PMID: 23275318
  • PMCID: 3541579
  • Citations: 28
  • Summary: The potential use of dynamic phosphometabolomic platform for disease diagnostics currently under development at Mayo Clinic is described and discussed briefly.
  • Evidence snippets:
  • Snippet 1 (score: 0.408) > Living cells represent an integrated and interacting network of genes, transcripts, proteins, small signaling molecules, and metabolites that define cellular phenotype and function. Traditionally the focus of biomedical research was on individual genes, single protein targets, single metabolites, and metabolic or signaling pathways. This "molecular reductionist" paradigm was based on the assumption that identifying genetic variations and molecular components would lead to discovery of cures for human diseases. However, most of diseases are complex and multi-factorial and the disease phenotype is determined by the alterations of multiple genes, pathways, proteins and metabolites (at cellular, tissue, and organismal levels). Therefore, an integrated "omics" approach is more viable direction for uncovering alterations in metabolic networks, disease mechanisms, and mechanisms of drug effects. > Recent advent of large-scale metabolomics and fluxomic (metabolite dynamics and metabolic flux analysis) completed the "omics revolution" (Figure 1), where genomics, transcriptomics, proteomics, metabolomics, and fluxomics all together complement phenotype determination of living organism. Such integrated "omics" cascades provide a framework for advances in system and network biology, integrative physiology, and system medicine as well as system pharmacology and regenerative medicine. Noteworthy is the "reverse omic" approach or "metabolomicsinformed pharmacogenomics, " where discovery of specific metabolite changes have led to discovery of genetic alterations (2). Therefore, bringing new "omics" technologies to clinical practice will improve disease diagnostics and treatment by targeting drugs and procedures for each unique transcriptomic and metabolomic profiles.

[8] Organoids in gastrointestinal diseases: from bench to clinic

  • Authors: Qinying Wang, Fanying Guo, Qinyuan Zhang, Tingting Hu, Yutao Jin et al.
  • Year: 2024
  • Venue: MedComm
  • URL: https://www.semanticscholar.org/paper/9b8880d8b9d45670da950197d7e353794f51d09e
  • DOI: 10.1002/mco2.574
  • PMID: 38948115
  • PMCID: 11214594
  • Citations: 12
  • Summary: A comprehensive and systematical depiction of organoids models is drawn, providing a novel insight into the utilization of organoids models from bench to clinic and clinical adhibition.
  • Evidence snippets:
  • Snippet 1 (score: 0.398) > Organoids models offer a robust platform for investigating the potential mechanisms of GI diseases and evaluating potential therapeutic interventions.By culturing organoids derived from patients' tissues or stem cells, researchers can delve into disease-specific cellular and molecular pathways, encompassing aberrant cell signaling, perturbed immune responses, and dysfunctional metabolic processes.These disease-specific phenotypes enable the study of disease progression, screening of prospective therapeutics, as well as identification of novel drug targets and mechanisms of action for GI diseases in a clinically relevant context.

[9] From Data to Cure: A Comprehensive Exploration of Multi-omics Data Analysis for Targeted Therapies

  • Authors: Arnab Mukherjee, S. Abraham, Akshita Singh, S. Balaji, K. Mukunthan
  • Year: 2024
  • Venue: Molecular Biotechnology
  • URL: https://www.semanticscholar.org/paper/04593d2268ccd7c26b5296d8342b468ca84ae7b1
  • DOI: 10.1007/s12033-024-01133-6
  • PMID: 38565775
  • PMCID: 11928429
  • Citations: 69
  • Influential citations: 2
  • Summary: This review navigates the expansive omics landscape, showcasing tailored assays for each molecular layer through genomes to metabolomes, and aims to illuminate the transformative impact of multi-omics in the big data era, shaping the future of biological research.
  • Evidence snippets:
  • Snippet 1 (score: 0.390) > Biological processes and molecular functions arise from intricate interactions among thousands of molecules, constituting inherent complexity. Integration of metabolomics data with other omics data holds significant promise for achieving a holistic understanding of disease mechanisms. Metabolomics, which focuses on the comprehensive analysis of small molecule metabolites within biological systems, provides unique insights into the functional status and metabolic phenotypes associated with various physiological and pathological conditions [160,161]. The integration of omics datasets with computational models and network analysis tools elucidates the complex interplay between genes, proteins, metabolites, and cellular processes underlying disease phenotypes. > Despite recent progress in omics technologies, the underlying genetic factors contributing to numerous metabolic phenotypes remain elusive. Metabolite biomarkers can be integrated with genomics and clinical parameters to enhance diagnostic accuracy or refine disease risk prediction models. Metabolites can also serve as intermediate phenotypes for genetic investigations, offering insights into underlying genetic mechanisms [162]. The integration of metabolomics data with either whole-exome sequencing or WGS-data presents a promising systematic strategy for pinpointing disease-causing variants and holds potential utility within the framework of a specific pathway under investigation [163]. Furthermore, at a more intricate biological and analytical level, metabolomics can be combined with various omic platforms, facilitating a comprehensive understanding of complex biological systems and interactions (Fig. 4). > The alterations in metabolite levels, perturbations in metabolic pathways, and the onset of disease states can be elucidated by assessing the epigenetic alterations. This approach offers molecular insights into the intricate interplay among genetic, epigenetic, and metabolic factors during the disease progression. Through the integration of epigenomic Fig. 4 The workflow for integration of metabolomics with other omics for a holistic understanding of disease progression and metabolomic data, the intricate relationships between epigenetic alterations and metabolic pathways in disease pathogenesis can be uncovered. In recent years, metabolomics and epigenomics have experienced notable advancement as prominent molecular and analytical methodologies for biomarker identification [164,165].

[10] Drug Repurposing in Rare Diseases: An Integrative Study of Drug Screening and Transcriptomic Analysis in Nephropathic Cystinosis

  • Authors: F. Bellomo, Ester De Leo, A. Taranta, L. Giaquinto, G. di Giovamberardino et al.
  • Year: 2021
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/5e45caf9d574a1dc3ebf53a7fcb57c10bb2373f8
  • DOI: 10.3390/ijms222312829
  • PMID: 34884638
  • PMCID: 8657658
  • Citations: 18
  • Summary: A drug repurposing strategy applied to nephropathic cystinosis, a rare inherited disorder belonging to the lysosomal storage diseases is shown, combining mechanism-based and cell-based screenings, coupled with an affordable computational analysis, which could result very useful to predict therapeutic responses at both molecular and system levels.
  • Evidence snippets:
  • Snippet 1 (score: 0.380) > Diagnosis and cure for rare diseases represent a great challenge for the scientific community who often comes up against the complexity and heterogeneity of clinical picture associated to a high cost and time-consuming drug development processes. Here we show a drug repurposing strategy applied to nephropathic cystinosis, a rare inherited disorder belonging to the lysosomal storage diseases. This approach consists in combining mechanism-based and cell-based screenings, coupled with an affordable computational analysis, which could result very useful to predict therapeutic responses at both molecular and system levels. Then, we identified potential drugs and metabolic pathways relevant for the pathophysiology of nephropathic cystinosis by comparing gene-expression signature of drugs that share common mechanisms of action or that involve similar pathways with the disease gene-expression signature achieved with RNA-seq.

[11] What next-generation sequencing (NGS) technology has enabled us to learn about primary autosomal recessive microcephaly (MCPH).

  • Authors: D. Morris-Rosendahl, A. Kaindl
  • Year: 2015
  • Venue: Molecular and cellular probes
  • URL: https://www.semanticscholar.org/paper/d5c3136364179627c6e534d6e7cb0b6715032dc9
  • DOI: 10.1016/j.mcp.2015.05.015
  • PMID: 26050940
  • Citations: 67
  • Influential citations: 2
  • Summary: Knowing of new genes mutated in MCPH over the last four years has contributed to the understanding of the disorder at both the clinical and cellular levels, and new mechanisms involving kinetochore-associated proteins and chromatin remodelling complexes have been elucidated.
  • Evidence snippets:
  • Snippet 1 (score: 0.377) > The impact that next-generation sequencing technology (NGS) is having on many aspects of molecular and cell biology, is becoming increasingly apparent. One of the most noticeable outcomes of the new technology in human genetics, has been the accelerated rate of identification of disease-causing genes. Especially for rare, heterogeneous disorders, such as autosomal recessive primary microcephaly (MCPH), the handful of genes previously known to harbour disease-causing mutations, has grown at an unprecedented rate within a few years. Knowledge of new genes mutated in MCPH over the last four years has contributed to our understanding of the disorder at both the clinical and cellular levels. The functions of proteins such as WDR62, CASC5, PHC1, CDK6, CENP-E, CENP-F, CEP63, ZNF335, PLK4 and TUBGPC, have been added to the complex network of critical cellular processes known to be involved in brain growth and size. In addition to the importance of mitotic spindle assembly and structure, centrosome and centriole function and DNA repair and damage response, new mechanisms involving kinetochore-associated proteins and chromatin remodelling complexes have been elucidated. Two of the major contributions to our clinical knowledge are the realisation that primary microcephaly caused by mutations in genes at the MCPH loci is seldom an isolated clinical feature and is often accompanied either by additional cortical malformations or primordial dwarfism. Gene-phenotype correlations are being revisited, with a new dimension of locus heterogeneity and phenotypic variability being revealed.

[12] Lateralized and Segmental Overgrowth in Children

  • Authors: A. Mussa, D. Carli, S. Cardaropoli, G. Ferrero, N. Resta
  • Year: 2021
  • Venue: Cancers
  • URL: https://www.semanticscholar.org/paper/1bf068188ceb52b6d570aedc7fc2b9bdfd8c7ca9
  • DOI: 10.3390/cancers13246166
  • PMID: 34944785
  • PMCID: 8699773
  • Citations: 19
  • Summary: Interestingly, some LO shares molecular mechanisms with cancer: recent advances in tumor biological pathway druggability and growth downregulation offer new avenues for the treatment of the most severe and complicated LO.
  • Evidence snippets:
  • Snippet 1 (score: 0.377) > Simple Summary Congenital lateralized or segmental overgrowth (LO) disorders are conditions characterized by excessive tissue growth of a body region often associated with a predisposition to cancer. LOs are caused by mosaic DNA anomalies, that is, they are present only in a part of the cells making up the body. LOs have an extremely heterogeneous clinical presentation: they widely overlap in presentation, are difficult to frame from a clinical point of view and have a diagnostic complexity representing a challenge for the clinician who approaches them. Here we review the key features of the various LOs, expose their molecular causes, and detail the implications for each of them, such as the need for specific cancer screening or the possibility of treatment. The latter represents a recent scientific achievement in medicine, allowed by the development of precision drugs finely tuning cellular pathways involved in growth and tumorigenesis deranged in LO. Abstract Congenital disorders of lateralized or segmental overgrowth (LO) are heterogeneous conditions with increased tissue growth in a body region. LO can affect every region, be localized or extensive, involve one or several embryonic tissues, showing variable severity, from mild forms with minor body asymmetry to severe ones with progressive tissue growth and related relevant complications. Recently, next-generation sequencing approaches have increased the knowledge on the molecular defects in LO, allowing classifying them based on the deranged cellular signaling pathway. LO is caused by either genetic or epigenetic somatic anomalies affecting cell proliferation. Most LOs are classifiable in the Beckwith–Wiedemann spectrum (BWSp), PI3KCA/AKT-related overgrowth spectrum (PROS/AROS), mosaic RASopathies, PTEN Hamartoma Tumor Syndrome, mosaic activating variants in angiogenesis pathways, and isolated LO (ILO). These disorders overlap over common phenotypes, making their appraisal and distinction challenging. The latter is crucial, as specific management strategies are key: some LO is associated with increased cancer risk making imperative tumor screening since childhood. Interestingly, some LO shares molecular mechanisms with cancer: recent advances in tumor biological pathway druggability and growth downregulation offer new avenues for the treatment of the most severe and complicated LO.

[13] Computational drug discovery approaches identify mebendazole as a candidate treatment for autosomal dominant polycystic kidney disease

  • Authors: P. Brownjohn, A. Zoufir, Daniel J O’Donovan, Saatviga Sudhahar, A. Syme et al.
  • Year: 2024
  • Venue: Frontiers in Pharmacology
  • URL: https://www.semanticscholar.org/paper/a595e78572ca02b8cb2897bfc4a989a2b021b279
  • DOI: 10.3389/fphar.2024.1397864
  • PMID: 38846086
  • PMCID: 11154008
  • Citations: 3
  • Summary: It is determined that the anthelmintic mebendazole was a potent anti-cystic agent in human cellular and in vivo models of ADPKD, and is likely acting through the inhibition of microtubule polymerisation and protein kinase activity.
  • Evidence snippets:
  • Snippet 1 (score: 0.373) > Targets and molecules were ultimately filtered for validation based on biological and chemical insights, and the potential for clinical translation.Earlier this year, Wilk et al., 2023 applied a similar transcriptomic approach to us, in that case making use of publicly available transcriptomic datasets to create Pkd2-specific ADPKD disease signatures, from which signature reversion was sought from the Library of Integrated Network-based Cellular Signatures (LINCs) drug signature database in order to identify drug repurposing candidates.While one group has previously made use of a knowledge graph-based approach to prioritise preclinically active compounds with the highest chance of clinical translation (Malas et al., 2019), to our knowledge, the current study provides the first combined application of transcriptomic and machine-learning approaches to identify and prioritise putative treatments for ADPKD, and further deconvolute potential mechanisms of action for experimental validation. > In summary we report, using computational, in vitro and in vivo approaches, that the anthelmintic drug mebendazole ameliorates disease-relevant phenotypes in cellular and animal models of ADPKD.We further show that this effect is likely primarily due to the inhibitory effect of mebendazole on the polymerisation of microtubules, which underlie cellular processes important in ADPKD, including cell proliferation, transport, and cilia signalling, and extends previous work linking the importance of the microtubule network to ADPKD pathophysiology.We also describe the inhibitory profile of mebendazole on known and novel protein kinase targets, some of which have previously been implicated in ADPKD, suggesting mebendazole may be acting via polypharmacology to impact disease mechanisms.We acknowledge that further experimental efforts will be required to confirm the actions of mebendazole on these putative targets in relevant disease model systems.It would be particularly informative to investigate these mechanisms in dedicated in vivo studies, where the effects of mebendazole on a wider range of ADPKD-relevant cell types and phenotypes could be evaluated.

[14] Small molecule metabolites: discovery of biomarkers and therapeutic targets

  • Authors: Shi Qiu, Ying Cai, Hong Yao, Chunsheng Lin, Yiqiang Xie et al.
  • Year: 2023
  • Venue: Signal Transduction and Targeted Therapy
  • URL: https://www.semanticscholar.org/paper/2ad9bd0b205340eea5987fc8a551f2024fa1e977
  • DOI: 10.1038/s41392-023-01399-3
  • PMID: 36941259
  • PMCID: 10026263
  • Citations: 631
  • Influential citations: 6
  • Summary: The metabolic analysis on the potential value of small-molecule candidate metabolites as biomarkers with clinical events, which may lead to better diagnosis, prognosis, drug screening and treatment, and challenges that need to be addressed to fuel the next wave of breakthroughs are summarized.
  • Evidence snippets:
  • Snippet 1 (score: 0.371) > resolve the major challenges with metabolite identification by used various spectroscopy, chromatographic methodology to influence specific constituent, result evaluation by employed different statistical methods and interpretation of clinical significance, all of which could affect experimental or clinical outcome and thus limit the application of small molecule metabolites-based metabolomics into clinical aspects. In the past decade, the significant progress and improvements in technical aspects have been made for small metabolite analysis from metabolic perturbations in tissues and biofluids to further promote understanding of molecular mechanisms to advance meaningful interpretation of metabolic features related to phenotypic variation. Analyzing and revealing metabolic changes in disease response to drugs could provide opportunities to discover the potential targets and biologically meaningful metabolic pathways for metabolism-related diseases therapy. Fortunately, targeted metabolic profiling of some metabolites has been endorsed to be applied in clinical practice for disease markers and potential targets identification for monitoring, diagnosis, and drug efficacy. > The accurate masses, fragment mass spectra and retention time should be provided to identify metabolites via database-based search methods. However, considering that significant amounts of datasets, special statistical software, complexity of computational processing, bioinformatics tool, lead to detecting specific molecules, validate the pathways and associations, analyze data even more difficult. Databases for metabolome analysis with extensive metabolite coverage with help of multivariate analysis have been significantly developed for data identification and visualization. Small metabolites are downstream of transcriptome-proteome and their metabolism were affected by various microbiota in vivo, so that multi-omics can create approach to explore the interactions of proteins, metabolites, genes, and microbiota, and then reveal the pathophysiological mechanisms in both diseased and non-diseased states. Fortunately, integration with other omics could insight into the characteristic metabolic alterations. 824,825 Integrative analysis of omics data by multi-omics technology could provide the mechanistic insights into diseases and bring precision treatment. > One of the biggest challenges is mainly in the realm of data integration still in early stages and needs additional consideration. To achieve this goal, high-throughput integration multi-omics with help improvement of computational and bioinformatics techniques has greatly contributed to accurately identify the relevant smallmetabolites and their biological processes involved in metabolic

[15] Precision Therapeutics in Lennox–Gastaut Syndrome: Targeting Molecular Pathophysiology in a Developmental and Epileptic Encephalopathy

  • Authors: Debopam Samanta
  • Year: 2025
  • Venue: Children
  • URL: https://www.semanticscholar.org/paper/455479c1bfbea7b90b73c109228f67c813d13888
  • DOI: 10.3390/children12040481
  • PMID: 40310132
  • PMCID: 12025602
  • Citations: 19
  • Influential citations: 1
  • Summary: A narrative review explores precision therapeutic strategies for LGS based on molecular pathophysiology, including channelopathies, receptor and ligand dysfunction, receptor and ligand dysfunction, cell signaling abnormalities, cell signaling abnormalities, synaptopathies, and the repurposing of existing medications with mechanism-specific effects.
  • Evidence snippets:
  • Snippet 1 (score: 0.370) > A key advantage of disease-modifying therapies is their potential to target pathogenic mechanisms early in the disease course, potentially preventing the progression of some infantile epileptic encephalopathies to LGS. > This narrative review explores precision therapeutic strategies based on specific monogenic causes and disease mechanisms relevant to LGS. A comprehensive literature search (PubMed, MEDLINE, ClinicalTrials.gov, conference abstracts from the American Academy of Neurology and American Epilepsy Society, and gray literature) was conducted through 19 February 2025 to identify established ASMs, repurposed and novel drugs, as well as various gene therapy approaches with potential relevance to LGS. Given that over 900 monogenic causes of DEEs have been identified-implicating diverse cellular components such as ion channels, receptors, synaptic proteins, signaling pathways, metabolic processes, and epigenetic regulators-this review discusses current and emerging precision therapeutics based on shared molecular mechanisms and the pathophysiology of select genes associated with LGS [17] (Table 1).

[16] Chromatin modifiers in neurodevelopment

  • Authors: Sarallah Rezazadeh, H. Ji, Cecilia Giulivi
  • Year: 2025
  • Venue: Frontiers in Molecular Neuroscience
  • URL: https://www.semanticscholar.org/paper/7a4d8c063c2b3a908a65bcb637cd818edad8db92
  • DOI: 10.3389/fnmol.2025.1551107
  • PMID: 40469903
  • PMCID: 12133960
  • Citations: 2
  • Summary: This mini review delves into key chromatin modifiers, including the histone methyl transferases NSD1 and ASH1L, the methyl-CpG-binding repressor MeCP2, and the enzymatic repressor EZH2, and spotlight their pivotal roles in early brain development and neurological disorders.
  • Evidence snippets:
  • Snippet 1 (score: 0.368) > Therefore, while epigenetic changes are essential for understanding specific aspects of neurodevelopmental disorders, it is crucial to view these mechanisms as part of a larger, more complex system that encompasses genetic, proteomic, and metabolic factors. Few examples underscore that while epigenetic mechanisms-such as DNA methylation and histone modificationsare essential in regulating gene expression and contribute to neurodevelopmental disorders, they do not fully explain the complex pathophysiology of these diseases. In many cases, the genetic mutations, absence of or dysfunction of protein, or toxic protein aggregation (e.g., Fragile X syndrome, HD) that occur in these disorders play a central role in the clinical phenotypes. Therefore, a comprehensive understanding of neurodevelopmental disorders must integrate epigenetic mechanisms and the broader genetic, proteomic, and cellular pathways that contribute to disease. An integrative approach that considers not only the regulation of gene expression but also the functional consequences of these changes at the protein, metabolic and cellular pathway levels will be essential for advancing our understanding of these intricate disorders and developing effective interventions and treatments. . B., Villate, O., Llano, I., Ocio, I., Martí, I., et al. (2020). Targeted next-generation sequencing in patients with suggestive X-linked intellectual disability. Genes 11:51. doi: 10.3390/genes11010051

[17] The ties that bind: functional clusters in limb-girdle muscular dystrophy

  • Authors: E. Barton, C. A. Pacak, Whitney L. Stoppel, P. Kang
  • Year: 2020
  • Venue: Skeletal Muscle
  • URL: https://www.semanticscholar.org/paper/653422e1a9dc9cc7f16758b10f3f203155bc68c9
  • DOI: 10.1186/s13395-020-00240-7
  • PMID: 32727611
  • PMCID: 7389686
  • Citations: 24
  • Summary: A deeper understanding of these disease pathways could yield a new generation of precision therapies that would each be expected to treat a broader range of LGMD patients than a single subtype, thus expanding the scope of the molecular medicines that may be developed for this complex array of muscular dystrophies.
  • Evidence snippets:
  • Snippet 1 (score: 0.368) > Pyridine nucleotide-disulfide reductase [55] Many of the protein functions listed require further confirmation or are disputed these methodologies. Those patients with moderate disease phenotypes regardless of the underlying causative gene mutation would likely fall into a category where there may be interest in testing a pharmacological treatment (that could be halted) but reduced interest in a more permanent experimental strategy. For all of the above-mentioned reasons, the identification of unifying therapeutic targets applicable to multiple subtypes of > LGMDs is highly desirable. > To identify such targets, we should first consider the question: What binds all of these LGMDs together? The two core phenotypic features are progressive proximal muscle weakness, along with characteristic signs of muscle fiber destruction on biopsy, referred to as "dystrophic" features. Nuances in clinical presentation have helped to distinguish some of the LGMDs, such as the frequent occurrence of difficulty walking on tiptoes in LGMD R2 (LGMD2B), caused by dysferlin deficiency. However, heterogeneity associated with variable ages of onset and ranges of severity makes it generally difficult to distinguish and diagnose LGMD subtypes based on clinical presentation alone. A change in perspective is in order to aid in understanding disease pathways responsible for clinical features even when the genetic mutation is unknown. Further, given the large number of genespecific LGMD subtypes, it could very well be that several major disease mechanisms may be shared across the family of diseases. Yet despite careful studies that have collectively determined the cellular localization of most proteins associated with LGMD (Fig. 1), there is limited knowledge of potentially unifying molecular disease mechanisms. We assert that the identification of functional clusters of these proteins, grouped by such common mechanisms, will streamline our understanding of the disease processes and identify therapeutic targets relevant to individuals in multiple disease subgroups, including individuals whose pathogenic mutations have not been found. By extension, this approach may serve as a tool to not only find common mechanisms, but may also help to distinguish LGMD subtypes that do not share similar functional patterns, and afford further refinement of potential treatments.

Notes

  • This provider combines search_papers_by_relevance with snippet_search.
  • No synthesis or second-stage model call is performed.