Small-molecule drugs arise as a prospective area to treat different types of cancer. A promising target is the NSD protein family. These proteins have been related to cancers like myeloid leukemia, multiple myeloma, prostate, lung, and breast cancer. However, their treatment is limited to chemotherapy, radiotherapy, and surgical operation that could affect the patient's life quality. In 2020, Huang and collaborators developed a novel kind of inhibitor for NSD1 protein, BT5. This inhibitor covalently binds to the SET domain of the NSD family proteins. However, there is a high affinity for NSD1 than their counterparts. These proteins share a similar structure, but their dynamics could explain the affinity difference. In this project, we compare the NSD family protein dynamics by measuring NMR relaxation experiments. We identify a higher percentage binding for NSD1 and NSD3 to BT5 than NSD2. We also determine the perturbed chemical shifts under the presence of BT5 in NSD1, where the most affected regions are the SET and post-SET domain (auto-inhibitory loop) and the beginning region of the AWS domain. By comparing different NMR relaxation measurements, we identify that the three proteins share high dynamics in the auto-inhibitory loop region, especially in NSD1, and in the AWS domain for NSD1 and NSD3. These motions corresponds to the obtained results by adding BT5 in NSD1, which could indicated a relationship between the AWS dynamics and the auto-inhibitory loop, and the protein affinity.

A síndrome de Sotos (MIM 117550) é caracterizada pelo crescimento pré e pós-natal acelerado, fácies típica com testa proeminente, hipertelorismo, estrabismo, fissura palpebral antimongolóide, as orelhas grandes, o palato alto e estreito, mãos e pés grandes e possibilidade de erupção prematura dos dentes. É também freqüentemente associada com anomalias cerebrais, cardiovasculares e urinárias, e, ocasionalmente, é acompanhado por lesões malignas, como tumor de Wilms e hepatocarcinoma. Com o avanço da idade, a face gradualmente se alonga, o queixo fica mais proeminente, a altura chega próxima ao normal e a macrocefalia não é mais pronunciada. A casuística total foi de 65 pacientes com suspeita de diagnóstico clínico da síndrome de Sotos. Esses 65 pacientes foram testados por MLPA com o Kit Salsa P026B e três deleções foram encontradas: deleção total do gene FGFR4 e regiões flanqueadas, incluindo o gene FGFR4 e dois casos de deleções parciais do gene, uma com os exons 13 e 14 deletados, e outra com deleção desde o gene FGFR4 até o exon 17 do gene FGFR4, todas \"de novo\". Na nossa amostra a freqüência de deleções foi de cerca de 5%, semelhante à observada nas populações nãojaponesas. Os pacientes com as deleções apresentam a \"fácies típica\" com abaulamento frontal, o queixo proeminente, a implantação frontal do cabelo alta; a macrocefalia, a dolicocefalia, as mãos grandes; a hipotonia neonatal e a icterícia neonatal também estão presentes nos três pacientes. Entretanto, os três pacientes nasceram com o comprimento e o peso dentro dos padrões de normalidade e não acima do percentil 97 como descrito para a Sos. Para a pesquisa de mutações no gene FGFR4, foram selecionados trinta pacientes com \"fácies típica\" da síndrome de Sotos e macrocefalia. O seqüenciamento até o momento foi realizado em quatro pares de \"primers\" referentes ao exon 5 do gene FGFR4. Dois SNPs foram encontrados, um no fragmento 5B e um no fragmento 5D. Os dois SNPs ocorreram por uma substituição da base nitrogenada C-> T e são substituições sinônimas. A comparação do estudo de Tatton-Brown, et al, (2005b) que analisou as características clínicas e comportamentais de 266 pacientes com síndrome de Sotos, cujo mecanismo genético foi desvendado, com a nossa amostra de 30 pacientes nos permitiu sugerir como critérios mínimos para o diagnóstico clínico da síndrome de Sotos a \"fácies típica\" (abaulamento frontal, testa proeminente, hipertelorismo, estrabismo, fissura palpebral antimongolóide) e a macrocefalia. As alterações no gene FGFR4 (microdeleções e mutações) são essencialmente específicas para a síndrome de Sotos e, por isso, o diagnóstico genético para qualquer caso em que haja alteração do gene FGFR4, é o de síndrome de Sotos. / Sotos syndrome (MIM 117550) is autosomal dominant condition characterized by prenatal and postnatal overgrowth, macrocephaly and a typical facial gestalt with frontal bossing, hypertelorism, antimongoloid slant of the palpebral fissures, prominent jaw, large ears, high and narrow palate and large hands and feet. The syndrome is also frequently associated with brain, cardiovascular, and urinary anomalies and is occasionally accompanied by malignant lesions such Wilms tumour and hepatocarcinoma. FGFR4 microdeletions were investigated in sixty five patients with clinical diagnosis of Sotos syndrome by multiplex ligation dependent probe amplification ( MLPA, Kit Salsa P026B). We identified one patient with a total deletion of FGFR4 and FGFR4, one with FGFR4 exon13-14 deletion and another with a deletion that included FGFR4 and FGFR4 exon1-17. All deletions were \"de novo\". In our sample, the frequency of deletions was ~5%, similar to that found in non-Japanese populations. The clinical features of the three patients with microdeletions are: the typical facial gestalt with frontal bossing, prominent jaw and high anterior hairline; macrocephaly, dolichocephaly, large hands; neonatal hypotonia and jaundice. However, those three patients presented normal length and weight at birth. Clinical and behavioral features of 30 patients presenting a typical facial gestalt and macrocephaly, cardinal characteristics of Sotos syndrome were described. The comparison of the clinical and behavioral features to those described for 266 patients with a genetic diagnosis of Sotos syndrome indicates that a high clinical suspition of Sotos syndrome includes the typical facial gestalt (frontal bossing, hipertelorism, strabismus, prominent jaw, antimongoloid slant of the palpebral fissures) and macrocephaly. Other features associated with Sotos syndrome, such as overgrowth, learning disability, behavioral problems confirms the clinical diagnosis. FGFR4 microdeletion investigations detects only 5% of the Brazilian patients with Sotos syndrome. Screening for intragenic FGFR4 mutations may not be necessary in classic Sotos syndrome cases. However, identification of an FGFR4 abnormality is diagnostic of Sotos syndrome.

En la presente tesis doctoral se ha realizado un estudio de investigación encaminado a definir los genes responsables que causan hipercrecimiento en humanos, así como la identificación y caracterización de las mutaciones de pacientes españoles con síndromes de hipercrecimiento, con especial atención a los afectos de síndrome de Sotos. Los resultados obtenidos han permitido definir el espectro mutacional en un considerable número de pacientes con síndrome de Sotos, caracterizar en detalle estas mutaciones así como muchos polimorfismos intragénicos, en ambos casos, algunos cambios no han sido previamente descritos y otros son recurrentes. Se ha verificado la escasez de microdeleciones en población española, como en otros estudios europeos, y en los casos en los que se han identificado, se han caracterizado en detalle el tamaño y origen parental de las mismas. Se ha corroborado la validez de los criterios clínicos como indicación para estudio molecular. Se han diseñado estudios para buscar grandes reordenamientos genómicos en pacientes sin mutación previamente identificada, llegándose a caracterizar de estar manera varios reordenamientos genómicos en pacientes con sobrecremiento. / This doctoral thesis presents a research study designed to identify genes causing overgrowth in humans. The indentification and the characterization of mutations in spanish patients with overgrowth syndromes, mainly focusing on the patients with Sotos syndrome, were permormed. The obtained results helped to define the mutational spectrum in considerable amount of patients with Sotos syndrome, the detailed characterization of these mutations and, also, many intragenic polymorphisms. In both cases some of the identified changes were not previously reported and others were recurrent. It was verified that in spanish population the ratio of microdeletions is low, being similar to those previously reported in other european studies. In the cases that were identified, the detailed analysis of the size and the parental origin of mutations was carried out. The validity of clinical criteria as indicators for molecular study was confirmed. For the patients without known mutations, the experiments exploring large genomic rearrangements were designed and, consiquently, several genomic rearrangements in the patients with overgrowth were discovered.

A síndrome de Sotos (MIM 117550) é caracterizada pelo crescimento pré e pós-natal acelerado, fácies típica com testa proeminente, hipertelorismo, estrabismo, fissura palpebral antimongolóide, as orelhas grandes, o palato alto e estreito, mãos e pés grandes e possibilidade de erupção prematura dos dentes. É também freqüentemente associada com anomalias cerebrais, cardiovasculares e urinárias, e, ocasionalmente, é acompanhado por lesões malignas, como tumor de Wilms e hepatocarcinoma. Com o avanço da idade, a face gradualmente se alonga, o queixo fica mais proeminente, a altura chega próxima ao normal e a macrocefalia não é mais pronunciada. A casuística total foi de 65 pacientes com suspeita de diagnóstico clínico da síndrome de Sotos. Esses 65 pacientes foram testados por MLPA com o Kit Salsa P026B e três deleções foram encontradas: deleção total do gene FGFR4 e regiões flanqueadas, incluindo o gene FGFR4 e dois casos de deleções parciais do gene, uma com os exons 13 e 14 deletados, e outra com deleção desde o gene FGFR4 até o exon 17 do gene FGFR4, todas \"de novo\". Na nossa amostra a freqüência de deleções foi de cerca de 5%, semelhante à observada nas populações nãojaponesas. Os pacientes com as deleções apresentam a \"fácies típica\" com abaulamento frontal, o queixo proeminente, a implantação frontal do cabelo alta; a macrocefalia, a dolicocefalia, as mãos grandes; a hipotonia neonatal e a icterícia neonatal também estão presentes nos três pacientes. Entretanto, os três pacientes nasceram com o comprimento e o peso dentro dos padrões de normalidade e não acima do percentil 97 como descrito para a Sos. Para a pesquisa de mutações no gene FGFR4, foram selecionados trinta pacientes com \"fácies típica\" da síndrome de Sotos e macrocefalia. O seqüenciamento até o momento foi realizado em quatro pares de \"primers\" referentes ao exon 5 do gene FGFR4. Dois SNPs foram encontrados, um no fragmento 5B e um no fragmento 5D. Os dois SNPs ocorreram por uma substituição da base nitrogenada C-> T e são substituições sinônimas. A comparação do estudo de Tatton-Brown, et al, (2005b) que analisou as características clínicas e comportamentais de 266 pacientes com síndrome de Sotos, cujo mecanismo genético foi desvendado, com a nossa amostra de 30 pacientes nos permitiu sugerir como critérios mínimos para o diagnóstico clínico da síndrome de Sotos a \"fácies típica\" (abaulamento frontal, testa proeminente, hipertelorismo, estrabismo, fissura palpebral antimongolóide) e a macrocefalia. As alterações no gene FGFR4 (microdeleções e mutações) são essencialmente específicas para a síndrome de Sotos e, por isso, o diagnóstico genético para qualquer caso em que haja alteração do gene FGFR4, é o de síndrome de Sotos. / Sotos syndrome (MIM 117550) is autosomal dominant condition characterized by prenatal and postnatal overgrowth, macrocephaly and a typical facial gestalt with frontal bossing, hypertelorism, antimongoloid slant of the palpebral fissures, prominent jaw, large ears, high and narrow palate and large hands and feet. The syndrome is also frequently associated with brain, cardiovascular, and urinary anomalies and is occasionally accompanied by malignant lesions such Wilms tumour and hepatocarcinoma. FGFR4 microdeletions were investigated in sixty five patients with clinical diagnosis of Sotos syndrome by multiplex ligation dependent probe amplification ( MLPA, Kit Salsa P026B). We identified one patient with a total deletion of FGFR4 and FGFR4, one with FGFR4 exon13-14 deletion and another with a deletion that included FGFR4 and FGFR4 exon1-17. All deletions were \"de novo\". In our sample, the frequency of deletions was ~5%, similar to that found in non-Japanese populations. The clinical features of the three patients with microdeletions are: the typical facial gestalt with frontal bossing, prominent jaw and high anterior hairline; macrocephaly, dolichocephaly, large hands; neonatal hypotonia and jaundice. However, those three patients presented normal length and weight at birth. Clinical and behavioral features of 30 patients presenting a typical facial gestalt and macrocephaly, cardinal characteristics of Sotos syndrome were described. The comparison of the clinical and behavioral features to those described for 266 patients with a genetic diagnosis of Sotos syndrome indicates that a high clinical suspition of Sotos syndrome includes the typical facial gestalt (frontal bossing, hipertelorism, strabismus, prominent jaw, antimongoloid slant of the palpebral fissures) and macrocephaly. Other features associated with Sotos syndrome, such as overgrowth, learning disability, behavioral problems confirms the clinical diagnosis. FGFR4 microdeletion investigations detects only 5% of the Brazilian patients with Sotos syndrome. Screening for intragenic FGFR4 mutations may not be necessary in classic Sotos syndrome cases. However, identification of an FGFR4 abnormality is diagnostic of Sotos syndrome.

There are more than 7000 described rare genetic disorders; however, the molecular basis underlying approximately half of these disorders is unknown, and the majority are currently untreatable. Stature and growth abnormalities are a common clinical feature of many rare disorders including: Floating-Harbor syndrome (FHS), a short stature syndrome characterized by delayed osseous maturation, language deficits, and unique dysmorphic facial features; Weaver syndrome, an overgrowth syndrome characterized by advanced osseous maturation, developmental delay, and macrocephaly; and Sotos syndrome with cutis laxa, an overgrowth syndrome with marked tissue laxity in addition to the typical Sotos characteristics of developmental delay, macrocephaly, and a unique facial gestalt. The genetic basis underlying these three rare stature conditions were unknown at the outset of this study. We utilized high-throughput exome sequencing approaches to investigate the molecular etiology of these rare disorders and identified truncating mutations in the final exon of SRCAP as the genetic cause underlying FHS, missense mutations in EZH2 in Weaver syndrome, and novel mutations in the Sotos syndrome gene NSD1 in Sotos syndrome with cutis laxa. Next, we investigated the spectrum of SRCAP mutations in FHS and established the clustering of truncating SRCAP mutations in the final exon as being highly suggestive of a non-haploinsufficiency mutational mechanism in FHS. Finally, global methylation array analysis identified a unique methylation ‘epi-signature’ in FHS individuals, providing further insight into FHS disease mechanism and a diagnostic signature. These studies have delineated the molecular etiology of these three rare stature/growth disorders, furthered our understanding of the associated clinical spectrum, and provided biological insight into disease pathogenesis.