Les élevages des poissons sont soumis à des épisodes de mortalité anormale. Les bactéries du genre Vibrio sont connues comme des pathogènes opportunistes et ont été associées à ces épisodes de mortalité. Pour faire face à ces problèmes d’épizooties, les pisciculteurs ont le plus souvent recours à l’utilisation des antibiotiques. Néanmoins, des abus dans son utilisation ont malheureusement conduit à l’apparition des souches résistantes et à des fréquents échecs de traitement. Actuellement, les traitements par des bactéries lactiques probiotiques permettent d’améliorer la qualité des alevins produits pour les besoins de l’aquaculture, tout en limitant le recours aux antibiotiques. Pour qu’un micro-organisme soit reconnu comme étant potentiellement probiotique, une évaluation de ce produit basée sur plusieurs critères doit être établie. Dans une première étape, nous avons sélectionné et caractérisé 55 souches de bactéries lactiques isolées en écloserie. Le premier critère de sélection a porté sur l’inhibition de souches de vibrions pathogènes in vitro. Les bactéries lactiques ayant un effet anti Vibrio ont subi des tests de formation de biofilms et des tests de caractérisations phénotypiques, enzymatiques, physiologiques et génétiques, afin de procéder à leur identification. Puis des tests de compétition avec V. aligonlyticus ont été pratiqués in vivo sur des larves d’Artemia. Ce travail nous a permis de sélectionner la souche Lactobacillus casei (X2), car elle présentait la meilleure combinaison de propriétés requises pour un probiotique. Elle possède en effet une bonne activité antagoniste, elle n’est pas hémolytique, elle présente une forte adhérence sur plaque polystyrène et elle offre la meilleure protection contre V. alginolyticus lors du test de challenge avec Artemia. Dans une deuxième étape, la souche retenue (La. casei X2) et une autre déjà commercialisée sous le nom de Bactocell (Pediococcus acidilactici) ont été testées sur des larves de bar, afin d'évaluer les effets sur la qualité des alevins, leur réponse immunitaire et la microflore associée. Nous avons vérifié que les deux probiotiques (La. Casei et P. acidilactici) diminuaient la charge en vibrions et en microflore totale chez les larves de bar. La souche P. acidilactici a également affecté les profils de la communauté bactérienne intestinale des larves de bar. Par contre, La. casei n’a pas affecté la structure de la communauté bactérienne, bien que la souche soit présente chez les larves au jour 40 à une concentration élevée. Ces deux bactéries ont pu améliorer la croissance en longueur des larves aux jours 30 et 45 et la croissance en poids au jour 20. L’étude de l’influence des deux probiotiques sur des marqueurs de la physiologie des larves a montré qu’au jour 41, P. acidilactici était plus efficace que La. casei dans la régulation du stress oxydatif. Néanmoins, P. acidilactici a engendré des effets inflammatoires chez les larves à j20, et elle a induit un retard dans le développement osseux. Bien que La. casei ait accéléré le processus d’ossification chez les larves à j20, l’étude histopathologique a révélé une forte incidence des malformations vertébrales avec les larves à j62. A l’inverse, les larves alimentées avec P. acidilactici ont présenté un taux supérieur d’ossification normale et complète. / Diseases cause major production losses in fish farms. Bacteria of the genus Vibrio are known as opportunistic pathogens, and have been associated with mass-mortality episodes. To cope with these disease outbreaks, fish farmers often resort to the use of antibiotics. However, preventive overuse has led to the emergence of resistant strains and frequent treatment failures. Probiotic lactic acid bacteria are increasingly used to improve the quality of seed production in aquaculture, while limiting antibiotic treatments. Microbial strains must fulfil several criteria to be evaluated as potential probiotics.In a first step, we selected and characterized 55 strains of lactic acid bacteria isolated from fish hatchery. The first selection criterion focused on the in-vitro inhibition of pathogenic Vibrio strains. Lactic acid bacteria with antagonistic properties were tested for biofilm formation. The strains were characterised with the phenotypes, based on enzymatic and physiological tests, and identified by genotyping. In-vivo challenges with Vibrio aligonlyticus were then performed on Artemia. Lactobacillus casei X2 was thus selected, due to the best combination of the attributes that are required for probiotics. The strain showed antagonistic activity, adhered strongly to polystyrene plate, and secured Artemia with the best protection against V. alginolyticus. In a second step, La. casei X2 and a commercial strain of probiotics (Bactocell, Pediococcus acidilactici) were tested on European sea bass larvae, with a view to assess the effects on alevin quality, immune response and associated microbiota. Both of the lactic acid bacteria, La. casei and P. acidilactici, decreased the bacterial load and Vibrio in sea bass larvae. P. acidilactici changed significantly the profile of the bacterial community associated with fish larvae, compared to the control group. La. casei did not affect the structure of the bacterial community, although the strain was detected at high concentration in the larvae at 40 day post hatch (dph). Both probiotic treatments increased fish larval growth in body mass at 20 dph, and in length at 30 and 45 dph. Two physiological markers for gene expression suggested that P. acidilactici was more efficient than La. casei for the regulation of oxidative stress in sea bass at 41 dph. P. acidilactici induced some delay in bone development, and inflammatory signs were observed in the larvae at 20 dph. Though La. casei accelerated the early ossification process in the larvae by 20 dph, the histopathological study revealed a high incidence of vertebral malformations at 62 dph. In contrast, the treatment with P. acidilactici produced the highest proportion of fish with normal and complete ossification.

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2006. / Titre provenant de l'écran-titre.

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Selon les lignes directrices de traitement de l'asthme pendant la grossesse, les beta2-agonistes inhalés à courte durée d’action (SABA) sont les médicaments de choix pour tous les types d’asthme [intermittent, persistant, léger, modéré et sévère] comme médicaments de secours rapide et dans la gestion des exacerbations aiguës. D’autre part, les beta2-agonistes inhalés à longue durée d’action (LABA) sont utilisés pour les patients atteints d'asthme persistant, modéré à sévère, qui ne sont pas entièrement contrôlés par des corticostéroïdes inhalés seuls. Malgré que plusieurs études aient examinées l’association entre les LABA, les SABA et les malformations congénitales chez les nouveau-nés, les risques réels restent controversés en raison de résultats contradictoires et des difficultés inhérentes à la réalisation d'études épidémiologiques chez les femmes enceintes. L'objectif de cette étude était d'évaluer l'association entre l'exposition maternelle aux SABA et LABA pendant le premier trimestre de grossesse et le risque de malformations congénitales chez les nouveau-nés de femmes asthmatiques. Une cohorte de grossesses de femmes asthmatiques ayant accouchées entre le 1er janvier 1990 et le 31 décembre 2002 a été formée en croisant trois banques de données administratives de la province de Québec (Canada). Les issues principales de cette étude étaient les malformations congénitales majeures de touts types. Comme issues secondaires, nous avons considéré des malformations congénitales spécifiques. L'exposition principale était la prise de SABA et/ou de LABA au cours du premier trimestre de grossesse. L'exposition secondaire étudiée était le nombre moyen de doses de SABA par semaine au cours du premier trimestre. L'association entre les malformations congénitales et la prise de SABA et de LABA a été évaluée en utilisant des modèles d’équations généralisées (GEE) en ajustant pour plusieurs variables confondantes reliées à la grossesse, l’asthme de la mère et la santé de la mère et du foetus. Dans la cohorte formée de 13 117 grossesses de femmes asthmatiques, nous avons identifié 1 242 enfants avec une malformation congénitale (9,5%), dont 762 avaient une malformation majeure (5,8%). Cinquante-cinq pour cent des femmes ont utilisé des SABA et 1,3% ont utilisé des LABA pendant le premier trimestre. Les rapports de cotes ajustées (IC à 95%) pour une malformation congénitale associée à l'utilisation des SABA et des LABA étaient de 1,0 (0,9-1,2) et 1,3 (0,9-2,1), respectivement. Les résultats correspondants étaient de 0,9 (0,8-1,1) et 1,3 (0,8-2,4) pour les malformations majeures. Concernant le nombre moyen de doses de SABA par semaine, les rapports de cotes ajustées (IC à 95%) pour une malformation congénitale était de 1.1 (1.0-1.3), 1.1 (0.9-1.3), et 0.9 (0.7-1.1) pour les doses >0-3, >3-10, and >10 respectivement. Les résultats correspondants étaient de 1.0 (0.8-1.2), 0.8 (0.7-1.1), et 0.7 (0.5-1.0) pour les malformations majeures. D'autre part, des rapports de cotes (IC à 95%) statistiquement significatifs ont été observés pour les malformations cardiaques (2.4 (1.1-5.1)), les malformations d'organes génitaux (6.8 (2.6-18.1)), et d'autres malformations congénitales (3.4 (1.4 à 8.5)), en association avec les LABA pris pendant le premier trimestre. Notre étude procure des données rassurantes pour l’utilisation des SABA pendant la grossesse, ce qui est en accord avec les lignes directrices de traitement de l’asthme. Toutefois, d'autres études sont nécessaires avant de pouvoir se prononcer sur l’innocuité des LABA pendant la grossesse. / According to asthma management guidelines during pregnancy, short-acting β2-agonists (SABA) are the drug of choice in all types of asthma [intermittent or persistent, mild, moderate and severe] as a quick reliever medication and in the management of acute exacerbations or emergency hospitalizations. On the other hand, long-acting β2-agonists (LABA) are used for patients with moderate and severe persistent asthma not fully controlled with inhaled corticosteroids alone. While many studies examined their associations with congenital malformations in newborns, the actual risks remain controversial due to the discordance between different risk reports and the difficulties in performing epidemiological studies on pregnant women. The objective of this study is to investigate the association between maternal exposure to SABA and LABA during the first trimester of pregnancy and the risk of congenital malformations in the newborns among asthmatic women. Through the linkage of three administrative databases from Québec, a cohort of pregnancies from asthmatic women insured by the RAMQ drug insurance plan was formed between January 1, 1990 and December 31, 2002. The primary outcomes were major and any congenital malformations and the secondary outcomes were specific malformations. The primary exposure was the separate exposure to SABA and LABA during the first trimester, while the secondary exposure was the average number of doses of SABA per week taken during the first trimester. The association between congenital malformations and SABA and LABA exposure was assessed using generalized estimating equation models while adjusting for sociodemographic, asthma, maternal and fetal variables. We identified 1242 infants with a congenital malformation (9.5%), 762 of which had a major malformation (5.8%) within the cohort formed of 13117 pregnancies. Fifty-five percent of the women used SABA during the first trimester, and 1.3% used LABA. The adjusted odds ratio (95% CI) for any malformation associated with the use of SABA and LABA were 1.0 (0.9-1.2) and 1.3 (0.9-2.1), respectively. The corresponding figures were 0.9 (0.8-1.1) and 1.3 (0.8-2.4) for major malformations. Regarding the average number of doses of SABA per week, the adjusted odds ratio (95% CI) for any malformation were 1.1 (1.0-1.3), 1.1 (0.9-1.3), and 0.9 (0.7-1.1) for doses >0-3, >3-10, and >10 respectively. The corresponding figures were 1.0 (0.8-1.2), 0.8 (0.7-1.1), and 0.7 (0.5-1.0) for major malformations. On the other hand, significant increased risks, odds ratio (95% CI), of cardiac malformations 2.4 (1.1-5.1), genital organ malformations 6.8 (2.6-18.1), and other congenital malformations 3.4 (1.4-8.5) were observed with LABA use in the 1st trimester. Our study adds evidence, in concordance with asthma management guidelines, to the safety of SABA during pregnancy. However, more research is needed before we can decide on the safety of LABA during pregnancy.

Le développement du membre passe par des étapes complexes de polarisation, dans les axes dorso-ventral et antéro-postérieur, qui ont lieu en parallèle de la croissance proximo-distale du bourgeon. Le déterminisme génétique de ces étapes est encore imparfaitement connu. Il implique des facteurs de transcription dont l’expression est temporo-spatiale spécifique, compliquant leur identification. L’étude de cohortes homogènes de patients porteurs d’anomalies développementales des membres est l’un des moyens d’identifier de nouveaux mécanismes impliqués dans leur modélisation. A cet effet, nous avons étudié des patients atteints de Syndrome Nail-Patella correspondant à un défaut de polarisation dorso-ventrale ; une grande famille de polydactylie préaxiale syndromique et une série de patients atteints de Syndrome de Nager comme modèles d’étude de la polarisation antéro-postérieure ; et enfin une cohorte de patients présentant des pieds et mains fendus correspondant à un défaut de la signalisation proximo-distale. Ces travaux nous ont permis de souligner le rôle crucial de la régulation d’expression génique dans la modélisation du bourgeon de membre et plus généralement dans le développement embryonnaire. / Limb development requires complex patterning along dorso-ventral, antero-posterior and proximo-distal axes. The molecular mechanisms underlying these stages are not fully delineated yet. Identification of the transcription factors involved is challenging because of their spatio-temporally restricted expression during limb bud development. Analysis of carefully selected series of patients affected with limb malformations is a clue to identify new mechanisms involved in this patterning. For this purpose, we studied several families presnsenting with Nail-Patella Syndrome corresponding to a disorder of dorso-ventral polarization; a large family affected with syndromic preaxial polydactyly and a series of Nager Syndrome cases as models of antero-posterior polarization; eventually, a cohort of patients affected with split hand/foot malformations corresponding to a defect in the signalisation center of proximo-distal growth and differenciation. This work has led us to emphasize the crucial role of gene expression regulation during limb bud patterning and more generally during embryological development.

La malformation anévrysmale de la veine de Galien (MAVG) est une malformation vasculaire cérébrale congénitale qui représente près d’un tiers des anomalies vasculaires pédiatriques. Au sein d’une cohorte de 51 patients atteints d’une MAVG, nous avons identifié 5 individus porteurs de mutations hétérozygotes pathogéniques d’EPHB4. Ces mutations incluent une mutation tronquante survenue de novo ainsi que des mutations d’épissage et faux-sens hétérozygotes délétères héritées d’un parent. L’invalidation d’EPHB4 chez les embryons de Danio rerio est à l’origine d’anomalies vasculaires cérébrales spécifiques impliquant la veine dorsale longitudinale, la veine orthologue médiane du prosencéphale (précurseur embryonnaire de la veine de Galien). La co-injection de l’ARNm tronqué a permis la restauration d’un phénotype sauvage démontrant que le phénotype vasculaire observé est la conséquence d’une perte de fonction d’EPHB4. L’ensemble de ces données indique qu’EPHB4 est un gène déterminant chez un sous-groupe de patients atteints d’une MAVG, comme chez Danio rerio. Les mutations perte de fonction d’EPHB4 sont à l’origine d’anomalies spécifiques du développement vasculaire cérébral. L’identification de mutations pathogéniques d’EPHB4 chez des patients présentant des malformations capillaires implique une surveillance attentive de la grossesse. Cette surveillance échographique renforcée pourrait permettre la détection précoce d’une MAVG et une prise en charge anténatale et néonatale optimale. / Vein of Galen aneurysmal malformation (VGAM) is one of the most common fetal brain vascular malformations. We conducted whole exome sequencing in 19 unrelated VGAM patients and subsequently screened candidate gene in a cohort of 32 additional patients. We found 5 affected individuals with heterozygous mutations in EPHB4 including de novo frameshift or inherited deleterious splice or missense mutations predicted to be pathogenic by in silico tools. Knockdown of EPHB4 in zebrafish embryos leads to specific anomalies of dorsal cranial vessels including dorsal longitudinal vein, the ortholog of the median prosencephalic vein, the embryonic precursor of the vein of Galen. This model allowed todemonstrate EPHB4 loss of function mutations in VGAM by the ability to rescue the brain vascular defect in knockdown zebrafish co-injected with wild type but not truncated EPHB4 mimicking the frameshift mutation. Our data showed that in both species, loss of function mutations of EPHB4 result in specific and similar brain vascular development anomaliesThe identification of EPHB4 pathogenic mutation in patients presenting capillary malformation or VGAM should lead to careful follow up of pregnancy of carriers for early detection of VGAM in order to propose optimal neonatal care. Endovascular embolization indeed greatly improved the prognosis of VGAM patients.

<p>Cerebral cavernous malformations (CCMs) are multicavernous vascular lesions affecting the central nervous system. Affected individuals have a lifetime risk of recurrent headaches, focal neurological deficits, seizures, and intracerebral hemorrhage leading to stroke. Patients tend to fall into two classes: familial cases with a known family history and multiple lesions, and; sporadic cases with no family history and single lesions. This epidemiological pattern suggests a two-hit mutational mechanism for CCM. While somatic mutations have been identified in lesions from familial patients, it is unknown if sporadic cases follow the same genetic mechanism. Using a next-generation sequencing strategy, I have identified somatic mutations from sporadic CCM lesions in the three known CCM genes, including one lesion bearing two independent mutations in CCM1. These data support a two-hit mutation mechanism in CCM for sporadic patients.</p><p>The mechanism of CCM pathogenesis (how mutations in one of the three CCM genes causes lesions to form and develop) is currently unknown. We developed mouse models that recapitulate the human disease. We have further shown that inhibition of Rho Kinase decreases the number of late-stage, multicavernous lesions. This is the first potential therapeutic strategy to specifically treat CCM, and suggests that the RhoA pathway is a central player in CCM pathogenesis.</p> / Dissertation

Developmental cortical malformations are a major cause of intractable seizures. Determining the location and timing of susceptibility for epileptiform activity is critical to identifying what mechanisms contribute to epileptogenesis in any model. Using the freeze lesion rat model of polymicrogyria, we have identified, in lesioned cortex, these two aspects of epileptogenesis. Previous studies have demonstrated that epileptiform activity cannot be evoked prior to postnatal day (P) 12, but the malformed cortex is more susceptible to seizures as early as P10. An increase in excitatory afferents to the epileptogenic zone occurs before the onset of network epileptiform activity. Whether or not these afferents are a major contributor to the hyperexcitability of the malformed cortex can be investigated by determining if they specifically create a susceptibility for epileptiform activity. We have examined that here by measuring whether that timing coincides with an increased susceptibility for evoked and spontaneous epileptiform activity. We report that the malformed cortex is more susceptible to evoked epileptiform activity than control cortex as earlier as P7 and as late as P36. Further, we also find that the form of spontaneous epileptiform activity in malformed cortex is altered as early as P7. The timing of these early disruptions of cortical function found here suggests additional epileptogenic mechanisms exist prior to the reported increase in excitatory afferents at P10. Determining the location of the seizure initiation is an essential part of epilepsy research. Some patients with developmental cortical malformations have seizures initiated within the malformation, while others have seizures generated by the surrounding cortex. Previous data in the freeze lesion model of microgyria suggests that the timing of freeze lesion (from P0 to P1) can shift the epileptogenic focus from the malformation to the paramicrogyrial region (PMR). We report that both the timing of the freeze lesion and the survival age of the animal can alter the epileptogenic circuitry of the malformation and surrounding tissue. These findings provide new insight to the timeline of hyperexcitability in malformed cortex and will possibly lead to greater surgical success for patients with intractable epilepsy.

Os corantes são utilizados pelo homem há mais de 20 mil anos, com emprego nas indústrias têxteis, farmacêuticas, alimentícias, cosméticas, fotográficas, entre outras. Contudo, apesar de sua importância, os corantes podem ser tóxicos, mutagênicos e resistentes a muitos processos de degradação utilizados em estações de tratamento de águas residuais. Dentro deste contexto, o objetivo desta pesquisa foi avaliar os efeitos ecotoxicológicos dos corantes têxteis Disperse Red 60 (DR 60), Disperse Red 73 (DR 73) e Disperse Red 78 (DR 78) por meio de testes de toxicidade em três organismos de diferentes níveis tróficos: a bactéria Vibrio fischeri, o microcrustáceo Daphnia similis e o peixe Danio rerio (zebrafish), além da mutagenicidade na bactéria Salmonella typhimurium. Nossos resultados mostraram que os corantes DR 73 e DR 78 induzem toxicidade aguda em Vibrio fischeri e Daphnia similis, reduzindo a luminescência da bactéria e causando imobilidade no microcrustáceo, ao passo que o corante Disperse Red 60 não altera esses endpoints. No entanto, todos os corantes causam efeitos tóxicos em embriões e larvas de Danio rerio. O corante DR 60 ocasionou edemas oculares, alteração no comportamento e indução de efeitos pró-oxidantes em zebrafish. O corante DR 73 reduziu a inflação da bexiga natatória, induziu edemas do pericárdio, promoveu escoliose e alteração no saco vitelínico. Além disso, os corantes DR 73 e DR 78 alteraram o comportamento e balanço energético, induziram efeitos pró-oxidantes e neurotoxicidade. Quanto à mutagenicidade, o corante DR 73 induziu deslocamento do quadro de leitura e substituição de pares de base, enquanto o corante DR 78 causou apenas deslocamento do quadro de leitura e o corante DR 60 não induziu mutagenicidade. Em conclusão, os corantes Disperse Red 73 e Disperse Red 78 foram os mais tóxicos para os organismos avaliados, uma vez que alteraram maior número de endpoints, assim como causaram efeitos em menores concentrações, a partir de 1 ?g/L. Este estudo também demonstra a importância do uso de organismos testes de diferentes níveis tróficos, bem como a necessidade de uma maior atenção quanto ao registro e liberação para uso de corantes, visando prevenir danos ao ambiente e à saúde humana / Dyes have been used for more than twenty thousand years in the textile, pharmaceutical, food, cosmetic, and photographic industry, among others. Despite their importance in these applications, dyes can be toxic, mutagenic and resistant to many degradation processes used in wastewater treatment plants. In this context, the aim of this research was to evaluate the ecotoxicological effects of the Disperse Red 60 (DR 60), Disperse Red 73 (DR 73) and Disperse Red 78 (DR 78) textile dyes by means of toxicity tests on three organisms of different trophic levels: the bacterium Vibrio fischeri, the microcrustacean Daphnia similis and the fish Danio rerio (zebrafish). In addition, the mutagenicity of these dyes to the bacterium Salmonella typhimurium was evaluated. Our results demonstrate that the dyes DR 73 and DR 78 induce acute toxicity to V. fischeri (luminescence reduction) and D. similis (immobility), whereas the DR 60 did not alter these endpoints at the concentrations tested. However, all dyes caused toxic effects on embryos and larvae of D. rerio. DR 60 caused ocular edema, altered behavior and induced pro-oxidant effects in zebrafish. DR 73 reduced swim bladder inflation, induced pericardial edema, promoted scoliosis and changes in yolk sacs. In addition, DR 73 and DR 78 altered the zebrafish juvenile behavior and energy balance, and induced pro-oxidant effects and neurotoxicity. As for the mutagenicity test, DR 73 induced frameshift and base pair substitution, whereas DR 78 caused only frameshift and DR 60 did not induce any mutagenic effects. In conclusion, DR 73 and DR 78 were the most toxic for the organisms tested since they altered a greater number of endpoints and caused toxic effects at lower concentrations, i.e. from 1 ?g/L onwards. These results indicate the importance of using a battery of test organisms from different trophic levels when evaluating the environmental risks of dyes, as well as the need for greater attention regarding the Registration and authorization of the use of dyes in order to prevent unacceptable risks to the environment and human health.

INTRODUÇÃO: As alterações cromossômicas são a primeira suspeita etiológica em indivíduos com múltiplas anomalias congênitas, atraso de desenvolvimento neuropsicomotor e/ou deficiência cognitiva. Verifica-se que em alguns pacientes esse fenótipo está associado a alterações pigmentares como as manchas cutâneas. Porém, nem sempre o resultado do cariótipo em sangue periférico para esses pacientes revela alterações cromossômicas. Dessa forma, a análise cromossômica de outro tecido, como a cultura e cariotipagem dos fibroblastos da pele, torna-se importante para verificar a ocorrência de mosaicismo oculto que poderia explicar o fenótipo clínico. OBJETIVOS: Padronizar e implantar um protocolo para cultura de fibroblastos de pele humana, oriunda de manchas cutâneas de pacientes com atraso de desenvolvimento neuropsicomotor e/ou malformações. Estabelecer o método de cariotipagem molecular de fibroblastos em tecido epitelial e realizar a correlação com o fenótipo. MÉTODOS: Os pacientes foram provenientes do ambulatório de Genética do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICR-HCFMUSP). Foram realizados cariótipos de fibroblastos de pele de 15 pacientes com cariótipo de sangue periférico normal, portadores de manchas cutâneas associadas ao atraso de desenvolvimento neuropsicomotor e/ou malformações. A análise citogenética dos fibroblastos foi feita a partir de biópsia cutânea das manchas, seguida dos seguintes procedimentos: cultura de fibroblastos, processamento, cariotipagem por bandamento G e análise citogenética molecular. RESULTADOS: Dentre os 15 casos estudados, 8 apresentaram isocromosomo de 12p (síndrome de Pallister-Killian), 1 apresentou um mosaicismo sexual atípico e os outros 6 apresentaram resultado normal. CONCLUSÃO: A análise cromossômica de fibroblastos foi imprescindível para o diagnóstico de pacientes com manchas cutâneas associadas à múltiplas anomalias congênitas, atraso de desenvolvimento neuropsicomotor e/ou deficiência cognitiva. A abordagem diagnóstica adequada é fundamental para conduzir o tratamento de forma apropriada e para definir o prognóstico desses pacientes, sendo também imprescindível para a realização do aconselhamento genético / INTRODUCTION: Chromosomal aberrations are the first suspected etiology in individuals with multiple congenital anomalies, developmental delay and/or intellectual disability. This phenotype is sometimes associated with pigmentary skin anomalies. However, in some cases the peripheral blood cells karyotype is normal. Therefore, the cytogenetic analysis of other tissues such as culture and karyotyping of skin fibroblasts is important to verify the occurrence of cryptic mosaicism that may explain the clinical phenotype. OBJECTIVES: To standardize and set a protocol for culture of human skin fibroblasts. To perform molecular karyotyping of fibroblasts and establish the correlation with phenotype. METHODS: Patients were recruited from the outpatient clinic of the Genetics Unit of Instituto da Criança do Hospital das Clínicas d Faculdade de Medicina da Universidade de São Paulo (ICR-HCFMUSP). The karyotypes of skin fibroblasts were performed in 15 patients with normal blood karyotype, presenting with pigmentary skin anomalies associated with developmental delay and/or malformations. The cytogenetic analysis of fibroblasts was made from skin biopsy of the spots, followed by fibroblast culture, processing, karyotyping by G-banding analysis and molecular cytogenetics. RESULTS: Among the 15 cases studied, 8 showed isochromosome 12p (Pallister-Killian syndrome), 1 had atypical sexual mosaicism and the other 6 had normal results. CONCLUSION: The cytogenetic analysis of skin fibroblasts is crucial for the diagnosis of patients with pigmentary skin anomalies associated with developmental delay and/or malformations. The proper diagnosis is fundamental for the appropriate treatment, to define prognosis for these patients and essential for the genetic counselling