Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1996 Oct;33(10):863–868. doi: 10.1136/jmg.33.10.863

Zellweger syndrome and associated phenotypes.

D R FitzPatrick 1
PMCID: PMC1050768  PMID: 8933342

Abstract

Until recently, the peroxisome was considered a "reactor chamber" for H2O2 producing oxidases, and it is now recognised as a versatile organelle performing complex catabolic and biosynthetic roles in the cell. Zellweger syndrome (ZS), the paradigm of human peroxisomal disorders, is characterised by neonatal hypotonia, severe neuro-developmental delay, hepatomegaly, renal cysts, senorineural deafness, retinal dysfunction, and facial dysmorphism. It is now clear that ZS is at the severe end of a phenotypic spectrum of Zellweger-like syndromes which may present for diagnosis later in childhood and even in adult life. It is important that clinical geneticists are aware of these milder clinical variants as the availability of sensitive and specific biochemical assays of peroxisomal function (for example, serum VLCFA ratios, platelet DHAP-AT activity) makes their diagnosis relatively straightforward.

Full text

PDF

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOWEN P., LEE C. S., ZELLWEGER H., LINDENBERG R. A FAMILIAL SYNDROME OF MULTIPLE CONGENITAL DEFECTS. Bull Johns Hopkins Hosp. 1964 Jun;114:402–414. [PubMed] [Google Scholar]
  2. Barr D. G., Kirk J. M., al Howasi M., Wanders R. J., Schutgens R. B. Rhizomelic chondrodysplasia punctata with isolated DHAP-AT deficiency. Arch Dis Child. 1993 Mar;68(3):415–417. doi: 10.1136/adc.68.3.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Barth P. G., Schutgens R. B., Bakkeren J. A., Dingemans K. P., Heymans H. S., Douwes A. C., van der Klei-van Moorsel J. M. A milder variant of Zellweger syndrome. Eur J Pediatr. 1985 Nov;144(4):338–342. doi: 10.1007/BF00441774. [DOI] [PubMed] [Google Scholar]
  4. Baudhuin P., Beaufay H., De Duve C. Combined biochemical and morphological study of particulate fractions from rat liver. Analysis of preparations enriched in lysosomes or in particles containing urate oxidase, D-amino acid oxidase, and catalase. J Cell Biol. 1965 Jul;26(1):219–243. doi: 10.1083/jcb.26.1.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cavalier-Smith T. The simultaneous symbiotic origin of mitochondria, chloroplasts, and microbodies. Ann N Y Acad Sci. 1987;503:55–71. doi: 10.1111/j.1749-6632.1987.tb40597.x. [DOI] [PubMed] [Google Scholar]
  6. Dodt G., Braverman N., Wong C., Moser A., Moser H. W., Watkins P., Valle D., Gould S. J. Mutations in the PTS1 receptor gene, PXR1, define complementation group 2 of the peroxisome biogenesis disorders. Nat Genet. 1995 Feb;9(2):115–125. doi: 10.1038/ng0295-115. [DOI] [PubMed] [Google Scholar]
  7. FitzPatrick D. R., Germain-Lee E., Valle D. Isolation and characterization of rat and human cDNAs encoding a novel putative peroxisomal enoyl-CoA hydratase. Genomics. 1995 Jun 10;27(3):457–466. doi: 10.1006/geno.1995.1077. [DOI] [PubMed] [Google Scholar]
  8. FitzPatrick D. R., Valle D. A new complementation assay for peroxisome-deficient cell lines. J Inherit Metab Dis. 1996;19(1):94–95. doi: 10.1007/BF01799359. [DOI] [PubMed] [Google Scholar]
  9. Gilbert E. F., Opitz J. M., Spranger J. W., Langer L. O., Jr, Wolfson J. J., Viseskul C. Chondrodysplasia punctata--rhizomelic form. Pathologic and radiologic studies of three infants. Eur J Pediatr. 1976 Sep 1;123(2):89–109. doi: 10.1007/BF00442639. [DOI] [PubMed] [Google Scholar]
  10. Gilchrist K. W., Gilbert E. F., Shahidi N. T., Opitz J. M. The evaluation of infants with the Zellweger (cerebro-hepato-renal) syndrome. Clin Genet. 1975 May-Jun;7(5):413–416. doi: 10.1111/j.1399-0004.1975.tb00350.x. [DOI] [PubMed] [Google Scholar]
  11. Goldfischer S., Collins J., Rapin I., Neumann P., Neglia W., Spiro A. J., Ishii T., Roels F., Vamecq J., Van Hoof F. Pseudo-Zellweger syndrome: deficiencies in several peroxisomal oxidative activities. J Pediatr. 1986 Jan;108(1):25–32. doi: 10.1016/s0022-3476(86)80764-8. [DOI] [PubMed] [Google Scholar]
  12. Goldfischer S., Moore C. L., Johnson A. B., Spiro A. J., Valsamis M. P., Wisniewski H. K., Ritch R. H., Norton W. T., Rapin I., Gartner L. M. Peroxisomal and mitochondrial defects in the cerebro-hepato-renal syndrome. Science. 1973 Oct 5;182(4107):62–64. doi: 10.1126/science.182.4107.62. [DOI] [PubMed] [Google Scholar]
  13. Goldfischer S., Powers J. M., Johnson A. B., Axe S., Brown F. R., Moser H. W. Striated adrenocortical cells in cerebro-hepato-renal (Zellweger) syndrome. Virchows Arch A Pathol Anat Histopathol. 1983;401(3):355–361. doi: 10.1007/BF00734851. [DOI] [PubMed] [Google Scholar]
  14. Gould S. J., Keller G. A., Hosken N., Wilkinson J., Subramani S. A conserved tripeptide sorts proteins to peroxisomes. J Cell Biol. 1989 May;108(5):1657–1664. doi: 10.1083/jcb.108.5.1657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Gould S. J., McCollum D., Spong A. P., Heyman J. A., Subramani S. Development of the yeast Pichia pastoris as a model organism for a genetic and molecular analysis of peroxisome assembly. Yeast. 1992 Aug;8(8):613–628. doi: 10.1002/yea.320080805. [DOI] [PubMed] [Google Scholar]
  16. Gärtner J., Moser H., Valle D. Mutations in the 70K peroxisomal membrane protein gene in Zellweger syndrome. Nat Genet. 1992 Apr;1(1):16–23. doi: 10.1038/ng0492-16. [DOI] [PubMed] [Google Scholar]
  17. Heymans H. S., Schutgens R. B., Tan R., van den Bosch H., Borst P. Severe plasmalogen deficiency in tissues of infants without peroxisomes (Zellweger syndrome). Nature. 1983 Nov 3;306(5938):69–70. doi: 10.1038/306069a0. [DOI] [PubMed] [Google Scholar]
  18. Hittner H. M., Kretzer F. L., Mehta R. S. Zellweger syndrome. Lenticular opacities indicating carrier status and lens abnormalities characteristic of homozygotes. Arch Ophthalmol. 1981 Nov;99(11):1977–1982. doi: 10.1001/archopht.1981.03930020853008. [DOI] [PubMed] [Google Scholar]
  19. Jinno Y., Niikawa N., Shimada K., Matsuda I. Restriction fragment length polymorphisms in the 5' end region of the human argininosuccinate synthetase gene. J Inherit Metab Dis. 1986;9(3):317–320. doi: 10.1007/BF01799674. [DOI] [PubMed] [Google Scholar]
  20. Lazarow P. B., Fujiki Y. Biogenesis of peroxisomes. Annu Rev Cell Biol. 1985;1:489–530. doi: 10.1146/annurev.cb.01.110185.002421. [DOI] [PubMed] [Google Scholar]
  21. Lazarow P. B., Small G. M., Santos M., Shio H., Moser A., Moser H., Esterman A., Black V., Dancis J. Zellweger syndrome amniocytes: morphological appearance and a simple sedimentation method for prenatal diagnosis. Pediatr Res. 1988 Jul;24(1):63–67. doi: 10.1203/00006450-198807000-00016. [DOI] [PubMed] [Google Scholar]
  22. McGuinness M. C., Moser A. B., Poll-The B. T., Watkins P. A. Complementation analysis of patients with intact peroxisomes and impaired peroxisomal beta-oxidation. Biochem Med Metab Biol. 1993 Apr;49(2):228–242. doi: 10.1006/bmmb.1993.1025. [DOI] [PubMed] [Google Scholar]
  23. Naritomi K., Hyakuna N., Suzuki Y., Orii T., Hirayama K. Zellweger syndrome and a microdeletion of the proximal long arm of chromosome 7. Hum Genet. 1988 Oct;80(2):201–202. doi: 10.1007/BF00702873. [DOI] [PubMed] [Google Scholar]
  24. Naritomi K., Izumikawa Y., Ohshiro S., Yoshida K., Shimozawa N., Suzuki Y., Orii T., Hirayama K. Gene assignment of Zellweger syndrome to 7q11.23: report of the second case associated with a pericentric inversion of chromosome 7. Hum Genet. 1989 Dec;84(1):79–80. doi: 10.1007/BF00210677. [DOI] [PubMed] [Google Scholar]
  25. Passarge E., McAdams A. J. Cerebro-hepato-renal syndrome. A newly recognized hereditary disorder of multiple congenital defects, including sudanophilic leukodystrophy, cirrhosis of the liver, and polycystic kidneys. J Pediatr. 1967 Nov;71(5):691–702. doi: 10.1016/s0022-3476(67)80205-1. [DOI] [PubMed] [Google Scholar]
  26. Passarge E., McAdams A. J. Cerebro-hepato-renal syndrome. A newly recognized hereditary disorder of multiple congenital defects, including sudanophilic leukodystrophy, cirrhosis of the liver, and polycystic kidneys. J Pediatr. 1967 Nov;71(5):691–702. doi: 10.1016/s0022-3476(67)80205-1. [DOI] [PubMed] [Google Scholar]
  27. Poll-The B. T., Roels F., Ogier H., Scotto J., Vamecq J., Schutgens R. B., Wanders R. J., van Roermund C. W., van Wijland M. J., Schram A. W. A new peroxisomal disorder with enlarged peroxisomes and a specific deficiency of acyl-CoA oxidase (pseudo-neonatal adrenoleukodystrophy). Am J Hum Genet. 1988 Mar;42(3):422–434. [PMC free article] [PubMed] [Google Scholar]
  28. Poulos A., Christodoulou J., Chow C. W., Goldblatt J., Paton B. C., Orii T., Suzuki Y., Shimozawa N. Peroxisomal assembly defects: clinical, pathologic, and biochemical findings in two patients in a newly identified complementation group. J Pediatr. 1995 Oct;127(4):596–599. doi: 10.1016/s0022-3476(95)70121-4. [DOI] [PubMed] [Google Scholar]
  29. Poznanski A. K., Nosanchuk J. S., Baublis J., Holt J. F. The cerebro-hepato-renal syndrome (CHRS) (Zellweger's syndrome). Am J Roentgenol Radium Ther Nucl Med. 1970 Jun;109(2):313–322. doi: 10.2214/ajr.109.2.313. [DOI] [PubMed] [Google Scholar]
  30. Roels F., Espeel M., Poggi F., Mandel H., van Maldergem L., Saudubray J. M. Human liver pathology in peroxisomal diseases: a review including novel data. Biochimie. 1993;75(3-4):281–292. doi: 10.1016/0300-9084(93)90088-a. [DOI] [PubMed] [Google Scholar]
  31. Schram A. W., Goldfischer S., van Roermund C. W., Brouwer-Kelder E. M., Collins J., Hashimoto T., Heymans H. S., van den Bosch H., Schutgens R. B., Tager J. M. Human peroxisomal 3-oxoacyl-coenzyme A thiolase deficiency. Proc Natl Acad Sci U S A. 1987 Apr;84(8):2494–2496. doi: 10.1073/pnas.84.8.2494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Sher T., Yi H. F., McBride O. W., Gonzalez F. J. cDNA cloning, chromosomal mapping, and functional characterization of the human peroxisome proliferator activated receptor. Biochemistry. 1993 Jun 1;32(21):5598–5604. doi: 10.1021/bi00072a015. [DOI] [PubMed] [Google Scholar]
  33. Shimozawa N., Tsukamoto T., Suzuki Y., Orii T., Shirayoshi Y., Mori T., Fujiki Y. A human gene responsible for Zellweger syndrome that affects peroxisome assembly. Science. 1992 Feb 28;255(5048):1132–1134. doi: 10.1126/science.1546315. [DOI] [PubMed] [Google Scholar]
  34. Smith D. W., Opitz J. M., Inhorn S. L. A syndrome of multiple developmental defects including polycystic kidneys and intrahepatic biliary dysgenesis in 2 siblings. J Pediatr. 1965 Oct;67(4):617–624. doi: 10.1016/s0022-3476(65)80433-4. [DOI] [PubMed] [Google Scholar]
  35. Subramani S. Protein import into peroxisomes and biogenesis of the organelle. Annu Rev Cell Biol. 1993;9:445–478. doi: 10.1146/annurev.cb.09.110193.002305. [DOI] [PubMed] [Google Scholar]
  36. Swinkels B. W., Gould S. J., Bodnar A. G., Rachubinski R. A., Subramani S. A novel, cleavable peroxisomal targeting signal at the amino-terminus of the rat 3-ketoacyl-CoA thiolase. EMBO J. 1991 Nov;10(11):3255–3262. doi: 10.1002/j.1460-2075.1991.tb04889.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Veenhuis M., Mateblowski M., Kunau W. H., Harder W. Proliferation of microbodies in Saccharomyces cerevisiae. Yeast. 1987 Jun;3(2):77–84. doi: 10.1002/yea.320030204. [DOI] [PubMed] [Google Scholar]
  38. Volpe J. J., Adams R. D. Cerebro-hepato-renal syndrome of Zellweger: an inherited disorder of neuronal migration. Acta Neuropathol. 1972;20(3):175–198. doi: 10.1007/BF00686900. [DOI] [PubMed] [Google Scholar]
  39. Watkins P. A., Chen W. W., Harris C. J., Hoefler G., Hoefler S., Blake D. C., Jr, Balfe A., Kelley R. I., Moser A. B., Beard M. E. Peroxisomal bifunctional enzyme deficiency. J Clin Invest. 1989 Mar;83(3):771–777. doi: 10.1172/JCI113956. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Wilson G. N., Holmes R. G., Custer J., Lipkowitz J. L., Stover J., Datta N., Hajra A. Zellweger syndrome: diagnostic assays, syndrome delineation, and potential therapy. Am J Med Genet. 1986 May;24(1):69–82. doi: 10.1002/ajmg.1320240109. [DOI] [PubMed] [Google Scholar]
  41. Zellweger H. The cerebro-hepato-renal (Zellweger) syndrome and other peroxisomal disorders. Dev Med Child Neurol. 1987 Dec;29(6):821–829. doi: 10.1111/j.1469-8749.1987.tb08833.x. [DOI] [PubMed] [Google Scholar]
  42. van den Bosch H., Schutgens R. B., Wanders R. J., Tager J. M. Biochemistry of peroxisomes. Annu Rev Biochem. 1992;61:157–197. doi: 10.1146/annurev.bi.61.070192.001105. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES