<unk>  <unk>  encompasses a spectrum of skeletal disorders, most of which are inherited in an autosomal dominant form. However, there is an autosomal recessive form. Associated genes include COL9A1, COL9A2, COL9A3, COMP, and MATN3. Types include: Type OMIM Gene EDM1 COMP EDM2 COL9A2 EDM3 COL9A3 EDM4 DTDST EDM5 MATN3 EDM6 COL9A1 In the dominant form, mutations in five genes are causative: COMP (chromosome 19), COL9A1 (chromosome 6), COL9A2 (chromosome 1), COL9A3 (chromosome 20), and MATN3 (chromosome 2). However, in approximately 10%–20% of samples analyzed, a mutation cannot be identified in any of the five genes above, suggesting that mutations in other as-yet unidentified genes are involved in the pathogenesis of dominant<unk> . The COMP gene is mutated in 70% of the molecularly confirmed<unk>  patients. Mutations are in the exons encoding the type III repeats (exons 8–14) and C-terminal domain (exons 15–19). The most common mutations in COL9A1 are in exons 8-10, in COL9A2 in exons 2-4, and in COL9A3 in exons 2-4. Altogether, those mutations cover 10% of the patients. The other 20% of affected people have mutations in MATN3 gene, all found within exon 2. The following testing regime has been recommended by the European Skeletal Dysplasia Network: * Level 1: COMP (exons 10–15) and MATN3 (exon 2) * Level 2: COMP (exons 8 & 9 and 16–19) * Level 3: COL9A1 (exon 8), COL9A2 and COL9A3 (exon 3) All those genes are involved in the production of the extracellular matrix (ECM). The role of COMP gene remains unclear. It is a noncollagenous protein of the ECM. Mutations in this gene can cause the pseudoachondroplasia (PSACH). It should play a role in the structural integrity of cartilage by its interaction with other extracellular matrix proteins and can be part of the interaction of the chondrocytes with the matrix and it is also a potent suppressor of apoptosis in chondrocytes. Another role is maintaining a vascular smooth muscle cells contractile under physiological or pathological stimuli. Since 2003, the European Skeletal Dysplasia Network has used an online system to diagnose cases referred to the network before mutation analysis to study the mutations causing PSACH or<unk> . COL9A1, COL9A2, COL9A3 are genes coding for collagen type IX, that is a component of hyaline cartilage. MATN3 protein may play a role in the formation of the extracellular filamentous networks and in the development and homeostasis of cartilage and bone. In the recessive form, the DTDST gene, also known as SLC26A2, is mutated in almost 90% of the patients, causing diastrophic dysplasia. It is a sulfate transporter, transmembrane glycoprotein implicated in several chondrodysplasias. It is important for sulfation of proteoglycans and matrix organization.
Multiple epiphyseal dysplasia
Melnick–Needles syndrome
Metaphyseal dysplasia
Radial dysplasia
Cemento-osseous dysplasia
Otospondylomegaepiphyseal dysplasia
Leri pleonosteosis
Osteochondrodysplasia