8%)  and 19/852 cases referred for clinical genetic testing Luminespib (2.2%) [23•]. Large unbalanced karyotypic changes are found more often in ASD cases with accompanying dysmorphology. Identifying balanced changes can also be important for genetic counseling, as they can predispose to subsequent unbalanced rearrangements [24 and 25]. While structural alterations have been observed for every chromosome, most are rare and their causal association with ASD difficult to prove, but a few occur commonly enough
to be proven ASD risk factors. The most common cytogenetic abnormality in individuals with ASD, detected in 1–3%, is the 15q11–q13 duplication (of the maternal allele) of the Prader-Willi/Angelman syndrome region . Other aneuploidies in ASD include trisomy 21; 45, X Turner syndrome; 47,XYY and 47,XXY . Rare de novo and some inherited CNVs typically too small to be detected by karyotyping can also contribute to the genetic vulnerability to
ASD in as many as 10% of cases examined [ 15, 16, 27, 28 and 29]. CNVs can involve a single gene and act much as a sequence-level mutation, or they can encompass several genes as part of a genomic disorder [ 30]. Roxadustat Fossariinae Screening for CNVs has proven to
be a rapid method to identify both large and small changes associated with ASD susceptibility. To quantify the role of CNV in ASD, different microarray platforms have been used to interrogate ASD cohorts [20••, 22, 23•, 31••, 32••, 33, 34, 35, 36, 37, 38•, 39, 40, 41 and 42]; there are also smaller studies and cases reports. The families examined included one or more members (simplex or multiplex families, respectively) who met minimal standard criteria for ASD. Table 1 summarizes the CNV data from two of the most comprehensive studies conducted to date [20•• and 38•]. These research studies examine stringently defined cases with autism and highlight some of the CNVs recognized as risk loci and their frequency of occurrence (all individually less than 1%) in ASD cases. These two studies represent midpoints from large cohorts for which new CNV data will further refine the data presented in Table 1. Other relevant findings from these and other studies include: (i) The proportion of de novo CNVs is three-fold to five-fold higher in ASD families than controls [ 20••, 22, 32••, 38• and 39], and in some studies differs between simplex and multiplex families [ 22 and 32••].