[Historical aspects of the Smith-Lemli-Opitz syndrome]

The new malformation syndrome was first described approximately 50 years ago in three unrelated patients in Department of Pediatrics at the University of Wisconsin, Madison, (Smith, Lemli, Opitz 1964). This syndrome was called RSH syndrome after the first 3 patients studied. First Slovak patient with phenotypic features of this new syndrome was described by professor Sršeň in 1972. In 1994 Tint from VA Medical Center, E. Orange, New Jersey analyzed plasma sterols of patient with Smith-Lemli-Opitz syndrome and found out that in addition to low plasma cholesterol level, the patient had 1000-fold increase of the plasma level of 7-dehydrocholesterol, the immediate precursor of cholesterol biosynthesis. After this biochemical discovery Smith-Lemli-Opitz syndrome became the metabolic-malformation syndrome with an exactly defined impairment of cholesterol metabolism. The first patient with biochemically proved Smith-Lemli-Opitz syndrome in Slovakia was described by Behulova et al. (1997) in cooperation with Department of Biochemistry and Medical Biotechnology, Federico II University in Naples, Italy. The three years later a screening method UV spectrometry of serum lipids for detection of 7-dehydrocholesterol was established in Department of Biochemistry, University Children´s Hospital in cooperation with the Institute of preventive and clinical medicine in Bratislava (Skodova et al.,2000). First results of molecular analysis of the 7-dehydrocholesterol reductase gene in 10 unrelated Czech and Slovak patients with Smith-Lemli-Opitz syndrome were reported by Kozak et al. (2000). The same year the first prenatal diagnosis of Smith-Lemli-Opitz syndrome by mutation analysis was achieved (Bzduch et al., 2000). Our research activities on this topic drew good response from abroad.