2653例新生儿常见耳聋基因筛查结果分析

目的了解本地区新生儿常见耳聋基因携带情况,为大规模开展新生儿听力与耳聋基因联合筛查提供依据。方法采用PCR+导流杂交法,对2653名新生儿在听力筛查的同时进行GJB2、GJB3、线粒体12Sr RNA、SLC26A4 4个常见耳聋易感基因的检测,检测位点包含以上基因的13个热点突变。结果 2653名新生儿中检出耳聋基因106例,检出率4.00%,其中GJB2检出62例,检出率2.34%,SCL26A4检出31例,检出率1.17%,GJB3检出6例,检出率0.23%,线粒体12Sr RNA检出7例,检出率0.26%。检出位点频率最高的是GJB2 235del C位点1.73%,其次是SCL26A4 IVS7-2AG位点1.02%。听力筛查未通过新生儿中耳聋基因检出率高于听力筛查通过新生儿,差异有统计学意义(χ2=7.004,P0.05),3例确诊的听力损失婴儿中有1例检出耳聋基因杂合携带。结论本地区新生儿中常见耳聋基因有较高检出率,在无条件进行筛查时可将听力筛查未通过新生儿作为目标人群进行筛查。     

沧州地区新生儿耳聋基因SLC26A4的筛查

目的通过对新生儿耳聋基因SLC26A4的筛查,为耳聋基因常规筛查和产前诊断提供理论和实验依据。方法收集本地新生儿500例为研究对象,进行常规的听力筛查,同时采集脐带血,应用Mass ARRAY分子量阵列分析系统对SLC26A4基因突变位点进行筛查。结果在500例新生儿中,通过听力初筛和复筛共有8(2%)例未通过。基因筛查共有6(1.2%)例携带杂合突变,5(1%)例携带SLC26A4基因IVS7-2AG杂合突变,589GA杂合突变1(0.2)例,此6例新生儿均通过听力筛查。结论在新生儿中进行SLC26A4基因筛查,在早期可以发现耳聋基因易感位点携带者,可以弥补听力筛查的不足,并且能发现潜在可能的耳聋患者。     

深圳市南山区25987例新生儿耳聋基因筛查结果分析

目的通过分析深圳市南山区所属5家医院出生的新生儿耳聋基因检测结果,以了解深圳南山区新生儿耳聋基因的突变携带情况。方法采集深圳市南山区2015年9月至2016年12月出生的新生儿足底血25 987份,用飞行时间质谱检测技术检测中国人群中常见的4个耳聋易感基因(GJB2、GBJ3,SLC26A4、12Sr RNA)的20个常见的突变位点。结果 25 987名新生儿中,检出耳聋基因异常1119例,总阳性率为4.31%。其中,GJB2基因35del G、176_191del16、235del C、和299_300del AT,共572例,突变携带率2.20%;SLC26A4基因281CT、589GA、1174AT、1226GA、1229CT、1975GC、2027TA、2162CT、2168AG、IVS7-2AG、IVS15+5GA,共412例,突变携带率1.59%;GJB3基因538CT、547GA,共86例,突变携带率0.33%;线粒体12Sr RNA基因1555AG、1494CT,共68例,突变携带率0.26%。结论深圳南山区出生的新生儿具有较高的耳聋基因突变携带率,耳聋易感基因筛查能够从分子水平发现新生儿非综合型耳聋,为早期发现新生儿耳聋和早期干预提供有利的参考。     

33911例新生儿听力联合耳聋基因筛查及随访结果的分析

目的通过分析新生儿听力联合耳聋基因筛查的结果,以及对阳性病例的随访和管理,提高遗传性耳聋的检出率。方法收集33911例新生儿听力联合耳聋基因筛查的结果,应用Sanger测序对听力未通过或基因筛查提示阳性的患儿进行验证。结果听力初筛通过率为93.32%,复筛为87.01%。耳聋基因筛查阳性率为4.18%。GJB2、SLC26A4、GJB3和12SrRNA基因变异的检出率分别为1.98%、1.58%、0.37%和0.25%。共检出126例迟发性耳聋,84例药物性耳聋,4例GJB2纯合/复合杂合变异,5例SLC26A4纯合/复合杂合变异。联合筛查发现GJB2、SLC26A4、GJB3和12SrRNA单杂合变异者听力初筛和复筛未通过的比例分别为6.75%和2.61%、3.3%和1.2%、0.72%和0.14%、0.36%和0%。纯合/单基因复合杂合变异、单基因杂合变异、多基因复合杂合以及GJB3纯合变异组听力筛查未通过率明显高于阴性组,差异具有统计学意义。结论基因检测是对新生儿听力筛查很好的补充。对阳性患儿的追踪管理能够有效提高耳聋的诊断率,但基因筛查不能等同于诊断,应综合分析基因检测、听力筛查和影像学的结果,Sanger/二代测序可作为重要的补充检查手段。     

宝鸡地区新生儿聋病易感基因及听力联合筛查的临床研究

目的采用新生儿聋病易感基联合听力筛查对宝鸡地区新生儿听力障碍进行筛查,了解宝鸡地区新生儿聋病流行病学资料,为先天性耳聋患儿及早采取干预措施提供科学数据,提升新生儿优生优育水平。方法我院2017年6月~2018年2月期间对宝鸡地区各区县医院符合纳入条件的568例新生儿足跟血行GJB2、GJB3、SLC26A4、线粒体12Sr RNA耳聋易感基因9个点位和15个点位筛查,同时对入组新生儿采用听力筛查仪进行听力初筛,对于听力初筛未通过者42d后行听力复查。总结所有患儿耳聋易感基因检出情况及特点,总结听力筛查结果,了解宝鸡地区先天性耳聋患儿的临床特点,探讨新生儿聋病易感基因检测在筛查先天性耳聋患儿中的临床价值。结果 2017年6月~2017年12月对454例新生儿行4个耳聋易感基因筛查9个位点位筛查,共筛查出12位新生儿耳聋易感基因突变阳性,阳性率为2.64%。所有患儿出生时听力筛查均通过。这些新生儿父母均听力正常,无家族史。2017年12月~2018年2月对114例新生儿作4个耳聋易感基因15个位点检测,筛查出9例异常,阳性率为7.89%;所有新生儿听力筛查均通过。宝鸡地区新生儿先天性耳聋患儿发生率3.70%。21例耳聋易感基因突变患儿中,GJB2基因突变8例次,SLC26A4基因突变8例次,线粒体12Sr RNA基因突变4例,GJB3基因突变1例次,其中一例患儿同时出现GJB2和SLC26A4两种基因突变。绝大多数基因突变点位为杂合型突变,仅3例为均质型突变,1例为异质突变型。增加突变点位的筛查,可明显提升耳聋易感基因阳性检出率(χ2值=14.353,P0.005)。结论宝鸡地区新生儿听力筛查先天性耳聋现患率低,但采用耳聋易感基因筛查迟发先天性耳聋患儿阳性率较高,且随着突变点位检测数量的增加,阳性检出率有明显提高,临床应加强新生儿耳聋易感基因筛查,完善检测突变基因点位,提升先天性耳聋患儿目标性随访率及干预率,提升患儿干预效果,促进患儿健康水平。     

山西运城地区新生儿听力与耳聋基因联合筛查结果分析

目的分析山西运城地区6 723例新生儿听力及耳聋基因筛查结果, 了解该地区耳聋基因常见的变异类型。方法回顾性分析2021年1月1日至2021年12月31日在运城地区出生的6 723例新生儿进行听力学检查结果, 包括瞬态诱发耳声发射和自动判别听性脑干诱发电位, 凡其中一项筛查未通过者, 均视为复查未通过。采用遗传性耳聋相关基因检测试剂盒对GJB2、SLC26A4、GJB3和mtDNA12S rRNA等我国常见耳聋变异基因的15个热点变异位点进行检测。听力学复查检查通过组与未通过组组间比较采用χ2检验。结果 6 723例新生儿中, 听力初筛通过6 456例(96.03%), 267例初筛未通过新生儿中有244例接受听力复查(91.38%), 14例未通过听力复查, 听力复查未通过率5.73%(14/244), 听力障碍患者的大概比例为0.21%(14/6 723)。67 23例新生儿中有363例检出耳聋基因变异, 检出率为5.40%(363/6 723)。GJB2基因变异166例, 检出率为2.47%(166/6 723);SLC26A4基因变异136例, 检出率为2.02%(136/6 ...     

湖南省9957例新生儿遗传性耳聋基因突变筛查分析

目的分析湖南省新生儿常见的遗传性耳聋基因携带率及突变谱,为临床耳聋疾病防治、生育咨询指导提供理论依据及数据支持。方法收集湖南长沙市、岳阳市、娄底市等10个地区共9957例新生儿足跟血血斑,采用微阵列芯片法(九项遗传性耳聋基因检测试剂盒)对中国人群常见4种耳聋基因突变进行筛查,包括GJB2基因35 del G、176_191 del16、235 del C和299_300 del AT;SLC26A4基因IVS 7-2 AG和2168 AG;线粒体12S r RNA基因1555 AG和1494 CT,GJB3基因538 CT)。结果基因芯片检测共发现366例耳聋基因突变,其中GJB2的突变携带者225例,235纯合突变1例,突变携带率2.26%(225/9957);SLC26A4基因突变携带者88例,2168 AG纯合突变1例,突变携带率0.88%(88/9957);线粒体12S r RNA基因突变携带者38例,突变携带率0.38%(38/9957);GJB3基因突变携带者10例,突变携带率0.1%(10/9957);双突变4例,双突变携带率0.04%(4/9957),分别是235杂合/1555均质1例,235/2168复合杂合1例,235 del C/IVS 7-2 AG双杂合突变2例。结论湖南省新生儿耳聋基因突变检测结果中,GJB2基因突变检出率最高,其次SLC26A4基因突变,GJB3最少。     

联合线粒体基因测序和导流杂交术在耳聋产前筛查中的应用

目的探讨联合线粒体基因测序和导流杂交术在孕妇耳聋易感基因筛查和产前诊断中的应用价值。方法采用多重PCR和导流杂交术筛查佛山地区8643名产检孕妇3个常见的耳聋易感基因(GJB2、GJB3、SLC26A4),并结合基因测序对阳性样本进行鉴定,并检测线粒体12SrRNA和tRNA基因突变情况。结果发现3个常见耳聋基因突变共257例(3.18%)。其中GJB2基因突变153例(1.78%),且4例(0.05%)为235delC位点纯合突变;SLC26A4基因突变94例(1.09%);GJB3基因突变10例(0.12%)。经基因测序发现线粒体基因突变76例(0.88%),包括一些可疑致病位点和不明致病性的位点,其中m.1555AG均质突变15例(0.17%)。有4对夫妇均为GJB2基因235delC位点携带者,在知情同意下选择了羊水穿刺行产前诊断,一例胎儿均为纯合突变,3例为杂合突变。结论佛山地区的耳聋基因GJB2携带者最多,联合线粒体基因测序和导流杂交术筛查孕妇耳聋易感基因在耳聋的一级预防中有重要的价值。     

马鞍山地区2534例新生儿耳聋基因突变方式调查

目的了解马鞍山地区新生儿耳聋基因的携带率及突变类型,为防聋治聋工作提供指导依据。方法应用芯片基因筛查技术,对2534例新生儿进行GJB2、SLC26A4、GJB3、线粒体12Sr RNA 4个常见耳聋基因9个热点突变位点的检测。结果 2534例新生儿中检测出基因突变134例,携带率5.29%,单基因杂合突变128例(GJB2基因突变76例,SLC26A4基因突变34例,GJB3基因突变9例,线粒体12Sr RNA基因突变9例),双基因突变3例(GJB2 235del C/SLC26A4 IVS7-2AG 2例,12S RNA 1555AG均质/SLC26A4 IVS7-2AG 1例),GJB2 235del C纯合突变3例。结论在马鞍山地区的新生儿中,耳聋基因GJB2和SLC26A4突变率较高,GJB3、线粒体12Sr RNA突变率较低。通过耳聋基因筛查,可预防和减少耳聋的发生,达到提高人口质量,优生优育的目的。     

新生儿听力筛查联合遗传性耳聋基因检测在NICU新生儿听力障碍筛查中的应用价值

目的探讨新生儿听力筛查联合遗传性耳聋基因检测在NICU新生儿听力障碍筛查中的应用价值。方法选取2015年8月至2017年8月我院妇产科正常分娩出生的及NICU收治住院的新生儿2000例,在其出生48 h和72h后行常规听力筛查及遗传性耳聋基因筛查。常规听力筛查采用耳声发射法(OAE)和自动听性脑干反应(AABR)法,初筛未通过的新生儿在出生后42 d复筛,复筛仍未通过的新生儿则于出生后3个月行听力学诊断,确诊其是否存在听力障碍。遗传性耳聋基因筛查采用微阵列芯片法,对4个耳聋易感基因9个突变位点进行检测。统计筛查结果。结果 2000例NICU新生儿中遗传性耳聋基因突变携带率为4.20%(84/2000),其中GJB2基因突变携带率为1.85%(37/2000)、GJB3基因突变携带率为0.35%(7/2000)、SLC26A4基因突变携带率为1.70%(34/2000)、线粒体12S rRNA基因突变携带率为0.30%(6/2000)。听力筛查未通过且携带耳聋基因突变的新生儿16例,经听力学诊断确诊为听力障碍的新生儿8例(分别为GJB2 299 del AT杂合型突变2例、GJB2 235 del C杂合型突变5例、SLC26A4 IVS 7-2 AG纯合型突变1例),诊断符合率为50.00%。结论新生儿听力筛查联合遗传性耳聋基因检测可相互弥补筛查范围的局限性,遗传性耳聋基因筛查可以作为NICU新生儿听力功能筛查的重要补充,以利于发现潜在性、迟发性耳聋患儿,提高新生儿听力障碍检出能力,并对其进行早期干预,具有一定的临床应用价值。     

湖州地区聋哑学校68名聋哑学生耳聋易感基因突变分析研究

目的研究4个耳聋易感基因GJB2、GJB3、SLC26A4、线粒体12SrRNA在湖州市聋哑学校68名聋哑学生中的突变类型分布情况。方法应用飞行时间质谱技术,对68名聋哑学生进行GJB2、GJB3、SLC26A4、线粒体12SrRNA 4个耳聋易感基因检测,检测位点包含以上基因的20个热点突变。结果68名聋哑学生中共检出耳聋基因突变27例,阳性率39.71％,其中GJB2基因突变19例,占70.37％;GJB3基因突变l例,占3.7％;SLC26A4基因突变5例,占18.52％;线粒体12SrRNA基因突变2例,占7.41％。结论在湖州市聋哑学校中,GJB2是最常见的耳聋突变基因,235delC是GJB2基因最常见的突变位点。     

DNA sequence analysis of GJB2, encoding connexin 26: observations from a population of hearing impaired cases and variable carrier rates, complex genotypes, and ethnic stratification of alleles among controls

Mutations in GJB2 are associated with hereditary hearing loss. DNA sequencing of GJB2 in a cohort of hearing impaired patients and a multi-ethnic control group is reported. Among 610 hearing impaired cases, 43 DNA sequence variations were identified in the coding region of GJB2 including 24 mutations, 8 polymorphisms, 3 unclassified variants (G4D, R127C, M163V), 1 controversial variant (V37I), and 7 novel variants (G12C, N14D, V63A, T86M, L132V, D159, 592_600delinsCAGTGTTCATGACATTC). Sixteen non-coding sequence variations were also identified among cases including the IVS1+1A>G mutation, 2 polymorphisms, and 13 novel variants. A diagnosis of GJB2-associated hearing loss was confirmed for 63 cases (10.3%). Heterozygous mutations were found in 39 cases (6.4%). Eleven cases carrying novel or unclassified variants (1.8 %) and 18 cases carrying the controversial V37I variant were identified (3%). In addition, 294 control subjects from 4 ethnic groups were sequenced for GJB2. Thirteen sequence variations in the coding region of GJB2 were identified among controls including 2 mutations, 6 polymorphisms, 2 unclassified variants (G4D, T123N), 1 controversial variant (V37I), and 2 novel variants (R127L, V207L). Nine sequence variations were identified among controls in the non-coding regions in and around GJB2 exon 2. Of particular interest among controls were the variability in carrier rates and ethnic stratification of alleles, and the complex genotypes among Asians, 47% of whom carried two to four sequence variations in the coding region of GJB2. These data provide new information about carrier rates for GJB2-based hearing loss in various ethnic groups and contribute to evaluation of the pathogenicity of the controversial V37I variant.     

Genetic analysis of presbycusis by arrayed primer extension

Using the Hereditary Hearing Loss arrayed primer extension (APEX) array, which contains 198 mutations across 8 hearing loss-associated genes (GJB2, GJB6, GJB3, GJA1, SLC26A4, SLC26A5, 12S-rRNA, and tRNA Ser), we compared the frequency of sequence variants in 94 individuals with early presbycusis to 50 unaffected controls and aimed to identify possible genetic contributors. This cross-sectional study was performed at Stanford University with presbycusis samples from the California Ear Institute. The patients were between ages 20 and 65 yr, with adult-onset sensorineural hearing loss of unknown etiology, and carried a clinical diagnosis of early presbycusis. Exclusion criteria comprised known causes of hearing loss such as significant noise exposure, trauma, ototoxic medication, neoplasm, and congenital infection or syndrome, as well as congenital or pediatric onset. Sequence changes were identified in 11.7% and 10% of presbycusis and control alleles, respectively. Among the presbycusis group, these solely occurred within the GJB2 and SLC26A4 genes. Homozygous and compound heterozygous pathogenic mutations were exclusively seen in affected individuals. We were unable to detect a statistically significant difference between our control and affected populations regarding the frequency of sequence variants detected with the APEX array. Individuals who carry two mild mutations in the GJB2 gene possibly have an increased risk of developing early presbycusis.     

GJB2: the spectrum of deafness-causing allele variants and their phenotype

Genetic testing was completed on 1,294 persons with deafness referred to the Molecular Otolaryngology Research Laboratories to establish a diagnosis of DFNB1. Exon 2 of GJB2 was screened for coding sequence allele variants by denaturing high-performance liquid chromatography (DHPLC) complemented by bidirectional sequencing. If two deafness-causing mutations of GJB2 (encoding Connexin 26) were identified, further screening was not performed. If only a single deafness-causing mutation was identified, we screened for the g.1777179_2085947del (hereafter called del(GJB6-D13S1830); GenBank NT_024524.13) and mutations in the noncoding region of GJB2. Phenotype-genotype correlations were evaluated by categorizing mutations as either protein truncating or nontruncating. A total of 205 persons carried two GJB2 exon 2 mutations and were diagnosed as having DFNB1; 100 persons carried only a single deafness-causing allele variant of exon 2. A total of 37 of these persons were c.35delG carriers, and 51 carried other allele variants of GJB2. Persons diagnosed with DFNB1 segregating two truncating/nonsense mutations had a more severe phenotype than persons carrying two missense mutations, with mean hearing impairments being 88 and 37%, respectively (P < 0.05). The number of deaf c.35delG carriers was greater than expected when compared to the c.35delG carrier frequency in normal-hearing controls (P < 0.05), suggesting the existence of at least one other mutation outside the GJB2 coding region that does not complement GJB2 deafness-causing allele variants.     

应用聚合酶链反应-限制性片段长度多态技术快速检测中国耳聋人群基因突变热点

目的 通过筛查耳聋基因热点突变:GJB2基因的235delC、SLC26A4基因的IVS7-2A>G和线粒体12S rRNA(12S)基因1555 A>G达到快速诊断耳聋患者.方法 多重PCR扩增包括GJB2、SLC26A4及12S基因的3个片段,限制性片段长度多态分析是否存在相应位点的突变.结果 200例耳聋患者中,共检测出235delC纯合突变18例,杂合突变18例;IVS7-2A>G纯合突变2例,杂合突变13例;1555 A>G突变8例.检测结果均与测序结果相符合.3个热点突变基因的致病单体的检出率为21.7%,基因诊断率为14%.结论 应用聚合酶链反应-限制性片段长度多态技术检测耳聋患者的热点突变是一种快速、简便、高效、经济的耳聋致病基因筛查的方法.     

变性高效液相色谱法分析非综合征型耳聋人群SLC26A4基因突变

目的 研究非综合征型耳聋(nonsyndromic hearing loss,NSHL)患者SLC26A4基因的突变情况,为临床上NSHL患者基因诊断提供指导.方法 PCR分别扩增SLC26A4基因的21个外显子及其侧翼序列,所得目的 片段用变性高效液相色谱(denaturing high-performance liquid chromatorgraphy,DHPLC)进行突变筛查,有异常峰形的样本进行DNA测序.结果 在所选30例无血缘关系且GJB2基因检测未发现突变的NSHL患者中,共检测出10种SLC26A4基因变异,其中包括7种已知突变,2种未见报道的新突变(F572L和D87Y),及一种已知多态(Ivs11+47T＞C),其中Ivs7-2A＞G是最常见的突变,约占总突变的40%.结论 SLC26A4基因为仅次于GJB2的导致NSHL的相关基因,在(GJB2基因检测未发现突变的NSHL人群中SLC26A4基因的检出率达到23.3%,其中Ivs7-2A＞G是其最常见的突变.     

Molecular screening of patients with nonsyndromic hearing loss from Nanjing city of China

Hearing loss is the most frequent sensory disorder involving a multitude of factors,and at least 50% of cases are due to genetic etiology.To further characterize the molecular etiology of hearing loss in the Chinese population,we recruited a total of 135 unrelated patients with nonsyndromic sensorineural hearing loss (NSHL) for mutational screening of GJB2,GJB3,GJB6,SLC26A4,SLC26A5 IVS2-2A>G and mitochondrial 12SrRNA,tRNA Ser(UCN) by PCR amplification and direct DNA sequencing.The carrier frequencies of deafness-causing mutations in these patients were 35.55% in GJB2,3.70% in GJB6,15.56% in SLC26A4 and 8.14% in mitochondrial 12SrRNA,respectively.The results indicate the necessity of genetic screening for mutations of these causative genes in Chinese population with nonsyndromic hearing loss.     

SNaPshot reveals high mutation and carrier frequencies of 15 common hearing loss mutants in a Chinese newborn cohort

Genetic causes account for more than half of congenital hearing loss cases. The most frequent mutations found in non‐syndromic hearing loss patients occur in GJB2 and SLC26A4. Mitochondrial genome mutations are also prevalent. However, the frequency of common hearing loss mutations in the Chinese population has not yet been well estimated. Here, we implemented the SNaPshot genotyping method to investigate the carrier frequency of 15 commonly reported hearing loss mutations in GJB2, SLC26A4 and the mitochondrial genome based on a cohort of 5800 neonates in China. Up to 15.9% (923/5800) of the newborns carry at least one mutant allele. The top three were GJB2‐c.109G>A, GJB2‐c.235delC, and SLC26A4‐c.919A>G, with notably high carrier frequencies of 1/10, 1/53 and 1/62 respectively, and mt‐7444G>A with 1/141 was the most frequent allele in the mitochondrial genome. In this cohort, 0.48% (28/5800) of neonates were genetically diagnosed with hearing loss, from which seven cases failed an OAE test. This is the first epidemiological study of non‐syndromic hearing loss in Chinese newborns indicating a notably high carrier frequency (1 per 6.3 newborns) among these 15 mutant alleles. Our carrier frequency data also aid in effective risk assessment and genetic counseling for hearing loss patients in the Chinese population.     

听力筛查联合遗传性耳聋基因检测在新生儿筛查中的应用

目的 探讨听力筛查联合遗传性耳聋基因检测在新生儿筛查中的应用。方法 选取2018年12月~2019年7月我院接受产检的产妇509例,对所有产妇进行遗传性耳聋基因检测,并在产妇完成分娩后48 h对新生儿作常规听力筛查,确诊新生儿是否存在听力障碍。结果 509例产妇经遗传性耳聋基因检测显示阳性16例,阳性率3.14%;听力筛查不通过同时伴有耳聋基因突变新生儿共5例,听力学诊断结合随访确诊3例新生儿存在听力障碍,包含1例GJB2 299-300delAT突变,1例GJB2 235delC突变、1例SLC26A4 919-2A＞G突变。结论 在新生儿常规听力筛查的同时提供遗传性耳聋基因检测,能够有效弥补听力筛查的不足,可用作听力筛查工作的有效补充,有助于筛查出迟发型及潜在性耳聋患儿,提升听力障碍的检出率。