色素失禁症一家系NEMO基因缺失

目的：检测家族性色素失禁症（incontinentia pigmenti,IP）患者NEMO基因的缺失突变.方法：选取NEMO基因特异引物nemo-Int3S、nemo-Rep3S和nemo-L2Rev,采用多重聚合酶链反应对家系内成员NEMO基因的缺失位点进行检测.结果：IP家系内所检测患者中皆有NEMO基因外显子4～10缺失,家系内正常人未见NEMO基因缺失.结论：该家系患者的基因突变方式为NEMO外显子4～10缺失.     

色素失禁症1家系NEMO基因新致病突变报道

【摘要】 目的 对1个色素失禁症家系进行基因诊断,以明确致病基因突变位点。方法 收集整理该家系所有患者的临床资料。提取该家系中患者、健康人、100例无关健康对照外周静脉血细胞DNA,针对NEMO基因外显子区及其侧翼序列进行Sanger测序。结果 该家系4代共4例患者,均有典型皮损,其他症状各有差异。基因测序示先证者及其他3例患者均存在NEMO基因8号外显子的杂合无义突变c.1153C>T（p.Gln385X）,编码区第1153位碱基由C突变为T,导致肽链第385位谷氨酰胺密码子（CAG）变成终止密码子（TAG）,14例健康亲属和100例健康对照未发现该突变。该突变与色素失禁症符合共分离,数据库查询显示其为新发无义突变,美国遗传学与基因组学学会指南判定致病证据为极强致病位点。结论 NEMO基因突变c.1153C>T与该家系色素失禁症发病有关。     

遗传性对称性色素异常症一家系DSRAD基因的突变

目的检测一个遗传性对称性色素异常症家系中的DSRAD基因突变情况。方法收集了一个遗传性对称性色素异常症家系的外周血标本,用聚合酶链反应(PCR)扩增DSRAD基因的全部15个外显子并测序,检测家系中的患者及正常人和100例无关正常人的DSRAD基因。结果家系中所有患者的DSRAD基因存在外显子3的杂合缺失突变:c.1615delG。家系中的正常人及100例无关正常人未发现此突变。结论发现DSH家系患者DSRAD基因的一个新的突变。     

遗传性对称性色素异常症1家系报告及ADAR基因突变分析

目的鉴定1个遗传性对称性色素异常症家系的突变,并对我国遗传性对称性色素异常症的致病基因ADAR基因突变位点加以分析。方法应用聚合酶链反应(PCR)扩增ADAR基因15个外显子及其侧翼序列、DNA直接测序明确突变位点,并以50例正常人作为对照。结果发现家系中先证者ADAR基因的2号外显子第1493位后缺失了两个碱基AG,造成编码氨基酸发生移码突变(c.1493-1494delAG),家系中健康者及正常对照不存在此种突变。结论 c.1493-1494delAG突变是导致该疾病发生的特异性突变。     

遗传性对称性色素异常症一家系基因突变研究

对一个遗传性对称性色素异常症家系的外周血标本,用聚合酶链反应(PCR)扩增DSRAD基因的全部外显子并测序,检测家系中的患者及正常人和100名无关正常人的DSRAD基因.家系患者的DSRAD基因第2外显子杂合插入突变,家系中的正常人及无关对照均无此改变.本研究中的DSH家系患者均存在DSRAD基因杂合突变,可能由此引起皮肤色素异常.     

遗传性对称性色素异常症一家系ADAR1基因突变检测

目的：检测1例中国汉族遗传性对称性色素异常症家系ADAR1基因突变情况。方法：收集该家系内的2例患者及2名表型正常者的临床资料和血样,提取外周血基因组DNA,PCR扩增后进行DNA测序。结果：该家系2例患者均存在ADAR1基因第13号外显子c.3232C〉T突变（p.R1078C）,而在该家系内表型正常的个体以及100名正常对照中均未发现该突变。结论：该DSH家系内ADAR1基因c.3232C〉T突变可能与DSH发病有关。     

遗传性对称性色素异常症两家系DSRAD基因突变分析

目的对2例遗传性对称性色素异常症(DSH)家系DSRAD基因中可能存在的突变进行鉴定。方法收集的两个遗传性对称性色素异常症家系和100份无亲缘关系正常人外周血标本,采用聚合酶链反应(PCR)方法扩增DSRAD基因的全部外显子并测序,结果和Genbank中相应序列进行比对。结果家系1中所有患者DSRAD基因检测到第9外显子存在一个旧的错义突变c.G2747A,导致p.R916Q;在家系2所有患者第12外显子发现一个新的错义突变c.C3124T,导致p.R1042C。两家系中正常人及无亲缘关系对照均未发现突变。结论两家系中均存在DSRAD基因的变异,导致编码蛋白的结构和功能发生改变。     

遗传性对称性色素异常症DSRAD基因的一个新突变

目的检测遗传性对称性色素异常症(DSH)家系中的DSRAD基因突变情况,探讨DSH的基因型与表型的关系。方法收集2个DSH家系的临床资料,提取外周血DNA,应用PCR扩增DSRAD基因编码区的全部外显子及其侧翼序列并测序,分别检测2个家系中的患者及正常人,并选取50例无关正常人做对照。结果发现全部患者均存在DSRAD基因的杂合突变,家系1中所有患者的DSRAD基因第12内含子剪切位点突变c.3203-2AC(IVS12-2AC);家系2中所有患者的DSRAD基因缺失突变c.2433_2434delAG。但该两家系中的正常人及50例正常对照者未发现上述突变。结论此两个DSH家系中存在DSRAD基因的特异性突变,其可能使编码蛋白功能缺陷,导致皮肤色素异常。     

遗传性对称性色素异常症一家系ADAR基因检测

目的：检测遗传性对称性色素异常症一家系的ADAR基因突变。方法：提取家系中患者、健康成员及无血缘健康对照人群外周血样DNA,PCR扩增ADAR基因外显子后测序。结果：该家系中患者均存在ADAR基因第2号外显子,第982位碱基突变（c.982C>T,p.R328X）,突变导致第328位的精氨酸被终止密码替代。家系中健康成员及健康对照人群未发现该突变。结论：该遗传性对称性色素异常症家系患者中的ADAR基因突变（c.982C>T,p.R328X）可能与发病有关。     

遗传性对称性色素异常症两家系ADAR基因的突变

目的检测两个遗传性对称性色素异常症家系ADAR基因的突变情况。方法收集患者临床资料,提取外周血DNA,采用PCR扩增ADAR基因编码区的全部外显子及其侧翼序列并测序。并以50例无关正常人作为对照。结果两个家系的患者中分别发现ADAR基因第5号外显子中的第2038位后插入两个碱基C(c.2038insCC)及ADAR基因3号外显子第1643位碱基缺失一个碱基C(c.1643delC)的杂合突变,分别导致编码氨基酸发生两种新的移码突变(p.A679fs,p.P547fs→564X),家系正常人及50例健康对照者均未发现相应突变。结论ADAR基因的c.2038insCC及c.1643delC移码突变可能为引起这两个家系患者临床表型的病因。     

Incontinentia pigmenti: a review and update on the molecular basis of pathophysiology

Incontinentia pigmenti is an uncommon X-linked dominant disorder, lethal in the majority of affected males in utero and variably expressed in females. Cutaneous manifestations are classically subdivided into 4 stages: vesicular, verrucous, hyperpigmented, and atrophic. Various hair and nail abnormalities, dental anomalies, and ophthalmologic and neurologic deficits are associated with the disorder. The gene for incontinentia pigmenti has been mapped to Xq28. Recently, mutations in the NEMO/IKKgamma gene located at Xq28 have been found to cause expression of the disease. Knockout mice heterozygous for NEMO/IKKgamma gene deficiency develop a clinical phenotype very similar to that of incontinentia pigmenti. NEMO/IKKgamma is an essential component of the newly discovered nuclear factor kappaB (NF-kappaB) signaling pathway. When activated, NF-kappaB controls the expression of multiple genes, including cytokines and chemokines, and protects cells against apoptosis. The mechanism by which NEMO/IKKgamma deficiency causes, via the NF-kappaB pathway, the phenotypical expression of the disease has recently been elucidated. In addition, the newest research findings on eosinophil recruitment through eotaxin release by activated keratinocytes are described in the review. Finally, anhidrotic ectodermal dysplasia with immunodeficiency, a disorder allelic to incontinentia pigmenti, is discussed together with implications on the current understanding of NF-kappaB function. (J Am Acad Dermatol 2002;47:169-87.) Learning objective: At the completion of this learning activity, participants will have a comprehensive and current understanding of incontinentia pigmenti, including its typical and uncommon clinical and histopathologic characteristics, diagnostic assessment, and current management strategies. Additionally, participants will gain the most current knowledge of the genetic and molecular basis of cutaneous pathomechanism.     

Clinical diagnosis of incontinentia pigmenti in a cohort of male patients

Eighteen male patients with incontinentia pigmenti (IP) showed the characteristic clinical features and, when examined, histologic skin defects observed in female patients with IP. Six of the patients had neurologic, ophthalmologic, or dental manifestations as well. Three patients showed evidence by polymerase chain reaction analysis of both the normal NEMO gene and the exon 4-10 deletion in NEMO that occurs in the majority of affected girls with IP, confirming postzygotic mosaicism for the NEMO gene.     

Incontinentia pigmenti in boys: a series and review of the literature

Incontinentia pigmenti is a rare X-linked genodermatosis, often associated with male lethality in utero. Occurrences of this disease in boys have been reported, however, its clinical phenotype has not been well characterized. The purpose of this study was to report on additional instances of incontinentia pigmenti in boys and to review the clinical, laboratory, and molecular characteristics of all published such patients. A retrospective chart review and Medline search using the keywords incontinentia pigmenti, males, and NEMO gene was undertaken. Six new boys with incontinentia pigmenti were found in our database and 36 more were previously reported in the literature. The vesiculo-bullous stage was the most frequent clinical presentation at diagnosis (80%). Fifteen percent of patients had an initial unilateral presentation. Recurrences of this stage were noted in 16%. Stages 2 and 3 of the disease were present in only 72.5% and 75% of patients, respectively. Only 15% of the boys had a documented stage 4. Extracutaneous manifestations were also documented (30% - central nervous system manifestations, 35% - eye involvement, 30% - alopecia, 40% - teeth anomalies). Thirty two percent of boys had peripheral eosinophilia. Only five had evidence of NEMO gene mutation. The male phenotype has clinical features similar to those of the female phenotype. Unilateral presentation is a distinct occurrence in boys, especially in early stages. Anomalies are the most common extracutaneous findings, followed by eye, hair, and central nervous system abnormalities.     

Nail dystrophy, an unusual presentation of incontinentia pigmenti

We describe a 57-year-old woman with a history of nail dystrophy since the age of 11 years. Multiple nail clippings were negative and multiple empirical treatments for presumed onychomycosis were unsuccessful. The patient has a daughter with classical incontinentia pigmenti. Molecular genetic analysis was positive for the NEMO gene deletion on the X chromosome, confirming the diagnosis of incontinentia pigmenti. Nail dystrophy was the sole feature of the disease in our patient.     

Clinical and molecular analysis of NF-kappaB essential modulator in Chinese incontinentia pigmenti patients

OBJECTIVE: To analyze clinical manifestation and gene of NF-kappaB essential modulator (NEMO) in 12 pediatric incontinentia pigmenti (IP) patients. METHODS: Twelve pediatric probands with three of their mothers were enrolled in this study. Physical examinations were undertaken for all patients and questionnaires requesting additional medical and developmental data were sent to the patients' families. The deletion of exon 4-10 and all 10 exons of NEMO gene were analyzed in these cases. Skin biopsy was performed in one case. RESULTS: All 15 patients had skin pigmentation abnormality and were diagnosed according to classic skin lesions. The prevalence of the dental, neurologic system, hair abnormality, and definite family history were 80.0%, 41.67%, 58.33%, and 25.0%, respectively. Histopathological examination was consistent with the diagnosis of IP with ectodermal dysplasia. In NEMO gene, deletion of exons 4-10 were noted in three cases and two of their mothers. A deletion of 19545 T in exon 6 was noted in one case and her mother. A 21690 T to C mutation in intron 8 of NEMO were found in another one case and her mother. CONCLUSION: The results suggest that skin lesion are the most prominent findings in clinics and the traditional diagnosis of IP is based on classic melanin pigmentation. Nucleotide deletion of exons 4-10 and single nucleotide mutation/polymorphism were found in these patients, which might account for etiopathogenesis of IP.     

Incontinentia pigmenti: three new cases that demonstrate it is not only a matter of women

Incontinentia pigmenti is a rare, dominantly X-linked genodermatosis characterized by multisystemic involvement that is lethal prenatally in the majority of affected males and shows great clinical variability when it is expressed in women. Recently it has been shown that mutations of the gene NEMO/IKK-g located in Xq28 cause the expression of the disease, being only one mutation responsible for approximately 80 % of the cases. The diagnosis of incontinentia pigmenti is performed based on clinical features and family history with the support of histological findings. Nevertheless, as the gene responsible for the phenotype of the disease has been identified, a genetic study may be employed for doubtful cases. We report three cases of this entity (two women and one man) in different clinical stages of development that show the broad clinical spectrum we may encounter in the clinic.