全外显子组测序发现FUT6基因在1例糖尿病肾病中的终止突变

目的:检测与糖尿病肾病相关的致病基因。方法:应用外显子捕获技术和高通量测序技术对1例临床病理确诊的糖尿病肾病患者的全基因组外显子进行测序,将测序数据筛选出的可能对基因功能有影响的非同义突变和剪切位点突变,与公共数据库YH、db SNP129、8Hap Mapexome和db SNP thousands genome进行对比过滤,然后对筛选出的候选基因进行免疫组化染色研究其表达量的变化。结果:通过数据的对比过滤,共发现509个突变位点,其中包括497个错义突变和12个无义突变。发生无义突变并且在肾脏高表达的基因有ANKRD35、ACSM2A、FUT6和HAAO。其中FUT6基因的315TAC>TAA,氨基酸残基由酪氨酸突变为终止密码子,免疫组化证实FUT6在该患者的肾活检组织中表达量减少。结论:糖尿病肾病患者中发现FUT6基因终止突变及其表达的显著降低,提示FUT6可能与糖尿病肾病的发病有关。     

A novel nonsense mutation in BBS4 gene identified in a Chinese family with Bardet-Biedl syndrome

Background Bardet-Biedl syndrome (BBS) is a genetically heterogeneous disease, and information about BBS in Chinese populations is very limited. The purpose of the present study was to determine the genetic cause of BBS in a Chinese Han family.

Methods Clinical data were recorded for the 4-year-old female proband and the available family members. The proband was screened for mutation by Sanger sequencing for a total of 142 exons of the 12 BBS-causing genes (BBS1-BBS12). The variants detected in the proband were further confirmed in the other family members.

Results We identified a novel homozygous nonsense mutation (c.70A>T, p.K24X) in the BBS4 gene exon 2 in the proband. Such mutant allele was predicted to cause a premature truncation in the N-terminal of the BBS4 protein, and probably induced the nonsense-mediated decay of BBS4 messenger RNAs. The proband’s parents and brother were heterozygous for the nonsense mutant allele. It was absent in 50 Chinese control subjects. An additional rare heterozygous missense single nucleotide polymorphism (SNP) named rs200718870 in BBS10 gene was also detected in the proband, her father and her brother. Some manifestations of the proband including atypical retinitis pigmentosa, choroidal sclerosis, high myopia, and early onset of obesity might be associated with this mutation in BBS4 gene. The proband’s father also reported surgical removal of an extra finger during childhood.

Conclusions The present study described a novel nonsense mutation in BBS4 gene in a Chinese family. This homozygous mutation was predicted to completely abolish the synthesis of the BBS4 protein. We also detected a rare heterozygous missense SNP in BBS10 gene in the family, but did not ?nd sufficient evidence to support the triallelic inheritance.

     

全外显子组测序发现FUT6基因在1例糖尿病肾病中的终止突变

目的:检测与糖尿病肾病相关的致病基因。方法: 应用外显子捕获技术和高通量测序技术对1例临床病理确诊的DN患者的全基因组外显子进行测序,将测序数据筛选出的可能对基因功能有影响的非同义突变和剪切位点突变,与公共数据库YH、dbSNP129、8HapMapexome和dbSNP thousands genome进行对比过滤,然后对筛选出的候选基因进行免疫组化染色研究其表达量的变化。结果:通过数据的对比过滤,共发现509个突变位点,其中包括497个错义突变和12个无义突变。发生无义突变并且在肾脏高表达的基因有ANKRD35、ACSM2A、 FUT6和HAAO。其中FUT6基因的315TAC>TAA,氨基酸残基由酪氨酸突变为终止密码子,免疫组化证实FUT6在该患者的肾活检组织中表达量减少。结论: 糖尿病肾病患者中发现FUT6基因终止突变及其表达的显著降低,提示FUT6可能与DN的发病有关。     

A novel mutation in TPRS1 gene caused tricho-rhino-phalangeal syndrome in a Chinese patient with severe osteoporosis

Tricho-rhino-phalangeal syndrome (TRPS) was first reported in 1966. Although mutation of TRPS1 gene is considered to be responsible for the syndromes in 2000, investigation of bone metabolism and changes of serum insulin-like growth factor (IGF)-1 level in this kind of patients is rare. Here, we report a patient with TRPS I (MIM 190350) presenting a novel mutation (1096insA) and abnormal changes of severe osteoporosis as well as low serum IGF-I level.

     

Novel PRNP mutation in a patient with a slow progressive dementia syndrome.

BACKGROUND: Creutzfeldt-Jakob disease is a rare neurodegenerative disorder with a worldwide incidence of 1.5 per million inhabitants. About 10-15% of all cases of Creutzfeldt-Jakob disease are of genetic origin and display a large variety in clinical presentation (regarding disease duration, age at onset, and others). The goal of this report was to describe the clinical features and diagnostic tests in a patient with a novel prion protein gene (PRNP) D202G mutation. CASE REPORT: A 71-year-old patient had all the clinical signs of Creutzfeldt-Jakob disease (CJD) but an extremely prolonged disease duration of 16 years. The 14-3-3 protein test was positive, while MRI and EEG did not show CJD typical changes. Family history was positive for cerebellar and dementia disorders without definite diagnoses. Full-length sequencing of the prion protein gene (PRNP) showed a new D202G mutation associated with valine on codon 129 of unknown significance. Methionine/valine heterozygosity at codon 129 was found. CONCLUSIONS: These findings highlight the value of 14-3-3 and gene analysis in unclear neurological disorders to detect possibly atypical presentations of prion disorders. The significance of this new mutation will remain unclear until further such patients are reported.     

Factor V Leiden mutation and deep venous thrombosis in a patient with hypereosinophilic syndrome

Idiopathic hypereosinophilic syndrome is a rare condition characterized by extremely high peripheral blood eosinophil counts. Patients with idiopathic hypereosinophilic syndrome are at increased risk for thrombosis. The coexistence of idiopathic hypereosinophilic syndrome with other thrombotic disease is rare. We present an additional case of idiopathic hypereosinophilic syndrome and factor V Leiden mutation, which lead to deep vein thrombosis.     

Molecular quantification of human beta-glucuronidase levels in a patient with Vohwinkel's syndrome

The skin must undergo the process of keratinization in order to perform its functions. During the process of differentiation, certain genes are activated while others are repressed, leading to changes in structural proteins and enzymes and in the synthesis of various lipids. An error in any of these steps can ultimately impair the process of keratinization. Vohwinkel's syndrome is the direct result of a defect in keratinization. Patients who have this epidermolytic palmoplantar keratoderma present clinically with hyperkeratosis of the stratum corneum. Hyperkeratosis has been linked to an increase in beta-glucuronidase levels. The authors studied the absolute concentration of human beta-glucuronidase in a patient with Vohwinkel's syndrome as determined through a double-antibody sandwich enzyme-linked immunosorbent assay and a Western blot assay of the blood, urine, and skin of the patient.     

Hallervorden-Spatz综合征患者一例的临床特征及泛酸激酶2基因突变检测

目的 研究中国Hallervorden-Spatz综合征患者的临床特征并对患者以及家系成员进行泛酸激酶2(PANK2)基因的突变检测.方法 对1例Hallervorden-Spatz综合征患者的临床特征进行分析,应用聚合酶链反应(PCR)、DNA直接测序技术检测患者和其父母及50名健康人PANK2基因序列.结果 患者主要临床表现为进行性加重的四肢不自主运动和构音不清,头部MRI T_2加权和FLAIR成像表现双侧苍白球对称性低信号,在低信号区的前内侧出现高信号,即"虎眼征";检测出PANK2基因一个新的复合杂合突变:位于第1外显子115位的G→T和第二外显子803位的A→G导致所编码的氨基酸发生改变(分别为E39X和D268G).父亲为G115T杂合突变,母亲为A803G杂合突变.结论 中国Hallervorden-Spatz综合征患者存在PANK2基因突变,PANK2基因A803G突变可能为中国大陆Hallervorden-Spatz综合征患者的突变热点.     

A novel splicing mutation in CLCNKB in a Chinese patient with Bartter syndrome type III

Bartter syndrome type Ⅲ is a Bartter syndrome subtype, which has a group of autosomal-recessive inherited disorders with clinical characteristics such as renal salt wasting, hypokalemic metabolic alkalosis,elevated renin and aldosterone levels, with normal or low blood pressure.1 Unlike other subtypes that often begin in the neonatal period, type Ⅲ, due to mutations in the CLCNKB gene,2-4 is highly variable and usually presents as a ＂classic＂ Barrter variant characterized by an onset in early childhood and less severe or absent hypercalciuria and nephrocalcinosis.     

Hyperammonaemic encephalopathy in an adult patient with citrin deficiency associated with a novel mutation

We report on an adult patient with citrin deficiency in Hong Kong, in whom a novel mutation was identified. The patient presented with recurrent hyperammonaemic encephalopathy due to impairment of the liver urea cycle enzyme argininosuccinate synthetase. This autosomal recessive condition is also characterised by interesting food preferences, notably aversion to carbohydrates and craving for protein-rich and/or lipid-rich foods, as well as neuropsychiatric symptoms. Plasma amino acid analysis is very useful in revealing urea cycle disorders, and mutational analysis of the SLC25A13 gene can confirm the diagnosis.     

两个线粒体12S rRNA C1494T突变及药物性耳聋家系的分子遗传学研究

目的:探讨2个氨基糖甙类药物性耳聋及非综合征型耳聋家系的分子遗传学特征?方法:收集家系成员外周血样,常规方法提取基因组DNA?首先,利用基因芯片对中国人4个常见耳聋基因的9个突变热点进行分子筛查,9个位点分别为:GJB2基因的35 delG?176 del16?235 delC和299 delAT;GJB3基因的538 C>T;PDS基因的IVS7-2 A>G和2168 A>G以及mtDNA 12S rRNA基因的1494 C>T和1555 A>G?然后,对两家系的先证者分别进行线粒体DNA全序列及核基因TRMU和MTO1编码区的PCR扩增和测序分析?结果:芯片检测发现两家系的7名母系成员均存在同质性mtDNA 12S rRNA C1494T突变?与修正的剑桥参考序列相比,2名先证者的mtDNA全序列分析共检测到53个碱基变异,但除已知的12S rRNA C1494T突变外,其余52个碱基变异均为已报道的多态性位点;两家系先证者线粒体单体型分别是D4和D5a;TRMU和MTO1基因序列分析无异常发现?结论:线粒体DNA 12S rRNA C1494T突变是两个家系耳聋发生的主要分子基础,而氨基糖甙类抗生素的应用增强了该突变的表型表达;未能证实线粒体单体型以及核基因TRMU和MTO1对家系成员C1494T突变的表型具有修饰作用?     

骨髓增生异常综合征患者SF3 B1基因突变的检测及意义

目的研究骨髓增生异常综合征( MDS)中关于RNA剪接因子3B第1亚单位(SF3B1)基因突变的检出率,进一步分析其与临床特征的关系。方法收集70例血液病患者骨髓标本,采用聚合酶链式反应技术( PCR)扩增目的片段,随后进行直接测序检测SF3B1突变情况。结果52例MDS患者中有4例发生SF3B1基因突变,发生率为7.7%,突变类型均为K700E。突变发生在环形铁粒幼细胞( RS)增多的MDS为3/4例,发生率为75%。突变患者显示较长时间的生存期,但病例数较少。结论伴 RS 增多的 MDS 患者中SF3B1突变常见,突变阳性患者具有独特的临床特征和较好的预后。     

CREBBP 基因突变所致Rubinstein-Taybi 综合征1例

Rubinstein-Taybi 综合征(Rubinstein-Taybi syndrome,RSTS) 又称宽拇指巨趾综合征(broad thumb-great toe syndrome)、巨指(趾)综合征(broad digits syndrome),是一类罕见的常染色体显性遗传病。患者的主要特征为颅面畸 形、骨骼畸形、生长延迟和精神及运动发育迟缓。本例患儿具有典型的RSTS特殊面容及生长迟滞,合并不典型的腹 股沟斜疝。二代测序技术基因结果显示：患儿的16 号染色体CREBBP基因外显子上存在1 个杂合突变位点c.4492C> T(p. Arg1498Ter),且为无义突变,使得肽链合成提前终止。受检者父母未发现上述变异,该变异可能为新生突 变。本病目前尚无特异性治疗方法。     

Recurrent ischemic colitis in a patient with leiden factor V mutation and systemic lupus erythematous with antiphospholipid syndrome

Ischemic colitis results from insufficient blood supply to the large intestine and is often associated with hypercoagulable states. The condition comprises a wide range presenting with mild to fulminant forms. Diagnosis remains difficult because these patients may present with non-specific abdominal symptoms. We report a 51- year-old female patient with known Leiden factor V mutation as well as systemic lupus erythematous along with antiphospholipid syndrome suffering from recurrent ischemic colitis. At admission, the patient complained about abdominal pain, diarrhea and rectal bleeding lasting for 24 hours. Laboratory tests showed an increased C-reactive protein (29.5 mg/dl), while the performed abdominal CT-scan revealed only a dilatation of the descending colon along with a thickening of the bowel wall. Laparotomy was performed showing an ischemic colon and massive peritonitis. Histological examination proved the suspected ischemic colitis. Consecutively, an anti-coagulation therapy with coumarin and aspirin 100 was initiated. Up to the time point of a follow up examination no further ischemic events had occurred. This case illustrates well the non-specific clinical presentation of ischemic colitis. A high index of suspicion, recognition of risk factors and a history of non-specific abdominal symptoms should alert the clinicians to the possibility of ischemic disease. Early diagnosis and initiation of anticoagulation therapy or surgical intervention in case of peritonitis are the major goals of therapy.     

新发角膜炎、鱼鳞病、耳聋综合征1例报告并文献复习

目的通过检测1例散发型角膜炎、鱼鳞病、耳聋综合征患儿的基因突变情况,明确其诊断。方法总结患儿临床资料,提取外周血DNA,采用PCR扩增GJB2基因编码区的全部外显子及其侧翼序列并测序。并以50例健康者作为对照。结果该患者GJB2基因外显子中的第148位碱基发生G→A杂合突变(C.148G>A),导致其编码的第50位氨基酸发生错义突变(p.D50N),患者父母均未发现该突变。患者诊断为角膜炎、鱼鳞病、耳聋综合征。结论对从临床表现上诊断困难的病例,在完善全面检查的基础上寻找基因的诊断依据是有效的诊断方法。     

噬血细胞综合征1例

1病例报告 女，42岁。发热，乏力，纳差，尿黄1个月，于2004年10月16日入院。病人自诉：1个月前无明显诱因下出现反复发热，呈不规则性，T38．5-40．5℃，伴有乏力，四肢酸软，胃纳减退，尿色加深如浓茶样。外院就诊查肝功能指标异常，经保肝治疗后肝功能进一步恶化，出现贫血，白细胞下降。予菌必治、氟嗪酸等治疗后仍发热，诊断为亚急性重型肝炎，发热待查，贫血转入我院。病人6年前有伤寒病史，已治愈。否认有其它疾病史，发热前无贫血。     

A vitamin K epoxide reductase complex subunit 1 mutation in an Irish patient with warfarin resistance

Background  Oral anticoagulant use continues to increase rapidly. In this setting, it is important to recognise that some normal individuals can demonstrate resistance to anticoagulation with warfarin. Such patients require high daily doses of warfarin (>20 mg) in order to maintain an international normalised ratio (INR) within the target therapeutic range (2–3). We describe the case of an elderly gentleman with atrial fibrillation who demonstrated true warfarin resistance. Methods  We performed vitamin K epoxide reductase subunit 1 (VKORC1) gene coding sequence analysis using polymerase chain reaction primers. Results  We demonstrated that our patient was heterozygous for a 383 T→G transition in exon 2 of the VKORC1 gene. Conclusions  This is the first documented Irish case of true warfarin resistance as a result of a mutation in VKORC1, a novel gene encoding a component of the epoxide reductase enzyme complex which is an essential component in the recycling pathway of vitamin K and is postulated to be one of the sites of action of warfarin.     

7例Goldenhar 综合征患者SALL1和TCOF1基因突变检测

目的探索Goldenhar综合征的致病原因。方法采集7例患者及其父母和正常同胞的详细临床资料和基因组DNA,PCR扩增SALL1和TCOF1的全部外显子及部分内含子,用直接双向测序、Blast比对进行突变分析。结果在SALL1发现了2个多态数据库已报道的单核苷酸多态;在TCOF1基因中发现了7个序列变异,其中6个已被报道为多态,1个为新发现的内含子突变。所有序列变异都存在于患者的正常亲属中,与疾病表型无共分离现象。结论排除了SALL1和TCOF1外显子突变导致此7例患者颜面畸形的可能性。