SEDL基因突变与X连锁迟发性脊柱骨骺发育不良研究进展

SEDL基因于定位于X短臂（Xp22.2）,含有6个外显子,第3～6外显子为编码外显子,翻译起始密码位于外显子3,翻译产物为含有140个氨基酸的Sedlin。SEDL基因是一个高度保守的基因,参与在内质网至高尔基体间囊泡运输的定位和融合,与蛋白质转运有关。X-连锁迟发性脊柱骨骺发育不良（SEDT）是累及脊椎椎体和身体承重大关节的骨软骨发育障碍性疾病,呈X-连锁隐性遗传。临床特点为短躯干性侏儒和进行性的大关节退行性变,X线检查腰部椎体前部上下缘凹陷、中后部呈驼峰状突起。1999年首次发现SEDT的致病基因为SEDL,迄今为止已在SEDL基因上发现47种突变,其中缺失突变最为常见。本文简要综述了SEDL基因的结构与功能以及SEDT的分子遗传学研究进展,有助于SEDT的基因诊断与产前诊断。     

X-连锁迟发性脊椎骨骺发育不良SEDL基因新突变

目的　研究X 连锁迟发性脊椎骨骺发育不良 (X linkedspondyloepiphysealdysplasiatarda ,SEDL)的发病机理。方法　应用聚合酶链反应 单链构象多态及变性聚丙烯酰胺测序凝胶电泳技术 ,并结合DNA序列分析方法 ,对 5例SEDL患者及 3 0名正常对照SEDL基因的全部编码外显子及其邻近序列进行突变分析。结果　在 1例SEDL患者中发现了致病突变 ,并经DNA序列分析证实 ,SEDL基因第 5内含子剪接受体处IVS5 2— 1delAG紧接第 6外显子 3 2 2— 3 3 2delTTTTCAATGAA共 13个碱基缺失。结论该突变系国内外尚未见报道的新突变 ,这一突变可引起SEDL。     

X-连锁迟发性脊椎骨骺发育不良家系SEDL基因突变及基因诊断

目的 确定一个X-连锁迟发性脊椎骨骺发育不良(X-linked spondyloepiphyseal dysplasia tarda,SEDL)家系的基因突变类型;建立一种快速基因诊断方法.方法 采用体格检查、影像学检查及家系分析进行临床诊断.针对SEDL基因的第3～6外显子及其侧翼序列设计4对引物,建立基于PCR的变性高效液相色谱技术(denaturing high performance liquid chromatography,DHPLC)快速基因分型方法.常规酚-氯仿法从该家系3代18名成员的外周血中提取基因组DNA,经PCR/DHPLC分析,筛查出SEDL基因突变所在的片段,对该片段进行序列分析以确定突变位点及类型.结果 DHPLC分析发现该家系的SEDL基因突变位点在第4外显子片段,序列分析证实为c.218C》T突变,导致氨基酸序列S73L改变.在该家系的18名成员中,3例男性患者,5例女性肯定携带者和2例未婚女性携带者均带有该突变,其余表型正常的8名成员中未检测到这一突变.各成员的DHPLC峰型所代表的基因型与表型结果相吻合.结论 首次报告中国人SEDL基因c.218C》T突变,丰富了中国人SEDL基因的突变谱.采用的技术快速、可靠,能对SEDL进行快速基因分型和产前诊断.     

X连锁迟发性脊椎骨骺发育不良家系SEDL基因突变分析

目的 鉴定中国西南地区一个4代迟发性脊椎骨骺发育不良大家系的分子遗传缺陷.方法 采用X染色体荧光标记微卫星标记物进行连锁分析,并通过直接序列分析筛查SEDL基因突变.结果 DXS987与DXS8051之间呈现连锁(最大LOD值:3.82;θ=0),致病基因定位于Xp22.2-Xp23.1;序列分析发现SEDL基因第4外显子发生点突变(c.239A＞G),导致在第80位编码氨基酸由组氨酸置换为精氨酸(H80R).结论 SEDL基因与此中国迟发性脊椎骨骺发育不良大家系表型完全连锁,并发现该基因新的致病突变(H80R).     

X-连锁迟发性脊椎骨骺发育不良家系SEDL基因突变研究

目的：确定中国汉族中一个X－连锁迟发性脊椎骨骺发育不良（spondyloepiphyseal dyskplasia tarda,SEDL)大家系SEDL基因突变类型，探讨SEDL发病的分子基础。方法：用聚合酶链反应扩增产物双向直接测序方法检测了患者构成SEDL基因可读框的第3－6外显子及相邻侧翼区的DNA序列，将测序结果与GenBank公布的SEDL基因正常序列对比找出突变。然后在家系其他成员中证实该突变。结果：在2例患者（Ⅳ15、Ⅴ3）SEDL基因第2内含子剪接受体处发现了IVS2－2A→C突变，4个外显子的核苷酸序列未见改变。该突变在4例女性携带者得到证实，她们的基因型表现为野生型与突变型杂合现象。家系中2名未受累男性和15名无关健康个体未检测到这一突变。在该家系还检测出4个无症状的携带者。结论：首次发现SEDL基因IVS2－2A→C突变。该突变引起SEDL基因第2内含子3'端剪接受体改变，使之不能与外显子3正常剪接，可能是SEDL发病的分子基础。检测该突变可进行基因诊断，有重要的临床价值。     

Loss of the SEDL gene product (Sedlin) causes X-linked spondyloepiphyseal dysplasia tarda: Identification of a molecular defect in a Japanese family

A 23-year-old man was diagnosed as having X-linked spondyloepiphyseal dysplasia tarda (SEDT; MIM 313400) based on his disproportionately short trunk, short stature, characteristic radiological features of the spine (posterior hump, end plate sclerosis, and disc space narrowing) and the hips (short and thick femoral necks), and positive family history. This Japanese family was found to have an intragenic deletion flanking intron 2 and exon 3 of the SEDL gene that not only included the 5' untranslated region but also the coding sequence for the first methionine through the 25th alanine. This mutation was present in the proband and his unaffected mother (a heterozygote), but not in an unaffected sister and an unaffected uncle. The nature of the mutation predicted that the SEDL protein (Sedlin) was not produced in the proband, indicating that loss of Sedlin caused SEDT.     

X-连锁迟发性脊椎骨骺发育不良家系基因突变研究

目的 研究X-连锁迟发性脊椎骨骺发育不良(X-linked spondyloepiphyseal dysplasia tarda,SEDL)患者的发病机理,并探讨该病的快速基因诊断方法.方法 应用逆转录聚合酶链反应,结合序列分析方法,对一个X-SEDL家系2例患者及育龄女性进行SEDL基因突变分析.结果 cDNA序列分析显示患者为G209A突变,并对突变所在第4外显子进行PCR扩增并测序进一步证实.患者女儿为该突变的携带者.结论 由于SEDL基因较小,直接对患者提取总RNA,逆转录后直接进行PCR扩增、测序,可直接发现基因阅读框内的多种类型的突变,相对于针对每一个外显子单独扩增检测更加直接、快速.     

X-linked spondyloepiphyseal dysplasia tarda: Novel and recurrent mutations in 13 European families

X-linked spondyloepiphyseal dysplasia tarda is a skeletal dysplasia mainly affecting the vertebrae and epiphyses and commonly associated with the early development of degenerative joint disease. Radiographically the disorder is characterized by a typical hump-shaped deformity of the vertebral bodies. SEDT is caused by mutations in SEDL located on Xp22.12-p22.31. To further elucidate the spectrum of underlying variations we performed a screening of all 6 exons of SEDL within 13 European SEDT families and identified 6 new (c.99delC, c.183_184delGA, c.236-5_236-8delATTA, c.325delT, c.345_346delTG, c.94-?_423+?del) and 9 previously reported mutations (c.1-?_93+?del, c.93+5G>A, c.157_158delAT, c.210G>A, c.236-9_236-12delTTAA, c.267_275delAAGAC, c.324-4_324-10delTCTTTCCinsAA). The recurrent splice site alteration c.93+5G>A (formerly described as IVS3+5G>A) was detected in 3 unrelated families. Two patients were carrying 2 changes in the allele. In one case, a novel variation in exon 4 (c.99delC) was associated with several nucleotide deletions in intron 4 (c.236-5_236-8delATTA), and in the second case we identified a previously reported transition c.210G>A and a novel deletion in exon 6 (c.325delT). All sequence variations identified are either deletions of complete exons or predicted to result in a premature stop codon or to lead into splicing defects and are associated with a loss of considerable parts of the sedlin protein.     

X-连锁迟发性脊椎骨骺发育不良SEDL基因剪接受体突变导致潜在剪接位点激活

目的 深入研究X-连锁迟发性脊椎骨骺发育不良（X-linked spondyloepiphyseal dysplasia tarda,SEDL）的发病机理，为最终防治本病提供依据。方法 应用逆转录-PCR及克隆测序方法对1例涉及SEDL基因第5内含子剪接受体缺失的SEDL患者进行mRNA表达研究。结果 该患者存在2个不同片段长度的mRNA表达产物，与GenBank正常序列进行BLAST比较后发现，393bp的表达产物是第6外显子内一个新的潜在剪接位点激活后形成的产物；433bp的表达产物与8号染色体的部分基因组序列完全一致。结论 SEDL基因第5内含子剪接受体位点及其后的第6外显子共13个碱基的缺失突变导致第6外显子内一个新的潜在剪接受体位点激活，使转录后的mRNA丢失了第6外显子内47bp的编码序列，并使紧接其后的2个密码子产生移码，导致翻译的提前终止（D109-S123del；S124fsX126）。另外，该突变可能激活了8号染色体上假基因SEDLP2的转录，从而部分地补偿了SEDL蛋白的功能。     

Loss of the SEDL gene product (Sedlin) causes X‐linked spondyloepiphyseal dysplasia tarda: Identification of a molecular defect in a Japanese family

A 23‐year‐old man was diagnosed as having X‐linked spondyloepiphyseal dysplasia tarda (SEDT; MIM 313400) based on his disproportionately short trunk, short stature, characteristic radiological features of the spine (posterior hump, end plate sclerosis, and disc space narrowing) and the hips (short and thick femoral necks), and positive family history. This Japanese family was found to have an intragenic deletion flanking intron 2 and exon 3 of the SEDL gene that not only included the 5′ untranslated region but also the coding sequence for the first methionine through the 25th alanine. This mutation was present in the proband and his unaffected mother (a heterozygote), but not in an unaffected sister and an unaffected uncle. The nature of the mutation predicted that the SEDL protein (Sedlin) was not produced in the proband, indicating that loss of Sedlin caused SEDT. © 2001 Wiley‐Liss, Inc.     

X连锁隐性遗传性少汗性外胚层发育不全一家系EDA基因突变分析

目的 对1个X连锁隐性遗传性少汗性外胚层发育不全(X-linked hypohidrotic ectodermal dysplasia,XLHED)家系进行EDA基因检测,分析基因突变类型,探讨其遗传学因素及发病原因.方法 对该XLHED家系进行家系调查,收集家系患者及部分成员和50名无亲缘关系的正常个体的外周血标本并提取基因组DNA,应用聚合酶链反应扩增EDA基因8个外显子,DNA直接测序进行突变检测.结果 该家系中患者检出EDA基因第3外显子存在c.467G＞A突变,导致R156H错义突变.先证者的母亲及姨妈携带c.467G＞A杂合突变,家系中正常个体和正常对照个体均未检测到该突变.结论 EDA基因的R156H突变可能是引起该XLHED家系先证者少汗性外胚层发育不全的致病原因.     

先天性脊柱骨骺发育不良一家系的临床及影像学特征研究

目的研究先天性脊柱骨骺发育不良（SEDC）一家系患者的临床及影像学特征。方法对一个4代9例患者共35人的SEDC家系进行家系调查，拍摄X片，研究其临床及影像学特征，并对11个月的先证者随访至39个月。结果该SEDC家系为常染色体显性遗传，患者均呈现身材矮小，颈短，跛行等一致的临床特点。X线示中等程度的扁平椎体，中等一严重的脊柱侧弯，股骨头骨化缺如，股骨颈严重的发育不良，结构不规则，髋臼顶扁平，结构不规则，髋内翻，不累及其他管状骨。先证者在39个月时股骨头继发骨化中心仍未出现。结论股骨头骨化缺如是该SEDC家系的独特表型，详细的临床、影像学研究丰富了人们对SEDC临床特征的认识，并为进一步进行分子遗传学研究奠定了基础。