六个成骨不全家系的临床表型分析及基因变异检测

目的分析6个成骨不全家系的临床表型并明确其致病变异,为遗传咨询及产前诊断提供依据。方法收集6个家系的临床资料以及外周血或引产组织样本,应用二代测序(next generation sequencing,NGS)技术对先证者的全部基因进行检测,用PCR反应扩增检出的变异位点,之后进行Sanger测序。在6个家系的所有成员以及100名健康对照中对检测到的变异位点进行验证。结果家系1的先证者及其女儿携带COL1A1基因c.1976G>C杂合变异,家系2~6的先证者分别携带COL1A2基因c.2224G>A、COL1A1基因c.2533G>A、COL1A2基因c.2845G>A、COL1A1基因c.2532_2540delCGGACCCGC以及COL1A2基因c.1847G>A杂合变异。先证者的双亲均未携带相应变异,在100名健康对照中均未检测到上述变异。结论6个成骨不全家系的致病原因可能均为COL1A1/2基因的变异。新发现的变异丰富了成骨不全症的表现型-基因型数据库,并为这些家系的遗传咨询及产前诊断提供了依据。     

Ⅰ型胶原基因突变与成骨不全研究进展

成骨不全（osteogenesis imperfecta,OI）（OIⅠ,MIM#166200;OIⅡ,MIM#166210;OIⅢ,MIM#259420;OIⅣ,MIM#166220）又称脆骨病,是一种全身性结缔组织遗传病,多数为常染色体显性遗传,少数为常染色体隐性遗传,发病率约为1∶10000。临床表现主要包括骨脆性增加、蓝巩膜、牙本质发育不全、听力下降等。90%以上的OI患者具有Ⅰ型胶原基因（COL1A1,COL1A2）突变,尤以COL1A1基因突变为主。Ⅰ型胶原基因突变的位点与OI临床表型有一定的相关性。本文主要就Ⅰ型胶原基因突变与OI的研究进展作一综述。     

COL1A1/COL1A2基因突变分析与成骨不全的产前基因诊断

目的对有成骨不全(Osteogenesis Imperfecta,OI)孕史的患者,进行系统B超及COL1A1/COL1A2基因检测,希望建立OI患儿产前诊断方案,为OI患儿进行产前诊断提供技术保障。方法对于有OI孕史的孕妇,进行系统B超监测;根据胎儿股骨、长骨的超声影像学表现,初诊为成骨不全。抽取羊水,采用直接测序法对羊水DNA的COL1A1和COL1A2基因全编码外显子及启动子区域进行突变位点检测。检出的新突变,对孕妇夫妇及家系其他成员直接测序证实。产前诊断标本均需做母血污染鉴定。结果胎儿超声影像学表现为股骨短小,胫腓骨弯曲成角,颅骨变薄且发现多处骨折,考虑OI。STR法鉴定,羊水无母血污染。DNA序列分析结果显示COL1A1基因鉴定出19个SNP位点,没有鉴定出突变位点;COL1A2基因鉴定出13个SNP位点及第36外显子的第2180位置碱基发生错义突变位点(c.2180G>A,p.Gly727Asp)。孕妇在COL1A2基因的第36外显子亦存在错义突变位点(c.2180G>A,p.Gly727Asp),但其临床特征不一致。其他成员均未检测到Gly727Asp突变。结论有OI孕史的孕妇,采取B超和COL1A1/COL1A2基因诊断技术,可以快速、有效对高危胎儿做出确诊,为预防患病胎儿出生提供技术保障。     

五个成骨不全家系COL1A1基因的变异分析

目的分析5个成骨不全家系的COL1A1基因致病变异位点,为家系遗传咨询及产前诊断提供依据。方法应用高通量测序方法对5个成骨不全家系的先证者进行225个骨病相关基因进行检测分析,所检岀的可疑变异经PCR扩增后进行Sanger测序,对5个家系的先证者及其家庭成员和100名正常个体进行验证,确定致病性变异后,对1个家系中的高危胎儿进行产前诊断。结果5个家系的先证者分别携带COL1A1基因c.3226G>A(p.Glyl076Ser)杂合错义变异、c.579delT(p.Glyl94Valfs*71)移码变异、c・2911_2912insAG(p.Gly971Glufs*138)插入变异、c.3037G>A(p.Glyl013Arg)杂合错义变异,以及c.642+5G>A杂合剪接变异;家系1胎儿产前诊断结果提示胎儿未携带与先证者相同的变异,与超声检查结果一致。5个家系的父母均未携带相应的变异,均为新发变异。100名正常个体均未检出上述变异。其中COL1A1基因c.3037G>A(p.Glyl013Arg),c.29U_2912insAG(p.Gly971Glufs*138)变异为未报道的新变异。结论COL1A1基因变异是5个成骨不全家系的致病病因。本研究的结果丰富了COL1A1基因的变异谱,为家系遗传咨询和产前诊断提供了依据。     

一例成骨不全家系致病变异的鉴定及胚胎植入前遗传学检测

目的:明确一例成骨不全(osteogenesis imperfecta,OI)家系的致病变异并为其提供胚胎植入前遗传学检测(preimplantation genetic testing,PGT)。方法:应用高通量测序结合Sanger测序的方法鉴定患者的候选变异,用直接检测变异的方法对胚胎进行PGT检测,同时筛查囊胚的...     

一个Angelman综合征家系的临床表型及遗传学分析

目的:明确1个Angelman综合征(Angelman syndrome,AS)家系的遗传学病因,为家系的遗传咨询提供理论依据。方法:应用高通量测序技术进行单基因遗传智力障碍相关基因检测;应用拷贝数变异测序技术(copy number variation sequencing,CNV-seq)进行染色体非整倍体、100...     

成骨不全胎儿2例的 COL1A1与 COL1A2基因变异分析

目的探讨2例成骨不全症(OI)胎儿的临床表型及遗传学特征, 明确致病原因。方法收集分别在2021年6月11日和2021年10月16日就诊于潍坊医学院附属医院的2例中孕期超声诊断疑似OI胎儿的临床资料信息。采集孕妇羊水及胎儿父母、亲属外周血样品提取基因组DNA, 对2例胎儿进行全外显子组测序(WES), 对候选变异进行Sanger家系验证。针对可能影响pre-mRNA剪接的变异, 利用minigene体外分析变异位点附近外显子的剪接方式, 对变异的致病性进行判定。结果胎儿1在胎龄17+6周超声显示双侧肱骨和股骨发育落后2周余, 四肢长骨多发骨折、成角畸形。胎儿2在胎龄23周超声显示双侧肱骨和股骨发育分别落后1+周和4周, 双侧股骨和胫腓骨弯曲。WES结果显示胎儿1的COL1A1基因第49外显子存在c.3949₃950insGGCATGT(p.N1317Rfs*114)杂合变异, 该变异导致翻译提前终止, 胎儿父母外周血中未检出该变异。根据美国医学遗传学与基因组学学会(ACMG)变异评级指南, c.3949₃950insGGCATGT变异评级为致...     

Ⅰ型成骨不全一家系的分子诊断

目的 对Ⅰ型成骨不全(osteogenesis imperfecta,OI)1个家系进行分子诊断.方法 从先证者的基因组DNA人手,自行设计30对引物,扩增产物涵盖全部COL1A1基因52个外显子及启动子区域,并以相应引物对PCR产物进行直接测序.针对突变位点,设计扩增阻滞突变系统(amplification refractory mutation system,ARMS)引物,在60名无关对照中进行突变筛查.结果 在先证者的其中1条COL1A1等位基因上存在突变,即COL1A1基因第1441位(位于第52外显子,P30)发生了GAT→CAT改变.使原来编码的天冬氨酸被组氨酸取代(D1441H);其母亲的其中1条COL1A1等位基因上也存在相同突变,而正常对照相应的COL1A1基因序列与GenBank参考序列相同.ARMS分析显示,在60个无关对照中均未检测到D1441H突变.查阅国内外相关文献及COL1A1基因突变数据库,未发现有关COL1A1基因D1441H突变的报道.结论 建立了基于COL1A1基因突变分析的成骨不全分子诊断方法 ,并在中国人Ⅰ型成骨不全患者中发现1个新的COL1A1基因D1441H突变.     

两例Menkes病家系的临床表型及基因突变分析

目的 探讨2例Menkes病(Menkes disease,MD)患儿家系的临床表型及致病基因突变,明确病因.方法 收集患者临床资料,提取2例家系中患儿及其父母的基因组DNA,并对两家系中先证者进行全外显子组测序(whole exome sequencing,WES),对候选致病突变进行生物信息学分析,并利用Sange...     

一个Usher综合征Ⅰ型家系的临床表型分析及基因诊断

目的筛查一个Usher综合征Ⅰ型家系的致病变异位点,分析其基因型-表型对应关系。方法详细采集先证者的临床表型及家族史,应用高通量测序技术对先证者进行全外显子组检测。应用Sanger测序对疑似致病变异以及家系其他成员的携带情况进行验证。结果先证者10岁时出现夜盲、白内障等症状,之后发生视网膜变性,并随年龄增加出现耳聋症状。高通量测序及Sanger测序提示其携带MYO7A基因c.2694+2T>G及c.6028G>A复合杂合变异。其姐携带相同的变异位点,且表型与先证者相似。先证者女儿携带MYO7A基因c.6028G>A杂合变异,表型无异常。结论明确了一个Usher综合征Ⅰ型家系的遗传学病因,并丰富了该病的表型与基因型数据库,为遗传咨询提供了依据。     

Mutations in the COL1A2 gene of type I collagen that result in nonlethal forms of osteogenesis imperfecta

Although virtually all mutations that result in osteogenesis imperfecta (OI) affect the genes that encode the chains of type I procollagen, the effects of mutations in the COL1A2 gene have received less attention than those in the COL1A1 gene. We have characterized mutations in 4 families that give rise to different OI phenotypes. In three families substitutions of glycine residues by cysteine in the triple helical domain (a single example at position 259 and 2 families in which substitution of glycine at 646 by cysteine) have been identified, and in the fourth a G for A transition at position + 4 in intron 33 led to use of an alternative splice site and inclusion of 6 amino acids (val-gly-arg-ile-leu-phe) between residues 585 and 586 of the normal triple helix. The relation between position of substitution of glycine by cysteine in the COL1A2 gene does not follow the pattern developed in the COL1A1 gene. To determine how COL1A2 mutations produce OI phenotypes, we have produced a full-length mouse cDNA into which we plan to place mutations and examine their effects in stably transfected osteogenic cells and in transgenic animals.     

Haplotype analysis of collagen type I genes in the general population and in osteogenesis imperfecta families

The allele frequencies of 2 new polymorphic markers of collagen type I proalpha 1 (COL1A1) and proalpha 2 (COL1A2) genes were determined in a random sample of chromosomes by polymerase chain reaction. The minor allele frequencies were 0.27 for COL1A1/+88Mn1I, and 0.39 for COL1A2/1446 PvuII RFLPs, respectively. These 2 polymorphisms increased the combined (PIC) values we previously determined in the Italian population with Southern blotting procedures, from 0.71 at the COL1A1 locus to 0.81, and from 0.71 at the COL1A2 locus to 0.88, respectively. With a combination of these markers, we have carried out the segregation analysis of 4 new families in which osteogenesis imperfecta (OI) segregated as a dominant trait. The disease segregated with COL1A1 in 2 OI type I families, and with COL1A2 in one OI type IV family. In one OI type I family the concordant locus was uncertain. This analysis was extended to the 7 dominant OI families we previously reported: in 3 out of 11 pedigrees either locus still could not be excluded, indicating the need for more genetic markers. COL1A1 and COL1A2 haplotype frequencies were compared in normal and OI chromosomes: no preferential association of the disease with a given haplotype was detected. The correlation between affected locus and clinical aspects is discussed.     

成骨不全一家系的COL1A1基因突变分析

目的探讨一个成骨不全家系的COL1A1基因的突变位点及其与临床特征的关系。方法收集一个成骨不全家系的临床资料，采用聚合酶链反应以及直接测序法对家系内成员进行COL1A1基因突变位点检测，同时对50名无血缘关系健康对照者的该位点进行限制性内切酶分析。结果该家系中成骨不全患者均存在COL1A1基因的第2461位点G→A突变（17．821S），但其临床特征不一致。而在家系内非患者及正常对照者中均未发现该突变。结论COL1A1基因突变是中国人群中成骨不全致病原因之一。成骨不全的表型不仅与基因型有关，还与遗传背景有关。     

Moderately severe osteogenesis imperfecta associated with substitutions of serine for glycine in the α1(I) chain of type I collagen

Fryns syndrome is a lethal autosomal recessive multiple congenital anomaly syndrome characteristic “coarse” facies, cleft palate, diaphragmatic hernia, and distal digital hypoplasia. The appearance of the face and digits is very similar to that observed in Pallister-Killian syndrome (mosaic isochromosome 12p), although the incidence of cleft palate, diaphragmatic hernia, and neonatal death is much lower in the latter condition. We report on an infant with many manifestations of Fryns syndrome (“course” face, cleft palate, cloudy corneae, diaphragmatic hernia, distal digital hypoplasia, and neonatal death) who was found to be mosaic for i(12p). Her diagnosis was changed to Pallister-Killian syndrome and the family was counselled accordingly. The clinical overlap between Fryns and Pallister-Killian syndromes is discussed. Because the chromosome abnormality in Pallister-Killian syndrome is often limited to fibroblasts and may be selectively eliminated both in vivo and in vitro, some Pallister-Killian patients may be misdiagnosed with Fryns syndrome and given an erroneously high recurrence risk. Newborn infants with the Fryns or Pallister-Killian phenotypes should have chromosome studies involving multiple tissues so that the correct diagnosis can be made. This will contribute to the understanding of both disorders and facilitate appropriate genetic counselling. © 1993 Wiley-Liss, Inc.     

Heterozygous C-propeptide mutations in COL1A1: osteogenesis imperfecta type IIC and dense bone variant

Osteogenesis imperfecta type IIC (OI IIC) is a rare variant of lethal OI that has been considered to be an autosomal recessive trait. Twisted, slender long bones with dense metaphyseal margins and normal vertebral bodies in OI IIC contrast with crumpled, thick long bones and multiple vertebral compression fractures in OI IIA. Here, we report on two sporadic patients with classical OI IIC and a pair of siblings, with features of OI IIC but less distortion of the tubular bones (OI dense bone variant). One case with OI IIC and the sibs had novel heterozygous mutations in the C-propeptide region of COL1A1, while the second patient with clear-cut OI IIC had no mutation in this region. Histological examination in the two sporadic cases showed a network of broad, interconnected cartilaginous trabeculae with thin osseous seams in the metaphyses. These changes differed from the narrow and short metaphyseal trabeculae found in other lethal or severe cases of OI. Our experience sheds light on the genetics and etiology of OI IIC and on its phenotypic spectrum.     

Consortium for osteogenesis imperfecta mutations in the helical domain of type I collagen: regions rich in lethal mutations align with collagen binding sites for integrins and proteoglycans

Osteogenesis imperfecta (OI) is a generalized disorder of connective tissue characterized by fragile bones and easy susceptibility to fracture. Most cases of OI are caused by mutations in type I collagen. We have identified and assembled structural mutations in type I collagen genes (COL1A1 and COL1A2, encoding the proalpha1(I) and proalpha2(I) chains, respectively) that result in OI. Quantitative defects causing type I OI were not included. Of these 832 independent mutations, 682 result in substitution for glycine residues in the triple helical domain of the encoded protein and 150 alter splice sites. Distinct genotype-phenotype relationships emerge for each chain. One-third of the mutations that result in glycine substitutions in alpha1(I) are lethal, especially when the substituting residues are charged or have a branched side chain. Substitutions in the first 200 residues are nonlethal and have variable outcome thereafter, unrelated to folding or helix stability domains. Two exclusively lethal regions (helix positions 691-823 and 910-964) align with major ligand binding regions (MLBRs), suggesting crucial interactions of collagen monomers or fibrils with integrins, matrix metalloproteinases (MMPs), fibronectin, and cartilage oligomeric matrix protein (COMP). Mutations in COL1A2 are predominantly nonlethal (80%). Lethal substitutions are located in eight regularly spaced clusters along the chain, supporting a regional model. The lethal regions align with proteoglycan binding sites along the fibril, suggesting a role in fibril-matrix interactions. Recurrences at the same site in alpha2(I) are generally concordant for outcome, unlike alpha1(I). Splice site mutations comprise 20% of helical mutations identified in OI patients, and may lead to exon skipping, intron inclusion, or the activation of cryptic splice sites. Splice site mutations in COL1A1 are rarely lethal; they often lead to frameshifts and the mild type I phenotype. In alpha2(I), lethal exon skipping events are located in the carboxyl half of the chain. Our data on genotype-phenotype relationships indicate that the two collagen chains play very different roles in matrix integrity and that phenotype depends on intracellular and extracellular events.