晶状体蛋白βB1基因错义突变引起常染色体显性遗传性白内障

目的对河北汉族一个四代先天性核性常染色体显性遗传白内障家系进行基因分析,了解此家系在候选基因上是否存在突变位点。方法该家系22名成员（包括患者7人,非患者15人）知情同意进人本研究,并接受全面的眼部及全身检查,以排除白内障以及外眼部及全身疾患。该家系成员中患病者经眼部裂隙灯检查发现晶状体均为核性混浊。采集22名家系成员的外周静脉血,提取基因组DNA。选择国内外已报道的与先天性核性白内障发生相关的7个候选基因（CRYBA3/A1、CRYBB1、CRYBB2、CRYGD、GJA3、GJA8和MIP）,设计引物使聚合酶链反应扩增的片段覆盖候选基因外显子,对扩增产物进行测序和序列分析,寻找突变位点。结果发现编码晶状体蛋白Βb1的基因（CRTBB1）第4外显子一个等位基因的第457个碱基发生错义突变C＆gt;A,形成杂合子,导致其编码蛋白第129位氨基酸由丝氨酸（S）转变为精氨酸（R）,其余外显子的碱基序列与GenBank数据库中的正常序列一致。结论该家系的核性先天性白内障是由于CRYBB1基因外显子4的错义突变C＆gt;A引起。     

一个先天性白内障家系基因突变热点分析报告

目的：对一个来自广东兴宁的四代先天性白内障家系进行常染色体显性基因突变热点的分析，了解这个家系在热点上是否有相应的改变。方法：该家系19名成员(包括患者8人，非患者11人)知情同意进入本研究。8例患者在中山眼科中心接受全面的眼部及全身检查．以排除存在白内障以外眼部及全身疾患。11例非患病亲属仅接受眼部检查。对这19例研究对象各抽取外周血5ml，提取基因组DNA。针对国外文献报道(截至2003年1月为止)的与常染色体显性遗传先天性白内障相关的10个基因(CRYAA、CRYAB、CRYBA1／A3、CRYGD、GJA8、CRYGC、CRYBB2、GJA3、MIP及BFSP2)的17个突变热点，设计引物使聚合酶链反应扩增的片段覆盖这17个位点，对扩增产物进行测序和序列分析，了解这19名研究对象在17个突变热点上是否有相应的序列改变。结果：19例研究对象，在国外文献报道的17个与常染色体显性遗传先天性白内障相关的突变热点，均未发现相应的序列改变。结论：初步排除这个常染色体显性遗传先天性白内障家系与国外文献报道的17个突变热点相关。     

东北地区一遗传性白内障家系的临床遗传学及基因定位研究

目的:分析一先天性核型白内障家系的遗传方式及致病基因所在位置。方法:收集一个3代遗传性白内障家系成员的临床资料;提取家系成员外周血DNA,选取62个态性微卫星标记进行连锁分析。应用LINKAGE软件(version 5.2)中的MLINK程序计算两点连锁LOD值,并人工构建家系成员的单体型。结果:确定该家系为一常染色体显性遗传性白内障大家系,在微卫星标记D22S689可获得最大LOD值2.71(θ=0时),单体型提示该家系表型可能与染色体22q11.2-12.1区域连锁。该区域含有CRYBB1,CRYBB2,CRYBB3,CRYBA44个候选基因。结论:本研究先天性核型白内障家系符合常染色体显性遗传规律,其致病基因定位于22q11.2-12.1区域。     

Investigation of crystallin genes in familial cataract, and report of two disease associated mutations

AIMS: Mutations of seven crystallin genes have been shown to cause familial cataract. The authors aimed to identify disease causing crystallin mutations in paediatric cataract families from south eastern Australia. METHODS: 38 families with autosomal dominant or recessive paediatric cataract were examined. Three large families were studied by linkage analysis. Candidate genes at regions providing significant LOD scores were sequenced. Single stranded conformational polymorphism (SSCP) analysis was used to screen five crystallin genes in the probands, followed by direct sequencing of observed electrophoretic shifts. Mutations predicted to affect the coding sequence were subsequently investigated in the entire pedigree. RESULTS: A LOD score of 3.72 was obtained at the gamma-crystallin locus in one pedigree. Sequencing revealed a P23T mutation of CRYGD, found to segregate with disease. A splice site mutation at the first base of intron 3 of the CRYBA1/A3 gene segregating with disease was identified by SSCP in another large family. Five polymorphisms were also detected. CONCLUSIONS: Although mutations in the five crystallin genes comprehensively screened in this study account for 38% of paediatric cataract mutations in the literature, only two causative mutations were detected in 38 pedigrees, suggesting that crystallin mutations are a relatively rare cause of the cataract phenotype in this population.     

Mutations in betaB3-crystallin associated with autosomal recessive cataract in two Pakistani families

PURPOSE: To identify the disease locus for autosomal recessive congenital cataracts in consanguineous Pakistani families. METHODS: Two Pakistani families were ascertained, patients were examined, blood samples were collected, and DNA was isolated. A genome-wide scan was performed using >382 polymorphic microsatellite markers on genomic DNA from affected and unaffected family members. Two-point lod scores were calculated, haplotypes were formed by inspection, and candidate genes were sequenced. Real-time quantitative PCR techniques were used to determine the mRNA levels, and molecular modeling was performed to gain a better understanding of the significance of the disease-causing mutation. RESULTS: In the genome-wide scan, maximum lod scores of 2.67 and 2.77 for family 60004 and 2.02 and 2.04 for family 60006 were obtained for markers D22S539 and D22S315, respectively. The linked region, 22.7 cM (10 Mb) flanked by markers D22S420 and D22S1163, contains the beta-crystallin gene cluster including the genes CRYBA4, CRYBB1, CRYBB2, and CRYBB3. Sequencing of these genes showed a G-->C transition in exon 6 of CRYBB3 resulting in a p.G165R change in the betaB3-crystallin protein that cosegregates with the disease in both families. Real-time PCR analysis suggested that betaB3-crystallin mRNA levels approximate those of other betagamma-crystallins. Molecular modeling predicted changes in electrostatic potential that would be expected to reduce the stability of the fourth Greek-key motif, and hence the entire protein, dramatically. CONCLUSIONS: For the first time, a mutation in CRYBB3 is reported in two consanguineous Pakistani families with autosomal recessive congenital cataracts.     

Further genetic heterogeneity for autosomal dominant human sutural cataracts

A unique sutural cataract was observed in a 4-generation German family to be transmitted as an isolated autosomal, dominant trait. Since mutations in the gamma-crystallin encoding CRYG genes have previously been demonstrated to be the most frequent reason for isolated congenital cataracts, all 4 active CRYG genes have been sequenced. A single base-pair change in the CRYGA gene has been shown, leading to a premature stop codon. This was not observed in 170 control individuals. However, it did not segregate with the disease phenotype. This is the first truncating mutation in an active CRYG gene without a dominant phenotype. As the CRYGA mutation did not explain the cataract, several other candidate loci (CCV, GJA8, CRYBB2, BFSP2, MIP, GJA8, CENTRAL POUCH-LIKE, CRYBA1) were investigated by microsatellite markers and linkage analysis, but they were excluded based on the combination of haplotype analysis and two-point linkage analysis. The phenotype in this family is due to a mutation in another sutural cataract gene yet to be identified.     

CRYBA3/A1 gene mutation associated with suture-sparing autosomal dominant congenital nuclear cataract: a novel phenotype

PURPOSE: To identify the genetic defect leading to the congenital nuclear cataract affecting a large five-generation Swiss family. METHODS: Family history and clinical data were recorded. The phenotype was documented by both slit lamp and Scheimpflug photography. One cortical lens was evaluated by electron microscopy after cataract extraction. Lenticular phenotyping and genotyping were performed independently with short tandem repeat polymorphism. Linkage analysis was performed, and candidate genes were PCR amplified and screened for mutations on both strands using direct sequencing. RESULTS: Affected individuals had a congenital nuclear lactescent cataract in both eyes. Linkage was observed on chromosome 17 for DNA marker D17S1857 (lod score: 3.44 at theta = 0). Direct sequencing of CRYBA3/A1, which maps to the vicinity, revealed an in-frame 3-bp deletion in exon 4 (279delGAG). This mutation involved a deletion of glycine-91, cosegregated in all affected individuals, and was not observed in unaffected individuals or in 250 normal control subjects from the same ethnic background. Electron microscopy showed that cortical lens fiber morphology was normal. CONCLUSIONS: The DeltaG91 mutation in CRYBA3/A1 is associated with an autosomal dominant congenital nuclear lactescent cataract. A splice mutation (IVS3+1G/A) in this gene has been reported in a zonular cataract with sutural opacities. These results indicate phenotypic heterogeneity related to mutations in this gene.     

先天性白内障致病基因及其功能研究进展

先天性白内障是儿童主要的致盲性眼病之一,约1/3与遗传有关.迄今为止,与遗传性白内障相关的基因至少有22个:O个晶状体蛋白基因:RYAA、CRYAB、CRYBA1/A3、CRYBA4、CRYBB1、CRYBB2、CRYBB3、CRYGC、CRYGD、CRYGS;4个膜蛋白基因:JA3、GJA8、MIP、LIM2;3个发育及转录因子基因:ITX3、MAF、HSF4;2个细胞骨架蛋白基因:SFP1、BSFP2;1个染色质修饰蛋白-4β基因:HMP4B;1个酪氨酸激酶受体基因:PHA2,1个NHS基因,其中部分基因已经在细胞学水平和(或)动物模型的整体水平对其功能进行研究,这将有助于揭示先天性白内障的发病机制.     

先天性后极性白内障超微结构分析及突变基因筛查

目的 探讨一先天性后极性白内障家系晶状体的超微结构改变,并初步筛查其致病基因.方法 收集一常染色体显性遗传性先天性后极性白内障家系资料,对家系成员行眼部检查;在透射电镜下观察晶状体细胞超微结构的改变;选择CRYAB、CRYBA1/A3、CRYBB2、GJA8、CHMP4B、PITX3和EPHA2这7个热点基因进行突变位点筛查.结果 根据家系图分析该家系为垂直遗传,符合单基因常染色体显性遗传特点.裂隙灯显微镜下检查示全部患者晶状体混浊形态完全相同.透射电镜下发现患者前囊面晶状体上皮细胞排列紧密,结构完整,未见特异性病理变化;前皮质晶状体纤维细胞排列紧密,细胞内密度均一一致,但后皮质晶状体纤维细胞内出现斑驳状中高密度异常颗粒沉着.热点基因筛查显示:7个候选基因的外显子及其邻近内含子序列与基因库对照未发现任何突变.结论 本研究将后极性白内障病变定位于后皮质晶状体纤维细胞,排除了前囊面晶状体上皮细胞及前皮质晶状体纤维细胞.此家系携带的遗传突变位点位于尚未见报道的与后极性白内障相关的致病基因上.     

先天性膜性白内障一家系致病基因的遗传分析

目的 分析一个先天性白内障家系的遗传规律,对其突变基因进行初步研究.方法 选取一先天性膜性白内障家系,对家系成员进行临床检查并采集静脉血.标准饱和酚/氯仿抽提法提取DNA,选取多态性微卫星遗传标记,合成引物,聚合酶链反应,聚丙烯酰胺凝胶电泳,基因分型,等位基因共享分析法对已知候选基因进行排除性定位.结果 该家系为常染色体显性遗传性先天性白内障家系.其致病基因与D22S315联系紧密,重组发生在以D22S303和D22S1167为上下边界的范围内.对该范围内已知的先天性白内障致病基因CRYBB1、CRYBB2、CRYBB3、CRYBA4进行DNA直接测序,未发现突变.结论 该家系致病基因定位于22q11.2～q12.1的2.4 Mbp范围内,其致病基因与已知基因座不同.该范围内可能存在导致先天性膜性白内障的新的致病基因.     

A novel splice site mutation of CRYBA3/A1 gene associated with congenital cataract in a Chinese family

AIM: To identify the disease-causing mutation responsible for the presence of congenital cataract in a Chinese family. METHODS: The study recruited a four-generation Chinese pedigree affected by autosomal dominant congenital cataract (ADCC). Family history and the history of cataract extraction were recorded. Blood samples were collected from individuals for DNA extraction. Direct sequencing of congenital cataract-associated genes was performed. Single-strand conformational polymorphism and bioinformatic analysis were conducted to further study the mutation. RESULTS: Direct sequencing revealed a novel splice site mutation of c.30-2 A>G in the CRYBA3/A1 gene. The mutation co-segregated within all affected individuals in the family and was not found in unaffected members or 100 unrelated normal controls. These results were further confirmed by single-strand conformational polymorphism and bioinformatic analysis using the Human Splicing Finder and MaxEnt online software and Annovar computer software. CONCLUSION: c.30-2 A>G mutation of CRYBA3/A1 gene is a novel mutation and broadens the genetic spectrum of ADCC.     

晶状体蛋白βB2基因突变导致常染色体显性遗传先天性白内障

目的定位常染色体显性遗传先天性粉尘状核性白内障一家系的致病基因。方法收集该家系资料,针对与常染色体显性遗传先天性白内障发病相关的14个热点致病基因设计引物,对此4代先天性白内障家系进行热点突变位点的分析,了解是否有相应的改变。结果此家系患者编码人类晶状体蛋白的基因βB2的第6外显子存在一个C→T突变,此突变导致终止密码子提前出现。该基因的第2外显子的第40个核苷酸存在A/T的单核苷酸多态性。结论编码人类晶状体蛋白的基因βB2是此先天性白内障家系的致病基因。     

先天性白内障的基因诊断

先天性白内障是儿童常见的致盲性眼病。与遗传有关的先天性白内障有多种遗传方式，其致病基因、基因突变的位点和引起先天性白内障的表现型相继被发现。到目前为止，分子遗传学的研究证明与先天性白内障有关的致病基因有16个，共有40多个基因位点与先天性白内障有关。先天性白内障的基因型和表现型的关系逐步明确，使先天性白内障的基因诊断，特别是产前诊断成为可能。     

Novel mutations in CRYBB1/CRYBB2 identified by targeted exome sequencing in Chinese families with congenital cataract

AIM: To summarize the phenotypes and identify the underlying genetic cause of the CRYBB1 and CRYBB2 gene responsible for congenital cataract in two Chinese families. METHODS: Detailed family histories and clinical data were collected from patients during an ophthalmologic examination. Of 523 inheritable genetic vision system-related genes were captured and sequenced by targeted next-generation sequencing, and the results were confirmed by Sanger sequencing. The possible functional impacts of an amino acid substitution were performed with PolyPhen-2 and SIFT predictions. RESULTS: The patients in the two families were affected with congenital cataract. Sixty-five (FAMILY-1) and sixty-two (FAMILY-2) single-nucleotide polymorphisms and indels were selected by recommended filtering criteria. Segregation was then analyzed by applying Sanger sequencing with the family members. A heterozygous CRYBB1 mutation in exon 4 (c.347T>C, p.L116P) was identified in sixteen patients in FAMILY-1. A heterozygous CRYBB2 mutation in exon 5 (c.355G>A, p.G119R) was identified in three patients in FAMILY-2. Each mutation co-segregated with the affected individuals and did not exist in unaffected family members and 200 unrelated normal controls. The mutation was predicted to be highly conservative and to be deleterious by both PolyPhen-2 and SIFT. CONCLUSION: The CRYBB1 mutation (c.347T>C) and CRYBB2 mutation (c.355G>A) are novel in patients with congenital cataract. We summarize the variable phenotypes among the patients, which expanded the phenotypic spectrum of congenital cataract in a different ethnic background.     

先天性白内障一家系晶状体蛋白突变基因筛查

目的对先天性白内障一家系进行晶状体蛋白致病基因的初步筛查。方法通过聚合酶链反应（PCR）对先天性白内障一家系中4代8例患者进行CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD6个候选基因的外显子及内含子扩增,扩增产物进行直接测序,测序结果与GeneBank中原始序列进行BLAST比对分析。结果该家系每代均有先天性白内障患者,遗传方式为常染色体显性遗传。该家系的CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD6个晶状体蛋白候选基因的外显子及其邻近的内含子与基因库对照未发现任何突变。结论CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD为该先天性白内障家系的非致病基因。     

Mutation analysis of congenital cataracts in Indian families: identification of SNPS and a new causative allele in CRYBB2 gene

PURPOSE: To study some functional candidate genes in cataract families of Indian descent. METHODS: Nine Indian families, clinically documented to have congenital/childhood cataracts, were screened for mutations in candidate genes such as CRYG (A-->D), CRYBB2, and GJA8 by PCR analyses and sequencing. Genomic DNA samples of either probands or any representative affected member of each family were PCR amplified and sequenced commercially. Documentation of single nucleotide polymorphisms (SNPs) and candidate mutations was done through BLAST SEARCH (http://www.ncbi.nlm.nih.gov/blast/Blast.cgi?). RESULTS: Several single nucleotide polymorphisms in CRYG, CRYBB2, and GJA8 genes were observed. Because they do not co-segregate with the phenotype, they were excluded as candidates for the cataract formation in these patients. However, a substitution (W151C in exon 6 of CRYBB2) was identified as the most likely causative mutation underlying the phenotype of central nuclear cataract in all affected members of family C176. Protein structural interpretations demonstrated that no major structural alterations could be predicted and that even the hydrogen bonds to the neighboring Leu166 were unchanged. Surprisingly, hydropathy analysis of the mutant betaB2-crystallin featuring the amino acids at position 147 to 155, further increased the hydrophobicity, which might impair the solubility of the mutant protein. Finally, the Cys residue at position 151 might possibly be involved in intramolecular disulphide bridges with other cysteines during translation, possibly leading to dramatic structural changes. CONCLUSIONS: Exon 6 of CRYBB2 appears to be a critical region susceptible for mutations leading to lens opacity.     

Genetic heterogeneity in microcornea-cataract: five novel mutations in CRYAA, CRYGD, and GJA8

PURPOSE: To unravel the molecular genetic background in families with congenital cataract in association with microcornea (CCMC, OMIM 116150). METHODS: CCMC families were recruited from a national database on hereditary eye diseases; DNA was procured from a national gene bank on hereditary eye diseases and by blood sampling from one large family. Genomewide linkage analysis, fine mapping, and direct genomic DNA sequencing of nine cataract candidate genes were applied. Restriction enzyme digests confirmed identified mutations. RESULTS: Analyses of 10 Danish families with hereditary congenital cataract and microcornea revealed five novel mutations. Three of these affected the crystallin, alpha-A gene (CRYAA), including two mutations (R12C and R21W) in the crystallin domain and one mutation (R116H) in the small heat shock domain. One mutation (P189L) affected the gap junction protein alpha 8 (GJA8), and one mutation (Y134X) was detected in crystallin gamma-D (CRYGD). CONCLUSIONS: The identification of a CRYGD mutation adds another gene to those that may be mutated in CCMC and underscores the genetic heterogeneity of this condition. Three CRYAA mutations at the R116 position, in association with CCMC, suggest that R116 represents a CCMC-mutational hotspot. The CCMC phenotype demonstrates variable expression with regard to cataract morphology and age of appearance. Clinical heterogeneity, including additional malformation of the anterior segment of the eye, confirm that dedicated cataract genes may be involved in the largely unknown developmental molecular mechanisms involved in lens-anterior segment interactions.     

Identification of a CRYAB mutation associated with autosomal dominant posterior polar cataract in a Chinese family

PURPOSE: A four-generation Chinese family with 13 members affected with autosomal dominant congenital posterior polar cataract was studied. The purpose of this study was to identify the disease-causing gene in the family and to validate that mutations in CRYAB, the alphaB-crystallin gene, cause the congenital cataract. METHODS: Linkage analysis was performed with a panel of microsatellite markers flanking candidate genetic loci for cataracts, including 14 known autosomal dominant congenital cataract (ADCC) genes. For mutation analysis, the complete coding region and exon-intron boundaries of CRYAB were sequenced with DNA from the proband. Single-strand conformation polymorphism (SSCP) analysis for exon 1 of CRYAB was performed in all family members and 200 normal control subjects. RESULTS: The disease gene in the Chinese family was mapped to chromosome 11 in region q22-22.3 with a maximum lod score of 4.52. Direct DNA sequence of CRYAB revealed a heterozygous C-->T transition at nucleotide 58, resulting in a novel 58 C-->T (Pro20Ser) mutation. The Pro20Ser mutation cosegregated with all affected individuals and was not present in unaffected members in the family or in 200 normal control subjects. The mutation occurs at the evolutionarily conserved residue Pro20 in the N-terminal region of alphaB-crystallin. CONCLUSIONS: To date, only one CRYAB mutation has been associated with congenital isolated cataract. This study identified a second novel mutation in CRYAB in a large Chinese cataract family. Together, these results provide strong evidence that CRYAB is a pathogenic gene for congenital cataract.     

The telomere of human chromosome 1p contains at least two independent autosomal dominant congenital cataract genes

AIMS: Multiple genetic causes of congenital cataract have been identified, both as a component of syndromes and in families that present with isolated congenital cataract. Linkage analysis was used to map the genetic locus in a six generation Australian family presenting with total congenital cataract. METHODS: Microsatellite markers located across all known autosomal dominant congenital cataract loci were genotyped in all recruited family members of the Tasmanian family. Both two point and multipoint linkage analysis were used to assess each locus under an autosomal dominant model. RESULTS: Significant linkage was detected at the telomere of the p arm of chromosome 1, with a maximum two point LOD of 4.21 at marker D1S507, a maximum multipoint exact LOD of 5.44, and an estimated location score of 5.61 at marker D1S507. Haplotype analysis places the gene inside a critical region between D1S228 and D1S199, a distance of approximately 6 megabases. The candidate gene PAX7 residing within the critical interval was excluded by direct sequencing in affected individuals. CONCLUSION: This is the third report of congenital cataract linkage to 1ptel. The critical region as defined by the shared haplotype in this family is clearly centromeric from the Volkmann cataract locus identified through study of a Danish family, indicating that two genes causing autosomal dominant congenital cataract map to the telomeric region of chromosome 1p.