应用微卫星DNA单体型检测Wilson病症状前患者及杂合子

目的建立快速、准确、有效的Ｗｉｌｓｏｎ病（Ｗｉｌｓｏｎｄｉｓｅａｓｅ，ＷＤ）患者早期诊断及杂合子检测的基因诊断技术。方法应用Ｄ１３Ｓ３０１、Ｄ１３Ｓ３１６、Ｄ１３Ｓ２９６、ＡＦＭ２３８ｖｃ３、ＡＦＭ０８４ｘｃ５等５个微卫星ＤＮＡ（ｓｈｏｒｔｔａｎｄｅｍｒｅｐｅａｔ，ＳＴＲ），经聚合酶链反应（ＰＣＲ），扩增片段长度多态性－聚丙烯酰胺凝胶电泳（ＡＦＬＰ－ＰＡＧＥ），对２３个ＷＤ家系１２０名成员的ＤＮＡ进行单体型分析。结果２例拟诊患者得到确诊。在３１例ＷＤ同胞中，检出肯定症状前患者４例、杂合子８例、正常人１７例、可疑患者２例。结论ＳＴＲ单体型可提供高信息量的遗传诊断信息，为ＷＤ基因诊断提供了重要的新途径     

中国北方20个Wilson病家系临床及RFLP结果分析

Ｗｉｌｓｏｎ病是一种由铜蓄积引起肝脑损害的常染色体隐性遗传病。本文对中国北方２０个ＷＤ家系２６名患者的发病年龄、首发症状、Ｋ－Ｆ环及铜氧化酶吸光度进行了总结，并应用Ｄｌ３Ｓ３１／ＴａｑⅠ和Ｄ１３Ｓ３１／ＰｖｕⅡ对这２０个家系９３名家系成员进行了ＲＦＬＰ分析（其中１１个家系加用了Ｄ１３Ｓ２６／ＨｐｈⅠ和ＲＢ／ＸｂａⅠ），２３名先证者同胞中２０名可作出诊断（８７％），表明ＲＦＬＰ分析是该病有效的诊断方法。     

D13S301位点Amp—FLP分析及在Wilson病基因诊断中的应用

Ｗｉｌｓｏｎ病（ＷＤ）基因内的Ｄ１３Ｓ３０１位点为二核苷酸重复序列（ｄＧ－ｄＴ）ｎ。为了探讨该病的产前诊断方法，应用聚合酶链反应方法对４１名无关中国汉族个体和４个ＷＤ家系Ｄ１３Ｓ３０１位点的多态性进行检测，用银染聚丙烯酰胺变性胶分析扩增片段长度多态性共发现８个等位片段，杂合率为７５％，多态信息量（ＰＩＣ）为０．７８。表明Ｄ１３Ｓ３０１位点ＰＩＣ高，可以作为中国汉人的ＷＤ基因的遗传标记对ＷＤ家系进行基因诊断。     

Wilson's病8号外显子突变研究

目的对中国人ＷＤ基因８号外显子进行突变分析。方法对中国人Ｗｉｌｓｏｎ＇ｓ病（Ｗｉｌｓｏｎ＇ｓｄｉｓｅａｓｅ,ＷＤ）４５例患者以及２０例正常人的ＡＴＰ７Ｂ基因８号外显子进行ＳＳＣＰ分析,对有异常者进行测序,根据突变点序列设计合适的内切酶对所有患者进行酶切分析。结果正常组未见异常。患者组发现ｅｘ－ｏｎ８有泳动异常,序列分析证实Ｇ２２７３Ｔ置换,即Ａｒｇ７７８Ｌｅｕ突变。用限制性内切酶ＭｓｐⅠ对４５例患者以及２０例正常对照进行该位点酶切分析,表明正常组未见异常,患者组有２例突变纯合子,占患者总数４．４％,１１例杂合子,占１２．２％。外显子８的Ａｒｇ７７８Ｌｅｕ突变率占ＷＤ突变基因的１６．６７％。检测了２个突变家系。结论８号外显子突变可能是中国人ＷＤ发病的较重要原因。     

Wilson病家系ATP7B基因第18外显子突变及多态

目的：检测中国人Ｗｉｌｓｏｎ病（ＷＤ）基因的第１８外显子（ｅｘｏｎ１８）突变及多态。方法：应用多聚酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）技术，分析１６个ＷＤ家系５４例个体和１８例正常人ＡＴＰ７Ｂ基因ｅｘｏｎ１８分子结构改变。结果：在ＷＤ家系中发现有３种单链构象，其中１种为正常构象，１种为突变，另１种可能为正常ＤＮＡ多态；１７例ＷＤ患者及其３７例一级亲属中分别检出突变者１０例和１１例，突变率分别为２９．４％和１４．９％。其中一级亲属检出的突变者中有３例经血清铜氧化酶及眼科Ｋ－Ｆ环检查证实为ＷＤ症状前患者。结论：ｅｘｏｎ１８是中国人ＷＤ基因突变热点之一，大多数ＷＤ患者为复合杂合子；应用ＰＣＲ－ＳＳＣＰ技术分析ｅｘ－ｏｎ１８是一种有效的ＷＤ基因筛选方法，也可为无家族史的ＷＤ可疑者提供诊疗依据     

中国人D13S31等位点的多态性及其在Wilson‘s病家系中的应用

本文对９０名无亲缘关系的正常中国人进行了Ｄ１３Ｓ３１和Ｄ１３Ｓ２５区域的限制性片段长度多太性分析（ＲＦＬＰ），表明中国上述位点的多态等位片段与西方人相同，但两者各等位片段的频率差异明显，杂合率亦不同。应用上述位点对４个Ｗｉｌｓｏｎ’ｓ病（ＷＤ）家系进行多位点连锁分析，证实它们可用于ＷＤ的症状前诊断。     

PCR直接测序在Wilson病基因第8外显子检出一个突变热点

目的寻找中国人Ｗｉｌｓｏｎ病（ＷＤ）基因突变热点。方法应用ＰＣＲ直接测序法对３０例Ｗｉｌｓｏｎ病患者ＷＤ基因第８外显子进行了突变筛查。结果在１４例患者中发现同一种错义突变Ａｒｇ７７８Ｌｅｕ，其中４例为这一突变的纯合，其余为杂合，突变率为３０％。结论ＷＤ基因第８外显子７７８位密码子（ＣＧＧ→ＣＴＧ）系中国人的突变热点之一。     

Wilson‘s病的分子生物学进展

Ｗｉｌｓｏｎ＇ｓ病（ＷＤ），又称肝豆状核变性，是一种以铜代谢障碍为特征的常染色体隐性遗传病。其致病基因已定位于１３ｑ１４．３。近年来，通过基因克隆技术已克隆到ＷＤ基因，且分离出ＷＤ基因的ｃＤＮＡ候选片段Ｗｃｌ。序列分析及家系突变研究表明，该基因编码与铜离子活化有关的Ｐ型ＡＴＰ酶。基因的突变形式主要为点突变，而且，通过连锁分析开展ＷＤ的基因诊断也取得了进展。     

肝豆状核变性（Wilson病）的发病曲线及其在遗传咨询中的应用

本文在分析了２６５例Ｗｉｌｓｏｎ病（ＷＤ）患者的初始发病年龄后，运用函数统计学中的曲线模拟方法，首次获得了中国人群ＷＤ的发病年龄与发病风险的相关曲线，再把发病年龄这一遗传咨询中的重要因素代入到ＷＤ的遗传咨询中，并探讨了年龄因素在应用Ｂａｙｅｓ定理对ＷＤ家系再发风险进行计算机综合判别分析中的意义。分析结果显示，年龄因素对再发风险的评估有着很重要的影响，可大大提高ＷＤ遗传咨询的准确性。本研究不仅填补了我国ＷＤ发病年龄的分布规律方面的资料，也为ＷＤ家系中再发风险的评估增添了有用的信息     

应用PCR—SSCP银染技术检测Wilson病基因第9,14外显子突变

为了研究中国人Ｗｉｌｓｏｎ病基因（ＡＴＰ７Ｂ基因）第９，１４外显子突变特性，方法：应用聚合酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）银染技术初步研究了１４１例Ｗｉｌｓｏｎ病患者ＡＴＰ７Ｂ基因第９及１４外显子分子结构改变，结果：通过用ＰＣＲ－ＳＳＣＰ对患者和正常人的ＤＮＡ的电泳带迁移作对比分析，发现在患者中第９和１４外显子ＰＣＲ扩增产物迁移异常者分别为６例（２．１％，６／２８２）和４２例（１４．９     

Common mutations of ATP7B in Wilson disease patients from Hungary

Wilson disease (WD) is an autosomal recessive disorder of copper metabolism. The H1069Q mutation in exon 14 of ATP7B is far the most frequent in Wilson patients of European origin. Mutations in exon 8 and 15 are also common among the over 150 described mutations in the WD gene. The aim was to investigate the frequency of these common WD gene mutations in Hungarian patients. A total of 42 patients with WD from 39 Hungarian families were examined. The H1069Q mutation was assessed by a seminested polymerase chain reaction (PCR)‐based restriction fragment length polymorphism (RFLP) assay, while mutations in exons 8, 13, 15, and 18 of WD gene were identified by sequencing. In addition, haplotype analysis was performed using three common microsatellite markers (D13S314, D13S301, D13S316). The H1069Q mutation was found in 27 patients (64.3%). Nine patients were H1069Q homozygous. Eighteen patients were H1069Q compound heterozygous, two of them had H1069Q/P969Q and one patient H1069Q/3400delC genotype. In two of the 15 H1069Q‐negative patients a novel mutation in exon 13 (T977M) was detected. One H1069Q‐negative patient had a mutation in exon 8 (G710S). None of the studied mutations was detected in 12 WD patients. H1069Q‐positive patients from various European countries had the same haplotype pattern. The H1069Q point mutation is frequent in Hungarian patients with WD and appears to have originated from a single founder in Eastern Europe. In contrast, mutations in exons 8, 13, 15, and 18 are uncommon in Hungarian WD patients. © 2002 Wiley‐Liss, Inc.     

Familial gene analysis for Wilson disease from north-west Indian patients

Background: A number of polymerase chain reaction (PCR) based techniques like single-strand conformational polymorphism (SSCP), amplification refractory mutation system (ARMS)-PCR, semi-nested PCR and dinucleotide-repeat marker analysis have been used in the diagnosis of asymptomatic Wilson disease (WD) patients and the carrier status of WD families. In the present study, we explore the utility of mutation analysis in combination with restriction fragment length polymorphism (RFLP) in the genetic diagnosis of WD.

Aim: The study was planned to provide a molecular diagnostic tool for the diagnosis of asymptomatic WD patients as well as assessment of the carrier status of WD families.

Subjects and methods: Four WD families were analyzed in which parents and siblings showed no clinical manifestations or biochemical abnormalities. The parents of the WD patients were not consanguineous and had no family history of WD. Mutations in ATP7B were characterized using SSCP and DNA sequencing. Further, RFLP was developed for the analysis of characterized mutations in ATP7B from the WD patients, their parents and siblings.

Results: Three mutations, Q1256R, A1003T and I1102T, were characterized in WD patients, using SSCP and DNA sequencing. These mutations created/deleted restriction sites for AccII, Bsh1236I and EcoRI restriction enzymes respectively. Despite having no clinical manifestations nor any significant alteration in biochemical investigations, eight carriers and one asymptomatic WD patient were diagnosed in 13 members of the patients families by restriction digestion analysis.

Conclusion: The report demonstrates that mutation analysis in combination with RFLP is useful for diagnosis of asymptomatic WD patients as well as for the elucidation of the carrier status of the patients’ family members. It is noteworthy that this combinational methodology provides a positive diagnosis in siblings/parents where biochemical parameters are ambiguous.     

Fetal akinesia deformation sequence: a study of 30 consecutive in utero diagnoses

Wilson disease (WD) is an autosomal recessive disorder of copper metabolism. The H1069Q mutation in exon 14 of ATP7B is far the most frequent in Wilson patients of European origin. Mutations in exon 8 and 15 are also common among the over 150 described mutations in the WD gene. The aim was to investigate the frequency of these common WD gene mutations in Hungarian patients. A total of 42 patients with WD from 39 Hungarian families were examined. The H1069Q mutation was assessed by a seminested polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) assay, while mutations in exons 8, 13, 15, and 18 of WD gene were identified by sequencing. In addition, haplotype analysis was performed using three common microsatellite markers (D13S314, D13S301, D13S316). The H1069Q mutation was found in 27 patients (64.3%). Nine patients were H1069Q homozygous. Eighteen patients were H1069Q compound heterozygous, two of them had H1069Q/P969Q and one patient H1069Q/3400delC genotype. In two of the 15 H1069Q-negative patients a novel mutation in exon 13 (T977M) was detected. One H1069Q-negative patient had a mutation in exon 8 (G710S). None of the studied mutations was detected in 12 WD patients. H1069Q-positive patients from various European countries had the same haplotype pattern. The H1069Q point mutation is frequent in Hungarian patients with WD and appears to have originated from a single founder in Eastern Europe. In contrast, mutations in exons 8, 13, 15, and 18 are uncommon in Hungarian WD patients.     

Familial gene analysis for Wilson disease from north-west Indian patients

BACKGROUND: A number of polymerase chain reaction (PCR) based techniques like single-strand conformational polymorphism (SSCP), amplification refractory mutation system (ARMS)-PCR, semi-nested PCR and dinucleotide-repeat marker analysis have been used in the diagnosis of asymptomatic Wilson disease (WD) patients and the carrier status of WD families. In the present study, we explore the utility of mutation analysis in combination with restriction fragment length polymorphism (RFLP) in the genetic diagnosis of WD. AIM: The study was planned to provide a molecular diagnostic tool for the diagnosis of asymptomatic WD patients as well as assessment of the carrier status of WD families. SUBJECTS AND METHODS: Four WD families were analyzed in which parents and siblings showed no clinical manifestations or biochemical abnormalities. The parents of the WD patients were not consanguineous and had no family history of WD. Mutations in ATP7B were characterized using SSCP and DNA sequencing. Further, RFLP was developed for the analysis of characterized mutations in ATP7B from the WD patients, their parents and siblings. RESULTS: Three mutations, Q1256R, A1003T and I1102T, were characterized in WD patients, using SSCP and DNA sequencing. These mutations created/deleted restriction sites for AccII, Bsh1236I and EcoRI restriction enzymes respectively. Despite having no clinical manifestations nor any significant alteration in biochemical investigations, eight carriers and one asymptomatic WD patient were diagnosed in 13 members of the patients families by restriction digestion analysis. CONCLUSION: The report demonstrates that mutation analysis in combination with RFLP is useful for diagnosis of asymptomatic WD patients as well as for the elucidation of the carrier status of the patients' family members. It is noteworthy that this combinational methodology provides a positive diagnosis in siblings/parents where biochemical parameters are ambiguous.     

应用变性高效液相色谱技术进行肝豆状核变性的基因突变筛查及产前诊断

目的 探讨变性高效液相色谱(denature high performance liquid chromatography,DHPLC)技术在肝豆状核变性(Wilson's disease,WD)的突变筛查及产前诊断中的临床应用.方法 以6个WD家系中的患者及其父母的DNA为模板,采用PCR技术扩增ATP7B基因的21个外显子及5'非翻译区,PCR产物经DHPLC技术进行突变筛查,对峰型有改变者进行测序验证.在确定了先证者突变类型的基础上,采用相同方法对其中4个家系(1个双胎和3个单胎)进行产前诊断.结果 6例患者中检测出5种已知的致病突变及8种多态类型.患者的父母均为相应突变类型的携带者.产前诊断结果显示,两例妊娠为异常胎儿,其中1例双胎为Arg778Leu/IVS4-1G>C双重杂合子,1例单胎为Ser975Tyr/Pro992Leu双重杂合子,这两对妊娠夫妇选择了终止妊娠.另两例妊娠中,1例为Ser975Tyr杂合子,1例完全正常,他们选择了继续妊娠,出生了表型正常儿.结论 DHPLC在Wilson病的突变检测和产前诊断中有良好的应用前景.     

Novel ATP7B mutations causing Wilson disease in several Israeli ethnic groups

We characterized microsatellite marker haplotypes and identified mutations in members of 19 ethnically diverse Israeli families affected by Wilson disease (WD). Eighteen unique haplotypes were derived from allelic combinations for four marker loci spanning the WD gene, ATP7B, at chromosome 13q14.3: D13S133, D13S296, D13S301 and D13S295. Most of these haplotypes are population specific and vary among and even within different ethnic groups. Intrafamilial variability of WD haplotypes was observed in two large consanguineous families in which a single origin of WD was expected. In contrast, some WD haplotypes were identified in more than one group. Five novel and four previously described mutations were detected in our sample. The novel mutations include two deletions (845delT and 1639delC) and three missense mutations (E1064A, M645R, and G1213V). Mutations were identified for 11 of the 18 WD haplotypes, suggesting that other mutations may reside in noncoding regions of the ATP7B gene. Identification of all WD mutations will undoubtedly increase our understanding of the normal function of ATP7B as well as lead to more accurate prognosis and genetic counseling. Hum Mutat 11:145–151, 1998. © 1998 Wiley-Liss, Inc.     

Clouston hidrotic ectodermal dysplasia (HED): genetic homogeneity, presence of a founder effect in the French Canadian population and fine genetic mapping

HED is an autosomal dominant skin disorder that is particularly common in the French Canadian population of south-west Quebec. We previously mapped the HED gene to the pericentromeric region of chromosome 13q using linkage analysis in eight French Canadian families. In this study, we extend our genetic analysis to include a multiethnic group of 29 families with 10 polymorphic markers spanning 5.1 cM in the candidate region. Two-point linkage analysis strongly suggests absence of genetic heterogeneity in HED in four families of French, Spanish, African and Malaysian origins. Multipoint linkage analysis in all 29 families generated a peak lod score of 53.5 at D13S1835 with a 1 lod unit support interval spanning 1.8 cM. Recombination mapping placed the HED gene in a 2.4 cM region flanked by D13S1828 proximally and D13S1830 distally. We next show evidence for a strong founder effect in families of French Canadian origin thereby representing the first example of a founder disease in the south-west part of the province of Quebec. Significant association was found between HED in these families and all markers analysed (Fisher's exact test, P < 0.001). Complete allelic association was detected at D13S1828, D13S1827, D13S1835, D13S141 and D13S175 (P(excess) = 1) spanning 1.3 cM. A major haplotype including all 10 associated alleles was present on 65% of affected chromosomes. This haplotype most likely represents the founder haplotype that introduced the HED mutation into the French Canadian population. Luria-Delbrück equations and multipoint likelihood linkage disequilibrium analysis positioned the gene at the D13S1828 locus (likely range estimate: 1.75 cM) and 0.58 cM telomeric to this marker (support interval: 3.27 cM) respectively.     

Molecular studies in Finnish patients with familial juvenile nephronophthisis exclude a founder effect and support a common mutation causing mechanism.

Familial juvenile nephronophthisis (NPH) is an autosomal recessive tubulointerstitial kidney disease associated with formation of medullary and corticomedullary cysts. It progresses to end stage renal failure and its biochemical defect is unknown. An NPH locus has been assigned to a 2 cM interval on chromosome 2q13 by linkage studies. Homozygous deletions of approximately 250 kb have been detected in 80% of familial cases and 65% of sporadic cases and a common mutation mechanism has been suggested. We examined 14 Finnish families for the presence or absence of a deletion. After detecting a deletion in 12 patients belonging to nine families, we studied a possible founder effect by haplotype analysis using markers D2S340, D2S1889, and D2S1893. No common ancestral disease associated haplotype was found suggesting no founder effect. Results of pairwise linkage analyses were suggestive of linkage in the nine families with a deletion (lod scores of 1.39-3.89 at a recombination fraction of 0). Negative lod scores were obtained in the five families without a deletion suggesting that the disease locus in these families lies elsewhere. The end stage renal disease occurred at a more advanced age in patients without a deletion compared to patients with a deletion, indicating a phenotypic difference between these two groups.