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散发Rett综合征患儿新生MECP2突变亲源鉴定和X染色体失活15例分析
引用本文:朱兴旺,潘虹,李美蓉,包新华,张晶晶,吴希如. 散发Rett综合征患儿新生MECP2突变亲源鉴定和X染色体失活15例分析[J]. 中华儿科杂志, 2009, 47(8): 565-569. DOI: 10.3760/cma.j.issn.0578-1310.2009.08.002
作者姓名:朱兴旺  潘虹  李美蓉  包新华  张晶晶  吴希如
作者单位:北京大学第一医院儿科,100034
摘    要:Objective Rett syndrome (RTT) is a neurodevelopmental disorder occurring almost exclusively in females as sporadic cases due to de novo mutations in the methyl-CpG-binding protein 2 gene ( MECP2 ). Familial cases of RTT are rare and are due to X-chromosomal inheritance from a cartier mother. Recently, DNA mutations in the MECP2 have been detected in approximately 84.7% of patients with RTT in China. To explain the sex-limited expression of RTT, it has been suggested that de novo X-linked mutations oecttr exclusively in male germ cells resulting therefore only in affected daughters. To test this hypothesis, we have analyzed the parental origin of mutations and the XCI status in 15 sporadic cases with RTT due to MECP2 molecular defects. Methods Allele-specific PCR was performed to amplify a fragment including the position of the mutation. The allele-specific PCR products were sequenced to determine which haplotype contained the mutation. It was then possible to determine the parent of origin by genotyping the single nucleotide polymorphism (SNP) in the parents. The degree of XCI and its direction relative to the X chromosome parent of origin were measured in DNA prepared from peripheral blood leucocytes by analyzing CAG repeat polymorphism in the androgen receptor gene (AR). Results Except for 2 cases who had a frameshifi mutation; all the remaining 13 cases had a C→T transition mutation. Paternal origin has been determined in all cases with the C→T transition mutation. For the two frameshift mutations, paternal origin has been determined in one case and maternal origin in the other. The frequency of male germ-line transmission in mutations is 93.3%. Except for 2 cases who were homozygotic at the AR locus, of the remaining 13 cases, 8 cases had a random XCI pattern; the other five cases had a skewed XCI pattern and they favor expression of the maternal origin allele. Conclusion De novo mutations in sporadic RTr occur almost exclusively on the paternally derived X chromosome and that this is most probably the cause for the high female: male ratio observed in sporadic cases with RTT. Random XCI was the main XCI pattern in sporadic RTT patients. The priority inactive X chromosome was mainly of paternal origin.

关 键 词:Rett综合征  X染色体失活  染色体畸变  基因  遗传

Analysis of the parental origin of de novo MECP2 mutations and X chromosome inactivation in fifteen sporadic cases with Rett syndrome
ZHU Xing-wang,PAN Hong,LI Mei-rong,BAO Xin-hua,ZHANG Jing-jing,WU Xi-ru. Analysis of the parental origin of de novo MECP2 mutations and X chromosome inactivation in fifteen sporadic cases with Rett syndrome[J]. Chinese journal of pediatrics, 2009, 47(8): 565-569. DOI: 10.3760/cma.j.issn.0578-1310.2009.08.002
Authors:ZHU Xing-wang  PAN Hong  LI Mei-rong  BAO Xin-hua  ZHANG Jing-jing  WU Xi-ru
Abstract:Objective Rett syndrome (RTT) is a neurodevelopmental disorder occurring almost exclusively in females as sporadic cases due to de novo mutations in the methyl-CpG-binding protein 2 gene ( MECP2 ). Familial cases of RTT are rare and are due to X-chromosomal inheritance from a cartier mother. Recently, DNA mutations in the MECP2 have been detected in approximately 84.7% of patients with RTT in China. To explain the sex-limited expression of RTT, it has been suggested that de novo X-linked mutations oecttr exclusively in male germ cells resulting therefore only in affected daughters. To test this hypothesis, we have analyzed the parental origin of mutations and the XCI status in 15 sporadic cases with RTT due to MECP2 molecular defects. Methods Allele-specific PCR was performed to amplify a fragment including the position of the mutation. The allele-specific PCR products were sequenced to determine which haplotype contained the mutation. It was then possible to determine the parent of origin by genotyping the single nucleotide polymorphism (SNP) in the parents. The degree of XCI and its direction relative to the X chromosome parent of origin were measured in DNA prepared from peripheral blood leucocytes by analyzing CAG repeat polymorphism in the androgen receptor gene (AR). Results Except for 2 cases who had a frameshifi mutation; all the remaining 13 cases had a C→T transition mutation. Paternal origin has been determined in all cases with the C→T transition mutation. For the two frameshift mutations, paternal origin has been determined in one case and maternal origin in the other. The frequency of male germ-line transmission in mutations is 93.3%. Except for 2 cases who were homozygotic at the AR locus, of the remaining 13 cases, 8 cases had a random XCI pattern; the other five cases had a skewed XCI pattern and they favor expression of the maternal origin allele. Conclusion De novo mutations in sporadic RTr occur almost exclusively on the paternally derived X chromosome and that this is most probably the cause for the high female: male ratio observed in sporadic cases with RTT. Random XCI was the main XCI pattern in sporadic RTT patients. The priority inactive X chromosome was mainly of paternal origin.
Keywords:Rett syndromeX Chromosome inactivationChromosomal aberrationsGenesHeredity
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