Sinici Incilay, Ozkara H Asuman, Topçu Meral, Ciliv Gönenç
Departments of Biochemistry, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
Pediatr Int. 2003 Feb;45(1):16-22. doi: 10.1046/j.1442-200x.2003.01669.x.
Tay-Sachs disease is a form of monosialoganglioside triaose (GM2) gangliosidosis that results from the mutations in the alpha-subunit gene of hexosaminidase A. In the B1 variant, the active site of the alpha-subunit of the enzyme is thought to be affected. In the present study, a patient who had previously been diagnosed as a B1 variant is further analyzed. The patient's parents and brother were also analyzed.
Single-stranded conformational polymorphism (SSCP) and DNA sequencing analysis were conducted in all cases. In addition, hexosaminidase A (Hex A) was isolated from leukocyte homogenates of the patient's parents and brother using DE 52 ion-exchange chromatography, and thermostability analyses of the isolated enzymes were performed.
Hexosaminidase A of the parents was found to be more thermostable than normal Hex A. DNA sequencing analysis revealed a 12-bp deletion mutation in exon 10 of the Hex A gene. The patient was a homozygote and the parents were heterozygotes for the mutation, which could also be observed at the DNA double strands by SSCP analysis. These deleted bases are located within the catalytic domain of the alpha-subunit.
The 12-bp deletion mutation in exon 10 of Hex A is responsible for the increased thermostability of the enzyme. Considering this mutation has previously been found in a Turkish Tay-Sachs patient, the patient in the present study may have another mutation on the Hex B gene that causes decreased thermostability of the enzyme. Thermal inactivation assay may not be sufficient for a correct diagnosis in such unusual cases.
泰-萨克斯病是一种单唾液酸神经节苷脂三己糖(GM2)神经节苷脂沉积症,由己糖胺酶A的α亚基基因突变引起。在B1变异型中,酶的α亚基活性位点被认为受到影响。在本研究中,对一名先前被诊断为B1变异型的患者进行了进一步分析。还对该患者的父母和兄弟进行了分析。
对所有病例进行单链构象多态性(SSCP)和DNA测序分析。此外,使用DE 52离子交换色谱法从患者父母和兄弟的白细胞匀浆中分离出己糖胺酶A(Hex A),并对分离出的酶进行热稳定性分析。
发现父母的己糖胺酶A比正常的Hex A更耐热。DNA测序分析显示Hex A基因第10外显子有一个12 bp的缺失突变。患者是该突变的纯合子,父母是杂合子,通过SSCP分析在DNA双链上也可观察到该突变。这些缺失的碱基位于α亚基的催化结构域内。
Hex A基因第10外显子的12 bp缺失突变导致酶的热稳定性增加。考虑到该突变先前已在一名土耳其泰-萨克斯病患者中发现,本研究中的患者可能在Hex B基因上还有另一个导致酶热稳定性降低的突变。在这种不寻常的病例中,热失活测定可能不足以做出正确诊断。