Bergmann Carsten, Küpper Fabian, Dornia Christian, Schneider Frank, Senderek Jan, Zerres Klaus
Department of Human Genetics, Aachen University, Aachen, Germany.
Hum Mutat. 2005 Mar;25(3):225-31. doi: 10.1002/humu.20145.
Autosomal recessive polycystic kidney disease (ARPKD) is an important cause of childhood renal- and liver-related morbidity and mortality with variable disease expression. While most cases manifest peri-/neonatally with a high mortality rate in the first month of life, others survive to adulthood. ARPKD is caused by mutations in the Polycystic Kidney and Hepatic Disease 1 (PKHD1) gene on chromosome 6p12. PKHD1 is an exceptionally large gene (470 kb) with a longest open reading frame transcript of 67 exons predicted to encode a 4,074-amino acid (aa) (447 kDa) multidomain integral membrane protein (fibrocystin/polyductin) of unknown function. Recent DHPLC-based mutational studies have reported detection rates of about 80% and a minimum of one PKHD1 mutation in more than 95% of families. Thus far, a total of 263 different PKHD1 mutations (639 mutated alleles) are included in the locus-specific database (www.humgen.rwth-aachen.de). Except for a few population-specific founder alleles and the common c.107C>T (p.Thr36Met) missense change, PKHD1 is characterized by significant allelic diversity, making mutation screening time-consuming and labor-intensive. Mutations are distributed throughout the gene's coding sequence; however, they are not equally scattered. Thus, we aimed to set up an algorithm for efficient molecular genetic diagnostics in ARPKD. A total of 80% of known PKHD1 mutations can be identified if a subset of 27 out of 77 DHPLC fragments is screened. The current study provides an essential platform for PKHD1 mutation screening in a routine setting that will largely alleviate molecular genetic diagnostics in patients suspected to have ARPKD.
常染色体隐性多囊肾病(ARPKD)是儿童期肾和肝相关发病及死亡的重要原因,疾病表现多样。虽然大多数病例在围产期/新生儿期发病,出生后第一个月死亡率很高,但其他病例可存活至成年。ARPKD由6号染色体p12上的多囊肾和肝病1(PKHD1)基因突变引起。PKHD1是一个特别大的基因(470 kb),其最长的开放阅读框转录本有67个外显子,预计编码一个4074个氨基酸(aa)(447 kDa)的多结构域整合膜蛋白(纤维囊素/多囊蛋白),其功能未知。最近基于变性高效液相色谱(DHPLC)的突变研究报告称,检测率约为80%,超过95%的家系中至少有一个PKHD1突变。到目前为止,位点特异性数据库(www.humgen.rwth-aachen.de)中总共包含263种不同的PKHD1突变(639个突变等位基因)。除了少数特定人群的奠基者等位基因和常见的c.107C>T(p.Thr36Met)错义改变外,PKHD1具有显著的等位基因多样性,使得突变筛查既耗时又费力。突变分布在整个基因的编码序列中;然而,它们分布并不均匀。因此,我们旨在建立一种算法,用于ARPKD的高效分子遗传学诊断。如果从77个DHPLC片段中筛选出27个片段的子集,就可以识别出80%的已知PKHD1突变。本研究为常规环境下的PKHD1突变筛查提供了一个重要平台,这将在很大程度上减轻对疑似患有ARPKD患者的分子遗传学诊断负担。
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