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印度人群中威尔逊病的分子发病机制:ATP7B基因突变谱、常见缺陷、临床异质性及对诊断的意义

Molecular pathogenesis of Wilson disease among Indians: a perspective on mutation spectrum in ATP7B gene, prevalent defects, clinical heterogeneity and implication towards diagnosis.

作者信息

Gupta Arnab, Chattopadhyay Ishita, Dey Sumit, Nasipuri Poonam, Das Shyamal K, Gangopadhyay Prasanta K, Ray Kunal

机构信息

Indian Institute of Chemical Biology, Jadavpur, Kolkata, 700 032, India.

出版信息

Cell Mol Neurobiol. 2007 Dec;27(8):1023-33. doi: 10.1007/s10571-007-9192-7. Epub 2007 Sep 2.

Abstract

AIMS

We aim to identify the molecular defects in the ATP7B, the causal gene for Wilson disease (WD), in eastern Indian patients and attempt to assess the overall mutation spectrum in India for detection of mutant allele for diagnostic purposes.

METHODS

Patients from 109 unrelated families and their first-degree relatives comprising 400 individuals were enrolled in this study as part of an ongoing project. Genomic DNA was prepared from the peripheral blood of Indian WD patients. PCR was done to amplify the exons and flanking regions of the WD gene followed by sequencing, to identify the nucleotide variants.

RESULTS

In addition to previous reports, we recently identified eight mutations including three novel (c.3412 + 1G > A, c.1771 G > A, c.3091 A > G) variants, and identified patients with variable phenotype despite similar mutation background suggesting potential role of modifier locus.

CONCLUSIONS

So far we have identified 17 mutations in eastern India including five common mutations that account for 44% of patients. Comparative study on WD mutations between different regions of India suggests high genetic heterogeneity and the absence of a single or a limited number of common founder mutations. Genotype-phenotype correlation revealed that no particular phenotype could be assigned to a particular mutation and even same set of mutations in different patients showed different phenotypes.

摘要

目的

我们旨在确定印度东部威尔逊病(WD)致病基因ATP7B的分子缺陷,并尝试评估印度的整体突变谱,以检测用于诊断目的的突变等位基因。

方法

作为一个正在进行的项目的一部分,本研究纳入了来自109个无关家庭的患者及其400名一级亲属。从印度WD患者的外周血中制备基因组DNA。进行PCR扩增WD基因的外显子和侧翼区域,然后进行测序,以鉴定核苷酸变异。

结果

除了先前的报道外,我们最近还鉴定出8种突变,包括3种新的(c.3412 + 1G > A、c.1771 G > A、c.3091 A > G)变异,并发现尽管突变背景相似,但患者的表型各异,提示修饰位点可能发挥作用。

结论

到目前为止,我们在印度东部已鉴定出17种突变,其中5种常见突变占患者的44%。印度不同地区WD突变的比较研究表明,遗传异质性高,不存在单一或少数常见的奠基者突变。基因型-表型相关性显示,无法将特定表型归因于特定突变,不同患者中相同的一组突变也表现出不同的表型。

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