Nie Liping
Center for Neuroscience and Department of Otolaryngology-Head and Neck Surgery, University of California Davis, Davis, California 95618, USA.
Curr Opin Otolaryngol Head Neck Surg. 2008 Oct;16(5):441-4. doi: 10.1097/MOO.0b013e32830f4aa3.
This article provides an update on the current progress in identification of KCNQ4 mutations responsible for DFNA2, a subtype of autosomal dominant nonsyndromic progressive hearing loss.
Hearing loss in pateints with DFNA2 usually start at high frequencies in their 20s and 30s, and then progress to more than 60 dB in less than 10 years, with middle and low frequencies often affected as well. To date, eight missense mutations and two deletions of the KCNQ4 gene have been identified in patients with DFNA2 with various clinical phenotypes. In general, missense mutations are associated with younger-onset and all-frequency hearing loss, whereas deletion mutations are underlying later-onset and pure high-frequency hearing loss. The etiology of DFNA2 remains largely unknown at this point, even though the degeneration of cochlear outer hair cells, caused by dysfunction of KCNQ4 channels, might be one of the underlying mechanisms.
During the last decade, significant progress has been made in identifying KCNQ4 mutations in patients with DFNA2. Elucidation of the pathogenic effect of these mutations will help to gain insights into the molecular mechanisms of hearing and hearing loss, which, in turn, will facilitate informative genetic counseling, early diagnosis, and even treatment of hearing loss.
本文就常染色体显性非综合征性进行性听力损失的一种亚型DFNA2相关KCNQ4突变鉴定的当前进展作一更新。
DFNA2患者的听力损失通常始于二三十岁时的高频段,然后在不到10年的时间里进展至超过60分贝,中低频段也常受影响。迄今为止,在具有各种临床表型的DFNA2患者中已鉴定出8个KCNQ4基因错义突变和2个缺失突变。一般而言,错义突变与发病较早及全频段听力损失有关,而缺失突变则是发病较晚及单纯高频听力损失的基础。尽管KCNQ4通道功能障碍导致的耳蜗外毛细胞退变可能是潜在机制之一,但目前DFNA2的病因在很大程度上仍不清楚。
在过去十年中,DFNA2患者KCNQ4突变的鉴定取得了重大进展。阐明这些突变的致病作用将有助于深入了解听力及听力损失的分子机制,进而有助于提供信息丰富的遗传咨询、早期诊断乃至听力损失的治疗。