Tüysüz Beyhan, Goldin Ehud, Metin Bariş, Korkmaz Bariş, Yalçinkaya Cengiz
Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatric Genetics, Istanbul, Turkey.
Brain Dev. 2009 Oct;31(9):702-5. doi: 10.1016/j.braindev.2008.10.001. Epub 2008 Nov 8.
Mucolipidosis type IV is a rare neurodegenerative lysosomal storage disorder that usually presents during the first year of life with severe mental retardation, delayed motor milestones and corneal opacities. Mucolipidosis IV is caused by mutations in MCOLN1, a gene encoding mucolipin-1 which is responsible for maintaining lysosomal function. The majority of known patients with this disorders are Ashkenazi Jews, and most have a splice IVS3-2 A>G, or a 6.4kb deletion mutation in MCOLN1. Here, we present a Turkish patient who, in addition to the typical neurological and visceral characteristics of mucolipidosis type IV, also demonstrates defects in the posterior limb of internal capsule by MRI, micrognathia and clinodactyly of the fifth fingers. Direct sequencing of his DNA revealed a homozygous c.1364C>T (S456L) mutation in MCOLN1, which was heterozygous in both consanguineous parents. This mutation, like several previously described, changes the protein sequence in the channel pore domain of the protein. Serine 456 is conserved in mucolipin proteins throughout evolution, therefore the mutation is considered as causative for the severe phenotype of this patient.
IV型粘脂贮积症是一种罕见的神经退行性溶酶体贮积病,通常在出生后第一年内出现,伴有严重智力发育迟缓、运动发育迟缓及角膜混浊。IV型粘脂贮积症由MCOLN1基因突变引起,该基因编码粘脂蛋白-1,负责维持溶酶体功能。已知的大多数该疾病患者为阿什肯纳兹犹太人,且大多数患者存在MCOLN1基因的剪接变异IVS3-2 A>G或6.4kb缺失突变。在此,我们报告一名土耳其患者,除具有IV型粘脂贮积症典型的神经和内脏特征外,磁共振成像还显示其内囊后肢存在缺陷,且有小颌畸形及第五指弯指畸形。对其DNA进行直接测序发现,MCOLN1基因存在纯合的c.1364C>T(S456L)突变,而在其近亲父母中该突变均为杂合。与先前描述的几种突变一样,此突变改变了该蛋白通道孔结构域中的蛋白质序列。丝氨酸456在整个进化过程中的粘脂蛋白中都是保守的,因此该突变被认为是导致该患者出现严重表型的原因。