Köker M Y, van Leeuwen K, de Boer M, Celmeli F, Metin A, Ozgür T T, Tezcan I, Sanal O, Roos D
Pediatric Immunology Unit, University of Hacettepe, Ankara, Turkey.
Eur J Clin Invest. 2009 Apr;39(4):311-9. doi: 10.1111/j.1365-2362.2009.02093.x.
One of the rarest forms of autosomal recessive chronic granulomatous disease (AR-CGD) is attributable to mutations in the CYBA gene, which encodes the alpha polypeptide of cytochrome b(558), (also known as p22-phox), a key transmembrane protein in the phagocyte NADPH oxidase system. This gene is localized on chromosome 16q24, encompasses 8.5 kb and contains six exons.
We report here the clinical and molecular characterization of 12 AR-CGD patients from 10 consanguineous, unrelated Turkish families with clinical CGD and positive family history. The ages of the six male and six female patients were between 1and 18 years. Before mutation analysis, subgroup analysis of patients was made by flow cytometry with antibodies against NADPH-oxidase components and with the DHR assay (flow cytometric assay of NADPH oxidase activity in leucocytes).
Mutation analysis of CYBA showed six different mutations: a frameshift insertion in exon 3 (C after C166); a missense mutation in exon 2 (p.Gly24Arg), a splice-site deletion in intron 1 (4-bp deletion +4_+7 AGTG), a novel nonsense mutation in exon 6 (p.Cys113X), a novel large deletion of exons 3-6 and a novel 1-bp deletion in exon 6 (c.408delC). All mutations were present in homozygous form and all parents investigated were found to be heterozygotes for these mutations.
In our series of 40 CGD families, approximately 25% of the families have p22-phox defects, with six different mutations, including three novel mutations. The high rate of consanguineous marriages seems to be the underlying aetiology.
常染色体隐性慢性肉芽肿病(AR-CGD)最罕见的形式之一归因于CYBA基因突变,该基因编码细胞色素b(558)的α多肽(也称为p22-吞噬细胞氧化酶),它是吞噬细胞NADPH氧化酶系统中的一种关键跨膜蛋白。该基因定位于16号染色体q24,全长8.5 kb,包含6个外显子。
我们在此报告了来自10个有血缘关系、无关联的土耳其家庭的12例AR-CGD患者的临床和分子特征,这些患者有临床慢性肉芽肿病且家族史呈阳性。6名男性和6名女性患者的年龄在1至18岁之间。在进行突变分析之前,通过使用针对NADPH氧化酶成分的抗体进行流式细胞术以及DHR检测(白细胞中NADPH氧化酶活性的流式细胞术检测)对患者进行亚组分析。
CYBA的突变分析显示了6种不同的突变:外显子3中的移码插入(C166后的C);外显子2中的错义突变(p.Gly24Arg),内含子1中的剪接位点缺失(4-bp缺失+4_+7 AGTG),外显子6中的一个新的无义突变(p.Cys113X),外显子3-6的一个新的大片段缺失以及外显子6中的一个新的1-bp缺失(c.408delC)。所有突变均以纯合形式存在,并且所有接受调查的父母均被发现是这些突变的杂合子。
在我们的40个慢性肉芽肿病家庭系列中,约25%的家庭存在p22-吞噬细胞氧化酶缺陷,有6种不同的突变,包括3种新突变。近亲结婚的高比例似乎是潜在病因。