Failly M, Bartoloni L, Letourneau A, Munoz A, Falconnet E, Rossier C, de Santi M M, Santamaria F, Sacco O, DeLozier-Blanchet C D, Lazor R, Blouin J-L
Genetic Medicine and Development, University of Geneva Medical School, CH-1211 Geneva 4, Switzerland.
J Med Genet. 2009 Apr;46(4):281-6. doi: 10.1136/jmg.2008.061176.
Primary ciliary dyskinesia (PCD) is characterised by recurrent infections of the upper respiratory airways (nose, bronchi, and frontal sinuses) and randomisation of left-right body asymmetry. To date, PCD is mainly described with autosomal recessive inheritance and mutations have been found in five genes: the dynein arm protein subunits DNAI1, DNAH5 and DNAH11, the kinase TXNDC3, and the X-linked retinitis pigmentosa GTPase regulator RPGR.
We screened 89 unrelated individuals with PCD for mutations in the coding and splice site regions of the gene DNAH5 by denaturing high performance liquid chromatography (DHPLC) and sequencing. Patients were mainly of European origin and were recruited without any phenotypic preselection.
We identified 18 novel (nonsense, splicing, small deletion and missense) and six previously described mutations. Interestingly, these DNAH5 mutations were mainly associated with outer + inner dyneins arm ultrastructural defects (50%).
Overall, mutations on both alleles of DNAH5 were identified in 15% of our clinically heterogeneous cohort of patients. Although genetic alterations remain to be identified in most patients, DNAH5 is to date the main PCD gene.
原发性纤毛运动障碍(PCD)的特征是上呼吸道(鼻子、支气管和额窦)反复感染以及左右身体不对称的随机化。迄今为止,PCD主要被描述为常染色体隐性遗传,并且已在五个基因中发现突变:动力蛋白臂蛋白亚基DNAI1、DNAH5和DNAH11、激酶TXNDC3以及X连锁视网膜色素变性GTP酶调节因子RPGR。
我们通过变性高效液相色谱(DHPLC)和测序,对89名无亲缘关系的PCD患者的DNAH5基因编码和剪接位点区域进行突变筛查。患者主要来自欧洲,招募时没有任何表型预选。
我们鉴定出18个新的(无义、剪接、小缺失和错义)突变以及6个先前描述的突变。有趣的是,这些DNAH5突变主要与外动力蛋白臂+内动力蛋白臂超微结构缺陷有关(50%)。
总体而言,在我们临床异质性患者队列中,15%的患者鉴定出了DNAH5两个等位基因上的突变。尽管大多数患者的基因改变仍有待确定,但迄今为止DNAH5是主要的PCD基因。