Elçioglu N H, Pawlik B, Colak B, Beck M, Wollnik B
Department of Pediatric Genetics, Marmara University Hospital, Istanbul, Turkey.
Genet Couns. 2009;20(2):133-9.
A novel loss-of-function mutation in the GNS gene causes Sanfilippo syndrome type D: Mucopolysaccharidosis type IIID (MIM 252940) is the least common form of the four subtypes of Sanfilippo syndrome. It is an autosomal recessive lysosomal disorder caused by a deficiency of the N-acetylglucosamine-6-sulphatase (GlcNAc-6S sulphatase, GNS), a hydrolase, which is one of the enzymes involved in heparan sulfate catabolism leading to lysosomal storage. The clinical features of this disorder are progressive neurodegeneration with relatively mild somatic symptoms. Twenty patients have been described in the literature and only seven causative mutations in the GNS gene encoding GlcNAc-6S sulphatase have been reported to date. We present the clinical and molecular results of a newly diagnosed Turkish patient with MPS IIID. We identified the novel homozygous single base pair insertion, c.1226GinsG, which leads to a frame-shift and a premature truncation of the GNS protein (p.R409Rfs21X).
This novel mutation provides further evidence that loss-of-function is the underlying pathophysiological mechanism of this rare phenotype.
GNS基因中的一种新型功能丧失突变导致Ⅲ型桑菲利波综合征:黏多糖贮积症Ⅲ型D型(MIM 252940)是桑菲利波综合征四种亚型中最不常见的一种。它是一种常染色体隐性溶酶体疾病,由N - 乙酰葡糖胺 - 6 - 硫酸酯酶(GlcNAc - 6S硫酸酯酶,GNS)缺乏引起,GNS是一种水解酶,是参与硫酸乙酰肝素分解代谢导致溶酶体贮积的酶之一。该疾病的临床特征是进行性神经退行性变伴相对较轻的躯体症状。文献中已描述了20例患者,迄今为止,仅报道了编码GlcNAc - 6S硫酸酯酶的GNS基因中的7个致病突变。我们展示了一名新诊断的Ⅲ型黏多糖贮积症土耳其患者的临床和分子检测结果。我们鉴定出一种新型纯合单碱基对插入,即c.1226GinsG,它导致GNS蛋白发生移码和过早截断(p.R409Rfs21X)。
这种新型突变进一步证明功能丧失是这种罕见表型的潜在病理生理机制。