Humphries P, Farrar G J, Kenna P, McWilliam P
Department of Genetics, Trinity College, Dublin, Ireland.
Clin Genet. 1990 Jul;38(1):1-13. doi: 10.1111/j.1399-0004.1990.tb03541.x.
Retinitis pigmentosa (RP) is an hereditary degenerative disease of the retina and a major cause of visual impairment, prevalence estimates ranging from 1 in 3000 to 1 in 7000. The condition may segregate as an autosomal dominant, autosomal recessive or an X-linked recessive trait and it may also occur on a sporadic basis in up to 50% of cases. In the autosomal dominant form, close linkage to the DNA marker C17 (D3S47) was recently established in a large family of Irish origin displaying early-onset disease (McWilliam et al. 1989), multipoint analysis indicating the gene for rhodopsin as a likely candidate (Farrar et al. 1990). In that gene, a C----A transversion in codon 23, resulting in a proline----histidine substitution has now been identified in 17 of 148 unrelated ADRP patients in the United States (Dryja et al. 1990). This mutation is absent however in the original Irish pedigree (it is also absent in 21 other dominant Irish pedigrees, representing approximately 70% of the estimated ADRP population) indicating that another mutation, either in rhodopsin itself, or in a gene very closely linked to rhodopsin is responsible for the disease in that family. Analysis of other dominant pedigrees using the C17 and/or rhodopsin probes has indicated either tight linkage (Bhattacharya, Personal Communication), looser linkage, possibly indicative of a second locus on 3q (Olsson et al. 1990) or no linkage (Farrar et al. 1990, Blanton et al. 1990, Inglehearn et al. 1990). Extensive genetic heterogeneity thus exists in the autosomal dominant form of this disease, and in the light of these new observations, earlier tentative evidence for linkage of ADRP to the Rhesus locus on chromosome 1 will be re-evaluated. A locus for type II Usher syndrome (classical RP combined with congenital pedial deafness, and normal vestibular function) has now been established on the long arm of chromosome 1 (Kimberling et al. 1990). Type I Usher families, in which hearing loss is more profound and vestibular function absent, do not segregate with the same chromosome 1q markers, indicating the existence of another, as yet unlocated gene. In the X-linked form of the disease, two genes, XLRP2 and XLRP3, have been located on the proximal short arm of the X chromosome using a combination of physical and linkage mapping techniques, and there is some evidence to suggest a possible third locus more distally located.(ABSTRACT TRUNCATED AT 400 WORDS)
视网膜色素变性(RP)是一种视网膜遗传性退行性疾病,是视力损害的主要原因,患病率估计在3000分之一至7000分之一之间。该病可能以常染色体显性、常染色体隐性或X连锁隐性性状遗传,也可能在高达50%的病例中散发性出现。在常染色体显性形式中,最近在一个起源于爱尔兰的大家族中发现与DNA标记C17(D3S47)紧密连锁,该家族表现为早发性疾病(麦克威廉等人,1989年),多点分析表明视紫红质基因是一个可能的候选基因(法拉尔等人,1990年)。在美国148例无关的常染色体显性视网膜色素变性(ADRP)患者中,现已在17例患者的该基因中鉴定出密码子23处的C到A颠换,导致脯氨酸到组氨酸的替代(德莱亚等人,1990年)。然而,在最初的爱尔兰家系中不存在这种突变(在另外21个显性爱尔兰家系中也不存在,约占估计的ADRP人群的70%),这表明视紫红质本身或与视紫红质紧密连锁的另一个基因中的另一种突变是该家族中该病的病因。使用C17和/或视紫红质探针分析其他显性家系表明,要么紧密连锁(巴塔查里亚,个人交流),要么连锁较松,可能表明在3q上有第二个位点(奥尔松等人,1990年)或者无连锁(法拉尔等人,1990年;布兰顿等人,1990年;英格利希恩等人,1990年)。因此,这种疾病的常染色体显性形式存在广泛的遗传异质性,鉴于这些新的观察结果,早期关于ADRP与1号染色体上恒河猴位点连锁的初步证据将被重新评估。II型Usher综合征(典型的RP合并先天性神经性耳聋,前庭功能正常)的一个位点现已在1号染色体长臂上确定(金伯林等人,1990年)。I型Usher家系中听力损失更严重且无前庭功能,不与相同的1q染色体标记连锁,这表明存在另一个尚未定位的基因。在该疾病的X连锁形式中,使用物理和连锁图谱技术相结合的方法,已将两个基因XLRP2和XLRP3定位在X染色体近端短臂上,并且有一些证据表明可能在更远处存在第三个位点。(摘要截短至400字)