Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada.
Orphanet J Rare Dis. 2012 Sep 17;7:67. doi: 10.1186/1750-1172-7-67.
Congenital nonprogressive spinocerebellar ataxia is characterized by early gross motor delay, hypotonia, gait ataxia, mild dysarthria and dysmetria. The clinical presentation remains fairly stable and may be associated with cerebellar atrophy. To date, only a few families with autosomal dominant congenital nonprogressive spinocerebellar ataxia have been reported. Linkage to 3pter was demonstrated in one large Australian family and this locus was designated spinocerebellar ataxia type 29. The objective of this study is to describe an unreported Canadian family with autosomal dominant congenital nonprogressive spinocerebellar ataxia and to identify the underlying genetic causes in this family and the original Australian family.
Exome sequencing was performed for the Australian family, resulting in the identification of a heterozygous mutation in the ITPR1 gene. For the Canadian family, genotyping with microsatellite markers and Sanger sequencing of ITPR1 gene were performed; a heterozygous missense mutation in ITPR1 was identified.
ITPR1 encodes inositol 1,4,5-trisphosphate receptor, type 1, a ligand-gated ion channel that mediates calcium release from the endoplasmic reticulum. Deletions of ITPR1 are known to cause spinocerebellar ataxia type 15, a distinct and very slowly progressive form of cerebellar ataxia with onset in adulthood. Our study demonstrates for the first time that, in addition to spinocerebellar ataxia type 15, alteration of ITPR1 function can cause a distinct congenital nonprogressive ataxia; highlighting important clinical heterogeneity associated with the ITPR1 gene and a significant role of the ITPR1-related pathway in the development and maintenance of the normal functions of the cerebellum.
先天性进行性脊髓小脑共济失调的特征为早期粗大运动迟缓、张力减退、步态共济失调、轻度构音障碍和运动失调。临床表现相对稳定,可能与小脑萎缩有关。迄今为止,仅报道了少数几个常染色体显性遗传性先天性进行性脊髓小脑共济失调的家族。在一个大型澳大利亚家族中已证实与 3pter 连锁,该基因座被命名为脊髓小脑共济失调 29 型。本研究的目的是描述一个未报道的加拿大常染色体显性遗传性先天性进行性脊髓小脑共济失调家族,并鉴定该家族和原始澳大利亚家族的潜在遗传原因。
对澳大利亚家族进行外显子组测序,结果发现 ITPR1 基因存在杂合突变。对于加拿大家族,进行微卫星标记基因分型和 ITPR1 基因的 Sanger 测序;鉴定出 ITPR1 中的杂合错义突变。
ITPR1 编码肌醇 1,4,5-三磷酸受体 1 型,这是一种配体门控离子通道,介导内质网中钙离子释放。ITPR1 的缺失已知会导致脊髓小脑共济失调 15 型,这是一种独特的、进展非常缓慢的成年起病的小脑性共济失调。我们的研究首次表明,除了脊髓小脑共济失调 15 型之外,ITPR1 功能的改变还可引起明显的先天性非进行性共济失调;突出了与 ITPR1 基因相关的重要临床异质性,以及 ITPR1 相关途径在小脑正常功能的发育和维持中的重要作用。