Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Eur J Hum Genet. 2013 Aug;21(8):844-9. doi: 10.1038/ejhg.2012.257. Epub 2012 Dec 19.
Congenital disorders of glycosylation (CDG) are a large group of recessive multisystem disorders caused by impaired protein or lipid glycosylation. The CDG-I subgroup is characterized by protein N-glycosylation defects originating in the endoplasmic reticulum. The genetic defect is known for 17 different CDG-I subtypes. Patients in the few reported DPAGT1-CDG families exhibit severe intellectual disability (ID), epilepsy, microcephaly, severe hypotonia, facial dysmorphism and structural brain anomalies. In this study, we report a non-consanguineous family with two affected adults presenting with a relatively mild phenotype consisting of moderate ID, epilepsy, hypotonia, aggressive behavior and balance problems. Exome sequencing revealed a compound heterozygous missense mutation, c.85A>T (p.I29F) and c.503T>C (p.L168P), in the DPAGT1 gene. The affected amino acids are located in the first and fifth transmembrane domains of the protein. Isoelectric focusing and high-resolution mass spectrometry analyses of serum transferrin revealed glycosylation profiles that are consistent with a CDG-I defect. Our results show that the clinical spectrum of DPAGT1-CDG is much broader than appreciated so far.
先天性糖基化障碍(CDG)是一大组隐性多系统疾病,由蛋白质或脂质糖基化受损引起。CDG-I 亚组的特征是内质网起源的蛋白质 N-糖基化缺陷。对于 17 种不同的 CDG-I 亚型,已知存在遗传缺陷。在少数报道的 DPAGT1-CDG 家族中,患者表现出严重的智力残疾(ID)、癫痫、小头畸形、严重的张力减退、面部畸形和结构性脑异常。在本研究中,我们报告了一个非近亲结婚的家庭,其中有两名受影响的成年人表现出相对较轻的表型,包括中度 ID、癫痫、张力减退、攻击性行为和平衡问题。外显子组测序显示 DPAGT1 基因存在复合杂合错义突变 c.85A>T(p.I29F)和 c.503T>C(p.L168P)。受影响的氨基酸位于蛋白质的第一和第五跨膜结构域。血清转铁蛋白等电聚焦和高分辨率质谱分析显示糖基化谱与 CDG-I 缺陷一致。我们的结果表明,DPAGT1-CDG 的临床谱比目前认识到的要广泛得多。