Karger Amy B, Wilson Jon D, Bower Matthew, Schimmenti Lisa A, Thyagarajan Bharat
1 Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, Minnesota.
Genet Test Mol Biomarkers. 2013 Oct;17(10):786-8. doi: 10.1089/gtmb.2013.0176. Epub 2013 Jun 11.
Renal coloboma syndrome (RCS) is a rare inherited disorder caused by mutations in the PAX2 gene. Clinical testing is currently performed by bidirectional Sanger sequencing of all 12 coding exons of the PAX2 gene, which detects point mutations or small insertion/deletion mutations. Large genomic deletions of PAX2 have been identified in 3/90 known RCS families, accounting for approximately (3%) of RCS cases. In these cases, the deletion was detected by cytogenetic techniques such as G-banding or array comparative genomic hybridization. While these methods would be sufficient to identify whole gene deletions, they may not be able to identify smaller rearrangements affecting single exons. Similarly, such deletions would not be detected by Sanger sequencing.
The aim of this study was to determine whether mutation-negative RCS probands harbor a genomic deletion or duplication involving one or more exons of the PAX2 gene. We evaluated this hypothesis in 46 patients with a clinical suspicion of RCS in whom no mutations were identified.
We developed a multiplex ligation-dependent probe amplification assay to detect gene deletion/duplication in all 12 exons of the PAX2 gene. Of the 46 PAX2 mutation-negative samples tested, none demonstrated deletions or duplications in the PAX2 gene. This suggests that deletions or duplications in PAX2 are unlikely to significantly contribute to the pathogenesis of RCS, beyond the known 3% of cases that have been attributed to whole gene deletions. Given these results, we hypothesize that other genes and/or locus control regions regulating PAX2 may be involved in the pathogenesis of PAX2 mutation-negative cases of RCS.
肾裂综合征(RCS)是一种由PAX2基因突变引起的罕见遗传性疾病。目前通过对PAX2基因的所有12个编码外显子进行双向桑格测序来进行临床检测,该方法可检测点突变或小的插入/缺失突变。在90个已知的RCS家族中有3个鉴定出PAX2基因的大片段基因组缺失,约占RCS病例的3%。在这些病例中,通过细胞遗传学技术如G显带或阵列比较基因组杂交检测到了缺失。虽然这些方法足以鉴定全基因缺失,但可能无法鉴定影响单个外显子的较小重排。同样,桑格测序也无法检测到此类缺失。
本研究的目的是确定突变阴性的RCS先证者是否存在涉及PAX2基因一个或多个外显子的基因组缺失或重复。我们在46例临床怀疑为RCS但未鉴定出突变的患者中评估了这一假设。
我们开发了一种多重连接依赖探针扩增分析方法来检测PAX2基因所有12个外显子中的基因缺失/重复。在检测的46个PAX2突变阴性样本中,没有一个显示PAX2基因存在缺失或重复。这表明,除了已知的3%归因于全基因缺失的病例外,PAX2基因的缺失或重复不太可能对RCS的发病机制有显著影响。基于这些结果,我们推测其他调节PAX2的基因和/或基因座控制区域可能参与了PAX2突变阴性的RCS病例的发病机制。