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散发性葡萄酒色斑中的新基因突变。

Novel genetic mutations in a sporadic port-wine stain.

出版信息

JAMA Dermatol. 2014 Dec;150(12):1336-40. doi: 10.1001/jamadermatol.2014.1244.

Abstract

IMPORTANCE Port-wine stains (PWSs) are common congenital cutaneous capillary malformations. A somatic GNAQ mutation was recently identified in patients with sporadic PWSs and Sturge-Weber syndrome. However, subsequent studies to confirm or extend this observation are lacking.OBSERVATIONS We report a long-standing, unilateral facial PWS of a man in his early 70s confirmed by histopathological analysis. Staged surgical excision of the vascular malformation was performed, and genomic DNA was extracted from the vascular malformation specimen and normal skin. Targeted next-generation sequencing of the coding sequence of 275 known cancer genes including GNAQ was performed in both specimens. A single-nucleotide variant(c.548G>A, p.Arg183Gln) in GNAQ was identified in the PWS-affected tissue but not in the normal skin sample. In addition, this sequencing approach uncovered several additional novel somatic mutations in the genes SMARCA4, EPHA3, MYB, PDGFR-β, and PIK3CA.CONCLUSIONS AND RELEVANCE Our findings confirm the presence of somatic mutations inGNAQ in the affected skin of a patient with congenital PWS, as well as alterations in several other novel genes of possible importance in the pathogenesis of PWS that may also offer substantial therapeutic targets.

摘要

重要性

葡萄酒色斑(PWS)是常见的先天性皮肤毛细血管畸形。最近在散发性 PWS 和 Sturge-Weber 综合征患者中发现了体细胞 GNAQ 突变。然而,后续的研究缺乏证实或扩展这一观察结果。

观察结果

我们报告了一名 70 多岁男性的长期单侧面部 PWS,通过组织病理学分析得到证实。对血管畸形进行了分期手术切除,从血管畸形标本和正常皮肤中提取基因组 DNA。对 275 个已知癌症基因(包括 GNAQ)的编码序列进行靶向下一代测序。在受 PWS 影响的组织中发现了 GNAQ 中的单个核苷酸变异(c.548G>A,p.Arg183Gln),但在正常皮肤样本中未发现。此外,这种测序方法还在 SMARCA4、EPHA3、MYB、PDGFR-β 和 PIK3CA 等几个其他新基因中发现了一些额外的体细胞突变。

结论和相关性

我们的发现证实了先天性 PWS 患者受影响皮肤中存在 GNAQ 的体细胞突变,以及几个可能对 PWS 发病机制有重要意义的其他新基因的改变,这些改变也可能提供有价值的治疗靶点。

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