Rao Mandava V, Sindhav Gaurang M, Mehta Jitendra J
Department of Zoology, Gujarat Genetic Diagnostic Center (GenDiCe), School of Sciences, Gujarat University, Navrangpura, India.
Department of Zoology, Indian Muscular Dystrophy society (IMDS), Paldi, Ahmedabad, Gujarat, India.
Ann Indian Acad Neurol. 2014 Jul;17(3):303-7. doi: 10.4103/0972-2327.138508.
In India, various groups have studied different regions to find out deletion pattern of dystrophin gene. We have investigated its deletion pattern among Duchenne/Becker muscular dystrophy (D/BMD) patients across Gujarat. Moreover, in this study we also correlate the same with reading frame rule. However, we too consider various clinicopathological features to establish as adjunct indices when deletion detection fails.
In this pilot study, a total of 88 D/BMD patients consulting at our centers in Gujarat, India were included. All patients were reviewed on basis of their clinical characteristics, tested by three primer sets of 10-plex, 9-plex, and 7-plex polymerase chain reaction (PCR) for genetic analysis; whereas, biochemical indices were measured using automated biochemical analyzers.
The diagnosis of D/BMD was confirmed by multiplex-PCR (M-PCR) in D/BMD patients. A number of 65 (73.86%) out of 88 patients showed deletion in dystrophin gene. The exon 50 (58.46%) was the most frequent deletion found in our study. The mean age of onset of DMD and BMD was 4.09 ± 0.15 and 7.14 ± 0.55 years, respectively. In patients, mean creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and myoglobin levels were elevated significantly (P < 0.05) in comparison to controls. Addition to CPK, LDH and myoglobin are good adjunct when deletion detection failed. These data are further in accordance with world literature when correlated with frame rule.
The analysis has been carried out for the first time for a total of 88 D/BMD patients particularly from Gujarat, India. More research is essential to elucidate specific mutation pattern in association with management and therapies of proband.
在印度,不同的研究小组对不同地区进行了研究,以找出肌营养不良蛋白基因的缺失模式。我们调查了古吉拉特邦杜兴氏/贝克氏肌营养不良症(D/BMD)患者中该基因的缺失模式。此外,在本研究中,我们还将其与读码框规则相关联。然而,当缺失检测失败时,我们也考虑各种临床病理特征以确立辅助指标。
在这项初步研究中,纳入了在印度古吉拉特邦我们中心就诊的88例D/BMD患者。所有患者均根据其临床特征进行评估,通过10重、9重和7重聚合酶链反应(PCR)的三组引物进行基因分析检测;而生化指标则使用自动生化分析仪进行测量。
通过多重PCR(M-PCR)确诊了D/BMD患者。88例患者中有65例(73.86%)显示肌营养不良蛋白基因存在缺失。外显子50(58.46%)是我们研究中最常见的缺失。DMD和BMD的平均发病年龄分别为4.09±0.15岁和7.14±0.55岁。与对照组相比,患者的平均肌酸磷酸激酶(CPK)、乳酸脱氢酶(LDH)和肌红蛋白水平显著升高(P<0.05)。除CPK外,当缺失检测失败时,LDH和肌红蛋白是良好的辅助指标。这些数据与读码框规则相关时,进一步与世界文献相符。
首次对总共88例D/BMD患者进行了分析,特别是来自印度古吉拉特邦的患者。需要更多的研究来阐明与先证者的管理和治疗相关的特定突变模式。