El-Mougy Fatma A, Sharaf Sahar A A, Elsharkawy Marwa M, Mandour Iman A, El-Essawy Riham A, Eldin Abeer M, Helmy Heba M, Soliman Dina H, Selim Lamia H, Sharafeldin Heba M, Mogahed Engy A, El-Karaksy Hanaa M
Department of Clinical and Chemical Pathology, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt.
Department of Clinical and Chemical Pathology, Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt.
Arab J Gastroenterol. 2014 Sep-Dec;15(3-4):114-8. doi: 10.1016/j.ajg.2014.10.005. Epub 2014 Nov 21.
Wilson disease (WD) is an autosomal recessive disorder, caused by defects in copper-transporting P-type adenosine triphosphatase (ATPase) encoded by the ATP7B gene, resulting in the deposition of copper in the liver and brain with significant disability or death if left untreated. An available regimen of treatment gives hope to those predisposed to the disease if diagnosed early. The objective of this study was to determine the frequency of the most common European mutation (p.H1069Q) in Egyptian children with WD, in addition to screening for previously reported mutations in the Egyptian patients in our selected group.
Direct DNA sequencing was applied to exons (13, 14, 18, and 19) of the ATP7B gene for 19 patients previously diagnosed with WD. Then DNA sequencing and pedigree analysis were performed in the families of the patients showing variations in their results for the purpose of family screening and carrier detection. Six out of 19 patients were studied with their families (three families).
We identified five variants of which two were novel among the studied patients. One of the novel variants was synonymous substitution (p.A1074A) in 16% of patients and the other was predicted to be missense disease-causing mutations (p.T1076I) in 16% of patients, and three previously published mutations p.H1069Q were detected in 5% of patients, p.P1273Q in 10% of patients, and a silent variant p.A1003A in 26% of patients.
Screening for the two exons 14 and 18 of the ATP7B gene is important in Egyptian patients especially in suspected patients without hepatic manifestations.
威尔逊病(WD)是一种常染色体隐性疾病,由ATP7B基因编码的铜转运P型三磷酸腺苷酶(ATP酶)缺陷引起,导致铜在肝脏和大脑中沉积,若不治疗会导致严重残疾或死亡。有效的治疗方案为那些易患该病且早期诊断的患者带来了希望。本研究的目的是确定埃及WD患儿中最常见的欧洲突变(p.H1069Q)的频率,此外还对我们所选组中的埃及患者进行先前报道的突变筛查。
对19例先前诊断为WD的患者的ATP7B基因外显子(13、14、18和19)进行直接DNA测序。然后对结果显示有变异的患者家庭进行DNA测序和系谱分析,以进行家庭筛查和携带者检测。19例患者中有6例与其家庭(三个家庭)一起进行了研究。
我们鉴定出五个变异,其中两个在研究患者中是新发现的。一个新变异是16%的患者中出现的同义替换(p.A1074A),另一个预计是16%的患者中导致疾病的错义突变(p.T1076I),并且检测到三个先前发表的突变,5%的患者中出现p.H1069Q,10%的患者中出现p.P1273Q,26%的患者中出现沉默变异p.A1003A。
对ATP7B基因的第14和18外显子进行筛查对埃及患者很重要,尤其是对无肝脏表现的疑似患者。