Liu Yaping, Wang Lianqing, Tian Xinlun, Xu Kai-Feng, Xu Wenbing, Li Xue, Yue Cai, Zhang Peng, Xiao Yi, Zhang Xue
Department of Medical Genetics, School of Basic Medicine Peking Union Medical College, Beijing, China.
Respirology. 2015 Feb;20(2):312-8. doi: 10.1111/resp.12452. Epub 2015 Jan 8.
Cystic fibrosis (CF) is a relatively common autosomal recessive disorder in Caucasians. CF is considered a very rare disease in Asians, and fewer than 30 Chinese CF patients are reported in the literature. We enrolled seven patients of Chinese Han origin diagnosed with CF at the Peking Union Medical College Hospital, to characterize gene mutations and phenotypes of CF in Chinese patients.
We analysed the clinical presentation and screened the coding region of the CFTR gene for each patient.
Patients were 0-6 years old at onset of symptoms and were 10-28 years old at the time of diagnosis with CF. None of the seven patients had a family history of CF, and only one patient had parents who were consanguineous. Two patients had gastrointestinal symptoms but stool Sudan III results were normal. Four of the seven CF patients also had allergic bronchopulmonary aspergillosis. The concentration of chloride in patients' sweat ranged from 66 mmol/l to 154 mmol/l. In total, we identified 11 different mutations in seven CF patients, including one novel mutation (△E7-E11). Only one of these mutations (R553X) is present in the Caucasian CFTR common mutation-screening panel; and none of the 11 mutations are common in Caucasian CF patients.
CF in China is difficult to diagnose because of a combination of low awareness, atypical clinical symptoms, and a lack of sweat and genetic testing facilities in most hospitals. The mutations identified in Chinese CF patients are different from the common Caucasian gene mutations.
囊性纤维化(CF)在白种人中是一种相对常见的常染色体隐性疾病。在亚洲人中,CF被认为是一种非常罕见的疾病,文献报道的中国CF患者少于30例。我们纳入了7例在北京协和医院被诊断为CF的汉族患者,以明确中国患者CF的基因突变和表型特征。
我们分析了每位患者的临床表现,并对CFTR基因的编码区进行了筛查。
患者症状出现时年龄为0至6岁,诊断为CF时年龄为10至28岁。7例患者均无CF家族史,只有1例患者的父母为近亲结婚。2例患者有胃肠道症状,但粪便苏丹III检测结果正常。7例CF患者中有4例还患有变应性支气管肺曲霉病。患者汗液中的氯化物浓度在66 mmol/L至154 mmol/L之间。我们总共在7例CF患者中鉴定出11种不同的突变,包括1种新突变(△E7-E11)。这些突变中只有1种(R553X)出现在白种人CFTR常见突变筛查组中;这11种突变在白种人CF患者中均不常见。
由于认识不足、临床症状不典型以及大多数医院缺乏汗液和基因检测设施,中国的CF难以诊断。中国CF患者中鉴定出的突变与白种人常见的基因突变不同。