Kumari Deepa, Tiwari Ankit, Choudhury Mahasweta, Kumar Abhishek, Rao Aparna, Dixit Manjusha
*School of Biological Sciences, National Institute of Science Education and Research, Institute of Physics Campus †Glaucoma Services, LV Prasad Eye Institute, Bhubaneswar, Odisha, India.
J Glaucoma. 2016 Feb;25(2):e106-9. doi: 10.1097/IJG.0000000000000258.
Keratocan is a cornea-specific keratan sulfate proteoglycan found predominantly in the adult vertebrate eye. In human beings, mutations in keratocan (KERA) are associated with autosomal recessive cornea plana (CNA2), which is characterized by a flattened forward convex curvature of the cornea. Here, we report a novel mutation in a case of autosomal recessive bilateral cornea plana presenting with primary angle-closure glaucoma in a 41-year-old woman from Eastern India.
The KERA gene of the patient and her sons was directly sequenced.
Mutational analysis of the KERA revealed 2 novel mutations. The first mutation was a 3 base-pair deletion (c.371_373delTCT), leading to the loss of a highly conserved amino acid (p.Phe125del). The second mutation was a base substitution resulting in a silent mutation (c.69G>A). One of her 2 sons carried the homozygous substitution (c.69G>A), whereas the other son was heterozygous (c.69G>R).
The mutation that we report here leads to the deletion of a conserved amino acid (p.Phe125del) from the third LRR motif of the keratocan protein, which might lead to an abnormal tertiary structure of the protein, thereby leading to the disease.
角膜蛋白聚糖是一种主要存在于成年脊椎动物眼睛中的角膜特异性硫酸角质素蛋白聚糖。在人类中,角膜蛋白聚糖(KERA)突变与常染色体隐性遗传性扁平角膜(CNA2)相关,其特征是角膜前凸曲率变平。在此,我们报告了一名来自印度东部的41岁女性常染色体隐性遗传性双侧扁平角膜合并原发性闭角型青光眼病例中的一种新突变。
对患者及其儿子的KERA基因进行直接测序。
KERA的突变分析发现了2种新突变。第一种突变是3个碱基对的缺失(c.371_373delTCT),导致一个高度保守的氨基酸缺失(p.Phe125del)。第二种突变是一个碱基替换,导致沉默突变(c.69G>A)。她的2个儿子中,一个携带纯合替换(c.69G>A),另一个儿子是杂合子(c.69G>R)。
我们在此报告的突变导致角膜蛋白聚糖蛋白第三个亮氨酸丰富重复序列基序中一个保守氨基酸缺失(p.Phe125del),这可能导致该蛋白三级结构异常,从而引发疾病。