Cnossen Wybrich R, Maurits Jake S F, Salomon Jody, Te Morsche René H M, Waanders Esmé, Drenth Joost P H
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Laboratory of Gastroenterology and Hepatology, ADPLD Diagnostics, Radboud University Medical Center, Nijmegen, The Netherlands.
J Clin Lab Anal. 2016 Sep;30(5):431-6. doi: 10.1002/jcla.21875. Epub 2015 Sep 13.
Isolated polycystic liver disease (ADPLD) is an autosomal dominant Mendelian disorder. Heterozygous PRKCSH (where PRKCSH is protein kinase C substrate 80K-H (80 kDa protein, heavy chain; MIM177060) mutations are the most frequent cause. Routine molecular testing using Sanger sequencing identifies pathogenic variants in the PRKCSH (15%) and SEC63 (where SEC63 is Saccharomyces cerevisiae homolog 63 (MIM608648); 6%) genes, but about approximately 80% of patients meeting the clinical ADPLD criteria carry no PRKCSH or SEC63 mutation. Cyst tissue often shows somatic deletions with loss of heterozygosity that was recently recognized as a general mechanism in ADPLD. We hypothesized that germline deletions in the PRKCSH gene may be responsible for hepatic cystogenesis in a significant number of mutation-negative ADPLD patients.
In this study, we designed a multiplex ligation-dependent probe amplification (MLPA) assay to screen for deletions of PRKCSH exons. Genomic DNA from 60 patients with an ADPLD phenotype was included.
MLPA analysis detected no exon deletions in mutation-negative ADPLD patients.
Large copy number variations on germline level are not present in patients with a clinical diagnosis of ADPLD. MLPA analysis of the PRKCSH gene should not be considered as a diagnostic method to explain hepatic cystogenesis.
孤立性多囊肝病(ADPLD)是一种常染色体显性孟德尔疾病。杂合子PRKCSH(其中PRKCSH是蛋白激酶C底物80K-H(80 kDa蛋白,重链;MIM177060))突变是最常见的病因。使用桑格测序进行的常规分子检测可识别PRKCSH(15%)和SEC63(其中SEC63是酿酒酵母同源物63(MIM608648);6%)基因中的致病变异,但约80%符合临床ADPLD标准的患者未携带PRKCSH或SEC63突变。囊肿组织常显示杂合性缺失的体细胞缺失,这一现象最近被认为是ADPLD的一种普遍机制。我们推测,PRKCSH基因中的种系缺失可能是导致大量突变阴性ADPLD患者肝囊肿形成的原因。
在本研究中,我们设计了一种多重连接依赖探针扩增(MLPA)检测方法,以筛查PRKCSH外显子的缺失。纳入了60例具有ADPLD表型患者的基因组DNA。
MLPA分析在突变阴性ADPLD患者中未检测到外显子缺失。
临床诊断为ADPLD的患者不存在种系水平的大拷贝数变异。PRKCSH基因的MLPA分析不应被视为解释肝囊肿形成的诊断方法。