Carrigan Matthew, Duignan Emma, Humphries Pete, Palfi Arpad, Kenna Paul F, Farrar G Jane
School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland.
Research Foundation, Royal Victoria Eye & Ear Hospital, Dublin, Ireland.
Br J Ophthalmol. 2016 Apr;100(4):495-500. doi: 10.1136/bjophthalmol-2015-306939. Epub 2015 Oct 15.
The GNAT1 gene encodes the α subunit of the rod transducin protein, a key element in the rod phototransduction cascade. Variants in GNAT1 have been implicated in stationary night-blindness in the past, but unlike other proteins in the same pathway, it has not previously been implicated in retinitis pigmentosa.
A panel of 182 retinopathy-associated genes was sequenced to locate disease-causing mutations in patients with inherited retinopathies.
Sequencing revealed a novel homozygous truncating mutation in the GNAT1 gene in a patient with significant pigmentary disturbance and constriction of visual fields, a presentation consistent with retinitis pigmentosa. This is the first report of a patient homozygous for a complete loss-of-function GNAT1 mutation. The clinical data from this patient provide definitive evidence of retinitis pigmentosa with late onset in addition to the lifelong night-blindness that would be expected from a lack of transducin function.
These data suggest that some truncating GNAT1 variants can indeed cause a recessive, mild, late-onset retinal degeneration in human beings rather than just stationary night-blindness as reported previously, with notable similarities to the phenotype of the Gnat1 knockout mouse.
GNAT1基因编码视杆转导蛋白的α亚基,这是视杆光转导级联反应中的关键元件。过去,GNAT1基因的变异与静止性夜盲症有关,但与同一信号通路中的其他蛋白质不同,此前它尚未被认为与色素性视网膜炎有关。
对182个与视网膜病变相关的基因进行测序,以确定遗传性视网膜病变患者的致病突变。
测序显示,一名患有明显色素紊乱和视野缩窄的患者的GNAT1基因存在一种新的纯合截断突变,这种表现与色素性视网膜炎一致。这是首例关于GNAT1基因功能完全丧失的纯合突变患者的报告。该患者的临床数据除了显示出因缺乏转导蛋白功能而预期的终身夜盲症外,还为迟发性色素性视网膜炎提供了确凿证据。
这些数据表明,一些截断型GNAT1变异确实可导致人类隐性、轻度、迟发性视网膜变性,而非如先前报道的仅导致静止性夜盲症,这与Gnat1基因敲除小鼠的表型有显著相似之处。