外显子组测序揭示了一名患有2型德布凯发育不良和生长激素缺乏症的波兰患者中两个新的XYLT1基因复合杂合突变。
Exome sequencing reveals two novel compound heterozygous XYLT1 mutations in a Polish patient with Desbuquois dysplasia type 2 and growth hormone deficiency.
作者信息
Jamsheer Aleksander, Olech Ewelina M, Kozłowski Kazimierz, Niedziela Marek, Sowińska-Seidler Anna, Obara-Moszyńska Monika, Latos-Bieleńska Anna, Karczewski Marek, Zemojtel Tomasz
机构信息
Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland.
NZOZ Center for Medical Genetics GENESIS, Poznan, Poland.
出版信息
J Hum Genet. 2016 Jul;61(7):577-83. doi: 10.1038/jhg.2016.30. Epub 2016 Mar 31.
Desbuquois dysplasia type 2 (DBQD2) is a rare recessively inherited skeletal genetic disorder characterized by severe prenatal and postnatal growth retardation, generalized joint laxity with dislocation of large joints and facial dysmorphism. The condition was recently described to result from autosomal recessive mutations in XYLT1, encoding the enzyme xylosyltransferase-1. In this paper, we report on a Polish patient with DBQD2 who presented with severe short stature of prenatal onset, joint laxity, psychomotor retardation and multiple radiological abnormalities including short metacarpals, advanced bone age and exaggerated trochanters. Endocrinological examinations revealed that sleep-induced growth hormone (GH) release and GH peak in clonidine- and glucagon-induced provocative tests as well as insulin-like growth factor 1 (IGF-1) and IGF-binding protein-3 levels were all markedly decreased, confirming deficiency of GH secretion. Bone age, unlikely to GH deficiency, was significantly advanced. To establish the diagnosis at a molecular level, we performed whole-exome sequencing and bioinformatic analysis in the index patient, which revealed compound heterozygous XYLT1 mutations: c.595C>T(p.Gln199*) and c.1651C>T(p.Arg551Cys), both of which are novel. Sanger sequencing showed that the former mutation was inherited from the healthy mother, whereas the latter one most probably occurred de novo. Our study describes the first case of DBQD2 resulting from compound heterozygous XYLT1 mutation, expands the mutational spectrum of the disease and provides evidence that the severe growth retardation and microsomia observed in DBQD2 patients may result not only from the skeletal dysplasia itself but also from GH and IGF-1 deficiency.
2型德斯布瓦氏发育不全(DBQD2)是一种罕见的隐性遗传性骨骼遗传病,其特征为严重的产前和产后生长迟缓、大关节脱位导致的全身关节松弛以及面部畸形。最近发现该病症是由编码木糖基转移酶-1的XYLT1基因的常染色体隐性突变引起的。在本文中,我们报告了一名患有DBQD2的波兰患者,该患者表现出产前开始的严重身材矮小、关节松弛、精神运动发育迟缓以及包括掌骨短小、骨龄提前和转子增大等多种放射学异常。内分泌检查显示,睡眠诱导的生长激素(GH)释放以及可乐定和胰高血糖素激发试验中的GH峰值,以及胰岛素样生长因子1(IGF-1)和IGF结合蛋白-3水平均显著降低,证实存在GH分泌不足。与GH缺乏不同,骨龄明显提前。为了在分子水平上确诊,我们对该索引患者进行了全外显子组测序和生物信息学分析,结果发现了复合杂合XYLT1突变:c.595C>T(p.Gln199*)和c.1651C>T(p.Arg551Cys),这两个突变均为新发现的。桑格测序显示,前一个突变来自健康的母亲,而后一个突变很可能是新生突变。我们的研究描述了首例由复合杂合XYLT1突变导致的DBQD2病例,扩展了该疾病的突变谱,并提供了证据表明,DBQD2患者中观察到的严重生长迟缓和小身材不仅可能源于骨骼发育异常本身,还可能源于GH和IGF-1缺乏。