Freund Paul R, Sergeev Yuri V, MacDonald Ian M
Department of Ophthalmology and Visual Sciences University of Alberta Edmonton Alberta Canada.
Ophthalmic Genetics and Visual Function Branch National Eye Institute National Institutes of Health Bethesda Maryland.
Mol Genet Genomic Med. 2016 Feb 28;4(3):344-58. doi: 10.1002/mgg3.208. eCollection 2016 May.
Choroideremia (CHM) is an X-linked degeneration of the retinal pigment epithelium, photoreceptors, and choroid, which causes nyctalopia and progressive constriction of visual fields leading to blindness. The CHM gene encodes Rab escort protein 1 (REP-1). In this work, we reviewed the phenotypes and genotypes of affected males with the purpose of understanding the functional effects of CHM mutations and their relationship with the phenotypes.
A retrospective review of 128 affected males was performed analyzing the onset of symptoms, visual acuity, and visual fields with respect to their mutations in the CHM gene.
In rank order, reflecting data from this report, the most common mutations found in the CHM gene were nonsense mutations (41%), exon deletions (37%), and splice sites (14%) associated with a loss of functional protein. In the pool of 106 CHM mutations, we discovered four novel missense mutations (c.238C>T; p.L80F, c.819G>T; p.Q273H, c.1327A>G; p.M443V, and c.1370C>T; p.L457P) predicted to be severe changes affecting protein stability and folding with the effect similar to that of other types of mutations. No significant genotype-phenotype correlation was found with respect to the onset of nyctalopia, the onset of other visual symptoms, visual acuity, or width of visual fields.
There is no evidence to support exclusion of CHM patients from clinical trials based on their genotypes or any potential genotype-phenotype correlations.
脉络膜视网膜病变(CHM)是一种视网膜色素上皮、光感受器和脉络膜的X连锁退行性疾病,可导致夜盲和视野逐渐缩小,最终导致失明。CHM基因编码Rab护送蛋白1(REP-1)。在本研究中,我们回顾了受影响男性的表型和基因型,旨在了解CHM突变的功能影响及其与表型的关系。
对128例受影响男性进行回顾性研究,分析其CHM基因突变的症状发作、视力和视野情况。
根据本报告的数据,CHM基因中最常见的突变依次为无义突变(41%)、外显子缺失(37%)和剪接位点突变(14%),这些突变均与功能性蛋白的缺失有关。在106个CHM突变中,我们发现了四个新的错义突变(c.238C>T;p.L80F、c.819G>T;p.Q273H、c.1327A>G;p.M443V和c.1370C>T;p.L457P),预计这些突变会导致严重的变化,影响蛋白质的稳定性和折叠,其效果与其他类型的突变相似。在夜盲症发作、其他视觉症状发作、视力或视野宽度方面,未发现显著的基因型-表型相关性。
没有证据支持根据CHM患者的基因型或任何潜在的基因型-表型相关性将其排除在临床试验之外。