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中国成骨不全患者FKBP10基因的新突变及其唑来膦酸治疗

Novel mutations in FKBP10 in Chinese patients with osteogenesis imperfecta and their treatment with zoledronic acid.

作者信息

Xu Xiao-Jie, Lv Fang, Liu Yi, Wang Jian-Yi, Ma Dou-Dou, Wang Jia-Wei, Song Li-Jie, Jiang Yan, Wang Ou, Xia Wei-Bo, Xing Xiao-Ping, Li Mei

机构信息

Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Research and Development Center, Binhai Genomics Institute, Tianjin, China.

出版信息

J Hum Genet. 2017 Feb;62(2):205-211. doi: 10.1038/jhg.2016.109. Epub 2016 Aug 25.

Abstract

Osteogenesis imperfecta (OI) is a group of hereditary disorders characterized by decreased bone mass and increased fracture risk. The majority of OI cases have an autosomal dominant pattern of inheritance and are usually caused by mutations in genes encoding type I collagen. OI cases of autosomal recessive inheritance are rare, and OI type XI is attributable to mutation of the FKBP10 gene. Here, we used next-generation sequencing and Sanger sequencing to detect mutations in FKBP10 and to analyze their relation to the phenotypes of OI type XI in three Chinese patients. We also evaluated the efficacy of zoledronic acid treatment in these patients. Two of the affected patients had novel compound heterozygous mutations, one patient with c.343C>T (p.R115X) in exon 2 and c.1085delC (p.A362fsX1) in exon 7, and the other patient with c.879C>G (p.Y293X) in exon 5 and c.918-3C>G in intron 5. In the third proband, we identified a homozygous single base-pair duplication, c.831dupC (p.G278RfsX95) in exon 5. In conclusion, we report for the first time that these novel pathogenic mutations of FKBP10 can lead to the extremely rare type XI OI without contractures, which expands the genotypic spectrum of OI. The phenotypes of these patients are similar to patients with types III or IV OI, and zoledronic acid is effective in increasing BMD, inhibiting bone resorption biomarkers and reducing fractures of these patients.

摘要

成骨不全症(OI)是一组遗传性疾病,其特征是骨量减少和骨折风险增加。大多数OI病例呈常染色体显性遗传模式,通常由编码I型胶原蛋白的基因突变引起。常染色体隐性遗传的OI病例很少见,XI型OI归因于FKBP10基因突变。在此,我们使用二代测序和桑格测序来检测FKBP10基因的突变,并分析其与三名中国患者XI型OI表型的关系。我们还评估了唑来膦酸治疗这些患者的疗效。两名受影响患者有新的复合杂合突变,一名患者外显子2中有c.343C>T(p.R115X),外显子7中有c.1085delC(p.A362fsX1);另一名患者外显子5中有c.879C>G(p.Y293X),内含子5中有c.918-3C>G。在第三个先证者中,我们在其外显子5中鉴定出一个纯合单碱基对重复,即c.831dupC(p.G278RfsX95)。总之,我们首次报道这些新的FKBP10致病突变可导致极为罕见的无挛缩XI型OI,这扩展了OI的基因型谱。这些患者的表型与III型或IV型OI患者相似,唑来膦酸在增加骨密度、抑制骨吸收生物标志物以及减少这些患者骨折方面有效。

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