Alagappan Uma, Pramono Zacharias A D, Chong Wei-Sheng
Department of Dermatology, Changi General Hospital, Singapore.
Department of Research, National Skin Center, Singapore.
Int J Dermatol. 2017 Mar;56(3):272-276. doi: 10.1111/ijd.13418. Epub 2017 Jan 4.
Erythropoietic protoporphyria (EPP) is a rare inherited disorder of heme biosynthesis caused by decreased activity of the enzyme ferrochelatase (FECH ). The frequency of the hypomorphic c.333-48C allele in a population directly contributes to the prevalence of EPP in the same population. This study sought to identify the molecular basis of EPP in a Chinese patient from Singapore and the c.333-48C allele frequency among the Chinese population in Singapore.
FECH gene was screened for mutation in the patient's DNA sample by polymerase chain reaction amplification and DNA sequencing. To validate the identified mutation, the FECH region harboring the mutation was screened in DNA samples from all healthy controls. One patient and 46 ethnically matched healthy controls were included in the study.
A novel c.474dupC which leads to a frameshift and premature stop codon was identified in one allele, while the other allele showed to carry c.333-48C and c.337C>T variants in the patient's FECH. The frequency of the c.333-48C hypomorphic allele is 27% among Chinese population in Singapore.
c.474dupC in one allele trans to hypomorphic c.333-48C and c.337C>T allele in FECH gene may be the underlying cause of the clinical EPP of the studied patient. The FECH hypomorphic c.333-48C allele frequency in Singapore is lower than the Han Chinese (41.3%) and Japanese (43%) populations but nearly the same as the Southeast Asian (31%) population and higher than the European (2.7-11%) population.
红细胞生成性原卟啉病(EPP)是一种罕见的遗传性血红素生物合成障碍疾病,由亚铁螯合酶(FECH)活性降低引起。人群中低表达的c.333-48C等位基因频率直接影响同一人群中EPP的患病率。本研究旨在确定一名来自新加坡的中国患者EPP的分子基础以及新加坡华人人群中c.333-48C等位基因频率。
通过聚合酶链反应扩增和DNA测序对患者的DNA样本进行FECH基因突变筛查。为验证所鉴定的突变,在所有健康对照的DNA样本中筛查含有该突变的FECH区域。本研究纳入了一名患者和46名种族匹配的健康对照。
在一个等位基因中鉴定出一种新的c.474dupC突变,该突变导致移码和提前终止密码子,而另一个等位基因显示在患者的FECH中携带c.333-48C和c.337C>T变体。新加坡华人人群中c.333-48C低表达等位基因频率为27%。
FECH基因中一个等位基因的c.474dupC与低表达的c.333-48C和c.337C>T等位基因可能是该研究患者临床EPP的潜在病因。新加坡FECH低表达c.333-48C等位基因频率低于汉族(41.3%)和日本(43%)人群,但与东南亚(31%)人群相近,高于欧洲(2.7-11%)人群。