de Almeida P A D, Machado-Costa M C, Manzoli G N, Ferreira L S, Rodrigues M C S, Bueno L S M, Saute J A M, Pinto Vairo F, Matte U S, Siebert M, Cossio S L, Macedo G S, Winckler P B, Becker M M, Magalhães L V B, Gonçalves M V M, Marrone C D, Nucci A, França M C
Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, Brazil.
University Hospital Professor Edgard Santos, Federal University of Bahia (UFBA), Salvador, Brazil.
Clin Genet. 2017 Aug;92(2):199-203. doi: 10.1111/cge.12975. Epub 2017 Feb 22.
Different types of mutations in the DMD gene underlie Duchenne muscular dystrophies (DMD) and Becker muscular dystrophies (BMD). Large deletions and duplications are the most frequent causative genetic alterations worldwide, but little is known about DMD/BMD genetic profile in Brazil. Hence, we recruited patients with DMD and BMD from 8 neuromuscular reference centers along the country, and performed a comprehensive molecular investigation that included Multiplex Ligation-dependent Probe Amplification and Next generation sequencing (NGS) analyses. We evaluated 199 patients from 177 unrelated families: 166 with DMD, 32 with BMD and 1 1.5 years old asymptomatic patient with persistent hiperCKemia. Overall, large deletions (58.2%) followed by nonsense mutations (12.4%) and large duplications (11.3%) were the most frequent variants in Brazilian families. Large deletions were less frequent in BMD than in DMD (44.8% vs 60.8%). We identified 19 new DMD variants. Nonsense mutations were significantly more frequent in patients from northeastern region than from southern/southeastern regions of Brazil (27.7% vs 8.5%, P < .05). Genetic profile of Brazilian patients with DMD/BMD is similar to previously reported cohorts, but it is not uniform across the country. This information is important to plan rational clinical care for patients in face of the new coming mutation-specific therapies.
杜兴氏肌营养不良症(DMD)和贝克氏肌营养不良症(BMD)是由DMD基因的不同类型突变引起的。大的缺失和重复是全球最常见的致病性基因改变,但巴西的DMD/BMD基因概况鲜为人知。因此,我们从巴西全国8个神经肌肉参考中心招募了DMD和BMD患者,并进行了全面的分子研究,包括多重连接依赖探针扩增和下一代测序(NGS)分析。我们评估了来自177个无关家庭的199名患者:166名患有DMD,32名患有BMD,还有1名1.5岁无症状但持续性高肌酸激酶血症的患者。总体而言,大的缺失(58.2%)、无义突变(12.4%)和大的重复(11.3%)是巴西家庭中最常见的变异类型。BMD中大片段缺失的频率低于DMD(44.8%对60.8%)。我们鉴定出19个新的DMD变异。巴西东北部患者的无义突变明显比南部/东南部患者更常见(27.7%对8.5%,P < 0.05)。巴西DMD/BMD患者的基因概况与之前报道的队列相似,但在全国范围内并不统一。面对即将到来的针对特定突变的治疗方法,这些信息对于为患者制定合理的临床护理计划非常重要。