Huang Y L, Tan M Y, Jiang X, Li B, Chen Q Y, Jia X F, Tang C F, Liu J L, Liu L
Department of Guangzhou Newborn Screening Center, Guangzhou Women and Children's Medical Center, Guangzhou 510180, China.
Zhonghua Er Ke Za Zhi. 2017 Mar 2;55(3):210-214. doi: 10.3760/cma.j.issn.0578-1310.2017.03.009.
To explore the TPO, DUOX2 and DUOXA2 genotypes and phenotypes of children with permanent congenital hypothyroidism(PCH) suspected dyshormonogenesis in Guangzhou, identified and treated at Guangzhou Newborn Screening Center. Six of them were born between 2011 and 2012. Retrospectively analyzed the clinical data of 9 children with PCH suspected dyshormonogenesis. Genetic analysis of TPO, DUOX2 and DUOXA2 genes were performed with Sanger sequencing. Of the 9 patients, four were identified variants in TPO gene including three cases with biallelic variants and one case with monoallelic variant. Novel c. 1784G>C( p. R595T) variant in TPO was predicted to be damaging by SIFT and PolyPhen-2. Four patients harbored monoallelic known variants in DUOX2 gene and the other one harbored heterozygous known mutation c. 738C>G(p.Y246X) in DUOXA2 gene.Two adolescent patients with biallelic variants in TPO gene showed classical PCH phenotypes with thyroid goiter or nodules. The six patients with monoallelic variant in TPO, DUOX2 or DUOXA2 presented variable phenotypes. Among the 433 578 newborns in the 2011-2012 cohort, there were 156 cases of CH. Six of these cases were PCH suspected dyshormonogenesis, among which 1 case was confirmed TPO biallelic variants and 5 cases were monoallelic variants of TPO, DUOX2, or DUOXA2 genes. TPO and DUOX2 variants are the common molecular pathogenesis in children with PCH suspected dyshormonogenesis. Monoallelic variants in TPO, DUOX2 or DUOXA2 are associated with PCH and showed wide variability in their phenotypes. The novel variant p. R595T in TPO is probably a pathologic variant. The prevalence of PCH caused by TPO gene defects is rare in Guangzhou.
为探究广州新生儿筛查中心确诊并接受治疗的永久性先天性甲状腺功能减退症(PCH)疑似激素合成障碍患儿的甲状腺过氧化物酶(TPO)、双氧化酶2(DUOX2)和双氧化酶激活蛋白2(DUOXA2)的基因型和表型。其中6例于2011年至2012年出生。回顾性分析9例PCH疑似激素合成障碍患儿的临床资料。采用桑格测序法对TPO、DUOX2和DUOXA2基因进行基因分析。9例患者中,4例在TPO基因中检测到变异,其中3例为双等位基因变异,1例为单等位基因变异。TPO基因中的新变异c.1784G>C(p.R595T)经SIFT和PolyPhen-2预测具有损害性。4例患者在DUOX2基因中携带单等位基因已知变异,另1例在DUOXA2基因中携带杂合已知突变c.738C>G(p.Y246X)。2例TPO基因双等位基因变异的青少年患者表现出伴有甲状腺肿大或结节的典型PCH表型。6例TPO、DUOX2或DUOXA2基因单等位基因变异患者表现出不同的表型。在2011 - 2012队列的433578例新生儿中,有156例先天性甲状腺功能减退症。其中6例为PCH疑似激素合成障碍,其中1例确诊为TPO双等位基因变异,5例为TPO、DUOX2或DUOXA2基因的单等位基因变异。TPO和DUOX2变异是PCH疑似激素合成障碍患儿常见的分子发病机制。TPO、DUOX2或DUOXA2基因的单等位基因变异与PCH相关,且表型差异较大。TPO基因中的新变异p.R595T可能是病理性变异。广州地区由TPO基因缺陷导致的PCH患病率较低。