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俄罗斯联邦无虹膜症患者的分子分析拓宽了 PAX6 突变谱。

Molecular analysis of patients with aniridia in Russian Federation broadens the spectrum of PAX6 mutations.

机构信息

Federal State Budgetary Institution 'Research Center for Medical Genetics', Moscow, Russian Federation.

Department of Ambulant Surgery and Conservative Treatment, Cheboksary Branch of S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary, Russian Federation.

出版信息

Clin Genet. 2017 Dec;92(6):639-644. doi: 10.1111/cge.13019. Epub 2017 Aug 2.

Abstract

Congenital aniridia is a severe autosomal dominant congenital panocular disorder, mainly associated with pathogenic variants in the PAX6 gene. The objective of the study was to investigate the mutational and clinical spectra of congenital aniridia in a cohort of 117 patients from Russia. Each patient underwent detailed ophthalmological examination. From 91 unrelated families, 110 patients were diagnosed with congenital aniridia and 7 with WAGR syndrome (Wilms tumor, Aniridia, Genitourinary anomalies, and mental Retardation syndrome). The clinical presentation in aniridia patients varied from the complete bilateral absence of the iris (75.5%) to partial aniridia or iris hypoplasia (24.5%). Additional ocular abnormalities were consistent with previous reports. In our cohort, we saw a previously not described high percentage of patients (45%) who showed non-ocular phenotypes. Prevalence of deletions coherent with WAGR syndrome appeared to be 19.4% out of sporadic patients. Among the other aniridia cases, PAX6 deletions were identified in 18 probands, and small intragenic changes were detected in 58 probands with 27 of these mutations being novel and 21 previously reported. In 3 families mosaic mutation was transmitted from a subtly affected parent. Therefore, PAX6 mutations explained 96.7% of aniridia phenotypes in this study with only 3 of 91 probands lacking pathogenic variants in the gene.

摘要

先天性无虹膜是一种严重的常染色体显性先天性全眼球疾病,主要与 PAX6 基因的致病性变异有关。本研究的目的是在俄罗斯的 117 名患者队列中研究先天性无虹膜的突变和临床谱。每位患者均接受了详细的眼科检查。在 91 个无关家庭中,有 110 名患者被诊断为先天性无虹膜,7 名患者为 WAGR 综合征(Wilms 瘤、无虹膜、泌尿生殖异常和智力迟钝综合征)。无虹膜患者的临床表现从完全双侧虹膜缺失(75.5%)到部分无虹膜或虹膜发育不良(24.5%)不等。其他眼部异常与先前的报道一致。在我们的队列中,我们看到了以前未描述的高比例(45%)的患者出现非眼部表型。与 WAGR 综合征一致的缺失的患病率在散发性患者中似乎为 19.4%。在其他无虹膜病例中,在 18 名先证者中鉴定出 PAX6 缺失,在 58 名先证者中检测到小的基因内变化,其中 27 种突变是新的,21 种是以前报道过的。在 3 个家族中,镶嵌突变从受轻微影响的父母遗传。因此,在本研究中,PAX6 突变解释了 96.7%的无虹膜表型,只有 91 个先证者中的 3 个缺乏该基因中的致病变异。

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