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基因筛查有助于复杂症状的诊断:病例报告。

Gene screening facilitates diagnosis of complicated symptoms: A case report.

机构信息

Department of Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing 100853, P.R. China.

出版信息

Mol Med Rep. 2017 Dec;16(6):7915-7922. doi: 10.3892/mmr.2017.7590. Epub 2017 Sep 22.


DOI:10.3892/mmr.2017.7590
PMID:28944914
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5779872/
Abstract

Gene mutation has an important role in disease pathogenesis; therefore, genetic screening is a useful tool for diagnosis. The present study screened pathogenic genes, ectodysplasin A (EDA) and lamin A/C (LMNA), in a patient with suspected syndromic hearing impairment and various other symptoms including tooth and skin abnormalities. Large‑scale sequencing of 438 deafness‑associated genes and whole‑genome sequencing was also performed. The present findings did not identify copy number variation and mutations in EDA; therefore, excluding the possibility of EDA‑initiated ectodermal dysplasia syndrome. A synonymous mutation in LMNA, possibly due to a splicing abnormality, did not elucidate the pathogenesis of Hutchinson‑Gilford progeria syndrome. Whole‑genome sequencing revealed copy number variations or mutations in various candidate genes which may elucidate part of the symptoms observed. The copy number variations and mutations were also used to identify single nucleotide variations (SNVs) in crystallin mu (CRYM), RAB3 GTPase activating protein catalytic subunit 1 (RAB3GAP1) and Wnt family member 10A (WNT10A), implicated in deafness, hypogonadism and tooth/skin abnormalities, respectively. The importance of an existing SNV in CRYM and a novel SNV in RAB3GAP1 in pathogenesis remains to be further elucidated. The WNT10A p.G213S mutation was confirmed to be the etiological cause of tooth agenesis and ectodermal dysplasia as previously described. It was concluded that a mutation in WNT10A may be the reason for some of the symptoms observed in the patient; however, other genes may also be involved for other symptoms. The findings of the present study provide putative gene mutations that require further investigation in order to determine their roles in pathogenesis.

摘要

基因突变在疾病发病机制中具有重要作用;因此,遗传筛查是诊断的有用工具。本研究对一名疑似综合征性听力障碍和其他多种症状(包括牙齿和皮肤异常)的患者进行了致病性基因外显子 1A(EDA)和核纤层蛋白 A/C(LMNA)的筛查。还对 438 个耳聋相关基因和全基因组进行了大规模测序。本研究结果未发现 EDA 中的拷贝数变异和突变;因此,排除了 EDA 引发的外胚层发育不良综合征的可能性。LMNA 中的同义突变可能由于剪接异常,无法阐明 Hutchinson-Gilford 早衰综合征的发病机制。全基因组测序显示,各种候选基因中存在拷贝数变异或突变,这可能阐明了观察到的部分症状的发病机制。这些拷贝数变异和突变还用于鉴定与耳聋、性腺功能减退和牙齿/皮肤异常相关的晶状体 mu(CRYM)、RAB3 GTPase 激活蛋白催化亚基 1(RAB3GAP1)和 Wnt 家族成员 10A(WNT10A)中的单核苷酸变异(SNV)。在 CRYM 中存在的现有 SNV 和 RAB3GAP1 中的新 SNV 在发病机制中的重要性仍有待进一步阐明。WNT10A p.G213S 突变被证实是先前描述的牙齿缺失和外胚层发育不良的病因。结论是,WNT10A 的突变可能是患者观察到的一些症状的原因;然而,其他基因也可能涉及其他症状。本研究的发现提供了可能的基因突变,需要进一步研究以确定它们在发病机制中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda8/5779872/68ab7039e26d/MMR-16-06-7915-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda8/5779872/f0358de0adba/MMR-16-06-7915-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda8/5779872/68ab7039e26d/MMR-16-06-7915-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda8/5779872/f0358de0adba/MMR-16-06-7915-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dda8/5779872/68ab7039e26d/MMR-16-06-7915-g01.jpg

相似文献

[1]
Gene screening facilitates diagnosis of complicated symptoms: A case report.

Mol Med Rep. 2017-9-22

[2]
Non-syndromic cardiac progeria in a patient with the rare pathogenic p.Asp300Asn variant in the LMNA gene.

BMC Med Genet. 2017-10-18

[3]
Novel EDA or EDAR Mutations Identified in Patients with X-Linked Hypohidrotic Ectodermal Dysplasia or Non-Syndromic Tooth Agenesis.

Genes (Basel). 2017-10-5

[4]
Hutchinson-Gilford progeria syndrome: clinical findings in three patients carrying the G608G mutation in LMNA and review of the literature.

Br J Dermatol. 2007-6

[5]
Novel missense mutation in the EDA gene in a family affected by oligodontia.

J Orofac Orthop. 2016-1

[6]
C1824T mutation in the LMNA gene has no association with senile cataract.

Neurobiol Aging. 2011-11-10

[7]
Novel lamin A/C gene (LMNA) mutations in atypical progeroid syndromes.

J Med Genet. 2004-4

[8]
Non-syndromic tooth agenesis associated with a nonsense mutation in ectodysplasin-A (EDA).

J Dent Res. 2013-4-19

[9]
Hutchinson-Gilford progeria syndrome caused by an LMNA mutation: a case report.

Pediatr Dermatol. 2015

[10]
A homozygous ZMPSTE24 null mutation in combination with a heterozygous mutation in the LMNA gene causes Hutchinson-Gilford progeria syndrome (HGPS): insights into the pathophysiology of HGPS.

Hum Mutat. 2006-6

本文引用的文献

[1]
Novel RAB3GAP1 compound heterozygous mutations in Japanese siblings with Warburg Micro syndrome.

Brain Dev. 2016-3

[2]
Comprehensive molecular diagnosis of 67 Chinese Usher syndrome probands: high rate of ethnicity specific mutations in Chinese USH patients.

Orphanet J Rare Dis. 2015-9-4

[3]
Mutations in EDA and EDAR Genes in a Large Mexican Hispanic Cohort with Hypohidrotic Ectodermal Dysplasia.

Ann Dermatol. 2015-8

[4]
POLD1 Germline Mutations in Patients Initially Diagnosed with Werner Syndrome.

Hum Mutat. 2015-11

[5]
The Outcome of Cochlear Implantation for Mitochondrial Disease Patients With Syndromic Hearing Loss.

Otol Neurotol. 2015-9

[6]
Correlation analysis of phenotype and genotype of GJB2 in patients with non-syndromic hearing loss in China.

Gene. 2015-10-10

[7]
Case of X-linked hypohidrotic ectodermal dysplasia with a novel EDA missense mutation.

J Dermatol. 2015-9

[8]
Taurodontism, variations in tooth number, and misshapened crowns in Wnt10a null mice and human kindreds.

Mol Genet Genomic Med. 2015-1

[9]
Common polymorphisms in WNT10A affect tooth morphology as well as hair shape.

Hum Mol Genet. 2015-5-1

[10]
MYO7A and USH2A gene sequence variants in Italian patients with Usher syndrome.

Mol Vis. 2014-12-23

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