Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro, Tokyo, 152-8902, Japan.
Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro, Tokyo, 152-8902, Japan.
Orphanet J Rare Dis. 2017 Sep 25;12(1):157. doi: 10.1186/s13023-017-0708-z.
To date, 102 genes have been reported as responsible for non-syndromic hearing loss, some of which are associated with specific audiogram features. Four genes have been reported as causative for mid-frequency sensorineural hearing loss (MFSNHL), among which TECTA is the most frequently reported; however, the prevalence of TECTA mutations is unknown. To elucidate the prevalence of TECTA mutation in MFSNHL and clarify genotype-phenotype correlations, we analyzed the genetic and clinical features of patients with MFSNHL.
Subjects with bilateral non-syndromic hearing loss were prescreened for GJB2 and m.1555A > G and m.3243A > G mitochondrial DNA mutations, and patients with inner ear malformations were excluded. We selected MFSNHL patients whose audiograms met the U-shaped criterion proposed by the GENDEAF study group, along with those with shallow U-shaped audiograms, for TECTA analysis. All TECTA exons were analyzed by Sanger sequencing. Novel missense variants were classified as possibly pathogenic, non-pathogenic, and variants of uncertain significance, based on genetic data. To evaluate novel possibly pathogenic variants, we predicted changes in protein structure by molecular modeling.
Pathogenic and possibly pathogenic variants of TECTA were found in 4 (6.0%) of 67 patients with MFSNHL. In patients with U-shaped audiograms, none (0%) of 21 had pathogenic or possibly pathogenic variants. In patients with shallow U-shaped audiograms, four (8.7%) of 46 had pathogenic or possibly pathogenic variants. Two novel possibly pathogenic variants were identified and two previously reported mutations were considered as variant of unknown significance. The clinical features of patients with pathogenic and possibly pathogenic variants were consistent with those in previous studies. Pathogenic or possibly pathogenic variants were identified in 3 of 23 families (13.0%) which have the family histories compatible with autosomal dominant and 1 of 44 families (2.3%) which have the family histories compatible with sporadic or autosomal recessive.
TECTA mutations were identified in 6.0% of MFSNHL. These mutations were more frequent in patients with shallow U-shaped audiograms than those with U-shaped audiograms, and in families which have the family histories compatible with autosomal dominant than those with the family histories compatible with sporadic or autosomal recessive.
迄今为止,已有 102 个基因被报道与非综合征型听力损失有关,其中一些与特定的听力图特征相关。有四个基因被报道与中频感音神经性听力损失(MFSNHL)有关,其中 TECTA 是最常报道的;然而,TECTA 突变的患病率尚不清楚。为了阐明 TECTA 突变在 MFSNHL 中的患病率,并阐明基因型-表型相关性,我们分析了 MFSNHL 患者的遗传和临床特征。
对双侧非综合征型听力损失患者进行 GJB2 和 m.1555A>G 及 m.3243A>G 线粒体 DNA 突变的预筛查,并排除内耳畸形患者。我们选择听力图符合 GENDEAF 研究组提出的 U 形标准的 MFSNHL 患者,以及听力图为浅 U 形的患者进行 TECTA 分析。所有 TECTA 外显子均通过 Sanger 测序进行分析。根据遗传数据,将新的错义变异分为可能致病性、非致病性和意义不明的变异。为了评估新的可能致病性变异,我们通过分子建模预测蛋白质结构的变化。
在 67 例 MFSNHL 患者中发现了 TECTA 的致病性和可能致病性变异 4 例(6.0%)。在 U 形听力图患者中,21 例均无致病性或可能致病性变异。在浅 U 形听力图患者中,46 例中有 4 例(8.7%)有致病性或可能致病性变异。发现了两个新的可能致病性变异和两个先前报道的突变被认为是意义不明的变异。致病性或可能致病性变异患者的临床特征与以往研究一致。在家族史与常染色体显性遗传相匹配的 23 个家族中有 3 个(13.0%)和家族史与散发性或常染色体隐性遗传相匹配的 44 个家族中有 1 个(2.3%)发现了致病性或可能致病性变异。
在 MFSNHL 中发现了 TECTA 突变,占 6.0%。这些突变在浅 U 形听力图患者中比 U 形听力图患者更常见,在与常染色体显性遗传家族史相匹配的患者中比与散发性或常染色体隐性遗传家族史相匹配的患者更常见。