Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China.
World J Pediatr. 2018 Apr;14(2):197-203. doi: 10.1007/s12519-018-0135-9. Epub 2018 Mar 5.
Classical homocystinuria (homocysteinemia type 1, MIM# 236200) is a rare inherited disorder in Mainland China. This study aimed to identify mutations in the cystathionine β-synthase (CBS) gene which are associated with classical homocystinuria in nine Chinese patients.
Nine Chinese patients were diagnosed at the age of 5 years 4 months to 18 years by plasma total homocysteine and blood methionine determination. CBS gene analysis was performed for the patients and their families.
All nine patients had significantly increased plasma total homocysteine (142-500 μmol/L vs. the normal range of 0-15 μmol/L) and blood methionine (144.3-500 μmol/L vs. the normal range of 0-50 μmol/L). None of the patients was pyridoxine responsive. Eleven mutations in CBS gene were identified in the nine patients. Eight mutations (IVS3+1G>A, p.Thr493fsX46, p.Thr236Asn, p.Leu230Gln, p.Lys72Ile, p.Ser201ProfsX36, p.Met337IlefsX115, and IVS14-1G>C) were novel. Three mutations (p.Arg125Gln, p.Thr257Met and p.Gly116Arg) had been previously reported.
In this study, eight novel mutations in CBS were identified in nine Chinese patients with classical homocystinuria. None of the hotspot mutations reported in other regions previously was found. These data indicated that Chinese maybe had different CBS mutation spectrum from other population. The identification of mutations not only confirms the diagnosis but also enables accurate genetic counselling and prenatal diagnosis for the fetuses of the families.
经典同型胱氨酸尿症(同型胱氨酸血症 1 型,MIM#236200)在中国内地是一种罕见的遗传性疾病。本研究旨在鉴定胱硫醚β-合酶(CBS)基因突变,以明确 9 例中国经典同型胱氨酸尿症患者的病因。
9 例患者均因血浆总同型半胱氨酸和血甲硫氨酸升高于 5 岁 4 个月至 18 岁时被确诊。对患者及其家系进行 CBS 基因突变分析。
9 例患者血浆总同型半胱氨酸(142500μmol/L 比正常值 015μmol/L)和血甲硫氨酸(144.3500μmol/L 比正常值 050μmol/L)均显著升高。所有患者均无吡哆醇反应性。在 9 例患者中发现 CBS 基因突变 11 种。8 种突变为新突变(IVS3+1G>A,p.Thr493fsX46,p.Thr236Asn,p.Leu230Gln,p.Lys72Ile,p.Ser201ProfsX36,p.Met337IlefsX115 和 IVS14-1G>C)。3 种突变为以往报道过的热点突变(p.Arg125Gln,p.Thr257Met 和 p.Gly116Arg)。
本研究在 9 例经典同型胱氨酸尿症患者中发现 8 种 CBS 新突变。既往报道的其他地区热点突变均未发现。这些数据表明中国人可能与其他人群具有不同的 CBS 突变谱。基因突变的鉴定不仅能明确诊断,还能为家系胎儿进行准确的遗传咨询和产前诊断。