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新型 SERPINH1 复合杂合突变导致罕见的常染色体隐性遗传型 X 型成骨不全症。

Novel compound heterozygous mutations in SERPINH1 cause rare autosomal recessive osteogenesis imperfecta type X.

机构信息

Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No.1, Dongcheng District, Beijing, 100730, China.

Department of Endocrinology, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing, 100035, China.

出版信息

Osteoporos Int. 2018 Jun;29(6):1389-1396. doi: 10.1007/s00198-018-4448-2. Epub 2018 Mar 9.

Abstract

UNLABELLED

We identified novel compound heterozygous mutations in SERPINH1 in a Chinese boy suffering from recurrent fractures, femoral deformities, and growth retardation, which resulted in extremely rare autosomal recessive OI type X. Long-term treatment of BPs was effective in increasing BMD Z-score, reducing fracture incidence and reshaping vertebrae compression.

INTRODUCTION

Osteogenesis imperfecta (OI) is a heritable bone disorder characterized by low bone mineral density, recurrent fractures, and progressive bone deformities. Mutation in serpin peptidase inhibitor clade H, member 1 (SERPINH1), which encodes heat shock protein 47 (HSP47), leads to rare autosomal recessive OI type X. We aimed to detect the phenotype and the pathogenic mutation of OI type X in a boy from a non-consanguineous Chinese family.

METHODS

We investigated the pathogenic mutations and analyzed their relationship with the phenotype in the patient using next-generation sequencing (NGS) and Sanger sequencing. Moreover, the efficacy of long-term bisphosphonate treatment in this patient was evaluated.

RESULTS

The patient suffered from multiple fractures, low bone mass, and bone deformities in the femur, without dentinogenesis imperfecta or hearing loss. Compound heterozygous variants were found in SERPINH1 as follows: c.149 T>G in exon 2 and c.1214G>A in exon 5. His parents were heterozygous carriers of each of these mutations, respectively. Bisphosphonates could be helpful in increasing BMD Z-score, reducing bone fracture risk and reshaping the compressed vertebral bodies of this patient.

CONCLUSION

We reported novel compound heterozygous mutations in SERPINH1 in a Chinese OI patient for the first time, which expanded the spectrum of phenotype and genotype of extremely rare OI type X.

摘要

目的

我们在一名患有复发性骨折、股骨畸形和生长迟缓的中国男孩中发现了 SERPINH1 中的新型复合杂合突变,导致极为罕见的常染色体隐性 OI 型 X。长期使用 BP 治疗可有效增加 BMD Z 评分,降低骨折发生率并重塑椎体压缩。

引言

成骨不全症(OI)是一种遗传性骨病,其特征为低骨密度、复发性骨折和进行性骨畸形。丝氨酸蛋白酶抑制剂超家族 H 成员 1(SERPINH1)中的突变导致罕见的常染色体隐性 OI 型 X。我们旨在检测一名非近亲中国男孩的 OI 型 X 的表型和致病突变。

方法

我们使用下一代测序(NGS)和 Sanger 测序法检测患者的致病突变,并分析其与表型的关系。此外,还评估了该患者长期使用双膦酸盐治疗的疗效。

结果

该患者患有多处骨折、低骨量和股骨畸形,无牙本质生成不全或听力损失。在 SERPINH1 中发现了复合杂合变体:c.149 T>G 位于外显子 2 中,c.1214G>A 位于外显子 5 中。他的父母分别是这两种突变的杂合携带者。双膦酸盐可能有助于增加 BMD Z 评分,降低骨折风险并重塑该患者受压的椎体。

结论

我们首次报道了中国 OI 患者中 SERPINH1 的新型复合杂合突变,扩展了极为罕见的 OI 型 X 的表型和基因型谱。

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