Xu Dechao, Ma Yiyi, Gu Xiangchen, Bian Rongrong, Lu Yunhui, Xing Xiaohong, Mei Changlin
Kidney Institute of PLA, Department of Nephrology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Kidney Blood Press Res. 2018;43(2):297-309. doi: 10.1159/000487899. Epub 2018 Mar 6.
BACKGROUND/AIMS: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder with mutations in PKD1 or PKD2. This study aimed to identify novel PKD1 and PKD2 mutations in Chinese patients with ADPKD.
Mutational analyses of both PKD genes were performed in 120 Chinese families with inherited ADPKD using long-range PCR and targeted next-generation sequencing approaches. Sanger sequencing was performed to check the positive mutations, while multiplex ligation-dependent probe amplification was adopted to examine those without mutations for the presence of large deletions.
A total of 93 mutations in PKD1 and PKD2 were identified in 98 Chinese families with ADPKD inheritance and the detection rate was 81.7% (98/120). The mutation rates of PKD1 and PKD2 were 91.4% (85/93) and 8.6% (85/93), respectively. Among the 93 mutations, 59.1% (55/93) were reported for the first time. A total of 65 mutations (26 nonsense, 33 frameshift, 2 large deletion, and 4 typical splicing mutations) were identified as definite pathogenic mutations. The remaining 28 mutations (21 missense, 3 in-frame deletion, and 4 atypical splicing mutations) were determined as probable pathogenic mutations. In addition, 9 de novo mutations were found by pedigree analysis. Correlation analysis between genotype and phenotype revealed that patients with PKD1 mutations or truncating mutations exhibited the most severe clinical outcome.
The newly identified sites for known mutations will facilitate the early diagnosis and prediction of prognosis in patients with ADPKD, and provide fundamental genetic information for clinical intervention to prevent the inheritance of this disease in affected families.
背景/目的:常染色体显性遗传性多囊肾病(ADPKD)是最常见的遗传性肾脏疾病,由PKD1或PKD2基因突变引起。本研究旨在鉴定中国ADPKD患者中的新型PKD1和PKD2基因突变。
采用长片段PCR和靶向二代测序技术,对120个中国遗传性ADPKD家系的两个PKD基因进行突变分析。通过Sanger测序验证阳性突变,采用多重连接依赖探针扩增技术检测无突变家系中是否存在大片段缺失。
在98个中国ADPKD遗传家系中,共鉴定出93个PKD1和PKD2基因突变,检出率为81.7%(98/120)。PKD1和PKD2的突变率分别为91.4%(85/93)和8.6%(8/93)。在这93个突变中,59.1%(55/93)为首次报道。共鉴定出65个明确的致病突变(26个无义突变、33个移码突变、2个大片段缺失和4个典型剪接突变)。其余28个突变(21个错义突变、3个框内缺失和4个非典型剪接突变)被判定为可能的致病突变。此外,通过家系分析发现9个新发突变。基因型与表型的相关性分析显示,PKD1突变或截短突变的患者临床结局最为严重。
新鉴定的已知突变位点将有助于ADPKD患者的早期诊断和预后预测,并为临床干预提供基础遗传信息,以防止该疾病在受累家庭中的遗传。