Teaching and Research Office of Medical Cosmetology, Department of Management, Fujian Health College, Fuzhou, Fujian 350001, P.R. China.
Provincial Clinical Medical College, Fujian Medical University, Fuzhou, Fujian 350001, P.R. China.
Mol Med Rep. 2018 Jun;17(6):7553-7558. doi: 10.3892/mmr.2018.8838. Epub 2018 Mar 29.
In the present study whole-exome sequencing using the Complete Genomics platform was employed to scan a proband from a split‑hand/split‑foot malformation (SHFM) 4 family. The missense mutation c.728G>A (p.Arg243Gln) in the TP63 gene was revealed to be associated with SHFM. Sanger sequencing confirmed the sequences of the proband and his father. The father was diagnosed with SHFM and harbored a CGG‑to‑CAG mutation in exon 5, which produced a R243Q substitution in the zinc binding site and dimerization site of TP63. The R243Q mutation was predicted to be pathogenic by PolyPhen‑2. The proband, who was diagnosed with four digit SHFM, exhibited a more severe phenotype. X‑ray analysis returned the following results: Absence of third phalange bilaterally and third metacarpus of the left hand; absence of the second toes bilaterally and partial third toes; and partial fusion of the second, third and metatarsal bones of the right side with deformity of the second metatarsal of the right side. Osteochondroma was present in the fourth proximal radial metacarpal of the left hand and the basal and proximal parts of the second metatarsal of the right side. The proband's father had five digits in both feet. These results indicate that the R243Q mutation produces a novel phenotype named SHFM4. The present study revealed that the R243Q mutation in the TP63 gene produced a novel phenotype named SHFM4, thereby demonstrating the mutational overlap between ectrodactyly‑ectodermal dysplasia‑cleft syndrome and SHFM4.
在本研究中,我们使用 Complete Genomics 平台进行全外显子组测序,以扫描来自一个并指(趾)畸形 4 型(SHFM4)家族的先证者。在 TP63 基因中发现的错义突变 c.728G>A(p.Arg243Gln)与 SHFM 相关。Sanger 测序证实了先证者及其父亲的序列。父亲被诊断为 SHFM,并在 5 号外显子中存在 CGG-to-CAG 突变,导致 TP63 的锌结合位点和二聚化位点的 R243Q 取代。PolyPhen-2 预测 R243Q 突变是致病性的。先证者被诊断为四指 SHFM,表现出更严重的表型。X 射线分析结果如下:双侧第三指骨缺失和左手第三掌骨缺失;双侧第二趾缺失和部分第三趾缺失;右侧第二、第三和跖骨部分融合,右侧第二跖骨畸形。左手第四近端桡骨掌骨和右侧第二跖骨基底部和近端存在骨软骨瘤。先证者的父亲双脚有五个脚趾。这些结果表明 R243Q 突变产生了一种新的表型,命名为 SHFM4。本研究表明,TP63 基因中的 R243Q 突变产生了一种新的表型,命名为 SHFM4,从而证明了外胚层发育不良-外胚层-指(趾)畸形综合征和 SHFM4 之间存在突变重叠。
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