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中国汉族常染色体显性遗传性多囊肾病患者的新突变鉴定及风险评估

Identification of novel mutations and risk assessment of Han Chinese patients with autosomal dominant polycystic kidney disease.

作者信息

Zhang Mingchao, Liu Shuaimei, Xia Xinyi, Cui Yingxia, Li Xiaojun

机构信息

Institute of Clinical Laboratory Science, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.

National Clinical Research Center of Kidney Diseases, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.

出版信息

Nephrology (Carlton). 2019 May;24(5):504-510. doi: 10.1111/nep.13270.

Abstract

AIM

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease in humans and is caused by mutations in the PKD1 or PKD2 gene. ADPKD is heterogeneous with regard to locus and allele heterogeneity and phenotypic variability.

METHODS

Using targeted capture associated with next generation sequencing (NGS), we performed a mutational analysis of Han Chinese patients with ADPKD from 62 unrelated families. Multivariate Cox proportional hazard modelling of their different clinical characteristics and mutation classes was performed.

RESULTS

The detection rate for a PKD1 and PKD2 mutation in the Chinese ADPKD patients was 95.2% (59/62). We identified pathogenic mutations in 64.4% (38/59) of patients, including 32PKD1 mutations (15 nonsense mutations, 15 frameshift mutation, one splice mutation, and one large deletion) and six PKD2 mutations (three nonsense mutations and three frameshift mutations). Of the pathogenic variants we identified, 50% (19/38) were novel variants and 50% (19/38) were known variants. Patients with PKD2 mutations had milder and indistinguishable phenotypes. Significant phenotypic differences were observed among the various types of PKD1 mutations.

CONCLUSION

Our results show that targeted capture associated with next-generation sequencing is an effective strategy for genetically testing ADPKD patients. This mutation analysis of ADPKD in Han Chinese extends our understanding of the genetic diversity of different ethnic groups, enriches the mutation database, and contributes to the genetic counselling of ADPKD patients.

摘要

目的

常染色体显性多囊肾病(ADPKD)是人类最常见的遗传性肾病,由PKD1或PKD2基因突变引起。ADPKD在基因座、等位基因及表型变异性方面具有异质性。

方法

我们采用与二代测序(NGS)相关的靶向捕获技术,对来自62个无亲缘关系家庭的汉族ADPKD患者进行了突变分析。对他们不同的临床特征和突变类型进行了多变量Cox比例风险建模。

结果

中国ADPKD患者中PKD1和PKD2突变的检出率为95.2%(59/62)。我们在64.4%(38/59)的患者中鉴定出致病突变,包括32个PKD1突变(15个无义突变、15个移码突变、1个剪接突变和1个大片段缺失)和6个PKD2突变(3个无义突变和3个移码突变)。在我们鉴定出的致病变体中,50%(19/38)是新变体,50%(19/38)是已知变体。携带PKD2突变的患者表型较轻且难以区分。不同类型的PKD1突变之间观察到显著的表型差异。

结论

我们的结果表明,与二代测序相关的靶向捕获技术是对ADPKD患者进行基因检测的有效策略。对汉族ADPKD患者的这种突变分析扩展了我们对不同种族遗传多样性的理解,丰富了突变数据库,并有助于ADPKD患者的遗传咨询。

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