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[NPHP1基因新突变的鉴定]

[Identification of a new mutation of the NPHP1 gene].

作者信息

La Russa Antonella, Cifarelli Rosa Anna, Perri Anna, Saracino Angelo, Santarsia Giovanni, Bonofiglio Renzo

机构信息

Centro di Ricerca "Rene e Trapianto" UOC Nefrologia e Dialisi abilitata al Trapianto, AO Cosenza, Italia.

Fondazione Basilicata - Ricerca Biomedica, Madonna delle Grazie, Matera, Italia.

出版信息

G Ital Nefrol. 2018 May;35(3).

Abstract

Kidney cystic diseases are inherited disorders causing chronic renal failure. According to the genetic defect they are classified as diseases of the primary ciliary complex and uromodulin-associated diseases. Mutations in genes coding for ciliary proteins are the basis of a broad category of genetic diseases, called ciliopathies. To date, three important ciliopathies are known: the autosomal dominant form and the recessive shape of the polycystic kidney and the nephronophthisis (NPHP). Juvenile Nephronophthisis (NPHP) is a progressive renal tubulo-interstitial disorder with a form of autosomal recessive inheritance that progresses inexorably towards terminal renal failure. Three different forms have been distinguished: juvenile (NPH1), infantile (NPH2) and adolescent (NPH3). Juvenile Nephronophthisis or nephronophthisis type 1 (NPH1), is the most frequent form. In most patients with a suspected diagnosis of NPHP, based primarily on clinical and radiological data, the deletion in homozygous NPHP1 is present in 20-40% of cases. Heterozygous deletions are found in 6% of patients, with concomitant mutation of the NPHP1 gene on the second allele. In this study we subjected to genetic screening 6 patients with suspected NPHP causing chronic renal failure, belonging to 6 families. The genetic screening identified in 2/6 patients a deletion of exons 5-7-20 and in 4/6 patients an heterozygous deletion of exon 20 and an heterozygous deletion on exon 17 not yet described in literature. Our results suggest that genetic screening should be included in the diagnostic procedure of patients with suspected nephronophthisis and that it may be used alternatively to renal biopsy.

摘要

肾囊性疾病是导致慢性肾衰竭的遗传性疾病。根据基因缺陷,它们被分类为原发性纤毛复合体疾病和尿调节蛋白相关疾病。编码纤毛蛋白的基因突变是一大类遗传性疾病(称为纤毛病)的基础。迄今为止,已知三种重要的纤毛病:多囊肾的常染色体显性形式和隐性形式以及肾单位肾痨(NPHP)。青少年肾单位肾痨(NPHP)是一种进行性肾小管间质性疾病,具有常染色体隐性遗传形式,会不可阻挡地发展为终末期肾衰竭。已区分出三种不同形式:青少年型(NPH1)、婴儿型(NPH2)和青少年型(NPH3)。青少年肾单位肾痨或1型肾单位肾痨(NPH1)是最常见的形式。在大多数主要基于临床和放射学数据疑似诊断为NPHP的患者中,纯合子NPHP1缺失在20%至40%的病例中存在。在6%的患者中发现杂合子缺失,同时第二个等位基因上存在NPHP1基因突变。在本研究中,我们对6例疑似由NPHP导致慢性肾衰竭的患者进行了基因筛查,这些患者来自6个家庭。基因筛查在2/6的患者中发现了外显子5 - 7 - 20的缺失,在4/6的患者中发现了外显子20的杂合子缺失以及外显子17上的杂合子缺失,后者尚未见文献报道。我们的结果表明,基因筛查应纳入疑似肾单位肾痨患者的诊断程序中,并且它可以替代肾活检使用。

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