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在一个患有X连锁扩张型心肌病伴高肌酸激酶血症的家族中发现了一种新的杜氏肌营养不良症剪接突变。

A novel DMD splicing mutation found in a family responsible for X-linked dilated cardiomyopathy with hyper-CKemia.

作者信息

Tang Jin, Song Xueqin, Ji Guang, Wu Hongran, Sun Shuyan, Lu Shan, Li Yuan, Zhang Chi, Zhang Huiqing

机构信息

Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11074. doi: 10.1097/MD.0000000000011074.

Abstract

This study was aimed to detect a new mutation responsible for X-linked dilated cardiomyopathy with hyper-CKemia.We studied a proband who presented with cardiac symptoms with hyper-CKemia, but no clinical skeletal involvement in physical examination, laboratory tests, electromyography, echocardiography, and magnetic resonance imaging (MRI) of cardiac muscles. Muscle biopsy for histopathology and immunohistochemistry for accessing sarcolemma changes. The next-generation sequencing and bioinformatics analysis were performed on the patient and Sanger sequencing was confirmed on the other 6 unaffected families.The clinic investigations illustrated a dilated cardiomyopathy. Histopathology and immunohistochemistry showed dystrophic changes and an obvious reduction of dystrophin-N and δ-sarcoglycan, respectively. One hemizygous splicing pathogenic mutation c.31 + 1G > C of exon 1 in the DMD gene (chrX33229398, NM_00 4006) was finally identified in the patient and his nephew, but it was carried in his mother and sister.A novel small mutation was identified at the first exon-intron boundary splicing site by next-generation sequencing and bioinformatics analysis.

摘要

本研究旨在检测一种导致伴有高肌酸激酶血症的X连锁扩张型心肌病的新突变。我们研究了一名先证者,其出现心脏症状并伴有高肌酸激酶血症,但体格检查、实验室检查、肌电图、超声心动图以及心肌磁共振成像(MRI)均未发现临床骨骼肌受累情况。进行肌肉活检以做组织病理学检查,并进行免疫组织化学检查以评估肌膜变化。对该患者进行了下一代测序和生物信息学分析,并对另外6个未受影响的家系进行了桑格测序验证。临床检查显示为扩张型心肌病。组织病理学和免疫组织化学分别显示了营养不良性改变以及抗肌萎缩蛋白-N和δ-肌聚糖明显减少。最终在该患者及其侄子中鉴定出DMD基因(chrX33229398,NM_004006)外显子1的一个半合子剪接致病突变c.31+1G>C,但其母亲和姐姐为该突变携带者。通过下一代测序和生物信息学分析,在第一个外显子-内含子边界剪接位点鉴定出一个新的小突变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/884f/6024070/840882bbd0b3/medi-97-e11074-g001.jpg

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