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鉴定先天性无痛无汗症(CIPA)患者 NTRK1 基因的一种新突变。

Identification of a novel mutation of the NTRK1 gene in patients with congenital insensitivity to pain with anhidrosis (CIPA).

机构信息

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

Department of Osteoporosis and Bone Diseases, Metabolic Bone Disease and Genetics Research Unit, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

出版信息

Gene. 2018 Dec 30;679:253-259. doi: 10.1016/j.gene.2018.09.009. Epub 2018 Sep 7.

Abstract

INTRODUCTION

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disorder resulting from NTRK1 mutation. Over 105 NTRK1 mutations have been reported in CIPA patients worldwide. The causative NTRK1 mutations lead to loss of function of the TrkA protein, an important ligand for nerve growth factor (NGF), and therefore induce various clinical phenotypes associated with neuron maturation defects.

MATERIALS AND METHODS

Three patients from unrelated families with CIPA were subjected to detailed clinical examinations. Blood samples were collected from all the patients and their available family members, as well as 200 healthy volunteers. Sanger sequencing for all the exons and splicing sites of NTRK1 was performed on all samples. The phenotype-genotype relationship and genetic epidemiology of Chinese CIPA patients were also analysed.

RESULTS

A total of four different NTRK1 mutations [c.851-33T>A, c.44G>A (p.Trp15*), c.287+2dupT, c.1549G>C (p.Gly517Arg)] were identified in these families, and c.1549G>C (p.Gly517Arg) was a novel mutation that had not been reported previously. The 'mild' manifestations observed in patients with c.851-33T>A indicated this mutation as a 'mild' mutation. After reviewing studies reporting mutations in Chinese CIPA patients, we speculate the mutation c.851-33T>A is one of the founder mutations in the Chinese population.

CONCLUSIONS

Our research expanded the spectrum of the NTRK1 mutations associated with CIPA patients, provided additional clues relating to the phenotype-genotype relationship in CIPA, and summarized the features of the genetic epidemiology of CIPA in the Chinese ethnic group.

摘要

引言

先天性无痛无汗症(CIPA)是一种罕见的常染色体隐性遗传疾病,由 NTRK1 突变引起。全世界已有超过 105 种 NTRK1 突变被报道与 CIPA 患者相关。致病的 NTRK1 突变导致 TrkA 蛋白功能丧失,TrkA 蛋白是神经生长因子(NGF)的重要配体,因此导致与神经元成熟缺陷相关的各种临床表型。

材料和方法

来自三个无关家系的 3 名 CIPA 患者接受了详细的临床检查。从所有患者及其可及的家庭成员以及 200 名健康志愿者中采集了血样。对所有样本进行了 NTRK1 所有外显子和剪接位点的 Sanger 测序。还分析了中国 CIPA 患者的表型-基因型关系和遗传流行病学。

结果

在这些家系中总共发现了 4 种不同的 NTRK1 突变[c.851-33T>A、c.44G>A(p.Trp15*)、c.287+2dupT、c.1549G>C(p.Gly517Arg)],其中 c.1549G>C(p.Gly517Arg)是一种新的突变,以前没有报道过。c.851-33T>A 患者的“轻度”表现表明该突变为“轻度”突变。在回顾了报道中国 CIPA 患者突变的研究后,我们推测突变 c.851-33T>A 是中国人群中的一个“ founder 突变”之一。

结论

我们的研究扩展了与 CIPA 患者相关的 NTRK1 突变谱,提供了与 CIPA 中表型-基因型关系相关的额外线索,并总结了中国人群中 CIPA 遗传流行病学的特征。

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