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巴西南部囊性纤维化儿童和青少年的遗传和表型特征。

Genetic and phenotypic traits of children and adolescents with cystic fibrosis in Southern Brazil.

作者信息

Rosa Katiana Murieli da, Lima Eliandra da Silveira de, Machado Camila Correia, Rispoli Thaiane, Silveira Victória d'Azevedo, Ongaratto Renata, Comaru Talitha, Pinto Leonardo Araújo

机构信息

. Pediatric Residency Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brazil.

. Post-Graduate Degree in Pediatrics and Children's Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brazil.

出版信息

J Bras Pneumol. 2018 Nov-Dec;44(6):498-504. doi: 10.1590/s1806-37562017000000418.

Abstract

OBJECTIVES

To characterize the main identified mutations on cystic fibrosis transmembrane conductance regulator (CFTR) in a group of children and adolescents at a cystic fibrosis center and its association with the clinical and laboratorial characteristics.

METHOD

Descriptive cross-sectional study including patients with cystic fibrosis who had two alleles identified with CFTR mutation. Clinical, anthropometrical, laboratorial and pulmonary function (spirometry) data were collected from patients' records in charts and described with the results of the sample genotyping.

RESULTS

42 patients with cystic fibrosis were included in the study. The most frequent mutation was F508del, covering 60 alleles (71.4%). The second most common mutation was G542X (six alleles, 7.1%), followed by N1303K and R1162X mutations (both with four alleles each). Three patients (7.14%) presented type III and IV mutations, and 22 patients (52.38%) presented homozygous mutation for F508del. Thirty three patients (78.6%) suffered of pancreatic insufficiency, 26.2% presented meconium ileus, and 16.7%, nutritional deficit. Of the patients in the study, 59.52% would be potential candidates for the use of CFTR-modulating drugs.

CONCLUSIONS

The mutations of CFTR identified more frequently were F508del and G542X. These are type II and I mutations, respectively. Along with type III, they present a more severe cystic fibrosis phenotype. More than half of the sample (52.38%) presented homozygous mutation for F508del, that is, patients who could be treated with Lumacaftor/Ivacaftor. Approximately 7% of the patients (7.14%) presented type III and IV mutations, therefore becoming candidates for the treatment with Ivacaftor.

摘要

目的

对某囊性纤维化中心一组儿童和青少年的囊性纤维化跨膜传导调节因子(CFTR)上已识别的主要突变进行特征分析,并分析其与临床及实验室特征的关联。

方法

描述性横断面研究,纳入已识别出两个CFTR突变等位基因的囊性纤维化患者。从患者病历中收集临床、人体测量、实验室及肺功能(肺量计)数据,并与样本基因分型结果进行描述。

结果

42例囊性纤维化患者纳入研究。最常见的突变是F508del,涵盖60个等位基因(71.4%)。第二常见的突变是G542X(6个等位基因,7.1%),其次是N1303K和R1162X突变(各有4个等位基因)。3例患者(7.14%)出现III型和IV型突变,22例患者(52.38%)出现F508del纯合突变。33例患者(78.6%)存在胰腺功能不全,26.2%出现胎粪性肠梗阻,16.7%存在营养缺乏。研究中的患者,59.52%可能是CFTR调节剂药物的潜在适用对象。

结论

CFTR中最常识别出的突变是F508del和G542X。这些分别是II型和I型突变。连同III型突变,它们呈现出更严重的囊性纤维化表型。超过一半的样本(52.38%)出现F508del纯合突变,即可以用鲁马卡托/依伐卡托治疗的患者。约7%的患者(7.14%)出现III型和IV型突变,因此成为依伐卡托治疗的适用对象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bfa/6459751/8f1f5a16537d/1806-3713-jbpneu-44-06-00498-gf1.jpg

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