Horner Faye, Wawrzynski James, MacLaren Robert E
Ophthalmology, Department of Clinical Neurosciences,John Radcliffe Hospital, Oxford, UK.
BMJ Case Rep. 2019 May 10;12(5):e224451. doi: 10.1136/bcr-2018-224451.
Retinitis pigmentosa (RP) relates to a heterogeneous group of rod-cone dystrophies of varying genetic aetiology. There is currently great interest in gene replacement therapy. Phenotyping is of particular importance because some RP genes are expressed ubiquitously and it is critically important to understand which retinal layer is primarily affected. is increasingly diagnosed in patients suffering from X-linked RP, which causes outer retinal degeneration. We present a case of a previously unreported null mutation in associated with severe RP. Loss of the retinal pigment epithelium (RPE) was noted in the central macula but not around the disc or peripherally. There was therefore no evidence of independent degeneration of the RPE. Hence despite expression in all retinal cells, RP2 deficiency does not appear to be pathogenic to the RPE. This observation may be helpful in considering the promoter and route of delivery of adeno-associated viral gene therapy vectors encoding RP2.
视网膜色素变性(RP)涉及一组病因各异的视杆-视锥营养不良症。目前人们对基因替代疗法极为关注。表型分析尤为重要,因为一些RP基因在全身广泛表达,了解哪个视网膜层受到主要影响至关重要。在患有X连锁RP(导致外层视网膜变性)的患者中越来越多地被诊断出来。我们报告了一例与严重RP相关的此前未报道的 基因无效突变病例。在中央黄斑区发现视网膜色素上皮(RPE)缺失,但在视盘周围或周边未发现。因此,没有证据表明RPE有独立的变性。因此,尽管 在所有视网膜细胞中都有表达,但RP2缺乏似乎对RPE没有致病性。这一观察结果可能有助于考虑编码RP2的腺相关病毒基因治疗载体的启动子和递送途径。