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一个中国脂蛋白肾小球病家系中载脂蛋白 E 突变导致的五氨基酸缺失:病例报告。

A novel apolipoprotein E mutation caused by a five amino acid deletion in a Chinese family with lipoprotein glomerulopathy: a case report.

机构信息

Department of Nephrology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.

Department of Nephrology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Diagn Pathol. 2019 May 15;14(1):41. doi: 10.1186/s13000-019-0820-6.

Abstract

BACKGROUND

Lipoprotein glomerulopathy (LPG) is a rare kidney disease with a poor prognosis that is related to mutation of the apoE gene. More than 10 variants of apoE associated with LPG have currently been identified.

CASE PRESENTATION

A male and his mother presented with proteinuria during a health examination. They went to hospital for further examination. Renal biopsy was performed, and the diagnosis was lipoprotein glomerulopathy (LPG), which is a rare, inherited renal disease. Medical histories were collected from the 2 LPG patients and their family members. The patients and family members underwent a routine urine test, and their renal function, blood lipids, and lipoprotein levels were examined. Genomic DNA was extracted from the peripheral blood of 7 family members, and exon 2, exon 3 and exon 4 of apoE were amplified by polymerase chain reaction (PCR). The purified PCR products were sequenced. Sequence analysis identified a 15 bp deletion (GCGCAAGCTGCGTAA) in exon 4 of the apoE gene that results in a novel 5 amino acid deletion in apoE (143 K-147R → 0). No mutations were found in exon 2 and exon 3 of the apoE gene.

CONCLUSIONS

This family study suggests that a novel ApoE mutation (143 K-147R → 0) may be etiologically related to LPG, and other genetic or environmental factors may be associated with the occurrence of LPG.

摘要

背景

脂蛋白肾小球病(LPG)是一种预后不良的罕见肾脏疾病,与载脂蛋白 E 基因的突变有关。目前已经发现了 10 多种与 LPG 相关的 apoE 变异体。

病例介绍

一名男性及其母亲在体检时出现蛋白尿,遂前往医院进一步检查。对其进行了肾活检,诊断为脂蛋白肾小球病(LPG),这是一种罕见的遗传性肾脏疾病。收集了 2 名 LPG 患者及其家属的病史,对患者及其家属进行了常规尿检,检测了他们的肾功能、血脂和脂蛋白水平。从 7 名家庭成员的外周血中提取基因组 DNA,通过聚合酶链反应(PCR)扩增 apoE 的外显子 2、外显子 3 和外显子 4。对纯化的 PCR 产物进行测序。序列分析发现 apoE 基因外显子 4 中有 15 个碱基缺失(GCGCAAGCTGCGTAA),导致 apoE 中出现一个新的 5 个氨基酸缺失(143K-147R→0)。在 apoE 基因的外显子 2 和外显子 3 中未发现突变。

结论

这项家族研究表明,一种新型 ApoE 突变(143K-147R→0)可能与 LPG 有病因学关联,而 LPG 的发生可能还与其他遗传或环境因素有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3214/6521367/bd928824f455/13000_2019_820_Fig1_HTML.jpg

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