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突变更新:TPP1 基因变异与神经元蜡样脂褐质沉积症 CLN2 疾病相关的综述。

Mutation update: Review of TPP1 gene variants associated with neuronal ceroid lipofuscinosis CLN2 disease.

机构信息

UCL MRC Laboratory for Molecular Cell Biology and UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.

Global Scientific Affairs, BioMarin Pharmaceutical Inc, Novato, California.

出版信息

Hum Mutat. 2019 Nov;40(11):1924-1938. doi: 10.1002/humu.23860. Epub 2019 Jul 26.

Abstract

Neuronal ceroid lipofuscinosis type 2 (CLN2 disease) is an autosomal recessive condition caused by variants in the TPP1 gene, leading to deficient activity of the lysosomal enzyme tripeptidyl peptidase I (TPP1). We update on the spectrum of TPP1 variants associated with CLN2 disease, comprising 131 unique variants from 389 individuals (717 alleles) collected from the literature review, public databases, and laboratory communications. Previously unrecorded individuals were added to the UCL TPP1-specific database. Two known pathogenic variants, c.509-1 G>C and c.622 C>T (p.(Arg208*)), collectively occur in 60% of affected individuals in the sample, and account for 50% of disease-associated alleles. At least 86 variants (66%) are private to single families. Homozygosity occurs in 45% of individuals where both alleles are known (87% of reported individuals). Atypical CLN2 disease, TPP1 enzyme deficiency with disease onset and/or progression distinct from classic late-infantile CLN2, represents 13% of individuals recorded with associated phenotype. NCBI ClinVar currently holds records for 37% of variants collected here. Effective CLN2 disease management requires early diagnosis; however, irreversible neurodegeneration occurs before a diagnosis is typically reached at age 5. Timely classification and public reporting of TPP1 variants is essential as molecular testing increases in use as a first-line diagnostic test for pediatric-onset neurological disease.

摘要

神经元蜡样脂褐质沉积症 2 型(CLN2 病)是一种常染色体隐性疾病,由 TPP1 基因的变异引起,导致溶酶体酶三肽基肽酶 I(TPP1)的活性降低。我们更新了与 CLN2 病相关的 TPP1 变异谱,该变异谱来自 389 名个体的文献综述、公共数据库和实验室通讯中的 131 个独特变异体(717 个等位基因)。以前未记录的个体被添加到 UCL TPP1 特异性数据库中。两个已知的致病性变异体 c.509-1G>C 和 c.622C>T(p.(Arg208*)),共同存在于样本中 60%的受影响个体中,占疾病相关等位基因的 50%。至少 86 个变异体(66%)是单个家族特有的。在已知两个等位基因的个体中,有 45%为纯合子(报告的个体中有 87%为纯合子)。非典型 CLN2 病,TPP1 酶缺乏症,其发病和/或进展与经典晚发性 CLN2 不同,占记录相关表型的个体的 13%。NCBI ClinVar 目前记录了这里收集的 37%的变异体。有效的 CLN2 病管理需要早期诊断;然而,在通常 5 岁时才被诊断出来之前,就已经发生了不可逆转的神经退行性变。及时分类和公开报告 TPP1 变异体至关重要,因为随着分子检测作为儿科发病神经疾病的一线诊断测试的使用增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ef8/6851559/109b8970e4ec/HUMU-40-1924-g001.jpg

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