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儿童期起病的激素抵抗型肾病综合征主要易感基因的系统分析

A Systematic Analysis of Major Susceptible Genes in Childhood-onset Steroid-resistant Nephrotic Syndrome.

作者信息

Li Yongzhen, He Qingnan, Wang Ying, Dang Xiqiang, Wu Xiaochuan, Li Xiaoyan, Shuai Lanjun, Yi Zhuwen

机构信息

Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Laboratory of Pediatric Nephrology, Institute of Pediatrics, Central South University, Changsha, Hunan, China.

出版信息

Ann Clin Lab Sci. 2019 May;49(3):330-337.

Abstract

AIM

Nephrotic syndrome is a urinary disease, causing high morbidity and mortality. However, the mutation prevalence of major susceptible genes in childhood-onset steroid-resistant nephrotic syndrome (SRNS) in China is limited. In this study, we performed a systematic analysis of the mutations in 18 major SRNS-susceptible genes in Chinese SRNS children.

METHODS

Mutation analysis was performed to sequence 18 major SRNS-susceptible genes (, and ) using a PCR-based MassArray technology in 38 childhood-onset SRNS patients in China. This cohort included 10 sporadic cases and 28 familial cases from 7 SRNS families with disease onset between the ages of 1-13 years.

RESULTS

Our analysis detected a heterozygous missense mutation (p.E447K, pathogenic) in in 3/28 familial patients (10.7%) and 1/10 (10.0%) patient without a family history. In addition, two mutations (p.R138X and p.R291W, pathogenic) were identified in 2 patients from another family (7.1% familial cases, 0% sporadic cases, 5.2% overall). Pathogenic mutations of remaining 16 SRNS-susceptible genes were not detected.

CONCLUSION

Our results have verified the significant prevalence of pathogenic and mutations in childhood-onset SRNS in China, while the other 16 SRNS-susceptible genes seem to have lesser contribution to child-onset SRNS. Therefore, our study indicates that it is very necessary to make more efforts to target NPHS1 and NPHS2 for childhood-onset SRNS treatment, especially in China.

摘要

目的

肾病综合征是一种泌尿系统疾病,发病率和死亡率较高。然而,中国儿童期起病的激素抵抗型肾病综合征(SRNS)主要易感基因的突变患病率有限。在本研究中,我们对中国SRNS儿童中18个主要的SRNS易感基因的突变进行了系统分析。

方法

采用基于PCR的MassArray技术,对38例中国儿童期起病的SRNS患者的18个主要SRNS易感基因( 、 和 )进行测序,以进行突变分析。该队列包括10例散发病例和来自7个SRNS家族的28例家族病例,发病年龄在1至13岁之间。

结果

我们的分析在3/28例(10.7%)家族性患者和1/10例(10.0%)无家族史患者中检测到 基因的杂合错义突变(p.E447K,致病性)。此外,在另一个家族的2例患者中鉴定出两个 基因突变(p.R138X和p.R291W,致病性)(家族性病例的7.1%,散发病例的0%,总体的5.2%)。未检测到其余16个SRNS易感基因的致病性突变。

结论

我们的结果证实了在中国儿童期起病的SRNS中,致病性 和 基因突变的显著患病率,而其他16个SRNS易感基因对儿童期起病的SRNS的贡献似乎较小。因此,我们的研究表明,尤其在中国,针对儿童期起病的SRNS治疗,加大对NPHS1和NPHS2的研究力度非常必要。

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