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[先天性甲状腺功能减退症患儿GNAS和THRA基因突变分析]

[An analysis of GNAS and THRA gene mutations in children with congenital hypothyroidism].

作者信息

Chen Xiao-Yu, Liu Yong, Liu Jian-Hua, Qin Xiao-Song

机构信息

Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jul;21(7):680-684. doi: 10.7499/j.issn.1008-8830.2019.07.012.

Abstract

OBJECTIVE

To preliminarily investigate the relationship between stimulatory G protein α subunit (GNAS) and thyroid hormone receptor α (THRA) gene mutations and clinical phenotypes in children with congenital hypothyroidism (CH).

METHODS

A total of 70 children with CH diagnosed by neonatal screening were enrolled. Their peripheral blood samples were collected to extract genomic DNA. GNAS and THRA genes were screened for mutations using next-generation sequencing. Bioinformatics software was used to analyze the pathogenicity of gene mutations.

RESULTS

Of the 70 children with CH, nine missense mutations (three known mutations and six novel mutations) in the GNAS gene were detected in three patients (4%), and one gene polymorphism, c.508A>G(p.I170V), in the THRA gene was detected in four patients. The analysis results of bioinformatics software and ACMG/AMP guidelines showed that the two GNAS gene mutations [c.301C>T(p.R101C) and c.334G>A(p.E112K)] were more likely to be pathogenic. Three children with GNAS gene mutations showed different degrees of hypothyroidism.

CONCLUSIONS

GNAS gene mutations are related to the development of CH, and children with CH have different clinical manifestations. THRA gene mutations may not be associated with CH.

摘要

目的

初步探讨刺激性G蛋白α亚基(GNAS)和甲状腺激素受体α(THRA)基因突变与先天性甲状腺功能减退症(CH)患儿临床表型之间的关系。

方法

纳入70例经新生儿筛查确诊的CH患儿。采集其外周血样本提取基因组DNA。采用二代测序技术筛查GNAS和THRA基因的突变情况。运用生物信息学软件分析基因突变的致病性。

结果

70例CH患儿中,3例(4%)检测到GNAS基因有9个错义突变(3个已知突变和6个新突变),4例检测到THRA基因有1个基因多态性位点c.508A>G(p.I170V)。生物信息学软件分析结果及美国医学遗传学与基因组学学会(ACMG)/分子病理学会(AMP)指南显示,GNAS基因的2个突变[c.301C>T(p.R101C)和c.334G>A(p.E112K)]更有可能具有致病性。3例GNAS基因突变患儿表现出不同程度的甲状腺功能减退。

结论

GNAS基因突变与CH的发生有关,且CH患儿有不同的临床表现。THRA基因突变可能与CH无关。

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