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中国患者结节性硬化症:TSC1/TSC2 基因突变分析与表型研究。

Tuberous Sclerosis Complex in Chinese patients: Phenotypic analysis and mutational screening of TSC1/TSC2 genes.

机构信息

Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.

Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Seizure. 2019 Oct;71:322-327. doi: 10.1016/j.seizure.2019.08.010. Epub 2019 Aug 23.

Abstract

PURPOSE

Tuberous sclerosis complex (TSC) is characterized by the development of hamartomas in multiple organ systems. This study attempted to screen mutations and to investigate the mutation distribution and related phenotypes including epilepsy of Chinese TSC patients.

METHODS

We performed the genotypic analysis of TSC1 and TSC2 genes in 77 unrelated Chinese TSC patients using direct Sanger sequencing and Multiplex ligation-dependent probe amplification (MLPA).

RESULTS

Mutations were identified in a total of 63 (81.8%) cases, including 18 TSC1 mutations (8 nonsense mutations, 6 frameshift, 1 in-frame shift, 1 missense and 2 splice-site) and 45 TSC2 mutations (13 missense, 3 nonsense, 6 splicing, 6 in-frame shift,12 frameshift mutations and 5 large deletions). Large deletions were presented exclusively in TSC2 gene, accounting for 7.9% of all mutations in this study. Fourteen novel mutations were identified in this study.

CONCLUSIONS

Epilepsy occurs in approximately 75.3% (58/77) of patients. Hypomelanotic macules occurred significantly more often in patients with TSC2 mutations and cases with TSC1/TSC2 mutations had a significantly higher frequency of cortical nodule than patients with no mutations identified. Overall, our data expands the spectrum of mutations associated with the TSC loci and will be of value to the genetic counseling in patients with the disease.

摘要

目的

结节性硬化症(TSC)的特征是多个器官系统中出现错构瘤。本研究试图筛选突变,并研究包括癫痫在内的中国 TSC 患者的突变分布和相关表型。

方法

我们对 77 名无亲缘关系的中国 TSC 患者进行了 TSC1 和 TSC2 基因的基因分型分析,使用直接 Sanger 测序和多重连接依赖性探针扩增(MLPA)。

结果

总共在 63 例(81.8%)患者中发现了突变,包括 18 个 TSC1 突变(8 个无义突变、6 个移码突变、1 个框移突变、1 个错义突变和 2 个剪接位点)和 45 个 TSC2 突变(13 个错义突变、3 个无义突变、6 个剪接突变、6 个框移突变、12 个移码突变和 5 个大片段缺失)。大片段缺失仅存在于 TSC2 基因中,占本研究所有突变的 7.9%。本研究共发现 14 个新突变。

结论

癫痫发生在大约 75.3%(58/77)的患者中。TSC2 突变患者的色素减退性斑明显较多,而 TSC1/TSC2 突变患者的皮质结节发生率明显高于未发现突变的患者。总体而言,我们的数据扩展了与 TSC 基因座相关的突变谱,将为患者的遗传咨询提供价值。

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