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检测 PAX8 基因突变以诊断中国先天性甲状腺功能减退症患者甲状腺发育不全。

Genetic testing of PAX8 mutations associated with thyroid dysgenesis in Chinese congenital hypothyroidism patients.

机构信息

Medical Genetic Department, The Affiliated Hospital of Qingdao University, Qingdao, China.

Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Endokrynol Pol. 2020;71(2):153-159. doi: 10.5603/EP.a2020.0004. Epub 2020 Feb 25.

Abstract

INTRODUCTION

Thyroid dysgenesis (TD) is the main cause of congenital hypothyroidism (CH), affecting nearly 1 in 2000-3000 newborns worldwide, as the most common neonatal endocrine disorder. Paired box gene 8 (PAX8), expressed during all stages of thyroid follicular cell, plays a key role in thyroid morphogenesis by a complex regulatory network. In conclusion, the genetic mechanism of PAX8 mutant in TD is still ambiguous; therefore, further research is needed.

MATERIAL AND METHODS

Blood samples were collected from 289 TD patients in Shandong Province, China. Genomic DNA was extracted from peripheral blood. All the exons of PAX8 along with their exon-intro boundaries were amplified by PCR and analysed by Sanger sequencing.

RESULTS

We identified three novel PAX8 nonsense mutations in three patients by sequence analysis of PAX8: Patient 1 (c.285C>G, p.Tyr95Ter), Patient 2 (c.747T>G, p.Tyr249Ter), and Patient 3 (c.786C>A, p.Tyr262Ter). All the three patients carrying PAX8 variants had obvious clinical phenotypes of thyroid anomaly, such as hypoplasia and athyreosis.

CONCLUSION

We conducted the largest worldwide PAX8 mutation screening so far in TD patients. Three presumably pathogenic PAX8 mutations were detected in 289 TD cases for the first time, showing the mutation rate of PAX8 is 1.04% in Chinese TD patients. In addition, our study expands the gene mutation spectrum of TD.

摘要

引言

甲状腺发育不全(TD)是先天性甲状腺功能减退症(CH)的主要原因,影响了全球近 2000-3000 名新生儿中的 1 名,是最常见的新生儿内分泌疾病。配对盒基因 8(PAX8)在甲状腺滤泡细胞的所有阶段表达,通过复杂的调控网络在甲状腺形态发生中发挥关键作用。总之,TD 中 PAX8 突变的遗传机制仍不清楚;因此,需要进一步研究。

材料与方法

采集中国山东省 289 例 TD 患者的血样。从外周血中提取基因组 DNA。通过 PCR 扩增 PAX8 的所有外显子及其外显子-内含子边界,并通过 Sanger 测序进行分析。

结果

通过对 PAX8 的序列分析,我们在 3 名患者中发现了 3 种新的 PAX8 无义突变:患者 1(c.285C>G,p.Tyr95Ter)、患者 2(c.747T>G,p.Tyr249Ter)和患者 3(c.786C>A,p.Tyr262Ter)。所有携带 PAX8 变异体的 3 名患者均表现出明显的甲状腺异常临床表型,如发育不全和无甲状腺。

结论

我们对 TD 患者进行了迄今为止全球最大的 PAX8 突变筛查。首次在 289 例 TD 病例中检测到 3 个可能的致病性 PAX8 突变,表明 PAX8 的突变率为 1.04%在中国 TD 患者中。此外,我们的研究扩展了 TD 的基因突变谱。

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