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21 个先天性无痛无汗症或伴有无汗症的中国家系的分子遗传学分析。

Molecular genetic analysis in 21 Chinese families with congenital insensitivity to pain with or without anhidrosis.

机构信息

Department of Medical Genetics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China.

Department of Orthopedic Surgery, People's Hospital of Wuqing District, Tianjin, China.

出版信息

Eur J Neurol. 2020 Aug;27(8):1697-1705. doi: 10.1111/ene.14234. Epub 2020 Apr 28.

Abstract

BACKGROUND AND PURPOSE

Hereditary sensory and autonomic neuropathies (HSANs) are a group of clinically and genetically heterogeneous neurological disorders characterized by sensory dysfunctions. Here, 21 affected Chinese families are reported, including 19 with congenital insensitivity to pain with anhidrosis (CIPA; namely HSAN IV) and two with congenital insensitivity to pain (CIP; namely HSAN IID) caused by biallelic variations in NTRK1 and SCN9A, respectively, aiming to identify causative variants in these families and compare how different variants in NTRK1 affect the function of tropomyosin receptor kinase A (TrkA).

METHODS

Recombinant plasmids harboring the wild-type and six mutant alleles (p.Gln216*, p.Glu584Lys, p.Leu595Arg, p.Pro684Leu, p.Val709Leu and p.Arg765Cys) of NTRK1 cDNA were constructed and transfected into HEK293 cells.

RESULTS

The results suggested that the five missense variants only presented a subtle influence on the expression level and glycosylation of TrkA but compromised the receptor phosphorylation. Our findings also suggested that a synonymous variant c.219C>T in NTRK1 may cause aberrant splicing, indicating a potential novel pathogenic mechanism of CIPA. Furthermore, gross deletion of SCN9A was first associated with CIP.

CONCLUSIONS

This study identified multiple forms of variants responsible for CIPA/CIP in the Chinese population and might provide new insights into the pathogenesis of CIPA.

摘要

背景与目的

遗传性感觉和自主神经病(HSANs)是一组临床和遗传异质性的神经系统疾病,其特征为感觉功能障碍。本研究报道了 21 个受影响的中国家系,包括 19 个先天性无痛无汗症(CIPA;即 HSAN IV)和 2 个先天性痛觉缺失症(CIP;即 HSAN IIID),分别由 NTRK1 和 SCN9A 的双等位基因突变引起,旨在鉴定这些家系中的致病变异,并比较 NTRK1 中的不同变异如何影响原肌球蛋白受体激酶 A(TrkA)的功能。

方法

构建了携带野生型和 6 个突变等位基因(p.Gln216*、p.Glu584Lys、p.Leu595Arg、p.Pro684Leu、p.Val709Leu 和 p.Arg765Cys)的 NTRK1 cDNA 重组质粒,并转染至 HEK293 细胞。

结果

结果表明,这 5 个错义变异仅对 TrkA 的表达水平和糖基化有轻微影响,但会损害受体磷酸化。我们的研究结果还表明,NTRK1 中的同义变异 c.219C>T 可能导致异常剪接,提示 CIPA 的潜在新发病机制。此外,SCN9A 的大片段缺失首先与 CIP 相关。

结论

本研究鉴定了中国人群中导致 CIPA/CIP 的多种形式变异,可能为 CIPA 的发病机制提供新的见解。

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