Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2020 May 1;23(5):319-325. doi: 10.34172/aim.2020.21.
Ménière's disease (MD) is a common inner ear disorder which is characterized by recurrent attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), tinnitus, and a sense of fullness in the affected ear. MD is a complex disorder; although six genes have been linked to familial autosomal dominant form of the disease, in many cases, the exact genetic etiology remains elusive.
To elucidate the genetic causes of MD in an Iranian family, we performed exome sequencing on all members of the family: consanguineous parents and four children (two affected and two unaffected). Variant filtering was completed using a customized workflow keeping variants based on segregation with MD in autosomal recessive (AR) inheritance pattern, minor allele frequency (MAF), and prediction of pathogenicity.
Analysis revealed that in this family, 970 variants co-segregated with MD in AR pattern, out of which eight variants (one intergenic, four intronic, and three exonic) were extremely rare. The exonic variants included a synonymous substitution in USP3 gene, an in-frame deletion in gene, and a rare, highly conserved deleterious missense alteration in gene.
The phenotype observed in the proband described here, i.e. vertigo, poor sense of smell, tinnitus, and borderline hearing ability, may originate from aberrant changes in the cerebellum and limbic system due to a deleterious mutation in the gene; hence, mutation is a possible candidate for the etiology of MD in this family.
梅尼埃病(MD)是一种常见的内耳疾病,其特征是反复发作的眩晕、波动性感音神经性听力损失(SNHL)、耳鸣和受影响耳的饱满感。MD 是一种复杂的疾病;尽管已经有六个基因与家族性常染色体显性形式的疾病有关,但在许多情况下,确切的遗传病因仍然难以捉摸。
为了阐明一个伊朗家庭 MD 的遗传原因,我们对该家庭的所有成员(有血缘关系的父母和四个孩子[两个患病和两个未患病])进行了外显子组测序。使用基于常染色体隐性(AR)遗传模式、小等位基因频率(MAF)和致病性预测的定制工作流程,完成了变体过滤。
分析表明,在这个家庭中,970 个变体与 AR 模式下的 MD 共分离,其中 8 个变体(一个基因间、四个内含子和三个外显子)极为罕见。外显子变体包括 USP3 基因中的同义替换、基因中的框内缺失以及基因中罕见的高度保守的有害错义改变。
在本文描述的先证者中观察到的表型,即眩晕、嗅觉差、耳鸣和听力边缘能力,可能源于小脑和边缘系统的异常变化,由于基因中的有害突变;因此,突变是该家庭 MD 病因的一个可能候选者。