Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH, Heidelberg University Hospital, Röntgenstr. 1, 69126 Heidelberg, Germany.
Translational Lung Research Centre (TLRC), German Centre for Lung Research (DZL), Im Neuenheimer Feld 156, 69120 Heidelberg, Germany.
Int J Mol Sci. 2020 May 8;21(9):3339. doi: 10.3390/ijms21093339.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease which is often caused by recurrent emboli. These are also frequently found in patients with myeloproliferative diseases. While myeloproliferative diseases can be caused by gene defects, the genetic predisposition to CTEPH is largely unexplored. Therefore, the objective of this study was to analyse these genes and further genes involved in pulmonary hypertension in CTEPH patients. A systematic screening was conducted for pathogenic variants using a gene panel based on next generation sequencing. CTEPH was diagnosed according to current guidelines. In this study, out of 40 CTEPH patients 4 (10%) carried pathogenic variants. One patient had a nonsense variant (c.2071A>T p.Lys691*) in the gene and three further patients carried the same pathogenic variant (missense variant, c.1849G>T p.Val617Phe) in the () gene. The latter led to a myeloproliferative disease in each patient. The prevalence of this variant was significantly higher than expected ( < 0.0001). CTEPH patients may have a genetic predisposition more often than previously thought. The predisposition for myeloproliferative diseases could be an additional risk factor for CTEPH development. Thus, clinical screening for myeloproliferative diseases and genetic testing may be considered also for CTEPH patients.
慢性血栓栓塞性肺动脉高压(CTEPH)是一种罕见的疾病,通常由反复的栓子引起。这些栓子也经常在骨髓增生性疾病患者中发现。虽然骨髓增生性疾病可能是由基因缺陷引起的,但 CTEPH 的遗传易感性在很大程度上尚未得到探索。因此,本研究的目的是分析这些基因以及 CTEPH 患者中与肺动脉高压相关的其他基因。使用基于下一代测序的基因面板对致病变异进行了系统筛选。根据当前指南诊断 CTEPH。在这项研究中,40 名 CTEPH 患者中有 4 名(10%)携带致病性变异。一名患者在 基因中携带无意义变异(c.2071A>T p.Lys691*),另有 3 名患者在 ()基因中携带相同的致病性变异(错义变异,c.1849G>T p.Val617Phe)。后者导致每位患者都患有骨髓增生性疾病。这种 变异的患病率明显高于预期(<0.0001)。CTEPH 患者可能比以前认为的更具有遗传易感性。骨髓增生性疾病的易感性可能是 CTEPH 发展的另一个风险因素。因此,对骨髓增生性疾病的临床筛查和基因检测也可能考虑用于 CTEPH 患者。