Zhang Cai, Du Caiqi, Ye Juan, Ye Feng, Wang Renfa, Luo Xiaoping, Liang Yan
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
BMC Med Genet. 2020 May 29;21(1):117. doi: 10.1186/s12881-020-01052-8.
Spondyloepiphyseal dysplasia tarda (SEDT) is a rare X-linked recessive inherited osteochondrodysplasia caused by mutations in the TRAPPC2 gene. It is clinically characterized by disproportionate short stature and early onset of degenerative osteoarthritis. Clinical diagnosis can be challenging due to the late-onset of the disease and lack of systemic metabolic abnomalites. Genetic diagnosis is critical in both early diagnosis and management of the disease. Here we reported a five-generation Chinese SEDT family and described the novel molecular findings.
Detailed family history and clinical data were collected. Genomic DNA was extracted from venous blood samples of family members. The exons of genes known to be associated with skeletal disorders were captured and deep sequenced. Variants were annotated by ANNOVAR and associated with multiple databases. Putative variants were confirmed by Sanger sequencing. The identified variant was classified according to the American College of Medical Genetics (ACMG) criteria.
The proband was a 27-year-old Chinese male who presented with short-trunk short stature and joint pain. His radiographs showed platyspondyly with posterior humping, narrow hip-joint surfaces, and pelvic osteosclerosis. A pedigree analysis of 5 generations with 6 affected males revealed an X-linked recessive mode of inheritance. Affected males were diagnosed as SEDT according to the clinical and radiological features. Next-generation sequencing identified a novel variant of c.216_217del in the exon 4 of TRAPPC2 gene in the proband and other affected males. This variant resulted in the shift of reading frame and early termination of protein translation (p.S73Gfs*15). The mother and maternal female relatives of the proband were heterozygous carriers of the same variant, while no variations were detected in this gene of his father and other unaffected males. Based on the ACMG criteria, the novel c.216_217del variant of the TRAPPC2 gene was the pathogenic variant of this SEDT family.
In this study we identified the novel pathogenic variant of of c.216_217del in the gene of TRAPPC2 in this five-generation Chinese SEDT family. Our findings expand the clinical and molecular spectrum of SEDT and helps the genetic diagnosis of SEDT patients.
迟发性脊椎骨骺发育不良(SEDT)是一种罕见的X连锁隐性遗传性骨软骨发育不良,由TRAPPC2基因突变引起。其临床特征为身材不成比例矮小和早发性退行性骨关节炎。由于该病发病较晚且缺乏系统性代谢异常,临床诊断具有挑战性。基因诊断对于该病的早期诊断和管理至关重要。在此,我们报告了一个五代中国SEDT家系并描述了新的分子学发现。
收集详细的家族史和临床资料。从家庭成员的静脉血样本中提取基因组DNA。捕获并深度测序已知与骨骼疾病相关基因的外显子。变异通过ANNOVAR注释并与多个数据库关联。推定的变异通过桑格测序确认。根据美国医学遗传学学会(ACMG)标准对鉴定出的变异进行分类。
先证者为一名27岁的中国男性,表现为短躯干矮小和关节疼痛。他的X线片显示椎体扁平伴后凸、髋关节面狭窄和骨盆骨质硬化。对一个有6名患病男性的五代家系进行系谱分析,显示为X连锁隐性遗传模式。根据临床和放射学特征,患病男性被诊断为SEDT。下一代测序在先证者和其他患病男性的TRAPPC2基因第4外显子中鉴定出一个新的变异c.216_217del。该变异导致阅读框移位和蛋白质翻译提前终止(p.S73Gfs*15)。先证者的母亲和母系女性亲属是同一变异的杂合携带者,而其父亲和其他未患病男性的该基因未检测到变异。根据ACMG标准,TRAPPC2基因新的c.216_217del变异是这个SEDT家系的致病变异。
在本研究中,我们在这个五代中国SEDT家系的TRAPPC2基因中鉴定出了新的致病变异c.216_217del。我们的发现扩展了SEDT的临床和分子谱,有助于SEDT患者的基因诊断。