Molecular Diagnosis and Rare Diseases Laboratory, Department of Clinical Biochemistry, Hospital Universitario Virgen del Rocío, Seville, Spain.
Fundación JL Castaño, Sociedad Española de Medicina de Laboratorio, Barcelona, Spain.
Clin Chem Lab Med. 2020 Jun 25;58(12):2017-2024. doi: 10.1515/cclm-2020-0306.
Objectives Gaucher disease (GD) is the most common inherited lysosomal storage disease, caused by mutations in acid β-glucosidase (GBA) gene. This study aimed to identify mutations in Andalusia patients with GD and their genotype-phenotype correlation. Methods Descriptive observational study. University Hospital Virgen del Rocio patients diagnosed from GD from 1999 to 2019 were included. Demographic and clinical data, β-glucocerebrosidase activity, variants pathogenic in GBA gene and biomarkers for monitoring treatment were collected from digital medical record. Results Twenty-six patients with aged between 1 day and 52 years were studied. A total of six mutations described as pathogenic and one mutation not described above [c.937T>C (p.Tyr313His)] were identified in the GBA gene, four patients were homozygotes and 22 compound heterozygotes. Twenty-four patients were diagnosed in non-neuropathic form (type 1) and two cases presented neurological involvement (type 2 or 3). The most common variant was c.1226A>G (p.Asn409Ser), which was detected in 24 patients, followed by c.1448T>C (p.Leu483Pro) variant, identified in 13 patients. The c.1448T>C (p.Leu483Pro) mutation has been presented in the most severe phenotypes with neurological involvement associated with type 2 and 3 GD, while c.1226A>G (p.Asn409Ser) mutation has not been associated with neurological alterations. Splenomegaly and bone disease were the most frequent clinical manifestations, and thrombocytopenia was the most common hematological disorder. Conclusions The c.1226A>G (p.Asn409Ser) and c.1448T>C (p.Leu483Pro) mutations were the most common. The c.937T>C (p.Tyr313His) was identified as a novel mutation. The c.1448T>C (p.Leu483Pro) mutation was associated with neurological alterations and c.1226A>G (p.Asn409Ser) mutation has not been associated it.
目的 戈谢病(GD)是最常见的遗传性溶酶体贮积病,由酸性β-葡萄糖苷酶(GBA)基因突变引起。本研究旨在鉴定安达卢西亚 GD 患者的突变及其与基因型-表型的相关性。
方法 描述性观察研究。纳入 1999 年至 2019 年期间在 Virgen del Rocio 大学医院诊断为 GD 的患者。从电子病历中收集人口统计学和临床数据、β-葡糖脑苷脂酶活性、GBA 基因突变和监测治疗的生物标志物。
结果 研究了 26 名年龄在 1 天至 52 岁之间的患者。在 GBA 基因中发现了六种已描述为致病性的突变和一种未描述的突变[c.937T>C(p.Tyr313His)],其中四名患者为纯合子,22 名患者为复合杂合子。24 名患者被诊断为非神经病变形式(1 型),两名患者出现神经病变(2 型或 3 型)。最常见的变异是 c.1226A>G(p.Asn409Ser),在 24 名患者中检测到,其次是 c.1448T>C(p.Leu483Pro)变异,在 13 名患者中检测到。c.1448T>C(p.Leu483Pro)突变与伴有神经病变的 2 型和 3 型 GD 最相关,而 c.1226A>G(p.Asn409Ser)突变与神经改变无关。脾肿大和骨病是最常见的临床表现,血小板减少症是最常见的血液学异常。
结论 c.1226A>G(p.Asn409Ser)和 c.1448T>C(p.Leu483Pro)突变最为常见。c.937T>C(p.Tyr313His)被鉴定为一种新的突变。c.1448T>C(p.Leu483Pro)突变与神经改变有关,而 c.1226A>G(p.Asn409Ser)突变与之无关。
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