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泰国杜氏肌营养不良症(DMD)男童的基因型和诊断年龄。

Genotype and age at diagnosis in Thai boys with Duchenne muscular dystrophy (DMD).

机构信息

Division of Neurology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Division of Medical Genetics Research and Laboratory, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Neuromuscul Disord. 2020 Oct;30(10):839-844. doi: 10.1016/j.nmd.2020.09.003. Epub 2020 Sep 8.

Abstract

Gene-based therapy is a treatment for Duchenne muscular dystrophy (DMD) has become lately available; limited use for specific of mutation and percentages of the patients. Diagnosis in Thailand is made by muscle biopsy or multiplex ligation-dependent probe amplification (MLPA). Appropriate treatment in developing countries is difficult because gene sequencing is expensive and has limited availability. We aimed to identify the clinical and genetic characteristics of Thai DMD. Patients aged 0-22 years were recruited from the pediatric neuromuscular clinic of Siriraj Hospital during 2017-2019. Ninety-four charts were reviewed for clinical and laboratory data. Patients with negative MLPA who underwent next generation sequencing were consented. The mean age at onset and diagnosis was 4 and 7 years, respectively. Approximately 70% of patients had loss of ambulation by the mean age of 9.6 ± 1.8 years. Eighty percent were treated with glucocorticoids. Genetic testing was performed in 70 patients. Molecular analysis revealed mutations in 90% of cases, including exon deletions in 48.57%, nonsense mutations in 20%, frameshift mutations in 12.86%, splice site in 7.14%, exon duplications in 5.71%, and in-frame deletion in 2.86%. Gene sequencing should be performed because baseline genetic mutation data is essential for gene-based therapies that will become available in the future.

摘要

基因治疗是最近可用的杜氏肌营养不良症(DMD)的一种治疗方法;但仅对特定的突变和患者的一定比例有效。泰国的诊断方法是通过肌肉活检或多重连接依赖性探针扩增(MLPA)进行。由于基因测序昂贵且可用性有限,发展中国家的适当治疗较为困难。我们旨在确定泰国 DMD 的临床和遗传特征。2017 年至 2019 年期间,我们从 Siriraj 医院儿科神经肌肉诊所招募了年龄在 0-22 岁的患者。我们对 94 份图表进行了临床和实验室数据的回顾。对经 MLPA 检测为阴性但接受下一代测序的患者征得同意。发病和诊断的平均年龄分别为 4 岁和 7 岁。大约 70%的患者在平均年龄为 9.6±1.8 岁时失去了行走能力。80%的患者接受了糖皮质激素治疗。对 70 名患者进行了基因检测。分子分析显示 90%的病例存在突变,包括 48.57%的外显子缺失、20%的无义突变、12.86%的移码突变、7.14%的剪接位点突变、5.71%的外显子重复和 2.86%的框内缺失。应该进行基因测序,因为基线遗传突变数据对于未来即将出现的基因治疗方法至关重要。

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