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IgA 肾病中的新 COL4A5 突变。

New COL4A5 mutation in IgA nephropathy.

机构信息

Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.

Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Postgrad Med J. 2022 Jan;98(1155):13-17. doi: 10.1136/postgradmedj-2020-138625. Epub 2020 Oct 21.

Abstract

PURPOSE

IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis and a leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Recently, some case reports have shown that mutation is associated with IgAN. Here, we identified a new gene mutation in IgAN in a Chinese family.

MATERIALS AND METHODS

In the present study, the proband and his 23-year-old younger brother were both diagnosed with IgAN, manifested as haematuria, proteinuria and chronic kidney injury without hearing loss or ocular symptoms. Additionally, the proband's 30-year-old younger brother, also diagnosed with ESKD, had been undergoing dialysis for 2 years with normal hearing and eyesight. To exclude genetic disease, we conducted whole-exome sequencing and Sanger sequencing assays.

RESULTS

We found a new mutation in the gene (chrX:107 814 698, c.438+2->AAACCAATTATA-), a novel insertion mutation. Using vector transcription and Minigene transcriptional analyses, we verified, for the first time, the novel mutation pathogenicity of the gene.

CONCLUSION

Together with other published data, we suggest that genetic screening should be performed in IgAN, particularly for patients with a familial history. The effects of different mutated splice sites of the gene, as well as the tissue specificity of the splicing machinery contributing to the pathogenesis and prognosis of IgAN, remains unclear and warrants further exploration in the future.

摘要

目的

IgA 肾病(IgAN)是最常见的原发性肾小球肾炎类型,也是慢性肾脏病(CKD)和终末期肾病(ESKD)的主要原因。最近,一些病例报告表明, 突变与 IgAN 有关。在这里,我们在一个中国家庭中鉴定出 IgAN 的一种新的 基因突变。

材料和方法

在本研究中,先证者和他 23 岁的弟弟均被诊断为 IgAN,表现为血尿、蛋白尿和慢性肾损伤,无听力损失或眼部症状。此外,先证者 30 岁的弟弟也被诊断为 ESKD,已接受透析 2 年,听力和视力正常。为排除遗传疾病,我们进行了全外显子组测序和 Sanger 测序分析。

结果

我们发现了一个 基因(chrX:107814698,c.438+2->AAACCAATTATA-)中的新突变,这是一种新的插入突变。通过载体转录和 Minigene 转录分析,我们首次验证了 基因的新突变致病性。

结论

结合其他已发表的数据,我们建议对 IgAN 进行遗传筛查,特别是对有家族史的患者。不同 基因突变剪接位点的影响,以及参与 IgAN 发病机制和预后的剪接机制的组织特异性,尚不清楚,值得未来进一步探索。

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