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69例USH2A基因突变中国患者的基因型与表型相关性:Usher综合征与非综合征性视网膜色素变性患者的比较研究

Correlation between Genotype and Phenotype in 69 Chinese Patients with USH2A Mutations: A comparative study of the patients with Usher Syndrome and Nonsyndromic Retinitis Pigmentosa.

作者信息

Meng Xiang, Liu XiaoZhen, Li YingYing, Guo Tong, Yang Liping

机构信息

Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China.

出版信息

Acta Ophthalmol. 2021 Jun;99(4):e447-e460. doi: 10.1111/aos.14626. Epub 2020 Oct 29.

Abstract

PURPOSE

The aim of this study was to analyse 69 Chinese patients with USH2A mutations and to assess the genotype-phenotype correlation.

METHODS

All 36 Usher syndrome type IIA patients and 33 nonsyndromic RP (retinitis pigmentosa) patients underwent clinical examinations. Eye examinations included best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination with dilated pupils, fundus fluorescent angiography, visual field test, full-field electroretinography and optic coherence tomography; audiological assessment included pure tone audiometry and hearing thresholds. The molecular diagnosis of genotype combined the single-gene Sanger sequencing and next-generation sequencing. This study is a retrospective study.

RESULTS

The mean age of first symptoms with Usher syndrome type IIa and nonsyndromic RP patients was 13.7 versus 29.8 years (ocular phenotypes, p < 0.001); 17.7 versus 29.9 years (nyctalopia, p < 0.001); 44.7 versus 54.8 years (low vision based on VF, p < 0.001); 41.7 versus 54.7 years (low vision based on VA, p < 0.001); and 46.0 versus 56.7 years (legal blindness based on VF, p < 0.001). There was significant difference in variants in the two groups (p < 0.05). Among patients with mutation c.2802T > G (p.Cys934Trp), more (66.7%) presented with normal hearing. All patients (3/3, 100%) with the variant c.8232G > C (p.Trp2744Cys) had hearing loss. Furthermore, we identified 23 novel variants in USH2A.

CONCLUSIONS

Patients with Usher syndrome type IIa had an earlier onset of the disease, inferior visual function and presented with more truncating variants, compared with the nonsyndromic RP patients.

摘要

目的

本研究旨在分析69例携带USH2A基因突变的中国患者,并评估基因型与表型的相关性。

方法

36例IIA型Usher综合征患者和33例非综合征性视网膜色素变性(RP)患者均接受了临床检查。眼部检查包括最佳矫正视力、裂隙灯显微镜检查、散瞳眼底检查、眼底荧光血管造影、视野检查、全视野视网膜电图和光学相干断层扫描;听力评估包括纯音听力测定和听力阈值。基因型的分子诊断结合了单基因桑格测序和下一代测序。本研究为回顾性研究。

结果

IIA型Usher综合征患者和非综合征性RP患者首次出现症状的平均年龄分别为13.7岁和29.8岁(眼部表型,p<0.001);17.7岁和29.9岁(夜盲,p<0.001);44.7岁和54.8岁(基于视野的低视力,p<0.001);41.7岁和54.7岁(基于视力的低视力,p<0.001);以及46.0岁和56.7岁(基于视野的法定盲,p<0.001)。两组患者的变异存在显著差异(p<0.05)。在携带c.2802T>G(p.Cys934Trp)突变的患者中,更多患者(66.7%)听力正常。所有携带c.8232G>C(p.Trp2744Cys)变异的患者(3/3,100%)均有听力损失。此外,我们在USH2A基因中鉴定出23个新变异。

结论

与非综合征性RP患者相比,IIA型Usher综合征患者发病更早,视觉功能较差,且出现更多截短变异。

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