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[过去15年来自单一中心的杜氏/贝克型肌营养不良症中国家系的变异分析与治疗前景]

[Variant analysis and therapeutic prospect for Chinese pedigrees affected with Duchenne/Becker muscular dystrophy from a single center over the past 15 years].

作者信息

Zhong Xingjian, Liu Li'na, Kong Xiangdong

机构信息

Center of Genetic and Prenatal Diagnosis, Department of Gynecology and Obstetrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 May 10;38(5):425-429. doi: 10.3760/cma.j.cn511374-20200622-00460.

DOI:10.3760/cma.j.cn511374-20200622-00460
PMID:33974248
Abstract

OBJECTIVE

To summarize the result of genetic testing and therapeutic prospect of 2042 unrelated Chinese pedigrees affected with Duchenne/Becker muscular dystrophy (DMD/BMD) from a single center from 2005 to 2019.

METHODS

Peripheral blood samples of the pedigrees were collected for the detection of DMD gene variants with combined multiple ligation-dependent probe amplification (MLPA), next generation sequencing (NGS) and Sanger sequencing.

RESULTS

DMD and BMD have respectively accounted for 78.60% and 21.40% of the pedigrees, which included 33 female probands. Variants of the DMD gene were detected in 1986 pedigrees (97.26%). Large deletions, duplications and small-scale mutations have respectively accounted for 71.85%, 8.76% and 19.39%. Common deletions and duplications have included deletion of exons 45-50 and duplications of exon 2, while no hot spot was found with small-scale mutations. For 1595 pedigrees affected with DMD, 935 (58.62%) were hereditary and 660 (41.38%) were de novo in origin. 34.28% (700/2042) of the patients had symptoms which could be relieved by gene therapy.

CONCLUSION

This has been the largest single-center study of DMD pedigrees, which has attained definite diagnosis in 97.26% of the patients. The results have enabled genetic counseling and prenatal diagnosis for the affected families upon their subsequent pregnancies, enriched the spectrum of DMD gene variants, as well as facilitated study of the mechanism of DMD gene mutations and exploration of clinical treatment.

摘要

目的

总结2005年至2019年来自单一中心的2042个中国杜氏/贝克型肌营养不良症(DMD/BMD)无关家系的基因检测结果及治疗前景。

方法

采集家系的外周血样本,采用多重连接依赖探针扩增(MLPA)、二代测序(NGS)和桑格测序检测DMD基因变异。

结果

DMD和BMD家系分别占78.60%和21.40%,其中包括33名女性先证者。1986个家系(97.26%)检测到DMD基因变异。大片段缺失、重复和小尺度突变分别占71.85%、8.76%和19.39%。常见的缺失和重复包括外显子45 - 50缺失和外显子2重复,而小尺度突变未发现热点。1595个DMD家系中,935个(58.62%)为遗传性,660个(41.38%)为新发突变。34.28%(700/2042)的患者症状可通过基因治疗缓解。

结论

这是最大规模的DMD家系单中心研究,97.26%的患者获得明确诊断。研究结果可为受累家庭后续妊娠提供遗传咨询和产前诊断,丰富DMD基因变异谱,促进DMD基因突变机制研究及临床治疗探索。

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