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[因TMEM237基因变异导致的Joubert综合征家系的表型和基因型分析]

[Phenotype and genotype analysis of a pedigree affected with Joubert syndrome due to variant of TMEM237 gene].

作者信息

Cui Shandan, Lou Haijuan, Yin Haijun, Geng Fangfang, Li Ning, Ma Lirong

机构信息

Prenatal Diagnosis Center, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010010, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 Dec 10;38(12):1211-1215. doi: 10.3760/cma.j.cn511374-20201015-00722.

Abstract

OBJECTIVE

To explore the pathogenesis of two siblings (including a fetus) from a pedigree affected with Joubert syndrome.

METHODS

Peripheral blood samples of the proband and his parents as well as amniotic fluid and abortion tissues of the fetus were collected. Part of the samples were used for the extraction of DNA, and whole exome sequencing (WES) was carried out to screen potential variants in the proband and his parents. Suspected variants were subjected to bioinformatics analysis with consideration of the clinical phenotype, and were verified by Sanger sequencing of the proband, fetus and their parents.The remainders were used for the extraction of RNA, and the mechanism of splicing variant was validated by reverse transcription-PCR (RT-PCR).

RESULTS

WES showed that both patients have carried c.175C>T (p.R59X) and c.553+1G>A compound heterozygous variants of the TMEM237 gene. Among these, c.175C>T was a nonsense mutation inherited from the asymptomatic mother, while c.553+1G>A was an alternative splicing mutation inherited from the asymptomatic father. RT-PCR showed that this variant has resulted in aberrant splicing by exon skipping.

CONCLUSION

The compound heterozygous variants of the TMEM237 gene probably underlay the etiology of Joubert syndrome in this pedigree. Above finding has enriched the phenotype and variant spectrum of the TMEM237 gene, and facilitated genetic counseling and prenatal diagnosis for the family.

摘要

目的

探究一个患有Joubert综合征家系中两名同胞(包括一名胎儿)的发病机制。

方法

采集先证者及其父母的外周血样本以及胎儿的羊水和流产组织。部分样本用于DNA提取,进行全外显子组测序(WES)以筛查先证者及其父母中的潜在变异。对疑似变异进行生物信息学分析并结合临床表型,通过对先证者、胎儿及其父母进行Sanger测序进行验证。其余样本用于RNA提取,通过逆转录聚合酶链反应(RT-PCR)验证剪接变异的机制。

结果

WES显示两名患者均携带TMEM237基因的c.175C>T(p.R59X)和c.553+1G>A复合杂合变异。其中,c.175C>T是从无症状母亲遗传而来的无义突变,而c.553+1G>A是从无症状父亲遗传而来的选择性剪接突变。RT-PCR显示该变异通过外显子跳跃导致异常剪接。

结论

TMEM237基因的复合杂合变异可能是该家系中Joubert综合征的病因。上述发现丰富了TMEM237基因的表型和变异谱,有助于该家庭的遗传咨询和产前诊断。

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