Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
J Hum Genet. 2022 Jul;67(7):427-440. doi: 10.1038/s10038-022-01020-5. Epub 2022 Feb 9.
Nephronophthisis is an autosomal-recessive kidney disease that is caused by abnormalities in primary cilia. Nephronophthisis-related ciliopathies (NPHP-RCs) are a common cause of end-stage kidney disease (ESKD) in children and adolescents. NPHP-RCs are often accompanied by extrarenal manifestations, including intellectual disability, retinitis pigmentosa, or polydactyly. Although more than 100 causative genes have been identified, its diagnosis is difficult because the clinical features of each mutation often overlap. From September 2010 to August 2021, we performed genetic analysis, including next-generation sequencing (NGS), in 574 probands with kidney dysfunction and retrospectively studied cases genetically diagnosed with NPHP-RCs. RESULTS: We detected mutations related to NPHP-RCs in 93 patients from 83 families. Members of 60 families were diagnosed using NGS, and the mutations and the corresponding number of families are as follows: NPHP1 (24), NPHP3 (10), OFD1 (7), WDR35 (5), SDCCAG8 (4), BBS10 (3), TMEM67 (3), WDR19 (3), BBS1 (2), BBS2 (2), IFT122 (2), IFT140 (2), IQCB1 (2), MKKS (2), SCLT1 (2), TTC21B (2), ALMS1 (1), ANKS6 (1), BBS4 (1), BBS12 (1), CC2D2A (1), DYNC2H1 (1), IFT172 (1), and MAPKBP1 (1). A total of 39 cases (41.9%) progressed to ESKD at the time of genetic analysis, whereas 58 cases (62.3%) showed extrarenal manifestations, the most common being developmental delay, intellectual disability, and autism spectrum disorder in 44 patients. Comprehensive genetic analysis using NGS is useful for diagnosing patients with NPHP-RCs.
常染色体隐性遗传的肾疾病,由初级纤毛异常引起。与肾单位发生相关的纤毛病(NPHP-RC)是儿童和青少年终末期肾病(ESKD)的常见原因。NPHP-RC 常伴有肾脏外表现,包括智力障碍、视网膜色素变性或多指(趾)畸形。尽管已经鉴定出 100 多个致病基因,但由于每种突变的临床特征经常重叠,因此其诊断仍然具有挑战性。从 2010 年 9 月至 2021 年 8 月,我们对 574 例肾功能障碍的患者进行了基因分析,包括下一代测序(NGS),并回顾性研究了基因诊断为 NPHP-RC 的病例。结果:我们在 83 个家系的 93 例患者中检测到与 NPHP-RC 相关的突变。60 个家系的成员使用 NGS 进行了诊断,突变及其对应的家系数如下:NPHP1(24)、NPHP3(10)、OFD1(7)、WDR35(5)、SDCCAG8(4)、BBS10(3)、TMEM67(3)、WDR19(3)、BBS1(2)、BBS2(2)、IFT122(2)、IFT140(2)、IQCB1(2)、MKKS(2)、SCLT1(2)、TTC21B(2)、ALMS1(1)、ANKS6(1)、BBS4(1)、BBS12(1)、CC2D2A(1)、DYNC2H1(1)、IFT172(1)和 MAPKBP1(1)。在基因分析时,共有 39 例(41.9%)进展为 ESKD,而 58 例(62.3%)表现出肾脏外表现,其中 44 例最常见的是发育迟缓、智力障碍和自闭症谱系障碍。使用 NGS 的综合基因分析有助于诊断 NPHP-RC 患者。