Goyal Manisha, Gupta Ashok, Agarwal Kamlesh, Kapoor Seema, Kumar Somesh
Department of Pediatrics, SMS Medical College, Jaipur, Rajasthan, India.
Division of Genetics, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
Ann Indian Acad Neurol. 2021 Nov-Dec;24(6):873-878. doi: 10.4103/aian.AIAN_126_21. Epub 2021 Aug 20.
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive muscular dystrophy that affects young boys and is caused by mutation of the dystrophin gene located over X chromosome.
In this prospective study, 120 clinically diagnosed DMD patients were tested for exon deletions, duplication or point mutation.
Of the 120 clinically suspected DMD patients, the diagnosis of DMD was confirmed by the genetic study or muscle biopsy in 116 patients. The mean age of onset was 3.2 years and the mean age at presentation was 7.2 years. 110/120 cases were confirmed by genetic testing and six were by absence of staining for dystrophin on muscle biopsy. DMD gene deletion was present in 78.5%, duplication in 5.3% and point mutation in 11.2% cases. 70.3% of patients had deletion located at a distal hot spot region. Single exon deletion was found in 16.5%. Distal hotspot exons 47, 48 and 50 were the commonly deleted exons.
In our study, 94.8% cases showed genetic change in the DMD gene. Muscle biopsy was the choice of investigation in earlier days. Detection of DMD by DNA based method eliminates the need to do an invasive procedure for diagnosis. Hence the genetic testing should be the investigation of choice in suspected cases of DMD. The pattern of deletion, obtained in the population of Rajasthan was similar when compared with other ethnic groups of the Indian population. It would be helpful for researchers to develop drugs specific to exons or for ongoing mutation-specific therapies.
杜氏肌营养不良症(DMD)是一种X连锁隐性肌营养不良症,影响幼年男孩,由位于X染色体上的肌营养不良蛋白基因突变引起。
在这项前瞻性研究中,对120例临床诊断为DMD的患者进行外显子缺失、重复或点突变检测。
在120例临床疑似DMD患者中,116例通过基因研究或肌肉活检确诊为DMD。平均发病年龄为3.2岁,平均就诊年龄为7.2岁。120例中有110例通过基因检测确诊,6例通过肌肉活检中肌营养不良蛋白染色缺失确诊。78.5%的病例存在DMD基因缺失,5.3%为重复,11.2%为点突变。70.3%的患者缺失位于远端热点区域。16.5%发现单个外显子缺失。远端热点外显子47、48和50是常见的缺失外显子。
在我们的研究中,94.8%的病例显示DMD基因发生遗传改变。肌肉活检在早期是首选的检查方法。基于DNA的方法检测DMD无需进行侵入性诊断程序。因此,基因检测应是疑似DMD病例的首选检查方法。与印度其他种族群体相比,拉贾斯坦邦人群中获得的缺失模式相似。这将有助于研究人员开发针对外显子的药物或进行正在进行的针对特定突变的治疗。