Department of Paediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University, Apartment No.-E3, Total Tomiz, 41, Dilu Road, Ramna, Dhaka, 1000, Bangladesh.
Department of Anatomy, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000, Bangladesh.
Indian J Gastroenterol. 2022 Oct;41(5):456-464. doi: 10.1007/s12664-022-01276-x. Epub 2022 Oct 29.
BACKGROUND : Wilson disease (WD) is an autosomal recessive disorder caused by mutation in the Adenosine Triphosphate 7B (ATP7B) gene. The spectrum of ATP7B mutation varies in different populations. The objective of this study was to identify the mutation in exon 8 and exon 14 of ATP7B gene in Bangladeshi children clinically diagnosed as WD. We also aimed to explore the phenotypic presentation.
It was a cross sectional observational study. The study was conducted at the Department of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2017 to June 2018. A total of 37 patients diagnosed with WD were enrolled for the study. Venous blood (about 3 mL) was drawn aseptically from each patient into tube containing ethyline diamine tetraacetic acid (EDTA) and preserved at -30°C for long-term preservation. The peripheral blood leukocytes of the patients and genomic DNAs were extracted. Exons 14 and 8 of ATP7B and their associated splice-site junctions were amplified by the polymerase chain reaction (PCR). The size and quantity of PCR products were verified by electrophoresis in 1.5% (w/v) agarose gel. 74 (37 × 2) PCR products were sent for Sanger Sequencing. The sequences were analyzed by Chromas version 2.6.6 software and the nucleotide blast was done by National Center for Biotechnology Information (NCBI) nucleoblast. Finally, the sequences were analyzed using AB Applied Bio systems and were matched with the reference sequences using MEGA software.
In this study, a single novel homozygous mutation pLeu.1071Val in the exon 14 was found in every (100%) studied child clinically diagnosed with WD. Heterozygous mutation p.Gly1061Glu in exon14 was also found in 6 patients (11%) with WD, which is one of the common mutations in this disease. In exon 8, p.Arg778Leu mutation was detected in one patient (2.7%), which is common in the Chinese and the South Asian populations and was heterozygous. Two novel heterozygous missense mutations p.K785R (2.7%) and p.S744F (2.7%) were also found in two other children in the exon 8.
We found three novel mutations in Bangladeshi children with WD, one of which may be tagged as founder mutation for Bangladeshi population. This finding indicates the necessity to study the mutation profiles of the whole ATP7B gene in our population for risk prediction. A further large-scale study will help in the development of a Mutational Data Base of Bangladeshi population with WD.
本研究旨在鉴定孟加拉国临床诊断为 WD 儿童 ATP7B 基因外显子 8 和外显子 14 的突变,并探讨表型表现。
这是一项横断面观察性研究。该研究于 2017 年 1 月至 2018 年 6 月在孟加拉国达卡的班加班杜谢赫·穆吉布医科大学儿科胃肠病学系进行。共纳入 37 例临床诊断为 WD 的患者进行研究。无菌从每位患者抽取约 3 mL 静脉血至含乙二胺四乙酸 (EDTA) 的管中,并在-30°C 下保存以长期保存。提取患者外周血白细胞和基因组 DNA。采用聚合酶链反应 (PCR) 扩增 ATP7B 基因外显子 14 和 8 及其相关剪接接头。通过 1.5% (w/v) 琼脂糖凝胶电泳验证 PCR 产物的大小和数量。74(37×2)个 PCR 产物被送往 Sanger 测序。使用 Chromas 版本 2.6.6 软件分析序列,并通过美国国家生物技术信息中心 (NCBI) nucleoblast 进行核苷酸比对。最后,使用 AB Applied Bio systems 分析序列,并使用 MEGA 软件将序列与参考序列进行匹配。
本研究发现,在 37 例临床诊断为 WD 的患儿中,外显子 14 中发现了一种新的纯合突变 pLeu.1071Val,突变率为 100%。在 6 例 WD 患儿中还发现了外显子 14 中的杂合突变 p.Gly1061Glu,这是该病的常见突变之一。在第 8 外显子中,检测到 p.Arg778Leu 突变,突变率为 2.7%,这是中国人和南亚人群中常见的突变,为杂合突变。在另外 2 例患儿的第 8 外显子中还发现了 2 种新的杂合错义突变 p.K785R(2.7%)和 p.S744F(2.7%)。
我们在孟加拉国 WD 患儿中发现了 3 种新突变,其中一种可能被标记为孟加拉国人群的创始突变。这一发现表明,有必要在本地区研究整个 ATP7B 基因的突变谱,以进行风险预测。进一步的大规模研究将有助于建立孟加拉国 WD 人群的突变数据库。