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[两个中国Joubert综合征家系的临床特征与基因分析]

[Clinical features and genetic analysis of two Chinese pedigrees affected with Joubert syndrome].

作者信息

Zhao Dengzhi, Chu Yan, Yang Ke, Huo Xiaodong, Lei Xingxing, Yang Yanli, Zhang Chaoyang, Xiao Hai, Liao Shixiu

机构信息

Henan Provincial People's Hospital, Medical Genetics Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, National Health Commission Key Laboratory for Birth Defect Prevention, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan 450003, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2023 Jan 10;40(1):21-25. doi: 10.3760/cma.j.cn511374-20220122-00055.

Abstract

OBJECTIVE

To explore the clinical characteristics and genetic basis of two Chinese pedigrees affected with Joubert syndrome.

METHODS

Clinical data of the two pedigrees was collected. Genomic DNA was extracted from peripheral blood samples and subjected to high-throughput sequencing. Candidate variants were verified by Sanger sequencing. Prenatal diagnosis was carried out for a high-risk fetus from pedigree 2.

RESULTS

The proband of pedigree 1 was a fetus at 23 weeks gestation, for which both ultrasound and MRI showed "cerebellar vermis malformation" and "molar tooth sign". No apparent abnormality was noted in the fetus after elected abortion. The fetus was found to harbor c.812+3G>T and c.1828G>C compound heterozygous variants of the INPP5E gene, which have been associated with Joubert syndrome type 1. The proband from pedigree 2 had growth retardation, mental deficiency, peculiar facial features, low muscle tone and postaxial polydactyly of right foot. MRI also revealed "cerebellar dysplasia" and "molar tooth sign". The proband was found to harbor c.485C>G and c.1878+1G>A compound heterozygous variants of the ARMC9 gene, which have been associated with Joubert syndrome type 30. Prenatal diagnosis found that the fetus only carried the c.485C>G variant. A healthy infant was born, and no anomalies was found during the follow-up.

CONCLUSION

The compound heterozygous variants of the INPP5E and ARMC9 genes probably underlay the disease in the two pedigrees. Above finding has expanded the spectrum of pathogenic variants underlying Joubert syndrome and provided a basis for genetic counseling and prenatal diagnosis.

摘要

目的

探讨两个患有Joubert综合征的中国家系的临床特征和遗传基础。

方法

收集两个家系的临床资料。从外周血样本中提取基因组DNA并进行高通量测序。通过Sanger测序验证候选变异。对家系2中的高危胎儿进行产前诊断。

结果

家系1的先证者为一名孕23周的胎儿,超声和MRI均显示“小脑蚓部畸形”和“磨牙征”。选择性流产后胎儿未发现明显异常。该胎儿被发现携带INPP5E基因的c.812+3G>T和c.1828G>C复合杂合变异,这些变异与1型Joubert综合征相关。家系2的先证者有生长发育迟缓、智力缺陷、特殊面容、肌张力低下和右足轴后多指畸形。MRI也显示“小脑发育不全”和“磨牙征”。该先证者被发现携带ARMC9基因的c.485C>G和c.1878+1G>A复合杂合变异,这些变异与30型Joubert综合征相关。产前诊断发现胎儿仅携带c.485C>G变异。一名健康婴儿出生,随访期间未发现异常。

结论

INPP5E和ARMC9基因的复合杂合变异可能是这两个家系疾病的病因。上述发现扩展了Joubert综合征潜在致病变异的谱,为遗传咨询和产前诊断提供了依据。

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