Department of Neonatology, Hunan Children's Hospital, Changsha, Hunan, China.
Department of Laboratory Diagnosis, Changsha Kingmed Center for Clinical Laboratory, Changsha, Hunan, China.
Mol Genet Genomic Med. 2024 Jan;12(1):e2354. doi: 10.1002/mgg3.2354.
BACKGROUND: The genetic background of neonatal encephalopathy (NE) is complicated and early diagnosis is beneficial to optimizing therapeutic strategy for patients. METHODS: NE Patients with unclear etiology received regular clinical tests including ammonia test, metabolic screening test, amplitude-integrated electroencephalographic (aEEG) monitoring, brain Magnetic Resonance Imaging (MRI) scanning, and genetic test. The protein structure change was predicted using Dynamut2 and RoseTTAFold. RESULTS: 15 out of a total of 113 NE Patients were detected with newly reported pathogenic variants. In this sub-cohort, (1) seizure was the primary initial symptoms; (2) four patients had abnormal metabolic screening results, and two of them were also diagnosed with excessive blood ammonia concentration; (3) the brain MRI results were irregular in three infants and the brain waves were of moderate-severe abnormality in about a half of the patients. The novel pathogenic variants discovered in this study belonged to 12 genes, and seven of them were predicted to introduce a premature translation termination. In-silicon predictions showed that four variants were destructive to the protein structure of KCNQ2. CONCLUSION: Our study expands the mutation spectrum of genes associated with NE and introduces new evidence for molecular diagnosis in this newborn illness.
背景:新生儿脑病(NE)的遗传背景复杂,早期诊断有利于优化患者的治疗策略。
方法:病因不明的 NE 患者接受了常规临床检查,包括氨试验、代谢筛查试验、振幅整合脑电图(aEEG)监测、脑磁共振成像(MRI)扫描和基因检测。使用 Dynamut2 和 RoseTTAFold 预测蛋白质结构变化。
结果:在总共 113 名 NE 患者中,有 15 名患者检测到新报道的致病性变异。在这个亚组中:(1)癫痫是主要的初始症状;(2)有 4 名患者的代谢筛查结果异常,其中 2 名患者还被诊断为血氨浓度过高;(3)3 名婴儿的脑 MRI 结果不规则,约一半患者的脑电波中度至重度异常。本研究发现的新的致病性变异属于 12 个基因,其中 7 个被预测会导致提前终止翻译。硅内预测显示,有 4 个变异会破坏 KCNQ2 蛋白的结构。
结论:本研究扩展了与 NE 相关基因的突变谱,并为这种新生儿疾病的分子诊断提供了新的证据。
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