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[两个中国1型呼吸窘迫型脊髓性肌萎缩症家系的变异分析及产前诊断]

[Variant analysis and prenatal diagnosis for two Chinese pedigrees affected with Spinal muscular atrophy with respiratory distress type 1].

作者信息

Li Huijun, Zhu Xiangyu, Yang Ying, Wu Xing, Li Jie

机构信息

Center for Obstetrics and Gynecology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2024 Feb 10;41(2):167-173. doi: 10.3760/cma.j.cn511374-20221223-00886.

Abstract

OBJECTIVE

To explore the genetic etiology of two children with Spinal muscular atrophy with respiratory distress type 1 (SMARD1), and prevent the recurrence of birth defects.

METHODS

Two unrelated families who had visited the Obstetrics and Gynecology Medical Center of Drum Tower Hospital from August to November 2021 were selected as the study subjects. Copy number of SMN1 gene exon 7 for the probands and their parents was detected by multiple ligation-dependent probe amplification (MLPA). and whole exome sequencing (WES) was carried out to screen the variants in the probands. Sanger sequencing was used to validate the variants within the families. Pathogenicity of the variants were predicted by bioinformatic analysis. Based on the results, prenatal diagnosis was performed for the fetuses.

RESULTS

Both probands were found to harbor compound heterozygous variants of the IGHMBP2 gene, which were inherited from their parents. Among these, c.1144C>T, c.866delG and c.1666C>G were previously unreported and respectively classified as pathogenic variant (PVS1+PM2_Supporting+PP3+PP4), likely pathogenic variant (PM1+PM2_Supporting+PM4+PP3+PP4) and likely pathogenic variant (PM1+PM2_Supporting+PP2+PP3+PP4) based on the ACMG guidelines. Through preimplantation genetic testing for monogenic (PGT-M) and interventional prenatal diagnosis, transmission of the variants within the families was successfully blocked.

CONCLUSION

The SMARD1 in both children may be attributed to the compound heterozygous variants of the IGHMBP2 gene, which has facilitated the genetic diagnosis and counselling, and provided reference for delineating the molecular pathogenesis of this disease.

摘要

目的

探讨2例1型脊髓性肌萎缩伴呼吸窘迫(SMARD1)患儿的遗传病因,预防出生缺陷的再次发生。

方法

选取2021年8月至11月就诊于鼓楼医院妇产科医疗中心的2个无关家庭作为研究对象。采用多重连接依赖探针扩增技术(MLPA)检测先证者及其父母的SMN1基因外显子7的拷贝数,并对先证者进行全外显子测序(WES)以筛选变异。采用Sanger测序对家系中的变异进行验证。通过生物信息学分析预测变异的致病性。根据结果对胎儿进行产前诊断。

结果

2例先证者均发现携带IGHMBP2基因的复合杂合变异,且均遗传自其父母。其中,c.1144C>T、c.866delG和c.1666C>G此前未见报道,根据美国医学遗传学与基因组学学会(ACMG)指南分别被分类为致病变异(PVS1+PM2_Supporting+PP3+PP4)、可能致病变异(PM1+PM2_Supporting+PM4+PP3+PP4)和可能致病变异(PM1+PM2_Supporting+PP2+PP3+PP4)。通过单基因病胚胎植入前遗传学检测(PGT-M)和介入性产前诊断,成功阻断了家系中变异的传递。

结论

2例患儿的SMARD1可能归因于IGHMBP2基因的复合杂合变异,这有助于进行遗传诊断和遗传咨询,并为阐明该疾病的分子发病机制提供了参考。

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