Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
The Children's hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
QJM. 2024 Aug 1;117(8):566-573. doi: 10.1093/qjmed/hcae038.
Fabry disease (FD) is a rare X-linked inherited disease caused by mutations in the galactosidase alpha (GLA) gene. We established a cohort of FD patients and performed whole-exome sequencing to identify some novel mutations.
The aim of this study is to investigate the etiology of the novel mutation (c.72G > A, p. Trp24*)in the GLA gene in affected patients by using induced pluripotent stem cells (iPSCs) as a valuable tool.
We explored the clinical implications of this proband and examined the deleteriousness and conservation of the mutation site through bioinformatics analysis. Simultaneously, we collected the peripheral blood mononuclear cells of the affected patient, then reprogrammed them into iPSCs and assessed their enzymatic activity to confirm the function of lysosomal enzyme α-galactosidase A (α-Gal A).
Clinical examination of the patient demonstrated a classical FD, such as neuropathic pain, gastrointestinal disorders, deficiency of α-Gal A activity and accumulation of Lyso-Gb-3. The novel mutation located on the N-terminal region, leading to a truncation of the protein and remaining only 24 amino acids. The α-Gal A activity of the patient-specific iPSC (iPS-FD) was significantly lower (60%) than that of normal iPSCs derived from healthy donors (iPS-B1).
This work not only elucidated the etiology of novel mutations in affected patients but also highlighted the utility of iPSCs as a valuable tool for clarifying the molecular mechanisms and providing new insights into the therapy of FD.
法布里病(FD)是一种罕见的 X 连锁遗传性疾病,由半乳糖苷酶α(GLA)基因突变引起。我们建立了 FD 患者队列,并进行了全外显子组测序以鉴定一些新的突变。
本研究旨在通过诱导多能干细胞(iPSC)作为有价值的工具,研究 GLA 基因中新突变(c.72G > A,p.Trp24*)在受影响患者中的病因。
我们探讨了该先证者的临床意义,并通过生物信息学分析研究了突变位点的有害性和保守性。同时,我们收集了受影响患者的外周血单核细胞,将其重编程为 iPSC,并评估其酶活性,以确认溶酶体酶α-半乳糖苷酶 A(α-Gal A)的功能。
对患者的临床检查显示出典型的 FD,如神经痛、胃肠道疾病、α-Gal A 活性缺乏和 Lyso-Gb-3 积累。新突变位于 N 端区域,导致蛋白截断,仅留下 24 个氨基酸。患者特异性 iPSC(iPS-FD)的 α-Gal A 活性明显低于健康供体来源的正常 iPSC(iPS-B1)(60%)。
这项工作不仅阐明了受影响患者新突变的病因,还强调了 iPSC 作为阐明分子机制和为 FD 治疗提供新见解的有价值工具的用途。