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16个中国家庭的Alport综合征基因诊断

Genetic diagnosis of Alport syndrome in 16 Chinese families.

作者信息

Xiao Tangli, Zhang Jun, Liu Li, Zhang Bo

机构信息

Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China.

出版信息

Mol Genet Genomic Med. 2024 Mar;12(3):e2406. doi: 10.1002/mgg3.2406.

DOI:10.1002/mgg3.2406
PMID:38433557
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10910213/
Abstract

BACKGROUND

Alport syndrome (AS) is a genetically heterogeneous disorder resulting from mutations in the collagen IV genes COL4A3, COL4A4, and COL4A5. The genetic diagnosis of AS is very important to make precise diagnosis and achieve optimal outcomes.

METHODS

In this study, 16 Chinese families with suspected AS were recruited after pedigree analysis, and the clinical presentations were analyzed by a nephrologist. The genetic diagnosis was performed by whole-exome sequencing (WES) and the disease-causing variants were confirmed by Sanger sequencing.

RESULTS

The cohort of probands included seven men and nine women, with a mean age of 19.9 years. Pathological analysis showed slight-to-moderate mesangial proliferation, and thin basement membrane was the main findings. Pathogenic variants were revealed by WES in each family, and the co-segregation with renal presentation was confirmed by PCR. In addition, RT-PCR analysis showed that the intronic variant led to aberrant splicing.

CONCLUSION

Our findings expand the spectrum of AS gene variation, which will inform genetic diagnosis and add to the theoretical basis for the prevention of AS.

摘要

背景

Alport综合征(AS)是一种由IV型胶原基因COL4A3、COL4A4和COL4A5突变引起的遗传异质性疾病。AS的基因诊断对于做出准确诊断和取得最佳治疗效果非常重要。

方法

在本研究中,经系谱分析招募了16个疑似AS的中国家庭,由肾病学家分析其临床表现。通过全外显子组测序(WES)进行基因诊断,并通过桑格测序确认致病变异。

结果

先证者队列包括7名男性和9名女性,平均年龄为19.9岁。病理分析显示轻度至中度系膜增生,主要表现为基底膜变薄。WES在每个家庭中均发现了致病变异,并通过PCR证实其与肾脏表现的共分离。此外,逆转录聚合酶链反应(RT-PCR)分析表明内含子变异导致异常剪接。

结论

我们的研究结果扩展了AS基因变异谱,这将为基因诊断提供信息,并为AS的预防增添理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a7c/10910213/7236172fd028/MGG3-12-e2406-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a7c/10910213/7236172fd028/MGG3-12-e2406-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a7c/10910213/7236172fd028/MGG3-12-e2406-g001.jpg

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引用本文的文献

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Front Pediatr. 2024 Dec 23;12:1487927. doi: 10.3389/fped.2024.1487927. eCollection 2024.

本文引用的文献

1
Heterozygous Pathogenic and Variants (Autosomal Dominant Alport Syndrome) Are Common, and Not Typically Associated With End-Stage Kidney Failure, Hearing Loss, or Ocular Abnormalities.杂合致病性变异(常染色体显性遗传性阿尔波特综合征)很常见,且通常与终末期肾衰竭、听力损失或眼部异常无关。
Kidney Int Rep. 2022 Jun 7;7(9):1933-1938. doi: 10.1016/j.ekir.2022.06.001. eCollection 2022 Sep.
2
Alport Syndrome With Kidney Cysts Is Still Alport Syndrome.伴有肾囊肿的Alport综合征仍是Alport综合征。
Kidney Int Rep. 2021 Nov 9;7(2):339-342. doi: 10.1016/j.ekir.2021.11.004. eCollection 2022 Feb.
3
Approach to genetic testing to optimize the safety of living donor transplantation in Alport syndrome spectrum.
针对 Alport 综合征谱中活体供者移植安全性的遗传检测方法。
Pediatr Nephrol. 2022 Sep;37(9):1981-1994. doi: 10.1007/s00467-022-05430-7. Epub 2022 Jan 27.
4
Guidelines for Genetic Testing and Management of Alport Syndrome.《Alport 综合征的基因检测与管理指南》。
Clin J Am Soc Nephrol. 2022 Jan;17(1):143-154. doi: 10.2215/CJN.04230321. Epub 2021 Dec 20.
5
A disease-causing variant of COL4A5 in a Chinese family with Alport syndrome: a case series.COL4A5 致病变体导致的一个中国 Alport 综合征家系:病例系列报告
BMC Nephrol. 2021 Nov 13;22(1):380. doi: 10.1186/s12882-021-02585-7.
6
A Novel LMX1B Variant Identified in a Patient Presenting with Severe Renal Involvement and Thin Glomerular Basement Membrane.在一名出现严重肾脏受累及薄肾小球基底膜的患者中鉴定出一种新型的LMX1B变体。
Nephron. 2021;145(6):776-782. doi: 10.1159/000518423. Epub 2021 Aug 26.
7
Prevalence Estimates of Predicted Pathogenic Variants in a Population Sequencing Database and Their Implications for Alport Syndrome.人群测序数据库中预测致病性变异的流行率估计及其对 Alport 综合征的影响。
J Am Soc Nephrol. 2021 Sep;32(9):2273-2290. doi: 10.1681/ASN.2020071065. Epub 2021 Jun 18.
8
Uncovering Modifier Genes of X-Linked Alport Syndrome Using a Novel Multiparent Mouse Model.利用新型多亲小鼠模型揭示X连锁遗传性肾炎的修饰基因
J Am Soc Nephrol. 2021 Aug;32(8):1961-1973. doi: 10.1681/ASN.2020060777. Epub 2021 May 27.
9
Consensus statement on standards and guidelines for the molecular diagnostics of Alport syndrome: refining the ACMG criteria.关于 Alport 综合征分子诊断标准和指南的共识声明:完善 ACMG 标准。
Eur J Hum Genet. 2021 Aug;29(8):1186-1197. doi: 10.1038/s41431-021-00858-1. Epub 2021 Apr 15.
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Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults-an update for 2020.临床实践推荐:儿童、青少年及青年 Alport 综合征的诊断与管理——2020 年更新。
Pediatr Nephrol. 2021 Mar;36(3):711-719. doi: 10.1007/s00467-020-04819-6. Epub 2020 Nov 6.