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39 例中国人糖原贮积病 I、VI 和 IX 型的基因型和表型特征。

Genotypic and phenotypic features of 39 Chinese patients with glycogen storage diseases type I, VI, and IX.

机构信息

Gastroenterology Department, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Grandomics Biosciences, Beijing, China.

出版信息

Clin Genet. 2024 Sep;106(3):267-276. doi: 10.1111/cge.14530. Epub 2024 Apr 5.

Abstract

Glycogen storage diseases (GSDs) are abnormally inherited glycogen metabolism mainly affecting the liver, muscles, and heart. Deficiency of proteins involved in glycogen metabolism caused by genetic mutations are responsible for different subtype of GSDs. However, there are still some challenges in diagnosing GSD. This study includes 39 suspected GSDs patients from unrelated families in China. Next-generation sequencing (NGS) was used to investigate the reason for their diseases at the genetic level. Finally, all 39 patients were diagnosed with GSDs, including 20 GSD-Ia, 4 GSD-VI, and 15 GSD IX (12 GSD-IXa patients and 3 GSD-IXb patients). Thirty-two mutations in G6PC1, PYGL, PHKA2, and PHKB genes were identified, with 14 of them being novel variants. The pathogenicity of novel variants was classified according to ACMG guildlines and predicted by in slico algorithms. Mutations p.L216L and p.R83H in G6PC1 gene may be the hot spot mutation in Chinese. Hearing impairment is a rare clinical feature of GSD Ia, which has also been observed in our cohort. The severity of GSD VI and IX was indicated by our patients. Close follow-up should be applied to GSD VI and IX patients. Our findings provided evidence for building the phenotype-genotype of GSDs and expanded the mutation spectrum of related genes.

摘要

糖原贮积病(GSDs)是一种异常遗传性糖原代谢疾病,主要影响肝脏、肌肉和心脏。基因突变导致参与糖原代谢的蛋白质缺乏,导致不同亚型的 GSDs。然而,在诊断 GSD 方面仍然存在一些挑战。本研究纳入了 39 名来自中国无关家庭的疑似 GSD 患者。采用下一代测序(NGS)技术从遗传水平上调查其疾病的原因。最终,所有 39 名患者均被诊断为 GSDs,包括 20 名 GSD-Ia、4 名 GSD-VI 和 15 名 GSD-IX(12 名 GSD-IXa 患者和 3 名 GSD-IXb 患者)。共鉴定出 G6PC1、PYGL、PHKA2 和 PHKB 基因中的 32 个突变,其中 14 个为新变异。根据 ACMG 指南对新变异的致病性进行分类,并通过在 slico 算法进行预测。G6PC1 基因中的 p.L216L 和 p.R83H 突变可能是中国人中的热点突变。听力损伤是 GSD Ia 的罕见临床特征,在我们的队列中也观察到了这种情况。我们的患者表明 GSD VI 和 IX 的严重程度。应密切随访 GSD VI 和 IX 患者。我们的发现为建立 GSDs 的表型-基因型提供了证据,并扩展了相关基因的突变谱。

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