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智利因先天性甲状腺功能减退症导致的甲状腺激素合成障碍患者中 基因突变的频率。

Frequency of Mutations in the Gene in Patients with Congenital Hypothyroidism Due to Dyshormonogenesis in Chile.

机构信息

Programa de Genética Humana, Institute of Biomedical Science (ICBM), Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile.

Vicerectoria de Investigación e Innovación, Universidad Arturo Prat, Iquique 1110939, Chile.

出版信息

Medicina (Kaunas). 2024 Jul 16;60(7):1145. doi: 10.3390/medicina60071145.

Abstract

: Congenital thyroid dyshormonogenesis is caused by alterations in the synthesis of thyroid hormones in a newborn. Additionally, 10 to 20% of these cases are hereditary, caused by defects in proteins involved in hormonal synthesis. One of the most common causes is mutations in the thyroid peroxidase (TPO) enzyme gene, an autosomal recessive disease. We aimed to detect mutations of the gene in 12 Chilean patients with congenital hypothyroidism due to dyshormonogenesis (CHD) and to characterize these patients clinically and molecularly. : Twelve patients under 20 years of age with CHD, controlled at San Juan de Dios Hospital in Santiago, Chile, were selected according to the inclusion criteria: elevated neonatal TSH, persistent hypothyroidism, and thyroid normotopic by imaging study. Those with deafness, Down syndrome, and central or transient congenital hypothyroidism were excluded. Blood samples were taken for DNA extraction, and the 17 exons and exon-intron junctions of the gene were amplified by PCR. The PCR products were sequenced by Sanger. : Two possibly pathogenic mutations of the gene were detected: c.2242G>A (p.Val748Met) and c.1103C>T (p.Pro368Leu). These mutations were detected in 2 of 12 patients (16.6%): 1 was compound heterozygous c.1103C>T/c.2242G>A, and the other was heterozygous for c.2242G>A. In the diagnostic confirmation test, both patients presented diffuse hyper-uptake goiter on thyroid scintigraphy and high TSH in venous blood (>190 uIU/mL). : The frequency of patients with possibly pathogenic mutations in with CHD was 16.6%. Its study would allow for genetic counseling to be offered to the families of affected patients.

摘要

先天性甲状腺功能减退症是由新生儿甲状腺激素合成异常引起的。此外,这些病例中有 10%到 20%是遗传性的,是由激素合成相关蛋白的缺陷引起的。最常见的原因之一是甲状腺过氧化物酶(TPO)酶基因的突变,这是一种常染色体隐性疾病。我们旨在检测 12 例智利先天性甲状腺功能减退症(CHD)患者中基因的突变,并对这些患者进行临床和分子特征分析。

我们选择了 12 例在智利圣地亚哥的 San Juan de Dios 医院接受 CHD 治疗的年龄在 20 岁以下的患者,根据纳入标准入选:新生儿 TSH 升高、持续性甲状腺功能减退症和影像学研究提示甲状腺正常位置。排除患有耳聋、唐氏综合征和中枢或暂时性先天性甲状腺功能减退症的患者。采集血样提取 DNA,通过 PCR 扩增基因的 17 个外显子和外显子-内含子接头。通过 Sanger 测序对 PCR 产物进行测序。

我们检测到了基因的两个可能致病的突变

c.2242G>A(p.Val748Met)和 c.1103C>T(p.Pro368Leu)。这两种突变在 12 例患者中的 2 例(16.6%)中发现:1 例为复合杂合子 c.1103C>T/c.2242G>A,另 1 例为杂合子 c.2242G>A。在诊断确认试验中,两名患者的甲状腺闪烁扫描均表现为弥漫性高摄取性甲状腺肿,静脉血 TSH 升高(>190 uIU/mL)。

患有 CHD 的患者中可能存在致病突变的频率为 16.6%。对其进行研究可以为受影响患者的家属提供遗传咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6c2/11279067/3cf17837bec4/medicina-60-01145-g002.jpg

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