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原发性纤毛运动障碍:双DNAH11突变等位基因病例报告

Primary ciliary dyskinesia: a case report of double DNAH11 mutant alleles.

作者信息

Pîrlog Lorin-Manuel, Pătrăşcanu Andrada-Adelaida, Kutasi Eniko, Iordănescu Irina, Militaru Mariela Sanda

机构信息

Department of Molecular Sciences, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Regional Laboratory Bucharest, Department of Medical Genetics, Regina Maria Health Network, Bucharest, Romania.

出版信息

Med Pharm Rep. 2025 Apr;98(2):252-256. doi: 10.15386/mpr-2743. Epub 2025 Apr 29.

Abstract

Primary ciliary dyskinesia (PCD), a rare disorder, is genetically varied. Mutations in proteins involved in the structure, function, or assembly of cilia are known to determine situs inversus, male infertility, and chronic destructive airway disease. PCD is inherited by an autosomal recessive pattern of inheritance in most cases. Nonetheless, patterns of autosomal dominant and X-linked inheritance have been mentioned. A history of recurrent upper and lower respiratory tract infections raised clinical suspicion of primary ciliary dyskinesia in a 10-year-old patient. Genetic tests were performed using next-generation sequencing technology (Illumina NextGen) with the multiplex ligation-dependent probe amplification technique for primary ciliopathies and syndromes subject to differential diagnosis. Genetic testing identified two pathogenic variants, not previously associated with a case report in the literature, c.7727A>G (p.Asp2576Gly) and c.8578G>A (p.Gly2860Ser), within the , which is associated with autosomal recessive PCD. The result also reported mutations in other genes involved in autosomal recessive PCD (, and ), which were classified as variants with uncertain clinical significance. Transmission electron microscopy of respiratory cilia and nasal nitric oxide measurement cannot be used to diagnose PCD in patients with mutations because the structure of cilia is normal, and the levels of NO are not constantly low. High-speed video microscopy analysis can be helpful because mutations cause a distinct phenotype of PCD. Nevertheless, the mutation analysis of various PCD-causing genes remains the easiest to conduct and with good results. Genetic research on PCD has identified a number of significant ciliary genes in recent years, offering fresh perspectives on the molecular processes underlying cilia assembly and function. This facilitates the development of new methods for the diagnosis, prevention, and treatment of PCD. However, because it is a highly complex and heterogeneous disease, the field of gene diagnosis and therapy in PCD is still in its infancy.

摘要

原发性纤毛运动障碍(PCD)是一种罕见疾病,具有遗传异质性。已知参与纤毛结构、功能或组装的蛋白质发生突变会导致内脏反位、男性不育和慢性进行性气道疾病。在大多数情况下,PCD以常染色体隐性遗传模式遗传。尽管如此,也有常染色体显性和X连锁遗传模式的相关报道。一名10岁患者反复出现上、下呼吸道感染病史,这引发了临床对原发性纤毛运动障碍的怀疑。使用下一代测序技术(Illumina NextGen)和用于原发性纤毛病及需鉴别诊断的综合征的多重连接依赖探针扩增技术进行了基因检测。基因检测在与常染色体隐性PCD相关的 内鉴定出两个此前文献中未与病例报告相关联的致病变体,即c.7727A>G(p.Asp2576Gly)和c.8578G>A(p.Gly2860Ser)。结果还报告了其他参与常染色体隐性PCD的基因( 、 和 )中的突变,这些突变被归类为临床意义不确定的变体。由于纤毛结构正常且一氧化氮(NO)水平并非持续降低,因此呼吸纤毛的透射电子显微镜检查和鼻一氧化氮测量不能用于诊断具有 突变的患者的PCD。高速视频显微镜分析可能会有帮助,因为 突变会导致PCD出现独特的表型。然而,对各种导致PCD的基因进行突变分析仍然是最容易进行且效果良好的方法。近年来,关于PCD的基因研究已经鉴定出许多重要的纤毛基因,为纤毛组装和功能的分子过程提供了新的视角。这有助于开发诊断、预防和治疗PCD的新方法。然而,由于PCD是一种高度复杂且异质性的疾病,PCD的基因诊断和治疗领域仍处于起步阶段。

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