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一小群遗传性大疱性表皮松解症患者的临床和等位基因异质性

Clinical and Allelic Heterogeneity in a Small Cohort of Patients with Inherited Epidermolysis Bullosa.

作者信息

Buianova Anastasiia A, Yagizarova Anastasia S, Kosykh Anastasiya V, Kubanov Alexey A, Belova Vera A, Shmitko Anna O, Karamova Arfenya E, Martynova Aleksandra A, Podmoskovnikov Grigoriy S, Nefedova Maria A, Monchakovskaya Ekaterina S, Korostin Dmitriy O, Gurskaya Nadya G, Rebrikov Denis V

机构信息

Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Pirogov Russian National Research Medical University, 1, bld. 1, Ostrovityanova St., Moscow 117513, Russia.

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare, 4, Oparin St., Moscow 117198, Russia.

出版信息

Int J Mol Sci. 2025 Jun 16;26(12):5762. doi: 10.3390/ijms26125762.

Abstract

Inherited epidermolysis bullosa (EB) comprises a group of genetic disorders characterized by fragile skin that blisters easily. Targeted therapies for EB necessitate personalized approaches, underscoring the importance of precise diagnostics through genetic analysis and skin biopsy using transmission electron microscopy and/or immunohistochemistry. This study highlights the application of whole-exome sequencing (WES) to identify key pathogenic variants associated with EB. Most identified variants were associated with the recessive form of dystrophic EB, including four novel mutations: p.Leu1488ArgfsTer222, c.7759-3C>G, p.Gln1886Ter, and c.6501+6T>C, as well as recurrent variants p.Lys142Arg and p.Gly2049Glu. Additionally, variants were detected in (c.971T>C, p.Val324Ala), associated with EB simplex, and in (c.2500C>T, p.Gln834Ter) in the homozygous state, associated with junctional EB. In silico splice prediction tools suggested disrupted splicing in both cases. One patient received topical gentamicin therapy targeting the nonsense mutation p.Gln1886Ter. These findings underscore the utility of WES in EB diagnostics, broaden the mutation spectrum, and contribute to the understanding of genotype-phenotype correlations in adult patients with EB.

摘要

遗传性大疱性表皮松解症(EB)是一组遗传性疾病,其特征是皮肤脆弱,容易起泡。针对EB的靶向治疗需要个性化方法,这突出了通过基因分析以及使用透射电子显微镜和/或免疫组织化学进行皮肤活检来进行精确诊断的重要性。本研究强调了全外显子组测序(WES)在识别与EB相关的关键致病变异中的应用。大多数鉴定出的变异与营养不良性EB的隐性形式相关,包括四个新突变:p.Leu1488ArgfsTer222、c.7759-3C>G、p.Gln1886Ter和c.6501+6T>C,以及复发性变异p.Lys142Arg和p.Gly2049Glu。此外,在与单纯性EB相关的(c.971T>C,p.Val324Ala)以及与交界性EB相关的纯合状态的(c.2500C>T,p.Gln834Ter)中检测到变异。计算机剪接预测工具表明在这两种情况下剪接均被破坏。一名患者接受了针对无义突变p.Gln1886Ter的局部庆大霉素治疗。这些发现强调了WES在EB诊断中的实用性,拓宽了突变谱,并有助于理解成年EB患者的基因型-表型相关性。

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