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一种与2型长QT综合征相关的新型高穿透性内含子致病变异体。

A New High Penetrant Intronic Pathogenic Variant Related to Long QT Syndrome Type 2.

作者信息

Rodríguez-Junquera Manuel, Alén Alberto, González-Urbistondo Francisco, Rodríguez-Reguero José Julián, Fernández Bárbara, Álvarez-Velasco Rut, Vazquez-Coto Daniel, Vega-Prado Lorena M, Avanzas Pablo, Coto Eliecer, Gómez Juan, Lorca Rebeca

机构信息

Hospital Álvarez-Buylla, 33611 Mieres, Spain.

Área del Corazón, Hospital Universitario Central Asturias, 33011 Oviedo, Spain.

出版信息

J Clin Med. 2025 Jul 1;14(13):4646. doi: 10.3390/jcm14134646.

Abstract

: Long QT Syndrome type 2 (LQT2) is a cardiac channelopathy linked to pathogenic variants in the gene, which encodes the Kv11.1 potassium channel, essential for cardiac repolarization. Variants affecting splice sites disrupt potassium ion flow, prolong QT interval, and increase the risk of arrhythmias and sudden cardiac death (SCD). Understanding genotype-phenotype correlations is key, given the variability of clinical manifestations even within families sharing the same variant. We aimed to evaluate new pathogenic variants by analyzing genotype-phenotype correlations in informative families. : Genetic and clinical assessments were performed on index cases and family members carrying pathogenic variants, referred for genetic testing between 2010 and June 2023. The next-generation sequencing (NGS) of 210 cardiovascular-related genes was conducted. Clinical data, including demographic details, family history, arrhythmic events, electrocardiographic parameters, and treatments, were collected. : Among 390 patients (152 probands) tested for LQTS, only 2 variants had over 5 carriers. The detailed clinical information of 22 carriers of this p.Ser261fs. has already been reported by our research group. Moreover, we identified 12 carriers of the c.77-2del variant, predicted to disrupt a splice site and not previously reported. Segregation analysis showed its high penetrance, supporting its classification as pathogenic. : The newly identified c.77-2del variant is a pathogenic, as strongly supported by the segregation analysis. Our findings underscore the importance of further research into splice site variants to enhance clinical management and genetic counseling for affected families.

摘要

2型长QT综合征(LQT2)是一种心脏离子通道病,与基因中的致病变异有关,该基因编码对心脏复极至关重要的Kv11.1钾通道。影响剪接位点的变异会破坏钾离子流动,延长QT间期,并增加心律失常和心源性猝死(SCD)的风险。鉴于即使在携带相同变异的家族中临床表现也存在差异,了解基因型-表型相关性是关键。我们旨在通过分析信息丰富的家族中的基因型-表型相关性来评估新的致病变异。

对携带致病变异的索引病例和家庭成员进行了遗传和临床评估,这些病例在2010年至2023年6月期间被转诊进行基因检测。对210个心血管相关基因进行了下一代测序(NGS)。收集了临床数据,包括人口统计学细节、家族史、心律失常事件、心电图参数和治疗情况。

在390例接受LQTS检测的患者(152例先证者)中,只有2种变异有超过5名携带者。我们的研究小组已经报道了该p.Ser261fs变异的22名携带者的详细临床信息。此外,我们鉴定出12名c.77-2del变异的携带者,预计该变异会破坏一个剪接位点,且此前未被报道。分离分析显示其高外显率,支持将其分类为致病性变异。

新鉴定出的c.77-2del变异是致病性的,分离分析有力地支持了这一点。我们的研究结果强调了进一步研究剪接位点变异对于加强对受影响家族的临床管理和遗传咨询的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a425/12251465/61aa2bff2fb8/jcm-14-04646-g001.jpg

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