Grompe M, St-Louis M, Demers S I, al-Dhalimy M, Leclerc B, Tanguay R M
Department of Molecular and Medical Genetics, Oregon Health Sciences University, Portland 97201-3098.
N Engl J Med. 1994 Aug 11;331(6):353-7. doi: 10.1056/NEJM199408113310603.
Hereditary tyrosinemia type I is an autosomal recessive inborn error of metabolism caused by a deficiency of the enzyme fumarylacetoacetate hydrolase. The disorder clusters in the Saguenay-Lac-St.-Jean area of Quebec. In this region, 1 of 1846 newborns is affected and 1 of every 22 persons is thought to be a carrier. Recently, we identified a splice mutation and two nonsense mutations in the fumarylacetoacetate hydrolase gene in two patients from Quebec with tyrosinemia type I.
We used allele-specific-oligonucleotide hybridization to examine the frequency of these three candidate mutations in patients with tyrosinemia type I and in the population of Quebec.
The splice mutation was found in 100 percent of patients from the Saguenay-Lac-St.-Jean area and in 28 percent of patients from other regions of the world. Of 25 patients from the Saguenay-Lac-St.-Jean region, 20 (80 percent) were homozygous for this mutation, a guanine-to-adenine change in the splice-donor sequence in intron 12 of the gene, indicating that it causes most cases of tyrosinemia type I in the region. The frequency of carrier status, based on screening of blood spots from newborns, was about 1 per 25 in the Saguenay-Lac-St.-Jean population and about 1 per 66 overall in Quebec.
This study identified the most prevalent mutation causing hereditary tyrosinemia in French Canada; it also showed the feasibility of DNA-based testing for carriers in the population at risk.
遗传性I型酪氨酸血症是一种常染色体隐性遗传的先天性代谢缺陷病,由延胡索酰乙酰乙酸水解酶缺乏所致。该疾病在魁北克的萨格奈-圣让湖地区呈聚集性发病。在该地区,每1846名新生儿中就有1例患病,每22人中就有1人被认为是携带者。最近,我们在两名来自魁北克的I型酪氨酸血症患者的延胡索酰乙酰乙酸水解酶基因中发现了一个剪接突变和两个无义突变。
我们采用等位基因特异性寡核苷酸杂交技术,检测I型酪氨酸血症患者及魁北克人群中这三种候选突变的发生频率。
在来自萨格奈-圣让湖地区的所有患者中均发现了该剪接突变,在世界其他地区的患者中,该突变的发生率为28%。在来自萨格奈-圣让湖地区所有25例患者中,有20例(80%)为该突变的纯合子,该突变是基因第12号内含子剪接供体序列中的鸟嘌呤到腺嘌呤的改变,这表明它是该地区大多数I型酪氨酸血症的病因。基于新生儿血斑筛查,萨格奈-圣让湖地区人群中携带者状态的频率约为每25人中有1人,魁北克总体人群中约为每66人中有1人。
本研究确定了法裔加拿大人中导致遗传性酪氨酸血症最常见的突变;同时也表明了对高危人群进行基于DNA的携带者检测的可行性。