Vidal R, Miravitlles M, Jardí R, Torrella M, Rodríguez-Frías F, Moral P, Vaqué J
Servei de Pneumologia, Hospital General Universitari de la Vall d'Hebron, Barcelona.
Med Clin (Barc). 1996 Jul 6;107(6):211-4.
Severe alpha-1-antitrypsin (AAT) deficiency is caused by homozygous inheritance of gene Z, and is associated with a high risk of developing pulmonary emphysema. Determination of frequencies of different genes associated with the deficiency (especially S and Z) gives a clue to estimate the number of individuals homozygous PiZZ, carrying a high risk for pulmonary disease, in any given population.
Pi phenotypes of 440 healthy individuals were determined by means of isoelectrofocusing in polyacrylamide gel. Seric values of AAT were determined by immunonephelometry. Mean age of participants was 30 years (range 18-49 yrs.). Results are compared with other published series.
Distribution of phenotypes was: PiMM 333 individuals (75%), PiMS 84 (19%), PiMZ 14 (3%), PiSS 4 (0.9%), PiM 3 (0.6%), PiMF 1 (0.2%), PiMP 1 (0.2%). The corresponding gene frequencies were PiM 87%, PiS 10.4%, and Pi*Z 1.5%. Normal values of AAT (phenotype PiMM) established in our laboratory were 116-232 mg/dl (21-41 micromol/I) (mean +/- 2 SD). According to Hardy-Weinberger equation, expected frequency of PiZZ individuals in our area would be 225 per million.
The frequency of Z gen individuals observed in our study is one of the highest in the Iberian Peninsula, but lower than the frequency in northern Europe. According to these results, AAT deficiency (PiZZ) is not a rare condition in contrast with the small number of patients diagnosed. The gen frequency of the S variant is higher than that of the rest of Europe, and similar to others found in some Spanish populations.
严重的α-1抗胰蛋白酶(AAT)缺乏症由基因Z的纯合遗传引起,与患肺气肿的高风险相关。确定与该缺乏症相关的不同基因(尤其是S和Z)的频率,有助于估计在任何特定人群中纯合PiZZ个体的数量,这些个体患肺部疾病的风险很高。
通过在聚丙烯酰胺凝胶中进行等电聚焦,确定了440名健康个体的Pi表型。采用免疫比浊法测定AAT的血清值。参与者的平均年龄为30岁(范围18 - 49岁)。将结果与其他已发表的系列进行比较。
表型分布为:PiMM 333例个体(75%),PiMS 84例(19%),PiMZ 14例(3%),PiSS 4例(0.9%),PiM 3例(0.6%),PiMF 1例(0.2%),PiMP 1例(0.2%)。相应的基因频率为PiM 87%,PiS 10.4%,Pi*Z 1.5%。我们实验室确定的AAT正常范围(表型PiMM)为116 - 232mg/dl(21 - 41μmol/L)(均值±2标准差)。根据哈迪 - 温伯格方程,我们地区PiZZ个体的预期频率为每百万225例。
我们研究中观察到的Z基因个体频率是伊比利亚半岛最高的之一,但低于北欧的频率。根据这些结果,与诊断出的患者数量较少形成对比的是,AAT缺乏症(PiZZ)并非罕见情况。S变异体的基因频率高于欧洲其他地区,与在一些西班牙人群中发现的频率相似。