广西一脊髓小脑共济失调3型家系SCA3/MJD基因突变和多态性的分析

常染色体显性脊髓小脑型共济失调(Autosomal dominant spinocerebellar ataxias, ADCAs)是一种神经系统退行性疾病, 具有高度的遗传异质性, 其中脊髓小脑型共济失调3型(Spinocerebellar ataxias type 3, SCA3)是一种常见的类型。文章通过PCR扩增广西一个脊髓小脑共济失调家系SCA3/MJD基因片段, 用毛细管电泳和测序方法检测了SCA3/MJD基因的CAG重复序列大小、传递特点以及SCA3/MJD基因的变异。结果显示：家系的所有4名患者和3名无症状携带者(Asymptomatic carrier)的SCA3/MJD基因第10外显子中存在异常扩增的CAG重复序列, 重复次数为64~71次; CAG重复次数在具有cgg等位基因的正常个体间传递时保持不变, 提示cgg等位基因不是正常个体两代间CAG重复序列稳定性的影响因素。SCA3/MJD基因中另有两个单碱基点突变, 一个是内含子区的杂合性突变(IVS9-113 T>C), 另一个是外显子区域的错义突变(220 G>A, 220 Glu>Gly)。这两个点突变为首次报道, 但尚不能明确这两个新的点突变对SCA3表型的影响。     

脊髓小脑共济失调第7型的临床特征及基因突变研究

对一脊髓小脑性共济失调(Spinocerebellar ataxia, SCA)家系的患者进行临床特征及相关基因突变研究。对该家系进行详细的病史采集, 并对患者行视力、眼底血管造影、眼底拍照、视觉诱发电位、视网膜电图以及头颅MRI等辅助检查; 采用聚合酶链反应分别扩增SCA1、SCA2、SCA3、SCA6、SCA7、SCA17及DRPLA基因的CAG重复序列, 用8%变性聚丙烯酰胺凝胶电泳及直接测序进行突变分析。结果2名患者主要表现为小脑性共济失调、视力下降、眼底视网膜色素变性、小脑和脑干萎缩; 并存在SCA7基因的突变, 而未发现SCA1、SCA2、SCA3、SCA6、SCA17及DRPLA基因突变。说明该家系为SCA7突变家系, SCA7基因中CAG三核苷酸重复拷贝数的异常扩增是其致病原因。     

过表达 PINK1改善SCA3/MJD转基因果蝇模型的线粒体功能

脊髓小脑性共济失调3型（SCA3/MJD）,是一种因致病基因MJD1编码区内CAG异常重复扩增所致的常染色体显性遗传迟发性神经退行性疾病. 已知PINK1蛋白可通过抗氧化稳定线粒体,阻止帕金森疾病的发生,但其在SCA3/MJD中的作用尚不清楚. 本文旨在探索过表达PINK1对SCA3/MJD转基因果蝇模型的保护作用.本研究利用Mhc-Gal4启动子表达致病蛋白质片段（MJDtr-Q78）获得SCA3/MJD果蝇模型,分别运用过表达PINK1和RNA干扰PINK1研究其在SCA3/MJD果蝇模型中的功能.结果显示,疾病模型组翅膀异常率增高,线粒体呈过度融合状态,ATP值降低;PINK1 RNA干扰组翅膀异常率明显增高,线粒体呈显著过度融合状态,ATP值明显降低;PINK1过表达组翅膀异常率明显降低,线粒体清晰、完整,ATP值明显升高.本文的结果提示, 过表达PINK1对SCA3/MJD转基因果蝇模型起保护作用,而RNA干扰PINK1表达加重SCA3/MJD转基因果蝇模型病情.PINK1在SCA3/MJD果蝇模型中的功能可能通过改善细胞内线粒体功能实现.     

Hsp22对SCA3/MJD转基因果蝇的神经保护作用研究

为了探讨Hsp22在SCA3/MJD发病机制中的作用．选用GMR-GAL4和elav-GAL4驱动子,利用经典的GAL4-UAS系统,将含有78个CAG重复扩增的ataxin-3蛋白片段(MJDtr-Q78)分别在果蝇眼睛和神经系统选择性表达,构建GMR-GAL4/UAS和elav-GAL4/UAS系统SCA3/MJD转基因果蝇模型, 然后利用遗传学方法和热休克反应使Hsp22在SCA3/ MJD转基因果蝇眼睛和神经系统以不同水平过表达．结果表明,Hsp22过表达显著抑制了MJDtr-Q78蛋白的神经毒性,果蝇眼睛视网膜光感受神经元变性明显缓解,果蝇存活能力也显著提高．Hsp22对SCA3/MJD具有保护作用,增强Hsp22表达对SCA3/MJD可能是一种潜在的治疗方法．     

研究报告: 沉默信息调节因子2对SCA3/MJD转基因果蝇的神经保护作用及其与自噬的相关性研究

为探讨沉默信息调节因子2(Sir2)在SCA3/MJD发病机制中的作用．选用GMR-GAL4 和Nrv2-GAL4驱动子,利用经典的GAL4-UAS系统,将含有78 个CAG 重复扩增的ataxin-3 蛋白片段(MJDtr-Q78)分别在果蝇眼睛和运动神经元内选择性表达,构建GMR-GAL4/UAS 和Nrv2-GAL4/UAS 系统SCA3/MJD 转基因果蝇模型,然后分别在抑制和不抑制自噬的情况下,使Sir2在SCA3/MJD 转基因果蝇眼睛和运动神经元内过表达．结果发现,Sir2过表达明显抑制了SCA3/MJD 转基因果蝇眼睛视网膜光感受神经元变性,显著改善了果蝇运动能力,而在自噬被抑制后,Sir2的作用效果明显减弱,表明Sir2对SCA3/MJD 转基因果蝇具有神经保护作用,而这种神经保护作用需要依赖自噬的功能．     

MJD基因CAG不稳定性扩增与临床研究

为了解Machado-Joseph病(MJD)基因突变及临床的神经电生理特点, 对16个诊断为遗传性小脑性共济失调(SCA)家系的45例病人及30例家系的“正常”人作MJD基因突变分析,检出MJD基因的病人行肢体运动及感觉神经传导速度(MCV及SCV)、脑干诱发电位(BAEP),视觉诱发电位(VEP)的检查。结果检出10个家系25例病人及1例症状前18岁女孩有MJD基因突变,CAG三核苷酸重复73～79次,异常等位基因片段长380～402bp,均为杂合子; 正常人CAG三核苷酸重复18～40次,等位片段长200～270bp,电生理发现MJD的SCV减慢比MCV明显,而下肢的MCV、SCV又较上肢明显,BAEP、VEP均有不同程度的潜伏期延长或波的异常;MJD的父亲遗传早于母亲,进展也较块,临床以小脑性共济失调为突出症状,其次为构音障碍、突眼等,肌肉萎缩仅见于晚期病人;MRI示小脑萎缩较明显,脑干萎缩并不严重,未见明显的颈髓萎缩。 Abstract:　To investigate the gene mutation of clinical and neuroelectrophysiological characteristics in Machado-Joseph disease(MJD). The gene mutation was detected in 45 patients diagnosed as spinocerebellar ataxia(SCA) and 30 “healthy relatives”. Brain stem evoked potentials(BAEP), visual evoked potentials(VEP) and motor conduction velocity (MCV) and sensory conduction velocity (SCV) were performed on MJD. Gene mutations were detected in 25 patients and a 18-year-old girl among 16 families. Trinucleotide repeats of CAG were 73～79. The fragments of abnormal alleles were 380～402bp, and all patients were heterozygous. The copy numbers of normal alleles were 18～40, fragments from 202～270bp. SCV reduction was much obvious compared to MCV, MCV and SCV in lower limb ?ere much more slow than that in upper's. BAEP, VEP were also delayed in latency. The anticipation in parental sex bias were much more obvioius than that in matental's. Cerebellar ataxia was most severe, the next were dysarthria and bulging eyes. Amytrophy was seen only in bed ridden patients. Cerebellar atrophy was more severe than brain stem, cord atrophy was n't observed in all MJD.     

硫氢化钠对脊髓小脑共济失调3型小鼠海马MBP及学习记忆的影响

目的: 探讨硫氢化钠(NaHS)对脊髓小脑共济失调3型(SCA3)小鼠海马神经元髓鞘碱性蛋白(MBP)及学习记忆的影响及其治疗意义。方法: 随机挑选12只雄性正常野生型小鼠(WT)作为正常对照组(NC Group),然后将48只SCA3小鼠随机分为SCA3模型组(M Group)、低剂量小鼠组(NL Group,10 μmol/kg)、中剂量小鼠组(NM Group,50 μmol/kg)和高剂量小鼠组(NH Group,100 μmol/kg),每组12只,用药组每日腹腔注射一次,连续4周。通过Morris水迷宫比较不同剂量NaHS干预前后SCA3小鼠学习记忆能力的变化,分光光度法测定海马内硫化氢(H₂S)含量,免疫组化技术检测髓鞘碱性蛋白(MBP)的表达差异,并借助电镜观察各组小鼠神经元髓鞘形态学变化。 结果:与对照组小鼠比较,SCA3小鼠的学习记忆能力显著下降(P＜0.05),海马内H₂S含量降低(P＜0.05),有髓神经纤维MBP表达量也降低(P＜0.05),经过不同剂量的外源性NaHS治疗后,学习记忆能力有不同程度改善(P＜0.05);且SCA3小鼠海马H₂S和MBP含量也有不同程度提高(P＜0.05)。结论: 外源性NaHS可能通过提高SCA3小鼠大脑海马的H₂S含量和MBP含量增加,对神经元细胞产生一定的保护作用,进而提高SCA3小鼠的学习记忆能力,为寻求SCA3的治疗提供新的思路,同时为临床SCA3患者的营养支持及治疗提供方向。     

贝伐珠单抗联合紫杉醇/卡铂方案治疗晚期非小细胞肺癌的临床疗效分析

目的:探讨贝伐珠单抗联合紫杉醇/卡铂方案治疗晚期非小细胞肺癌的临床疗效和安全性.方法:选择本研究中心入组SAiL (MO19390)研究的13例患者为研究对象,给予贝伐珠单抗15 mg/kg,化疗d1静点,以后每3周重复;联合化疗方案为175mg/m2紫杉醇,d1,卡铂AUC=6,d1,每3周重复.化疗4-6周期,贝伐珠单抗每3周应用一次直至病情进展.评价患者的不良反应、客观有效率(objective response rate,ORR)、中位无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS).同时,对可取得肿瘤组织标本的患者进行回顾性EGFR和KRAS突变检测.结果:13例患者中,发生5级肺动脉栓塞1例,4级脑梗塞1例,4级蛋白尿2例,3级鼻出血1例,最常见的不良反应为鼻出血(69.2％)、蛋白尿(46.2％)、高血压(38.5％)、咯血(30.8％)、流涕(30.8％)、头晕(23.1％),大多程度较轻可以耐受.部分缓解(partial response,PR)7例(53.8％),疾病稳定(stable disease,SD)6例(46.2),总有效率53.8％,疾病控制率100％,中位PFS 7.7个月,中位OS 16.1个月.6例可进行EGFR和KRAS突变检测的患者中,1例存在EGFR 19外显子缺失突变,1例存在21外显子L858R点突变,4例未检测到EGFR敏感突变,6例患者KRAS突变均为阴性.结论:贝伐珠单抗联合紫杉醇/卡铂方案治疗中国晚期非小细胞肺癌可延长PFS和OS,患者的耐受性良好.     

p53基因5/6外显子突变与广西肝癌高发区肝癌家族聚集性的相关性

为了研究p53基因5/6外显子突变与广西肝癌高发地区肝癌家族聚集性的关系。研究采用配对方法,选取肝癌高发家族、肝癌单发家族和无癌家族中未发生肝癌的家族成员各130例作为研究对象,同时选取上述高发地区肝癌患者30例作为肝癌组对照。应用PCR-SSCP技术检测研究对象外周血细胞DNA中p53基因5/6外显子的突变情况并进行基因测序。研究发现三组家族成员中p53基因5/6外显子的突变率为0%。肝癌组中p53基因5/6外显子的总突变率为10%(3/30)。肝癌组p53基因5/6外显子的总突变率与肝癌家族组间突变率比较,差异均具有统计学意义(p0.05)。综上,p53基因5/6外显子突变可能不是广西肝癌高发区肝癌家族聚集性的遗传易感因素,广西肝癌高发区肝癌家族成员中可能尚未发生p53基因5/6外显子突变或较为罕见,肝癌患者中出现的p53基因5/6外显子突变可能是在后天多因素的影响下发生,从而参与了肝癌的发生发展。     

基于转录组测序的枫香EST-SSR引物开发及有效性评价

枫香是广西重要的乡土树种之一，具有较高的用材、观赏及药用价值。为验证枫香SSR引物的实际应用效果，该研究基于转录组测序技术，检测枫香SSR位点并设计引物，通过PCR扩增和聚丙烯酰胺凝胶电泳筛选出具有较高多态性的枫香EST-SSR引物，并对1个枫香天然群体进行遗传多样性分析。结果表明：(1)共发掘到23 777个SSR位点，单核苷酸重复类型SSR位点占总位点比例最高(46.54%),在重复次数上5～12次之间的SSR位点占比最高(72.36%)。(2)共开发出262对SSR引物，有效扩增率为53.1%,最终筛选出扩增稳定、条带清晰的引物18对。(3)多态性检测结果显示所有位点均具有多态性，天然群体遗传多样性结果显示该天然群体中等位基因数量(Na)、有效等位基因数量(Ne)、Shannon多样性指数(I)、观测杂合度(Ho)变化范围分别为2～4、1.112 8～2.609 6、0.208 9～1.112 7和0.275 9～1.000 0,平均值分别为2.333 3、1.957 4、0.708 5和0.722 6。综上认为，枫香中占优势的SSR位点重复类型和重复基序与其他物种基本相同，所开...     

Expanded CAG repeats in spinocerebellar ataxia (SCA1) segregate with distinct haplotypes in South African families

The autosomal dominant late onset spinocerebellar ataxias (SCAs) are genetically heterogeneous. Three genes, SCA1 on 6p, SCA2 on 12q and MJD1 on 14q, have been isolated for SCA1, SCA2 and Machado-Joseph disease (MJD), respectively. In these three autosomal dominant disorders the mutation is an expanded CAG repeat. Evidence for heterogeneity in families not linked to the SCA1, SCA2 and MJD loci is provided by the mapping of SCA loci to chromosomes 16q, 11cen and 3p. A total of 14 South African kindreds and 22 sporadic individuals with SCA were investigated for the expanded SCA1 and MJD repeats. None of the families nor the sporadic individuals showed expansion of the MJD repeat. Expanded SCA1 and CAG repeats were found to cosegregate with the disorder in six of the families tested and were also observed in one sporadic individual with a negative family history of SCA. The use of the microsatellite markers D6S260, D6S89 and D6S274 provided evidence that the expanded SCA1 repeats segregated with three distinct haplotypes in the six families. Use of the highly polymorphic tightly linked microsatellite markers is still important as this stage, particularly where this coincides with the possibility of a homozygous genotype with the trinucleotide repeat marker. Importantly, our molecular findings indicate: (1) an absence of MJD expanded repeats underlying SCA; (2) the major disease in this group is due to mutations in the SCA1 gene; and (3) the familial disorder in the majority population group (i.e. mixed ancestry) in the Western Cape region of South Africa is most likely to be the result of two distinct founder events. Received: 4 November 1996 / Accepted: 6 February 1997     

Analysis of CAG repeats in SCA1, SCA2, SCA3, SCA6, SCA7 and DRPLA loci in spinocerebellar ataxia patients and distribution of CAG repeats at the SCA1, SCA2 and SCA6 loci in nine ethnic populations of eastern India

To identify various subtypes of spinocerebellar ataxias (SCAs) among 57 unrelated individuals clinically diagnosed as ataxia patients we analysed the SCA1, SCA2, SCA3, SCA6, SCA7 and DRPLA loci for expansion of CAG repeats. We detected CAG repeat expansion in 6 patients (10.5%) at the SCA1 locus. Ten of the 57 patients (17.5%) had CAG repeat expansion at the SCA2 locus, while four had CAG expansion at the SCA3/MJD locus (7%). At the SCA6 locus there was a single patient (1.8%) with 21 CAG repeats. We have not detected any patient with expansion in the SCA7 and DRPLA loci. To test whether the frequencies of the large normal alleles in SCA1, SCA2 and SCA6 loci can reflect some light on prevalence of the subtypes of SCAs we studied the CAG repeat variation in these loci in nine ethnic sub-populations of eastern India from which the patients originated. We report here that the frequency of large normal alleles (>31 CAG repeats) in SCA1 locus to be 0.211 of 394 chromosomes studied. We also report that the frequency of large normal alleles (>22 CAG repeats) at the SCA2 locus is 0.038 while at the SCA6 locus frequency of large normal alleles (>13 repeats) is 0.032. We discussed our data in light of the distribution of normal alleles and prevalence of SCAs in the Japanese and white populations.     

Mutation detection in Machado-Joseph disease using repeat expansion detection.

BACKGROUND: Several neurological disorders have recently been explained through the discovery of expanded DNA repeat sequences. Among these is Machado-Joseph disease, one of the most common spinocerebellar ataxias (MJD/SCA3), caused by a CAG repeat expansion on chromosome 14. A useful way of detecting repeat sequence mutations is offered by the repeat expansion detection method (RED), in which a thermostable ligase is used to detect repeat expansions directly from genomic DNA. We have used RED to detect CAG expansions in families with either MJD/SCA3 or with previously uncharacterized spinocerebellar ataxia (SCA). MATERIALS AND METHODS: Five MJD/SCA3 families and one SCA family where linkage to SCA1-5 had been excluded were analyzed by RED and polymerase chain reaction (PCR). RESULTS: An expansion represented by RED products of 180-270 bp segregated with MJD/SCA3 (p < 0.00001) in five families (n = 60) and PCR products corresponding to 66-80 repeat copies were observed in all affected individuals. We also detected a 210-bp RED product segregating with disease (p < 0.01) in a non-SCA1-5 family (n = 16), suggesting involvement of a CAG expansion in the pathophysiology. PCR analysis subsequently revealed an elongated MJD/SCA3 allele in all affected family members. CONCLUSIONS: RED products detected in Machado-Joseph disease families correlated with elongated PCR products at the MJD/SCA3 locus. We demonstrate the added usefulness of RED in detecting repeat expansions in disorders where linkage is complicated by phenotyping problems in gradually developing adult-onset disorders, as in the non-SCA1-5 family examined. The RED method is informative without any knowledge of flanking sequences. This is particularly useful when studying diseases where the mutated gene is unknown. We conclude that RED is a reliable method for analyzing expanded repeat sequences in the genome.     

The prevalence and wide clinical spectrum of the spinocerebellar ataxia type 2 trinucleotide repeat in patients with autosomal dominant cerebellar ataxia.

The dominant cerebellar ataxias (ADCAs) represent a clinically and genetically heterogeneous group of disorders linked by progressive deterioration in balance and coordination. The utility of genetic classification of the ADCAs has been highlighted by the striking variability in clinical phenotype observed within families and the overlap in clinical phenotype observed between those with different genotypes. The recent demonstration that spinocerebellar ataxia type 2 (SCA2) is caused by a CAG repeat expansion within the ataxin-2 gene has allowed us to determine the frequency of SCA2 compared with SCA1, SCA3/Machado-Joseph disease (MJD), and dentatorubropallidoluysian atrophy (DRPLA) in patients with sporadic and inherited ataxia. SCA2 accounts for 13% of patients with ADCA (without retinal degeneration), intermediate between SCA1 and SCA3/MJD, which account for 6% and 23%, respectively. Together, SCA1, SCA2, and SCA3/MJD constitute >40% of the mutations leading to ADCA I in our population. No patient without a family history of ataxia, or with a pure cerebellar or spastic syndrome, tested positive for SCA1, SCA2, or SCA3. No overlap in ataxin-2 allele size between normal and disease chromosomes, or intermediate-sized alleles, were observed. Repeat length correlated inversely with age at onset, accounting for approximately 80% of the variability in onset age. Haplotype analysis provided no evidence for a single founder chromosome, and diverse ethnic origins were observed among SCA2 kindreds. In addition, a wide spectrum of clinical phenotypes was observed among SCA2 patients, including typical mild dominant ataxia, the MJD phenotype with facial fasciculations and lid retraction, and early-onset ataxia with a rapid course, chorea, and dementia.     

Two Novel SNPs in ATXN3 3’ UTR May Decrease Age at Onset of SCA3/MJD in Chinese Patients

Spinocerebellar ataxia type 3 (SCA3), or Machado—Joseph disease (MJD), is an autosomal dominantly-inherited disease that produces progressive problems with movement. It is caused by the expansion of an area of CAG repeats in a coding region of ATXN3. The number of repeats is inversely associated with age at disease onset (AO) and is significantly associated with disease severity; however, the degree of CAG expansion only explains 50 to 70% of variance in AO. We tested two SNPs, rs709930 and rs910369, in the 3’ UTR of ATXN3 gene for association with SCA3/MJD risk and with SCA3/MJD AO in an independent cohort of 170 patients with SCA3/MJD and 200 healthy controls from mainland China. rs709930 genotype frequencies were statistically significantly different between patients and controls (p = 0.001, α = 0.05). SCA3/MJD patients carrying the rs709930 A allele and rs910369 T allele experienced an earlier onset, with a decrease in AO of approximately 2 to 4 years. The two novel SNPs found in this study might be genetic modifiers for AO in SCA3/MJD.     

Fluorescent multiplex PCR--fast method for autosomal dominant spinocerebellar ataxias screening

Expansion of CAG trinucleotide repeats has been shown to cause a number of autosomal dominant spinocerebellar ataxias such as SCA1, SCA2, SCA3/MJD, SCA6 and SCA7. These disorders are characterized by a wide inter- and intrafamiliar variation in clinical features. The same mutation can result in different phenotypes and the very similar phenotypes can be caused by different mutations. Therefore it is necessary to investigate more SCA genes (according to prevalence) to identify the causal elongation. We developed a fast and efficient screening method based on touchdown multiplex PCR with fluorescent labelled primers for the most common types of SCAs (SCA 1, 2, 3 and 7). It has been reliable in 113 probands tested. Fragment analysis was performed by using 6% denaturing polyacrylamide gel and employing the automated DNA sequencer. This method considerably shortens the process of molecular genetic screening of SCAs and might be used as a tip for designing other SCA screening sets.     

Polymorphisms at 13 expressed human sequences containing CAG/CTG repeats and analysis in autosomal dominant cerebellar ataxia (ADCA) patients

Genetic anticipation – increasing severity and a decrease in the age of onset with successive generations of a pedigree – is clearly present in autosomal dominant cerebellar ataxia (ADCA). Anticipation is correlated with expansion of the CAG/CTG repeat sequence to sizes above those in the normal range through the generations of a pedigree. Genetic heterogeneity has been demonstrated for ADCA, with four cloned genes (SCA1, SCA2, SCA3/MJD, and SCA6) and three mapped loci (SCA4, SCA5 and SCA7). Another related dominant ataxia, dentatorubral-pallidoluysian atrophy (DRPLA), presents anticipation with CAG/CTG repeat expansions. We had previously analysed ADCA patients who had not shown repeat expansions in cloned genes for CAG/CTG repeat expansions by the repeat expansion detection method (RED) and had detected expansions of between 48 and 88 units in 17 unrelated familial cases. We present here an analysis of 13 genes and expressed sequence tags (ESTs) containing 10 or more CAG/ CTG repeat sequences selected from public databases in the 17 unrelated ADCA patients. Of the 13 selected genes and ESTs, 9 were found to be polymorphic with heterozygosities ranging between 0.09 and 0.80 and 2 to 17 alleles. In ADCA patients none of the loci showed expansions above the normal range of the CAG/CTG repeat sequences, excluding them as the mutation causing ADCA. Received: 28 May 1997 / Accepted: 30 June 1997