成骨不全Ⅰ型家系的基因检测和COL1A2基因新突变的致病性鉴定

为了揭示成骨不全(Osteogenesis imperfecta,OI)Ⅰ型家系的分子遗传学发生机制,文章采用PCR-DNA直接测序法,对患儿COL1A1和COL1A2基因共103个外显子(E)进行突变检测。结果显示:患儿COL1A1基因未发现任何病理性突变,而在COL1A2基因E19内发现一新的杂合错义突变(p.G316C),该突变来自其父,而其母正常,其他表型正常的6位亲属也均未发现该突变;通过DHPLC(Denaturing high performance uid chromatography)筛检,发现患儿与其父均有异常双峰,而其母和所有正常对照均为正常单峰;通过ASA(Allele specific amplification)筛检,患儿与其父均有391 bp的特异扩增带,而其母和所有正常对照均未见特异扩增带;保守性分析结果显示,该突变位点所在甘氨酸在进化上具有高度保守性;SIFT和Poly Phen-2软件预测结果显示,新突变造成的结果是"有害的"和"很可能有害"。上述结果均说明COL1A2基因c.946GT/p.G316C新突变是导致OI-Ⅰ型的致病性突变,是引起患儿发病的真正内因。患儿父母若再次孕育,可在孕早期进行产前基因诊断或孕前期进行PGD(Preimplantation genetic diagnosis)予以防患。     

家族性不宁腿综合征候选基因的连锁分析

不宁腿综合征（restless legs syndrome,RLS)是以下肢部出现蚁行样及酸、麻、胀等不适感而使肢体不得休息为特征的一组病症。由于症状常在晚间发作并导致运动不安,患者长期入睡困难,经受严重的继发性失眠。作为一种常见的神经系统疾病,RLS发病率高达5％,其中原发性RLS多呈阳性家族史,表现为单基因决定的常染色体显性遗传。现在,人们普遍认为RLS的发生很可能与神经系统内多巴胺能功能异常和脑内铁缺乏有关,并初步建立了脑铁－多巴胺能系统的致病模型。为了探求脑铁－多巴胺能系统在RLS中的作用,选择了与脑铁－多巴胺能系统相关的16个疾病侯选基因,在每个候选基因附近染色体区域内选取若干个微卫星多态标记,应用微卫星引物荧光标记－基因扫描技术,对一个汉族家族性不宁腿综合征家系进行了基因分型和常染色体显性遗传模式下的连锁分析,试图从分子遗传学层面上确认或排除一些可能与RLS相关的重要侯选基因。结果显示,当重组系数θ=0.00时,LOD值均小于－2.00,所选位点与家族性不宁腿综合征不连锁。由此得出结论,在本家系中,所有候选基因均与家族性不宁腿综合征的发病无关,家族性不宁腿综合征可能是由其他多巴胺传导和脑铁代谢相关基因所致,或是存在全新的致病机制参与RLS的发生。     

一中国正常血钾周期性麻痹家系中的SCN4A基因的T704M突变

家族性周期性麻痹(periodic paralysis,PP)是以反复发作骨骼肌迟缓性瘫痪为特征的一组疾病。我们对一个来自湖北省的正常血钾周期性麻痹家系进行致病基因突变检测。应用微卫星标记对该家系进行连锁分析,证实致病基因可能同SCN4A连锁。对SCN4A基因全部外显子测序,发现患者在一个致病突变热点存在碱基替换C2188T。该突变导致编码氨基酸改变Thr704Met,经单链构象多态性分析证明该突变只存在于该家系患者,不存在于家系中健康人和100名无亲缘关系对照中,Thr704Met是该家系的致病突变。     

一个非综合征性耳聋家系致病基因的研究

非综合征性耳聋(nonsyndromic hearing impairment, NSHI)是一种十分常见的人类神经系统疾病, 约有1/1000的新生儿患有语前聋。GJB2基因编码间隙连接蛋白Cx26, 是最常见的NSHI致病基因, 大约50%的常染色体隐性遗传NSHI是由GJB2基因突变引起的。在本研究中, 收集了江苏省一个复杂的非综合征性耳聋家系, 并对其进行了分子遗传学研究。对所有已知常染色体隐性遗传的NSHI致病基因, 选用其侧翼的微卫星标记进行连锁分析, 发现该家系的致病基因与D13S175连锁。对GJB2基因进行整个编码区域的测序, 发现235碱基处发生了碱基C的纯合缺失, 这一突变可能是该家系中绝大多数患者致病的遗传基础。     

Smith—Fineman—Myers综合征与GRIA3基因的连锁和突变分析

探讨GRIA3基因与中国山东Smith-Fineman-Myers综合征的连锁关系,并分析SFMS患者GRIA3基因突变。采用PCR结合变性聚丙烯酰胺凝胶电泳方法,分析GRIA3基因内多态位点与致病基因之间的连锁关系。采用PCR扩增结合PCR产物直接测序方法检测GRIA3基因开放性阅读框架区域基因突变。GRIA3基因内多态位点分析表明,GRIA3基因与中国山东SFMS家系致病基因紧密连锁,但在该基因开放性阅读框架区域内并未检测到导致疾病的基因突变。中国山东SFMS家系患者不是由于GRIA3基因编码区域基因突变所致。     

25个携带线粒体12S rRNA A1555G 突变的中国汉族非综合征型耳聋家系

线粒体12S rRNA A1555G突变是引起氨基糖甙类药物诱导的非综合征型耳聋的重要原因之一。文章对收集的25个携带A1555G突变的中国汉族非综合征型耳聋家系进行了临床和分子遗传学评估。结果表明,这25个家系的母系成员在耳聋外显率、听力损失严重程度和发病年龄上存在较大差异。当包括和不包括氨基糖甙类药物使用史时,耳聋的平均外显率分别为28.1%和21.5%,排除氨基糖甙类药物时,耳聋的平均发病年龄从1~15岁不等。线粒体全序列分析发现了16个新变异,不同的线粒体DNA多态性位点显示这25个家系分别属于东亚人群A、B、D、F、G、M、N和R单倍型,其中线粒体单倍型B的家系耳聋外显率和表现度较其他单倍型高。此外,7个继发突变位点和21个高保守性位点突变可能增加了这些家系的耳聋外显率。GJB2基因上未检测到与耳聋相关的突变,表明在本研究的耳聋家系中,GJB2基因可能没有参与A1555G突变的表型表达。以上各方面提示,线粒体单倍型和其他因素可能参与了这25个家系耳聋患者的表型修饰。     

播散性浅表性光线性汗孔角化症DSAP1位点的精细定位和候选基因的突变检测

播散性浅表性光线性汗孔角化症(DSAP)是一种以多个浅表的角化性皮损,边缘轻微嵴状角化性隆起为特征的少见的慢性角化性皮肤病,呈常染色体显性遗传。以往的研究将该病基因定位于12q23．2—24．1区域(DSAP1)和15q25．1-26．1区域(DSAP2)。本研究对2个无关的六代DSAP家系进行了全基因组扫描和连锁分析,结果显示,这2个DSAP家系在D12窝4位点的最高累积LOD值为8．28(θ=0．00)。单倍型分析结果显示,这2个DSAP家系致病基因位于12q24．1-q24．2(D12S330和D12S354)之间8．0cM的区域内。该区域与DSAP1的致病区域部分重叠。对重叠区域内6个候选基因(CRY1,PWP1,ASCL4,PRDM4,KIAA0789和CMKLR1)的编码区进行序列分析,在DSAP病人中未发现突变位点。提示该6个候选基因可能与这2个DSAP家系的发病机理无关。     

中国人Ⅱ型MPS家系IDS基因的一种新突变的鉴定

为了研究粘多糖贮积症Ⅱ型(MPSⅡ)患者发病的分子遗传学机制, 以便为今后的产前基因诊断等创造必要的前提条件, 文章先采用尿糖胺聚糖(GAGs)定性检测法对疑似MPSⅡ的先证者进行初诊, 然后采用PCR、PCR 产物直接测序法对先证者及其家系成员进行突变检测。在检出IDS基因c.876del2新突变后, 对随机采集的120例正常对照和其他非II型MPS患者包括MPSⅠ, Ⅳ, Ⅵ三型的病人共15例的IDS基因exon 6进行序列分析, 同时采用不同物种突变点序列的保守性分析法, 以及直接测定患儿及其家庭相关成员IDS酶活性的方法对该新突变进行致病性分析。结果显示: 先证者尿检呈强阳性(GAGs +++); 其IDS基因exon 6编码区内存在c.876-877 del TC新缺失突变, 为半合子突变, 而其母、其姐为杂合突变; 正常对照和其他非II型MPS患者的IDS基因exon 6的检测结果均未发现该突变; 不同物种氨基酸序列的同源性比对显示: c.876-877 del TC突变所在的位置即p.292-293的苯丙氨酸(F)谷氨酰胺(Q)高度保守; 酶活性测定的结果显示: 先证者的IDS酶活性仅为2.3 nmol/4 h/mL, 大大低于正常值, 而其父的为641.9 nmol/4 h/mL, 其母的血浆酶活性为95.8 nmol/ 4h/mL, 其姐的为103.2 nmol/4 h/mL。说明所发现的c.876-877 del TC缺失移码突变是一种新的病理性突变, 是该MPSⅡ患儿发病的根本内因。     

PRRSV NJ-a株ORF5基因A表位的修饰与糖基化位点的突变对其DNA疫苗免疫效力的影响

为了提高PRRSV ORF5基因的免疫效力,对ORF5基因进行了改造,将CpG序列和通用型辅助性T淋巴细胞表位插入A表位与B表位之间,并对N33与N51位糖基化位点进行了点突变,获得改造的ORF5基因。在此基础上构建了由两个CMV启动子调控的共表达改造的ORF5(MORF5)与ORF6基因的真核表达质粒pcDNA-M5A-6A。经Western-blot与IFA验证真核质粒的体外表达后,免疫6周龄Balb/c小鼠,利用微量中和试验检测免疫后的中和抗体,利用MTT法检测免疫后淋巴细胞的增生情况,并与未改造ORF5基因真核表达质粒pcDNA-5A-6A、弱毒疫苗以及灭活疫苗的免疫效果进行比较。结果表明,pcDNA-M5A-6A不但能够刺激免疫小鼠在较短的时间内产生更高水平的中和抗体,而且可以诱导产生更强烈的T淋巴细胞增殖反应。所构建的共表达PRRSV改造的ORF5基因与ORF6基因的DNA疫苗pcDNA-M5A-6A,能够较好的诱发小鼠产生较高的特异性针对PRRSV的中和抗体和细胞免疫应答,为研究能够更好地防制PRRSV的新型疫苗提供了新的思路。     

PRRSV NJ-a株ORF5基因A表位的修饰与糖基化位点的突变对其DNA疫苗免疫效力的影响

为了提高PRRSVORF5基因的免疫效力,对ORF5基因进行了改造,将CpG序列和通用型辅助性T淋巴细胞表位插入A表位与B表位之间,并对N33与N51位糖基化位点进行了点突变,获得改造的ORF5基因。在此基础上构建了由两个CMV启动子调控的共表达改造的ORF5(MORF5)与ORF6基因的真核表达质粒pcDNA-M5A-6A。经Western-blot与IFA验证真核质粒的体外表达后,免疫6周龄Balb/c小鼠,利用微量中和试验检测免疫后的中和抗体,利用MTT法检测免疫后淋巴细胞的增生情况,并与未改造ORF5基因真核表达质粒pcDNA-5A-6A、弱毒疫苗以及灭活疫苗的免疫效果进行比较。结果表明,pcDNA-M5A-6A不但能够刺激免疫小鼠在较短的时间内产生更高水平的中和抗体,而且可以诱导产生更强烈的T淋巴细胞增殖反应。所构建的共表达PRRSV改造的ORF5基因与ORF6基因的DNA疫苗pcDNA-M5A-6A,能够较好的诱发小鼠产生较高的特异性针对PRRSV的中和抗体和细胞免疫应答,为研究能够更好地防制PRRSV的新型疫苗提供了新的思路。     

Mutation c.359_363delGTATTinsATAC in the COL4A5 Causes alport syndrome in a Chinese family

The X-linked form of Alport syndrome is associated with mutations in the COL4A5 gene, which is located at Xq22.3 and encodes the α5 chain of type IV collagen. Here we clinically characterized a Chinese family with Alport Syndrome, but no ocular or hearing abnormalities have been observed in any patient in the family. Through Linkage analysis and direct DNA sequencing, a novel complex deletion/insertion mutation c.359_363delGTATTinsATAC in the COL4A5 gene was identified in the family. The mutation was found in all affected family members, but was not present in the unaffected family individuals or the 200 controls. The predicted mutant protein in the family is a truncated protein consisting of only 153 residues. Our report for the first time revealed that the frameshift mutation in the type IV collagen chain α5 causes only renal disease, without extrarenal lesion. Our study broadens genotypic and phenotypic spectrum of COL4A5 mutations associated with Alport syndrome.     

Establishment of X-linked Alport syndrome model mice with a Col4a5 R471X mutation

Alport syndrome (AS) is an inherited disorder characterized by glomerular basement membrane (GBM) abnormality and development of chronic kidney disease at an early age. The cause of AS is a genetic mutation in type IV collagen, and more than 80% of patients have X-linked AS (XLAS) with mutation in COL4A5. Although the causal gene has been identified, mechanisms of progression have not been elucidated, and no effective treatment has been developed. In this study, we generated a Col4a5 mutant mouse harboring a nonsense mutation (R471X) obtained from a patient with XLAS using clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated system. Col4a5 mRNA and protein expressions were not observed in the kidneys of hemizygous R471X male mice. R471X mice showed proteinuria and hematuria. Pathology revealed progression of glomerulosclerosis and interstitial fibrosis by age. Electron microscopy identified irregular thickening in GBM accompanied by irregular lamination. These observations were consistent with the clinical and pathological features of patients with AS and other established models. In addition, our mice models develop end-stage renal disease at the median age of 28 weeks, much later compared to previous models much more consistent with clinical course of human XLAS. Our models have advantages for future experiments in regard with treatment for human XLAS.     

一成骨不全家系的COL1A1基因突变检测

成骨不全(Osteogenesisimperfecta,OI)是一种由于Ⅰ型胶原形成障碍,导致骨脆性增强为主要症状的 常染色体显性遗传性疾病。临床上主要表现为骨质脆弱、蓝巩膜、耳聋和中等程度的关节畸形等症状。成骨不全 基因分别定位于17q21.31 q22和7q22.1,其致病基因分别为COL1A1和COL1A2。对一常染色体显性遗传的 成骨不全家系进行连锁分析,在COL1A1遗传位点发现紧密连锁(LOD=9.31;θ=.00)。突变检测发现在 COL1A1基因第26内含子5′端剪接位点处存在一由GT转换为AT的致病突变,该突变引起的异常剪接是导致成 骨不全的致病原因之一。     

Identification of a novel COL4A5 mutation in a Chinese family with X-linked Alport syndrome using exome sequencing

Alport syndrome (AS) is an inherited disorder and clinically characterized by glomerulonephritis and end-stage kidney disease (ESRD). The aim of this study was to identify the gene responsible for glomerulopathy in a 4-generation Chinese pedigree. Exome sequencing was conducted in four patients of the family, and then direct sequencing was performed in other members of the pedigree. A novel missense mutation c.368G>A (p.Gly123Glu) in the collagen type IV alpha-5 gene (COL4A5) was found to be the genetic cause. The p.Gly123Glu mutation occurs prior to Gly-X-Y repeats in the alpha-5 chain of type IV collagen. Neither sensorineural hearing loss nor ocular abnormalities were present in patients of this family. Other clinical features, such as age of onset, age of ESRD, disease severity and complications, varied among patients of this family. Our finding may provide new insights into the cause and diagnosis of AS, and also have implications for genetic counseling.     

The COL5A1 genotype is associated with range of motion

[Purpose]

The aim of our study was to investigate the association between COL5A1 genotype and Range of Motion as measured by the passive straight leg raise (SLR) and whole body join laxity (WBJL) in Asian population.

[Methods]

One hundred and seventy seven participants including Korean and Japanese college students (male = 109, female = 68) participated in the study. Each subject performed the passive straight leg raise and whole body join laxity test. Genotyping for the COL5A1 (rs 12722) polymorphism was performed using the TaqMan approach. The COL5A1 genotype exhibited a Hardy-Weinberg equilibrium distribution in our population.

[Results]

The physical parameters including height, weight, and BMI were higher in < 90° group than > 90° group. The SLR exhibited significant difference among the COL5A1 group. However, the WBJL did not differ significantly among the COL5A1 genotype, but significant difference was seen in CC genotype when compared to CT (2.99 ± 1.72) or TT (2.70 ± 1.52) genotype.

[Conclusion]

We concluded that COL5A1 gene polymorphism is associated with increased SLR ROM in Asian population.     

Identification of a novel COL4A5 mutation in the proband initially diagnosed as IgAN from a Chinese family with X-linked Alport syndrome

Alport syndrome(AS) is a hereditary progressive nephropathy characterized by hematuria, ultrastructural lesions of the glomerular basement membrane, ocular lesions and sensorineural hearing loss. Germline mutations of COL4 A5 are associated with X-linked AS with an extreme phenotypic heterogeneity. Here, we investigated a Chinese family with Alport syndrome. The proband was a 9-year-old boy with hematuria and proteinuria. Based on the test results of renal biopsy and immunofluorescence,the proband was initially diagnosed as Ig A nephropathy and the treatment was recommended accordingly. Meanwhile, we found that the treatment outcome was poor. Therefore, for proper clinical diagnosis and appropriate treatment, targeted exome-based next-generation sequencing has been undertaken. We identified a novel hemizygous single nucleotide deletion c.1902 del A in COL4 A5 gene. Segregation analysis identified that this novel mutation is co-segregated among the affected family members but absent in unaffected family members. The clinical diagnosis of the proband was revised as AS accompanied by Ig A nephropathy,which has been rarely reported. Our findings demonstrated the significance of the application of Genetic screening, expanded the mutation spectrum of COL4 A5 associated AS patients with atypical renal phenotypes and provided a good lesson to be learned from our detour during the diagnosis.     

Identification of a Novel Mutation in the COL2A1 Gene in a Chinese Family with Spondyloepiphyseal Dysplasia Congenita

Spondyloepiphyseal dysplasia congenita (SEDC) is an autosomal dominant chondrodysplasia characterized by disproportionate short-trunk dwarfism, skeletal and vertebral deformities. Exome sequencing and Sanger sequencing were performed in a Chinese Han family with typical SEDC, and a novel mutation, c.620G>A (p.Gly207Glu), in the collagen type II alpha-1 gene (COL2A1) was identified. The mutation may impair protein stability, and lead to dysfunction of type II collagen. Family-based study suggested that the mutation is a de novo mutation. Our study extends the mutation spectrum of SEDC and confirms genotype-phenotype relationship between mutations at glycine in the triple helix of the alpha-1(II) chains of the COL2A1 and clinical findings of SEDC, which may be helpful in the genetic counseling of patients with SEDC.     

Clonal overgrowth of esophageal smooth muscle cells in diffuse leiomyomatosis-Alport syndrome caused by partial deletion in COL4A5 and COL4A6 genes

This is a study of a patient who manifests all of the features of a diffuse leiomyomatosis-Alport syndrome (DL-ATS), and her two-year-old son who has already been diagnosed with Alport syndrome. Fourteen years ago, the patient underwent a partial esophageal resection followed by a replacement with jejunum. Recently, she underwent a surgical resection of the esophagus due to esophageal dysfunction. Genetic analyses of COL4A5 and COL4A6 on the X-chromosome were efficiently performed using the genomic DNA of her son. We have identified a novel deletion of 194-kb in length, encompassing COL4A5-COL4A6 promoters as well as nearly the entire large intron 1 of COL4A5 and intron 2 of COL4A6. To uncover the relationship of the esophagus-specific occurrence of the tumor and the expression of those genes, immunohistochemical analyses of type IV collagen α chains were conducted in the non-affected individuals. The esophageal smooth muscle-specific expression of α5(IV) and α6(IV) chains in the gastrointestinal tract was observed. Moreover, CAG repeat analysis of the androgen receptor gene and an immunohistochemical analysis in the leiomyoma revealed clonal overgrowth of the cells which received X-inactivation on the non-affected allele. These results may suggest that the dominant effect was caused by the partial deletion of the esophageal smooth muscle-specific genes, COL4A5 and COL4A6.     

一个Ⅰ型遗传性淋巴水肿中国家系的VEGFR3基因的新突变方式

通过对国人Ⅰ型遗传性淋巴水肿一家系分子遗传学检测,报告VEGFR-3基因新突变。首先在Ⅰ型遗传性淋巴水肿对该家系进行致病基因的连锁分析,然后用DNA直接测序方法进行基因突变分析。连锁分析和单倍体分析确定该家系致病基因位于5q35.3,与Ⅰ型遗传性淋巴水肿连锁。VEGFR-3基因突变分析发现了一个新的错义突变D1055V,该错义突变在家系中共分离,且在100个正常对照组中未发现该序列改变。本研究首次报告了国内Ⅰ型遗传性淋巴水肿VEGFR-3基因新的错义突变D1055V,丰富了VEGFR-3基因基因突变谱,为今后开展遗传性淋巴水肿的基因诊断和遗传咨询奠定基础。     

一中国脑海绵状血管瘤家系中发现krit1基因新的缺失突变

脑海绵状血管瘤（CCM）是多定位于中枢神经系统的一种脑部血管异常,少数在皮肤和视网膜处有并发症。依据致病基因在染色体上的不同位置分为CCM1、CCM2和CCM33种类型。目前,CCM1、CCM2和CCM3的致病基因已经被克隆,分别为krit1、MGC4607和细胞程序性死亡10基因（PDCD10）。利用连锁分析发现内蒙古的一个家系属于CCM1,突变检测发现患者CCM1基因（krit1）第9内含子和第10外显子拼接位点处存在一“GTA”缺失,该突变导致终止密码子提前出现,产生截短蛋白。实验结果支持krit1为CCM1致病基因。