中国人先天性巨结肠RET基因突变特征研究

为了研究中国人先天性巨结肠(HD)RET基因突变特征,从分子水平探讨先天性巨结肠症(HD)的发病机理,揭示中国人群HD与RET基因突变的关系。我们应用聚合酶链反应-单链构象多态性(PCR—SSCP)-DNA测序方法,对50例HD患儿和30例无便秘正常对照者,进行RET基因第13外显子突变筛查,并对第13外显子突变阳性患儿家系作研究。结果发现在50例HD患儿中,有7例第13外显子扩增片段在SSCP分析时出现泳动变位。经DNA测序证实,有3种点突变类型(错义、同义和移码),第13外显子突变率为14％(7／50)。在7例第13外显子突变的患儿中,发现2例患儿的父亲存在与其子相同的突变。实验表明中国先天性巨结肠人群存在着RET基因突变,且以杂和性点突变为主,HD具有一定的遗传性。     

EDNRB基因编码区点突变及多态性在浙江地区散发性先天性巨结肠症中的检测与分析

本实验应用聚合酶链反应-单链构象多态性(single strand confbrmation polymorphism analysis of polymerase chain reaction products,PCR-SSCP)和DNA直接测序技术,对75例浙江地区散发性先天性巨结肠病例EDNRB基因编码区的全部7个外显子,进行了点突变与单核苷酸多态性的检测与分析,探讨浙江地区先天性巨结肠患者EDNRB基因的突变特征,阐明EDNRB基因与散发性先天性巨结肠症发病之间可能存在的关系。结果有6例患者在第4外显子上检测到密码子277位点 CTG→CTA的置换,导致亮氨酸的同义突变(L277L),属于单核苷酸多态性,发生率为8％(6/75)。有 2例患者在第2外显子上检测到密码子185位点GTG→ATG的置换,导致缬氨酸到蛋氨酸的错义突变(V185M),此突变型未在国内外文献中报道过,认为是新的基因突变型,突变率2．7％(2/75)。研究结果表明,浙江地区先天性巨结肠群体可发生EDNRB基因的杂合性突变,提示EDNRB基因与先天性巨结肠症的发病存在一定程度的关联。     

先天性甲减患儿的甲状腺过氧化物酶基因突变研究

目的:研究甲状腺过氧化物酶基因(TPO)在中国先天性甲状腺功能减退症(CH)患儿中的突变及其家系遗传规律。方法:收集140例CH患儿及部分家系,提取外周血DNA,采用靶向测序的方法检测患者TPO基因的突变情况,设计引物扩增TPO基因的各个外显子区以及外显子内含子的交界区,用二代测序技术检测TPO基因的突变且进行一代测序验证,同时对其中两例携带有TPO基因复合杂合突变的患儿的父母进行一代测序验证。结果:140名先天性甲减患儿中,13例病人携带12个不同的TPO基因突变位点(R189Q、C269S、W428R、A430E、A433P、A489T、V748M、C756fs、E799D、G860R、P883S、Q913fs),其中有一个位点为热点突变(6个病人携带C756fs),三个突变为新发现的位点(C269S、A430E、E799D)。结论:TPO基因在中国先天性甲减患儿中的突变率较高,遗传模式为常染色体隐性遗传。     

先天性甲状腺功能减退症伴发育不全患儿FOXE1基因突变的初步研究（英文）

目的:研究先天性甲状腺功能减退症(CH)伴甲状腺发育不全患儿转录因子2(FOXE1)的基因突变。方法:选取90例CH伴甲状腺发育不全患儿及90例正常儿童作为对照,提取外周静脉血基因组DNA,采用PCR扩增与直接测序技术,对FOXE1基因外显子进行突变筛查。结果:分别在1例先天性甲状腺功能减退症伴甲状腺发育不全患者外显子测序中发现一杂合错义变体c.A3401G(p.K1134R),在1例患者中发现1个已知的单核苷酸多态性(single nucleotide polymorphisms,SNP)位点(rs755282859,c.483GC),在正常对照组中未发现以上变化。结论:在先天性甲状腺功能减退症(CH)伴甲状腺发育不全患儿中发现新的关于FOXE1杂合错义变体。     

27例雄激素不敏感综合征患儿AR基因突变

雄激素受体(AR)基因突变是雄激素不敏感综合征(AIS)的主要直接原因,本研究是为了了解中国病人AR基因突变谱.本研究根据病史、查体、激素检测、染色体核型分析及影像学检查结果,确诊AIS患儿27例.收集患儿及其部分家属静脉抗凝血,提取DNA,合成外显子1~8及外显子和内含子剪切处引物, PCR扩增,扩增产物送公司测序,分析AR基因突变情况.结果提示, 27例AIS患儿共发现突变23个, 10例携带5个相同突变(p.R841H, p.P914S,p.S176R, p.Y572S和p.Y782N),未报道突变11个. 8/27例家族史阳性. 12个已知突变中,仅1个为内含子4的剪切突变:c.2173+1GT;余均为点突变,含1个已报道的第6外显子的新生突变:p.R775C. 2例病人具有相同第8外显子突变:p.P914S,患者均表现为CAIS,与报道的PAIS不符;其余临床分型与已经报道的分型一致.未报道突变中,点突变为8/11个,另有2个碱基缺失导致的移码突变:p.345fs和p.828_829del, 1个碱基插入导致的移码突变:p.885fs, 1例病人携带两个点突变:p.Y365C和p.E898D.突变由多至少在外显子的分布:外显子7有6例患儿5个不同突变;外显子8有5例患儿4个突变,外显子1和5各有3个突变;外显子2, 3, 4和6各有2个不同突变. 23个突变在功能区的分布情况:16个突变位于LBD, 4个位于DBD, 3个位于NTD.本研究报道了不同AIS表型AR的突变谱, 50%为未报道突变,进一步丰富了AR数据库.错义突变是主要形式,且大部分位于LBD区.携带相同突变的病人可呈现不同表型.     

先天性甲状腺功能减退症伴发育不全患儿FOXE1基因突变的初步研究

目的：研究先天性甲状腺功能减退症(CH)伴甲状腺发育不全患儿转录因子2( FOXE )的基因突变。方法：选取90 例CH伴甲 状腺发育不全患儿及90 例正常儿童作为对照,提取外周静脉血基因组DNA,采用PCR扩增与直接测序技术,对基因外 显子进行突变筛查。结果：分别在1 例先天性甲状腺功能减退症伴甲状腺发育不全患者外显子测序中发现一杂合错义变体c. A3401G (p.K1134R),在1 例患者中发现1 个已知的单核苷酸多态性(single nucleotide polymorphisms,SNP)位点(rs755282859, c. 483G>C),在正常对照组中未发现以上变化。结论：在先天性甲状腺功能减退症(CH) 伴甲状腺发育不全患儿中发现新的关于FOXE1 杂合错义变体。     

中国汉族两个马凡综合征家系FBN1基因的一个新插入突变和一个复发点突变

目的:明确两个中国北方汉族马凡综合征(Marfan syndrome,MFS)家系的临床特点,并对其进行基因诊断。方法:对两个家系进行家系调查和系谱分析,应用聚合酶链式反应-DNA测序方法对原纤维蛋白1基因(Fibrillin-1,FBN1)的所有外显子进行测序。应用Swiss-model、Polyphen-2和SIFT软件对发现的变异位点进行功能预测。结果:两个家系均呈常染色显性遗传特点,在家系1患者中发现一个新的插入突变,即第13外显子1691位碱基处插入碱基A(1691 ins A),导致蛋白在第571位氨基酸处翻译提前终止。此外,在家系2患者中发现一个已知的点突变,即第27外显子第3463位碱基由G变为A(3463 GA),导致第1155位氨基酸由天冬氨酸变为天冬酰胺。这两个变异位点在家系的健康人及50例健康对照中均未出现。功能预测发现这两个变异位点均可能会影响FBN1蛋白的结构或功能。结论:在两个MFS家系中发现一个新插入突变位点(1691 ins A)和一个已知点突变位点(3463 GA),为扩大FBN1基因的突变谱及进一步阐明FBN1基因突变在MFS中的作用提供理论依据。     

Ret：一种受体酪氨酸激酶及其基因突变与疾病

RET是一个在转化中发生重排的原癌基因,且因此行为而得名.它编码细胞膜受体酪氨酸激酶,初步研究表明它介导的信号转导途径较为独特.RET基因突变与人类4种癌症的发生相关：甲状腺乳头状腺癌存在RET基因与其他基因多种重排;多发性内分泌腺瘤2型,家族遗传甲状腺髓样癌等存在7个位点点突变;先天巨结肠疾病与RET基因缺失相关.因此近年来备受关注.对Ret蛋白的结构功能,RET基因突变对Ret蛋白功能的影响及与人类相关疾病的关系作一综述.     

人肝细胞癌中抑癌基因PTEN/MMAC1/TEP1的突变分析

PTEN／MMAC1／TEP1(PTEN)是新近分离到的抑癌基因,在多种肿瘤中存在突变。我们检测了34例人肝细胞癌中PTEN基因第5外显子和第8外显子的突变。采用聚合酶链方法以内含子引物扩增第5和第8外显子,继之以单链构象多态性和测序技术分析PTEN基因突变。有4例肝细胞癌SSCP显示异常条带并经测序证实存在突变。2例发生于第4内含子,突变位点相同;另两例发生于第8外显子,其中1例碱基颠换导致PTEN蛋白产物304位半胱氨酸突变为甘氨酸。     

RET原癌基因与先天性巨结肠相关性的分子遗传学研究进展

先天性巨结肠(hirschsprung disease,HSCR),又称肠无神经节细胞症,是典型的肠神经系统发育异常疾病.目前已经发现11种基因和5个易感位点与HSCR发病相关.其中RET原癌基因(RET proto-oncogene,RET)是主要的易感基因.虽然大部分HSCR发病风险都与RET基因相关,但只有不到15%的散发性HSCR患者发生RET基因编码区的突变.近期研究发现,RET基因非编码区的调节性突变可能在HSCR发生中起重要作用.现着重对RET基因与HSCR相关性的最新研究进展进行综述.     

Mutation analysis of the RET proto-oncogene in Dutch families with MEN 2A, MEN 2B and FMTC: two novel mutations and one de novo mutation for MEN 2A

Hereditary C-cell carcinoma is encountered in multiple endocrine neoplasia type 2A (MEN 2A), MEN 2B, and familial medullary thyroid carcinoma (FMTC). Mutations of the RET proto-oncogene are associated with all three diseases. To obtain an insight into the molecular heterogeneity of MEN 2 syndromes and FMTC in the Netherlands, probands of 20 MEN 2A families, two FMTC families, and seven MEN 2B families were analyzed by the polymerase chain reaction (PCR), DNA sequencing, and restriction enzyme digestion for abnormalities in the RET proto-oncogene. RET mutations were found in all cases. All MEN 2A families had a mutation involving one of five cysteine codons in exons 10 and 11 of RET. Two novel dinucleotide mutations and a de novo mutation were found. Both FMTC families had a mutation of the Cys at codon 618. All MEN 2B probands carried a Met to Thr mutation in exon 16. All mutations could be confirmed by restriction enzyme digestion of PCR amplicons. Identification of the RET mutation in the Dutch population with hereditary C-cell carcinoma facilitates genetic testing for families or individuals at risk for MEN 2A, FMTC, and MEN 2B.     

苯丙氨酸羟化酶（PAH）基因外显子7及其两侧内含子的突变研究

为探讨中国苯丙酮尿症（PKU）人群中苯丙氨酸羟化酶（PAH）基因外显子7的突变特征,对147例PKU患儿的294个PAH基因外显子7以及两侧部分内含子序列,应用PCR－单链构象多态性（SSCP）分析及基因序列分析的方法进行了筛查和确定。共发现13种突变基因：G239D、R241C、R241fs、R243Q、G247S、G247V、R252Q、L255S、R261Q、M276K、E280G、P281L、Ivs7+2T>A,其中7 种突变基因在中国PKU人群首次发现：G239D 、R241fs 、G247S 、E280G、L255S、R261Q、P281L,前4种在国际上尚未见到报道,并已提交到国际PAH突变数据库（www.pahdb.mcgill.ca）。突变基因的总频率为30.61%（90 /294）。突变涉及了错义、缺失、移码和剪接位点4种突变类型。结果明确了PAH基因外显子7的突变种类和分布等特征,表明外显子7是中国人PAH基因突变的热点区域。 Abstract: To study mutation in exon 7 of the gene for the phenylalanine hydroxylase（PAH）, the mutations in exon 7 and flanking sequence of PAH gene were detected by means of SSCP analysis and DNA sequencing, in 147 unrelated Chinese children with phynelketonuria and their parents. Thirteen different mutations, including 11 missense, 1 deletion and 1 splice mutation, were revealed in 90/294 mutant alleles (30.61%). The prevalent mutations were R243Q (22.8%) and Ivs7nt2t->a (2.38%). Seven novel mutations were identified: G239D, R241fsdelG, G247S, E280G, L255S, R261Q, P281L. These new mutations have not been described in Chinese PKU population and the first 4 mutants have not been reported and thus been submitted to www.pahdb,mcgill.ca. The missense was the most common type. The deletion and frameshift mutations were detected for the first time in Chinese PKU population. This study showed the mutation characteristics and their distribution in exon 7 of PAH gene and proved that the exon 7 was the hot region of PAH gene mutation in Chinese PKU population .     

Medullary thyroid carcinoma: pitfalls in diagnosis by fine needle aspiration cytology and relationship of cytomorphology to RET proto-oncogene mutations

OBJECTIVE: To elucidate the pitfalls in the diagnosis of medullary thyroid carcinoma (MTC) by fine needle aspiration cytology (FNAC) and the relationship of cytomorphology to RET proto-oncogene mutations. STUDY DESIGN: Cytomorphology was reviewed in the fine needle aspiration slides of 34 patients with MTC proven by surgery and pathology. Germline or somatic RET proto-oncogene mutations were determined using polymerase chain reaction-based sequencing in 15 of 34 patients, and the relationship to cytomorphology was evaluated. RESULTS: Twenty-eight (82.4%) of 34 cases were diagnosed correctly as MTC by FNAC, 3 cases were misdiagnosed as follicular neoplasm and 1 as desmoid, and 2 cases were suspicious for MTC. The main reason for misdiagnosis was overlooking the slight angular shape of the nuclei or atypical changes. In 15 of 34 cases with germline or somatic RET proto-oncogene mutations determined, 10 cases had a germline mutation, and 1 had only a somatic mutation. There were 4 cases that had neither germline nor somatic RET proto-oncogene mutations. Cells with small/round and spindled forms were the predominant findings of codon 918 ATG-->ACG mutation, and cells with small/round and large oval to polygonal forms were the main findings of codon 634 mutations. There were no misdiagnoses in patients with RET proto-oncogene mutations. CONCLUSION: FNAC is a good diagnostic method for MTC. Codon 918 mutation correlates mainly with small/round and spindled cells and codon 634 with small/round, large oval to polygonal forms.     

高脂血症患者脂蛋白脂酶基因外显子4区域变异的研究

为了探讨广东地区高脂血症患者脂蛋白脂酸(lipoprotein lipase,LPL)基因的分子变异,从258例高脂血症患者外周血白细胞中提取基因组DNA,用PCR-SSCP方法分析外显子4及其附近区域,对SSCP带型异常样品进行克隆和序列测定。在2名高脂血症患者LPL基因内含子3的3′端－6bp处发现C→T转换突变,252例正常对照中未发现该突变。IVS-3 的C→T突变可能与高脂血症有关。 Variants of Exon 4 and Its Flanking Region of LPL Genein Patients with Hyperlipidemia ZHAO Ying-she1,YANG Zhong-han2,FENG Jian-sheng1,JIANG Jian-wei1,WU Mei-yu1,ZHOU Tian-hong3 1.Department of Biochemistry,Medical College,Jinan University,Guangzhou 510632,China; 2.Department of Biochemistry,Sun Yat-sen University of Medical Sciences,Guangzhou 510089,China; 3.College of Life Sciences and Technology,Jinan University,Guangzhou 510632,China Abstract:To elucidate abnormalities of LPL gene in hyperlipidemia in the Chinese population in Guangdong,genomic DNA was extracted from leukocyte of 258 patients with primary hyperlipidemia.A segment of LPL gene including exon 4 and its flanking sequences was analyzed by PCR-SSCP.The PCR products with abnormal SSCP pattern were cloned and sequenced. As a C→T transition mutation at-6 bp of intron 3 was found in two Chinese with hyperlipidemia and the mutation was not found in 252 normolipidemic controls,the C→T transition in intron 3 may be related to hyperlipedemia. Key words：lipoprotein lipase;hyperlipidemia;polymerase chain reaction;single strand conformation polymorphism     

人肝细胞癌中抑癌基因PTEN／MMAC1／TEP1的突变分析

PTEN/MMAC1/TEP1 is a tumor suppressor gene. Its mutation has been found in several different types of human cancers. 34 primary human hepatocellular carcinomas have been examined for mutations in exon 5 and exon 8 of the PTEN gene. Exon 5 and exon 8 were amplified by polymerase chain reaction (PCR) with intronic primers and subjected to single strand conformation polymorphism (SSCP) analysis. SSCPs were found in 4 of the 34 hepatocellular carcinomas analyzed. Direct sequencing of the PCR products identified single base-pair substitutions in the four tumor DNA samples, two in intron 4 and two in exon 8. One of the base-pair substitution in exon 8 is a missense mutation, which changed codon 304 of PTEN protein from Cys to Gly. These data suggest that PTEN may be involved in the carcinogenesis and development of hepatocellular carcinoma.     

Description of the first two seemingly unrelated Greek Cypriot families with a common C618R RET proto-oncogene mutation

Germ-line mutations of the RET proto-oncogene cause three different cancer syndromes: multiple endocrine neoplasia type 2A (MEN2A), multiple endocrine neoplasia type 2B, and familial medullary thyroid carcinoma (FMTC). The objective of the present study was the clinical and molecular characterization of the first two Greek Cypriot families diagnosed with MEN2A and FMTC. The clinical diagnosis of the probands was based on clinical presentation and supported with laboratory findings (calcitonin and carcinoembryonic antigen tumor marker levels). We screened the RET gene by direct DNA sequencing of exons 10, 11, and 16 using genomic DNA as templates. After identification of the mutation, we also developed the amplification refractory mutation system (ARMS) as an alternative method to direct sequencing for genetic diagnosis of 22 additional individuals from both families. We identified the germ-line missense mutation T --> C of codon 618 of exon 10 (C618R) in the probands of both families. By using ARMS, two members of the MEN2A family and five members of the FMTC family were also found positive for the C618R mutation. These are the first seemingly unrelated families in Cyprus investigated clinically and molecularly in detail and shown to transmit this common RET proto-oncogene mutation.     

Efficient mutation detection in mismatch repair genes using a combination of single-strand conformational polymorphism and heteroduplex analysis at a controlled temperature

Single-strand conformational polymorphism analysis (SSCP) and heteroduplex analysis (HD) were tested as methods for mutation screening with respect to experimental variation, sensitivity, and specificity. Thirty-nine fluorescently labeled PCR products covering the two mismatch repair genes, hMLH1 and hMSH2, were tested in 15 patients for pattern changes, using SSCP and HD at two temperatures, in a total of 2340 runs. SSCP was most efficient in detecting base changes, whereas HD was the method of choice when detecting deletions. SSCP and HD at 20 degrees C were most effective (sensitivity 97%, specificity 49%), and SSCP and HD at 10 degrees C gave no additional information, except in one case where an exon had two base changes. Several mutations only showed a small pattern change in one of the two strands, most explicit at 20 degrees C. No correlation between the type of base change and the size or direction of the pattern changes could be found.