Comparison of complementary and genomic DNA sequencing for the detection of mutations in the HMBS gene in British patients with acute intermittent porphyria: identification of 25 novel mutations |
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Authors: | Sharon D Whatley Jackie R Woolf G H Elder |
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Institution: | (1) Department of Medical Biochemistry, University Hospital of Wales NHS Healthcare Trust and University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK e-mail: elder@cardiff.ac.uk, Tel.: +44-1222-742799, Fax: +44-1222-744905, GB |
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Abstract: | Acute intermittent porphyria (AIP) is a low-penetrant autosomal dominant disorder caused by mutations in the hydroxymethylbilane
synthase (HMBS) gene. Direct detection of mutations is becoming the method of choice for the accurate identification of asymptomatic affected
individuals within AIP families so that they can be advised to avoid drugs and other compounds that provoke the life-threatening
acute neurovisceral crises that characterise the condition. We describe a prospective comparison of direct automated sequencing
of cDNA (29 patients) or genomic DNA (28 patients) to identify HMBS mutations in 57 patients referred consecutively for mutational analysis; 39 different mutations were identified in 54 patients.
The sensitivity of the cDNA and genomic DNA methods was 69% and 95%, respectively, indicating that analysis of genomic DNA
provides a higher mutation detection rate. Thirty mutations were restricted to a single family; only one (R173W) occurred
in more than three families. Of the mutations (6 missense, 8 splice defects, 10 frameshifts, 1 nonsense), 25 have not been
reported previously. One novel mutation (344+33G→T) was located in a putative intron splice enhancer in intron 7. Our results
define the extent of allelic heterogeneity and the types (41% missense; 59% truncating) and distribution (35% in exons 10,
12, 14) of HMBS mutations, for AIP in the United Kingdom.
Received: 4 January 1999 / Accepted: 19 March 1999 |
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