眼科

• 论著 • 上一篇    下一篇

两个Waardenburg综合征家系致病基因突变和临床特征分析

陈纯洁  肖婷  许可  谢玥  张晓慧  李杨   

  1. 100730首都医科大学附属北京同仁医院  北京同仁眼科中心  北京市眼科研究所  眼科学与视觉科学北京市重点实验室
  • 收稿日期:2019-04-10 出版日期:2019-05-25 发布日期:2019-06-06
  • 通讯作者: 李杨,Email: yanglibio@aliyun.com E-mail:yanglibio@aliyun.com
  • 基金资助:

    国家重点研发计划(2016YFC0905200)

Genetic and phenotype characteristics analysis of two Waardenburg syndrome families

CHEN Chun-jie, XIAO Ting, XU Ke, XIE Yue, ZHANG Xiao-hui, LI Yang   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of  Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University,  Beijing 100730, China
  • Received:2019-04-10 Online:2019-05-25 Published:2019-06-06
  • Contact: LI Yang, Email: yanglibio@aliyun.com E-mail:yanglibio@aliyun.com

摘要:

目的 分析两个Waardenburg综合征家系中先证者和2例患病家系成员的临床表现和致病基因突变特征。设计 回顾性病例系列。研究对象 2018年北京同仁医院两个Waardenburg综合征家系4例患者。方法 记录两个家系中先证者和患病成员以及可疑患病成员的病史以及毛发和皮肤色素异常的情况,并对先证者和2例患病成员进行详细眼科检查和耳科听力检测。采集先证者、其父母及患病成员的外周血样。对先证者进行Waardenburg综合征的6个已知的致病基因Sanger测序检测,应用多种在线生物信息学分析软件对检出的突变进行致病性预测,并对致病性突变进行家系共分离验证,最后根据美国医学遗传学与基因组学学会致病性分级指南对突变进行分级。主要指标 致病基因突变、眼部及全身色素异常情况、眼底情况、听力。结果 在两个Waardenburg综合征家系中分别检出EDNRB 基因p.G186E和PAX基因p.C70R 两个杂合错义突变,分别导致Waardenburg综合征IV型和Waardenburg综合征I型。两个家系的先证者均有虹膜色素异常、听力差、头发变白和鼻根部宽的表现,但程度和部位有所不同。两个家系内所有确诊或可疑患病的成员均有头发变白或额前白发,而无皮肤色素异常表现。结论 本研究确定了两个Waardenburg综合征家系的致病基因,扩大了PAX3和EDNRB基因突变谱,基因检测是可疑Waardenburg综合征患者鉴别诊断及分型的重要手段。

关键词: Waardenburg综合征, EDNRB基因, PAX3基因, 基因突变

Abstract:

Objective To report genetic and clinical features of two Waardenburg syndrome families. Design Retrospective case series. Participants Two Waardenburg syndrome families, four patients, were collected from Beijing Tongren Hospital in 2018. Methods The medical history, abnormalities of hair, and skin pigmentation of the probands and the affected members in the two families were recorded. The probands and affected members underwent a detailed ophthalmic evaluation and auditory examinations. Peripheral blood were collected from two probands and their family members and the relationships of the members and pedigree diagrams were recorded. The DNA of two probands were sequenced with six genes lead to Waardenburg syndrome with Sanger sequencing. The online bioinformatics analysis software were used to predict the pathogenicity of the detected mutations, and the pathogenic mutations were performed the co-segregated analysis. Finally, according to the American College of Medical Genetics and Genomics (ACMG) pathogenic grading guidelines, the detected mutations were classified into the five levels. Main Outcome Measures Pathogenic mutation, eye and systemic pigment abnormalities, fundus and audiometry. Results EDNRB and PAX gene mutations were detected in two Waardenburg syndrome families, caused Waardenburg syndrome type I and Waardenburg syndrome type IV, respectively. The probands of both families had abnormal iris pigmentation, poor hearing, whitening of the hair and wide roots of the nose, but the degree and location were different. All confirmed or suspected members of both families had white hair or prefrontal white hair without abnormal skin pigmentation. Conclusion The study identified the pathogenic genes of two Waardenburg syndrome families and expanded the mutation spectrum of PAX3 and EDRRB genes. Genetic testing is an important means for differential and subtypes diagnosis of the suspected Waardenburg syndrome.

Key words: Waardenburg syndrome, EDNRB gene, PAX3 gene, gene mutation