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外显子测序揭示罕见疾病致病基因

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来自魁北克的医生和研究员们发现引起多个肠闭锁疾病(MIA)的基因,多个肠闭锁是一种罕见,但危及新生儿生命的遗传异常性疾病。另外,研究员们也探究了新的治疗方法,他们发现基因TTC7A也可作为一种潜在的诊断测试和筛选测试的工具,针对携带有这种基因的父母。 MIA是一种先天性疾病,表现为全消化道的多处梗阻——从胃到小肠及结肠——与严...






来自魁北克的医生和研究员们发现引起多个肠闭锁疾病(MIA)的基因,多个肠闭锁是一种罕见,但危及新生儿生命的遗传异常性疾病。另外,研究员们也探究了新的治疗方法,他们发现基因TTC7A也可作为一种潜在的诊断测试和筛选测试的工具,针对携带有这种基因的父母。

MIA是一种先天性疾病,表现为全消化道的多处梗阻——从胃到小肠及结肠——与严重的免疫缺陷有关。通过研究MIA患者的小儿的DNA,研究团队们发现TTC7A基因发生了突变,其中一种TTC7A基因的突变在法国说魁北克语的人群中很常见。

一个毁灭性和危胁生命的疾病

这种疾病很罕见,在过去的30年了,在魁北克大约发生了30例。但即使在今天,这个疾病仍是一个毁灭性和致命性的疾病。Dr. Bruno Maranda表示:“多种手术,包括肠道移植和骨髓移植都不能真正解决这个问题。即使经过多种干预,新生儿的消化道仍不能正常的工作。这些孩子大约只能活2个或3个月。这个基因的发现,可以作为诊断这种疾病的一种工具。”

遗传原因

尽管这种疾病很罕见,它在魁北克法裔加拿大人口中发生的频率相对较高,根据研究表示,这部分人群影响了世界上其它的人群。原因最可能是遗传引起的。表现为隐性遗传。Vincent Raymond表示:“我们发现许多先天的MIA患者携带有来自父母双方的相同的基因突变。这项发现表明这种隐性遗传性疾病突变来自父亲和母亲。而且父母不会患这种疾病,因此它们也不知道它们携带了这种突变。TTC7A基因的发现使我们知道了引起这种疾病的原因。对魁北克家族及世界上携带有这种突变的家族来说这是个好消息。”

对怀孕妇女及家庭中可能携带有这种突变的人群进行筛查

MIA患者的家族,母亲再怀孕就会有25%的风险生出MIA的患儿。Dr. Maranda表示:“产前诊断来筛查再次怀孕的孕妇肚子的孩子是否会患这种疾病。我们同使也可以进行家族成员的筛查,比如兄弟姐妹携带有这种突变,他们的后代患这种疾病的风险。”
CHUS2013年夏季将会提供产前诊断测试及筛选测试。进一步的研究将会帮助人群如何阻止MIA患者的出生及发现基因的携带着。这项测试也是遗传性疾病的一个整体性研究。

新的治疗方法

Dr. Mark Samuels表示:“这个基因的发现为患MIA的患儿打开了潜在的治疗的大门,这个基因的发现将会帮助我们更好的理解这种疾病的潜在的机制及其涉及的免疫调节。”Dr. Elie Haddad表示:“这项发现将会帮助我们更好的理解小儿异常的消化道发育与异常免疫调节之间的关系。”

原文链接:


Exome sequencing identifies mutations in the gene TTC7A in French-Canadian cases with hereditary multiple intestinal atresia


BACKGROUND: Congenital multiple intestinal atresia (MIA) is a severe, fatal neonatal disorder, involving the occurrence of obstructions in the small and large intestines ultimately leading to organ failure. Surgical interventions are palliative but do not provide long-term survival. Severe immunodeficiency may be associated with the phenotype. A genetic basis for MIA is likely. We had previously ascertained a cohort of patients of French-Canadian origin, most of whom were deceased as infants or in utero. The goal of the study was to identify the molecular basis for the disease in the patients of this cohort.
METHODS: We performed whole exome sequencing on samples from five patients of four families. Validation of mutations and familial segregation was performed using standard Sanger sequencing in these and three additional families with deceased cases. Exon skipping was assessed by reverse transcription-PCR and Sanger sequencing.
RESULTS: Five patients from four different families were each homozygous for a four base intronic deletion in the gene TTC7A, immediately adjacent to a consensus GT splice donor site. The deletion was demonstrated to have deleterious effects on splicing causing the skipping of the attendant upstream coding exon, thereby leading to a predicted severe protein truncation. Parents were heterozygous carriers of the deletion in these families and in two additional families segregating affected cases. In a seventh family, an affected case was compound heterozygous for the same 4bp deletion and a second missense mutation p.L823P, also predicted as pathogenic. No other sequenced genes possessed deleterious variants explanatory for all patients in the cohort. Neither mutation was seen in a large set of control chromosomes.
CONCLUSIONS: Based on our genetic results, TTC7A is the likely causal gene for MIA.






来源:测序中国

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