基础医学与临床 ›› 2024, Vol. 44 ›› Issue (5): 677-682.doi: 10.16352/j.issn.1001-6325.2024.05.0677

• 研究论文 • 上一篇    下一篇

2例中国原发性纤毛运动障碍患者致病变异的鉴定

郑海霞1, 周王继2, 田欣伦2*, 刘雅萍3*   

  1. 1.中国医学科学院基础医学研究所 北京协和医学院基础学院 麦库西克-张孝骞协和遗传医学中心疑难重症及罕见病国家重点实验室,北京 100005;
    中国医学科学院 北京协和医学院 北京协和医院 2.呼吸与危重症医学科 疑难重症及罕见病国家重点实验室;3.临床医学研究所,北京 100730
  • 收稿日期:2024-02-19 修回日期:2024-03-19 出版日期:2024-05-05 发布日期:2024-04-23
  • 通讯作者: *ypliu_pumc@163.com;xinlun_t@sina.com
  • 基金资助:
    北京协和医院中央高水平医院临床科研专项-科技创新人才项目(2023-PUMCH-E-012)

Identification of the pathogenic variants in two Chinese patients with primary ciliary dyskinesia

ZHENG Haixia1, ZHOU Wangji2, TIAN Xinlun2*, LIU Yaping3*   

  1. 1. McKusick-Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare Diseases, Institute of Basic Medical Sciences CAMS, School of Basic Medicine PUMC, Beijing 100005;
    2. Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases; 3. Institute of Clinical Medicine, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
  • Received:2024-02-19 Revised:2024-03-19 Online:2024-05-05 Published:2024-04-23
  • Contact: *ypliu_pumc@163.com;xinlun_t@sina.com

摘要: 目的 分析2例中国原发性纤毛运动障碍(PCD)患者的临床特征,并进行致病变异鉴定。方法 收集患者的临床资料,采集患者外周血提取基因组DNA,应用全外显子组测序(WES)和Sanger测序鉴定PCD的潜在致病变异,最后通过生物信息学分析预测候选变异的致病性。结果 2例中国PCD患者均有双肺弥漫性支气管扩张合并感染,鼻呼出一氧化氮(nNO)水平均低于正常值。WES结果发现两例患者均携带PCD已知致病基因的移码突变。患者1携带外动蛋白臂对接复合物亚基1(ODAD1)(NM_144577)基因纯合变异:c.702_705dupGCAG (p.P236Afs*11),患者2携带动力蛋白轴丝组装因子6(DNAAF6) (NM_173494)基因半合子变异:c.532_533delCT (p.L178Sfs*2)。2个变异均未被人类基因突变数据库(HGMD)收录。这两个移码突变均会引起开放阅读框改变,导致终止密码子提前出现。根据美国医学遗传学与基因组学学会(ACMG)指南,ODAD1基因c.702_705dupGCAG变异被判定为致病变异(PVS1+PM2+PM3+PP4),DNAAF6基因c.532_533delCT变异被判定为致病变异(PVS1+PM2+PM3+PP4)。结论 本研究新发现的ODAD1变异c.702_705dupGCAG及DNAAF6变异c.532_533delCT分别是这2例患者的致病变异,支持其PCD诊断。以上结果将丰富ODAD1和DNAAF6的突变谱。

关键词: 原发性纤毛运动障碍, 全外显子组测序, 致病变异

Abstract: Objective To characterize the clinical features and to identify the pathogenic variants in two Chinese patients with primary ciliary dyskinesia (PCD). Methods The clinical data and peripheral blood sample from the patients were collected, and genomic DNA was subsequently extracted from the peripheral blood. Candidate pathogenic variants were identified using whole exome sequencing (WES) and further confirmed by Sanger sequencing technology. Finally, the pathogenicity of the variants was predicted through bioinformatic analysis. Results Two Chinese patients with PCD had diffuse bronchiectasis cpmlicated with recurrent infection and the decreased level of nasal nitric oxide (nNO). WES results showed that both patients carried frameshift mutations in known pathogenic genes of PCD. Patient 1 carried a homozygous variant in outer dynein arm docking complex subunit 1 (ODAD1) (NM_144577): c.702_705dupGCAG (p.P236Afs*11) and patient 2 carried a hemizygous variant in dynein axonemal assembly factor 6 (DNAAF6) (NM_173494): c.532_533delCT (p.L178Sfs*2). Neither variant had been recorded in The Human Gene Mutation Database (HGMD). Both frameshift variants caused changes in the open reading frame, which resulted in premature termination codon. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, c.702_705dupGCAG in ODAD1 was categorized as a pathogenic variant (PVS1+PM2+PM3+PP4) and c.532_533delCT in DNAAF6 was categorized as a pathogenic variant (PVS1+PM2+PM3+PP4). Conclusions The novel variants c.702_705dupGCAG found in ODAD1 and c.532_533delCT found in DNAAF6 are pathogenic and support their PCD diagnosis for the two patients, respectively. These results may enrich the mutation spectrum of the ODAD1 and DNAAF6.

Key words: primary ciliary dyskinesia, whole exome sequencing, pathogenic variant

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