罕见病研究2024,Vol.3Issue(1) :63-76.DOI:10.12376/j.issn.2097-0501.2024.01.009

WT1基因变异与Denys-Drash综合征和Frasier综合征的基因型-表型关联性分析

Genotype-Phenotype Correlation Analysis of WT1 Gene Variants in Denys-Drash Syndrome and Frasier Syndrome

曹雅清 郭保程 聂敏
罕见病研究2024,Vol.3Issue(1) :63-76.DOI:10.12376/j.issn.2097-0501.2024.01.009

WT1基因变异与Denys-Drash综合征和Frasier综合征的基因型-表型关联性分析

Genotype-Phenotype Correlation Analysis of WT1 Gene Variants in Denys-Drash Syndrome and Frasier Syndrome

曹雅清 1郭保程 1聂敏1
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作者信息

  • 1. 中国医学科学院北京协和医院内分泌科国家卫生健康委员会内分泌重点实验室,北京 100730
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摘要

目的 探讨WT1 不同基因型与Denys-Drash综合征(DDS)和Frasier综合征(FS)不同表型之间的关联.方法 检索和归纳1991 年1 月1 日至2023 年10 月31 日期间NCBI PubMed和CNKI数据库收录的WT1 基因变异患者信息,分析变异类型、发生位置和进展性肾功能损伤、泌尿生殖系统发育不全、肾母细胞瘤、性腺肿瘤等表型的关联性.结果 本研究纳入128 篇文献,包含304 例研究对象,检出 86 种WT1 致病性变异.这些变异的位置分布特点为:最常见发生于外显子9(24/86,27.9%)和外显子8(23/86,26.7%);变异类型特点为:错义变异(51/86,59.3%)最常见,次常见为剪接位点变异(13/86,15.1%).WT1 基因变异导致的疾病种类特点为:DDS病例数最多(174/304,57.2%),其次为FS(83/304,27.3%);DDS主要由外显子 9 和外显子 8 上的错义变异(143/174,82.2%)导致,而FS主要由内含子9 上的剪接位点变异(76/83,91.6%)导致.结论 WT1 基因上外显子 9 和外显子 8 的错义变异主要导致DDS,而内含子9 的剪接变异主要导致FS.对进展性肾损伤的婴幼儿及儿童应进行泌尿生殖系统的全面评估,早期明确基因诊断,以改善预后.

Abstract

Objective This study aims to explore the association between different genotypes of WT1 gene variations and the phenotypes of Denys-Drash syndrome(DDS)and Frasier syndrome(FS).Methods Through searching and summarizing the case information of WT1 gene variations recorded in NCBI PubMed and CNKI databases from January 1,1991 to October 31,2023,we analyzed the association between variation types,occurrence locations,and phenotypes such as progressive renal function impairment,genitourinary developmental abnormalities,nephroblastoma,and gonadal tumors between DDS and FS.Results A total of 128 articles,including 304 subjects,were included in this study,and 86 pathogenic variations of the WT1 gene were detected.The distribution characteristics of these variations were as follows:the most common occurrence was in exon 9(24/86,27.9%)and exon 8(23/86,26.7%);the most common variation type was missense mutation(51/86,59.3%),followed by splice site mutation(13/86,15.1%).The disease types caused by WT1 gene variations were as follows:DDS had the highest number of cases(174/304,57.2%),followed by FS(83/304,27.3%);DDS was mainly caused by missense mutations on exon 9 and exon 8(143/174,82.2%),while FS was mainly caused by splice site mutations on intron 9(76/83,91.6%).Conclusions The missense variants in exon 9 and exon 8 on the WT1 gene mainly resulted in DDS,while the splice variants in intron 9 mainly resulted in FS.Infants and children with progressive renal injury should undergo a comprehensive evaluation of the genitourinary system,and early genetic diagnosis should be established to improve prognosis.

关键词

WT1基因/Denys-Drash综合征/Frasier综合征/46,XY性发育障碍/孤立性肾病综合征/肾母细胞瘤

Key words

WT1 gene/Denys-Drash syndrome/Frasier syndrome/46,XY disorders of sex development/isolated nephrotic syndrome/Wilms tumor

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基金项目

中央高水平医院临床科研业务费(2022-PUMCH-D-002)

中国医学科学院医学与健康科技创新工程(2021-I2M-1-003)

出版年

2024
罕见病研究

罕见病研究

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