神经解剖学杂志2024,Vol.40Issue(2) :153-161.DOI:10.16557/j.cnki.1000-7547.2024.02.003

DMD基因c.2622+2T>C导致假肥大型肌营养不良的时空表达特异性分析

Spatiotemporal expression specificity analysis of Duchenne/Becker muscular dystrophy caused by DMD gene c.2622+2T>C variant

张李钰 车凤玉 王国霞 李本昌 莫丽党芝 杨颖
神经解剖学杂志2024,Vol.40Issue(2) :153-161.DOI:10.16557/j.cnki.1000-7547.2024.02.003

DMD基因c.2622+2T>C导致假肥大型肌营养不良的时空表达特异性分析

Spatiotemporal expression specificity analysis of Duchenne/Becker muscular dystrophy caused by DMD gene c.2622+2T>C variant

张李钰 1车凤玉 1王国霞 1李本昌 1莫丽党芝 1杨颖1
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作者信息

  • 1. 西安市儿童医院,陕西省儿科疾病研究所,西安 710003
  • 折叠

摘要

目的:对一例假肥大型肌营养不良(DMD)患儿进行基因变异分析,探究基因型和临床表型的相关性.方法:采集家系成员的临床数据和家族史,采用多重连接探针扩增技术(MLPA)检测目标基因拷贝数变异是否异常、全外显子组测序(WES)分析先证者致病基因、Sanger测序验证可疑位点.针对发现的剪切位点突变构建mini-gene表达载体,采用mRNA体外剪接mini-gene实验验证变异对mRNA剪切的影响.结果:该家系先证者男,双下肢无明显受累,外周血肌酸激酶(CK)水平升高(700~1600 U/L),肌电图示肌源性损害.MLPA检测未发现受检者DMD基因存在外显子拷贝数变异.测序结果显示先证者携带DMD基因(NM_004006.2)c.2622+2T>C母源剪切变异.体外mini-gene实验发现该变异影响剪切且产生多种新转录本.结合患儿临床表现及基因检测结果,推测受检者为DMD基因剪切变异导致的假肥大型肌营养不良.结论:本研究明确了 DMD基因剪切变异为一例DMD患儿致病原因,进一步丰富了中国DMD突变谱,证实了 DMD基因c.2622+2T>C变异可产生多种转录本导致不同的功能受损,对患者临床表现与基于时空表达相关联,有一定的基因型-表型对应关系的参考意义.

Abstract

Objective:To analyze the gene variants of a patient affected with Duchenne/Becker muscular dystrophy in a pedigree and further explore the genotype-phenotype correlation for providing basis for family genetic counseling.Methods:The clinical features and family history of family members were collected.Multiplex ligation-dependent probe amplification(MLPA)was utilized to detect copy number variation of target genes.The pathogenic variations were ana-lyzed by whole exome sequencing(WES).The suspected gene variations were verified by Sanger sequencing.For the splice site mutations,mini-gene was constructed and expressed in vitro to detect the number of transcript and cDNA se-quence.Results:The proband of this family is a male,with no obvious involvement of the lower limbs.Laboratory tests showed an elevated level of creatine kinase(CK)in peripheral blood(700-1600 U/L),and electromyography showed myogenic damage.MLPA did not detect pathogenic exon copy number variation in dystrophin(DMD)gene.Genetic testing showed the proband carried a maternal hemizygotic splicing variation of DMD gene(NM_004006.2):c.2622+2T>C.An in vitro mini-gene splicing assay confirmed that this splicing mutation could affect RNA splicing.According to clinical features and genetic testing results,the proband was speculated first proof of Duchenne/Becker muscular dys-trophy(DMD/BMD)caused by DMD gene mutation.Conclusion:This study identified the pathogenic variation of a proband with DMD/BMD of DMD gene,which enriched the variation spectrum of DMD/BMD in China.It was con-firmed that the splicing variation of the DMD gene c.2622+2T>C can produce multiple transcripts leading to different functional impairments,and based on the specificity of temporal and spatial expression,it corresponded to the mild clin-ical manifestations of the patient,providing some reference value for the correlation between genotype and phenotype.

关键词

肌营养不良蛋白基因/剪切变异/mini-gene技术/假肥大型肌营养不良

Key words

dystrophin gene/splicing variation/mini-gene technique/Duchenne/Becker muscular dystrophy

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基金项目

陕西省创新能力支撑计划(2019KJXX-055)

陕西省自然科学基础研究计划(2023-JC-QN-0208)

西安市儿童医院院级项目(2022C04)

出版年

2024
神经解剖学杂志
中国解剖学会,第四军医大学

神经解剖学杂志

CSTPCD北大核心
影响因子:0.538
ISSN:1000-7547
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