尿调蛋白基因突变引起的常染色体显性肾小管间质性肾病(ADTKD-UMOD)是一系列遗传性肾病,以早发高尿酸血症为特征,痛风和进行性肾病。这项研究在ADTKD家系中提出了一种新的UMOD突变,并回顾了中国人群的研究。索引患者是一名16岁的高血压女孩,高尿酸血症和血清肌酐水平正常。四个受影响的成员和六个未受影响的成员可用于遗传筛选。通过下一代测序和直接测序进行突变分析。进行了文献研究以回顾中国ADTKD-UMOD病例。MEDLINE和中国生物医学数据库用“尿调蛋白”进行了搜索,“青少年痛风”及其相关术语。基因测序显示外显子3(Cys223Gly)内有从头突变,在这个谱系中与表型共分离。在审查中,4项研究和我们的研究共涉及11个家庭的67例ADTKD患者.在这些病人中,27例被证实携带UMOD突变。通常观察到外显子3中发生的突变,而在中国ADTKD-UMOD病例中,外显子4、5和9内的突变发生率较低。在这些案例中,症状发作的中位年龄为26.5岁,终末期肾病(ESRD)或ESRD导致的死亡的中位年龄为41.9岁,未接受肾脏替代治疗.D8C结构域突变引起的表型似乎比GPI结构域严重。与其他种族的患者相比,中国ADTKD-UMOD患者更积极地进展到ESRD。
Autosomal dominant tubulointerstitial kidney disease caused by mutations in uromodulin gene (ADTKD-UMOD) is a spectrum of hereditary renal disorders, characterized by early-onset hyperuricemia, gout and progressive nephropathy. This
study presented a novel UMOD mutation in an ADTKD pedigree and reviewed studies in Chinese population. The index patient is a 16-year-old girl with hypertension, hyperuricemia and normal serum creatinine level. Four affected and six unaffected members were available for genetic screen. The mutation analysis was performed by next-generation sequencing and direct sequencing. A literature research was conducted to review Chinese ADTKD-UMOD cases. MEDLINE and Chinese Biomedicine Databases were searched with \'uromodulin\', \'juvenile gout\' and their related terms. Genetic sequencing revealed a de novo mutation within exon 3 (Cys223Gly), which was co-segregating with phenotype in this pedigree. In the review, four studies and our
study involving a total of 67 ADTKD patients from 11 families were identified. Of these patients, 27 were confirmed to carry UMOD mutations. Mutations occurred in exon 3 were commonly observed, while mutations within exon 4, 5 and 9 occurred less frequently in Chinese ADTKD-UMOD cases. Among these cases, median age of symptom onset was 26.5 years, median age of end-stage renal diseases (ESRD) or death by ESRD was 41.9 years without renal replacement treatment. Phenotype caused by mutations in D8C domain seemed to be severe than those in GPI domain. Compared with patients of other race, Chinese ADTKD-UMOD patients advanced more aggressively to ESRD.