Ciliopathies

纤毛病
  • 文章类型: Case Reports
    背景:常染色体隐性遗传性多囊肾病(ARPKD)是一种罕见的遗传性囊性疾病,其特征是双侧肾囊肿形成和先天性肝纤维化。ARPKD尚未报道心血管疾病,例如心室心肌致密化不全(NVM)。
    方法:一名5个月大的女孩出现发热、尿浊1天后进行检查,诊断为尿路感染。尿超声显示多个圆形,两个肾脏大小不同的小囊肿。基因检测发现多囊肾肝病1基因有2个杂合突变和1个外显子缺失,提示ARPKD的诊断。住院期间,她被发现呼吸道感染后患有慢性心力衰竭,射血分数为29%,缩短分数为13%。当病人15个月大的时候,通过超声心动图发现,她有明显的小梁和较深的小梁间凹陷,并出现了从心室腔进入小梁间凹陷的血流。非致密化心肌为0.716cm,致密化心肌为0.221cm(N/C=3.27),指示NVM的诊断。4年随访期间肝肾功能保持正常。
    结论:这是ARPKD患者的NVM首次报告。不确定NVM和ARPKD的共存是否是巧合,或者它们是心脏和肾脏纤毛功能障碍的不同表现。
    BACKGROUND: Autosomal recessive polycystic kidney disease (ARPKD) is a rare inherited cystic disease characterized by bilateral renal cyst formation and congenital liver fibrosis. Cardiovascular disorders such as noncompaction of ventricular myocardium (NVM) have not been reported with ARPKD.
    METHODS: A 5-month-old girl was examined after presenting with a fever and turbid urine for one day and was diagnosed as urinary tract infection. Urinary ultrasound showed multiple round, small cysts varying in size in both kidneys. Genetic testing revealed two heterozygous mutations and one exon deletion in the polycystic kidney and hepatic disease 1 gene, indicating a diagnosis of ARPKD. During hospitalization, she was found to have chronic heart failure after respiratory tract infection, with an ejection fraction of 29% and fraction shortening of 13%. When the patient was 15 months old, it was found that she had prominent trabeculations and deep intertrabecular recesses with the appearance of blood flow from the ventricular cavity into the intertrabecular recesses by echocardiography. The noncompaction myocardium was 0.716 cm and compaction myocardium was 0.221 cm (N/C = 3.27), indicating a diagnosis of NVM. Liver and kidney function remained normal during four-year follow-up.
    CONCLUSIONS: This is the first report of NVM in a patient with ARPKD. It is unsure if the coexistence of NVM and ARPKD is a coincidence or they are different manifestations of ciliary dysfunction in the heart and kidneys.
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  • 文章类型: Journal Article
    背景:综合征性纤毛病是一组以广泛的临床和遗传重叠为特征的先天性疾病,包括肥胖,视觉问题,骨骼异常,智力迟钝,和肾脏疾病。这些疾病中病理生理学的标志是纤毛功能或形成缺陷。许多不同的基因与这些疾病的发病机理有关,但一些患者仍不清楚他们的基因型。
    方法:本研究的目的是确定综合征性纤毛病患者的遗传原因。在台湾南部的一个单一诊断医疗中心招募了怀疑或符合任何类型的综合征性纤毛病临床诊断标准的患者。全外显子组测序(WES)用于鉴定其基因型并阐明台湾综合征性纤毛病患者的突变谱。在患者登记时收集临床信息。
    结果:共有14例分子诊断为综合征型纤毛病。在这些案例中,10人患有Bardet-Biedl综合征(BBS),包括8例BBS2患者和2例BBS7患者。此外,两例被诊断为Alström综合征,一个患有14型口腔-面部-数字综合征,另一个患有10型Joubert综合征。总共鉴定了4种新的变体。一个反复发生的剪接位点突变,BBS2:c.534+1G>T,存在于所有8名BBS2患者中,暗示了创始人的影响。一名具有纯合子c.534+1G>T突变的BBS2患者携带第三个纤毛等位基因,TTC21B:c.264_267dupTAGA,无义突变导致过早终止密码子和蛋白质截短。
    结论:全外显子组测序(WES)有助于识别纤毛病患者的分子致病变异,以及特定人群的遗传热点突变。应将其视为以多种基因和多种临床表现为特征的异质性疾病的一线基因检测。
    BACKGROUND: Syndromic ciliopathies are a group of congenital disorders characterized by broad clinical and genetic overlap, including obesity, visual problems, skeletal anomalies, mental retardation, and renal diseases. The hallmark of the pathophysiology among these disorders is defective ciliary functions or formation. Many different genes have been implicated in the pathogenesis of these diseases, but some patients still remain unclear about their genotypes.
    METHODS: The aim of this study was to identify the genetic causes in patients with syndromic ciliopathy. Patients suspected of or meeting clinical diagnostic criteria for any type of syndromic ciliopathy were recruited at a single diagnostic medical center in Southern Taiwan. Whole exome sequencing (WES) was employed to identify their genotypes and elucidate the mutation spectrum in Taiwanese patients with syndromic ciliopathy. Clinical information was collected at the time of patient enrollment.
    RESULTS: A total of 14 cases were molecularly diagnosed with syndromic ciliopathy. Among these cases, 10 had Bardet-Biedl syndrome (BBS), comprising eight BBS2 patients and two BBS7 patients. Additionally, two cases were diagnosed with Alström syndrome, one with Oral-facial-digital syndrome type 14, and another with Joubert syndrome type 10. A total of 4 novel variants were identified. A recurrent splice site mutation, BBS2: c.534 + 1G > T, was present in all eight BBS2 patients, suggesting a founder effect. One BBS2 patient with homozygous c.534 + 1G > T mutations carried a third ciliopathic allele, TTC21B: c.264_267dupTAGA, a nonsense mutation resulting in a premature stop codon and protein truncation.
    CONCLUSIONS: Whole exome sequencing (WES) assists in identifying molecular pathogenic variants in ciliopathic patients, as well as the genetic hotspot mutations in specific populations. It should be considered as the first-line genetic testing for heterogeneous disorders characterized by the involvement of multiple genes and diverse clinical manifestations.
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  • 文章类型: Journal Article
    背景:Bardet-Biedl综合征(BBS)是一种非运动性纤毛病。迄今为止,已报导26个基因与BBS有关。然而,BBS是遗传异质性的,与其他纤毛病变有显著的临床重叠,使诊断复杂化。BBS患者的残疾和死亡率很高;因此,迫切需要提高我们对BBS的认识。因此,我们的研究旨在描述中国BBS的基因型和表型谱,并阐明基因型与表型的相关性。
    方法:本研究纳入20例确诊为BBS的中国患者。我们在这项研究中比较了中国BBS患者与其他国家患者的表型,以分析全球患者的表型差异。此外,我们描述了我们队列的基因型-表型相关性.我们还总结了以前报道的所有中国患者(71例)的BBS病例,并确定了中国人群中常见和特定的遗传变异。
    结果:28种变体,其中10个是小说,在20例中国BBS患者中鉴定出5种不同的BBS相关基因。通过比较BBSome编码基因(BBS2,7,9)的表型与分子伴侣编码基因(BBS10,12)的表型,我们发现BBS10和12突变的患者发病年龄较早(1.10Vs.2.20,p<0.01)和诊断(4.64Vs。13.17,p<0.01),而具有BBS2、7和9突变的患者的体重指数较高(28.35Vs.24.21,p<0.05)和更多的视力问题(p<0.05)。此外,在91名中国BBS患者中,在BBS2(28.89%)和BBS7(15.56%)中,最常见的变异是BBS2:c.534+1G>T(10/182等位基因)和BBS7:c.1002delT(7/182等位基因),与国外报道的BBS基因型谱有差异。
    结论:我们招募了20名中国BBS患者进行遗传和表型分析,并确定了常见的临床表现,致病基因,和变体。我们还描述了全球患者和不同BBS相关基因之间的表型差异。这项研究涉及中国最大的BBS患者队列,并为特定致病变异的独特临床特征提供了新的见解。
    BACKGROUND: Bardet-Biedl syndrome (BBS) is a type of non-motile ciliopathy. To date, 26 genes have been reported to be associated with BBS. However, BBS is genetically heterogeneous, with significant clinical overlap with other ciliopathies, which complicates diagnosis. Disability and mortality rates are high in BBS patients; therefore, it is urgent to improve our understanding of BBS. Thus, our study aimed to describe the genotypic and phenotypic spectra of BBS in China and to elucidate genotype-phenotype correlations.
    METHODS: Twenty Chinese patients diagnosed with BBS were enrolled in this study. We compared the phenotypes of Chinese BBS patients in this study with those from other countries to analyze the phenotypic differences across patients worldwide. In addition, genotype-phenotype correlations were described for our cohort. We also summarized all previously reported cases of BBS in Chinese patients (71 patients) and identified common and specific genetic variants in the Chinese population.
    RESULTS: Twenty-eight variants, of which 10 are novel, in 5 different BBS-associated genes were identified in 20 Chinese BBS patients. By comparing the phenotypes of BBSome-coding genes (BBS2,7,9) with those of chaperonin-coding genes (BBS10,12), we found that patients with mutations in BBS10 and 12 had an earlier age of onset (1.10 Vs. 2.20, p < 0.01) and diagnosis (4.64 Vs. 13.17, p < 0.01), whereas patients with mutations in BBS2, 7, and 9 had a higher body mass index (28.35 Vs. 24.21, p < 0.05) and more vision problems (p < 0.05). Furthermore, in 91 Chinese BBS patients, mutations were predominant in BBS2 (28.89%) and BBS7 (15.56%), and the most frequent variants were in BBS2: c.534 + 1G > T (10/182 alleles) and BBS7: c.1002delT (7/182 alleles), marking a difference from the genotypic spectra of BBS reported abroad.
    CONCLUSIONS: We recruited 20 Chinese patients with BBS for genetic and phenotypic analyses, and identified common clinical manifestations, pathogenic genes, and variants. We also described the phenotypic differences across patients worldwide and among different BBS-associated genes. This study involved the largest cohort of Chinese patients with BBS, and provides new insights into the distinctive clinical features of specific pathogenic variants.
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  • 文章类型: Journal Article
    初级纤毛广泛分布在角膜上皮和内皮内。然而,角膜基质中纤毛的存在以及内皮和基质纤毛在角膜稳态中的动态变化和作用仍不清楚。这里,我们提供了角膜基质中存在原发性纤毛的令人信服的证据,体内和体外。我们还证明了角膜发育过程中内皮和基质纤毛的动态变化。此外,我们的数据显示,冷冻损伤会在角膜内皮和基质中引发明显的纤毛形成。此外,缺乏滑膜内转运蛋白88的突变小鼠的纤毛耗竭损害了角膜内皮建立有效组织屏障的能力,导致角膜基质内α-平滑肌肌动蛋白上调,以响应冷冻损伤。这些观察结果强调了角膜内皮和基质纤毛在维持角膜稳态中的重要作用,并为角膜损伤和疾病的治疗提供了创新策略。
    Primary cilia are distributed extensively within the corneal epithelium and endothelium. However, the presence of cilia in the corneal stroma and the dynamic changes and roles of endothelial and stromal cilia in corneal homeostasis remain largely unknown. Here, we present compelling evidence for the presence of primary cilia in the corneal stroma, both in vivo and in vitro. We also demonstrate dynamic changes of both endothelial and stromal cilia during corneal development. In addition, our data show that cryoinjury triggers dramatic cilium formation in the corneal endothelium and stroma. Furthermore, depletion of cilia in mutant mice lacking intraflagellar transport protein 88 compromises the corneal endothelial capacity to establish the effective tissue barrier, leading to an upregulation of α-smooth muscle actin within the corneal stroma in response to cryoinjury. These observations underscore the essential involvement of corneal endothelial and stromal cilia in maintaining corneal homeostasis and provide an innovative strategy for the treatment of corneal injuries and diseases.
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  • 文章类型: Journal Article
    初级纤毛是大多数哺乳动物细胞中保守的细胞器,充当“天线”来感测外部信号。纤毛功能需要保持生理纤毛长度。microRNAs(miRNAs)是有效的基因表达调控因子,miRNA表达异常与纤毛病变密切相关。然而,miRNA如何调节纤毛长度仍然难以捉摸。这里,使用钙休克法和小RNA测序,一个miRNA被鉴定出来,即,miR-669a-5p,在纤毛富集的非细胞部分中高度表达。显示miR-669a-5p促进培养细胞中的纤毛伸长但不促进纤毛形成。机械上,已证明miR-669a-5p抑制ras-GTP酶激活蛋白SH3结构域结合蛋白(G3BP)的表达以抑制组蛋白脱乙酰酶6(HDAC6)的表达,这进一步上调了A激酶锚定蛋白12(AKAP12)的表达。这种效果最终会阻止纤毛的分解,并导致纤毛长度更长,可以通过上调HDAC6或下调AKAP12恢复到野生型长度。总的来说,这些结果阐明了以前未鉴定的调节纤毛长度的miR-669a-5p/G3BP/HDAC6/AKAP12信号通路,为治疗纤毛病提供潜在的药物靶点。
    Primary cilia are conserved organelles in most mammalian cells, acting as \"antennae\" to sense external signals. Maintaining a physiological cilium length is required for cilium function. MicroRNAs (miRNAs) are potent gene expression regulators, and aberrant miRNA expression is closely associated with ciliopathies. However, how miRNAs modulate cilium length remains elusive. Here, using the calcium-shock method and small RNA sequencing, a miRNA is identified, namely, miR-669a-5p, that is highly expressed in the cilia-enriched noncellular fraction. It is shown that miR-669a-5p promotes cilium elongation but not cilium formation in cultured cells. Mechanistically, it is demonstrated that miR-669a-5p represses ras-GTPase-activating protein SH3-domain-binding protein (G3BP) expression to inhibit histone deacetylase 6 (HDAC6) expression, which further upregulates A-kinase anchor protein 12 (AKAP12) expression. This effect ultimately blocks cilia disassembly and leads to greater cilium length, which can be restored to wild-type lengths by either upregulating HDAC6 or downregulating AKAP12. Collectively, these results elucidate a previously unidentified miR-669a-5p/G3BP/HDAC6/AKAP12 signaling pathway that regulates cilium length, providing potential pharmaceutical targets for treating ciliopathies.
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  • 文章类型: Journal Article
    纤毛是从真核细胞表面突出的毛发样细胞器,几乎存在于所有人类细胞的表面。纤毛在信号转导中起着至关重要的作用,器官发育和组织稳态。纤毛结构和功能的异常可导致一组称为纤毛病的人类疾病。目前,斑马鱼由于其与人类相比相对保守的纤毛结构和功能,是研究纤毛功能和纤毛病的理想模型。在这次审查中,我们将总结斑马鱼胚胎和成年斑马鱼中存在的不同类型的纤毛,并概述了使用斑马鱼作为纤毛研究的脊椎动物模型的优势。根据最近的研究,我们将特别关注纤毛在斑马鱼器官发生过程中的作用。此外,我们将强调斑马鱼纤毛研究的未来前景。
    Cilia are hair-like organelles that protrude from the surface of eukaryotic cells and are present on the surface of nearly all human cells. Cilia play a crucial role in signal transduction, organ development and tissue homeostasis. Abnormalities in the structure and function of cilia can lead to a group of human diseases known as ciliopathies. Currently, zebrafish serves as an ideal model for studying ciliary function and ciliopathies due to its relatively conserved structure and function of cilia compared to humans. In this review, we will summarize the different types of cilia that present in embryonic and adult zebrafish, and provide an overview of the advantages of using zebrafish as a vertebrate model for cilia research. We will specifically focus on the roles of cilia during zebrafish organogenesis based on recent studies. Additionally, we will highlight future prospects for ciliary research in zebrafish.
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  • 文章类型: Journal Article
    背景:短肋骨多指综合征(SRPS)是指一组致命的骨骼发育不良,可能难以区分亚型或其他非致命的骨骼发育不良,如Ellis-vanCreveld综合征和Jeune综合征。我们报告了四个与骨骼发育不良无关的胎儿的超声和遗传发现。
    方法:在妊娠中期或晚期进行系统的产前超声检查。基因测试包括GTG条带,对羊膜细胞或流产胎儿组织进行单核苷酸多态性(SNP)阵列和外显子组测序.
    结果:四个无关胎儿的主要和常见超声异常包括四肢长骨短和胸部狭窄。未检测到染色体异常和致病性拷贝数变异。外显子组测序揭示了DYNC2H1基因中的三个新变体,即NM_001080463.2:c.6809G>Ap.(Arg2270Gln),NM_001080463.2:3133C>Tp.(Gln1045Ter),和NM_001080463.2:c.333C>Tp。(Arg113Trp);IFT172基因中的一个新变体,NM_015662.3:4540-5T>A;以及WDR19基因中的一个新变体,NM_025132.4:c.2596G>Cp.(Gly866Arg)。DYNC2H1,IFT172和WDR19的基因型以及胎儿的表型分别为诊断有或没有多指3、10和5的短肋骨胸发育不良(SRTD)提供了线索。
    结论:我们的发现扩展了DYNC2H1,IFT172和WDR19与骨骼纤毛病变相关的突变谱,并为罕见骨骼疾病的产前诊断和遗传咨询提供有用的信息。
    Short-rib polydactyly syndrome (SRPS) refers to a group of lethal skeletal dysplasias that can be difficult to differentiate between subtypes or from other non-lethal skeletal dysplasias such as Ellis-van Creveld syndrome and Jeune syndrome in a prenatal setting. We report the ultrasound and genetic findings of four unrelated fetuses with skeletal dysplasias.
    Systemic prenatal ultrasound examination was performed in the second or third trimester. Genetic tests including GTG-banding, single nucleotide polymorphism (SNP) array and exome sequencing were performed with amniocytes or aborted fetal tissues.
    The major and common ultrasound anomalies for the four unrelated fetuses included short long bones of the limbs and narrow thorax. No chromosomal abnormalities and pathogenic copy number variations were detected. Exome sequencing revealed three novel variants in the DYNC2H1 gene, namely NM_001080463.2:c.6809G > A p.(Arg2270Gln), NM_001080463.2:3133C > T p.(Gln1045Ter), and NM_001080463.2:c.337C > T p.(Arg113Trp); one novel variant in the IFT172 gene, NM_015662.3:4540-5 T > A; and one novel variant in the WDR19 gene, NM_025132.4:c.2596G > C p.(Gly866Arg). The genotypes of DYNC2H1, IFT172 and WDR19 and the phenotypes of the fetuses give hints for the diagnosis of short-rib thoracic dysplasia (SRTD) with or without polydactyly 3, 10, and 5, respectively.
    Our findings expand the mutation spectrum of DYNC2H1, IFT172 and WDR19 associated with skeletal ciliopathies, and provide useful information for prenatal diagnosis and genetic counseling on rare skeletal disorders.
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  • 文章类型: Review
    在脊椎动物中,多纤毛细胞(MCC)是终末分化的细胞,排列在气道,脑室,和生殖导管。每个MCC包含数十到数百个活动纤毛,它们以同步的方式跳动以驱动流体流过上皮,其功能障碍与一组称为活动纤毛病的人类疾病有关,如原发性纤毛运动障碍。鉴于多毛生成的动态和复杂过程,形成多个活动纤毛所必需的生物学事件是相对不清楚的。由于基因工具的进步,组学技术,和结构生物学,在过去的十年中,在理解多种活动纤毛形成调节的分子机制方面取得了重大进展。在这次审查中,我们讨论了体外培养MCC和动物模型的最新研究,总结当前多毛发生的知识,并特别强调最近的进展及其影响。
    In vertebrates, multiciliated cells (MCCs) are terminally differentiated cells that line the airway tracts, brain ventricles, and reproductive ducts. Each MCC contains dozens to hundreds of motile cilia that beat in a synchronized manner to drive fluid flow across epithelia, the dysfunction of which is associated with a group of human diseases referred to as motile ciliopathies, such as primary cilia dyskinesia. Given the dynamic and complex process of multiciliogenesis, the biological events essential for forming multiple motile cilia are comparatively unelucidated. Thanks to advancements in genetic tools, omics technologies, and structural biology, significant progress has been achieved in the past decade in understanding the molecular mechanism underlying the regulation of multiple motile cilia formation. In this review, we discuss recent studies with ex vivo culture MCC and animal models, summarize current knowledge of multiciliogenesis, and particularly highlight recent advances and their implications.
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  • 文章类型: Journal Article
    纤毛异常形态发生引起的内部转移和脑畸形等疾病越来越受到重视。这些与纤毛相关的疾病分为两类:由原发性纤毛缺陷引起的纤毛病和由活动纤毛的功能失调引起的原发性纤毛运动障碍(PCD)。Cilia分布广泛,它们的相关疾病可以覆盖许多人体器官和组织。最近的研究证明,初级纤毛在维持心血管系统的稳态中起着关键作用。然而,纤毛相关疾病的分子机制仍然难以捉摸。这里,我们回顾了近年来关于特征的研究进展,纤毛病和PCD的分子机制和治疗方法。我们的综述有助于进一步研究纤毛相关疾病的发病机制和治疗策略。
    More and more attention is paid to diseases such as internal transfer and brain malformation which are caused by the abnormal morphogenesis of cilia. These cilia-related diseases are divided into two categories: ciliopathy resulting from defects of primary cilia and primary ciliary dyskinesia (PCD) caused by functional dysregulation of motile cilia. Cilia are widely distributed, and their related diseases can cover many human organs and tissues. Recent studies prove that primary cilia play a key role in maintaining homeostasis in the cardiovascular system. However, molecular mechanisms of cilia-related diseases remain elusive. Here, we reviewed recent research progresses on characteristics, molecular mechanisms and treatment methods of ciliopathy and PCD. Our review is beneficial to the further research on the pathogenesis and treatment strategies of cilia-related diseases.
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  • 文章类型: English Abstract
    目的:探讨一个患有Meckel综合征的中国家系的遗传病因。
    方法:选择2017年8月31日在郑州大学第一附属医院就诊的有3次连续不良妊娠史的家系作为研究对象。收集家系的临床数据。在人工流产后的第三个胎儿中进行高通量测序以筛选纤毛病相关基因的变异。候选变异体通过Sanger测序进行验证。
    结果:这对夫妇的第一次怀孕以自然流产结束,而第二次怀孕的胎儿被怀疑患有纤毛病,虽然没有进行基因检测后选择堕胎。第三次怀孕的胎儿被怀疑患有纤毛病,高通量测序和Sanger测序表明,胎儿具有TMEM67基因的复合杂合变体,包括来自父亲的c.978+1G>A和c.1288G>C(第D430H)来自母亲。根据美国医学遗传学和基因组学学院(ACMG)的指南,c.978+1G>A被归类为致病变体(PVS1+PM2_支持+PP5),而新发现的c.1288G>C(p.D430H)被归类为可能的致病变体(PM2_支持PM3PM5PP3)。
    结论:c.978+1G>A和c.1288G>C(p。D430H)TMEM67基因的复合杂合变体可能是该谱系中怀疑有纤毛病的三个连续不良妊娠的基础。c.1288G>C的发现(p。D430H)还扩展了TMEM67基因的突变谱。
    OBJECTIVE: To explore the genetic etiology for a Chinese pedigree affected with Meckel syndrome.
    METHODS: A pedigree with a history of three consecutive adverse pregnancies which presented at the First Affiliated Hospital of Zhengzhou University on August 31, 2017 was selected as the study subject. Clinical data of the pedigree were collected. High-throughput sequencing was carried out to screen for variants of ciliopathy-related genes in the third fetus following induced abortion, and candidate variant was verified by Sanger sequencing.
    RESULTS: The first pregnancy of the couple had ended as spontaneous abortion, whilst the fetus of the second pregnancy was suspected for having ciliopathy, though no genetic testing was carried out following elected abortion. The fetus of the third pregnancy was suspected for having ciliopathy, and high-throughput sequencing and Sanger sequencing had shown that the fetus had harbored compound heterozygous variants of the TMEM67 gene, including c.978+1G>A from the father and c.1288G>C (p.D430H) from the mother. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.978+1G>A was classified as a pathogenic variant (PVS1+PM2_Supporting+PP5), whilst the newly discovered c.1288G>C (p.D430H) was classified as a likely pathogenic variant (PM2_Supporting+PM3+PM5+PP3).
    CONCLUSIONS: The c.978+1G>A and c.1288G>C (p.D430H) compound heterozygous variants of the TMEM67 gene probably underlay the three consecutive adverse pregnancies suspected for ciliopathy in this pedigree. The discovery of c.1288G>C (p.D430H) has also expanded the mutational spectrum of the TMEM67 gene.
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