Genetic Variation

遗传变异
  • 文章类型: Journal Article
    背景:高危型人乳头瘤病毒(HR-HPV)感染是宫颈癌发生的重要因素。HPV18是仅次于HPV16的第二常见HR-HPV。
    方法:在本研究中,采用MEGA11软件对HPV18E6-E7和L1基因进行变异和系统发育树分析。使用pamlX估计对E6、E7和L1基因的选择压力。此外,通过ABCpred服务器和IEDB网站预测了HPV18中L1氨基酸序列的B细胞表位和E6-E7氨基酸序列的T细胞表位,分别。
    结果:在E6-E7序列中共发现了9个单核苷酸变体,其中2个为非同义变体,7个为同义变体.在L1序列中鉴定出20个单核苷酸变体,包括11个非同义变体和9个同义变体。系统发育分析表明,E6-E7和L1序列均分布在A系。在HPV18E6、E7和L1序列中,未发现阳性选择位点.L1中的非保守取代R545C影响了假设的B细胞表位。两个非保守替换,E6中的S82A和E7中的R53Q影响多个假设的T细胞表位。
    结论:HPV18的序列变异数据可能为病毒诊断奠定基础。中国中部宫颈癌的进一步研究和疫苗设计。
    BACKGROUND: High-risk human papillomavirus (HR-HPV) infection is an important factor for the development of cervical cancer. HPV18 is the second most common HR-HPV after HPV16.
    METHODS: In this study, MEGA11 software was used to analyze the variation and phylogenetic tree of HPV18 E6-E7 and L1 genes. The selective pressure to E6, E7 and L1 genes was estimated using pamlX. In addition, the B cell epitopes of L1 amino acid sequences and T cell epitopes of E6-E7 amino acid sequences in HPV18 were predicted by ABCpred server and IEDB website, respectively.
    RESULTS: A total of 9 single nucleotide variants were found in E6-E7 sequences, of which 2 were nonsynonymous variants and 7 were synonymous variants. Twenty single nucleotide variants were identified in L1 sequence, including 11 nonsynonymous variants and 9 synonymous variants. Phylogenetic analysis showed that E6-E7 and L1 sequences were all distributed in A lineage. In HPV18 E6, E7 and L1 sequences, no positively selected site was found. The nonconservative substitution R545C in L1 affected hypothetical B cell epitope. Two nonconservative substitutions, S82A in E6, and R53Q in E7, impacted multiple hypothetical T cell epitopes.
    CONCLUSIONS: The sequence variation data of HPV18 may lay a foundation for the virus diagnosis, further study of cervical cancer and vaccine design in central China.
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  • 文章类型: Journal Article
    背景:三带囊库蚊在中国分布广泛,从南面的海南岛到北面的黑龙江,覆盖热带,亚热带,和温带气候区。三带库蚊携带19种虫媒病毒。它是日本脑炎病毒(JEV)的主要载体,严重威胁人类健康。了解环境因素对三带库蚊的影响可以为其种群结构或隔离模式提供重要的见解。目前尚不清楚。
    结果:总计,在552个扩增序列中检测到138个COI单倍型,单倍型多样性(Hd)值从温带(0.534)增加到热带(0.979)。单倍型系统发育分析表明,单倍型分为两个高支持进化分支。温带种群主要分布在进化分支II中,显示出与热带/亚热带种群的遗传隔离,群体之间的基因流动较少。HNQH(琼海)和HNHK(海口)人群的中性检测结果均为阴性(P<0.05),表明种群中存在许多低频突变,并且种群可能处于扩展过程中。此外,Wolbachia感染仅在SDJN(济宁)中检测到(2.24%),所有Wolbachia基因型都属于超群B。为了了解环境因素对蚊媒病毒的影响,我们在山东省三个生态环境中检测了三带钩状库蚊的感染情况。我们发现,与灌溉渠地区相比,莲池中的三带囊库蚊的JEV感染发生率明显更高。在这项研究中,JEV的总感染率为15.27/1000,提示目前山东省发生乙型脑炎的风险.
    结论:热带和亚热带三带囊库蚊种群具有较高的遗传多样性,这些气候条件为三带囊库蚊的建立和扩展提供了巨大的优势。在不同的生态条件下,三带囊库蚊野生种群的JEV感染率存在差异。我们的结果表明遗传分化的复杂相互作用,人口结构,和环境因素在塑造三带囊库蚊动力学中的作用。Wolbachia在野生种群中的低患病率可能反映了最近在三带囊库蚊中存在Wolbachia入侵。
    BACKGROUND: Culex tritaeniorhynchus is widely distributed in China, from Hainan Island in the south to Heilongjiang in the north, covering tropical, subtropical, and temperate climate zones. Culex tritaeniorhynchus carries 19 types of arboviruses. It is the main vector of the Japanese encephalitis virus (JEV), posing a serious threat to human health. Understanding the effects of environmental factors on Culex tritaeniorhynchus can provide important insights into its population structure or isolation patterns, which is currently unclear.
    RESULTS: In total, 138 COI haplotypes were detected in the 552 amplified sequences, and the haplotype diversity (Hd) value increased from temperate (0.534) to tropical (0.979) regions. The haplotype phylogeny analysis revealed that the haplotypes were divided into two high-support evolutionary branches. Temperate populations were predominantly distributed in evolutionary branch II, showing some genetic isolation from tropical/subtropical populations and less gene flow between groups. The neutral test results of HNQH (Qionghai) and HNHK(Haikou) populations were negative (P < 0.05), indicating many low-frequency mutations in the populations and that the populations might be in the process of expansion. Moreover, Wolbachia infection was detected only in SDJN (Jining) (2.24%), and all Wolbachia genotypes belonged to supergroup B. To understand the influence of environmental factors on mosquito-borne viruses, we examined the prevalence of Culex tritaeniorhynchus infection in three ecological environments in Shandong Province. We discovered that the incidence of JEV infection was notably greater in Culex tritaeniorhynchus from lotus ponds compared to those from irrigation canal regions. In this study, the overall JEV infection rate was 15.27 per 1000, suggesting the current risk of Japanese encephalitis outbreaks in Shandong Province.
    CONCLUSIONS: Tropical and subtropical populations of Culex tritaeniorhynchus showed higher genetic diversity and those climatic conditions provide great advantages for the establishment and expansion of Culex tritaeniorhynchus. There are differences in JEV infection rates in wild populations of Culex tritaeniorhynchus under different ecological conditions. Our results suggest a complex interplay of genetic differentiation, population structure, and environmental factors in shaping the dynamics of Culex tritaeniorhynchus. The low prevalence of Wolbachia in wild populations may reflect the recent presence of Wolbachia invasion in Culex tritaeniorhynchus.
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  • 文章类型: Journal Article
    多倍体化在植物进化和生物多样性中起着重要作用。然而,与种间多倍体相比,种内多倍体受到的关注较少。丁香科(百合科)具有二倍体(2n=2x=14)和同源四倍体(2n=4x=28)细胞类型。在华龙山,同源四倍体生长在北坡,而二倍体生长在南坡。通过野外观察和形态学方法测量和分析了克隆生长特征和克隆结构。使用SSR标记研究了两种不同细胞类型的多样性水平和分化模式。结果表明,克隆生长参数,例如同源四倍体中每个根茎节的芽数和根茎分枝的比率高于二倍体。二倍体和同源四倍体都出现了指骨克隆结构,分株之间的节间短。然而,二倍体的分株或基因组分布相对分散,而同源四倍体的则相对成团。二倍体和同源四倍体都为其营养生长分配了更多的生物量。二倍体对生殖器官的分配比同源四倍体高,这表明四倍体比二倍体在克隆繁殖上投入了更多的资源。同源四倍体的克隆多样性和遗传多样性均高于二倍体。在两种不同细胞类型之间观察到显着的遗传分化(P<0.01)。在建立和发展过程中,C.udensis同源四倍体比二倍体采用更多的成团指骨克隆结构,并表现出更多的遗传变异。
    Polyploidization plays an important role in plant evolution and biodiversity. However, intraspecific polyploidy compared to interspecific polyploidy received less attention. Clintonia udensis (Liliaceae) possess diploid (2n = 2x = 14) and autotetraploid (2n = 4x = 28) cytotypes. In the Hualongshan Mountains, the autotetraploids grew on the northern slope, while the diploids grew on the southern slopes. The clonal growth characteristics and clonal architecture were measured and analyzed by field observations and morphological methods. The diversity level and differentiation patterns for two different cytotypes were investigated using SSR markers. The results showed that the clonal growth parameters, such as the bud numbers of each rhizome node and the ratio of rhizome branches in the autotetraploids were higher than those in the diploids. Both the diploids and autotetraploids appeared phalanx clonal architectures with short internodes between ramets. However, the ramets or genets of the diploids had a relatively scattered distribution, while those of the autotetraploids were relatively clumping. The diploids and autotetraploids all allocated more biomass to their vegetative growth. The diploids had a higher allocation to reproductive organs than that of autotetraploids, which indicated that the tetraploids invested more resources in clonal reproduction than diploids. The clone diversity and genetic diversity of the autotetraploids were higher than that of the diploids. Significant genetic differentiation between two different cytotypes was observed (P < 0.01). During establishment and evolution, C. udensis autotetraploids employed more clumping phalanx clonal architecture and exhibited more genetic variation than the diploids.
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  • 文章类型: Journal Article
    藜麦(藜麦,2n=4x=36),一种超级假作物,已被引入中国近60年。通过大量的选择,已经开发了许多优秀的品种;然而,很少是通过诱变育种开发的。在这项研究中,\'Longli-4\'品种,在甘肃省本地种植,中国西北地区,被选中进行实验。用浓度为0.8%的甲磺酸乙酯(EMS)处理\'Longli-4\'的谷物8h。随机选择来自独立M2家族的9株植物,以研究EMS对藜麦基因组的诱变作用。结果表明,EMS诱导的单核苷酸多态性(SNPs)在所有18条染色体上分布不均。平均突变频率为91.2个SNPs/Mb,范围从4.5到203.5SNPs/Mb。通过线性模型分析,SNP的数量与染色体长度之间存在显着正相关。在所有变体类别中,从G/C到A/T的转换最为主导,占突变的34.4-67.2%,SNP在基因间区域显著富集,代表总突变的69.2-75.1%。本研究为低浓度EMS处理在藜麦育种中的应用提供了经验支持。
    Quinoa (Chenopodium quinoa, 2n = 4x = 36), a super pseudocereal crop, has been introduced into China nearly 60 years. Many excellent varieties have been developed through massive selection; however, few are developed through mutagenesis breeding. In this study, the \'Longli-4\' variety, locally cultivated in Gansu province, Northwest China, was selected for experimentation. The grains of \'Longli-4\' were treated with ethyl methanesulfonate (EMS) at a concentration of 0.8% for 8 h. Nine plants from independent M2 families were randomly selected to investigate the mutagenesis effect of EMS on the quinoa genome. The results indicated that the single nucleotide polymorphisms (SNPs) induced by EMS were unevenly distributed across all 18 chromosomes, with an average mutation frequency of 91.2 SNPs/Mb, ranging from 4.5 to 203.5 SNPs/Mb. A significant positive correlation between the number of SNPs and chromosome length was identified through linear model analysis. Transitions from G/C to A/T were the most predominated in all variant categories, accounting for 34.4-67.2% of the mutations, and SNPs were significantly enriched in intergenic regions, representing 69.2-75.1% of the total mutations. This study provides empirical support for the application of low concentration EMS treatment in quinoa breeding.
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  • 文章类型: Journal Article
    背景:新疆宫颈癌发病率高。人乳头瘤病毒的遗传变异可能会增加其侵袭能力,传播,逃避宿主的免疫反应。
    方法:对90份HPV16感染阳性样本的HPV16基因组进行测序。分析了E4,E5和L2基因的序列,以揭示新疆HPV16的序列变异以及HPV16感染阳性样品之间变异的分布。
    结果:90份HPV16感染样本中有81份显示HPV16E4基因变异,有18个核苷酸变异位点,其中8个位点为同义变异,11个为错义变异。90例HPV16感染样本显示HPV16E5和L2基因变异,具有16个核苷酸变异位点(6个同义,E5基因中的11个错义变异)和L2基因中的100个核苷酸变异位点(37个同义,67种错义变化)。HPV16L2基因错义变异的频率G3377A、G3599A,G3703A,病例组的G3757A高于对照组。
    结论:系统发育树分析表明,87个样本为欧洲菌株,3例为亚洲毒株,没有其他变化,G4181A与亚洲菌株有关。HPV16L2基因错义变异G3377A,G3599A,G3703A,病例组和G3757A的频率明显高于对照组。
    BACKGROUND: There is a high incidence of cervical cancer in Xinjiang. Genetic variation in human papillomavirus may increase its ability to invade, spread, and escape host immune response.
    METHODS: HPV16 genome was sequenced for 90 positive samples of HPV16 infection. Sequences of the E4, E5 and L2 genes were analysed to reveal sequence variation of HPV16 in Xinjiang and the distribution of variation among the positive samples of HPV16 infection.
    RESULTS: Eighty-one of the 90 samples of HPV16 infection showed variation in HPV16 E4 gene with 18 nucleotide variation sites, of which 8 sites were synonymous variations and 11 missense variations. 90 samples of HPV16 infection showed variation in HPV16 E5 and L2 genes with 16 nucleotide variation sites (6 synonymous, 11 missense variations) in the E5 gene and 100 nucleotide variation sites in L2 gene (37 synonymous, 67 missense variations). The frequency of HPV16 L2 gene missense variations G3377A, G3599A, G3703A, and G3757A was higher in the case groups than in the control groups.
    CONCLUSIONS: Phylogenetic tree analysis showed that 87 samples were European strains, 3 cases were Asian strains, there were no other variations, and G4181A was related to Asian strains. HPV16 L2 gene missense variations G3377A, G3599A, G3703A, and G3757A were significantly more frequent in the case groups than in the control groups.
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  • 文章类型: Journal Article
    背景:小麦地方品种被认为是育种计划遗传多样性的宝贵来源。在育种研究中评估遗传多样性是有用的,例如标记辅助选择(MAS),全基因组关联研究(GWAS),和基因组选择。此外,构建代表整个品种集遗传多样性的核心种质集对小麦地方品种种质资源的高效保存和利用具有重要意义。
    结果:为了了解小麦地方品种的遗传多样性,以江苏省作物种质资源库中的2023份种质为研究对象,利用Illumina15K单核苷酸多态性(SNP)芯片对其分子多样性和种群结构进行了研究。根据种群结构将这些种群分为五个亚群,主坐标和亲属关系分析。根据分子方差分析(AMOVA),在亚群内部和亚群之间发现了显着差异。亚群3基于不同的等位基因模式显示出更多的遗传变异性(Na,Ne和I)。在MStratv4.1软件中实施的M策略用于构建代表性核心集合。根据基因型和12种不同的表型性状,从整个地方品种种质中选择了总共311种(15.37%)的核心种质。与最初的地方品种相比,核心集合表现出更高的基因多样性(0.31)和多态性信息含量(PIC)(0.25),代表了几乎所有的表型变异。
    结论:开发了一个包含311种种质的核心集合,其中包含初始种群中100%的遗传变异。本馆藏为有效管理提供了种质基础,养护,以及原始集合中变化的利用。
    BACKGROUND: Wheat landraces are considered a valuable source of genetic diversity for breeding programs. It is useful to evaluate the genetic diversity in breeding studies such as marker-assisted selection (MAS), genome-wide association studies (GWAS), and genomic selection. In addition, constructing a core germplasm set that represents the genetic diversity of the entire variety set is of great significance for the efficient conservation and utilization of wheat landrace germplasms.
    RESULTS: To understand the genetic diversity in wheat landrace, 2,023 accessions in the Jiangsu Provincial Crop Germplasm Resource Bank were used to explore the molecular diversity and population structure using the Illumina 15 K single nucleotide polymorphism (SNP) chip. These accessions were divided into five subpopulations based on population structure, principal coordinate and kinship analysis. A significant variation was found within and among the subpopulations based on the molecular variance analysis (AMOVA). Subpopulation 3 showed more genetic variability based on the different allelic patterns (Na, Ne and I). The M strategy as implemented in MStratv 4.1 software was used to construct the representative core collection. A core collection with a total of 311 accessions (15.37%) was selected from the entire landrace germplasm based on genotype and 12 different phenotypic traits. Compared to the initial landrace collections, the core collection displayed higher gene diversity (0.31) and polymorphism information content (PIC) (0.25), and represented almost all phenotypic variation.
    CONCLUSIONS: A core collection comprising 311 accessions containing 100% of the genetic variation in the initial population was developed. This collection provides a germplasm base for effective management, conservation, and utilization of the variation in the original set.
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  • 文章类型: Journal Article
    尽管进化生物学痴迷于自然选择,很少有研究在自然种群的全基因组尺度上评估多代系列的选择模式。这里,我们报道了一项10年的微甲壳类水蚤种群基因组调查。[公式:参见文本]800个分离株的基因组序列提供了对无法从长期分子进化研究中获得的选择模式的见解,包括以下内容:整个基因组中接近准中性的普遍性(接近零的平均净选择系数,但是均值的时间差异很大,几乎没有证据表明跨时间间隔的选择正协方差);弱的正选择对次要等位基因起作用的优势;以及影响核苷酸多样性水平的许多可观察选择的小连锁岛的全基因组分布。这些结果表明,年际波动选择是自然种群变化水平的主要决定因素,挑战解释核苷酸多样性和分歧模式的传统范式,并激发了进一步发展解释群体基因组数据的理论表达式的必要性。
    Despite evolutionary biology\'s obsession with natural selection, few studies have evaluated multigenerational series of patterns of selection on a genome-wide scale in natural populations. Here, we report on a 10-y population-genomic survey of the microcrustacean Daphnia pulex. The genome sequences of [Formula: see text]800 isolates provide insights into patterns of selection that cannot be obtained from long-term molecular-evolution studies, including the following: the pervasiveness of near quasi-neutrality across the genome (mean net selection coefficients near zero, but with significant temporal variance about the mean, and little evidence of positive covariance of selection across time intervals); the preponderance of weak positive selection operating on minor alleles; and a genome-wide distribution of numerous small linkage islands of observable selection influencing levels of nucleotide diversity. These results suggest that interannual fluctuating selection is a major determinant of standing levels of variation in natural populations, challenge the conventional paradigm for interpreting patterns of nucleotide diversity and divergence, and motivate the need for the further development of theoretical expressions for the interpretation of population-genomic data.
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  • 文章类型: Journal Article
    过去30年的研究进展证实了遗传学在扩张型心肌病(DCMs)的病因学中的关键作用。然而,对DCM遗传结构的全面了解仍然不完整。我们确定了候选DCM致病基因,C10orf71,在一个有8名DCM患者的大家庭中,通过全外显子组测序。随后在来自2个独立队列的另外492例散发性DCM患者中发现了C10orf71的4种功能丧失变体。发现C10orf71是在心肌细胞中特异性表达的内在无序蛋白。C10orf71-KO小鼠在胚胎发育和心脏功能障碍期间具有异常的心脏形态发生,成年后收缩心脏基因的表达和剪接发生改变。C10orf71空心肌细胞表现出收缩功能受损,肌节结构未受影响。来自具有C10orf71移码变体的人诱导多能干细胞的心肌细胞和心脏类器官也具有具有正常电生理活性的收缩缺陷。一项使用心脏肌球蛋白激活剂的救援研究,omecamtivmecarbil,恢复C10orf71-KO小鼠的收缩功能。这些数据通过促进心肌细胞的收缩功能而支持C10orf71作为DCM的致病基因。突变特异性病理生理学可能提示治疗靶标和更个性化的治疗。
    Research advances over the past 30 years have confirmed a critical role for genetics in the etiology of dilated cardiomyopathies (DCMs). However, full knowledge of the genetic architecture of DCM remains incomplete. We identified candidate DCM causal gene, C10orf71, in a large family with 8 patients with DCM by whole-exome sequencing. Four loss-of-function variants of C10orf71 were subsequently identified in an additional group of492 patients with sporadic DCM from 2 independent cohorts. C10orf71 was found to be an intrinsically disordered protein specifically expressed in cardiomyocytes. C10orf71-KO mice had abnormal heart morphogenesis during embryonic development and cardiac dysfunction as adults with altered expression and splicing of contractile cardiac genes. C10orf71-null cardiomyocytes exhibited impaired contractile function with unaffected sarcomere structure. Cardiomyocytes and heart organoids derived from human induced pluripotent stem cells with C10orf71 frameshift variants also had contractile defects with normal electrophysiological activity. A rescue study using a cardiac myosin activator, omecamtiv mecarbil, restored contractile function in C10orf71-KO mice. These data support C10orf71 as a causal gene for DCM by contributing to the contractile function of cardiomyocytes. Mutation-specific pathophysiology may suggest therapeutic targets and more individualized therapy.
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  • 文章类型: English Abstract
    目的:分析1例多发性骨phy发育不良(MED)家系的遗传变异和分子致病机制。
    方法:选择2020年9月13日在首都医科大学附属北京积水潭医院发表的MED家系作为研究对象。收集家系的临床数据。从谱系成员中抽取外周血样品用于提取基因组DNA。对谱系进行全外显子组测序(WES)。通过Sanger测序验证候选变体。构建野生型和突变型SLC26A2表达质粒并转染到人原代软骨细胞中。通过免疫荧光和CCK8测定确定变体对蛋白质定位和细胞增殖的影响。
    结果:WES和Sanger测序显示先证者含有SLC26A2基因的复合杂合变体,包括父系衍生的c.484G>T(p.Val162Leu)错义变体和母系衍生的c.485_486delTG(p。Val162Glyfs*12)移码变体。SLC26A2WT及其突变体SLC26A2Val162Leu和SLC26A2Val162Glyfs*12表达质粒分布在人原代软骨细胞的细胞核和细胞质中。与SLC26A2WT相比,SLC26A2Val162Leu和SLC26A2Val162Glyfs*12的表达降低,伴随着人原代软骨细胞的增殖减少。
    结论:SLC26A2基因的c.484G>T和c.485_486delTG复合杂合变体可能会影响人原代软骨细胞的增殖,并为该家系MED的发病机理奠定了基础。
    OBJECTIVE: To analyze the genetic variant and molecular pathogenesis in a Chinese pedigree affected with Multiple epiphyseal dysplasia (MED).
    METHODS: A MED pedigree which had presented at the Beijing Jishuitan Hospital Affiliated to Capital Medical University on September 13, 2020 was selected as the study subject. Clinical data of the pedigree were collected. Peripheral blood samples were drawn from pedigree members for the extraction of genomic DNA. Whole exome sequencing (WES) was carried out for the pedigree. Candidate variant was verified by Sanger sequencing. Wild type and mutant SLC26A2 expression plasmids were constructed and transfected into human primary chondrocytes. The effect of the variants on the protein localization and cell proliferation was determined by immunofluorescence and CCK8 assays.
    RESULTS: WES and Sanger sequencing revealed that the proband has harbored compound heterozygous variants of the SLC26A2 gene, including a paternally derived c.484G>T (p.Val162Leu) missense variant and a maternally derived c.485_486delTG (p.Val162Glyfs*12) frameshifting variant. The SLC26A2WT and its mutant SLC26A2Val162Leu and SLC26A2Val162Glyfs*12 expression plasmids were distributed in the nuclei and cytoplasm of human primary chondrocytes. Compared with SLC26A2WT, the expressions of SLC26A2Val162Leu and SLC26A2Val162Glyfs*12 were decreased, along with reduced proliferation of human primary chondrocytes.
    CONCLUSIONS: The c.484G>T and c.485_486delTG compound heterozygous variants of the SLC26A2 gene may affect the proliferation of human primary chondrocytes and underlay the pathogenesis of MED in this pedigree.
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  • 文章类型: English Abstract
    目的:探讨3例晚发型多酰基辅酶A脱氢酶缺乏症(MADDⅢ型)患儿的临床特点及遗传变异。
    方法:回顾性分析2020年3月至2022年3月郑州大学附属儿童医院收治的3例晚发性MADD患儿的临床资料。所有儿童均接受全外显子组测序(WES),和候选变体通过Sanger测序进行验证。所有患儿均接受改善代谢治疗,随访1~3年。
    结果:儿童包括2名男性和1名女性,年龄由2个月至11岁零7个月。儿童1有间歇性呕吐,孩子2有下肢无力,而儿童3除了异常新生儿筛查外没有任何症状。三个孩子的串联质谱显示多个酰基肉碱升高,中链和长链。儿童1和2通过尿液气相色谱-质谱(GC-MS)分析显示戊二酸和多种二羧酸增加。发现所有儿童都带有ETFDH基因的复合杂合变体,包括父系c.1211T>C(p。M404T)和儿童1的母体c.488-22T>G变体,父系c.1717C>T(p。Q573X)和母体c.250G>A(p。A84T)在儿童2中变异,父系c.12851G>A,母系c.629A>G(p。S210N)子3中的变体。至于治疗,给予大剂量维生素B2、左卡尼汀和辅酶Q10以改善代谢,除了低脂肪,低蛋白质和高碳水化合物饮食。所有患儿在随访期间病情稳定,生长发育正常。
    结论:ETFDH基因的复合杂合变体可能是肌肉无力的基础,及时呕吐,升高短,中等,和长链酰基肉碱,3例Ⅲ型MADD患儿戊二酸和各种二羧酸水平升高。
    OBJECTIVE: To explore the clinical characteristics and genetic variants in three children with late-onset Multiple acyl-Coenzyme A dehydrogenase deficiency (MADD type Ⅲ).
    METHODS: Clinical data of three children diagnosed with late-onset MADD at the Children\'s Hospital Affiliated to Zhengzhou University between March 2020 and March 2022 were retrospectively analyzed. All children were subjected to whole exome sequencing (WES), and candidate variants were verified by Sanger sequencing. All children had received improved metabolic therapy and followed up for 1 ~ 3 years.
    RESULTS: The children had included 2 males and 1 female, and aged from 2 months to 11 years and 7 months. Child 1 had intermittent vomiting, child 2 had weakness in lower limbs, while child 3 had no symptom except abnormal neonatal screening. Tandem mass spectrometry of the three children showed elevation of multiple acylcarnitines with short, medium and long chains. Children 1 and 2 showed increased glutaric acid and multiple dicarboxylic acids by urine Gas chromatography-mass spectrometry (GC-MS) analysis. All children were found to harbor compound heterozygous variants of the ETFDH gene, including a paternal c.1211T>C (p.M404T) and a maternal c.488-22T>G variant in child 1, a paternal c.1717C>T (p.Q573X) and a maternal c.250G>A (p.A84T) variant in child 2, and a paternal c.1285+1G>A and maternal c.629A>G (p.S210N) variant in child 3. As for the treatment, high-dose vitamin B2, levocarnitine and coenzyme Q10 were given to improve the metabolism, in addition with a low fat, hypoproteinic and high carbohydrate diet. All children showed a stable condition with normal growth and development during the follow-up.
    CONCLUSIONS: The compound heterozygous variants of the ETFDH gene probably underlay the muscle weakness, remittent vomiting, elevated short, medium, and long chain acylcarnitine, as well as elevated glutaric acid and various dicarboxylic acids in the three children with type Ⅲ MADD.
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