Keratoderma, Palmoplantar

角质病,掌足底
  • 文章类型: Journal Article
    遗传性鱼鳞病包括一系列不均匀的真皮疾病;它主要表现为广泛的角化过度,干燥和皮肤结垢。有时,重叠症状需要在鱼鳞病和其他几种类似疾病之间进行鉴别诊断。通过进行彻底的临床和遗传调查,本研究报告了7例确诊或怀疑与鱼鳞病有关的患者。基因检测是使用全外显子组测序进行的,以Sanger测序为验证方法。MEGA7程序用于分析受检测到的错义变体影响的氨基酸残基的保守性。入选患者表现为鱼鳞病样,但临床表现明显。遗传分析确定了FLG的诊断变异,STS,KRT10和SERPINB7基因,并阐明了各自家族成员中每个变体的携带状态。受检测到的错义变体影响的两个残基在多个物种中保持保守。值得注意的是,这两种变体,即STS:c.452C>T(p。P151L)和c.647_650del(p。L216fs)是新颖的。总之,对纳入的鱼鳞病相关患者进行了明确的遗传差异诊断;研究结果还扩展了鱼鳞病的突变谱,并为受影响家庭的咨询提供了确凿的证据.
    Inherited ichthyosis comprises a series of heterogeneous dermal conditions; it mainly manifests as widespread hyperkeratosis, xerosis and scaling of the skin. At times, overlapping symptoms require differential diagnosis between ichthyosis and several other similar disorders. The present study reports seven patients with confirmed or suspected to be associated with ichthyosis by conducting a thorough clinical and genetic investigation. Genetic testing was conducted using whole‑exome sequencing, with Sanger sequencing as the validation method. The MEGA7 program was used to analyze the conservation of amino acid residues affected by the detected missense variants. The enrolled patients exhibited ichthyosis‑like but distinct clinical manifestations. Genetic analysis identified diagnostic variations in the FLG, STS, KRT10 and SERPINB7 genes and clarified the carrying status of each variant in the respective family members. The two residues affected by the detected missense variants remained conserved across multiple species. Of note, the two variants, namely STS: c.452C>T(p.P151L) and c.647_650del(p.L216fs) are novel. In conclusion, a clear genetic differential diagnosis was made for the enrolled ichthyosis‑associated patients; the study findings also extended the mutation spectrum of ichthyosis and provided solid evidence for the counseling of the affected families.
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  • 文章类型: Journal Article
    去角化弹性组织(AKE)是一种罕见的常染色体显性遗传性皮肤病,其特征是小,圆形椭圆形,手掌上的平顶角化丘疹,手或脚的脚底和背侧。AKE的致病基因仍未确定。本研究旨在鉴定AKE的致病基因并探讨其潜在的生物学机制。一个大的,确定了表现出经典AKE症状的三代中国家庭。采用全基因组连锁分析和全外显子组测序来确定致病基因。人皮肤成纤维细胞中的shRNA敲除和HEK293T细胞中的CRISPR/Cas9敲除用于评估弹性纤维生物合成进展中的基因功能。连锁分析确定了12号染色体上rs7296765与rs10784618之间的易感区域。全外显子组测序证实CCDC91基因有1101+1G>A的剪接突变,导致外显子11跳跃和随后的59个氨基酸残基丢失(残基L309-Q367del)。进一步的功能分析显示高尔基池扩张,细胞质囊泡积累,和溶酶体的存在。si-CCDC91-HSF细胞的免疫染色显示了高尔基体中的原弹性蛋白积累和异常的细胞外聚集体。Fibrillin-1微原纤维组装和赖氨酰氧化酶活性没有显着变化。研究结果强烈表明,CCDC91基因的蛋白质产物在弹性蛋白转运中起着至关重要的作用。这一发现增强了我们对CCDC91功能的理解,并拓宽了已知的AKE致病机制。
    Acrokeratoelastoidosis (AKE) is a rare autosomal dominant hereditary skin disease characterized by small, round-oval, flat-topped keratotic papules on the palms, soles and dorsal aspect of hands or feet. The causative gene for AKE remains unidentified. This study aims to identify the causative gene of AKE and explore the underlying biological mechanisms. A large, three-generation Chinese family exhibiting classic AKE symptoms was identified. A genome-wide linkage analysis and whole-exome sequencing were employed to determine the causative gene. shRNA knockdown in human skin fibroblasts and CRISPR/Cas9 knockout in HEK293T cells were utilized to assess gene functions in the progression of elastic fiber biosynthesis. The linkage analysis identified a susceptibility region between rs7296765 to rs10784618 on chromosome 12. Whole-exome sequencing confirmed a splicing mutation of 1101 + 1 G > A in the CCDC91 gene, resulting in exon 11 skipping and a subsequent 59-amino-acid-residue loss (residues L309-Q367del). Further functional analysis revealed distended Golgi cisternae, cytoplasmic vesicle accumulation, and lysosome presence. Immnunostaining of si-CCDC91-HSF cells demonstrated tropoelastin accumulation in the Golgi and abnormal extracellular aggregates. There are no significant changes in Fibrillin-1 microfibril assembly and lysyl oxidase activity. The findings strongly suggest that the protein product of the CCDC91 gene plays a crucial role in elastin transport. This discovery enhances our understanding of CCDC91\'s function and broadens the known pathogenic mechanisms of AKE.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    该病例报告描述了一个6岁的女孩,她的手掌上有对称的大量角化斑块,鞋底,和口周区域,以及脱发4年。
    This case report describes a 6-year-old girl who presented with symmetrical massive keratotic plaques on the palms, soles, and perioral area, as well as hair loss for 4 years.
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  • 文章类型: Journal Article
    背景:MaldeMeleda是一种常染色体隐性遗传的掌足底角化病,SLURP1被鉴定为致病基因。尽管已经报道了超过20个SLURP1突变,只有突变c.256G>A(p.G87R)已在中国患者中检测到。这里,我们报道了一个中国家庭中的一个新的杂合SLURP1突变。
    方法:我们评估了两名中国MaldeMeleda患者的临床表现,并从患者和其他家庭成员收集标本进行全外显子组和Sanger测序。我们使用了算法(MutationTaster,SIFT,PolyPhen-2,PROVEAN,PANTHER,FATHMM,mCSM,SDM和DUET)来预测检测到的突变的致病潜力。我们还使用AlphaFold2和PyMOL进行蛋白质结构分析。
    结果:2例患者均表现为掌趾角化病的典型表现。在Proband1中,我们在SLURP1的外显子3中检测到了一个新的复合杂合突变(c.243C>A和c.256G>A)。Proband2是一个近亲家族的成年女性,具有纯合突变(c.211C>T)。算法表明这两种突变可能是致病的。我们使用AlphaFold2来预测这些突变的蛋白质结构,发现它们会导致不稳定,如PyMOL所示。
    结论:我们的研究在中国MaldeMeleda患者中发现了一种新的复合杂合突变(c.243C>A和c.256G>A),该突变可能导致蛋白质结构不稳定。此外,本研究扩展了SLURP1突变的现有知识,有助于了解MaldeMeleda.
    Mal de Meleda is an autosomal recessive palmoplantar keratoderma, with SLURP1 identified as the pathogenic gene responsible. Although over 20 mutations in SLURP1 have been reported, only the mutation c.256G > A (p.G87R) has been detected in Chinese patients. Here, we report a novel heterozygous SLURP1 mutation in a Chinese family.
    We assessed the clinical manifestations of two Chinese patients with Mal de Meleda and collected specimens from the patients and other family members for whole-exome and Sanger sequencing. We used algorithms (MutationTaster, SIFT, PolyPhen-2, PROVEAN, PANTHER, FATHMM, mCSM, SDM and DUET) to predict the pathogenetic potential of the mutation detected. We also employed AlphaFold2 and PyMOL for protein structure analysis.
    Both patients displayed the typical manifestation of palmoplantar keratoderma. In Proband 1, we detected a novel compound heterozygous mutation (c.243C > A and c.256G > A) in exon 3 of SLURP1. Proband 2 was an adult female born to a consanguineous family and carried a homozygous mutation (c.211C > T). Algorithms indicated both mutations to be probably disease causing. We used AlphaFold2 to predict the protein structure of these mutations and found that they cause instability, as shown by PyMOL.
    Our study identified a novel compound heterozygous mutation (c.243C > A and c.256G > A) in a Chinese patient with Mal de Meleda that has the potential to cause instability in protein structure. Moreover, this study expands on the existing knowledge of SLURP1 mutations and contributes to knowledge of Mal de Meleda.
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  • 文章类型: Journal Article
    组织决策及其动机对于成功实施可持续采购实践(SSP)至关重要。尽管如此,关于企业动机(CM)如何影响SSP的研究很少。为了填补这一研究空白,我们形成了一个基于三层利益相关者理论(ST)的范式,该范式解释了监管压力(RP)的调节作用,同时研究了不同类型的公司动机(工具,关系,和道德)和SSP。偏最小二乘结构方程模型(PLS-SEM)用于检查从巴基斯坦制造业的248名受访者收集的数据。SEM的输出表明,所有CM都会影响SSP。RP还令人困惑地缓和了这些有针对性的关系。重要性绩效图分析(IPMA)表明,调节压力(0.319)和关系动机(67.38)比所有其他外生变量更重要,表现更好。本研究以多种方式阐明了企业战略和决策。CM的所有尺寸都直接和通过RP大大提高了SSP,由于RP坚定地调节这些协会,表明ST的相关性。最后,这项实证调查以可检验的断言框架和许多关于环境可持续性的未来研究努力结束。
    Organizational decisions and their motivations are crucial for successfully implementing sustainable sourcing practices (SSP). Still, there is scant research on how SSPs are impacted by corporate motives (CM). To fill this research gap, we formed a three-tiered stakeholder theory (ST) based paradigm that accounts for the moderating impact of regulatory pressure (RP) while examining the relationship between different types of corporate motives (instrumental, relational, and moral) and SSP. Partial least squares structural equation modeling (PLS-SEM) was used to examine data collected from 248 respondents in the Pakistani manufacturing industry. The outputs of SEM disclosed that all CMs affect SSP. RP also confoundedly moderated these targeted relationships. Importance performance map analysis (IPMA) showed that regulatory pressure (0.319) and relational motives (67.38) are more important and perform better than all other exogenous variables. This study sheds light on corporate strategies and decision-making in multi ways. All dimensions of CM greatly enhance SSP directly and through RP, as RP firmly moderates these associations, indicating the relevance of ST. Finally, this empirical investigation ends with a framework of testable assertions and many future research endeavors on environmental sustainability.
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  • 文章类型: Case Reports
    残破性掌足底角化病(PPK)是一种异质性遗传疾病,对临床诊断和遗传咨询提出了巨大挑战。羊毛甾醇合酶(LSS)基因编码参与胆固醇生物合成途径的LSS。发现LSS的双等位基因突变与白内障等疾病有关,脱发症和掌plant角化症-先天性脱发综合征。这项研究的目的是研究LSS突变对中国患者PPK致残的贡献。评估患者的临床和分子特征。在这项研究中招募了一名38岁的男性患者,该患者患有PPK。我们鉴定了LSS基因中的双等位基因变体(c.683C>T,p.Thr228Ileandc.779G>A,p.Arg260His)。免疫印迹显示,Arg260His突变体显示显著降低的表达水平,而Thr228Ile显示与野生型相似的表达水平。薄层色谱显示,突变体Thr228Ile保留了部分酶活性,突变体Arg260His未显示任何催化活性。我们的发现显示了LSS突变与PPK突变之间的相关性。
    Mutilating palmoplantar keratoderma (PPK) is a heterogeneous genetic disease that poses enormous challenges to clinical diagnosis and genetic counselling. Lanosterol synthase (LSS) gene encodes LSS involved in the biosynthesis pathway of cholesterol. Biallelic mutations in LSS were found to be related to diseases such as cataracts, hypotrichosis and palmoplantar keratoderma-congenital alopecia syndrome. The aim of this study was to investigate the contribution of the LSS mutation to mutilating PPK in a Chinese patient. The clinical and molecular characteristics of the patient were evaluated. A 38-year-old male patient with mutilating PPK was recruited in this study. We identified biallelic variants in the LSS gene (c.683C > T, p.Thr228Ile and c.779G > A, p.Arg260His). Immunoblotting revealed that the Arg260His mutant showed a significantly reduced expression level while Thr228Ile showed an expression level similar to that of the wild type. Thin layer chromatography revealed that mutant Thr228Ile retained partial enzymatic activity and mutant Arg260His did not show any catalytic activity. Our findings show the correlation between LSS mutations and mutilating PPK.
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  • 文章类型: Journal Article
    据报道,丝氨酸蛋白酶抑制剂B7(SERPINB7)突变会导致Nagashima型掌plant角化病(NPPK),但是它们的生物学效应在很大程度上是未知的。我们进行了全外显子组测序,鉴定出c.796C>T(p。中国家系中SERPINB7的Arg266Ter)突变,表现为常染色体隐性遗传模式。我们评估了SERPINB7在纯合和杂合突变携带者中的功能,结果表明,单个c.796C>T突变可能会改变SERPINB7的亚细胞定位。其中一名纯合突变患者(II-3)接受了ixekizumab治疗,并显示角质化的适度改善。此外,我们分析了人类SERPINB7的斑马鱼同源物serpinb1l1和serpinb1l3的时空表达,它们在幼虫和成虫中表达。在幼虫中,serpinb1l1和serpinb1l3均在消化道中表达。然后,我们根据与人类NPPK表达位点的相似性对成年鳍进行了RT-PCR,发现这些基因在五个鳍中表达(胸肌,骨盆,背侧,肛门,和尾端)斑马鱼远端。一起来看,我们的结果表明,单个c.796C>T(p。Arg266Ter)突变可能会改变SERPINB7编码蛋白在皮肤中的位置,而斑马鱼SERPINB7同源物在成年鳍中表达。这些发现将使我们能够构建敲除模型来探索掌plant角化病的发病机理。
    Serine protease inhibitor B7 (SERPINB7) mutations have been reported to cause Nagashima-type palmoplantar keratosis (NPPK), but their biological effects are largely unknown. We conducted whole-exome sequencing and identified a c.796C>T (p.Arg266Ter) mutation in SERPINB7 in a Chinese pedigree, which presented as an autosomal recessive inheritance pattern. We assessed the function of SERPINB7 in homozygous and heterozygous mutation carriers, and the results suggested that the single c.796C>T mutation may alter the subcellular localization of SERPINB7. One of the homozygous mutation patients (II-3) was treated with ixekizumab and showed moderate improvement in keratinization. In addition, we analysed the spatiotemporal expression of serpinb1l1 and serpinb1l3, the zebrafish homologue of human SERPINB7, which is expressed in larvae and adults. In larvae, both serpinb1l1 and serpinb1l3 were expressed in the digestive tract. Then, we performed RT-PCR on adult fins based on similarity to the site of NPPK expression in humans and found that the genes were expressed in five fins (pectoral, pelvic, dorsal, anal and caudal) of the zebrafish distal extremity. Taken together, our results demonstrated that the single c.796C>T (p.Arg266Ter) mutation may alter the location of SERPINB7-encoded protein in the skin, while zebrafish SERPINB7 homologue was expressed in adult fins. These findings will enable us to construct knock-out models to explore the pathogenesis of palmoplantar keratosis.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    毛囊鱼鳞病伴萎缩性和畏光综合征(IFAP)是一种罕见的遗传性皮肤病,其特征是滤泡性鱼鳞病的经典三联征,脱发,和畏光。我们报告了一名中国患者,表现出IFAP三联征的特征以及疼痛的掌plant角化病,反复感染,骨周角化斑块,指甲营养不良,和白甲。全外显子组测序揭示了基因MBTPS2中的内含子变体(NM_015884.3:外显子7:c.970+5G>A)。Sanger测序证实该变体在该家族中具有表型。来自患者的cDNA测序表明该变体引入了新的剪接供体位点,导致外显子7的部分跳跃(r.951_970del)。体外微型基因测定也显示外显子7的异常剪接。这项研究提出了一例X连锁IFAP综合征和Olmsted综合征,并强调了使用验证测定法来鉴定MBTPS2中内含子变体的致病性的重要性。
    Ichthyosis follicularis with atrichia and photophobia (IFAP) syndrome is a rare genodermatosis characterized by a classic triad of follicular ichthyosis, alopecia, and photophobia. We report a Chinese patient displaying features of IFAP triad along with painful palmoplantar keratoderma, recurrent infections, periorificial keratotic plaques, nail dystrophy, and pachyonychia. Whole-exome sequencing revealed an intronic variant (NM_015884.3: exon7:c.970+5G>A) in the gene MBTPS2. Sanger sequencing confirmed that the variant segerated with phenotype in the family. Sequencing of cDNAs derived from the patient indicated the variant introduced a new splice donor site, leading to partial skipping of exon 7 (r.951_970del). An in vitro mini-gene assay also revealed abnormal splicing of exon 7. This study presents a case complicated with X-linked IFAP syndrome and Olmsted syndrome, and highlights the significance of using validation assays to identify the pathogenicity of intronic variants in MBTPS2.
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