目的 确定各家系凝血因子Ⅷ(F Ⅷ)基因突变类型,了解基因突变与临床表型的关系。方法 对7 个家系患者进行活化部分凝血酶原时间(APTT)及凝血因子Ⅷ凝结活性(F Ⅷ :C)检测,再采用PCR 方法对7 个血友病A家系患者进行内含子22、内含子1 倒位检测,对检测结果阴性患者采用直接测序法确定基因突变类型,并对家系相关成员进行相应位点的扩增与测序。结果 8 例血友病A患者APTT 为91.6~131 s,F Ⅷ :C 为0.8%~2%,基因检测结果显示8 例患者中未检出内含子22 倒位,仅检出1 例内含子1 倒位。余7 例血友病A 患者中,共检出5 种基因型,其中6例位于外显子14,1例位于外显子23,均为单碱基突变;有1 例检出基因型为p.His1202LeufsX16(c.3666delA),经检索为新突变。结论 F Ⅷ突变热点区域位于外显子14,新突变p.His1202LeufsX16 的发现丰富了F Ⅷ基因突变数据库。
Abstract
Objective To study the mutation types of factor VIII (FVIII) gene in patients from 7 hemophilia A (HA) families and the relationship between FVIII gene mutations and clinical phenotypes.Methods A total of 8 patients from 7 HA families were recruited. The activated partial thromboplastin time (APTT) and factor VIII coagulant activity (VIII:C) in these patients were measured. Polymerase chain reaction (PCR) was performed to analyze FVIII gene intron 1 and 22 inversions. For patients without the FVIII intron inversions, direct sequencing was performed to determine their mutation types and other related members of their families were also tested by PCR and sequencing to analyze the corresponding mutation sites.Results The ranges of APTT and VIII:C of the 8 patients were 91.6-131 seconds and 0.8%-2%, respectively. FVIII gene intron 22 inversion was not detected, while intron 1 inversion was detected in one patient. There were 5 types of mutations in FVIII gene detected in the remaining 7 patients, including 6 patients with mutations in exon 14 and 1 patient with mutation in exon 23; all of the 5 types of mutations were single nucleotide mutations. Among the detected mutations in FVIII gene, p.His1202LeufsX16 (c.3666delA) detected in one patient was found to be a previously unreported mutation in FVIII gene.Conclusions FVIII gene exon 14 is a hot-spot mutation region and p.His1202LeufsX16 is found to be a novel mutation in FVIII gene.
关键词
血友病A /
基因型 /
临床表型
Key words
Hemophilia A /
Genotype /
Clinical phenotype
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中华医学会血液学会分会血栓与止血学组, 中国血友病协作 组. 血友病诊断与治疗中国专家共识(2013 版) [J]. 中华血液 学杂志, 2013, 34(5):461-463.
[2] Keeney S, Mitchell M, Goodeve A. The molecular analysis of haemophilia A:a guideline from the UK haemophilia centre doctors, organization haemophilia genetics laboratory network[J]. Haemophilia, 2005, 11(4):387-397.
[3] 梁燕, 赵耘, 王战勇, 等. 血友病甲基因分析技术的改进及其 在产前诊断中的应用[J]. 中华医学遗传学杂志, 2007, 24(4):437-439.
[4] 周竣荔, 韦红英, 吴华, 等. STR 遗传标记在广西地区血友病 A 携带者诊断中的运用[J]. 中国当代儿科杂志, 2012, 14(14):951-955.
[5] 张之南, 杨天楹, 郝玉书. 血液病学[M]. 北京:人民卫生出 版社, 2003:1724-1725.
[6] Liu Q, Nozari G, Sommer SS. Single-tube polymerase chain reaction for rapid diagnosis of the inversion hotspot of mutation in hemophilia A[J]. Blood, 1998, 92(4):1458-1459.
[7] 李坦, 戴菁, 吴竞生, 等. 血友病A 患者凝血因子Ⅷ基因内 含子1 及22 倒位分析[J]. 中华血液学杂志, 2009, 30(3):150-153.
[8] Viel KR, Machiah DK, Warren DM, et al. A sequence variation scan of the coagulation factor VIII (FVIII) structural gene and associations with plasma FVIII activity levels[J]. Blood, 2007, 109(9):3713-3724.
[9] Lin SY, Su YN, Hung CC, et al. Mutation spectrum of 122 hemophilia A families from Taiwanese population by LD-PCR, DHPLC, multiplex PCR and evaluating the clinical application of HRM[J]. BMC Med Genet, 2008, 9:53.
[10] Bagnall RD, Waseem N, Green PM, et al. Recurrent inversion breaking intron l of the factor VIII gene is a frequent cause of severe hemophilia A[J]. Blood, 2002, 99(1):168-174.
[11] Nadja B, Ameni M, Reswith E, et al. Spectmm of molecular defects and mutation deteetion rate in patients with mild and moderate hemophilia A[J]. Hum Mutat, 2007, 28(1):54-60.
[12] Zimmermann MA, Oldenburg J, Müller CR, et al. Unusual genomic rearrangements in introns 1 and 22 of the F8 gene[J]. Hamostaseologie, 2011, 31 Suppl 1:S69-S73.
[13] Bogdanova N, Markoff A, Pollmann H, et al. Prevalence of small rearrangements in the factor VIII gene F8C among patients with severe hemophilia A[J]. Hum Mutat, 2002, 20(3):236-237.
[14] Pelak K, Shianna KV, Ge D, et al. The characterization of twenty sequenced human genomes[J]. PLoS Genet, 2010, 6(9):e1001111.
[15] Santacroce R, Acquila M, Belvini D, et al. Identification of 217 unreported mutations in the F8 gene in a group of 1,410 unselected Italian patients with hemophilia A[J]. J Hum Genet, 2008, 53(3):275-284.
[16] 李汶, 胡晓, 高伯笛, 等. 10 个甲型血友病家系F Ⅷ基因突 变分析[J]. 中华遗传学杂志, 2011, 28(2):127-132.
[17] Bowen DJ. Haemophilia A and haemophilia B:molecular insights[J]. Mol Pathol, 2002, 55(1):1-18.