由PIK3CD突变引起的活性酸3-酶δ综合征:扩大表型
Peiwei Zhao1, Juan Huang2, Huicong Fu3
1Precision Medical Center, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science & Technology, Wuhan, 430016, China.
Pediatric rheumatology online journal
|January 30, 2024
概括
激活的酸3-酶三角酶 (PI3Kδ) 综合征1型 (APDS1) 是一种罕见的免疫缺陷,由PIK3CD突变引起. 整体外体序列测定发现了新的PIK3CD变异,并扩展了APDS1的临床表现,帮助诊断.
科学领域:
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
- 分子生物学分子生物学
背景情况:
- 激活的酸3-酶三角酶 (PI3Kδ) 综合征1型 (APDS1) 是一种罕见的原发性免疫缺陷,由生殖线异构基因在PIK3CD基因中的功能增益突变引起.
- 患者表现出各种临床症状,包括复发性呼吸道感染,淋巴增殖,IgM升高和病毒感染 (EBV,CMV).
- APDS1的异质表型往往导致误诊.
研究的目的:
- 在怀疑免疫缺陷的患者中识别PIK3CD的致病变体.
- 扩大对APDS的临床和遗传谱的理解1.
- 突出整体外体序列测序 (WES) 对免疫缺陷的诊断实用性.
主要方法:
- 三个全外因组测序 (trio-WES) 用于检测三名患者的PIK3CD变异.
- 桑格测序用于确认已识别的变异.
- 对患者的临床表现进行了回顾性分析.
主要成果:
- 确定了两个异构的PIK3CD突变 (c.3061G>A,p.E1021K和c.1574A>G,p.E525G).
- 一名患有c.3061G>A突变的患者呈现出因结肠多而引起的内分泌.
- 患有c.1574A>G突变的患者表现出与抗中性粒细胞质抗体 (ANCA) 相关的血管炎 (AAV) 类似的症状.
结论:
- 这项研究扩大了APDS1.1已知的临床和遗传谱.
- 全外体测序 (WES) 显示了免疫缺陷相关症状的高诊断收益率.
- 早期的分子诊断对于管理各种APDS1表现,包括血管炎和胃肠道问题至关重要.
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