结核线RTEL1变异在端粒生物学障碍中的变异
Ashley S Thompson1, Marena R Niewisch1,2, Neelam Giri1
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA.
American journal of medical genetics. Part A
|September 16, 2024
概括
端粒延长酶1 (RTEL1) 基因调节者的罕见生殖系变异会导致端粒生物学障碍. 双性RTEL1变体导致严重的童年疾病,而异性变体则导致晚期发病的疾病.
科学领域:
- 遗传学 是一个遗传学.
- 分子生物学分子生物学
- 临床医学 临床医学
背景情况:
- 端粒延长酶1 (RTEL1) 调节者的罕见生殖系变异与端粒生物学障碍 (TBD) 有关.
- 双性RTEL1变异通常在童年时表现为严重的综合征,如先天性硬化症和Hoyeraal-Hreidarsson综合征.
- 异性RTEL1变异常常与晚期出现的疾病有关,包括肺纤维化和骨髓衰竭.
研究的目的:
- 从文献中编译和分析所有报告的TBD相关的RTEL1变异.
- 评估具有单种或双种RTEL1变异的个体的表型和结果.
- 使用适应的ACMG-AMP指导方针对RTEL1变异进行分类,其中包括临床数据,端粒长度和变异性等位基因频率.
主要方法:
- 文献审查以确定所有与TBD相关的RTEL1变异.
- 分析了临床试验中参加临床试验的14个家庭44名个体的临床数据NCT00027274.4.
- 变异分类根据ACMG-AMP指导方针进行调整,利用临床信息,端粒长度和变异等位基因频率.
主要成果:
- 双性RTEL1变异的个体在诊断时表现出明显较早的年龄 (中位数为5.1岁) 与异构细胞 (中位数为35.5岁) 相比.
- 双性RTEL1变体 (中位数为22.9年) 患者的整体存活率明显较差,而异构细胞的患者 (中位数为66.5年).
- 在报告的257种独特的RTEL1变异中,只有38.3%符合致病性/可能致病性标准,其中8种变异被错误分类为良性/可能良性.
结论:
- RTEL1变种显著影响TBD发病和进展,双变种导致更严重和更早发病的疾病.
- 对于RTEL1,有必要进行系统的功能研究和标准化的变异治疗,以改善TBD的临床管理.
- 鉴于与RTEL1生殖系变异相关的广泛表型和结果,准确的变异分类至关重要.
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