A Novel Mutation (c.200T>C) in the NAGLU Gene of a Korean Patient with Mucopolysaccharidosis IIIB
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Mucopolysaccharidosis (MPS) IIIB is a lysosomal storage disorder (LSD) caused by abnormalities of the enzyme α-N-acetylglucosaminidase (NAGLU) that is required for degradation of heparan sulfate. The patient in this study was a 4-yr-old boy. He presented with normal height and weight, pectus carinatum, and multiple persistent Mongolian spots on his back. He had mild dysmorphic features with prominent speech developmental delays and, to a lesser extent, motor developmental delays. The cetylpyridinium chloride precipitation test revealed excessive mucopolysacchariduria (657.2 mg glycosaminoglycan/g creatinine;reference range, <175 mg glycosaminoglycan/g creatinine). Thin layer chromatography showed urinary heparan sulfate excretion. NAGLU enzyme activity was significantly decreased in leukocytes (not detected; reference range, 0.9-1.51 nmol/hr/mg protein)as well as in plasma (0.14 nmol/hr/mg protein; reference range, 22.3-60.9 nmol/hr/mg protein). PCR and direct sequencing analysis of the NAGLU gene showed that the patient was a compound heterozygote for 2 mutations: c.200T>C (p.L67P) and c.1444C>T (p.R482W). The c.200T>C mutation was a novel finding. This is the first report of a Korean patient with MPS IIIB who was confirmed by molecular genetic analyses and biochemical investigation.
Abstract
Mucopolysaccharidosis (MPS) IIIB is a lysosomal storage disorder (LSD) caused by abnormalities of the enzyme α-N-acetylglucosaminidase (NAGLU) that is required for degradation of heparan sulfate. The patient in this study was a 4-yr-old boy. He presented with normal height and weight, pectus carinatum, and multiple persistent Mongolian spots on his back. He had mild dysmorphic features with prominent speech developmental delays and, to a lesser extent, motor developmental delays. The cetylpyridinium chloride precipitation test revealed excessive mucopolysacchariduria (657.2 mg glycosaminoglycan/g creatinine;reference range, <175 mg glycosaminoglycan/g creatinine). Thin layer chromatography showed urinary heparan sulfate excretion. NAGLU enzyme activity was significantly decreased in leukocytes (not detected; reference range, 0.9-1.51 nmol/hr/mg protein)as well as in plasma (0.14 nmol/hr/mg protein; reference range, 22.3-60.9 nmol/hr/mg protein). PCR and direct sequencing analysis of the NAGLU gene showed that the patient was a compound heterozygote for 2 mutations: c.200T>C (p.L67P) and c.1444C>T (p.R482W). The c.200T>C mutation was a novel finding. This is the first report of a Korean patient with MPS IIIB who was confirmed by molecular genetic analyses and biochemical investigation.
참고문헌 (19)
- Saudubray JM, "Inborn metabolic disease. 5th ed", pp.580~590 (2012), Springer
- Valstar MJ, "Mucopolysaccharidosis type IIIB may predominantly present with an attenuated clinical phenotype", J Inherit Metab Dis, 33, pp.759~767 (2010)
- Verhoeven WM, "Sanfilippo B in an elderly female psychiatric patient: a rare but relevant diagnosis in presenile dementia", Acta Psychiatr Scand, 122, pp.162~165 (2010)
- Zhao HG, "The molecular basis of Sanfilippo syndrome type B", Proc Natl Acad Sci U S A, 93, pp.6101~6105 (1996)
- Weber B, "Cloning and expression of the gene involved in Sanfilippo B syndrome (mucopolysaccharidosis III B)", Hum Mol Genet, 5, pp.771~777 (1996)
- 손우연, "Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs)", Korean Journal of Pediatrics, 48(10), pp.1132~1138 (2005), 대한소아과학회
- Ng PC, "Predicting deleterious amino acid substitutions", Genome Res, 11, pp.863~874 (2001)
- Ramensky V, "Human non-synonymous SNPs: server and survey", Nucleic Acids Res, 30, pp.3894~3900 (2002)
- Bunge S, "Mucopolysaccharidosis type IIIB (Sanfilippo B): identification of 18 novel alpha-N-acetylglucosaminidase gene mutations", J Med Genet, 36, pp.28~31 (1999)
- Tanaka A, "Molecular analysis of the alpha-N-acetylglucosaminidase gene in seven Japanese patients from six unrelated families with mucopolysaccharidosis IIIB (Sanfilippo type B), including two novel mutations", J Hum Genet, 47, pp.484~487 (2002)
- Valstar MJ, "Sanfilippo syndrome: A mini-review", J Inherit Metab Dis, 31, pp.240~252 (2008)
- Lin HY, "Incidence of the mucopolysaccharidoses in Taiwan, 1984-2004", Am J Med Genet A, 149A, pp.960~964 (2009)
- Héron B, "Incidence and natural history of mucopolysaccharidosis type III in France and comparison with United Kingdom and Greece", Am J Med Genet A, 155A, pp.58~68 (2011)
- Poorthuis BJ, "The frequency of lysosomal storage diseases in The Netherlands", Hum Genet, 105, pp.151~156 (1999)
- Baehner F, "Cumulative incidence rates of the mucopolysaccharidoses in Germany", J Inherit Metab Dis, 28, pp.1011~1017 (2005)
- Weber B, "Sanfilippo type B syndrome (mucopolysaccharidosis III B): allelic heterogeneity corresponds to the wide spectrum of clinical phenotypes", Eur J Hum Genet, 7, pp.34~44 (1999)
- Yogalingam G, "Molecular genetics of mucopolysaccharidosis type IIIA and IIIB: Diagnostic, clinical, and biological implications", Hum Mutat, 18, pp.264~281 (2001)
- van de Kamp JJ, "Genetic heterogeneity and clinical variability in the Sanfilippo syndrome (types A, B, and C)", Clin Genet, 20, pp.152~160 (1981)
- Zhao HG, "Genotype-phenotype correspondence in Sanfilippo syndrome type B", Am J Hum Genet, 62, pp.53~63 (1998)
