一个中国手足裂畸形家系的遗传学分析

Genetic analysis of a Chinese pedigree with split hand and foot malformation

目的研究中国人手足裂畸形家系产生的分子遗传基础。方法通过X光片对一家系4代手足裂畸形患者进行了临床分析,采集了家系成员中18人的外周静脉血并提取基因组DNA。利用微卫星标记对该家系进行基因组扫描、连锁分析以及单倍型分析,并对于候选区域内的指趾发育相关基因Dactylin（DAC）基因的编码区、外显子/内含子交界区域以及部分的启动子区域进行测序分析。结果该家系大部分患者食指缺失或者发育不全,中指以缺指或以3、4并指出现,脚趾畸形程度略高于手指,表型特征符合已报道的手足裂畸形症的基本特征。两点间连锁分析在D10S192处获得最大的LOD值Z=3.50（θ=0.00）,将该家系临床类型确定为SHFM3型手足裂畸形,单倍型分析将该家系的致病基因定位于D10S185和D10S1693之间约21cM的范围内,在对DAC基因测序中,未检测到任何的序列突变。结论通过对家系内表型分析,可将疾病类型确定为典型的手足裂畸形症,并将致病基因定位于10q23-q26约21cM范围内,测序结果显示DAC基因的点突变不是引发该家系手足裂畸形的原因。

Objective To analyze the clinical manefestation and genetic basis of split hand and foot malformation （SHFM） in a Chinese pedigree. Methods The affected people in the family were checked by X-rays. Eighteen patients provided their peripheral blood, and the genomic DNA of the samples was extracted. The linkage and haplotype analysis were carried out using the microsateUite markers, and the limb malformation related gene Dactylin（DAC） including the coding region, exon-intron boundaries and part of promoter region was sequenced. Results Most members of the family with the disease phenotype showed absence or hypoplasia of the index finger, and absence or 3-4 syndactyly of the middle finger. The degree of abnormality in feet was severer than that in hands. All phenotypes of the patients display the basic characters of SHFM. Since the maximum two point LOD score of the D10S192 was 3.50（0= 0.00）, the SHFM in this pedigree can be categorized to the SI-IFM3. The haplotype analysis of recombination events revealed the candidate locus to a 21cM region between D10S185 and D10S1693. No mutation was found by the sequencing result of DAC gene. Conclusion 3hrough the analysis of phenotype of the patients, the typical SHFM disease can be confirmed. The linkage and haplotype analysis demonstrated that the 21cM region in 10q23-q26 locus was the major cause to the disease in this pedigree. The mutation of DAC gene can be excluded from cause of SHFM3 phenotype.