New SLC12A3 disease causative mutation of Gitelman's syndrome

Gitelman's syndrome(GS) is a salt-losing tubulopathy with an autosomal recessive inheritance caused by mutations of SLC12A3, which encodes for the thiazidesensitive Na Cl cotransporter. In this study we report a new mutation of SLC12A3 found in two brothers affected by GS. Hypokalemia, hypocalciuria and hyperreninemia were present in both patients while hypomagnesemia was detected only in one. Both patients are compound heterozygotes carrying one well known GS associated mutation(c.2581 C > T) and a new one(c.283 del C) in SLC12A3 gene. The new mutation results in a possible frame-shift with a premature stopcodon(pG ln95 Argfs X19). The parents of the patients, heterozygous carriers of the mutations found in SLC12A3, have no disease associated phenotype. Therefore, the new mutation is causative of GS.

Analysis of Mutations of Two Gitelman Syndrome Family SLC12A3 Genes and Proposed Treatments Using Chinese Medicine

Objective： To determine the gene location of two Gitelman syndrome （GS） family SLC12A3 genes and explore treatments using Chinese medicine （CM） prescriptions. Methods： In order to locate the two GS mutations, samples were collected from 11 people from two different pedigrees for direct genetic sequencing and comparison of the 26 exons of SLC12A3. Furthermore, the change of serum potassium was monitored throughout the therapy and those two probands undertook a sequential superposition of Western medicine （including potassium, Panangin and potassium-sparing diuretics） with CM prescription based on Buyang Huanwu Decoction （补阳还五汤） and Sijunzi Decoction （四君子汤）. The treatment included three stages, oral potassium chloride for the first 2 weeks （stage 1）, potassium-sparing diuretic and Panangin with potassium chloride for the next 2 weeks （stage 2）, CM along with the medicine in stage 2 for the final 2 weeks （stage 3）. Results： The three mutations occurring in proband 1 from pedigree 1 were Thr60Met, 965-1_976de113ins12 （small indels mutation） and Ala122Ala （homozygous silent mutation）. Likewise, three mutations, Asn359Lys, Thr382Met and Arg913GIn, appeared in the proband 2 from pedigree Ⅱ. The serum potassium levels increasing from baseline to sequential stages were 1.63 mmol/L （baseline）, 2.5 mmol/L （stage 1）, 3.1 mmol/L （stage 2） and 3.9 mmol/L （stage 3） in the proband 1, and 2.8 mmol/L （baseline）, 3.1 mmol/L （stage 1）, 3.5 mmol/L （stage 2） and 4.3 mmol/L （stage 3） in the proband 2, respectively. The symptoms （numbness of limbs, weakness, palpitations, etc.） of both probands were all alleviated. Conclusions： The mutations of both GS pedigrees can be defined as compound heterozygous mutations, most of which are known as missense mutations. Applying CM could be an appropriate choice for future intervention of GS.

SLC12A3基因rs11643718位点基因多态性与EH发病的多因素分析

为探讨SLC12A3基因rs11643718位点基因多态性与原发性高血压（EH）发病的关系及对EH患者的健康教育对策,本研究选取心血管内科门诊确诊的高血压患者150例（EH组）、健康自愿者300例进行调查（对照组）,采用聚合酶链反应（PCR）技术检测两组人群的SLC12A3基因rs11643718位点基因多态性,并收集两组的一般资料、生活行为方式资料,采用多因素分析EH发病的危险因素及其防治对策。研究发现EH组患者的SLC12A3基因rs11643718位点基因型与对照组比较差异无统计学意义（p〉0.05）;EH组SLC12A3基因rs11643718位点等位基因频率A （10.57%）显著的低于对照组“16.33%”,差异具有统计学意义（p〈0.05）;采用Logistic回归分析可知,食盐量、LDL-C、TC、TG增加、SLC12A3基因rs11643718位点等位基因频率A降低是人群发生高血压的独立危险因素,差异有统计学意义（p〈0.05）。本研究的结果说明,高血压的发病受多种因素的影响,SLC12A3基因rs11643718位点等位基因频率A表达可以降低人群发生高血压疾病的风险。