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High frequency of the c.3207C>A (p.H1069Q) mutation in ATP7B gene of Lithuanian patients with hepatic presentation of Wilson's disease

查看全文 作　　者：Laimutis [1]Kucinskas;Jolanta [2]Jeroch;Astra [3]Vitkauskiene;Raimundas [4]Sakalauskas;Vitalija [5]Petrenkiene;Vaidutis [6]Kucinskas;Rima [7]Naginiene;Hartmut [8]Schmidt;Limas [9]Kupcinskas 高影响力作者 机构地区：[1]Institute of Biology of Kaunas University of Medicine, Mickeviiaus 9, Kaunas LT-44307, Lithuania;[2]Institute of Biomedical Research of Kaunas University of Medicine, Eiveniu 4, Kaunas LT-50009, Lithuania;[3]Laboratory of Immunology and Genetics, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania;[4]Department of Pulmonology and Immunology, Kaunas University of Medicine, Eiveniu 2,Kaunas LT-50009, Lithuania;[5]Department of Gastroenterology, Kaunas University of Medicine, Eiveniu 2,Kaunas LT-50009, Lithuania;[6]Department of Human and Medical Genetics, Faculty of Medicine, Vilnius University, Santariskiu 2,Vilnius LT-08661, Lithuania;[7]Institute of Biomedical Research of Kaunas University of Medicine, Eiveniu 4,Kaunas LT-50009, Lithuania;[8]Department of Hepatotransplanthology, University of Munster, Schlossplatz 2,Munster D-48149, Germany;[9]Department of Gastroenterology, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania高影响力机构 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第38期,共4页高影响力期刊 基　　金：The National Science and Education Foundation of Lithuania, No. M-06005 摘　　要：AIM: To investigate the prevalence of the ATP7B gene mutation in patients with hepatic presentation of Wilson's disease (WD) in Lithuania. METHODS: Eleven unrelated Lithuanian families, including 13 WD patients were tested. Clinically WD diagnosis was established in accordance to the Leipzig scoring system. Genomic DNA was extracted fromwhole venous blood using a salt precipitation method. Firstly, the semi-nested polymerase chain reaction (PCR) technique was used to detect the c.3207C>A (p.H1069Q) mutation. Patients not homozygous for the c.3207C>A (p.H1069Q) mutation were further analyzed. The 21 exons of the WD gene were amplified in a thermal cycler (Biometra T3 Thermocycler, G?ttingen, Germany). Direct sequencing of the amplified PCR products was performed by cycle sequencing using fluorescent dye terminators in an automatic sequencer (Applied Biosystems, Darmstadt, Germany). RESULTS: Total of 13 WD patients (mean age 26.4 years; range 17-40; male/female 3/10) presented with hepatic disorders and 16 their first degree relatives (including 12 siblings) were studied. Some of WD patients, in addition to hepatic symptoms, have had extrahepatic disorders (hemolytic anemia 3; Fanconi syndrome 1; neurophsychiatric and behavioural disorder 2). Liver biopsy specimens were available in all of 13 WD patients (8 had cirrhosis; 1-chronic hepatitis; 3-acute liver failure, 1-liver steatosis). Twelve of 13 (92.3%) WD patients had the c.3207C>A (p.H1069Q) mutation, 6 of them in both chromosomes, 6 were presented as compound heterozygotes with additional c.3472-82delGGTTTAACCAT, c.3402delC, c.3121C>T (p.R1041W) or unknown mutations. For one patient with liver cirrhosis and psychiatric disorder (Leipzig score 6), no mutations were found. Out of 16 first degree WD relatives, 11 (68.7%) were heterozygous for the c.3207C>A (p.H1069Q) mutation. Two patients with fulminant WD died from acute liver failure and 11 are in full remission under penicillamine or zinc acetate treatment. Three women with WD successfully delivered healthy babies. CONCLUSION: The c.3207C>A (p.H1069Q) missense mutation is the most characteristic mutation for Lithuanian patients with WD. Even 92.3% of WD patients with hepatic presentation of the disease are homozygous or compound heterozygotes for the p.H1069Q mutation. 关 键 词：威尔逊氏病 ATP7B基因 基因突变 肝硬化 铜 立陶宛人
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