新疆维汉NSHL GJB2基因突变及其与肾虚血瘀型的相关性研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:利用基因诊断的方法对新疆维汉非综合征型遗传性耳聋患者GJB2基因突变进行分析,研究新疆地区维汉非综合征型遗传性耳聋人群中GJB2基因突变位点、突变频率,并探讨其与肾虚血瘀型之间的关系。方法:收集非综合征型遗传性耳聋患者83例,其中耳聋组维族43例,汉族40例,并对耳聋患者中医辨证分为肾虚血瘀型和非肾虚血瘀型;无耳聋家族史正常人98例,其中维族46例,汉族52例。应用聚合酶链反应(PCR)和正反双向直接测序法对所有受试者进行GJB2基因检测。结果:在耳聋组发现10种碱基改变,其中致病突变4种(235delC、233delC、35delG、71G-A),携带率为10.8%,233-235delC突变共6例,突变率为7.23%,占致病突变总携带率的66.6%。35delG、71G-A突变仅在维族耳聋人群中发现。对照组检测到9种基因碱基改变。79G-A、109G-A和341G-A是各组中常见的多态。196G-A、281A-G和21G-T为新发现突变。汉族GJB2基因的突变率高于维族。肾虚血瘀型患者占所有耳聋患者的38.6%;GJB2基因突变与肾虚血瘀型有关(P<0.05)。结论:新疆地区非综合征型遗传性耳聋患者GJB2基因的致病突变热点为233-235delC,但突变率低于国内其它地区。GJB2基因突变具有种族差异性。新发现的突变和多态丰富了新疆GJB2基因突变及多态性图谱,为深入开展新疆地区耳聋基因筛查及建立基因库奠定了基础。肾虚血瘀型可能是导致新疆地区GJB2基因突变的原因之一。
Objective:To detect gene mutations of GJB2 in Uyghur and Han people with non-syndromic hereditary hearing impairment,and to analyze the relationship between gene mutations and kidney asthenia blood stasis type. Method:83 patients of non-syndromic hereditary hearing impairment,including 43 Uyghur and 40 Han,and 98 health adults,including 46 Uyghur and 52 Han,were collected.The patients were differentiated into kidney asthenia blood stasis type and non-kidney asthenia blood stasis type,according to Traditional Chinese Mdecine Differentiation.The GJB2 of patients and normal persons were polymerse chain reaction(PCR),then the PCR products were subjected to automatic DNA sequencing. Results:Ten gene mutations were found in deafness group.The four mutations,235delC、233delC、35delG、71G-A,were disease caused mutation,which have 10.8% detected rate.The quantity of 233-235delC was six,the mutation rate of which is 7.23%,and 66.6% in the totle detected rate of disease caused mutation.71G-A、35delG were found only in the Uyghur deaf-mutes.Nine gene mutations were detected in control group.The mutations of 79G-A、109G-A、341G-A were the most frequent types of polymophism,and 196G-A、281A-G、21G-T were the newly discovered.The GJB2 mutation rate of Han is higher than Uyghur.Kidney asthenia blood stasis type was 38.6% in all of patients.The GJB2 gene mutation is related to kidney asthenia blood stasis(P<0.05). Conclusion:The hot spot of disease caused mutation of GJB2 is 233-235delC in patients with hereditary nonsyndromic hearing impairment in xinjiang region,but mutaional rate of which is lower than other reagions in China. GJB2 gene mutation has racial diversify Newly discovered mutation and polymorphism of GJB2 gene has enriched gene mutation and polymorphism mapping in Chinese population,and laid the foundation for an in-depth genetic screening for deafness and the gene library in Xinjiang region. Kidney asthenia blood stasis type might be one of the reasons which lead to GJB2 gene mutation in the Xinjiang region.
引文
[1]王幼勤,杨崇玲,许世文等.WHO关于耳疾与听觉障碍调查方案在贵州省的实施报告[J].临床耳鼻咽喉头颈外科杂志,2007,21(16):731-734.
    [2]王树辉,胡正茂,肖自安.GJB2基因在湖南地区非综合征耳聋患者中的突变分析[J].中南大学学报(医学版),2009,34(6):498-503.
    [3] Posukh O,Pallares-Ruiz N,Tadinova V,et al.Frist molecular sereening of deafness in the Altai RePublic PoPulation.BMC Med Gene,2005,6:12-18.
    [4] Eva T,Raquel,R,Maria L,et al.Human connexin26 deafness mutation aeffct the fun- ction channels at diefferent levels of pretein expression[J].Human Gneties,2002,10: 1007.
    [5]李琦,戴朴,黄德亮.GJB2基因型相关听力表型研究进展[J].听力学及言语疾病杂志,2008,16(2):158-159.
    [6] Kenneson A,Van Naarden Braun K,Boyle C.GJB2(connex2 in 26)variants and nonsyndromic sensorineural hearing loss:a huge review[J].Genet Med,2002,4:258.
    [7]贝政平,舒怀,周梁等.眼耳鼻咽喉科疾病诊断标准[M].北京:科学出版社,2007.
    [8]朱文锋.中医诊断学.上海:上海科学技术出版社,1995:160.
    [9]中华医学会耳鼻咽喉科学分会.耳聋的分级标准.《实用耳鼻咽喉科学》[M].人民卫生出版社,1998:265.
    [10] MukhereeM,Phadke SR,MittalB1 Connexin26 and autosomal recessive nonsyndromic hearing loss ndian J Hum Genet,2003,9(2):402-01.
    [11] Lefebvre PP,Van De Water TR Connexins,hearing and deafness:clinical aspects of mutations in the connexin26 gene Brain ResBrainRes Rev,2000,32(1):159-162.
    [12] YanD,Park HJ,Ouyang XM,et al.Evidence of a founder effect for the 235delC mutation of GJB2(connexin26) in east Asians Hum Genet,2003,114(1):442-501.
    [13] Evans WH,Martin PE.Gap junctions:structure and function(review).Mol Membr Biol, 2002,19:121.
    [14] MukherjeeM,Phadke SR,MittalB1Connexin 26 and autosomal recessive non- syndromic hearing loss.Indian J Hum Genet,2003,9(2):40-50.
    [15] Lefebvre PP,Van De Water TR1Connexins,hearing and deafness:clinical aspects of mutations in the connexin 26 gene.Brain ResBrain Res Rev,2000,32(1):159-162.
    [16]王国建.耳聋基因诊断的临床实践.北京.博士学位论文.军医进修学院.2008.
    [17]于飞.非综合型耳聋患者GJB2基因突变筛查和全频谱突变图谱绘制.北京.博士学位论文.军医进修学院.2006.
    [18]中华医学会、中华医学会耳鼻咽喉-头颈外科学分会.第十次全国耳鼻咽喉-头颈外科学术会议论文汇编.南京.戴朴,刘新,于飞等.2007.
    [19]柯肖枚,路远,刘玉和等.connexin26基因突变与中国人遗传性无综合征耳聋相关性分析[J].中华耳鼻咽喉科杂志,2001,36:163-165.
    [20]于飞,韩东一,戴朴等.1190例非综合征性聋患者GJB2基因突变分析[J].中华医学杂志,2007:87(40):2814-2819.
    [21] Liu X Z,Xia X J,Ke X M,et al.The prevalence of connexin 26(GJB2)mutations in the Chinese population[J].Hum Genet,2002,111(4-5):394-397.
    [22] Li Q Z,Wang Q J,Chi F L,et al.The roles of connexin genes in sporadic hearing loss population[J].Zhonghua Yi Xue Za Zhi,2007,87(16):1097-1101.
    [23]戴朴,刘新,于飞等.18个省市聋校学生非综合征性聋病分子流行病学研究(Ⅰ)-GJB2 235delC和线粒体DNA 12SrRNAA1555G突变筛查报告[J].中华耳科学杂志,2006,4(1):1-5.
    [24] Liu Y,Ke X,Qi Y,et al.Connexin26 gene(GJB2):prevalence of mutations in the Chinese population.J Hum Genet,2002,47:688-690.
    [25] Kudo T,Ikeda K,Kure S,et al.Novel mutations in the connexin 26 gene (GJB2) responsible for childhood deafness in the Japanese population[J].Am J Med Genet, 2000,90(2):141-145.
    [26] Wang Y C,Kung C Y,Su M C,et al.Mutations of Cx26 gene(GJB2)for prelingual deafness in Taiwan[J].Eur J Hum Genet,2002,10(8):495-498.
    [27]孟玮,张瀛.非综合征型遗传性耳聋患者中GJB2基因的致病突变与多态性研究进展[J].中国医学文摘耳鼻咽喉科,2006,21(2):96-98.
    [28]于飞.非综合型耳聋患者GJB2基因突变筛查和全频谱突变图谱绘制.北京.博士学位论文.军医进修学院.2006.
    [29]韩明鳗.聋病分子诊断的临床应用研究.北京.博士学位论文.军医进修学院.2008.
    [30] Wang Q,Li Q,Han D,et al.Clinical and molecular analysis of a four-generation Chine- se family with aminoglycoside-induced and nonsyndromic hearing loss associated with the mitochondrial 12S rRNA C1494T mutation.Biochem Biophys Res Commun, 2006,340:583-588.
    [31] Wang C,Kong Q,Yao Y,et al.mtDNA mutation C1494T,haplogroup A,and hearing loss in Chinese.Biochem Biophys Res Commun,2006,348:712-715.
    [32] Kelley PM,Harris DJ,Comer BC,et al.Novel mutations in the connexin 26 gene(GJB2)that cause autosomal recessive(DFNB1)hearing loss.Am JHum Genet,1998,62:792- 799.
    [33] W ilcox SA,SaundersK,OsbornAH,et al High frequency hearing loss correlated with mutations in theGJB2 gene.Hum Genet,2000,106:399-405.
    [34] Bason L,Dudley T,Lewis K,et al.Homozygosity for the V37I connexin 26 mutation in three unrelated children with sensorineural hearing loss.Clin Genet,2002,61:459-464.
    [35] Bruzzone R,Veronesi V,Gomes D,et al.Loss-of-function and residual channel activity of connexin26 mutations associated with non-syndromic deafness.FEBS Letters,2003, 533:79-88.
    [36]鲁雅洁,程洪波,邢光前等.非综合征型耳聋GJB2基因和mtDNA 12SrRNA A1555G位点的突变分析[J].南京医科大学学报,2008,28(7):855-860.
    [37] Marazita ML,Plouhgman LM,Rawlings B,et al.Genetic epidemiological sutdies of eariy-onset deafness in the U.S.school-age poulation.Am J Med Genet.1993,46:486- 491.
    [38]余培福.中医“肾”与“耳”关系的现代医学研究进展[J].中西医结合杂志,1985,5(9):514.
    [39]季中朴.现代中医生理学基础第一版.北京:学苑出版社,1991:237.
    [40]钟自勇,沈自尹,蔡定芳等.补肾、健脾、活血三类复方对下丘脑-垂体-肾上腺-胸腺轴及CRF基因表达的影响[J].中国中西医杂志,1997,17(1):39.
    [41]曾兆麟.中医肾与耳关系的研究进展[J].中国中西医结合杂志,1993,(2):119-121.
    [42]孙爱华,萧轼之,李兆基等.从缺铁肾虚大鼠耳蜗显微结构与生理功能变化探讨肾与耳联系的物质基础[J].中医研究,1993,6(3):14-16.
    [43]莫启忠,张美莉,宫斌等.中医“肾”和耳联系的物质基础的探讨—3H-醛固酮在豚鼠耳蜗和其他组织中的分布[J].中医杂志,1982,23(7):549.
    [44]高下.一种最重要的钙离子受体蛋白-钙调素[J].国外医学耳鼻喉科分册,1984,18(6):327.
    [45]梁绍鸿.肾虚与耳鸣耳聋[J].广州中医学院学报,1984,(11):24.
    [46]张国强.青海土族中年人“肾”与纯音听力关系的初步研究[J].中西医结合杂志,1987,(9):537-538.
    [47]卢标清,刘蓬,王士贞等.肾虚的临床听力学特性初步研究[J].中国中西医结合耳鼻咽喉科杂志,2002(10)4:157-160.
    [48]洪智林,曾纪德.从纯音听力的改变探讨中医肾与耳的关系[J].湖南中医药导报,1997,3(2,3):12-14.
    [49]骆华伟,顾旭东.“肾开窍于耳”理论的临床电生理检测评价[J].浙江中西医结合杂志,2006,16(6):344-345.
    [50]张振声.迟发性遗传性聋[J].国外医学参考资料耳鼻咽喉科分册,1982,5:276.
    [51]徐泳,俞军,傅晓东等.慢性肾衰患者听力损害与血清微量元素及肾虚的关系[J].江苏中医,1996,17(3):38-39.
    [52]孙启新.肾与耳关系的探讨[J].中国医药学报,1988,3(3):9.
    [53]刘蓬,邱宝珊,王士贞等.强的松豚鼠肾虚模型的听力观察[J].广州中医药大学学报,1999,16(1):1-4.
    [54]周光源,周协和.25例感音神经性耳聋的血液流变学分析[J].湖南中医学院学报,1994,14(4):17-18.
    [55]张向阳,钱欣梅,王琳.突发性耳聋与血液流变学LPO、SOD关系的研究[J].济宁医学院学报,1996,19(4):36-37.
    [56]王明山,陈建福.突发性聋患者凝血状态的研究[J].临床耳鼻咽喉科杂志,2000,14(7):305-307.
    [57]傅晓东,葛灏.突发性耳聋听力、甲皱微循环与中医辨证关系初探[J].中国中西医结合耳鼻咽喉科杂志,2000,8(4):170-172.
    [58]张大宁主编.中医补肾活血法研究[M].中国中医药科技出版社,1997,156-164.
    [59]李正会.老年性耳聋证治规律的探讨.硕士学位论文,2008:14.
    [60]申维玺,孙燕.论中医证的化学本质是蛋白质和肤及证本质的分子标准[J].中国中西医结合杂志,1999,19(11):696-698.
    [61]申维玺,孙燕.细胞因子网络紊乱是疾病的基本发病学原理[[J].医学研究通,2000,29(7):1-4.
    [62]刘福春,丁光霞,李菊仙等.淫羊霍对经基脉所致“阳虚”动物骨髓细胞DNA合成率的影响[[J].中国中药杂志,1991,16(10):626.
    [63]朴仁范.浅谈体质与疾病的关系[J].陕西中医,2009,30(3):310-312.
    [64]孙洁,李秋芬,周安方.“肾为先天之本”考辨[J].中国中医基础医学杂志,2006,12(7):506-507.
    [65]沈自尹.补肾法调节肾阳虚证T细胞凋亡的规律—重塑基因平衡[J].中西医结合学报,2004,2(5):321-322.
    [66]赵晓山,肾阴虚证相关基因的初步研究.博士学位论文.2004.
    [1] Nance WE.The Geneties ofdeaess.Ment Retard Dev Disabil Res Rev,2003,9:109-119.
    [2] Marazita ML,Ploughman LM,Rawlings B,et al.Genetic epidemiological studies of early-onset deafness in the U.S.sehool-age poulation.Am J Med Genet,1993,46: 486-491.
    [3] Cohen MM,Goriin RL.Epidemiology,etiology,and genetie patterns.In:Gorlin RJ, Toriello HV Cohen MM(eds).Hereditary Hearing loss and its Syndromes.Oxford University Press,1995,NY,9-21.
    [4] Steel KP.Seienee,medieine and the future:New intervenetions in hearing impairm- ent.BMJ,2000,320:622-625.
    [5] Van Camp G,Willems PJ,Smith RJ.Nonsyndromic hearing impairment:unparall-eled heterogeneity.Am J Hum Genet,1997,60:758-764.
    [6] Posukh O,Pallares-Ruiz N,Tadinova V,et al.Frist molecular sereening of deafness in the Altai RePublic PoPulation.BMC Med Gene,2005,6:12-18.
    [7] Anil K.Lalwani,Caley M C.Castelein.Cracking the auditory genetic code:nonsy- ndromic hereditary hearing impairment.American Journal of Otology 1999;30:115- 132.
    [8] Reardon W.Sex linked deafness:Wilde revisited J Med Genet 1990,27:376-379.
    [9] Konigsmark BW,et al.Genetic and metabolic deafness.Saunders,Philadelphia.1976.
    [10] Fraser GR.The causes of profound deafness in childhood.The Johns Hopkins University Press.Baltimore,MD.1976.
    [11] Wang QJ,Lu CY,LIN,et al.y-linked inheritance of non-syndromic hearing impairment in alarge Chinese family.J Med Genet,2004,41:80.
    [12]王秋菊,杨伟炎,韩东一等.Y-连锁遗传性耳聋:中国一大家系的听力学表型特征[J].中华耳科学杂志,2004,2:81-87.
    [13]医学遗传学原理T.D.盖来哈特,F.S.柯林斯,D.金斯伯格著,孙开来等译,科学出版社,北京,2001:190-197.
    [14] Rabionet R,GasParini,P,Estivill X,Moleeular geneties of hearing impairment due to mutations in gap junction genes encoding connexin.HumMutal,2000,3:190.
    [15] Van Camp G,Willems PJ,Smith RJH.Nonsyndromic hearing impair-ment: unparalleled heterogeneity[J].Am J Hum Genet,1997,60:758.
    [16] Lench N,HousemanM,Newton V,et al.Connexin-26 mutations in Sporadic non- syndromal sensorineural deafness[J].Lancet,1998,351:415.
    [17] Todt I,Hennies HC,Basta D1Vestibular dysfunction of patients with mutations of Connexin 261Neuroreport,2005,16(11):1179-1181.
    [18] MukherjeeM,Phadke SR,MittalB1Connexin 26 and autosomal recessive non- syndromic hearing loss.Indian J Hum Genet,2003,9(2):40-50.
    [19] Lefebvre PP,Van De Water TR1Connexins,hearing and deafness:clinical aspects of mutations in the connexin 26 gene.Brain ResBrain Res Rev,2000,32(1):159-162.
    [20] CrynsK,OrzanE,MurgiaA,et al:Agenoty Pe-Phenoty Pe correlation for GJB2 (con- nexin26) deafness.JdGenet2004,41(3):147-154.
    [21] SnoeckxRL,HuynPL,FeldmannD,et al:GJB2 mutations and degree of hearing loss: amulticenter study.Am J hum Genet2005,77(6):945-957.
    [22] MurgiaA,OrzanE,PolliR,et al.Cx26 deafness mutation analysis and Clinical varia- bility.JMedGenet1999,36(11):829-832.
    [23] CohnES,KelleyPM,FowlerTW,et al.Clinicalsstu dies of families with hearing loss
    [24] Snoeckx R,Huygen P,Feldmann D,et al.GJB2 mutations and degree of hearing loss:a multicenter study[J].Am J Hum Genet,2005,77:945.
    [25] Kenneson A,Van Naarden Braun K,Boyle C.GJB2 (connex2 in 26) variants and nonsyndromic sensorineural hearing loss:a huge review[J].Genet Med,2002,4:258.
    [26] Estivill X et al.Laneet,1998,351(9100):394-398.
    [27] Baris I et al.ClinGenet,2001,60:452-455.
    [28] Obe T et al.Hum Genet,2000,106:50-57.
    [29] BatissoeoAC,Abreu-SilvaRS,Braga MC,et al.Prevalenceof GJB2(cormexin-26) and GJB6 mutations in a cohort of 300 Brazilian hearing impaired individu- als:implications for diagnosis and genetic counseling.Ear Hear.2009,230(1):1-7.
    [30]肖自安,冯永,潘乾等.非综合征性耳聋患者连接蛋白Cx26基因突变的研究[J].中华耳鼻咽喉科杂志,2000,35(3):188-191.
    [31] http://davinci.crg.es/deafness/index~pol=cx26po12006-4-21.
    [32] Yoshinaga-Itano C,Sedey AL,Coulter DK,et al.L anguage of early and later-identified children with Hearing loss.Pediatrics,1998,102:1161-1171.
    [33] MarlinS,FeldmannD,BlonsH,et al.GJB2 and GJB6 Mutations:genotypic and phenoty- pic correlations in a large cohort of hearing-impaired patients.Arch Otolaryn-gology Head Neek Surgery,2005,131:481-487.
    [34] LimLH,BradshawJK,GuoY,et al.Genotypic and phenotypic correlations of DFNBI- related hearing impairment in the Midwestern United States.Areh Otolaryngology Head.Neeksurgery,2003,129:836-840.
    [35]李琦,戴朴,黄德亮.GJB2基因型相关听力表型研究进展[J].听力学及言语疾病杂志,2008,16(2):158-159.
    [36]孟玮,张瀛.非综合征型遗传性耳聋患者中GJB2基因的致病突变与多态性研究进展[J].中国医学文摘耳鼻咽喉科,2006,21(2):96-98.
    [37]徐志勇,王沙燕.GJB2基因突变与临床表型关系的研究进展[J].中国优生与遗传杂志,2008,16(8):3-4.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700