Circulation. Cardiovascular Genetics:与年轻人猝死风险有关的基因被发现

2017-03-13 佚名 sciencedaily

来自加拿大、南非和意大利的国际研究小组发现了一个与年轻人猝死有关的重要基因——CDH2!

近日,来自加拿大、南非和意大利的国际研究小组发现了一个与年轻人猝死有关的重要基因——CDH2!

研究发表在心血管遗传学专科期刊《Circulation: Cardiovascular Genetics》上[1]。研究人员发现,它的突变能够引起致心律失常性右心室心肌病(ARVC),这是“看似很健康的”年轻人猝死的主要原因,发病群体大都在35岁以下。

ARVC的病因目前所知甚少,家系研究认为它属于常染色体显性遗传病。患者的心肌纤维减少,被脂肪组织代替。由于ARVC是一种慢性进展性疾病,很多患者长期身体状况稳定,体检也无明显异常,有部分可见心律失常,因此常常不被重视,但一旦发病,心脏骤停、猝死的比例很高。


RVC患者心肌活检样本,黄色的为脂肪组织

小组中来自开普敦大学的心脏病学教授Bongani Mayosi带领团队对一个南非的有ARVC遗传的家族进行了长达20年(1990-2010)的追踪研究,调查了3代人的发病状况。家族的第二代为四名女性,其中一名女性未结婚没有后代,而其余三名女性组成的家庭中,有两个家庭的第三代中发现了ARVC,其中有两个年轻人因此死亡。两人中的男孩死于1992年,21岁,他的妹妹因同样的症状死于24岁。

在过去大量的研究中,科学家们已经发现了几个与ARVC有关的基因(PKP2、DSP、DSC2、DSG2和JUP)[2,3],但这5个基因的突变最多只能够解释60%的ARVC的发病[4]。经过检测,研究人员排除了所有这些已知的基因的突变。为了进一步查明病因,他们对两个家庭中所有的患病成员进行了全外显子组测序(WES),也就是对他们基因组中所有的蛋白编码区进行测序。

结果让研究人员在13000多个共同基因变异中锁定了CDH2,CDH2编码产生钙粘蛋白2(Cadherin 2),这是一种在多个组织中表达的蛋白,负责细胞与细胞之间的粘附。在2005年以小鼠为模型的研究中,科学家发现,钙粘蛋白2缺失的小鼠会表现出心脏功能受损和扩张型心肌病等。实验的小鼠在两个月内因室性心动过速(ventricular tachycardia,VT)而猝死[5]。

钙粘蛋白2结构示意图

后来,研究人员在对另外一个家族中患有ARVC的患者进行基因测序时也发现了这一突变,因此,他们认为CDH2的突变的确是造成ARVC的一个原因。

对于这个结果,研究人员认为,它有非常重要的意义,如果家族中有ARVC患者,携带CDH2突变的话,那么其他的家族成员就要十分小心了,最好通过基因检测鉴定自己是否携带这一突变,尽早采取预防措施。他们认为,这样的做法能够显着减少年轻人猝死的数量。当然,研究人员也指出了这个研究的局限性,他们认为后续还需要更大型的队列研究来评估CDH2突变的重要性。

原始出处: Bongani M. Mayosi et al. Identification of Cadherin 2 (CDH2) Mutations in Arrhythmogenic Right Ventricular Cardiomyopathy. Circulation: Cardiovascular Genetics, March 2017 DOI: 10.1161/CIRCGENETICS.116.001605

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    2017-06-06 quxin068
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    2018-01-06 一叶知秋
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    2017-04-12 huperzia
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  5. 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    2017-06-07 cy0324
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    2017-03-14 wxl882001

    学习一下

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