遗传 ›› 2024, Vol. 46 ›› Issue (9): 750-756.doi: 10.16288/j.yczz.24-141

• 遗传资源 • 上一篇    

一例手足裂畸形6型家系的致病变异鉴定及胚胎植入前遗传学检测

梅利斌(), 张译元, 黄娴静, 纪红, 邱乒乒, 丁露, 何雪梅, 李萍()   

  1. 厦门大学附属妇女儿童医院生殖医学科,厦门市生殖与遗传重点实验室,厦门 361003
  • 收稿日期:2024-06-06 修回日期:2024-08-06 出版日期:2024-08-08 发布日期:2024-08-08
  • 通讯作者: 李萍,硕士,主任医师,研究方向:生殖医学。E-mail: saarc2001@sina.com
  • 作者简介:梅利斌,博士,副研究员,研究方向:遗传学。E-mail: meilibinxm@163.com
  • 基金资助:
    厦门市自然科学基金面上项目(3502Z202373117);福建省自然科学基金面上项目(2023J011611)

Identification of a pathogenic variant and pre-implantation genetic testing for a Chinese family affected with split-hand/foot malformation

Libin Mei(), Yiyuan Zhang, Xianjing Huang, Hong Ji, Pingping Qiu, Lu Ding, Xuemei He, Ping Li()   

  1. Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen Key Laboratory of Reproduction and Genetics, Xiamen 361003, China
  • Received:2024-06-06 Revised:2024-08-06 Published:2024-08-08 Online:2024-08-08
  • Supported by:
    General Fund Project of Xiamen Natural Science Foundation(3502Z202373117);General Fund Project of Fujian Natural Science Foundation(2023J011611)

摘要:

手足裂畸形(split-hand/split-foot malformation,SHFM)是一种严重的先天性肢端畸形,主要临床特征为并指(趾)畸形、指(趾)骨及掌(跖)骨发育不全。本研究报道了一例手足裂畸形胎儿,利用全外显子组测序技术结合Sanger测序的方法筛选候选基因变异位点,并为其家庭成员提供了胚胎植入前遗传学检测(preimplantation genetic testing,PGT)。基因检测结果显示胎儿WNT10B基因存在c.786G>A(p.Trp262*)纯合变异,其父母均为杂合突变携带者;PGT检测结果显示家系的2枚囊胚中,1枚基因型为突变杂合子,1枚基因型为突变纯合子,所有胚胎染色体均为二倍体,移植突变杂合子胚胎后成功达到单胎妊娠。本研究表明WNT10B基因纯合突变可能是导致该家系患手足裂畸形的原因,对于单基因病家系,在明确其致病突变后,通过胚胎植入前遗传学检测可有效避免患儿出生。

关键词: 手足裂畸形6型, WNT10B基因, 基因突变, 胚胎植入前遗传学检测, 囊胚

Abstract:

Split-hand/foot malformation is a serious congenital limb malformation characterized by syndactyly and underdevelopment of the phalanges and metatarsals. In this study, we reported a case of a fetus with hand-foot cleft deformity. Whole exome and Sanger sequencing were used to filter out candidate gene mutation sites and provide pre-implantation genetic testing(PGT) for family members. Genetic testing results showed that there was a homozygous mutation c.786G>A (p.Trp262*) in the fetal WNT10B, and both parents were carriers of heterozygous mutations. PGT results showed that out of the two blastocysts, one was a heterozygous mutant and the other was a homozygous mutant. All the embryos had diploid chromosomes. The heterozygous embryo was transferred, and a singleton pregnancy was successfully achieved. This study suggests that homozygous mutations in WNT10B are the likely cause of hand-foot clefts in this family. For families with monogenic diseases, preimplantation genetic testing can effectively prevent the birth of an affected child only after identifying the pathogenic mutation.

Key words: split-hand/foot malformation 6, WNT10B, gene mutation, preimplantation genetic testing, blastocyst