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    SYNE1基因突变致痉挛性截瘫表型分析

    Analysis of spastic paraplegia phenotype caused by SYNE1 gene mutation

    • 摘要: 目的 SYNE1基因是常染色体隐性小脑共济失调1型(ARCA1)的致病基因,主要表现为小脑性共济失调。本研究收集1例存在SYNE1基因变异、临床表现为痉挛性截瘫的先证者及其家系,分析其临床及遗传学特征,并初步探讨该变异的可能致病机制。方法 研究对象为1名35岁男性患者,因"双下肢僵硬、步态不稳15年"于徐州医科大学附属医院就诊。收集该患者(先证者)及其父母的临床资料,并开展相关检查,包括头颅MRI平扫、弥散张量成像(DTI)、肌电图及神经心理量表评估等。进行全外显子组测序,并通过Sanger测序进行验证。结果 该先证者仅表现为痉挛性截瘫,即上运动神经元受累的表型,其临床症状、体征及头颅MRI均未提示小脑受累。基因检测发现,该患者的SYNE1基因存在复合杂合变异c.11798A>G(p.Gln3933Arg)与c.19789G>T(p.Ala6597Ser),分别由母亲(p.Gln3933Arg)和父亲(p.Ala6597Ser)遗传而来。多种生物信息学工具预测,上述变异可能会对蛋白质结构产生有害影响,并可能与致病性相关。结论 SYNE1基因的c.11798A>G和c.19789G>T变异可能仅表现为痉挛性截瘫,而无小脑受累。本研究丰富了SYNE1基因的突变谱,并为进一步探讨痉挛性截瘫的致病机制提供了新的思路。

       

      Abstract: Objective The SYNE1 gene is the pathogenic gene for autosomal recessive cerebellar ataxia type 1 (ARCA1), which mainly presents as cerebellar ataxia. This study aims to collect clinical data of a proband and his family with a SYNE1 gene mutation, who presents with spastic paraplegia, to analyze the clinical and genetic characteristics and to explore the possible pathogenic mechanisms of this mutation. Methods The study subject was a 35-year-old male patient who had been experiencing "stiffness in both lower limbs and unstable gait for 15 years" and were admitted to the Affiliated Hospital of Xuzhou Medical University. The clinical data of the patient (proband) and his parents were collected, and relevant examinations were conducted, including brain MRI, diffusion tensor imaging (DTI), electromyography (EMG), and neuropsychological scale assessments. Whole exome sequencing was performed, and Sanger sequencing was used for validation. Results The proband exhibited only spastic paraplegia, a phenotype of upper motor neuron involvement. Clinical symptoms, signs, and brain MRI did not suggest cerebellar involvement. Genetic testing revealed that the patient carried compound heterozygous mutations in the SYNE1 gene: c.11798A>G (p.Gln3933Arg) and c.19789G>T (p.Ala6597Ser), inherited from his mother (p.Gln3933Arg) and father (p.Ala6597Ser), respectively. Various bioinformatic tools predicted that these mutations may have harmful effects on the protein structure and be associated with pathogenicity. Conclusions The c.11798A>G and c.19789G>T mutations in the SYNE1 gene may manifest solely as spastic paraplegia without cerebellar involvement. This study enriches the mutation spectrum of the SYNE1 gene and provides new insights for further investigation into the pathogenic mechanisms of spastic paraplegia.

       

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