Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease

Abstract Aim To discover the novel ATP7B mutations in 103 southern Chinese patients with Wilson disease (WD), and to determine the spectrum and frequency of mutations in the ATP7B gene and genotype–phenotype correlation in a large-scale sample of Chinese WD patients. Methods One hundred three WD pat...

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Main Authors: Mingming Li, Jing Ma, Wenlong Wang, Xu Yang, Kaizhong Luo
Format: Article
Language:English
Published: BMC 2021-09-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-021-01911-5
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author Mingming Li
Jing Ma
Wenlong Wang
Xu Yang
Kaizhong Luo
author_facet Mingming Li
Jing Ma
Wenlong Wang
Xu Yang
Kaizhong Luo
author_sort Mingming Li
collection DOAJ
description Abstract Aim To discover the novel ATP7B mutations in 103 southern Chinese patients with Wilson disease (WD), and to determine the spectrum and frequency of mutations in the ATP7B gene and genotype–phenotype correlation in a large-scale sample of Chinese WD patients. Methods One hundred three WD patients from 101 unrelated families in southern China were enrolled in this study. Genomic DNA was extracted from the peripheral blood. Direct sequencing of all 21 exons within ATP7B was performed. Subsequently, an extensive study of the overall spectrum and frequency of ATP7B mutations and genotype–phenotype correlation was performed in all Chinese patients eligible from the literature, combined with the current southern group. Results In 103 patients with WD, we identified 48 different mutations (42 missense mutations, 4 nonsense mutations and 2 frameshifts). Of these, 3 mutations had not been previously reported: c.1510_1511insA, c.2233C>A (p.Leu745Met) and c.3824T>C (p.Leu1275Ser). The c.2333G>T (p.Arg778 Leu) at exon 8, was the most common mutation with an allelic frequency of 18.8%, followed by c.2975C>T (p.Pro992Leu) at exon 13, with an allelic frequency of 13.4%. In the comprehensive study, 233 distinct mutations were identified, including 154 missense mutations, 23 nonsense mutations and 56 frameshifts. Eighty-five variants were identified as novel mutations. The c.2333G>T (p.Arg778 Leu) and c.2975C>T (p.Pro992Leu) were the most common mutations, with allelic frequencies of 28.6% and 13.0%, respectively. Exons 8, 12, 13, 16 and 18 were recognised as hotspot exons. Phenotype–genotype correlation analysis suggested that c.2333G>T (p.Arg778 Leu) was significantly associated with lower levels of serum ceruloplasmin (P = 0.034). c.2975C>T (p.Pro992Leu) was correlated with earlier age of disease onset (P = 0.002). Additionally, we found that the c.3809A>G (p.Asn1270Ser) mutation significantly indicated younger onset age (P = 0.012), and the c.3884C>T (p.Ala1295Val) mutation at exon 18 was significantly associated with hepatic presentation (P = 0.048). Moreover, the patients with mixed presentation displayed the initial WD features at an older onset age than the groups with either liver disease or neurological presentation (P = 0.039, P = 0.015, respectively). No significant difference was observed in the presence of KF rings among the three groups with different clinical manifestations. Conclusion In this study, we identified three novel mutations in 103 WD patients from the southern part of China, which could enrich the previously established mutational spectrum of the ATP7B gene. Moreover, we tapped into a large-scale study of a Chinese WD cohort to characterise the overall phenotypic and genotypic spectra and assess the association between genotype and phenotype, which enhances the current knowledge about the population genetics of WD in China.
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spelling doaj.art-8f8c09d0742f47238881d0457128b7322022-12-21T21:34:28ZengBMCBMC Gastroenterology1471-230X2021-09-0121112110.1186/s12876-021-01911-5Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson diseaseMingming Li0Jing Ma1Wenlong Wang2Xu Yang3Kaizhong Luo4Department of Infectious Diseases, Institute of Hepatology, The Second Xiangya Hospital, Central South UniversityDepartment of Infectious Diseases, Institute of Hepatology, The Second Xiangya Hospital, Central South UniversityDepartment of Infectious Diseases, Institute of Hepatology, The Second Xiangya Hospital, Central South UniversityDepartment of Infectious Diseases, Institute of Hepatology, The Second Xiangya Hospital, Central South UniversityDepartment of Infectious Diseases, Institute of Hepatology, The Second Xiangya Hospital, Central South UniversityAbstract Aim To discover the novel ATP7B mutations in 103 southern Chinese patients with Wilson disease (WD), and to determine the spectrum and frequency of mutations in the ATP7B gene and genotype–phenotype correlation in a large-scale sample of Chinese WD patients. Methods One hundred three WD patients from 101 unrelated families in southern China were enrolled in this study. Genomic DNA was extracted from the peripheral blood. Direct sequencing of all 21 exons within ATP7B was performed. Subsequently, an extensive study of the overall spectrum and frequency of ATP7B mutations and genotype–phenotype correlation was performed in all Chinese patients eligible from the literature, combined with the current southern group. Results In 103 patients with WD, we identified 48 different mutations (42 missense mutations, 4 nonsense mutations and 2 frameshifts). Of these, 3 mutations had not been previously reported: c.1510_1511insA, c.2233C>A (p.Leu745Met) and c.3824T>C (p.Leu1275Ser). The c.2333G>T (p.Arg778 Leu) at exon 8, was the most common mutation with an allelic frequency of 18.8%, followed by c.2975C>T (p.Pro992Leu) at exon 13, with an allelic frequency of 13.4%. In the comprehensive study, 233 distinct mutations were identified, including 154 missense mutations, 23 nonsense mutations and 56 frameshifts. Eighty-five variants were identified as novel mutations. The c.2333G>T (p.Arg778 Leu) and c.2975C>T (p.Pro992Leu) were the most common mutations, with allelic frequencies of 28.6% and 13.0%, respectively. Exons 8, 12, 13, 16 and 18 were recognised as hotspot exons. Phenotype–genotype correlation analysis suggested that c.2333G>T (p.Arg778 Leu) was significantly associated with lower levels of serum ceruloplasmin (P = 0.034). c.2975C>T (p.Pro992Leu) was correlated with earlier age of disease onset (P = 0.002). Additionally, we found that the c.3809A>G (p.Asn1270Ser) mutation significantly indicated younger onset age (P = 0.012), and the c.3884C>T (p.Ala1295Val) mutation at exon 18 was significantly associated with hepatic presentation (P = 0.048). Moreover, the patients with mixed presentation displayed the initial WD features at an older onset age than the groups with either liver disease or neurological presentation (P = 0.039, P = 0.015, respectively). No significant difference was observed in the presence of KF rings among the three groups with different clinical manifestations. Conclusion In this study, we identified three novel mutations in 103 WD patients from the southern part of China, which could enrich the previously established mutational spectrum of the ATP7B gene. Moreover, we tapped into a large-scale study of a Chinese WD cohort to characterise the overall phenotypic and genotypic spectra and assess the association between genotype and phenotype, which enhances the current knowledge about the population genetics of WD in China.https://doi.org/10.1186/s12876-021-01911-5Wilson diseaseATP7B geneMutationsCorrelationChinese
spellingShingle Mingming Li
Jing Ma
Wenlong Wang
Xu Yang
Kaizhong Luo
Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
BMC Gastroenterology
Wilson disease
ATP7B gene
Mutations
Correlation
Chinese
title Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
title_full Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
title_fullStr Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
title_full_unstemmed Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
title_short Mutation analysis of the ATP7B gene and genotype–phenotype correlation in Chinese patients with Wilson disease
title_sort mutation analysis of the atp7b gene and genotype phenotype correlation in chinese patients with wilson disease
topic Wilson disease
ATP7B gene
Mutations
Correlation
Chinese
url https://doi.org/10.1186/s12876-021-01911-5
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