检验医学 ›› 2026, Vol. 41 ›› Issue (2): 133-143.DOI: 10.3969/j.issn.1673-8640.2026.02.006

• 遗传性疾病精准检测与诊断专题 • 上一篇    下一篇

TRAPPC2基因变异致X-连锁迟发性脊椎骨骺发育不良的3个家系分析

王亚琼1, 应令雯2, 陈瑶2, 姚如恩3, 娄丹1, 卢亚亚1, 李娟2, 王秀敏2()   

  1. 1.河南科技大学第一附属医院儿童保健科河南 洛阳 471000
    2.上海交通大学医学院附属上海儿童医学中心内分泌遗传代谢科上海 200127
    3.上海交通大学医学院附属上海儿童医学中心遗传分子诊断科上海 200127
  • 收稿日期:2025-03-03 修回日期:2025-12-29 出版日期:2026-02-28 发布日期:2026-03-06
  • 通讯作者: 王秀敏,E-mail:wangxiumin1019@126.com
  • 作者简介:王亚琼,女,1986年生,主治医师,主要从事儿童生长发育障碍性疾病的基础和临床研究。
  • 基金资助:
    洛阳市核心技术公关类公益专项重点项目(2302006A)

Analysis of 3 families with X-linked spondyloepiphyseal dysplasia tarda caused by TRAPPC2 gene variation

WANG Yaqiong1, YING Lingwen2, CHEN Yao2, YAO Ruen3, LOU Dan1, LU Yaya1, LI Juan2, WANG Xiumin2()   

  1. 1. Department of Child Healthcarethe First Affiliated Hospital of Henan University of Science and TechnologyLuoyang 471000,Henan, China
    2. Department of EndocrinologyGenetics and Metabolism,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of MedicineShanghai 200127, China
    3. Department of Genetic and Molecular DiagnosisShanghai Children's Medical Center,Shanghai Jiao Tong University School of MedicineShanghai 200127, China
  • Received:2025-03-03 Revised:2025-12-29 Online:2026-02-28 Published:2026-03-06

摘要:

目的 探讨转运蛋白复合体亚单位2(TRAPPC2)基因变异致X-连锁迟发性脊椎骨骺发育不良(SEDT)家系的临床表型和遗传学特点。方法 选取2019年1月—2024年9月上海交通大学医学院附属上海儿童医学中心确诊的3个X-连锁SEDT家系。收集家系成员的临床资料,并进行全外显子组测序(WES)和生物信息学分析,采用Sanger测序对可疑突变进行验证。参照美国医学遗传学与基因组学学会(ACMG)相关指南对变异进行评级。结果 3个家系的先证者均为男性,均因生长迟缓就诊,脊柱X线片示椎体扁平、前部上下缘凹陷、中后部呈驼峰样突起改变。家系1和家系2的先证者TRAPPC2基因(NM_001011658.4)均存在半合子变异c.271_275del(p.Gln91Argfs*9),为致病性变异;先证者母亲该位点均存在杂合突变,父亲未检测到该突变。家系3先证者TRAPPC2基因(NM_001011658.4)存在半合子变异c.191_192delTG(p.Val64Glyfs*24),其父母未发现该位点存在任何突变,考虑为假定新发变异;行重组人生长激素(rhGH)治疗,疗效欠佳。结论 TRAPPC2基因变异所致的SEDT呈晚发性、进行性特征,可致不成比例的身材矮小和关节过早退化。对于青少年时期起病的患儿,若合并上下部量异常或指尖距不匹配,需警惕SEDT。WES检测有助于明确病因。

关键词: 转运蛋白复合体亚单位2基因, 缺失突变, X-连锁迟发性脊椎骨骺发育不良

Abstract:

Objective To investigate the clinical phenotype and genetic characteristics of X-linked spondyloepiphyseal dysplasia tarda(SEDT) families caused by trafficking protein particle complex subunit 2(TRAPPC2) gene variations. Methods Totall,3 families with X-linked SEDT were enrolled from Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine from January 2019 to September 2024. The clinical data of family members were collected,and whole-exome sequencing(WES) was performed,and bioinformatics analysis was conducted. Suspected mutations were verified by Sanger sequencing. The variations were rated according to the relevant guidelines of American College of Medical Genetics and Genomics(ACMG). Results The probands of all the 3 families were male,and they presented with growth retardation. X-ray of the spine showed flattened vertebrae,depression of the anterior upper and lower margins of the vertebrae,and hump-like protrusions in the middle and posterior parts. The probands of family 1 and family 2 had hemizygous variations c.271_275del(p.Gln91Argfs*9) in TRAPPC2 gene(NM_001011658.4),which were pathogenic variations. The mothers of the probands in these 2 families had heterozygous mutations at this site,while the fathers did not detect the mutation. The proband of family 3 had a hemizygous variation c.191_192delTG(p.Val64Glyfs*24) in the TRAPPC2 gene(NM_001011658.4),and no mutations were found at this site in the parents,and it was considered as a putative de novo variation. Recombinant human growth hormone(rhGH) treatment was used,but the efficacy was poor. Conclusions The SEDT caused by TRAPPC2 gene variations is late-onset and progressive,resulting in disproportionate short stature and premature degeneration of joints. For children with onset in adolescence,if there are abnormal upper and lower body measurements or mismatch in the interphalangeal distance,SEDT should be vigilant. WES is helpful for clarifying the cause.

Key words: Trafficking protein particle complex subunit 2 gene, Deletion mutation, X-linked spondyloepiphyseal dysplasia tarda

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