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A Mutation in the UBIAD1 Gene in a Han Chinese Family with Schnyder Corneal Dystrophy

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A Mutation in the UBIAD1 Gene in a Han Chinese Family with Schnyder Corneal Dystrophy Molecular Vision 2011; 17:2685-2692 <http://www.molvis.org/molvis/v17/a290> © 2011 Molecular Vision Received 9 January 2011 | Accepted 1 October 2011 | Published 15 October 2011 A mutation in the UBIAD1 gene in a Han Chinese family with Schnyder corneal dystrophy Chunyu Du, Ying Li, Lili Dai, Lingmin Gong, Chengcheng Han Department of Ophthalmology, Harbin Medical University the 2nd Affiliated Hospital, Harbin, China Purpose: To identify the molecular defect in the UbiA prenyltransferase domain containing 1 (UBIAD1) gene in a four-generation Chinese family with Schnyder corneal dystrophy (SCD). Methods: A four-generation Chinese family with SCD and 50 unrelated normal individuals as controls were enrolled in. The complete ophthalmic examination was performed and blood samples were taken for subsequent genetic analysis. Mutation screening of UBIAD1 was performed by polymerase chain reaction (PCR) based DNA sequencing. Results: The missense mutation N102S in UBIAD1 was identified in this pedigree from the mainland of China for the first time. The molecular defect cosegregates with the affected individuals, whereas not found in unaffected family members or normal controls. Conclusions: The nonsynonymous mutation, N102S, in UBIAD1 detected in this family confirms that it is a mutation hot spot not only in Caucasian but also in Chinese. This finding adds support to the proposal that N102S has been independently mutated and argues against the likelihood of a founder effect. Schnyder corneal dystrophy (SCD; OMIM 121800) is a mutational UbiA prenyltransferase domain containing 1 gene rare autosomal dominant disease characterized by bilateral (UBIAD1) caused SCD. Thus, it is generally postulated that and usually symmetric cholesterol and lipid deposits in the the onset of SCD is associated with mutations in UBIAD1 corneal stroma with or without crystals. SCD results in caused by base substitution. To date, 22 different mutations progressive corneal opacification, loss of visual acuity (only in exons 1 and 2) have been reported: A97T [9], G98S (especially photopic vision [1]), and eventually corneal [10], Y174C [11], N102S [7,8,12,13], D112G [7], D112N sensation or glare. The clinical manifestation of this [9], D118G [13], R119G [7,12], L121V [12,13], L121F [14], dystrophy, while variant, is most commonly in an axially V122E [9], V122G [9], S171P [13,15], T175I [7,13], G177R distributed, annular, or discoid pattern. The appearance of the [8,13], K181R [11], G186R [13], L188H [9], N232S [7], cornea can be predicted based on age. Although SCD has also N233H [11], D236E [13], and D240N [16]. Studies of the been known as Schnyder crystalline corneal dystrophy, only genetic basis of SCD demonstrated that all mutations in the 54% of patients have corneal crystals [1]; the nomenclature UBIAD1 gene were missense mutations, with N102S itself confounded the ability to make an accurate diagnosis. postulated to be a hot spot in Caucasians because it was the Recently, the International Committee for the Classification most frequent mutation [13]. SCD results from one of the of Corneal Dystrophies (IC3D) [2] renamed the dystrophy numerous mutations in UBIAD1 [7,8]. To our knowledge, the Schnyder corneal dystrophy to clarify that crystalline present study contains the first description of the mutation deposition was not integral to the diagnosis. Other systemic N102S in the Han Chinese in mainland China. findings associated with SCD are hypercholesterolemia and genu valgum, which are thought to be independent traits and METHODS are found in approximately 66% [3-5] and 4% [1] of affected patients, respectively. Patients and controls: This study was approved by the Institutional Review Board of Harbin Medical University In the past decade, significant advances have been made (Harbin, China), and informed consent was obtained from in determining the genetic basis of SCD. Shearman et al. [6] each participant before participation. All subjects underwent first localized SCD to chromosome 1p36 through the linkage a complete eye examination, including uncorrected visual analysis in two large Swedish-Finnish families. In 2007, Orr acuity (UCVA), best-corrected visual acuity (BCVA), et al. [7] and Weiss et al. [8] independently verified that the pupillary reaction, intraocular pressure, motility, slit-lamp examination, corneal sensitivity testing, and fundus examination. Corneal sensation was tested by lightly touching Correspondence to: Dr. Ying Li, Department of Ophthalmology, Harbin Medical University the 2nd Affiliated Hospital, 246 Xuefu the cornea with a wisp of cotton from a cotton swab. We Road, Harbin, Heilongjiang, 150086, P R China; Phone: studied a four-generation Chinese family from northeastern 86-451-86605547; FAX: 86-451 −86605116; email: mainland China with SCD (Figure 1); the family’s ethnic [email protected] background was not Caucasian. Three patients, ten unaffected 2685 Molecular Vision 2011; 17:2685-2692 <http://www.molvis.org/molvis/v17/a290> © 2011 Molecular Vision Figure 1. Pedigree of the proband’s family with Schnyder corneal dystrophy. Black symbols, gray symbols, and unfilled symbols represent individuals of affected members, indeterminate phenotype, and unaffected members, respectively. Question marks indicate individuals of unknown affected status, and arrow indicates the proband. Asterisks indicate individuals in whom DNA analysis were performed. Deceased family member was denoted by slash. family members, and fifty healthy unrelated normal controls RESULTS were recruited in this research. In addition, each subject with Clinical findings: The proband (Figure 1) was a 57-year-old SCD underwent laboratory examinations including routine male who was referred to our center due to his complaint that blood tests, biochemical examination of the blood, physical he had been “seeing things hazily” for two decades. UCVA examination, and radiography of the knee joints. was 20/40 OD, 20/200 OS, and BCVA was 20/30 OD, 20/80 Genetic Analysis: Venipuncture was performed for DNA OS. Slit-lamp examination revealed central and paracentral collection, and peripheral blood (3 ml) was drawn from each subepithelial crystalline deposits, central and midperipheral subject. Genomic DNA was isolated from the peripheral blood haze, and arcus lipoides (Figure 2). Corneal sensation was leukocytes using the TIANamp Blood DNA Kit (Tiangen reduced in the right eye and normal in the left eye. Pupillary Biotech Co. Ltd, Beijing, China), following the reaction, intraocular pressure, and motility were normal, yet manufacturer’s instructions. Exons 1 and 2 of UBIAD1 were the fundus of both eyes could not be clearly observed. Knee amplified by polymerase chain reaction (PCR) using a 50-ml valgus was not found through knee examination. The blood reaction volume that contained 10× PCR buffer, 0.2 mM of biochemical examination showed elevated levels of serum each deoxyribonucleotide triphosphate, 2 μl of 1 mM of each total cholesterol and low levels of calcium. He had a history primer, 0.5 units of Taq polymerase (Takara Biotechnology of ocular contusion injuries without treatment 25 years ago, Co. Ltd, Dalian, China), and 10–200 ng of genomic DNA. and no history of coronary heart disease or cerebrovascular Primers for the two coding exons of UBIAD1 were UBIAD1: disease. The proband’s 34-year-old daughter (Patient III:1) 1F-CTC GTG GGG TGT AAG ACC CAC TT, 1R-GCG GCT had good vision (20/15 OD and 20/20 OS); nevertheless, slit- TAA ATT AGA AAG CCA CCT; 2F-AGT GCC CAC CTG lamp examination demonstrated bilateral central discoid haze, CAC AGT CTA AG, 2R-CAA ACT GGG CAG CTC CTT midperipheral clouding, and peripheral arcus lipoides without TAC AA [12]. The iCycler Thermal Cycler (Bio-Rad, crystals (Figure 3). Pupillary reaction, motility, corneal Hercules, CA) was used for the thermocycling procedure. The sensation, intraocular pressure, fundus examination, and knee protocol for amplification reactions was as follows: examination were all normal. The only abnormal laboratory denaturation at 95 °C for 5 min, then followed by 35 cycles at reading was a slight decrease in fasting plasma glucose 94 °C for 30 s, 63 °C to 65 °C for 30 s, 72 °C for 40 s, and the recorded during biochemical examination of the blood. terminal extension step at 72 °C for 8 min. The annealing Patient IV: 1 (Figure 1) was an 11-year-old girl with good temperatures are 63 °C for exon 1 and 65 °C for exon 2. 2% UCVA: 20/20 OD and 20/15 OS. Slit-lamp examination agarose gel was used to detect PCR products, and revealed an almost complete circle of subtle subepithelial subsequently the PCR products were purified with a TIANgel crystal deposits that appeared to be asymmetric and denser in Midi Purification Kit (Tiangen Biotech Co. Ltd). For direct her left eye (Figure 4). The results for her other tests were sequencing via an ABI BigDye Terminator Cycle Sequencing normal except for mildly elevated serum total cholesterol and kit v3.1 (ABI Applied Biosystems, Foster City, CA), the PCR fasting plasma glucose. She had a history of suppurative products were sequenced by an ABI 3100 Genetic Analyzer encephalitis at two months of age. (Applied Biosystems). Nucleotide sequences of PCR products Mutation analysis: A missense mutation on exon1, c.305A>G were manually compared with gene annotation from (p.Asn102Ser), was identified in the heterozygous state in the GeneBank (NM_013319.2). proband and affected individuals in whom UBIAD1 genetic 2686 Molecular Vision 2011; 17:2685-2692 <http://www.molvis.org/molvis/v17/a290> © 2011 Molecular Vision Figure 2. The proband’s corneal findings. Corneal photos of the proband demonstrate central and paracentral crystalline deposits, central and midperipheral haze, and arcus lipoides in a 57 year old male. A and B: External photographs of OD and OS. C and D: Slit-lamp photograph of OD and OS, demonstrate subepithelial crystalline deposits. Figure 3. Corneal findings of the proband’s daughter. External photographs of the cornea of the proband’s daughter, a 34 year old female, III:1, with central discoid haze, midperipheral clouding, and peripheral arcus lipoides, without crystals.
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