Background Familial hypercholesterolemia （FH） is an autosomal dominant disorder of lipoprotein metabolism which can lead to premature coronary heart disease （pCHD）. There are about 3.8 million potential FH patients in China, whereas the clinical and genetic data of FH are limited. Methods Dutch Lipid Clinic Network （DLCN） criteria was used to diagnose FH in outpatients with hypercholesterolemia. Resequencing chip analysis combined with Sanger sequencing validation were used to identify mutations in the definite FH patients according to DLCN criteria. In silico analysis was conducted in mutations with previously unknown pathogenicity. Then, the novel mutant receptors were transfected into human embryo kidney 293 （HEK-293） cells. The binding and the internalization activities of the mu- tant receptors were analyzed by flow cytometry. Results The prevalence of definite FH in outpatients with hypercholesterolemia in this study is 3.2%. Using genetic testing, one homozygous FH （HoFH）, one heterozygous FH （HeFH） and three compound heterozygous FH patients were confirmed. Eight mutations in low-density lipoprotein receptor （LDLR） gene were identified, in which c.357delG was a novel mutation and co-segregated with the FH phenotype. Bioinformatic analysis confirmed that c.357delG was a pathogenic mutation. Furthermore, when compared with the wild-type LDLRs by flow eytometry analysis, the binding and internalization activities of c.357delG mutant LDLRs were reduced by 35% and 49%, respectively. Conclusions This study identified eight LDLR gene mutations in five patients with definite FH, in which c.357delG is a novel pathogenic mutation. These findings increase our understanding of the genetic spectrum of FH in China.
Xu WANGLong JIANGLi-Yuan SUNYue WUWen-Hui WENXi-Fu WANGWei LIUYu-Jie ZHOULu-Ya WANG
目的介绍提高和促进低密度蛋白受体(low density lipoprote in receptor,LDLR)基因表达药物的研究进展,提出提高LD-LR转录和转录后水平可作为开发降脂药物的一个新靶点,从而预防高胆固醇血症和动脉粥样硬化(atherosc lerosis,AS)的发生。方法以国内外发表的论文为材料,按药物对提高LDLR转录和转录后水平等分别予以介绍。结果与结论研究证实,许多药物可提高和促进LDLR基因表达,使血中LDL水平降低。本文提出提高LDLR转录和转录后水平可作为开发降脂药物的一个新靶点,从而预防高胆固醇血症和AS的发生。
