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Journal of hepatology, 2006-07, Vol.45 (1), p.108-116
Ort / Verlag
Oxford: Elsevier B.V
Erscheinungsjahr
2006
Quelle
MEDLINE
Beschreibungen/Notizen
Alpers syndrome is a developmental mitochondrial DNA depletion syndrome leading to fatal brain and liver disease in children and young adults. Mutations in the gene for the mitochondrial DNA polymerase (
POLG) have recently been shown to cause this disorder.
The
POLG locus was sequenced in 15 sequential probands diagnosed with Alpers syndrome. In addition, the
POLG mutations found to cause Alpers syndrome in the 20 cases published to date were analyzed.
POLG DNA testing accurately diagnosed 87% (13/15
=
87%: 95% confidence interval
=
60–98%) of cases. Five new
POLG amino acid substitutions (F749S, R852C, T914P, L966R, and L1173fsX) were found that were associated with Alpers syndrome in five unrelated kindreds, and 14 different allelic combinations of
POLG mutations were found to cause Alpers syndrome in the 20 probands published to date. The most common Alpers-causing mutation was the A467T substitution, located in the linker region of the pol γ protein, which accounted for about 40% of the alleles and was present in 65% of the patients. All patients with
POLG mutations had either the A467T or the W748S substitution in the linker region.
Screening for A467T and W748S substitutions in
POLG now constitutes the most rapid and sensitive test available for confirming the clinical diagnosis of Alpers syndrome.