Zusammenfassung
Hintergrund: Das LAV (Large bzw. Enlarged Aquaeductus Vestibularis)- und Pendred-Syndrom sind autosomal rezessiv vererbte Erkrankungen. Das LAV-Syndrom ist im Gegensatz zum Pendred-Syndrom ausschließlich durch einen bilateralen erweiterten Aquaeductus vestibularis charakterisiert. Das Pendred-Syndrom ist eine komplexe Erkrankung. Neben einer sensorineuralen Schwerhörigkeit tritt auch eine Schilddrüsenfunktionsstörung auf. Bisher wurden nur Mutationen im SLC26A4-Gen für beide Syndrome verantwortlich gemacht. Dieses wurde durch Kopplungsanalyse auf Chromosom 7q31 kartiert. Das Genprodukt (Pendrin) wird im Innenohr, in der Schilddrüse, Niere und Placenta exprimiert. Funktionelle Untersuchungen nach Expression von Pendrin in Xenopus laevis Oozyten zeigten, dass es sich bei diesem Protein um einen Jodid/Chlorid- bzw. Jodid/Format-Transporter handelt. Methode: Der Nachweis von Mutationen erfolgte durch direkte Sequenzierung der kodierenden Exone einschließlich der Intronübergänge. Eine Haplotypenanalyse erfolgte mittels polymorpher Mikrosatellitenmarker, die einen genomischen Bereich von 5 Mbp um den Genort für das SLC26A4-Gen abdecken. Ergebnisse: Bei der Sequenzanalyse von 42 Patienten mit einem bilateralen erweiterten Aquaeductus Vestibularis konnte in 30 % der Fälle keine Mutation im Gen SLC26A4 nachgewiesen werden. Im Einzelfall konnte gezeigt werden, dass keine Kopplung an dem Genort auf Chromosom 7q31 vorliegt. Schlussfolgerung: Die hier vorgestellten Ergebnisse deuten daraufhin, dass zumindest noch ein weiteres Gen an der Ausbildung des Enlarged Vestibular Aqueduct Syndroms beteiligt ist.
Abstract
Background: Both LAV- (large or enlarged vestibular aqueduct) and Pendred-syndrome are autosomal recessive diseases. In contrast to Pendred-syndrome, LAV-syndrome is characterised only by an enlarged vestibular aqueduct. Pendred-syndrome is a more complex disease. Classically it is characterised by sensorineural hearing loss and enlargement of the thyroid gland. Up to now, only mutations in SLC26A4 gene are known as being responsible for both syndromes. The gene for Pendred-syndrome (SLC26A4) has been localised by linkage analysis of chromosome 7q31. This protein is expressed in the inner ear, thyroid gland, kidney, and placenta. Functional analysis of the gene product (pendrin) in Xenopus laevis oocytes revealed that pendrin acts as an iodide/chloride and chloride/formate exchanger. Method: Each of the exons and flanking splice regions of the SLC26A4 gene were analysed by direct sequencing. Haplotype analysis was undertaken with microsatellite markers spanning a 5 Mbp area around the localisation of the SLC26A4 gene. Results: In sequence analysis of 42 patients with bilateral enlargement of the vestibular aqueduct, no mutation could be identified in 30 % of cases. In some of these cases, a linkage to the gene localisation on chromosome 7q31 could not be detected. Conclusion: Our results indicate evidence for a second gene involved in the development of LAV-syndrome.
Schlüsselwörter
LAV-Syndrom - SLC26A4 Gen - Mutationsanalyse - Haplotypenanalyse
Key words
LAV-syndrome - SLC26A4 gene - mutation analysis - haplotype analysis
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Dr. Ralf Birkenhäger
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik Universitätsklinikum Freiburg
Killianstraße 5 D-79106 Freiburg
eMail: birkenhaeger@hno.ukl.uni-freiburg.de