Splicing abnormalities caused by a novel mutation in the PHKA2 gene in children with glycogen storage disease type IX / 中华肝脏病杂志

Objective: Glycogen storage disease type IX (GSD-IX) is a rare primary glucose metabolism abnormality caused by phosphorylase kinase deficiency and a series of pathogenic gene mutations. The clinical characteristics, gene analysis, and functional verification of a mutation in a child with hepatomegaly are summarized here to clarify the pathogenic cause of the disease. Methods: The clinical data of a child with GSD-IX was collected. Peripheral blood from the child and his parents was collected for genomic DNA extraction. The patient's gene diagnosis was performed by second-generation sequencing. The suspected mutations were verified by Sanger sequencing and bioinformatics analysis. The suspected splicing mutations were verified in vivo by RT-PCR and first-generation sequencing. Results: Hepatomegaly, transaminitis, and hypertriglyceridemia were present in children. Liver biopsy pathological examination results indicated glycogen storage disease. Gene sequencing revealed that the child had a c.285 + 2_285 + 5delTAGG hemizygous mutation in the PHKA2 gene. Sanger sequencing verification showed that the mother of the child was heterozygous and the father of the child was of the wild type. Software such as HSF3.1 and ESEfinder predicted that the gene mutation affected splicing. RT-PCR of peripheral blood from children and his mother confirmed that the mutation had caused the skipping of exon 3 during the constitutive splicing of the PHKA2 gene. Conclusion: The hemizygous mutation in the PHKA2 gene (c.285 + 2_285 + 5delTAGG) is the pathogenic cause of the patient's disease. The detection of the novel mutation site enriches the mutation spectrum of the PHKA2 gene and serves as a basis for the family's genetic counseling.

Clinical, Biochemical, and Genetic Characterization of Glycogen Storage Type IX in a Child with Asymptomatic Hepatomegaly / 대한소아소화기영양학회지

Glycogen storage disease type IX (GSD IX) is caused by a defect in phosphorylase b kinase (PhK) that results from mutations in the PHKA2, PHKB, and PHKG2 genes. Patients usually manifest recurrent ketotic hypoglycemia with growth delay, but some may present simple hepatomegaly. Although GSD IX is one of the most common causes of GSDs, its biochemical and genetic diagnosis has been problematic due to its rarity, phenotypic overlap with other types of GSDs, and genetic heterogeneities. In our report, a 22-month-old boy with GSD IX is described. No other manifestations were evident except for hepatomegaly. His growth and development also have been proceeding normally. Diagnosed was made by histologic examination, an enzyme assay, and genetic testing with known c.3210_3212del (p.Arg1070del) mutation in PHKA2 gene.

Determinação da atividade da fosforilase b-quinase em hemácias / Determination of the phosphorylase b-kinase in erythrocytes

A enzima fosforilase b-quinase catalisa a fosforilação da fosforilase (b), inativa, em fosforilase (a), ativa. A sua deficiência provoca a glicogenose tipo IX. Neste trabalho é desenvolvido um método para a determinação da atividade da fosforilase b-quinase em hemácias possibilitando o diagnóstico laboratorial desta doença de estocagem de glicogênio.

Activación plaquetaria por trombina / Platelet activation by thrombin

Cuando un agonista se une a su receptor específico sobre la membrana plaquetaria se inician una serie de cambios morfológicosy metabólicos que llevan al cambio de forma, agregación y secreción de contenidos granulares. La trombina, serinoproteasa multifuncional y fuerte agonosta plaquetario, tiene dos tipos de receptores sobre la membrana plaquetaria: de alta y de moderada afinidad. Este último pertenece a la familia de receptores ß2 adrenérgicos que presentan siete dominios de intramembrana, e inician la activación a través de G proteínas específicas. De esta manera se desencadenan diversos pasos metabólicos a través de varias enzimas claves. La actividad de la fosfolipasa Cß (PLCß) origina dos segundos mensajeros: Inositol 3 fosfato (IP3) que promueve la movilización de calcio del sistema tubular denso al citosol y el diacilglicerol (DG) que activa proteína quinasa C (PKC). Si bien la plaqueta no prolifera se han detectado enzimas relacionadas a oncogenes. De esta manera se han estudiado y comprendido nuevos caminos de activación. La familia de la tirosina quinasas, relacionas a la proliferación celular y oncogenes, fosforilan residuos tirosinas; en su mayoría son quinasas del tipo no receptor que se encuentran en el citosol como ser: Scr, Syk y FAK. La fosfolipasa Cy necesita la presencia de RasGAP, Rap 1b para hidrolizar fosfoinosítidos de membrana. La formación de este complejo trimérico se induce por trombina. La fosfoinositol-3-quinasa fosforila la posición 3 del anillo del inositol generando nuevos compuestos. La regulación completa de estos mecanismos de activación llevan a la respuesta hemostática plaquetaria. Su conocimiento hace posible el desarrollo de moléculas inhibitorias como terapéutica en los procesos trombóticos y tromboembólicos