Volume 109, Issue 3 , Pages 192-200, March 2010
NEMO Gene Mutations in Chinese Patients With Incontinentia Pigmenti
Article Outline
Background/Purpose
Incontinentia pigmenti is a rare, X-linked, dominant genodermatosis affecting skin, teeth, eyes, and central nervous system. Symptoms are associated with mutations in the nuclear factor-kappa B essential modulator (NEMO) gene on chromosome Xq28. Here, a subpopulation of Chinese patients with incontinentia pigmenti were examined to investigate the frequency and pattern of NEMO mutations, and to analyze their clinical features.
Methods
From January 1996 to August 2006, 52 participants (21 probands and 31 family members) were screened for symptoms of incontinentia pigmenti and NEMO gene mutations. We designed a NEMO-specific PCR primer, referred to as In2S, to detect a deletion of exon 4–10 of the NEMO gene, which represents the mutation most frequently associated with incontinentia pigmenti. For participants without this deletion, all exons were sequenced to screen for other NEMO mutations. In addition, the clinical manifestations and family histories of the participants were analyzed.
Results
Exon 4–10 was deleted in 13 probands, and one proband had a novel point mutation (G549C) in exon 5 that converted a glutamine to a histidine. Seven probands (33%) had no mutation in any of the exons of the NEMO gene. One of four participants who presented with hyperpigmentation also had the exon 4–10 deletion. One patient had a positive family history before the study took place, but no NEMO mutation was identified in any of the family members. Remarkably, the mothers of three of the probands exhibited the exon 4–10 deletion; however, their clinical manifestations were subtle and unrecognizable.
Conclusion
Mutational analysis of the NEMO gene was helpful in diagnosing incontinentia pigmenti among participants with a nearly normal phenotype or an incomplete form of the disease that only caused hyperpigmentation symptoms.
Key Words: incontinentia pigmenti , NEMO gene
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References
- . Incontinentia pigmenti: a review and update on the molecular basis of pathophysiology . J Am Acad Dermatol . 2002;47:169–187
- . Incontinentia pigmenti (BlochSulzberger syndrome) . J Med Genet . 1993;30:53–59
- Genomic rearrangement in NEMO impairs NF-kappaB activation and is a cause of incontinentia pigmenti. The International Incontinentia Pigmenti (IP) Consortium . Nature . 2000;405:466–472
- . Control of apoptosis by Rel/ NF-kappaB transcription factors . Oncogene . 1999;18:6910–6924
- Genetic approaches in mice to understand Rel/NF-kappaB and IkappaB function: transgenics and knockouts . Oncogene . 1999;18:6888–6895
- A recurrent deletion in the ubiquitously expressed NEMO (IKK-gamma) gene accounts for the vast majority of incontinentia pigmenti mutations . Hum Mol Genet . 2001;10:2171–2179
- Molecular analysis of the genetic defect in a large cohort of IP patients and identification of novel NEMO mutations interfering with NF-kappaB activation . Hum Mol Genet . 2004;13:1763–1773
- Two cases of misinterpretation of molecular results in incontinentia pigmenti, and a PCR-based method to discriminate NEMO/ IKKgamma gene deletion . Hum Mutat . 2003;21:8–11
- A novel PCR approach for prenatal detection of the common NEMO rearrangement in incontinentia pigmenti . Prenat Diagn . 2004;24:384–388
- Whole-genome shotgun assembly and comparison of human genome assemblies . Proc Natl Acad Sci USA . 2004;101:1916–1921
- Alterations of the IKBKG locus and diseases: an update and a report of 13 novel mutations . Hum Mutat . 2008;29:595–604
- De novo incontinentia pigmenti in female twins . Acta Paediatr Taiwan . 2004;45:178–180
- NEMO Delta 4–10 deletion of NEMO gene in Chinese incontinentia pigmenti cases . Zhonghua Er Ke Za Zhi . 2005;43:89–92
- Multiple clinical manifestations and diagnostic challenges of incontinentia pigmenti—12 years' experience in 1 medical center . J Chin Med Assoc . 2008;71:455–460
- An incontinentia pigmenti family with deletion in both NEMO gene and pseudogene DeltaNEMO . Zhonghua Yi Xue Yi Chuan Xue Za Zhi . 2008;25:573–575
- . A case report of incontinentia pigmenti . Zhongguo Dang Dai Er Ke Za Zhi . 2007;9:503–504
- . Clinical and molecular analysis of NF-kappaB essential modulator in Chinese incontinentia pigmenti patients . Int J Dermatol . 2007;46:1017–1022
- Incontinentia pigmenti: clinical observation of 40 Korean cases . J Korean Med Sci . 2006;21:474–477
- . A case of incontinentia pigmenti in Japan and its genetic examination . Jpn J Ophthalmol . 2007;51:142–145
- NEMO mutational analysis in a Japanese family with incontinentia pigmenti . Eye . 2007;21:888–890
- Atypical forms of incontinentia pigmenti in male individuals result from mutations of a cytosine tract in exon 10 of NEMO (IKK-gamma) . Am J Hum Genet . 2001;68:765–771
- A new mutation in exon 7 of NEMO gene: late skewed X-chromosome inactivation in an incontinentia pigmenti female patient with immunodeficiency . Hum Genet . 2005;118:458–465
- Incontinentia pigmenti in a newborn with a novel nonsense mutation in the NEMO gene . Br J Dermatol . 2007;156:392–393
- . Incontinentia pigmenti case series: clinical spectrum of incontinentia pigmenti in 53 female patients and their relatives . Clin Exp Dermatol . 2005;30:474–480
- . Reticulate hyperpigmentation . Semin Cutan Med Surg . 1997;16:72–80
- . X-linked ectodermal dysplasia with immunodeficiency caused by NEMO mutation: early recognition and diagnosis . Arch Dermatol . 2008;144:342–346
PII: S0929-6646(10)60042-3
doi:10.1016/S0929-6646(10)60042-3
© 2010 Formosan Medical Association & Elsevier. Published by Elsevier Inc. All rights reserved.
Volume 109, Issue 3 , Pages 192-200, March 2010
