Identification of allele-specific p22-phoxmutations in a compound heterozygous patient with chronic granulomatous disease by mismatch PCR and restriction enzyme analysis

摘要

A rare subgroup (approx. 5) of all chronic granulomatous disease (CGD) patients suffers from mutations in the gene encoding the small p22-phoxsubunit of the flavocytochromeb558heterodimer, the terminal redox component of the phagocyte NADPH oxidase. A male CGD patient with neutrophil granulocytes devoid of any spectrometrically detectable cytochromeb558owing to autosomally inherited p22-phoxdeficiency (phenotype, A22−) is reported. The patient was identified as being compound heterozygous for two independent mutations of his p22-phoxalleles. On the maternal allele a single base substitution (A186 to T) was found that predicts a nonconservative replacement of Glu 53 by Val. On his paternal p22-phoxallele a G was found to be added to a G stretch between nucleotides G195 and G199 in the cDNA sequence. The resulting frame shift predicts an aberrant open reading frame, 16 amino acids longer than the normal p22-phoxpolypeptide. Genomic DNA was tested for the presence of the mutant allele by mismatch PCR (polymerase chain reaction). For this purpose, a single base mismatch was introduced at nucleotide position 189, leading to digestion of the normal allele by the restriction enzymeHinfI. The maternal allele was found to be present in 50 of the patient's DNA and in 50 of the DNA from his mother. The same mismatch PCR analysis with control DNA from 35 healthy individuals ruled out the possibility that the single base substitution (A186 to T) represents a common polymorphism. Inheritance of the second allelic mutation (G insertion) was verified by restriction enzyme analysis usingBslI CC(N)7GG to digest PCR-amplified genomic DNA at the mutation site. PCR in combination with restriction enzyme analysis proved to be a powerful tool for verification of point mutations in the compound heterozygous CGD patient analyzed and may be used for prenatal diagnosis in this famil