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Characterization of Molecular Defects in Korean Families with Inherited Ornithine Transcarbamylase Deficiency and Their Genotype-Phenotype Correlations

Journal of the Korean Pediatric Society 1999;42(7):900-910.
Published online July 15, 1999.
Characterization of Molecular Defects in Korean Families with Inherited Ornithine Transcarbamylase Deficiency and Their Genotype-Phenotype Correlations
Han-Wook Yoo
Department of Pediatrics, Asan Medical Center, School of Medicine, Ulsan University, Seoul, Korea
유전성 Ornithine Transcarbamylase(OTC) 결핍 한국인 가계의 분자유전학적 결함과 표현형과의 상관관계에 관한 연구
유한욱
울산대학교 의과대학 서울중앙병원 소아과
Correspondence: 
Han-Wook Yoo, Email: 1
Abstract
Purpose
: This study was undertaken to characterize molecular defects in Korean families with ornithine transcarbamylase(OTC) deficiency, correlate it with phenotype using in vitro expression study, and utilize it for making prenatal molecular diagnosis.
Methods
: To investigate molecular lesions resulting in OTC deficiency in 15 unrelated Korean families, the OTC genes of probands were amplified exon by exon and analyzed by direct sequencing of double stranded DNA. Based on their molecular lesions, prenatal monitoring of six fetuses at risk from four unrelated families was performed using genomic DNA from chorionic villi sampling(CVS). To analyze expression in vitro, mutant OTC cDNAs were constructed and cotransfected with β-galactosidase gene into COS-1 cells by using lipofection. After transient expression, OTC activity was measured by colorimetric method.
Results
: Nine different mutations were identified in 10 out of 15 families ; six mutations were novel, involving well-conserved nucleotide sequences across species or CpG hot spot : T44I, M205T, H214Y, D249G, F281S, R320X. In vitro expression study revealed that the H214Y mutant showed a residual enzyme activity(13% vs 0% for D249G, 0% for R320X). However, clinical phenotype for H214Y was severe with neonatal onset. Three mutations were previously reported in other ethnic groups : R26Q, R141Q, R277W. Prenatal evaluation of 6 fetuses including one fraternal twins were successfully made. We predicted the outcome of all fetuses prenatally. They were also tested postnatally for the mutations to be unaffected.
Conclusion
: The genotypes of Korean patients with OTC deficiency are genetically heterogeneous. Therefore, molecular diagnosis should be individualized in each family with OTC deficiency.
Key Words: Ornithine transcarbamylase(OTC) deficiency, Molecular defects, Genotype-phenotype, Expression, Prenatal diagnosis


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