Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2017

Open Access 01-12-2017 | Research

Clinical and genetic characteristics of chinese patients with Birt-Hogg-Dubé syndrome

Authors: Yaping Liu, Zhiyan Xu, Ruie Feng, Yongzhong Zhan, Jun Wang, Guozhen Li, Xue Li, Weihong Zhang, Xiaowen Hu, Xinlun Tian, Kai-Feng Xu, Xue Zhang

Published in: Orphanet Journal of Rare Diseases | Issue 1/2017

Login to get access

Abstract

Background

Birt-Hogg-Dubé syndrome (BHD) is an autosomal dominant disorder, the main manifestations of which are fibrofolliculomas, renal tumors, pulmonary cysts and recurrent pneumothorax. The known causative gene for BHD syndrome is the folliculin (FLCN) gene on chromosome 17p11.2. Studies of the FLCN mutation for BHD syndrome are less prevalent in Chinese populations than in Caucasian populations. Our study aims to investigate the genotype spectrum in a group of Chinese patients with BHD.

Methods

We enrolled 51 patients with symptoms highly suggestive of BHD from January 2014 to February 2017. The FLCN gene was examined using PCR and Sanger sequencing in every patient, for those whose Sanger sequencing showed negative mutation results, multiplex ligation-dependent probe amplification (MLPA) testing was conducted to detect any losses of large segments.

Main results

Among the 51 patients, 27 had FLCN germline mutations. In total, 20 mutations were identified: 14 were novel mutations, including 3 splice acceptor site mutations, 2 different deletions, 6 nonsense mutations, 1 missense mutation, 1 small insertion, and 1 deletion of the whole exon 8.

Conclusions

We found a similar genotype spectrum but different mutant loci in Chinese patients with BHD compared with European and American patients, thus providing stronger evidence for the clinical molecular diagnosis of BHD in China. It suggests that mutation analysis of the FLCN gene should be systematically conducted in patients with cystic lung diseases.
Appendix
Available only for authorised users
Literature
1.
go back to reference Birt AR, Hogg GR, Dube WJ. Hereditary multiple fibrofolliculomas with trichodiscomas and acrochordons. Arch Dermatol. 1977;113(12):1674–7.CrossRefPubMed Birt AR, Hogg GR, Dube WJ. Hereditary multiple fibrofolliculomas with trichodiscomas and acrochordons. Arch Dermatol. 1977;113(12):1674–7.CrossRefPubMed
2.
go back to reference Zbar B, Alvord WG, Glenn G, Turner M, Pavlovich CP, Schmidt L, Walther M, Choyke P, Weirich G, Hewitt SM, et al. Risk of renal and colonic neoplasms and spontaneous pneumothorax in the Birt-Hogg-Dube syndrome. Cancer Epidemiol Biomarkers Prev. 2002;11(4):393–400.PubMed Zbar B, Alvord WG, Glenn G, Turner M, Pavlovich CP, Schmidt L, Walther M, Choyke P, Weirich G, Hewitt SM, et al. Risk of renal and colonic neoplasms and spontaneous pneumothorax in the Birt-Hogg-Dube syndrome. Cancer Epidemiol Biomarkers Prev. 2002;11(4):393–400.PubMed
3.
go back to reference Furuya M, Nakatani Y. Birt-Hogg-Dube syndrome: clinicopathological features of the lung. J Clin Pathol. 2013;66(3):178–86.CrossRefPubMed Furuya M, Nakatani Y. Birt-Hogg-Dube syndrome: clinicopathological features of the lung. J Clin Pathol. 2013;66(3):178–86.CrossRefPubMed
4.
go back to reference Kunogi Okura M, Yae T, Nagashima O, Hirai S, Kumasaka T, Iwase A. Pneumothorax developing for the first time in a 73-year-old woman diagnosed with Birt-Hogg-Dube syndrome. Intern Med. 2013;52(21):2453–5.CrossRefPubMed Kunogi Okura M, Yae T, Nagashima O, Hirai S, Kumasaka T, Iwase A. Pneumothorax developing for the first time in a 73-year-old woman diagnosed with Birt-Hogg-Dube syndrome. Intern Med. 2013;52(21):2453–5.CrossRefPubMed
5.
go back to reference Xu KF, Feng R, Cui H, Tian X, Wang H, Zhao J, Huang H, Zhang W, Lo BH. Diffuse cystic lung diseases: diagnostic considerations. Semin Respir Crit Care Med. 2016;37(3):457–67.CrossRefPubMed Xu KF, Feng R, Cui H, Tian X, Wang H, Zhao J, Huang H, Zhang W, Lo BH. Diffuse cystic lung diseases: diagnostic considerations. Semin Respir Crit Care Med. 2016;37(3):457–67.CrossRefPubMed
6.
go back to reference Nickerson ML, Warren MB, Toro JR, Matrosova V, Glenn G, Turner ML, Duray P, Merino M, Choyke P, Pavlovich CP, et al. Mutations in a novel gene lead to kidney tumors, lung wall defects, and benign tumors of the hair follicle in patients with the Birt-Hogg-Dube syndrome. Cancer Cell. 2002;2(2):157–64.CrossRefPubMed Nickerson ML, Warren MB, Toro JR, Matrosova V, Glenn G, Turner ML, Duray P, Merino M, Choyke P, Pavlovich CP, et al. Mutations in a novel gene lead to kidney tumors, lung wall defects, and benign tumors of the hair follicle in patients with the Birt-Hogg-Dube syndrome. Cancer Cell. 2002;2(2):157–64.CrossRefPubMed
8.
go back to reference Toro JR, Glenn G, Duray P, Darling T, Weirich G, Zbar B, Linehan M, Turner ML. Birt-Hogg-Dube syndrome: a novel marker of kidney neoplasia. Arch Dermatol. 1999;135(10):1195–202.CrossRefPubMed Toro JR, Glenn G, Duray P, Darling T, Weirich G, Zbar B, Linehan M, Turner ML. Birt-Hogg-Dube syndrome: a novel marker of kidney neoplasia. Arch Dermatol. 1999;135(10):1195–202.CrossRefPubMed
9.
go back to reference Hong S, Oh H, Valera VA, Baba M, Schmidt LS, Linehan WM. Inactivation of the FLCN tumor suppressor gene induces TFE3 transcriptional activity by increasing its nuclear localization. PLOS One. 2010;12:e15793.CrossRef Hong S, Oh H, Valera VA, Baba M, Schmidt LS, Linehan WM. Inactivation of the FLCN tumor suppressor gene induces TFE3 transcriptional activity by increasing its nuclear localization. PLOS One. 2010;12:e15793.CrossRef
10.
go back to reference Baba M, Furihata M, Hong S, Tessarollo L, Haines DC, Southon E, Patel VG, Igarashi P, Alvord WG, Leighty RM. Kidney-Targeted Birt-Hogg-Dubé gene inactivation in a mouse model: Erk1/2 and Akt-mTOR activation, cell hyperproliferation, and polycystic kidneys. J Natl Cancer Inst. 2008;100(2):140–54.CrossRefPubMedPubMedCentral Baba M, Furihata M, Hong S, Tessarollo L, Haines DC, Southon E, Patel VG, Igarashi P, Alvord WG, Leighty RM. Kidney-Targeted Birt-Hogg-Dubé gene inactivation in a mouse model: Erk1/2 and Akt-mTOR activation, cell hyperproliferation, and polycystic kidneys. J Natl Cancer Inst. 2008;100(2):140–54.CrossRefPubMedPubMedCentral
12.
go back to reference Khoo SK, Giraud S, Kahnoski K, Chen J, Motorna O, Nickolov R, Binet O, Lambert D, Friedel J, Levy R, et al. Clinical and genetic studies of Birt-Hogg-Dube syndrome. J Med Genet. 2002;39(12):906–12.CrossRefPubMedPubMedCentral Khoo SK, Giraud S, Kahnoski K, Chen J, Motorna O, Nickolov R, Binet O, Lambert D, Friedel J, Levy R, et al. Clinical and genetic studies of Birt-Hogg-Dube syndrome. J Med Genet. 2002;39(12):906–12.CrossRefPubMedPubMedCentral
13.
go back to reference Gunji Y, Akiyoshi T, Sato T, Kurihara M, Tominaga S, Takahashi K, Seyama K. Mutations of the Birt Hogg Dube gene in patients with multiple lung cysts and recurrent pneumothorax. J Med Genet. 2007;44(9):588–93.CrossRefPubMedPubMedCentral Gunji Y, Akiyoshi T, Sato T, Kurihara M, Tominaga S, Takahashi K, Seyama K. Mutations of the Birt Hogg Dube gene in patients with multiple lung cysts and recurrent pneumothorax. J Med Genet. 2007;44(9):588–93.CrossRefPubMedPubMedCentral
14.
go back to reference Furuya M, Yao M, Tanaka R, Nagashima Y, Kuroda N, Hasumi H, Baba M, Matsushima J, Nomura F, Nakatani Y. Genetic, epidemiologic and clinicopathologic studies of Japanese Asian patients with Birt-Hogg-Dube syndrome. Clin Genet. 2016;90(5):403–12.CrossRefPubMed Furuya M, Yao M, Tanaka R, Nagashima Y, Kuroda N, Hasumi H, Baba M, Matsushima J, Nomura F, Nakatani Y. Genetic, epidemiologic and clinicopathologic studies of Japanese Asian patients with Birt-Hogg-Dube syndrome. Clin Genet. 2016;90(5):403–12.CrossRefPubMed
15.
go back to reference Ren HZ, Zhu CC, Yang C, Chen SL, Xie J, Hou YY, Xu ZF, Wang DJ, Mu DK, Ma DH, et al. Mutation analysis of the FLCN gene in Chinese patients with sporadic and familial isolated primary spontaneous pneumothorax. Clin Genet. 2008;74(2):178–83.CrossRefPubMed Ren HZ, Zhu CC, Yang C, Chen SL, Xie J, Hou YY, Xu ZF, Wang DJ, Mu DK, Ma DH, et al. Mutation analysis of the FLCN gene in Chinese patients with sporadic and familial isolated primary spontaneous pneumothorax. Clin Genet. 2008;74(2):178–83.CrossRefPubMed
16.
go back to reference Menko FH, van Steensel MA, Giraud S, Friis-Hansen L, Richard S, Ungari S, Nordenskjold M, Hansen TV, Solly J, Maher ER. Birt-Hogg-Dube syndrome: diagnosis and management. Lancet Oncol. 2009;10(12):1199–206.CrossRefPubMed Menko FH, van Steensel MA, Giraud S, Friis-Hansen L, Richard S, Ungari S, Nordenskjold M, Hansen TV, Solly J, Maher ER. Birt-Hogg-Dube syndrome: diagnosis and management. Lancet Oncol. 2009;10(12):1199–206.CrossRefPubMed
17.
go back to reference Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. Part II. Am J Respir Crit Care Med. 2015;192(1):17–29.CrossRefPubMed Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. Part II. Am J Respir Crit Care Med. 2015;192(1):17–29.CrossRefPubMed
18.
go back to reference Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. Part I. Am J Respir Crit Care Med. 2015;191(12):1354–66.CrossRefPubMed Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. Part I. Am J Respir Crit Care Med. 2015;191(12):1354–66.CrossRefPubMed
19.
go back to reference den Dunnen JT, Antonarakis SE. Mutation nomenclature extensions and suggestions to describe complex mutations: a discussion. Hum Mutat. 2000;15(1):7–12.CrossRef den Dunnen JT, Antonarakis SE. Mutation nomenclature extensions and suggestions to describe complex mutations: a discussion. Hum Mutat. 2000;15(1):7–12.CrossRef
20.
go back to reference Kozlowski P, Jasinska AJ, Kwiatkowski DJ. New applications and developments in the use of multiplex ligation-dependent probe amplification. Electrophoresis. 2008;29(23):4627–36.CrossRefPubMed Kozlowski P, Jasinska AJ, Kwiatkowski DJ. New applications and developments in the use of multiplex ligation-dependent probe amplification. Electrophoresis. 2008;29(23):4627–36.CrossRefPubMed
21.
go back to reference Benhammou JN, Vocke CD, Santani A, Schmidt LS, Baba M, Seyama K, Wu X, Korolevich S, Nathanson KL, Stolle CA, et al. Identification of intragenic deletions and duplication in the FLCN gene in Birt-Hogg-Dube syndrome. Genes, Chromosomes and Cancer. 2011;50(6):466–77.CrossRefPubMedPubMedCentral Benhammou JN, Vocke CD, Santani A, Schmidt LS, Baba M, Seyama K, Wu X, Korolevich S, Nathanson KL, Stolle CA, et al. Identification of intragenic deletions and duplication in the FLCN gene in Birt-Hogg-Dube syndrome. Genes, Chromosomes and Cancer. 2011;50(6):466–77.CrossRefPubMedPubMedCentral
22.
go back to reference Toro JR, Pautler SE, Stewart L, Glenn GM, Weinreich M, Toure O, Wei MH, Schmidt LS, Davis L, Zbar B, et al. Lung cysts, spontaneous pneumothorax, and genetic associations in 89 families with Birt-Hogg-Dube syndrome. Am J Respir Crit Care Med. 2007;175(10):1044–53.CrossRefPubMedPubMedCentral Toro JR, Pautler SE, Stewart L, Glenn GM, Weinreich M, Toure O, Wei MH, Schmidt LS, Davis L, Zbar B, et al. Lung cysts, spontaneous pneumothorax, and genetic associations in 89 families with Birt-Hogg-Dube syndrome. Am J Respir Crit Care Med. 2007;175(10):1044–53.CrossRefPubMedPubMedCentral
23.
go back to reference Schmidt LS, Warren MB, Nickerson ML, Weirich G, Matrosova V, Toro JR, Turner ML, Duray P, Merino M, Hewitt S, et al. Birt-Hogg-Dube syndrome, a genodermatosis associated with spontaneous pneumothorax and kidney neoplasia, maps to chromosome 17p11.2. Am J Hum Genet. 2001;69(4):876–82.CrossRefPubMedPubMedCentral Schmidt LS, Warren MB, Nickerson ML, Weirich G, Matrosova V, Toro JR, Turner ML, Duray P, Merino M, Hewitt S, et al. Birt-Hogg-Dube syndrome, a genodermatosis associated with spontaneous pneumothorax and kidney neoplasia, maps to chromosome 17p11.2. Am J Hum Genet. 2001;69(4):876–82.CrossRefPubMedPubMedCentral
24.
go back to reference Zhang X, Ma D, Zou W, Ding Y, Zhu C, Min H, Zhang B, Wang W, Chen B, Ye M. A rapid NGS strategy for comprehensive molecular diagnosis of Birt-Hogg-Dubé syndrome in patients with primary spontaneous pneumothorax. Respir Res. 2016;17(1):64.CrossRefPubMedPubMedCentral Zhang X, Ma D, Zou W, Ding Y, Zhu C, Min H, Zhang B, Wang W, Chen B, Ye M. A rapid NGS strategy for comprehensive molecular diagnosis of Birt-Hogg-Dubé syndrome in patients with primary spontaneous pneumothorax. Respir Res. 2016;17(1):64.CrossRefPubMedPubMedCentral
25.
go back to reference Rossing M, Albrechtsen A, Skytte AB, Jensen UB, Ousager LB, Gerdes AM, Nielsen FC, Hansen TV. Genetic screening of the FLCN gene identify six novel variants and a Danish founder mutation. J Hum Genet. 2017;62(2):151–7.CrossRefPubMed Rossing M, Albrechtsen A, Skytte AB, Jensen UB, Ousager LB, Gerdes AM, Nielsen FC, Hansen TV. Genetic screening of the FLCN gene identify six novel variants and a Danish founder mutation. J Hum Genet. 2017;62(2):151–7.CrossRefPubMed
Metadata
Title
Clinical and genetic characteristics of chinese patients with Birt-Hogg-Dubé syndrome
Authors
Yaping Liu
Zhiyan Xu
Ruie Feng
Yongzhong Zhan
Jun Wang
Guozhen Li
Xue Li
Weihong Zhang
Xiaowen Hu
Xinlun Tian
Kai-Feng Xu
Xue Zhang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2017
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-017-0656-7

Other articles of this Issue 1/2017

Orphanet Journal of Rare Diseases 1/2017 Go to the issue