F. Denoyelle et al., Clinical features of the prevalent form of childhood deafness, DFNB1, due to a connexin-26 gene defect: implications for genetic counselling, LANCET, 353(9161), 1999, pp. 1298-1303
Citations number
27
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background DFNB1, the locus of an autosomal recessive form of deafness due
to mutations in the connexin-26 gene (CX26 or GJB2) is one of the most freq
uent hereditary defects in human beings. To date, no clinical characterisat
ion of the DFNB1 inner-ear defects has been reported, which precludes the p
rovision of prognostic information and genetic counselling.
Methods We enrolled, in a prospective study, 140 children from 104 families
affected by sensorineural deafness with various degrees of hearing loss. T
he children either belonged to a family affected by autosomal recessive dea
fness (DFNB family) or represented sporadic cases. We searched for mutation
s in the 5' non-coding exon and in the coding region of CX26. Audiometric a
nd radiological features were investigated and compared in deaf children wi
th and without CX26 mutations.
Findings CX26 mutations were present in 43 (49%) of the 88 families with ca
ses of prelingual deafness versus none of;the 16 families with postlingual
forms of deafness (p < 0 . 01). The inner-ear defects of 54 prelingually de
af children with biallelic CX26 mutations were compared with the defects in
57 prelingually deaf children without CX26 mutations. DFNB1 deafness varie
d from mild to profound, associated with sloping or flat audiometric curves
and a radiologically normal inner ear. Hearing loss was not progressive in
11 of 16 cases tested, and variations in the severity of deafness between
siblings were common.
Interpretation The characteristic audiometric and radiological features of
DFNB1 should be the reference used to guide the investigation,by CX26 molec
ular diagnostic tests,of deaf children with a compatible phenotype. Prognos
tic information can now be given to families: the hearing loss in DFNB1 dea
fness is non-progressive in most cases, at least up to young adulthood. An
important element for genetic counselling is that the severity of hearing l
oss due to DFNB1 is extremely variable and cannot be predicted, even within
families.