Many of the genes involved in CMT have now been cloned
and sequenced, allowing a genetic classification to be made
depending on the mutation or gene locus identified. Mutations
in over five genes have been reported in CMT, including
PMP22 (peripheral myelin protein on chromosome 17),
MPZ (myelin protein zero on chromosome 1), Connexin-32
(X chromosome), EGR2 and NEFL. The commonest mutational
event is the duplication of the entire PMP22 gene resulting in
clinical CMT type 1a. A deletion of the same gene gives rise to
the milder HNPP phenotype. Phenotypes of varying severity
can also be produced by point mutations (often base
substitutions) in any of the five genes mentioned above.
Prediction of disease severity in presymptomatic patients is
difficult as there is varying severity even within families.
Saturday, April 11, 2009
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