Associação de polimorfismos nos genes MSX1 e PAX9 com agenesia dentária

Abstract

Tooth agenesis, the failure of development of tooth bud causing definitive absence of the tooth, is the most common dental anomaly affecting up to one quarter of the general population. The main cause is related to abnormal function of specific genes which play key roles during odontogenesis, particularly MSX1 and PAX9. Despite the high frequency of this anomaly, there are only a restricted number of mutations in MSX1 and PAX9 that have been associated with non–syndromic tooth agenesis so far. Since a greater number of affected subjects is expected over the coming years, a deeper analysis of the gene networks underlying tooth agenesis is critical. The aim of this research was to investigate six families segregating non–syndromic oligodontia/hypodontia as well as to screen for mutations in their MSX1 and PAX9 genes, attempting to associate phenotype and genotype. Families were selected from a private office. They should present more than one relative affected with agenesis. All subjects had a sample of buccal epithelial cells collected with cytology brushes. DNA was isolated, amplificated and sequenced. All sequences were compared to those in GenBank. Homology of the mutant sequences was also compared using BLAST online software. MSX1 and PAX9 genes from ten unrelated unaffected control subjects were also sequenced. A novel missense mutation lying in the exon 2 close to the end of the paired domain of PAX9 was identified in three families. Heterozygous mutation C503G is expected to result in an alanine–to–glycine amino acid change in residue 168 (Ala168Gly), which is invariably conserved among several species. The alanine–glycine change might lead to protein structural alteration due to the unique flexibility properties of glycine, leading to tooth agenesis. This is a novel mutation since it is not registered neither in any known database nor in literature. Intronic mutations IVS2–109G>C, IVS2–54A>G and IVS2–41A>G were also identified in PAX9. These polymorphic variants may be involved in the phenotype as one proband, showing all three intronic mutations in homozygosis, was affected with the most severe oligodontia within the sample. Transition *6C>T lying in the exon 2 six base pairs after the stop codon was detected in MSX1 gene in one family. Due to its proximity to the stop codon, this homozygous mutation can hinder a regular translation termination thus contributing to the phenotype. Further studies with gene expression in larger affected families will increase knowledge of tooth agenesis. Such understanding will allow to achieve better treatment options and, perhaps, an early diagnosis tool which would possibly lie on the DNA examination based on polymorphic variants. All this data may assist dental practice in a near future.