Genetic diseases

遗传性疾病
  • 文章类型: Journal Article
    目的:恒牙牙根吸收是一种常见的病理过程,常伴随着牙外伤或正畸治疗。很少,牙根吸收是遗传性疾病的一个特征,可以帮助诊断。因此,本综述旨在确定哪些遗传疾病可以引起病理性牙根吸收,从而确定哪些突变基因可能与之相关。
    方法:我们遵循PRISMA指南进行了系统评价。来自PubMed的文章描述了遗传性疾病患者的牙根吸收,Embase,WebofScience,谷歌学者。我们合成了遗传疾病,类型,严重程度,以及吸收的程度,以及其他全身和口腔症状和组织学特征。
    结果:综合分析包括937项确定记录中的25项研究。我们分析了21例病例报告,三个案例系列,和一项队列研究。总的来说,我们强调了14种不同的病理与描述的牙根吸收。根据病理学,吸收的部位,他们的程度,和他们的严重程度显示出差异。
    结论:怀疑有14种遗传病导致牙根吸收,我们的发现意义重大,丰富了以往的分类.其中,三种代谢紊乱,三种钙磷代谢紊乱,并确定了骨溶解障碍。
    OBJECTIVE: Root resorption in permanent teeth is a common pathological process that often follows dental trauma or orthodontic treatment. More rarely, root resorption is a feature of genetic disorders and can help with diagnosis. Thus, the present review aims to determine which genetic disorders could induce pathological root resorptions and thus which mutated genes could be associated with them.
    METHODS: We conducted a systematic review following the PRISMA guidelines. Articles describing root resorptions in patients with genetic disorders were included from PubMed, Embase, Web of Science, and Google Scholar. We synthesized the genetic disorder, the type, severity, and extent of the resorptions, as well as the other systemic and oral symptoms and histological features.
    RESULTS: The synthetic analysis included 25 studies among 937 identified records. We analyzed 21 case reports, three case series, and one cohort study. Overall, we highlighted 14 different pathologies with described root resorptions. Depending on the pathology, the sites of resorption, their extent, and their severity showed differences.
    CONCLUSIONS: With 14 genetic pathologies suspected to induce root resorptions, our findings are significant and enrich a previous classification. Among them, three metabolic disorders, three calcium-phosphorus metabolism disorders, and osteolysis disorders were identified.
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  • 缝隙连接(GJ)是由连接蛋白构成的一种特殊的细胞膜结构。缝隙连接蛋白广泛分布并在除分化骨骼肌外的所有组织中表达。红细胞,成熟的精子细胞,这与许多遗传性疾病的发生有关。其调节免疫反应的功能,细胞增殖,迁移,凋亡,和致癌作用使其成为各种疾病的治疗靶标。在本文中,综述了其在神经系统相关疾病和治疗中的作用机制。
    Gap junction (GJ) is a special cell membrane structure composed of connexin. Connexin is widely distributed and expressed in all tissues except differentiated skeletal muscle, red blood cells, and mature sperm cells, which is related to the occurrence of many genetic diseases due to its mutation. Its function of regulating immune response, cell proliferation, migration, apoptosis, and carcinogenesis makes it a therapeutic target for a variety of diseases. In this paper, the possible mechanism of its action in nervous system-related diseases and treatment are reviewed.
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  • 文章类型: Systematic Review
    肺泡微石症(PAM)是一种罕见的常染色体隐性遗传肺病,由编码钠依赖性磷酸盐转运蛋白2B的SLC34A2基因变异引起,NaPi-2b.PAM的特征在于磷酸钙晶体在肺泡中的沉积。发病和临床病程差异很大;一些患者无症状,而另一些患者则出现严重的呼吸衰竭,症状负担显着,生存率下降。由于缺乏认可,PAM很可能被低估了,误诊,和轻微的临床表现。大多数患者在遗传上没有表征,因为PAM的诊断确认传统上不包括遗传分析。将来,基因检测可能会成为诊断的首选工具,而不是侵入性方法。本系统综述旨在提供对PAM遗传学不断增长的知识的概述。在几乎所有经过基因测试的患者中都发现了SLC34A2的罕见变异。到目前为止,已经在至少68名患者中鉴定了34个等位基因变体。其中大多数以纯合状态存在;然而,在复合杂合形式中发现了一些。大多数等位基因变体仅涉及单个核苷酸。一半的变体要么是胡说八道,要么是移码,导致蛋白质的过早终止或mRNA的衰减。目前没有治疗PAM的方法,唯一有效的治疗方法是肺移植。管理主要是对症,但对潜在病理生理学的更好理解将有望导致靶向治疗方案的发展。关于PAM患者的更多标准化数据,包括覆盖更多国际人口的基因诊断,将支持临床研究的设计和实施,以使患者受益。进一步的遗传表征和对分子变化如何影响疾病表型的理解将有望在将来对疾病进行早期诊断和治疗。
    Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive lung disease caused by variants in the SLC34A2 gene encoding the sodium-dependent phosphate transport protein 2B, NaPi-2b. PAM is characterized by deposition of calcium phosphate crystals in the alveoli. Onset and clinical course vary considerably; some patients remain asymptomatic while others develop severe respiratory failure with a significant symptom burden and compromised survival. It is likely that PAM is under-reported due to lack of recognition, misdiagnosis, and mild clinical presentation. Most patients are genetically uncharacterized as the diagnostic confirmation of PAM has traditionally not included a genetic analysis. Genetic testing may in the future be the preferred tool for diagnostics instead of invasive methods. This systematic review aims to provide an overview of the growing knowledge of PAM genetics. Rare variants in SLC34A2 are found in almost all genetically tested patients. So far, 34 allelic variants have been identified in at least 68 patients. A majority of these are present in the homozygous state; however, a few are found in the compound heterozygous form. Most of the allelic variants involve only a single nucleotide. Half of the variants are either nonsense or frameshifts, resulting in premature termination of the protein or decay of the mRNA. There is currently no cure for PAM, and the only effective treatment is lung transplantation. Management is mainly symptomatic, but an improved understanding of the underlying pathophysiology will hopefully result in development of targeted treatment options. More standardized data on PAM patients, including a genetic diagnosis covering larger international populations, would support the design and implementation of clinical studies to the benefit of patients. Further genetic characterization and understanding of how the molecular changes influence disease phenotype will hopefully allow earlier diagnosis and treatment of the disease in the future.
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  • 文章类型: Case Reports
    歌舞uki综合征(KS)是一种罕见的遗传性疾病,以畸形面部特征为特征,骨骼异常,皮纹异常,智力残疾,身材矮小。在该患者群体中可以更频繁地看到自身免疫性疾病。白癜风是一种自身免疫性疾病,在KS患者中很少报道。本报告描述了一例KS患者出现的白癜风,并讨论了使用Janus激酶抑制剂作为治疗方法。
    Kabuki Syndrome (KS) is a rare genetic disorder characterized by dysmorphic facial features, skeletal anomalies, dermatoglyphic abnormalities, intellectual disability, and short stature. Autoimmune disease can be seen more frequently in this patient population. Vitiligo is an autoimmune disease that is uncommonly reported in patients with KS. This report describes a case of vitiligo manifesting in a patient with KS and discusses the use of Janus kinase inhibitors as treatment.
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  • 文章类型: Journal Article
    背景:肌营养不良蛋白病是由肌营养不良蛋白(DMD)基因的致病变体引起的X连锁隐性疾病。在一个包括两个由于外显子45-47的DMD缺失而患有贝克尔肌营养不良症(BMD)的男孩的家庭中,母体携带者测试意外地发现了外显子45-47和49-51的双等位基因DMD缺失。
    方法:患者在双等位基因DMD变异中的轻度表型促使进一步研究外显子49-51缺失,通过文献回顾和回顾性图表回顾在我们机构的综合神经肌肉中心评估和/或在我们的临床基因检测实验室诊断的患者。
    结果:据我们所知,这只是第5例女性DMD双等位基因变异的确诊病例.在男性中,DMD外显子49-51缺失似乎导致轻度BMD表型,肌酸激酶水平低或正常.在我们的临床实验室中,在过去的十年中,这种缺失包括通过染色体微阵列(CMA)诊断为男性的19%(4/21)的肌营养不良蛋白病。大多数通过图表审查确定的人都是通过CMA诊断的,尽管微阵列是全基因组的,而不是DMD特异性的。这个案例引发了重要的遗传咨询问题。
    结论:DMD外显子49-51缺失似乎导致可变的但通常是轻度的BMD表型。CMA相对频繁的检测表明它可能被诊断不足。
    Dystrophinopathies are X-linked recessive conditions caused by pathogenic variants in the dystrophin (DMD) gene. In a family that included two boys with Becker muscular dystrophy (BMD) due to a DMD deletion of exons 45-47, maternal carrier testing unexpectedly identified biallelic DMD deletions of exons 45-47 and 49-51.
    The patient\'s mild phenotype in the setting of biallelic DMD variants prompted further investigation of the exon 49-51 deletion in particular, via literature review and retrospective chart review of patients who have been evaluated in our institution\'s comprehensive neuromuscular center and/or diagnosed in our clinical genetic testing laboratory.
    To our knowledge, this is only the fifth case of confirmed biallelic DMD variants in a female. In males, the DMD exon 49-51 deletion appears to result in a mild BMD phenotype with low or normal creatine kinase levels. This deletion comprised 19% (4/21) of dystrophinopathies diagnosed by chromosomal microarray (CMA) in males during the past ten years in our clinical laboratory. Most individuals identified by chart review were diagnosed through CMA, despite the fact that microarray was genome-wide and not DMD-specific. This case raised important genetic counseling issues.
    The DMD exon 49-51 deletion appears to cause a variable but generally mild BMD phenotype. Its relatively frequent detection by CMA suggests it may be underdiagnosed.
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  • 文章类型: Review
    Ehlers-Danlos综合征(EDS)是一组异质性的遗传传播的结缔组织疾病,直接影响胶原蛋白的合成,有广泛的症状。病例介绍:本研究介绍了一名哥伦比亚妇女的临床病例,该妇女患有肌病性EDS和多种合并症,需要40年的病史才能做出正确的诊断。本文还对当前有关EDS的文献进行了综述,不仅可以提醒该综合征,还可以帮助临床医生正确识别该综合征的症状。结论:采用多学科方法对患者进行诊断,包括临床和分子分析,神经心理学和心理评估,对于改善患者的治疗选择和预后预测具有重要意义。
    Ehlers-Danlos syndromes (EDS) are a heterogeneous group of genetically transmitted connective tissue disorders that directly affect collagen synthesis, with a broad range of symptoms. Case presentation: This study presents a clinical case of a Colombian woman with myopathic EDS and multiple comorbidities taking 40 years of medical history to make the right diagnosis. This article also presents a review of the current literature on EDS, not only to remind the syndrome but also to help the clinician correctly identify symptoms of this diverse syndrome. Conclusion: A multidisciplinary approach to the diagnosis of the patient, including clinical and molecular analysis, and neuropsychological and psychological assessment, is important to improve the treatment choice and the outcome prediction of the patients.
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  • 文章类型: Journal Article
    Taurodontism是一种形态异常,涉及多根牙齿,其特征在于牙髓腔的垂直移动和根部的缩短。对文献进行了分析,以确定诊断为牙体病对牙科治疗的影响。对2005-2021年的85篇全文出版物进行了分析,本研究包括20篇出版物。由于牙髓腔底板的根尖移位和根管系统的不正确配置,对牛磺酸牙的牙髓治疗具有挑战性,或额外的运河的存在。在假肢方面,不建议使用牛磺齿作为基台,因为它们由于根部较短而缺乏稳定性。由于根分叉的根尖移位,牛磺酸牙的拔除可能很复杂。在牙周学中,由于分叉参与的机会较少,因此牛磺酸牙可以有更好的预后。从正畸的角度来看,重要的是要注意,牛磺酸牙没有充分嵌入肺泡中,并且有更大的根吸收趋势。关于遗传疾病,据报道,这种异常可以作为一个孤立的特征存在。然而,大多数作者认为,牛磺酸症与唐氏综合症等病症有关,Klinefelter综合征,唇腭裂,缺省症,釉质发育不全,和其他人。从临床的角度来看,在治疗前诊断牛磺酸症非常重要。在这种情况下通常发生的畸形的早期诊断中,对牛磺酸症的诊断可能很重要。
    Taurodontism is a morphological anomaly involving multirooted teeth that is characterized by a vertical shift of the pulp chamber and shortening of the roots. The literature was analyzed to determine the impact of a diagnosis of taurodontism on dental treatment. A total of 85 full-text publications from the years 2005-2021 were analyzed and 20 publications were included in this research. The endodontic treatment of a taurodont tooth is challenging due to the apical displacement of the pulpal chamber floor and the incorrect configuration of the root canal system, or the presence of additional canals. In terms of prosthetics, the use of taurodont teeth as abutments is not recommended as they lack stability due to shorter roots. The extraction of taurodont teeth can be complicated due to an apical shift of the root furcation. In periodontology, taurodont teeth can have a better prognosis as there is less chance of furcation involvement. From an orthodontic point of view, it is important to note that taurodont teeth are not sufficiently embedded in the alveolus and have a greater tendency for root resorption. With regard to genetic diseases, it has been reported that this anomaly can exist as an isolated feature. However, the majority of authors agree that taurodontism is associated with conditions such as Down syndrome, Klinefelter syndrome, cleft lip and palate, hypodontia, amelogenesis imperfecta, and others. From a clinical standpoint, it is very important to diagnose taurodontism before treatment. A diagnosis of taurodontism can be important in the early diagnosis of malformations that commonly occur with this condition.
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  • 文章类型: Journal Article
    一个8周龄的孩子,男性,混合品种的小狗被一个救援组织收养。从收养的时候,这只小狗的疾病影响了各种器官系统,通过支持疗法解决,但一旦停止药物治疗后复发。血液学数据的审查显示循环血细胞的周期性波动。中性粒细胞中的周期性最为明显,复发性严重中性粒细胞减少症。中性粒细胞减少症持续5-6天,中性粒细胞计数在最低点之间有11-14d的规律周期。基因检测确定该患者是衔接蛋白复合物3β亚基(AP3B1)基因移码突变的纯合突变体,最初在具有循环造血(CH)的灰牧羊犬中发现。没有谱系信息,但患者的特征在表型上与牧羊犬不同。我们在这里描述了一个在不像牧羊犬的混种狗中发生AP3B1突变的案例,以前没有描述过,我们的知识。我们的发现表明,AP3B1突变和CH存在于普通犬类人群中,并且不仅限于牧羊犬。
    An 8-wk-old, male, mixed-breed puppy was adopted from a rescue organization. From the time of adoption, the puppy suffered episodes of illness affecting various organ systems, which resolved with supportive therapy but relapsed once medical therapy was discontinued. Review of the hematologic data revealed cyclic fluctuations in circulating blood cells. Cyclicity was most prominent in neutrophils, with recurrent severe neutropenia. Neutropenic episodes lasted 5-6 d, with regular cycles of 11-14 d between nadir neutrophil counts. Genetic testing determined that the patient was homozygous mutant for the frameshift mutation in the adaptor protein complex 3 β-subunit (AP3B1) gene, originally identified in gray collies with cyclic hematopoiesis (CH). Pedigree information was not available, but the patient\'s features were phenotypically distinct from those of collies. We describe here a case of the AP3B1 mutation in a mixed-breed dog that did not resemble a collie, undescribed previously, to our knowledge. Our findings indicate that the AP3B1 mutation and CH are present within the general canine population and are not restricted to collies.
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  • 文章类型: Journal Article
    自2019年12月以来,COVID-19大流行,起源于武汉,中国,已导致全球600多万人死亡。数百万在SARS-CoV-2感染中幸存的人显示出许多COVID后并发症。虽然,共病条件和后COVID复杂性在某种程度上得到了很好的审查和了解,COVID-19对先前存在的先天性异常和遗传疾病的影响仅记录在孤立的病例报告和病例系列中,到目前为止。在本次审查中,我们分析了2019年12月至2022年1月出版的PubMed索引文献,从不同的角度理解这种关系,比如易感性,严重性和遗传力。根据我们的知识,这是关于COVID-19及其与各种先天性异常和遗传性疾病的相关性的首次全面综述.根据报道的研究,一些先天性疾病存在发展为严重COVID-19的高风险,因为这些疾病已经包括一些与呼吸和心血管系统的结构和功能相关的合并症,导致严重的肺炎。其他先天性疾病反而会给患者带来心理负担,并不被认为是发展为严重COVID-19感染的高风险。
    Since December 2019, the COVID-19 pandemic, which originated in Wuhan, China, has resulted in over six million deaths worldwide. Millions of people who survived this SARS-CoV-2 infection show a number of post-COVID complications. Although, the comorbid conditions and post-COVID complexities are to some extent well reviewed and known, the impact of COVID-19 on pre-existing congenital anomalies and genetic diseases are only documented in isolated case reports and case series, so far. In the present review, we analyzed the PubMed indexed literature published between December 2019 and January 2022 to understand this relationship from various points of view, such as susceptibility, severity and heritability. Based on our knowledge, this is the first comprehensive review on COVID-19 and its associations with various congenital anomalies and genetic diseases. According to reported studies, some congenital disorders present high-risk for developing severe COVID-19 since these disorders already include some comorbidities related to the structure and function of the respiratory and cardiovascular systems, leading to severe pneumonia. Other congenital disorders rather cause psychological burdens to patients and are not considered high-risk for the development of severe COVID-19 infection.
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  • 文章类型: Case Reports
    低钾性周期性麻痹(hypoPP)是一种以发作性,短暂的,和低反射性骨骼肌无力。hypoPP是由与钠或钙离子通道表达相关的基因突变引起的罕见疾病。大多数突变与常染色体显性遗传有关,但有些是在没有相关家族史的患者中发现的。在这项研究中,评估了一名28岁的男子因瘫痪发作而前往急诊室。他表现出四肢运动无力。没有既往病史或家族史。最初的心电图显示平坦的T波和QT延长。他的验血被推迟了,观察到突发性低血压和心动过缓。血液检查显示严重低钾血症。纠正低钾血症后,他的肌肉麻痹恢复了,没有任何神经缺陷。患者的甲状腺功能和长期运动试验结果正常。然而,由于高碳水化合物饮食和运动的历史,怀疑是hypoPP。因此,进行下一代测序(NGS),在SCN4A基因中发现Arg669His突变。虽然hypoPP是一种罕见的疾病,它可以怀疑在低钾性瘫痪患者中,明确这种情况对于防止进一步发作和改善患者预后很重要。通过靶向NGS诊断hypoPP是一种经济有效且有用的方法。
    Hypokalemic periodic paralysis (hypoPP) is a disorder characterized by episodic, short-lived, and hypo-reflexive skeletal muscle weakness. HypoPP is a rare disease caused by genetic mutations related to expression of sodium or calcium ion channels. Most mutations are associated with autosomal dominant inheritance, but some are found in patients with no relevant family history. A 28-year-old man who visited the emergency room for paralytic attack was assessed in this study. He exhibited motor weakness in four limbs. There was no previous medical history or family history. The initial electrocardiogram showed a flat T wave and QT prolongation. His blood test was delayed, and sudden hypotension and bradycardia were observed. The blood test showed severe hypokalemia. After correcting hypokalemia, his muscle paralysis recovered without any neurological deficits. The patient\'s thyroid function and long exercise test results were normal. However, because of the history of high carbohydrate diet and exercise, hypoPP was suspected. Hence, next-generation sequencing (NGS) was performed, and a mutation of Arg669His was noted in the SCN4A gene. Although hypoPP is a rare disease, it can be suspected in patients with hypokalemic paralysis, and iden tification of this condition is important for preventing further attacks and improving patient outcomes. Diagnosing hypoPP through targeted NGS is a cost-effective and useful method.
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