NPC1

NPC1
  • 文章类型: Journal Article
    背景:维持细胞内平衡对于肿瘤细胞的生存能力至关重要,往往特别容易受到环境压力的影响。因此,针对这种稳态的破坏为肿瘤治疗提供了一种有希望的方法.Wogonin的一种新型衍生物LW-213,通过启动内质网(ER)应激有效诱导癌细胞凋亡,尽管所涉及的精确分子途径仍然是复杂和多方面的。
    目的:本研究旨在探讨LW-213如何促进非小细胞肺癌(NSCLC)细胞凋亡,并阐明控制这一过程的详细机制。
    方法:利用各种NSCLC细胞系来描述由LW-213诱导的凋亡效应。先进的方法论,包括RNA测序(RNA-seq),蛋白质印迹(WB),免疫荧光(IF),免疫沉淀(IP),流式细胞术(Fc),实时定量聚合酶链反应(RT-qPCR),和电子显微镜,被用来研究潜在的分子相互作用。还在使用裸小鼠的异种移植模型中评估了LW-213的功效和机制作用。
    结果:我们证明了LW-213,一种小分子阳离子两亲性药物(CAD),抑制Niemann-PickC1(NPC1)功能并诱导溶酶体膜损伤,从而激活磷酸肌醇引发的膜束缚和脂质转运(PITT)途径。这种激活促进了胆固醇从ER到溶酶体的转运,在急诊室保持胆固醇缺乏状态,包括大量的Ca2+胞吐和FAM134B介导的网状吞噬的激活。最终,过度的网状吞噬诱导致死性内质网应激。
    结论:总之,我们的研究阐明了由溶酶体损伤引发的细胞器多米诺反应和一系列最终导致不可逆致死效应的自救机制,揭示了一种潜在的药物干预策略。
    BACKGROUND: Maintaining intracellular equilibrium is essential for the viability of tumor cells, which tend to be particularly vulnerable to environmental stressors. Consequently, targeting the disruption of this homeostasis offers a promising approach for oncological treatments. LW-213, a novel derivative of wogonin, effectively induces apoptosis in cancer cells by initiating endoplasmic reticulum (ER) stress, although the precise molecular pathways involved remain intricate and multifaceted.
    OBJECTIVE: This research aimed to explore how LW-213 prompts apoptosis in non-small cell lung cancer (NSCLC) cells and to clarify the detailed mechanisms that govern this process.
    METHODS: Various NSCLC cell lines were utilized to delineate the apoptotic effects induced by LW-213. Advanced methodologies, including RNA sequencing (RNA-seq), Western blotting (WB), immunofluorescence (IF), immunoprecipitation (IP), flow cytometry (Fc), real-time quantitative polymerase chain reaction (RT-qPCR), and electron microscopy, were employed to investigate the underlying molecular interactions. The efficacy and mechanistic action of LW-213 were also assessed in a xenograft model using nude mice.
    RESULTS: We demonstrated that LW-213, a small molecule cationic amphiphilic drug (CAD), inhibited Niemann-Pick C1 (NPC1) function and induced lysosomal membrane damage, thereby activating the phosphoinositide-initiated membrane tethering and lipid transport (PITT) pathway. This activation promoted cholesterol transport from the ER to the lysosome, perpetuating a cholesterol-deficient state in the ER, including massive exocytosis of Ca2+ and activation of FAM134B-mediated reticulophagy. Ultimately, excessive reticulophagy induced lethal ER stress.
    CONCLUSIONS: In summary, our study elucidates an organelle domino reaction initiated by lysosome damage and a series of self-rescue mechanisms that eventually lead to irreversible lethal effects, revealing a potential drug intervention strategy.
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  • 文章类型: Journal Article
    Besnoitiabesnoiti是一种形成囊肿的顶孔虫寄生虫,是牛胸膜病的病因。在感染的早期阶段,速殖子在宿主细胞胆固醇依赖性过程中在宿主内皮细胞内复制。通过应用U18666A处理,我们在这里评估了Niemann-PickC型蛋白1(NPC1)在两者中的作用,胞内芽孢杆菌复制和宿主细胞胆固醇分布。此外,通过qPCR研究了B.besnoiti驱动的NPC1基因转录变化。总的来说,U18666A处理显着降低了B.besnoiti增殖并诱导了宿主细胞质致密囊泡中的胆固醇积累。然而,NPC1基因转录不受B.besnoiti感染的影响。
    Besnoitia besnoiti is a cyst-forming apicomplexan parasite and the causal agent of bovine besnoitiosis. During early phase of infection, tachyzoites replicate within host endothelial cells in a host cell cholesterol-dependent process. By applying U18666A treatments, we here evaluated the role of Niemann-Pick type C protein 1 (NPC1) in both, intracellular B. besnoiti replication and host cellular cholesterol distribution. Additionally, B. besnoiti-driven changes in NPC1 gene transcription were studied by qPCR. Overall, U18666A treatments significantly reduced B. besnoiti proliferation and induced cholesterol accumulation in host cytoplasmic dense vesicles. However, NPC1 gene transcription was not affected by B. besnoiti infection.
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  • 文章类型: Journal Article
    尼曼-匹克病C型(NPC)是一种主要由NPC1基因突变引起的神经退行性疾病,导致未酯化胆固醇在细胞晚期内体/溶酶体中大量积累。小胶质细胞的受损表型是Npc1突变小鼠(Npc1-/-小鼠)的标志。然而,Npc1调节小胶质细胞功能的机制尚不清楚。这里,我们发现,新生Npc1-/-小鼠中溶酶体蛋白CD68和吞噬活性增加所显示的反应性小胶质细胞与小胶质细胞中TREM2-mTOR信号传导的中断有关.此外,在Npc1缺陷的BV2细胞中,Trem2基因缺失部分恢复小胶质细胞功能,可能是通过恢复mTOR信号。一起来看,我们的发现表明,小胶质细胞中Npc1的丢失导致其形态的改变和溶酶体功能的损害,与TREM2-mTOR信号通路相关。
    Niemann-Pick disease Type C (NPC) is a neurodegenerative disease mainly caused by the mutation in NPC1 gene, leading to massive accumulation of unesterified cholesterol in the late endosome/lysosome of cells. Impaired phenotype of microglia is a hallmark in Npc1 mutant mice (Npc1-/- mice). However, the mechanism of Npc1 in regulating microglial function is still unclear. Here, we showed that the reactive microglia in the neonatal Npc1-/- mice indicated by the increased lysosome protein CD68 and phagocytic activity were associated with disrupted TREM2-mTOR signaling in microglia. Furthermore, in Npc1-deficient BV2 cells, genetic deletion of Trem2 partially restored microglial function, probably via restored mTOR signaling. Taken together, our findings indicated that loss of Npc1 in microglia caused changes of their morphologies and the impairment of lysosomal function, which were linked to the TREM2-mTOR signaling pathway.
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  • 文章类型: Journal Article
    Niemann-Pick病C1型(NPC1,MIM257220)是一种遗传性溶酶体贮积病,其特征是进行性神经系统变性,导致残疾和过早死亡。Npc1-/-的小鼠模型显示Npc1疾病的快速发展形式,其特点是体重减轻,共济失调,和增加胆固醇储存。Npc1-/-接受miglustat(MIGLU)联合治疗(COMBI)的小鼠,神经类固醇别孕烯醇酮(ALLO)和环状寡糖2-羟丙基-β-环糊精(HPβCD)显示预防浦肯野细胞丢失,改善运动功能,减少细胞内脂质储存。尽管用COMBI治疗Npc1-/-小鼠,MIGLU或HPβCD导致预防体重减轻,减少总脑重量没有积极的影响。
    为了评估药物治疗引起的不同脑区的改变,我们使用体视学方法测量了经过洗发和药物处理的野生型和突变小鼠的各种脑结构的新鲜体积(根据石蜡包埋的脑切片确定的体积计算的体积).
    在野生型小鼠中,两种疗法均未显著改变所研究的脑区体积.与各自的野生型相比,特定大脑区域的新鲜体积,在假治疗的Npc1-/-小鼠中显著降低,在所有治疗策略中,药物治疗后部分增加;在海马CA1区和嗅觉结构中发现了最显著的差异.
    服用COMBI后,Npc1-/-小鼠的脑区体积在功能方面没有特别变化,MIGLU,或HPβCD。Npc1-/-小鼠脑区新鲜体积的测量可以监测区域特异性变化和对药物治疗的反应,在某种程度上,这种小鼠模型的行为改善。
    UNASSIGNED: Niemann-Pick disease type C1 (NPC1, MIM 257220) is a heritable lysosomal storage disease characterized by a progressive neurological degeneration that causes disability and premature death. A murine model of Npc1-/- displays a rapidly progressing form of Npc1 disease, which is characterized by weight loss, ataxia, and increased cholesterol storage. Npc1-/- mice receiving a combined therapy (COMBI) of miglustat (MIGLU), the neurosteroid allopregnanolone (ALLO) and the cyclic oligosaccharide 2-hydroxypropyl-β-cyclodextrin (HPßCD) showed prevention of Purkinje cell loss, improved motor function and reduced intracellular lipid storage. Although therapy of Npc1-/- mice with COMBI, MIGLU or HPßCD resulted in the prevention of body weight loss, reduced total brain weight was not positively influenced.
    UNASSIGNED: In order to evaluate alterations of different brain areas caused by pharmacotherapy, fresh volumes (volumes calculated from the volumes determined from paraffin embedded brain slices) of various brain structures in sham- and drug-treated wild type and mutant mice were measured using stereological methods.
    UNASSIGNED: In the wild type mice, the volumes of investigated brain areas were not significantly altered by either therapy. Compared with the respective wild types, fresh volumes of specific brain areas, which were significantly reduced in sham-treated Npc1-/- mice, partly increased after the pharmacotherapies in all treatment strategies; most pronounced differences were found in the CA1 area of the hippocampus and in olfactory structures.
    UNASSIGNED: Volumes of brain areas of Npc1-/- mice were not specifically changed in terms of functionality after administering COMBI, MIGLU, or HPßCD. Measurements of fresh volumes of brain areas in Npc1-/- mice could monitor region-specific changes and response to drug treatment that correlated, in part, with behavioral improvements in this mouse model.
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  • 文章类型: Journal Article
    早老素蛋白(PS1和PS2)代表γ-分泌酶的催化亚基,在淀粉样β(Aβ)肽的产生和阿尔茨海默病(AD)的发病机理中起关键作用。然而,PS蛋白还发挥Aβ生成以外的多种功能。在这项研究中,我们研究了PS1和PS2在细胞胆固醇代谢中的个体作用.在小鼠模型中PS1或PS2的缺失导致大脑神经元中的胆固醇积累。在来自Psen1敲除(PS1-KO)和Psen2-KO(PS2-KO)小鼠的胚胎成纤维细胞的溶酶体中也观察到胆固醇积累,并且与Niemann-Pick型C1(NPC1)蛋白的表达降低有关晚期内体/溶酶体区室中的细胞内胆固醇转运。质谱和互补生化分析也揭示了PS1-KO和PS2-KO细胞中NPC1和几种其他膜蛋白的异常N-糖基化。有趣的是,N-糖基化的药理学抑制导致细胞内胆固醇在溶酶体中显著积累并减少NPC1,从而类似于PS1-KO和PS2-KO细胞的变化。反过来,用伴侣诱导剂arimoclomol处理PS1-KO和PS2-KO小鼠胚胎成纤维细胞(MEF)部分使NPC1表达正常化,并挽救了溶酶体胆固醇积累。此外,NPC1的过表达阻止了PS1-KO和PS2-KOMEF中的细胞内胆固醇积累。总的来说,这些数据表明,PS功能的丧失导致蛋白质N-糖基化受损,最终导致NPC1表达降低和细胞内胆固醇积累。这种机制可能导致在PSKO小鼠中观察到的神经变性,并可能导致AD的发病机理。
    Presenilin proteins (PS1 and PS2) represent the catalytic subunit of γ-secretase and play a critical role in the generation of the amyloid β (Aβ) peptide and the pathogenesis of Alzheimer disease (AD). However, PS proteins also exert multiple functions beyond Aβ generation. In this study, we examine the individual roles of PS1 and PS2 in cellular cholesterol metabolism. Deletion of PS1 or PS2 in mouse models led to cholesterol accumulation in cerebral neurons. Cholesterol accumulation was also observed in the lysosomes of embryonic fibroblasts from Psen1-knockout (PS1-KO) and Psen2-KO (PS2-KO) mice and was associated with decreased expression of the Niemann-Pick type C1 (NPC1) protein involved in intracellular cholesterol transport in late endosomal/lysosomal compartments. Mass spectrometry and complementary biochemical analyses also revealed abnormal N-glycosylation of NPC1 and several other membrane proteins in PS1-KO and PS2-KO cells. Interestingly, pharmacological inhibition of N-glycosylation resulted in intracellular cholesterol accumulation prominently in lysosomes and decreased NPC1, thereby resembling the changes in PS1-KO and PS2-KO cells. In turn, treatment of PS1-KO and PS2-KO mouse embryonic fibroblasts (MEFs) with the chaperone inducer arimoclomol partially normalized NPC1 expression and rescued lysosomal cholesterol accumulation. Additionally, the intracellular cholesterol accumulation in PS1-KO and PS2-KO MEFs was prevented by overexpression of NPC1. Collectively, these data indicate that a loss of PS function results in impaired protein N-glycosylation, which eventually causes decreased expression of NPC1 and intracellular cholesterol accumulation. This mechanism could contribute to the neurodegeneration observed in PS KO mice and potentially to the pathogenesis of AD.
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  • 文章类型: Journal Article
    Niemann-PickC1型(NPC1)疾病是罕见的神经退行性胆固醇和鞘脂贮积症,主要是由于胆固醇运输蛋白NPC1的突变。除了分解代谢衍生的鞘脂,NPC1功能障碍还导致从头鞘脂生物合成增加,然而,所涉及的细胞机制知之甚少。尽管NPC1的缺失或NPC1固醇结合域的抑制增强了神经鞘脂的从头生物合成,令人惊讶的ORMDL水平,丝氨酸棕榈酰转移酶(SPT)的调节亚基,鞘脂生物合成的限速步骤,也大大增加了。然而,尽管神经酰胺水平升高,但SPT-ORMDL复合物中结合的ORMDL较少.相反,ORMDL与p62,选择性自噬受体,并且由于NPC1疾病细胞中自噬缺陷而积累在停滞的自噬体中。NPC1缺失细胞中N-乙酰-L-亮氨酸恢复自噬通量减少了ORMDL在自噬体中的积累,并减少了从头鞘脂生物合成及其积累。这项研究揭示了一个以前未知的从头鞘脂生物合成之间的联系,ORMDL和自噬缺陷存在于NCP1疾病中。此外,我们为N-乙酰-L-亮氨酸治疗NPC1疾病的有益作用提供了进一步的证据和机制见解,目前正在等待食品和药物管理局和欧洲药品管理局的批准.
    Niemann-Pick type C1 (NPC1) disease is a rare neurodegenerative cholesterol and sphingolipid storage disorder primarily due to mutations in the cholesterol-trafficking protein NPC1. In addition to catabolic-derived sphingolipids, NPC1 dysfunction also leads to an increase in de novo sphingolipid biosynthesis, yet little is known about the cellular mechanism involved. Although deletion of NPC1 or inhibition of the NPC1 sterol binding domain enhanced de novo sphingolipid biosynthesis, surprisingly levels of the ORMDLs, the regulatory subunits of serine palmitoyltransferase (SPT), the rate-limiting step in sphingolipid biosynthesis, were also greatly increased. Nevertheless, less ORMDL was bound in the SPT-ORMDL complex despite elevated ceramide levels. Instead, ORMDL colocalized with p62, the selective autophagy receptor, and accumulated in stalled autophagosomes due to defective autophagy in NPC1 disease cells. Restoration of autophagic flux with N-acetyl-L-leucine in NPC1 deleted cells decreased ORMDL accumulation in autophagosomes and reduced de novo sphingolipid biosynthesis and their accumulation. This study revealed a previously unknown link between de novo sphingolipid biosynthesis, ORMDL, and autophagic defects present in NCP1 disease. In addition, we provide further evidence and mechanistic insight for the beneficial role of N-acetyl-L-leucine treatment for NPC1 disease which is presently awaiting approval from the Food and Drug Administration and the European Medicines Agency.
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  • 文章类型: Journal Article
    Niemann-Pick疾病C1型(NPC1)是一种溶酶体疾病,原因是细胞内胆固醇转运出内溶酶体区室。.在具有相同NPC1基因型的个体中观察到明显的异质性,因此表明修饰基因的显着影响。先前的工作表明,在NPC1小鼠模型中,SOAT1活性的降低降低了疾病的严重程度。因此,我们假设与SOAT1表达降低相关的多态性可能影响NPC1表型.作为自然历史试验的一部分,对117名NPC1个体进行了表型分析和基因组测序。表型包括确定疾病严重程度和疾病负担。显著的临床异质性存在于NPC1I1061T变体纯合的个体和兄弟姐妹中。SOAT1多态性分析,rs1044925(A>C),显示C等位基因与神经系统发病的较早年龄显着相关。C等位基因可能与较高的年化严重度指数评分以及肝病和癫痫发作的频率增加有关。与SOAT1表达降低相关的多态性似乎是NPC1表型的遗传修饰。该发现与显示Npc1-/-:Soat1-/-小鼠中表型严重性降低的先前数据一致,并且支持研究SOAT1抑制剂作为NPC1的潜在疗法的潜力的努力。
    Niemann-Pick disease type C1 (NPC1) is a lysosomal disorder due to impaired intracellular cholesterol transport out of the endolysosomal compartment.. Marked heterogeneity has been observed in individuals with the same NPC1 genotype, thus suggesting a significant effect of modifier genes. Prior work demonstrated that decreased SOAT1 activity decreased disease severity in an NPC1 mouse model. Thus, we hypothesized that a polymorphism associated with decreased SOAT1 expression might influence the NPC1 phenotype. Phenotyping and genomic sequencing of 117 individuals with NPC1 was performed as part of a Natural History trial. Phenotyping included determination of disease severity and disease burden. Significant clinical heterogeneity is present in individuals homozygous for the NPC1I1061T variant and in siblings. Analysis of the SOAT1 polymorphism, rs1044925 (A>C), showed a significant association of the C-allele with earlier age of neurological onset. The C-allele may be associated with a higher Annualized Severity Index Score as well as increased frequency of liver disease and seizures. A polymorphism associated with decreased expression of SOAT1 appears to be a genetic modifier of the NPC1 phenotype. This finding is consistent with prior data showing decreased phenotypic severity in Npc1-/-:Soat1-/- mice and supports efforts to investigate the potential of SOAT1 inhibitors as a potential therapy for NPC1.
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  • 文章类型: Journal Article
    高血胆固醇水平是心血管疾病的主要危险因素。一种纯化的水提物,富含间氯单宁和多肽,已经描述了其抑制胆固醇生物合成和肠道吸收的潜力。在这项工作中,分析了这种提取物对肠细胞代谢产物和蛋白质的影响,以更深入地了解其对脂质代谢的作用方式,特别是关于外源性胆固醇的吸收和运输。Caco-2细胞,分化为肠细胞,暴露于提取物中,并通过非靶向代谢组学和蛋白质组学进行分析。代谢组学分析结果显示,与对照细胞相比,暴露于提取物的细胞的谷胱甘肽含量存在统计学上的显着差异,随着暴露细胞中脂肪酸酰胺的表达增加。蛋白质组分析显示,与FAB1和NPC1的对照细胞相比,暴露于提取物的细胞中的表达增加,FAB1和NPC1是已知与脂质代谢和转运有关的蛋白质。在我们的知识范围内,这项研究是首次使用非靶向代谢组学和蛋白质组学分析来研究水痘对分化的Caco-2细胞的影响,提供对提取物化合物对肠细胞的分子机制的见解。
    High blood cholesterol levels are a major risk factor for cardiovascular diseases. A purified aqueous extract of Fucus vesiculosus, rich in phlorotannins and peptides, has been described for its potential to inhibit cholesterol biosynthesis and intestinal absorption. In this work, the effect of this extract on intestinal cells\' metabolites and proteins was analysed to gain a deeper understanding of its mode of action on lipids\' metabolism, particularly concerning the absorption and transport of exogenous cholesterol. Caco-2 cells, differentiated into enterocytes, were exposed to the extract, and analysed by untargeted metabolomics and proteomics. The results of the metabolomic analysis showed statistically significant differences in glutathione content of cells exposed to the extract compared to control cells, along with an increased expression of fatty acid amides in exposed cells. A proteomic analysis showed an increased expression in cells exposed to the extract compared to control cells of FAB1 and NPC1, proteins known to be involved in lipid metabolism and transport. To the extent of our knowledge, this study is the first use of untargeted metabolomics and a proteomic analysis to investigate the effects of F. vesiculosus on differentiated Caco-2 cells, offering insights into the molecular mechanism of the extract\'s compounds on intestinal cells.
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  • 文章类型: Journal Article
    原理:NPC1是一种位于溶酶体膜上的蛋白质,调节细胞内胆固醇的运输并维持正常的溶酶体功能。GWAS研究发现,NPC1变异体在T2D是胰岛表达的数量性状位点,提示NPC1在T2D胰岛病理生理学中的潜在作用。方法:采用2周龄的Npc1-/-小鼠和野生型同窝动物检查Npc1缺失引起的胰腺β细胞形态和功能变化。在原代胰岛上进行单细胞RNA测序。使用CRISPR/Cas9基因编辑产生Npc1-/-Min6细胞系。海马XF24用于分析原代胰岛和Min6细胞线粒体呼吸。采用LatticeSIM2超高分辨率细胞成像和电镜成像技术观察原代胰岛β和Min6细胞的线粒体和溶酶体。使用线粒体自噬染料和mt-Keima测量β细胞的线粒体自噬。结果:在Npc1-/-小鼠中,我们发现2周龄小鼠的β细胞存活和胰腺β细胞量扩增以及胰岛葡萄糖诱导的胰岛素分泌减少。Npc1丢失阻碍了出生后β细胞的分化和生长以及线粒体氧化磷酸化(OXPHOS)功能受损,以增加线粒体超氧化物的产生,这可能归因于自噬通量受损,特别是Npc1空β细胞中功能失调的溶酶体诱导的线粒体自噬(线粒体自噬)。结论:我们的研究表明,NPC1在维持正常的溶酶体功能和线粒体更新中起着重要作用。确保建立足够的线粒体OXPHOS用于胰岛β细胞分化和成熟。
    Rationale: NPC1 is a protein localized on the lysosome membrane regulating intracellular cholesterol transportation and maintaining normal lysosome function. GWAS studies have found that NPC1 variants in T2D was a pancreatic islet expression quantitative trait locus, suggesting a potential role of NPC1 in T2D islet pathophysiology. Methods: Two-week-old Npc1-/- mice and wild type littermates were employed to examine pancreatic β cell morphology and functional changes induced by loss of Npc1. Single cell RNA sequencing was conducted on primary islets. Npc1-/- Min6 cell line was generated using CRISPR/Cas9 gene editing. Seahorse XF24 was used to analyze primary islet and Min6 cell mitochondria respiration. Ultra-high-resolution cell imaging with Lattice SIM2 and electron microscope imaging were used to observe mitochondria and lysosome in primary islet β and Min6 cells. Mitophagy Dye and mt-Keima were used to measure β cell mitophagy. Results: In Npc1-/- mice, we found that β cell survival and pancreatic β cell mass expansion as well as islet glucose induced insulin secretion in 2-week-old mice were reduced. Npc1 loss retarded postnatal β cell differentiation and growth as well as impaired mitochondria oxidative phosphorylation (OXPHOS) function to increase mitochondrial superoxide production, which might be attributed to impaired autophagy flux particularly mitochondria autophagy (mitophagy) induced by dysfunctional lysosome in Npc1 null β cells. Conclusion: Our study revealed that NPC1 played an important role in maintaining normal lysosome function and mitochondria turnover, which ensured establishment of sufficient mitochondria OXPHOS for islet β cells differentiation and maturation.
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  • 文章类型: Journal Article
    尼曼-皮克病(NPD)是一种罕见的常染色体隐性遗传疾病,属于溶酶体贮积症。已经描述了三种类型的NPD:NPDA型,B,和C.NPDA型和B型是由编码鞘磷脂磷酸二酯酶1的基因SMPD1中的突变引起的,因此缺乏酸性鞘磷脂酶活性。因此,这些疾病被分类为酸性鞘磷脂酶缺乏(ASMD)。C型NPD是一种神经系统疾病,由于NPC1或NPC2基因突变,导致胆固醇运输和酯化缺陷。尽管所有三种类型的NPD都可以表现为肺部受累,肺部疾病在NPDB型中更常见,通常患有间质性肺病,反复肺部感染,和呼吸衰竭。在这个意义上,支气管镜检查与支气管肺泡灌洗或活检与高分辨率计算机断层扫描是基本的诊断工具。尽管已经做出了一些努力来寻找NPD的有效疗法,到目前为止,只有有限的治疗选择是可用的。用Olipudaseα进行的酶替代疗法是第一个也是唯一一个被批准用于ASMD患者的疾病修饰疗法。文献中还描述了ASMD的肺移植和造血干细胞移植。NPDC型中唯一批准的疾病改善疗法是米格卢司他,基材还原处理。这篇综述的目的是描述NPD的遗传基础和肺部受累的最新技术,注重临床表现,该病的放射学和组织病理学特征,和可用的治疗选择,凝视未来的治疗策略。
    Niemann-Pick Disease (NPD) is a rare autosomal recessive disease belonging to lysosomal storage disorders. Three types of NPD have been described: NPD type A, B, and C. NPD type A and B are caused by mutations in the gene SMPD1 coding for sphingomyelin phosphodiesterase 1, with a consequent lack of acid sphingomyelinase activity. These diseases have been thus classified as acid sphingomyelinase deficiencies (ASMDs). NPD type C is a neurologic disorder due to mutations in the genes NPC1 or NPC2, causing a defect of cholesterol trafficking and esterification. Although all three types of NPD can manifest with pulmonary involvement, lung disease occurs more frequently in NPD type B, typically with interstitial lung disease, recurrent pulmonary infections, and respiratory failure. In this sense, bronchoscopy with broncho-alveolar lavage or biopsy together with high-resolution computed tomography are fundamental diagnostic tools. Although several efforts have been made to find an effective therapy for NPD, to date, only limited therapeutic options are available. Enzyme replacement therapy with Olipudase α is the first and only approved disease-modifying therapy for patients with ASMD. A lung transplant and hematopoietic stem cell transplantation are also described for ASMD in the literature. The only approved disease-modifying therapy in NPD type C is miglustat, a substrate-reduction treatment. The aim of this review was to delineate a state of the art on the genetic basis and lung involvement in NPD, focusing on clinical manifestations, radiologic and histopathologic characteristics of the disease, and available therapeutic options, with a gaze on future therapeutic strategies.
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