pathogenic mutations

  • 文章类型: Journal Article
    卵圆孔未闭(PFO)具有遗传易感性,与隐源性中风(CS)密切相关,偏头痛,减压病,和低氧血症。通过全外显子组测序(WES)鉴定PFO相关突变基因有助于早期识别心血管遗传危险因素。及时指导临床干预,减少心血管事件的发生。
    我们分析了ClinVar和OMIM数据库中的突变基因。对浙江省中医院25例PFO患者进行了WES。使用美国医学遗传学和基因组学学院(ACMG)和分子病理学协会评估变体的致病性。(AMP)指南。
    在ClinVar(2023年2月4日),发现113个编码基因突变,包括与PFO相关的83个。来自OMIM(2023年4月18日),分析了184个基因突变,有110个突变编码基因。WES在25例PFO患者中的2例(8%)中鉴定出致病性突变。LDLR,SDHC,NKX2-5基因与PFO相关,主要参与心肌组织功能。NKX2-5可能在PFO发育中起关键作用,与NOTCH1、GATA4、MYH6、SCN5A信号通路相互作用调节心肌细胞特性。
    我们确定了LDLR的致病性突变,SDHC,和NKX2-5基因,暗示他们在PFO发展中的作用。功能富集分析揭示了NKX2-5与调节心肌细胞功能的信号通路的相互作用。这些发现增强了我们对PFO的遗传基础的理解,为未来的研究提出潜在的治疗目标。
    UNASSIGNED: Patent foramen ovale (PFO) has a genetic predisposition and is closely associated with cryptogenic stroke (CS), migraine, decompression sickness, and hypoxemia. Identifying PFO-related mutant genes through whole-exome sequencing (WES) can help in the early recognition of cardiovascular genetic risk factors, guide timely clinical intervention, and reduce the occurrence of cardiovascular events.
    UNASSIGNED: We analyzed mutant genes from ClinVar and OMIM databases. WES was performed on 25 PFO patients from Zhejiang Provincial Hospital of Chinese Medicine. Pathogenicity of variants was evaluated using American College of Medical Genetics and Genomics (ACMG) and Association for Molecular Pathology. (AMP) guidelines.
    UNASSIGNED: In ClinVar (4 Feb 2023), 113 coding gene mutations were found, including 83 associated with PFO. From OMIM (18 Apr 2023), 184 gene mutations were analyzed, with 110 mutant coding genes. WES identified pathogenic mutations in two of 25 PFO patients (8%). LDLR, SDHC, and NKX2-5 genes were linked to PFO and primarily involved in myocardial tissue function. NKX2-5 may play a crucial role in PFO development, interacting with NOTCH1, GATA4, MYH6, SCN5A signaling pathways regulating cardiomyocyte characteristics.
    UNASSIGNED: We identified pathogenic mutations in LDLR, SDHC, and NKX2-5 genes, implying their role in PFO development. Functional enrichment analysis revealed NKX2-5\'s interaction with signaling pathways regulating cardiomyocyte function. These findings enhance our understanding of PFO\'s genetic basis, suggesting potential therapeutic targets for future research.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    KCNQ是控制神经元兴奋性的电压门控K通道,在癫痫和自闭症谱系障碍(ASD)中发生突变。KCNQ已经在神经元中进行了广泛的研究,但它们在胶质细胞中的作用是未知的.使用电压,钙,和GABA成像,光遗传学,和行为分析,我们在这里首次展示秀丽隐杆线虫(C.秀丽隐杆线虫),神经胶质KCNQ通道通过调节L型电压门控Ca2通道的功能来介导神经胶质的GABA释放,从而控制神经元的兴奋性。Further,我们表明,人类KCNQ通道在线虫神经胶质细胞中表达时具有相同的作用,强调跨物种的功能保护。最后,我们表明致病性功能丧失和功能获得人类KCNQ2突变以不同的方式改变神经胶质-神经元GABA信号传导,并且KCNQ通道开放剂瑞替加滨具有挽救作用.这项工作通过控制神经胶质中的GABA释放,将神经胶质KCNQ通道确定为神经元兴奋性的关键调节剂。
    KCNQs are voltage-gated K+ channels that control neuronal excitability and are mutated in epilepsy and autism spectrum disorder (ASD). KCNQs have been extensively studied in neurons, but their function in glia is unknown. Using voltage, calcium, and GABA imaging, optogenetics, and behavioral assays, we show here for the first time in Caenorhabditis elegans (C. elegans) that glial KCNQ channels control neuronal excitability by mediating GABA release from glia via regulation of the function of L-type voltage-gated Ca2+ channels. Further, we show that human KCNQ channels have the same role when expressed in nematode glia, underscoring conservation of function across species. Finally, we show that pathogenic loss-of-function and gain-of-function human KCNQ2 mutations alter glia-to-neuron GABA signaling in distinct ways and that the KCNQ channel opener retigabine exerts rescuing effects. This work identifies glial KCNQ channels as key regulators of neuronal excitability via control of GABA release from glia.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • DOI:
    文章类型: Journal Article
    子宫内膜癌(UCEC)是一个重要的健康问题,具有影响疾病易感性和进展的复杂遗传景观。这项研究旨在通过下一代测序(NGS)揭示巴基斯坦UCEC患者的DNA修复基因突变谱,并通过下游分析探索其潜在的功能后果。对来自30名UCEC患者的基因组DNA进行NGS分析以鉴定DNA修复基因中的临床显著致病性突变。这项分析揭示了4个关键DNA修复基因的突变:BRCA1,BRCA2,APC,和CDH1。采用Kaplan-Meier(KM)分析评估这些突变对UCEC患者总生存期(OS)的预后价值。为了深入研究这些突变的功能影响,我们进行了RT-qPCR,免疫组织化学(IHC),和蛋白质印迹分析的突变的UCEC样品相比,其非突变的对应物。这些结果揭示了突变基因表达的上调,表明鉴定的突变与增强的基因活性之间存在潜在的关联。此外,靶向亚硫酸氢盐测序分析用于评估突变基因启动子中的DNA甲基化模式。引人注目的是,BRCA1,BRCA2,APC启动子中的低甲基化,和CDH1在突变的UCEC样品中观察到相对于未突变的,表明表观遗传机制参与改变的基因表达。总之,这项研究为巴基斯坦UCEC患者DNA修复基因突变的遗传前景提供了见解。BRCA1、BRCA2、APC、和CDH1,再加上它们的下调和超甲基化,表明遗传和表观遗传因素的趋同导致UCEC细胞中的基因组不稳定。这些发现增强了我们对UCEC易感性的理解,并为巴基斯坦UCEC患者的针对性治疗干预提供了潜在的途径。
    Uterine Corpus Endometrial Carcinoma (UCEC) is a significant health concern with a complex genetic landscape impacting disease susceptibility and progression. This study aimed to unravel the spectrum of DNA repair gene mutations in Pakistani UCEC patients through Next Generation Sequencing (NGS) and explore their potential functional consequences via downstream analyses. NGS analysis of genomic DNA from 30 UCEC patients was conducted to identify clinically significant pathogenic mutations in DNA repair genes. This analysis revealed mutations in 4 key DNA repair genes: BRCA1, BRCA2, APC, and CDH1. Kaplan-Meier (KM) analysis was employed to assess the prognostic value of these mutations on patient overall survival (OS) in UCEC. To delve into the functional impact of these mutations, we performed RT-qPCR, immunohistochemistry (IHC), and western blot analyses on the mutated UCEC samples compared to their non-mutated counterparts. These results unveiled the up-regulation in the expression of the mutated genes, suggesting a potential association between the identified mutations and enhanced gene activity. Additionally, targeted bisulfite sequencing analysis was utilized to evaluate DNA methylation patterns in the promoters of the mutated genes. Strikingly, hypomethylation in the promoters of BRCA1, BRCA2, APC, and CDH1 was observed in the mutated UCEC samples relative to the non-mutated, indicating the involvement of epigenetic mechanisms in the altered gene expression. In conclusion, this study offers insights into the genetic landscape of DNA repair gene mutations in Pakistani UCEC patients. The presence of pathogenic mutations in BRCA1, BRCA2, APC, and CDH1, coupled with their down-regulation and hypermethylation, suggests a convergence of genetic and epigenetic factors contributing to genomic instability in UCEC cells. These findings enhance our understanding of UCEC susceptibility and provide potential avenues for targeted therapeutic interventions in Pakistani UCEC patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    泛素羧基末端水解酶L1(UCHL1),也被称为帕金森病蛋白5,是一种在大脑中高度表达的蛋白质。它在泛素-蛋白酶体系统(UPS)中起着重要作用,它充当去泛素酶(DUB)酶。作为UCHDUB家族中最小的成员,它催化泛素前体加工的反应和泛素化蛋白残余物的裂解,从而维持脑细胞中泛素单体的水平。UCHL1突变体,含有氨基酸取代,影响催化活性及其聚集性。其中一些在毒素诱导的帕金森病(PD)模型中保护细胞和转基因小鼠。对UCHL1推定的蛋白质伴侣的研究揭示了位于细胞所有主要区室中的约60种单独的蛋白质:细胞核,细胞质,内质网,质膜,线粒体,和过氧化物酶体。这些包括与PD发育相关的蛋白质,比如α-突触核蛋白,淀粉样β前体蛋白,泛素蛋白连接酶parkin,和热休克蛋白。在催化范式的背景下,这些相互作用的重要性尚不清楚。然而,越来越多的人认识到UCHL1通过蛋白质-蛋白质相互作用以催化独立的方式表现出各种作用。由于这种蛋白质占大脑中可溶性蛋白质的5%,其结构的PD相关变化将对其涉及的蛋白质组/相互作用组有深远的影响。越来越多的证据表明,UCHL1在PD中的作用显然是由正则催化活性和众多独立于活性的蛋白质-蛋白质相互作用的平衡决定的。这仍然需要更好的表征。
    Ubiquitin carboxyl-terminal hydrolase L1 (UCHL1), also known as Parkinson\'s disease protein 5, is a highly expressed protein in the brain. It plays an important role in the ubiquitin-proteasome system (UPS), where it acts as a deubiquitinase (DUB) enzyme. Being the smallest member of the UCH family of DUBs, it catalyzes the reaction of ubiquitin precursor processing and the cleavage of ubiquitinated protein remnants, thus maintaining the level of ubiquitin monomers in the brain cells. UCHL1 mutants, containing amino acid substitutions, influence catalytic activity and its aggregability. Some of them protect cells and transgenic mice in toxin-induced Parkinson\'s disease (PD) models. Studies of putative protein partners of UCHL1 revealed about sixty individual proteins located in all major compartments of the cell: nucleus, cytoplasm, endoplasmic reticulum, plasma membrane, mitochondria, and peroxisomes. These include proteins related to the development of PD, such as alpha-synuclein, amyloid-beta precursor protein, ubiquitin-protein ligase parkin, and heat shock proteins. In the context of the catalytic paradigm, the importance of these interactions is not clear. However, there is increasing understanding that UCHL1 exhibits various effects in a catalytically independent manner through protein-protein interactions. Since this protein represents up to 5% of the soluble protein in the brain, PD-related changes in its structure will have profound effects on the proteomes/interactomes in which it is involved. Growing evidence is accumulating that the role of UCHL1 in PD is obviously determined by a balance of canonic catalytic activity and numerous activity-independent protein-protein interactions, which still need better characterization.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    遗传异常与原发性醛固酮增多症有关,继发性高血压的主要原因。这包括KCNJ5基因的突变,它编码G蛋白门控向内整流K通道4(GIRK4)。例如,甘氨酸与谷氨酸的取代引起致病性GIRK4G151E突变,这改变了信道选择性,使其对Na+和Ca2+更具渗透性。虽然tertiapin和tertiapin-Q是众所周知的GIRK4WT通道的肽抑制剂,临床上,需要开发突变通道的选择性调节剂,包括GIRK4G151E.使用计算机模拟方法,包括同源性建模,蛋白质-肽对接,配体结合位点预测,和分子对接,我们旨在探索GIRK4WT和GIRK4G151E的潜在调节剂。首先,进行蛋白质-肽对接以表征tertiapin及其衍生物与GIRK4通道的结合位点。根据以前的研究,与GIRK4G151E相比,肽抑制剂优先结合GIRK4WT通道选择性过滤器。随后进行配体结合位点分析,从而识别出两个潜在的感兴趣区域:中心腔和G环门。利用精选的化学图书馆,我们针对GIRK4通道的中央腔筛选了700多个小分子。黄酮类化合物,包括木犀草素-7-O-rutinoside和芦丁,大环内酯类雷帕霉素和曲洛多姆霉素与GIRK4通道强烈结合。同样,叶黄素,尤其是叶黄素,与GIRK4WT相比,与中央腔结合,对突变的GIRK4G151E通道具有强烈的偏好。总的来说,我们的研究结果表明潜在的先导化合物需要进一步研究,尤其是叶黄素,可以选择性地调节GIRK4通道。
    Genetic abnormalities have been associated with primary aldosteronism, a major cause of secondary hypertension. This includes mutations in the KCNJ5 gene, which encodes G protein-gated inwardly rectifying K+ channel 4 (GIRK4). For example, the substitution of glycine with glutamic acid gives rise to the pathogenic GIRK4G151E mutation, which alters channel selectivity, making it more permeable to Na+ and Ca2+. While tertiapin and tertiapin-Q are well-known peptide inhibitors of the GIRK4WT channel, clinically, there is a need for the development of selective modulators of mutated channels, including GIRK4G151E. Using in silico methods, including homology modeling, protein-peptide docking, ligand-binding site prediction, and molecular docking, we aimed to explore potential modulators of GIRK4WT and GIRK4G151E. Firstly, protein-peptide docking was performed to characterize the binding site of tertiapin and its derivative to the GIRK4 channels. In accordance with previous studies, the peptide inhibitors preferentially bind to the GIRK4WT channel selectivity filter compared to GIRK4G151E. A ligand-binding site analysis was subsequently performed, resulting in the identification of two potential regions of interest: the central cavity and G-loop gate. Utilizing curated chemical libraries, we screened over 700 small molecules against the central cavity of the GIRK4 channels. Flavonoids, including luteolin-7-O-rutinoside and rutin, and the macrolides rapamycin and troleandomycin bound strongly to the GIRK4 channels. Similarly, xanthophylls, particularly luteoxanthin, bound to the central cavity with a strong preference towards the mutated GIRK4G151E channel compared to GIRK4WT. Overall, our findings suggest potential lead compounds for further investigation, particularly luteoxanthin, that may selectively modulate GIRK4 channels.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    铁是一种重要的过渡金属,因为它参与了几个关键的生物学功能,最值得注意的是氧气储存和运输。由于其高反应性和潜在毒性,细胞内和细胞外铁水平必须严格调节。这是通过在质膜水平和溶酶体膜上介导细胞摄取和流出的转运系统实现的。内体和线粒体。在这些运输系统中,关键参与者是ferroportin,唯一已知的介导铁流出细胞的转运蛋白;DMT1,ZIP8和ZIP14,相反,介导铁流入细胞质,作用于质膜以及溶酶体和核内体的膜;和有丝分裂铁蛋白,参与铁转运到线粒体中进行血红素合成和Fe-S簇组装。这篇综述的重点是提供这些膜蛋白的生理作用以及这些运输系统缺陷引起的病理的最新观点。
    Iron is an essential transition metal for its involvement in several crucial biological functions, the most notable being oxygen storage and transport. Due to its high reactivity and potential toxicity, intracellular and extracellular iron levels must be tightly regulated. This is achieved through transport systems that mediate cellular uptake and efflux both at the level of the plasma membrane and on the membranes of lysosomes, endosomes and mitochondria. Among these transport systems, the key players are ferroportin, the only known transporter mediating iron efflux from cells; DMT1, ZIP8 and ZIP14, which on the contrary, mediate iron influx into the cytoplasm, acting on the plasma membrane and on the membranes of lysosomes and endosomes; and mitoferrin, involved in iron transport into the mitochondria for heme synthesis and Fe-S cluster assembly. The focus of this review is to provide an updated view of the physiological role of these membrane proteins and of the pathologies that arise from defects of these transport systems.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    最近的发现确立了tRNA作为mRNA翻译动力学的中心调节因子,因此,编码蛋白质的共翻译折叠和功能。tRNA池,其组成和丰度以细胞和组织依赖性的方式变化,是决定mRNA翻译速度的主要因素。在这次审查中,我们讨论了一组致病突变,在蛋白质编码基因或tRNA基因的编码序列中,改变mRNA翻译动力学。我们还总结了tRNA生物学的进展,这些进展揭示了由于基因突变而导致的tRNA水平变化如何影响蛋白质折叠和功能。从而有助于临床表现的表型多样性。
    Recent discoveries establish tRNAs as central regulators of mRNA translation dynamics, and therefore cotranslational folding and function of the encoded protein. The tRNA pool, whose composition and abundance change in a cell- and tissue-dependent manner, is the main factor which determines mRNA translation velocity. In this review, we discuss a group of pathogenic mutations, in the coding sequences of either protein-coding genes or in tRNA genes, that alter mRNA translation dynamics. We also summarize advances in tRNA biology that have uncovered how variations in tRNA levels on account of genetic mutations affect protein folding and function, and thereby contribute to phenotypic diversity in clinical manifestations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    未经证实:为了评估先前报道的单基因基因与膀胱癌风险增加相关,我们回顾了有关基因与膀胱癌风险关联的已发表论文,并在一个基于人群的大型队列中对这些基因进行了确证研究.
    UNASSIGNED:首先对2022年6月之前发表的论文进行了系统评价,以确定种系突变与膀胱癌风险相关的所有基因。然后在英国生物库(UKB)的1695例膀胱癌病例和186271例对照中测试了这些候选基因与膀胱癌风险的关联。强大的SKAT-O,一种基于基因的分析,可以正确控制由于病例对照比例不平衡而导致的I型错误率,用于在招募时调整年龄的关联测试,性别,吸烟状况,和遗传背景。
    UNASSIGNED:系统评价在至少一项研究中确定了与膀胱癌风险显着相关的9个基因(p<0.05),包括MUTYH,MSH2,MSH6,MLH1,ATM,BRCA2、ERCC5、TGFB1和CHEK2。当致病性/可能的致病性突变聚集在每个基因中时,在p<0.0056时,UKB中的三个基因的相关性得到了证实(9个测试的Bonferroni校正),包括CHEK2,ATM和BRCA2,都已知与遗传性乳腺癌有关。发现了另外两个基因的关联证据,包括MLH1(p=0.006)和MSH2(p=0.007),两者都与Lynch综合征有关.在这五个基因中,膀胱癌的风险范围从1.60(ATM)到4.88(MLH1),病例中的突变携带者率为0.06%(MSH2)至2.01%(CHEK2)。
    UNASSIGNED:这项研究为以前报道的基因与膀胱癌风险的关联提供了统计证据,并在风险评估和遗传咨询方面具有临床实用性。
    UNASSIGNED: To evaluate which of previously reported monogenic genes are associated with increased bladder cancer risk, we reviewed published papers on associations of genes and bladder cancer risk and performed a confirmation study of these genes in a large population-based cohort.
    UNASSIGNED: A systematic review of published papers prior to June 2022 was performed first to identify all genes where germline mutations were associated with bladder cancer risk. The associations of these candidate genes with bladder cancer risk were then tested among 1695 bladder cancer cases and 186 271 controls in the UK Biobank (UKB). The robust SKAT-O, a gene-based analysis that properly controls for type I error rates due to unbalanced case-control ratio, was used for association tests adjusting for age at recruitment, gender, smoking status, and genetic background.
    UNASSIGNED: The systematic review identified nine genes that were significantly associated with bladder cancer risk in at least one study (p < 0.05), including MUTYH, MSH2, MSH6, MLH1, ATM, BRCA2, ERCC5, TGFB1 and CHEK2. When pathogenic/likely pathogenic mutations were aggregated within each gene, the association was confirmed for three genes in the UKB at p < 0.0056 (Bonferroni correction for nine tests), including CHEK2, ATM and BRCA2, all also known to be associated with hereditary breast cancer. Suggestive evidence of association was found for two other genes, including MLH1 (p = 0.006) and MSH2 (p = 0.007), both known to be associated with Lynch syndrome. Among these five genes, the bladder cancer risks range from 1.60 (ATM) to 4.88 (MLH1), and mutation carrier rates in cases range from 0.06% (MSH2) to 2.01% (CHEK2).
    UNASSIGNED: This study provides statistical evidence for association of previously reported genes and bladder cancer risk and has clinical utility for risk assessment and genetic counselling.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    肥厚型心肌病(HCM)是一种常见的遗传性心脏病,估计患病率高达200人中的1人。在大多数情况下,HCM被认为是一种孟德尔病,主要具有常染色体显性遗传。大多数致病变体通常在肌节蛋白的基因中检测到。如今,HCM的遗传基础被认为是相当复杂的。已经描述了与HCM相关的60多个基因中的数千个突变。然而,筛选大量基因会导致鉴定出许多具有不确定意义的遗传变异,并使结果的解释变得困难。现在认为缺乏致病性变异的患者患有非孟德尔性HCM,并且可能比具有肌节致病性突变的患者具有更好的预后。识别HCM的遗传基础为了解疾病的发展创造了非凡的机会,引申开来,如何在未来扰乱疾病进展。这篇综述的目的是讨论HCM遗传学的简要历史和最新进展,以及分子遗传学检测在常见临床实践中的应用。
    Hypertrophic cardiomyopathy (HCM) is a common inherited heart disease with an estimated prevalence of up to 1 in 200 individuals. In the majority of cases, HCM is considered a Mendelian disease, with mainly autosomal dominant inheritance. Most pathogenic variants are usually detected in genes for sarcomeric proteins. Nowadays, the genetic basis of HCM is believed to be rather complex. Thousands of mutations in more than 60 genes have been described in association with HCM. Nevertheless, screening large numbers of genes results in the identification of many genetic variants of uncertain significance and makes the interpretation of the results difficult. Patients lacking a pathogenic variant are now believed to have non-Mendelian HCM and probably have a better prognosis than patients with sarcomeric pathogenic mutations. Identifying the genetic basis of HCM creates remarkable opportunities to understand how the disease develops, and by extension, how to disrupt the disease progression in the future. The aim of this review is to discuss the brief history and recent advances in the genetics of HCM and the application of molecular genetic testing into common clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:脑白质营养不良常被视为儿童疾病,但是它们可以发生在任何年龄,成人发病形式的临床和影像学模式通常与众所周知的儿童期变异不同。一些报告显示,各种迟发性脑白质营养不良,如X连锁肾上腺脑白质营养不良和Krabbe病,可能表现为痉挛性截瘫,在神经影像学上没有特征性白质病变;这很容易被误诊为遗传性痉挛性截瘫。这项研究的目的是调查痉挛性截瘫患者迟发性脑白质营养不良的频率。
    方法:我们在112例遗传性痉挛性截瘫样患者中使用定制设计的脑白质营养不良基因面板进行了遗传分析。
    结果:我们在112例患者中发现了13例的致病突变,包括五名肾上腺神经病变患者,三个患有Krabbe病,三个患有亚历山大病,两个患有脑性黄瘤病。在临床表现方面,除了痉挛性截瘫,三个肾上腺神经神经病先证者也有肾上腺皮质功能不全,两名亚历山大病先证者出现尿潴留,一名CTX先证者出现白内障和慢性腹泻,另一名出现慢性腹泻和轻度肌腱黄瘤病。没有患者在神经影像学上有弥漫性脑白质营养不良的证据。
    结论:应对迟发性痉挛性截瘫患者进行筛查,无论是否存在其他复杂症状和神经影像学异常。
    OBJECTIVE: Leukodystrophies are frequently regarded as childhood disorders, but they can occur at any age, and the clinical and imaging patterns of the adult-onset form are usually different from the better-known childhood variants. Several reports have shown that various late-onset leukodystrophies, such as X-linked adrenoleukodystrophy and Krabbe disease, may present as spastic paraplegia with the absence of the characteristic white matter lesions on neuroimaging; this can be easily misdiagnosed as hereditary spastic paraplegia. The objective of this study was to investigate the frequency of late-onset leukodystrophies in patients with spastic paraplegia.
    METHODS: We performed genetic analysis using a custom-designed gene panel for leukodystrophies in 112 hereditary spastic paraplegia-like patients.
    RESULTS: We identified pathogenic mutations in 13 out of 112 patients, including five patients with adrenomyeloneuropathy, three with Krabbe disease, three with Alexander disease, and two with cerebrotendinous xanthomatosis. In terms of clinical manifestations, in addition to spastic paraplegia, three adrenomyeloneuropathy probands also had adrenocortical insufficiency, two Alexander disease probands developed urinary retention, one CTX proband developed cataracts and chronic diarrhea and the other presented with chronic diarrhea and mild tendon xanthomatosis. None of the patients had evidence of diffuse leukodystrophy on neuroimaging.
    CONCLUSIONS: Patients with late-onset spastic paraplegia should be screened for underlying leukodystrophies, irrespective of the presence of additional complicating symptoms and neuroimaging abnormalities.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号