TGFB2

TGFB2
  • 文章类型: Journal Article
    流入道的发育无疑是四腔心脏形成中最复杂的重塑事件之一。它涉及创建两个独立的心房腔,心房/房室间隔复合体的形成,腔静脉和冠状窦并入右心房,以及导致肺静脉回流到左心房的重塑事件。在这些过程中,房室间充质复合物,由主要的房室(AV)垫组成,主房间隔(pAS)上的间充质帽,和背侧间充质突起(DMP),起着至关重要的作用。
    The development of the inflow tract is undoubtedly one of the most complex remodeling events in the formation of the four-chambered heart. It involves the creation of two separate atrial chambers, the formation of an atrial/atrioventricular (AV) septal complex, the incorporation of the caval veins and coronary sinus into the right atrium, and the remodeling events that result in pulmonary venous return draining into the left atrium. In these processes, the atrioventricular mesenchymal complex, consisting of the major atrioventricular (AV) cushions, the mesenchymal cap on the primary atrial septum (pAS), and the dorsal mesenchymal protrusion (DMP), plays a crucial role.
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  • 文章类型: Journal Article
    脑-半球不对称性/侧性是正常脑发育的一个保守的生物学特征。几行证据,通过不同研究的荟萃分析证实,支持精神分裂症(SCZ)等精神疾病中大脑侧向性的破坏,双相情感障碍(BD),注意缺陷/多动障碍(ADHD),强迫症(强迫症),和自闭症。此外,据报道,SCZ患者在颞平面(听觉语言处理中的关键结构)中异常的大脑偏侧化,它被认为是听觉言语幻觉发作的主要原因。有趣的是,精神疾病中异常脑偏侧的外围对应物,特别是在SCZ,也显示在人体的几种结构中。例如,SCZ患者的指纹表现出异常的不对称性,虽然他们的头发旋转是随机的,95%的普通人群表现出顺时针旋转。在这项工作中,我们提供了一篇关于精神疾病如SCZ,BD,多动症,和强迫症,随后对可能参与精神健康障碍患者大脑偏侧化破坏的表观遗传因素进行了系统评价.最后,我们将讨论现有的非药物疗法,如rTMS和ECT是否可用于影响大脑右半球和左半球功能不对称的改变。以及它们的表观遗传和相应的基因表达模式。
    Brain-hemisphere asymmetry/laterality is a well-conserved biological feature of normal brain development. Several lines of evidence, confirmed by the meta-analysis of different studies, support the disruption of brain laterality in mental illnesses such as schizophrenia (SCZ), bipolar disorder (BD), attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and autism. Furthermore, as abnormal brain lateralization in the planum temporale (a critical structure in auditory language processing) has been reported in patients with SCZ, it has been considered a major cause for the onset of auditory verbal hallucinations. Interestingly, the peripheral counterparts of abnormal brain laterality in mental illness, particularly in SCZ, have also been shown in several structures of the human body. For instance, the fingerprints of patients with SCZ exhibit aberrant asymmetry, and while their hair whorl rotation is random, 95% of the general population exhibit a clockwise rotation. In this work, we present a comprehensive literature review of brain laterality disturbances in mental illnesses such as SCZ, BD, ADHD, and OCD, followed by a systematic review of the epigenetic factors that may be involved in the disruption of brain lateralization in mental health disorders. We will conclude with a discussion on whether existing non-pharmacological therapies such as rTMS and ECT may be used to influence the altered functional asymmetry of the right and left hemispheres of the brain, along with their epigenetic and corresponding gene-expression patterns.
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  • 文章类型: Journal Article
    这项假设产生的研究表征了儿科脑干弥漫性中线神经胶质瘤(pbDMG)肿瘤中抗原呈递细胞(APC)标志物(CD14,CD163,CD86和ITGAX/CD11c)的mRNA表达谱和预后影响。我们还评估了两个治疗靶点的mRNA水平,转化生长因子β2(TGFB2)和干扰素γ受体2(IFNGR2),它们在这些高度侵袭性pbDMG肿瘤中的生物标志物潜力。CD14,CD163和ITGAX/CD11cmRNA的表达显着降低了1.64倍(p=0.037),1.75倍(p=0.019),和3.33倍(p<0.0001),分别,相对于正常脑干/脑桥样品中的pbDMG肿瘤。PbDMG样品与高水平的TGFB2结合低水平的APC标志物,反映了pbDMG肿瘤的冷免疫状态,在CD14,CD163和CD86的低表达水平下,总体生存结局明显更差.IFNGR2和TGFB2的表达水平(增加1.51倍(p=0.002)和增加1.58倍(p=5.5×10-4),分别)与正常脑干/脑桥样品相比,pbDMG肿瘤显着上调。我们进行了多变量Cox比例风险模型,显示TGFB2是预后指标(TGFB2高组pbDMG患者的HR=2.88(1.12-7.39);p=0.028),总体生存率(OS)较差,并且与IFNGR2水平无关。病人的年龄,在IFNGR2和TGFB2之间观察到显著的交互效应(p=0.015)。当在低IFNGR2水平的背景下比较高与低TGFB2水平时,pbDMG患者的更糟糕的生存结果表明,在免疫冷肿瘤微环境中TGFB2mRNA表达的废除可用于治疗pbDMG患者。此外,JAK1或STAT1mRNA表达水平低,TGFB2水平高的pbDMG患者也表现出不良的OS结果,提示在抗肿瘤APC细胞中包含(干扰素-γ)IFN-γ来刺激和激活JAK1和STAT1,目前脑干TME可以增强TGFB2阻断的效果。
    This hypothesis-generating study characterized the mRNA expression profiles and prognostic impacts of antigen-presenting cell (APC) markers (CD14, CD163, CD86, and ITGAX/CD11c) in pediatric brainstem diffuse midline glioma (pbDMG) tumors. We also assessed the mRNA levels of two therapeutic targets, transforming growth factor beta 2 (TGFB2) and interferon gamma receptor 2 (IFNGR2), for their biomarker potentials in these highly aggressive pbDMG tumors. The expressions of CD14, CD163, and ITGAX/CD11c mRNAs exhibited significant decreases of 1.64-fold (p = 0.037), 1.75-fold (p = 0.019), and 3.33-fold (p < 0.0001), respectively, in pbDMG tumors relative to those in normal brainstem/pons samples. The pbDMG samples with high levels of TGFB2 in combination with low levels of APC markers, reflecting the cold immune state of pbDMG tumors, exhibited significantly worse overall survival outcomes at low expression levels of CD14, CD163, and CD86. The expression levels of IFNGR2 and TGFB2 (1.51-fold increase (p = 0.002) and 1.58-fold increase (p = 5.5 × 10-4), respectively) were significantly upregulated in pbDMG tumors compared with normal brainstem/pons samples. We performed multivariate Cox proportional hazards modelling that showed TGFB2 was a prognostic indicator (HR for patients in the TGFB2high group of pbDMG patients = 2.88 (1.12-7.39); p = 0.028) for poor overall survival (OS) and was independent of IFNGR2 levels, the age of the patient, and the significant interaction effect observed between IFNGR2 and TGFB2 (p = 0.015). Worse survival outcomes in pbDMG patients when comparing high versus low TGFB2 levels in the context of low IFNGR2 levels suggest that the abrogation of the TGFB2 mRNA expression in the immunologically cold tumor microenvironment can be used to treat pbDMG patients. Furthermore, pbDMG patients with low levels of JAK1 or STAT1 mRNA expression in combination with high levels of TGFB2 also exhibited poor OS outcomes, suggesting that the inclusion of (interferon-gamma) IFN-γ to stimulate and activate JAK1 and STAT1 in anti-tumor APC cells present the brainstem TME can enhance the effect of the TGFB2 blockade.
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  • 文章类型: Journal Article
    作为最常见的恶性肿瘤之一,黑色素瘤是严重威胁人类健康的疾病。超过一半的黑色素瘤患者有BRAF突变,其中90%有BRAF(V600E)突变。对于使用BRAF(V600E)抑制剂的患者存在靶向治疗。然而,由于黑色素瘤的异质性,对治疗无反应通常是不可避免的.再加上它的高转移性,黑色素瘤最终导致整体生存率低下。本研究旨在探讨黑色素瘤转移的可能机制,寻找更有效的治疗黑色素瘤的方法。在本文中,我们报道TCF12在黑色素瘤中的表达更高,特别是在转移性肿瘤中,通过分析来自TCGA的数据。然后,细胞增殖,菌落形成,和transwell实验表明TCF12的表达上调可以促进黑色素瘤细胞的体外增殖和转移。在皮下肿瘤形成测定中证实了相同的结果。此外,TGFB2被RNA-seq鉴定为TCF12的直接下游靶标,qPCR,免疫印迹,ChIP,和双荧光素酶报告测定。有趣的是,TCF12的消耗可以使黑色素瘤在体外和体内对BRAF抑制敏感。总的来说,我们的结果表明TCF12促进黑色素瘤的进展,并且可以成为潜在的肿瘤治疗靶点.
    As one of the most common malignant tumors, melanoma is a serious threat to human health. More than half of melanoma patients have a BRAF mutation, and 90% of them have a BRAF(V600E) mutation. There is a targeted therapy for patients using a BRAF(V600E) inhibitor. However, no response to treatment is generally inevitable due to the heterogeneity of melanoma. Coupled with its high metastatic character, melanoma ultimately leads to poor overall survival. This study aimed to explore the possible mechanisms of melanoma metastasis and identify a more effective method for the treatment of melanoma. In this paper, we report that TCF12 expression is higher in melanoma, especially in metastatic tumors, through analyzing data from TCGA. Then, cell proliferation, colony formation, and transwell assays show that the upregulated expression of TCF12 can promote proliferation and metastasis of melanoma cells in vitro. The same result is confirmed in the subcutaneous tumor formation assay. Moreover, TGFB2 is identified as a direct downstream target of TCF12 by RNA-seq, qPCR, immunoblotting, ChIP, and a dual luciferase reporting assay. Interestingly, depletion of TCF12 can sensitize melanoma to BRAF inhibition both in vitro and in vivo. Overall, our results demonstrate that TCF12 promotes melanoma progression and can be a potential tumor therapeutic target.
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  • 文章类型: Journal Article
    这项研究的目的是研究最近鉴定的hsa_circ_0004805/hsa_miR-149-5p/转化生长因子β2(TGFB2)轴在糖尿病视网膜病变(DR)进展中的作用机制。定量逆转录-聚合酶链反应(qRT-PCR)分析表明,hsa_circ_0004805在DR患者的房水样本中高表达,而hsa_miR-149-5p表现出相反的趋势。同时,双荧光素酶报告基因分析的结果表明hsa_miR-149-5p直接与hsa_circ_0004805和TGFB2相互作用。使用多种测定法(细胞计数试剂盒-8,EdU-标记,Transwell,流式细胞仪,伤口愈合,管形成测定),我们发现,hsa_circ_0004805的过表达显著下调hsa_miR-149-5p的水平,促进DNA合成,扩散,迁移,和在高糖环境中培养的人视网膜微血管上皮细胞(hRECs)中的管形成。相比之下,hsa_miR-149-5p模拟物抑制DNA合成,扩散,迁移,通过降低其下游靶标TGFB2的表达以及磷酸化SMAD2的水平,在hRECs中形成管;然而,这些效应被hsa_circ_0004805的过表达逆转。在链脲佐菌素诱导的SD大鼠DR模型中,视网膜血管渗漏,毛细管去细胞化,周细胞的损失,纤维化,胶质增生很明显,通过玻璃体显微注射大鼠miR-149-5p模拟物(rno-miR-149-5pagomir)可以逆转。合并,我们的研究结果表明,在高血糖下,hsa_circ_0004805/hsa_miR-149-5p/TGFB2轴在与DR的发展相关的视网膜病理生理学中起关键作用,并有可能作为治疗这种疾病的治疗靶点。
    The aim of this study was to investigate the mechanism underlying the role of a recently identified hsa_circ_0004805/hsa_miR-149-5p/transforming growth factor beta 2 (TGFB2) axis in the progression of diabetic retinopathy (DR). Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis suggested that hsa_circ_0004805 was highly expressed in aqueous humor samples of patients with DR, whereas hsa_miR-149-5p showed the opposite trend. Meanwhile, the results of a dual-luciferase reporter assay indicated that hsa_miR-149-5p directly interacted with both hsa_circ_0004805 and TGFB2. Using a variety of assays (Cell Counting Kit-8, EdU-labeling, Transwell, flow cytometric, wound healing, tube formation assays), we found that the overexpression of hsa_circ_0004805 significantly downregulated the level of hsa_miR-149-5p and promoted DNA synthesis, proliferation, migration, and tube formation in human retinal microvascular epithelial cells (hRECs) cultivated in a high-glucose environment. In contrast, hsa_miR-149-5p mimics inhibited DNA synthesis, proliferation, migration, and tube formation in hRECs by reducing the expression of its downstream target TGFB2 as well as the levels of phosphorylated SMAD2; however, these effects were reversed by the overexpression of hsa_circ_0004805. In a streptozotocin-induced Sprague-Dawley rat model of DR, retinal vascular leakage, capillary decellularization, loss of pericytes, fibrosis, and gliosis were evident, which could be reversed by vitreous microinjection of rat miR-149-5p mimics (rno-miR-149-5p agomir). Combined, our findings indicated that, under hyperglycemia, the hsa_circ_0004805/hsa_miR-149-5p/TGFB2 axis plays a critical role in the retinal pathophysiology associated with the development of DR, and has potential as a therapeutic target in the treatment of this condition.
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  • 文章类型: Journal Article
    潜在转化生长因子(TGF)-β2的活化尚未完全了解。与TGF-β1和β3不同,TGF-β2前结构域缺乏七个残基的RGDLXX(L/I)整联蛋白识别基序,并且被认为不会被整联蛋白激活。这里,我们报告了一个令人惊讶的发现,即TGF-β2含有一个相关但不同的13个残基的整合素识别基序(YTSGDQKTIKSTR),该基序专门用于通过整合素αVβ6而不是αVβ8激活。两类基序在αVβ6中竞争相同的结合位点。较长基序的多种变化是其特异性的基础。ProTGF-β2结构定义了与proTGF-β1的有趣差异以及αVβ6活化的结构背景。对于原TGF-β2也观察到一些不依赖整合素的激活,对于原TGF-β3甚至更多。我们的发现对纤维化临床试验中αVβ6的治疗具有重要意义。其中尚未预期抑制TGF-β2活化。
    Activation of latent transforming growth factor (TGF)-β2 is incompletely understood. Unlike TGF-β1 and β3, the TGF-β2 prodomain lacks a seven-residue RGDLXX (L/I) integrin-recognition motif and is thought not to be activated by integrins. Here, we report the surprising finding that TGF-β2 contains a related but divergent 13-residue integrin-recognition motif (YTSGDQKTIKSTR) that specializes it for activation by integrin αVβ6 but not αVβ8. Both classes of motifs compete for the same binding site in αVβ6. Multiple changes in the longer motif underlie its specificity. ProTGF-β2 structures define interesting differences from proTGF-β1 and the structural context for activation by αVβ6. Some integrin-independent activation is also seen for proTGF-β2 and even more so for proTGF-β3. Our findings have important implications for therapeutics to αVβ6 in clinical trials for fibrosis, in which inhibition of TGF-β2 activation has not been anticipated.
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  • 文章类型: Journal Article
    Here, we report that tumor samples from newly diagnosed pediatric diffuse intrinsic pontine glioma (DIPG) patients express significantly higher levels of transforming growth factor beta 2 (TGFB2) messenger ribonucleic acid (mRNA) than control pons samples, which correlated with augmented expression of transcription factors that upregulate TGFB2 gene expression. Our study also demonstrated that RNA sequencing (RNAseq)-based high TGFB2 mRNA level is an indicator of poor prognosis for DIPG patients, but not for pediatric glioblastoma (GBM) patients or pediatric diffuse midline glioma (DMG) patients with tumor locations outside of the pons/brainstem. Notably, DIPG patients with high levels of TGFB2 mRNA expression in their tumor samples had significantly worse overall survival (OS) and progression-free survival (PFS). By comparison, high levels of transforming growth factor beta 3 (TGFB3) mRNA expression in tumor samples was associated with significantly better survival outcomes of DIPG patients, whereas high levels of transforming growth factor beta 1 (TGFB1) expression was not prognostic. Our study fills a significant gap in our understanding of the clinical significance of high TGFB2 expression in pediatric high-grade gliomas.
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  • 文章类型: Journal Article
    目的:子痫前期(PE)是一种涉及多个系统的产科疾病,这是孕产妇和胎儿并发症和死亡率增加的原因。环状RNA(circularRNAs,circRNAs)最近被认为与PE的发病机制有关。本研究旨在阐明circRNAhsa_circ_0001326与PE的相关性,并探讨其在PE中的生物学功能。
    方法:通过实时定量PCR(qRT-PCR)检测PE胎盘中hsa_circ_0001326的表达。在滋养层细胞中过度表达或抑制hsa_circ_0001326后,细胞生长,迁移,通过细胞计数试剂盒-8(CCK-8)和transwell测定评估和侵袭。Westernblot检测上皮间质转化(EMT)蛋白,E-钙粘蛋白和波形蛋白。此外,双荧光素酶报告基因测定用于验证hsa_circ_0001326,miR-145-5p的结合位点,和转化生长因子β2(TGFB2)。
    结果:发现Hsa_circ_0001326在PE胎盘中的表达高于正常胎盘。此外,hsa_circ_0001326在滋养层细胞活力中起负调节作用,迁移,和入侵。hsa_circ_0001326的过表达抑制了活力,迁移,和滋养层细胞的入侵,而抑制hsa_circ_0001326则表现出相反的效果。机械上,hsa_circ_0001326海绵化miR-145-5p以提高滋养层细胞中的TGFB2表达。
    结论:这项研究提供了证据,表明在PE中上调hsa_circ_0001326抑制了滋养层细胞的增殖,迁移,和侵袭通过海绵miR-145-5p来提高TGFB2表达。我们的结果可能为hsa_circ_0001326在PE发病机理中的作用提供新的见解。本文受版权保护。保留所有权利。
    Preeclampsia (PE) is an obstetric disease involving multiple systems, which account for maternal and fetal complications and increased mortality. Circular RNAs (circRNAs) were recently deemed to associate with the pathogenesis of PE. This study aims to clarify the correlation between circRNA hsa_circ_0001326 and PE and explore its biological function in PE.
    The expression of hsa_circ_0001326 in PE placentas was detected by real-time quantitative PCR (qRT-PCR). After overexpressing or inhibiting hsa_circ_0001326 in trophoblast cells, the cell growth, migration, and invasion were evaluated by Cell Counting Kit-8 (CCK-8) and transwell assays. Western blot assay was applied to detect the epithelial-mesenchymal transition (EMT) proteins, E-cadherin and Vimentin. Furthermore, a dual-luciferase reporter assay was applied to verify the binding sites of hsa_circ_0001326, miR-145-5p, and transforming growth factor beta 2 (TGFB2).
    Hsa_circ_0001326 was found to be higher expressed in PE placentas than in normal placentas. Furthermore, hsa_circ_0001326 played a negative regulating role in trophoblast cell viability, migration, and invasion. Overexpression of hsa_circ_0001326 inhibited the viability, migration, and invasion of trophoblast cells, while inhibition of hsa_circ_0001326 showed opposite effects. Mechanistically, hsa_circ_0001326 sponged miR-145-5p to elevate TGFB2 expression in trophoblast cells.
    This study provided evidence that the up-regulated hsa_circ_0001326 in PE restrained trophoblast cells proliferation, migration, and invasion by sponging miR-145-5p to elevate TGFB2 expression. Our results might provide a novel insight into the role of hsa_circ_0001326 in the pathogenesis of PE.
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  • 文章类型: Journal Article
    卵丘扩张对于从卵巢释放可受精的卵母细胞是必要的,这对哺乳动物的正常受精至关重要。积云扩张需要表皮生长因子(EGF)样生长因子和卵母细胞旁分泌因子之间的合作。生长分化因子9(GDF9)和骨形态发生蛋白15(BMP15)是众所周知的卵母细胞分泌的旁分泌因子。此外,转化生长因子β2(TGFB2)主要在卵母细胞中表达,其膜受体1型受体(TGFBR1)和2型受体(TGFBR2)位于卵丘细胞中。在我们目前的研究中,在存在EGF的情况下,TGFB2诱导卵细胞瘤(OOX)复合物的扩增并增加扩增相关基因的表达,这表明TGFB2能够促进积云扩张。用SD208抑制TGF-β信号传导阻断了TGFB2促进的卵丘扩张。此外,在颗粒细胞中Tgfbr2特异性耗竭小鼠的OOX复合物的培养中,TGFB2促进的卵丘扩张和扩张相关基因的表达受损。这些结果表明,TGFB2可以通过TGFBR-SMAD2/3信号传导诱导卵丘扩张。使用Zp3-Cre小鼠在卵母细胞中的Tgfb2特异性消耗对体内卵丘扩张没有影响,可能是由于其他积云扩张促成因素的补偿作用。一起来看,TGFB2参与扩增相关基因表达和随后的卵丘扩增。
    Cumulus expansion is necessary for the release of a fertilizable oocyte from the ovary, which is critical for the normal fertilization of mammals. Cumulus expansion requires cooperation between epidermal growth factor (EGF)-like growth factors and oocyte paracrine factors. Growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) are well-known paracrine factors secreted by oocytes. In addition, transforming growth factor-β2 (TGFB2) was primarily expressed in oocytes and its membrane receptors type 1 receptor (TGFBR1) and type 2 receptor (TGFBR2) were located in cumulus cells. In our present study, TGFB2 induced expansion of oocytectomized (OOX) complexes and increased the expression of expansion-related genes in the presence of EGF, suggesting that TGFB2 enables cumulus expansion. Inhibition of TGF-β signaling with SD208 blocked TGFB2-promoted cumulus expansion. Furthermore, in the culture of OOX complexes from mice of Tgfbr2-specific depletion in granulosa cells, TGFB2-promoted cumulus expansion and the expression of expansion-related genes were impaired. These results suggest that TGFB2 could induce cumulus expansion through TGFBR-SMAD2/3 signaling. Tgfb2-specific depletion in oocytes using Zp3-Cre mice had no effect on cumulus expansion in vivo, possibly due to the compensatory effect of other cumulus expansion-enabling factors. Taken together, TGFB2 is involved in expansion-related gene expression and consequent cumulus expansion.
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  • 文章类型: Journal Article
    Loeys-Dietz综合征(LDS)是一种结缔组织疾病,由改变转化生长因子β信号通路的突变引起。由于最近发现导致LDS的潜在基因突变,特征和并发症的范围尚未完全了解。
    我们的搜索包括五个数据库(Pubmed,Scopus,WebofScience,EMBASE和谷歌学者),并包括“Loeys-Dietz综合征”的变体作为搜索词,使用所有可用数据,直到2021年2月。包括所有研究类型。三位审稿人筛选了1394份摘要,其中418项进行了全文审查,392项纳入了最终分析。
    我们确定了3896例LDS报告病例,其中最常见的报告特征和并发症是:主动脉瘤和夹层,动脉弯曲,高拱形腭,异常的悬垂和过度的。LDS类型1和2共有许多临床特征,LDS2型似乎具有更具侵袭性的主动脉疾病。LDS类型3显示二尖瓣脱垂和关节炎的患病率增加。LDS类型4和5显示肌肉骨骼和心血管受累的患病率较低。在222名妇女中,有522次怀孕,4%发生主动脉夹层,围产期死亡率为1%。
    我们观察到LDS是一种多系统结缔组织疾病,与高负担的并发症有关。需要多学科的方法。不断尝试更好地表征这些特征将允许临床医生适当地筛查和管理这些并发症。
    Loeys-Dietz syndrome (LDS) is a connective tissue disorder that arises from mutations altering the transforming growth factor β signalling pathway. Due to the recent discovery of the underlying genetic mutations leading to LDS, the spectrum of characteristics and complications is not fully understood.
    Our search included five databases (Pubmed, SCOPUS, Web of Science, EMBASE and google scholar) and included variations of \"Loeys-Dietz Syndrome\" as search terms, using all available data until February 2021. All study types were included. Three reviewers screened 1394 abstracts, of which 418 underwent full-text review and 392 were included in the final analysis.
    We identified 3896 reported cases of LDS with the most commonly reported features and complications being: aortic aneurysms and dissections, arterial tortuosity, high arched palate, abnormal uvula and hypertelorism. LDS Types 1 and 2 share many clinical features, LDS Type 2 appears to have a more aggressive aortic disease. LDS Type 3 demonstrated an increased prevalence of mitral valve prolapse and arthritis. LDS Type 4 and 5 demonstrated a lower prevalence of musculoskeletal and cardiovascular involvement. Amongst 222 women who underwent 522 pregnancies, 4% experienced an aortic dissection and the peripartum mortality rate was 1%.
    We observed that LDS is a multisystem connective tissue disorder that is associated with a high burden of complications, requiring a multidisciplinary approach. Ongoing attempts to better characterise these features will allow clinicians to appropriately screen and manage these complications.
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