genetic disease

遗传性疾病
  • 文章类型: Journal Article
    先天性脑积水(CH)的全球患病率约为每500名具有多方面诱发因素的婴儿中的1名。遗传影响是CH发病机理的主要贡献者,流行病学证据表明,他们参与了全球观察到的所有病例的40%。关于个体遗传易感性的知识可以显著提高预后准确性,同时帮助临床决策过程。然而,精确的遗传病因仅在不到5%的人类病例中被确定。为了发现其他潜在的遗传基因座,需要更多的CH病例进行全面的基因测序。对其潜在遗传学的更深入理解可能会为这种脑部疾病的分子和细胞基础提供宝贵的见解。这篇综述总结了通过基因测序技术在人类中鉴定的相关基因,除了目前与CH相关的4个基因(两个X连锁基因L1CAM和AP1S2,两个常染色体隐性遗传MPDZ和CCDC88C)。其他人主要参与渡槽异常,纤毛运动,神经系统发育。进一步概述了通过动物模型基因编辑技术揭示的前瞻性CH相关基因,主要集中在4个途径,即纤毛合成和运动,离子通道和运输,Reissner的光纤(RF)合成,细胞凋亡,和神经发生。值得注意的是,活动纤毛的正常功能为脑室内的脑脊液(CSF)循环提供了重要的动力,而纤毛相关基因的突变是这种情况的主要原因。到目前为止,在人类中仅鉴定出有限数量的CH相关基因。基因型和表型的整合用于疾病诊断代表了医学领域的新趋势。动物模型提供了对CH发病机制的见解,并有助于我们理解其与相关并发症的关系。如肾囊肿,脊柱侧弯,和心肌病,因为这些基因也可能在这些疾病的发展中起作用。在动物中发现的基因为新疗法提供了潜在的靶标,但需要通过未来的人类研究进一步验证。
    The global prevalence rate for congenital hydrocephalus (CH) is approximately one out of every five hundred births with multifaceted predisposing factors at play. Genetic influences stand as a major contributor to CH pathogenesis, and epidemiological evidence suggests their involvement in up to 40% of all cases observed globally. Knowledge about an individual\'s genetic susceptibility can significantly improve prognostic precision while aiding clinical decision-making processes. However, the precise genetic etiology has only been pinpointed in fewer than 5% of human instances. More occurrences of CH cases are required for comprehensive gene sequencing aimed at uncovering additional potential genetic loci. A deeper comprehension of its underlying genetics may offer invaluable insights into the molecular and cellular basis of this brain disorder. This review provides a summary of pertinent genes identified through gene sequencing technologies in humans, in addition to the 4 genes currently associated with CH (two X-linked genes L1CAM and AP1S2, two autosomal recessive MPDZ and CCDC88C). Others predominantly participate in aqueduct abnormalities, ciliary movement, and nervous system development. The prospective CH-related genes revealed through animal model gene-editing techniques are further outlined, focusing mainly on 4 pathways, namely cilia synthesis and movement, ion channels and transportation, Reissner\'s fiber (RF) synthesis, cell apoptosis, and neurogenesis. Notably, the proper functioning of motile cilia provides significant impulsion for cerebrospinal fluid (CSF) circulation within the brain ventricles while mutations in cilia-related genes constitute a primary cause underlying this condition. So far, only a limited number of CH-associated genes have been identified in humans. The integration of genotype and phenotype for disease diagnosis represents a new trend in the medical field. Animal models provide insights into the pathogenesis of CH and contribute to our understanding of its association with related complications, such as renal cysts, scoliosis, and cardiomyopathy, as these genes may also play a role in the development of these diseases. Genes discovered in animals present potential targets for new treatments but require further validation through future human studies.
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  • 文章类型: Journal Article
    碱尿症是一种罕见的常染色体隐性遗传先天性代谢障碍,影响25万例活产中的1例。由于软骨和心脏瓣膜中的均质酸的积累以及肾脏的沉淀,它表现为慢性和退行性关节炎。唾液,胰腺和胆囊结石。注意到在10%的患者中引起心脏瓣膜狭窄和继发于钙化的反流,导致心力衰竭。通过这份报告,我们提出了一个成功的围手术期麻醉管理的一个74岁的男性患有心脏慢性疾病,在我们中心接受了冠状动脉旁路移植手术的主动脉瓣置换术。
    Alkaptonuria is a rare autosomal recessive congenital disorder of metabolism that affects 1 in 250,000 live births. It manifests as ochronosis and degenerative arthritis due to the accumulation of homogentistic acid in cartilage and heart valves along with precipitation of renal, salivary, pancreatic and gall bladder calculi. It is noted to cause cardiac valve stenosis and regurgitation secondary to calcification leading to cardiac failure in 10% of patients. Through this report, we present a successful perioperative anaesthetic management of a 74-year-old man with cardiac ochronosis, who underwent an aortic valve replacement with coronary artery bypass graft surgery at our centre.
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  • 文章类型: Journal Article
    骨软骨病(OC)是一种发育性骨科疾病,在许多运动马品种中受到关注,具有重要的国际相关性。使用数字射线照片,我们评估了参与形态功能测试的3.048PuraRazaEspañola(PRE)马的hock(tar骨关节)OC的发生,在tar骨四肢的三个特定位置:胫骨远端中间脊(DIRT),距骨外侧滑车脊(LTT),和距骨内侧滑车脊(MTT)。在分析的样本中发现飞节OC的发生率为13.3%,DIRT发病率最高(10.0%),MTT最低(0.2%)。使用三种遗传方法进行了对OC的遗传易感性的估计:1a)基于OC的存在或不存在的二项阈值模型,1b)多项式阈值模型,在从0(缺席)到3(最大)的范围内,和2)线性模型。模型中考虑的影响包括性别,遗传起源和种马类。所有的分析都是基于贝叶斯推断方法,使用THRGIBBS3F90软件。二项式阈值模型产生了最合适的结果,在基础量表上,总hockOC的估计遗传力为0.71±0.055(在观察量表上为0.53),在基础量表上的不同位置从0.48±0.087(LTT)到0.66±0.063(DIRT)(在观察量表上为0.10和0.38,分别)。在方法1a中,在Overall和DIRT(0.97)之间观察到最高的显著遗传相关性,最低的显著遗传相关性是总体和LTT(0.49),方法2。这项研究为遗传易感性提供了宝贵的见解,以及选择性育种的潜力,在PRE马匹中hockOC,并为未来的研究和育种计划提供基础,旨在最大程度地减少hockOC的发生并促进该品种的整体健康。
    Osteochondrosis (OC) is a developmental orthopaedic disease of significant concern in numerous sport horse breeds, with significant international relevance. Using digital radiographs, we assessed the occurrence of hock (tarsocrural joint) OC in 3 048 Pura Raza Española (PRE) horses which took part in a morpho-functional test, in three specific locations in the tarsus limbs: the Distal Intermediate Ridge of the Tibia (DIRT), the lateral trochlear ridges of the talus (LTT), and the medial trochlear ridges of the talus (MTT). An incidence rate of 13.3% was found for hock OC in the analysed sample, with the highest incidence rate observed in DIRT (10.0%) and the lowest in MTT (0.2%). Estimates of genetic predisposition to hock OC were carried out using three genetic approaches: 1a) a binomial threshold model based on the presence or absence of OC, 1b) a multinomial threshold model, on a scale from 0 (absence) to 3 (maximum), and 2) a linear model. The effects considered in the models included sex, genetic origin and stud class. All the analyses were based on the Bayesian inference methodology, using the THRGIBBS3F90 software. The binomial threshold model yielded the most suitable results, with an estimated heritability for Overall hock OC of 0.71 ± 0.055 on the underlying scale (0.53 on the observed scale), ranging in different locations from 0.48 ± 0.087 (LTT) to 0.66 ± 0.063 (DIRT) on the underlying scale (0.10 and 0.38 on the observed scale, respectively). The highest significative genetic correlation was observed between Overall and DIRT (0.97) for approach 1a, and the lowest significant genetic correlation was between Overall and LTT (0.49), for approach 2. This study contributes valuable insights into the genetic predisposition towards, as well as for the potential for selective breeding against, hock OC in PRE horses, and provides a basis for future research and breeding programmes aimed at minimising the occurrence of hock OC and promoting the overall health of this breed.
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  • 文章类型: Journal Article
    背景:运动型马的运动性肺出血(EIPH)的特征是剧烈运动后气管支气管树中存在来自肺部的血液。尽管EIPH在马匹中的患病率很高,主要病因尚不清楚。编码CD39和CD39L1(分别为ENTPD1和ENTPD2)的基因中的变异体先前被报道为涉及EIPH发病机理的潜在遗传原因。然而,这些变异体在止血功能中的作用尚不清楚.
    结果:为了研究EIPH与ENTPD1(rs1152296272,rs68621348和rs68621347)和ENTPD2基因(rs782872967)中错义变体之间的关联,对76匹诊断为EIPH的纯种马和56匹通过气管-支气管内窥镜检查无EIPH临床体征的纯种马(对照组)进行基因分型。rs1152296272和rs68621347变体是连接的,这解释了为什么在所有马匹中都发现了相同的结果。大约96%和95%的EIPH和对照马,分别,携带这些变体的至少一个非参考等位基因。相比之下,100%的对照马和96%的EIPH马对于rs68621348变体的参考等位基因是纯合的。在EIPH组中,对于rs782872967变体的非参考等位基因,1.5%的马是纯合子,24%是杂合的。在对照组中,仅在杂合子中观察到该变体的非参考等位基因(16%).对于任何变体,组间没有显著差异。
    结论:先前在编码CD39和CD39L1酶的基因中描述的变体在研究群体中高度存在。然而,在这项研究中,在纯种马中没有发现EIPH的发生和这些变异的存在之间的关联.
    BACKGROUND: Exercise-induced pulmonary haemorrhage (EIPH) in athletic horses is characterized by the presence of blood from the lungs in the tracheobronchial tree after intense exercise. Despite the high prevalence of EIPH in horses, the primary aetiology remains unknown. Variants in the genes encoding CD39 and CD39L1 (ENTPD1 and ENTPD2, respectively) were previously reported as potential genetic causes involved in EIPH pathogenesis. However, the role of these variants in haemostatic functions is unknown.
    RESULTS: To investigate the association between EIPH and missense variants in the ENTPD1 (rs1152296272, rs68621348, and rs68621347) and ENTPD2 genes (rs782872967), 76 Thoroughbred horses diagnosed with EIPH and 56 without clinical signs of EIPH (control group) by trachea-bronchial endoscopy were genotyped. The rs1152296272 and rs68621347 variants were linked, which explained why the same results were found in all horses. Approximately 96% and 95% of the EIPH and control horses, respectively, carried at least one nonreference allele for these variants. In contrast, 100% of the control horses and 96% of the EIPH horses were homozygous for the reference allele for the rs68621348 variant. In the EIPH group, 1.5% of the horses were homozygotes and 24% were heterozygous for the nonreference allele of the rs782872967 variant. In the control group, the nonreference allele of this variant was observed only in heterozygotes (16%). There were no significant differences between groups for any of the variants.
    CONCLUSIONS: The variants previously described in the genes encoding the CD39 and CD39L1 enzymes were highly present in the studied population. However, no association was found between the occurrence of EIPH and the presence of these variants in Thoroughbred horses in this study.
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  • 文章类型: Journal Article
    关于α-1抗胰蛋白酶缺乏症(AATD)患者疾病负担的真实世界分析是有限的。我们调查了美国成人和儿童AATD患者肝脏相关临床事件的真实世界负担。
    这是一个回顾,对2011年至2022年IQVIAPharMetrics®Plus和门诊电子病历数据库中的行政索赔数据进行观察分析.在首次诊断之前和之后≥90天,在IQVIAPharMetricsPlus数据库中连续≥180天,患者诊断为肝脏和/或肺部疾病。随访时间被分配到AATD与肝脏疾病健康状态或AATD与肝脏和肺部疾病健康状态(仅对于年龄≥18岁的患者)。报告了基线人口统计学特征和肝脏相关的临床事件。
    在5136名符合条件的患者中,771名成人和123名儿科患者为肝病健康状况的AATD贡献了时间;541名成年人为肝脏和肺部疾病健康状况的AATD贡献了时间。在成年人中,同时患有肝脏和肺部疾病的患者的肝脏相关临床事件发生率高于单独患有肝脏疾病的患者.腹水是两种健康状态下成年人中最常见的临床事件。在所有合并的成人中,任何肝脏相关临床事件发生复合事件的中位时间为26.5天.在所有儿科年龄组中,腹水,胃肠道出血和肝性脑病比自发性细菌性腹膜炎和肝细胞癌更常见,但在指定日期和事件类型时,肝脏相关临床事件发生的中位时间因年龄组而异.6-17岁患者无肝移植。
    经诊断的AATD合并肝病对成人和儿科患者造成了沉重负担;新的治疗选择是必要的,以避免疾病进展为失代偿事件。
    UNASSIGNED: Real-world analyses on burden of illness in patients with alpha-1 antitrypsin deficiency (AATD) are limited. We investigated the real-world burden of liver-related clinical events among adult and pediatric patients with AATD in the USA.
    UNASSIGNED: This was a retrospective, observational analysis of administrative claims data from the IQVIA PharMetrics® Plus and Ambulatory Electronic Medical Records databases from 2011 to 2022. Patients had a diagnosis of liver and/or lung disease with ≥180 days of continuous enrollment in the IQVIA PharMetrics Plus database before and ≥90 days after their first diagnosis. Follow-up time was assigned to the AATD with liver disease health state or AATD with both liver and lung disease health state (for patients aged ≥18 years only). Baseline demographic characteristics and liver-related clinical events of interest were reported.
    UNASSIGNED: Of 5136 eligible patients, 771 adult and 123 pediatric patients contributed time to the AATD with liver disease health state; 541 adults contributed time to the AATD with both liver and lung disease health state. Among adults, patients with both liver and lung disease had higher rates of liver-related clinical events than patients with liver disease alone. Ascites was the most frequently observed clinical event among adults in both health states, and the median time to the composite of any liver-related clinical event was 26.5 days among all adults combined. Across all pediatric age groups, ascites, gastrointestinal bleed and hepatic encephalopathy were more common than spontaneous bacterial peritonitis and hepatocellular carcinoma, but median time to liver-related clinical event varied by age group at index date and type of event. No liver transplantations occurred in patients aged 6-17 years.
    UNASSIGNED: Diagnosed AATD with liver disease carries a substantial burden on adult and pediatric patients; new treatment options are warranted to avoid disease progression to decompensating events.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    Na,K-ATP酶是α-β异二聚体。众所周知,Na,K-ATP酶β亚基是α亚基生物合成和运输到质膜所必需的。在研究293细胞中人类ATP1A3突变的特性期间,当表达ATP1A3时,我们观察到内源性ATP1A1的相互损失。1991年的零星报道表明,一个亚基的实验表达可以导致另一个亚基的减少,这表明总量是严格限制的。似乎合乎逻辑的是,α或β亚基应为组装和功能表达的限速。这里,我们提供的证据表明,α和β都不是限制性的,并且有另一个水平的控制限制了Na的量,K-ATP酶达到生理水平。我们建议α亚基竞争特定的东西,像一个私人监护人,需要完成它们的生物合成或防止它们在内质网中的降解。
    The Na,K-ATPase is an α-β heterodimer. It is well known that the Na,K-ATPase β subunit is required for the biosynthesis and trafficking of the α subunit to the plasma membrane. During investigation of properties of human ATP1A3 mutations in 293 cells, we observed a reciprocal loss of endogenous ATP1A1 when expressing ATP1A3. Scattered reports going back as far as 1991 have shown that experimental expression of one subunit can result in reduction in another, suggesting that the total amount is strictly limited. It seems logical that either α or β subunit should be rate-limiting for assembly and functional expression. Here, we present evidence that neither α nor β may be limiting and that there is another level of control that limits the amount of Na,K-ATPase to physiological levels. We propose that α subunits compete for something specific, like a private chaperone, required to finalize their biosynthesis or to prevent their degradation in the endoplasmic reticulum.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    由于对健康的有害影响,许多基因座将等位基因分类为“遗传性疾病”。然而,据报道,一些疾病等位基因在某些条件下或某些人群中显示出有益的作用。这些拮抗多效等位基因的有益作用可以解释它们的持续流行,但是拮抗多效的普遍或罕见程度尚未解决。我们调查了医学文献,以确定拮抗多效性的例子,以帮助确定拮抗多效性是否罕见或常见。
    我们确定了十个具有多态性的基因座示例,其中拮抗多效性的存在得到了人类详细的遗传或流行病学信息的很好支持。确定了另一个基因座,其支持证据来自动物研究。这些例子补充了其他评论中报告的20多个例子。
    30多个已鉴定的拮抗多效人类疾病等位基因的存在表明,这种现象可能很普遍。这对我们对人类进化遗传学的理解以及我们的临床治疗和疾病预防方法都具有重要意义。尤其是基于基因改造的疗法。
    UNASSIGNED: Many loci segregate alleles classified as \"genetic diseases\" due to their deleterious effects on health. However, some disease alleles have been reported to show beneficial effects under certain conditions or in certain populations. The beneficial effects of these antagonistically pleiotropic alleles may explain their continued prevalence, but the degree to which antagonistic pleiotropy is common or rare is unresolved. We surveyed the medical literature to identify examples of antagonistic pleiotropy to help determine whether antagonistic pleiotropy appears to be rare or common.
    UNASSIGNED: We identified ten examples of loci with polymorphisms for which the presence of antagonistic pleiotropy is well supported by detailed genetic or epidemiological information in humans. One additional locus was identified for which the supporting evidence comes from animal studies. These examples complement over 20 others reported in other reviews.
    UNASSIGNED: The existence of more than 30 identified antagonistically pleiotropic human disease alleles suggests that this phenomenon may be widespread. This poses important implications for both our understanding of human evolutionary genetics and our approaches to clinical treatment and disease prevention, especially therapies based on genetic modification.
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  • 文章类型: English Abstract
    The International Committee on Classification of Corneal Dystrophies (IC3D) was founded in 2005 to address difficulties arising from the outdated nomenclature for corneal dystrophies (CD) and to correct misconceptions in the literature. For each of the 22 CDs, a separate template was created to represent the current clinical, pathological and genetic knowledge of the disease. In addition, each template contains representative clinical photographs as well as light and electron microscopic images and, if available, confocal microscopic and coherence tomographic images of the respective CD. After the first edition was published in 2008, the revised version followed in 2015. The third edition of the IC3D was published as open access in February 2024. The latest edition is intended to serve as a reference work in everyday clinical practice and facilitate the diagnosis of CD, which might sometimes be difficult. This article provides an overview of the diagnostic and treatment principles of CD and presents the IC3D and its changes over time.
    UNASSIGNED: Das Internationale Komitee für die Klassifikation von Hornhautdystrophien („International Committee on Classification of Corneal Dystrophies“ [IC3D]) wurde im Jahr 2005 gegründet, um Schwierigkeiten zu beseitigen, die sich aus der veralteten Nomenklatur für Hornhautdystrophien (HD) ergaben, und um Fehleinschätzungen in der Literatur zu korrigieren. Für jede der 22 HD wurde eine eigene Vorlage (sog. „Template“) erstellt, die den aktuellen klinischen, pathologischen und genetischen Wissensstand über die Erkrankung widerspiegelt. Darüber hinaus enthält jedes „Template“ repräsentative klinische Fotografien sowie licht- und elektronenmikroskopische Bilder und, falls vorhanden, konfokalmikroskopische und kohärenztomographische Aufnahmen der jeweiligen HD. Nach Veröffentlichung der ersten Ausgabe im Jahr 2008 folgte 2015 die überarbeitete Version. Die dritte Ausgabe der IC3D wurde im Februar 2024 veröffentlicht und ist frei zugänglich. Die neueste Auflage soll als Nachschlagewerk im klinischen Alltag dienen und die Diagnose von HD erleichtern. Dieser Artikel bietet einen Überblick über die Diagnose- und Behandlungsprinzipien der HD und stellt die IC3D und deren Veränderungen im Laufe der Zeit vor.
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