Johansson J, Holmgren G, Forsgren L, Holmberg M
Klinisk genetik/institutionen för cell- och molekylärbiologi, Umeå Universitet.
Lakartidningen. 1999 Feb 24;96(8):897-900.
A growing number of hereditary neurodegenerative disorders have been found to be caused by expansion of trinucleotide repeats. A smaller number of diseases such as fragile X syndrome, myotonic dystrophy, and Friedreich's ataxia, have been found to be due to expansions in non-coding DNA. In a large group of diseases, the expansion consists of CAG repeats in the coding region of the gene, producing an expanded polyglutamine sequence in the protein. Nine diseases have so far been identified as belonging to this group: Huntington's disease, spinobulbar muscular atrophy (SBMA), dentatorubral pallidoluysian atrophy (DRPLA), autosomal dominant "pure" spastic paraplegia (ADPSP), and five forms of spinocerebellar ataxia (SCA 1,2,3,6 and 7). Except for SBMA, all of the CAG repeat disorders are characterised by autosomal dominant heredity and anticipation (i.e., earlier onset age and increasing severity in successive generations). The mutated protein causes disease via an as yet unidentified gain-of-function mechanism in specific subsets of neurones. Today, DNA analysis permits the diagnosis of a trinucleotide disease in individual cases.
越来越多的遗传性神经退行性疾病被发现是由三核苷酸重复序列的扩增引起的。少数疾病如脆性X综合征、强直性肌营养不良和弗里德赖希共济失调,被发现是由于非编码DNA的扩增所致。在一大类疾病中,扩增由基因编码区的CAG重复序列组成,在蛋白质中产生一个扩增的聚谷氨酰胺序列。迄今为止,已有9种疾病被确定属于这一组:亨廷顿舞蹈病、脊髓延髓肌萎缩症(SBMA)、齿状核红核苍白球路易体萎缩症(DRPLA)、常染色体显性“纯”痉挛性截瘫(ADPSP)以及5种形式的脊髓小脑共济失调(SCA 1、2、3、6和7)。除了SBMA外,所有CAG重复序列疾病的特征都是常染色体显性遗传和遗传早现(即发病年龄提前且在连续几代中病情加重)。突变蛋白通过在特定神经元亚群中尚未明确的功能获得机制导致疾病。如今,DNA分析能够在个别病例中诊断三核苷酸疾病。