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从基因到疾病;参与杜兴氏和贝克氏肌肉营养不良症的肌营养不良蛋白基因

[From gene to disease; the dystrophin gene involved in Duchenne and Becker muscular dystrophy].

作者信息

den Dunnen J T, de Visser M, Bakker E

机构信息

Afd. Humane Genetica, Leids Universitair Medisch Centrum, Wassenaarseweg 72, 2333 AL Leiden.

出版信息

Ned Tijdschr Geneeskd. 2002 Feb 23;146(8):364-7.

Abstract

Duchenne and Becker muscular dystrophy (DMD and BMD) are progressive disorders, which almost exclusively affect males. DMD is the more severe type with an onset at 2-3 years of age. Patients become wheelchair-bound before the age of 13 and often die due to cardiac arrest or respiratory insufficiency. BMD, a more varying phenotype which may overlap with limb girdle muscular dystrophy (LGMD), has a less severe muscle weakness which starts later than in DMD patients. DMD carriers may show some muscle weakness. The dystrophin gene (2.4 Mb), known to be involved in DMD/BMD, codes for a 427 kilodalton muscle-specific protein named dystrophin as well as several tissue-specific isoforms. Dystrophin, as part of a membrane-bound complex of proteins, connects the cytoskeleton of the muscle cell to the extracellular matrix. Since 1985, when highly reliable carrier detection and prenatal diagnosis at the DNA level became possible, over 250 prenatal tests have been performed. Molecular genetic analysis, highlighted a phenomenon called germinal mosaicism, which explains the recurrence of de novo mutations and led to the discovery of the so-called reading-frame rule, which helps to discriminate between DMD and BMD. Fifteen years after the discovery of the dystrophin gene, mutations can be detected in 95% of the patients, while the remaining 5% are still hiding within this very large gene.

摘要

杜兴氏和贝克氏肌营养不良症(DMD和BMD)是进行性疾病,几乎只影响男性。DMD是较严重的类型,发病于2至3岁。患者在13岁前就需要依靠轮椅行动,并且常常因心脏骤停或呼吸功能不全而死亡。BMD的表型更为多样,可能与肢带型肌营养不良症(LGMD)重叠,其肌肉无力症状较轻,发病时间比DMD患者晚。DMD携带者可能会表现出一些肌肉无力症状。已知与DMD/BMD相关的肌营养不良蛋白基因(2.4兆碱基)编码一种名为肌营养不良蛋白的427千道尔顿肌肉特异性蛋白以及几种组织特异性同工型。肌营养不良蛋白作为膜结合蛋白复合物的一部分,将肌肉细胞的细胞骨架与细胞外基质连接起来。自1985年在DNA水平上实现高度可靠的携带者检测和产前诊断成为可能以来,已经进行了超过250次产前检测。分子遗传学分析突出了一种称为生殖系嵌合现象,这解释了新发突变的复发,并导致了所谓的读码框规则的发现,该规则有助于区分DMD和BMD。在发现肌营养不良蛋白基因15年后,95%的患者中可以检测到突变,而其余5%的患者仍隐藏在这个非常大的基因中。

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