Berciano José, Combarros Onofre
Service of Neurology, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain.
Curr Opin Neurol. 2003 Oct;16(5):613-22. doi: 10.1097/01.wco.0000093105.34793.dd.
This review will update recent advances in the genetics, clinico-electrophysiological, pathological data and pathophysiology of Charcot-Marie-Tooth disease and related disorders.
Hereditary neuropathies continue to be in a state of constant flux, reflecting the rapid advances in the description of causative genes, three additional Charcot-Marie-Tooth genes having been identified in recent months. Such an ever-increasing body of genetic data provides valuable clues to the pathogenetic mechanisms of both nerve demyelination and nerve axonal degeneration. The classification of Charcot-Marie-Tooth disease is increasingly more complex as there are approximately 26 loci; for clinicians to reach a simplified classification is a pressing need. Genotypic-phenotypic correlations are still incomplete and will require further research, starting from both refined molecular investigations and detailed clinical, electrophysiological, and pathological studies. Recent epidemiological surveys have corroborated the fact that Charcot-Marie-Tooth disease is the most common type of hereditary neuropathy.
Advances in molecular genetics in hereditary neuropathies, and mainly in Charcot-Marie-Tooth disease, have enriched our knowledge of this heterogeneous group of disorders. In spite of this there remain important and basic issues, such as an updated and revised classification of Charcot-Marie-Tooth disorders, the better delineation of phenotypic-genotypic correlations, and further research to map as yet non-localized loci or to identify unknown gene mutations.
本综述将更新夏科-马里-图思病及相关疾病在遗传学、临床电生理学、病理数据和病理生理学方面的最新进展。
遗传性神经病仍处于不断变化的状态,这反映了致病基因描述方面的快速进展,近几个月又鉴定出另外三个夏科-马里-图思病基因。如此不断增加的遗传数据为神经脱髓鞘和神经轴突变性的发病机制提供了有价值的线索。由于大约有26个基因座,夏科-马里-图思病的分类越来越复杂;临床医生迫切需要达成一个简化的分类。基因型与表型的相关性仍不完整,需要从精细的分子研究以及详细的临床、电生理和病理研究两方面入手进行进一步研究。最近的流行病学调查证实了夏科-马里-图思病是最常见的遗传性神经病类型这一事实。
遗传性神经病,主要是夏科-马里-图思病,在分子遗传学方面的进展丰富了我们对这一异质性疾病组的认识。尽管如此,仍存在重要的基础问题,如夏科-马里-图思病的更新和修订分类、对表型-基因型相关性的更好界定,以及进一步研究以定位尚未定位的基因座或识别未知基因突变。