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唇腭裂的复杂遗传学

The complex genetics of cleft lip and palate.

作者信息

Cobourne Martyn T

机构信息

Division of Orthodontics and Craniofacial Development, GKT Dental Institute, London, UK.

出版信息

Eur J Orthod. 2004 Feb;26(1):7-16. doi: 10.1093/ejo/26.1.7.

Abstract

Clefts of the lip and palate are a common craniofacial anomaly, requiring complex multidisciplinary treatment and having lifelong implications for affected individuals. The aetiology of both cleft lip with or without cleft palate (CLP) and isolated cleft palate (CP) is thought to be multifactorial, with both genetic and environmental factors playing a role. In recent years, a number of significant breakthroughs have occurred with respect to the genetics of these conditions, in particular, characterization of the underlying gene defects associated with several important clefting syndromes. These include the identification of mutations in the interferon regulatory factor-6 (IRF6) gene as the cause of van der Woude syndrome and the poliovirus receptor related-1 (PVRL1) gene as being responsible for an autosomal recessive ectodermal dysplasia syndrome associated with clefting. While no specific disease-causing gene mutations have been identified in non-syndromic clefting, a number of candidate genes have been isolated through both linkage and association studies. However, it is clear that environmental factors also play a role and an important area of future research will be to unravel interactions that occur between candidate genes and environmental factors during early development of the embryo. Orthodontists are intimately involved in the therapeutic management of individuals affected by CLP and it is important that they keep abreast of current knowledge of the aetiology behind these conditions. This review aims to summarize some of the more significant advances in the genetics of CLP and highlight current thinking on the modes of inheritance and genetic loci that might be involved in this complex disorder.

摘要

唇腭裂是一种常见的颅面畸形,需要复杂的多学科治疗,对患者有终身影响。唇裂伴或不伴腭裂(CLP)和孤立性腭裂(CP)的病因被认为是多因素的,遗传和环境因素都起作用。近年来,在这些疾病的遗传学方面有了一些重大突破,特别是与几种重要的腭裂综合征相关的潜在基因缺陷的特征。这些包括鉴定出干扰素调节因子6(IRF6)基因突变是范德伍德综合征的病因,以及脊髓灰质炎病毒受体相关1(PVRL1)基因是与腭裂相关的常染色体隐性外胚层发育不良综合征的病因。虽然在非综合征性腭裂中尚未鉴定出特定的致病基因突变,但通过连锁和关联研究已经分离出了一些候选基因。然而,很明显环境因素也起作用,未来研究的一个重要领域将是揭示胚胎早期发育过程中候选基因与环境因素之间发生的相互作用。正畸医生密切参与CLP患者的治疗管理,他们了解这些疾病背后病因的最新知识很重要。这篇综述旨在总结CLP遗传学方面的一些更显著进展,并强调目前对可能参与这种复杂疾病的遗传模式和基因位点的看法。

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