Greene Nicholas D E, Copp Andrew J
Neural Development Unit, Institute of Child Health, University College London, UK.
Am J Med Genet C Semin Med Genet. 2005 May 15;135C(1):31-41. doi: 10.1002/ajmg.c.30051.
Neural tube defects (NTD), including anencephaly and spina bifida, are a group of severe congenital abnormalities in which the future brain and/or spinal cord fail to close. In mice, NTD may result from genetic mutations or knockouts, or from exposure to teratogenic agents, several of which are known risk factors in humans. Among the many mouse NTD models that have been identified to date, a number have been tested for possible primary prevention of NTD by exogenous agents, such as folic acid. In genetic NTD models such as Cart1, splotch, Cited2, and crooked tail, and NTD induced by teratogens including valproic acid and fumonisins, the incidence of defects is reduced by maternal folic acid supplementation. These folate-responsive models provide an opportunity to investigate the possible mechanisms underlying prevention of NTD by folic acid in humans. In another group of mouse models, that includes curly tail, axial defects, and the Ephrin-A5 knockout, NTD are not preventable by folic acid, reflecting the situation in humans in which a subset of NTD appear resistant to folic acid therapy. In this group of mutants alternative preventive agents, including inositol and methionine, have been shown to be effective. Overall, the data from mouse models suggests that a broad-based in utero therapy may offer scope for prevention of a greater proportion of NTD than is currently possible.
神经管缺陷(NTD),包括无脑儿和脊柱裂,是一组严重的先天性异常疾病,其中未来的大脑和/或脊髓无法闭合。在小鼠中,NTD可能由基因突变或基因敲除引起,也可能由接触致畸剂导致,其中有几种致畸剂在人类中是已知的风险因素。在迄今已确定的众多小鼠NTD模型中,有一些已经通过外源性物质(如叶酸)对NTD的可能一级预防进行了测试。在诸如Cart1、斑点、Cited2和弯尾等遗传性NTD模型以及由丙戊酸和伏马菌素等致畸剂诱导的NTD中,母体补充叶酸可降低缺陷的发生率。这些叶酸反应性模型为研究叶酸预防人类NTD的潜在机制提供了机会。在另一组小鼠模型中,包括卷尾、轴向缺陷和Ephrin - A5基因敲除模型,NTD不能通过叶酸预防,这反映了人类中一部分NTD对叶酸治疗有抗性的情况。在这组突变体中,包括肌醇和蛋氨酸在内的其他预防剂已被证明是有效的。总体而言,来自小鼠模型的数据表明,一种广泛的宫内治疗可能比目前更有机会预防更大比例的NTD。