Schilsky Michael L, Oikonomou Ioannis
Department of Medicine, Center for Liver Disease and Transplantation, Weill Cornell Medical Center, New York, NY 10021, USA.
Curr Opin Gastroenterol. 2005 May;21(3):275-82. doi: 10.1097/01.mog.0000159821.78532.21.
The purpose of this review is to identify and discuss recent findings related to inherited metabolic disorders of the liver that increase our understanding of the pathophysiology and treatment for hemochromatosis and other iron overload disorders, Wilson disease and alpha one antitrypsin deficiency.
The main theme in the recent discoveries for both iron overload disorders and Wilson disease is our increasing understanding that the phenotypic expression of these disorders are greatly influenced by genes involved in the metabolic pathways for these metals, or influence the progression of liver disease independent of metal metabolism. For example, the role of hepcidin dysregulation in hemochromatosis has been a surprising discovery that provides some mechanistic understanding for the increased iron absorption that is present in this disorder.
Given the recent explosion of information on iron and copper metabolism and the cellular processing of alpha one antitrypsin, the highlights reviewed in this article will help the reader keep up to date with the current understanding of these diseases and potential future approaches to their treatment.
本综述旨在识别并讨论与遗传性肝脏代谢紊乱相关的近期研究发现,这些发现增进了我们对血色素沉着症及其他铁过载疾病、威尔逊氏病和α1抗胰蛋白酶缺乏症的病理生理学及治疗方法的理解。
近期关于铁过载疾病和威尔逊氏病的主要发现是,我们越来越认识到这些疾病的表型表达受到参与这些金属代谢途径的基因的极大影响,或者独立于金属代谢影响肝病的进展。例如,铁调素失调在血色素沉着症中的作用是一项惊人的发现,为该疾病中存在的铁吸收增加提供了一些机制性理解。
鉴于近期关于铁和铜代谢以及α1抗胰蛋白酶细胞处理的信息激增,本文综述的要点将帮助读者跟上对这些疾病的当前理解以及未来潜在的治疗方法。