Boileau Catherine, Jondeau Guillaume, Mizuguchi Takeshi, Matsumoto Naomichi
INSERM U383, Hôpital Necker-Enfants Malades, Université Paris 5, Paris, France.
Curr Opin Cardiol. 2005 May;20(3):194-200. doi: 10.1097/01.hco.0000162398.21972.cd.
Marfan syndrome, the founding member of connective tissue disorders, is characterized by involvement of three major systems (skeletal, ocular, and cardiovascular) due to alteration in microfibrils. FBN1 at 15q21.1 was found to cause Marfan syndrome in 1991, and in 2004 TGFBR2 at 3p24.1 was newly identified as the Marfan syndrome type II gene. Several studies implied that fibrillin-1 and transforming growth factor-beta (TGF-beta) signaling are functionally related in extracellular matrix. Identification of TGFBR2 mutations in Marfan syndrome type II provided the direct evidence of the relation in humans.
More than 500 FBN1 mutations have been found in Marfan syndrome, tentative genotype - phenotype correlations have emerged, and mouse models are providing insight into pathogenic mechanisms. TGFBR2 mutations are still limited, however, in 2005 were also reported to cause a new aneurysm syndrome. Functional association between fibrillin-1 and TGF-beta signaling in extracellular matrix has been presented.
This review focuses on recent molecular genetics advances in Marfan syndrome and overlapping connective tissue disorders. Mutation spectrum of FBN1 and TGFBR2 in relation to phenotype is presented. Functional relation between fibrillin-1 and TGF-beta signaling is discussed. Future prospects in the study of Marfan syndrome are presented.
马凡综合征作为结缔组织疾病的首个成员,其特征是由于微原纤维改变而累及三个主要系统(骨骼、眼部和心血管系统)。1991年发现位于15q21.1的FBN1基因可导致马凡综合征,2004年新确定位于3p24.1的TGFBR2基因为II型马凡综合征基因。多项研究表明,原纤维蛋白-1与转化生长因子-β(TGF-β)信号传导在细胞外基质中存在功能关联。II型马凡综合征中TGFBR2突变的鉴定为两者在人体中的关联提供了直接证据。
在马凡综合征中已发现500多种FBN1突变,初步的基因型-表型相关性已经显现,小鼠模型也有助于深入了解致病机制。然而,TGFBR2突变的情况仍然有限,不过在2005年也有报道称其可导致一种新的动脉瘤综合征。已提出原纤维蛋白-1与TGF-β信号传导在细胞外基质中的功能关联。
本综述重点关注马凡综合征及重叠性结缔组织疾病在分子遗传学方面的最新进展。阐述了FBN1和TGFBR2的突变谱与表型的关系。讨论了原纤维蛋白-1与TGF-β信号传导的功能关系。介绍了马凡综合征研究的未来前景。