Schara U, Mortier W
Zentrum für Neuropädiatrie, Städtische Kliniken, Neuss.
Nervenarzt. 2005 Feb;76(2):219-37; quiz 238-9. doi: 10.1007/s00115-004-1847-8.
Traditionally, muscular dystrophies (MDs) are progressive, hereditary, and primarily degenerative myopathies. Nowadays, due to molecular biology, MDs are looked upon as clinically and genetically heterogeneous myopathies characterized by protein defects of muscle tissue resulting most often in muscle weakness. They are caused by gene mutations leading to a decrease of structural proteins or enzymes. The site of the primary defect and the protein function are different. The disorders are defined according to the underlying protein defect (dystrophinopathy, calpainopathy, and others). The gene or gene product are not yet known in all forms of MD (for example, facioscapulohumeral muscular dystrophy). Therefore, the nomenclature based on the protein defects and the term MD are used concurrently. Clinical symptoms, pathogenesis, diagnosis, therapy, prognosis, and possible prevention of the more frequent MDs are discussed: dystrophinopathies (Duchenne, Becker type), Emery-Dreifuss syndrome (3 forms), facioscapulohumeral MD, limb-girdle MD (17 forms), myotonic dystrophies (2 forms), and congenital MD (11 forms). This article highlights the significance of molecular analyses and the possible multisystemic symptoms in these myopathies.
传统上,肌营养不良症(MDs)是进行性、遗传性且主要为退行性的肌病。如今,由于分子生物学的发展,MDs被视为临床和基因异质性的肌病,其特征是肌肉组织的蛋白质缺陷,最常导致肌肉无力。它们由基因突变引起,导致结构蛋白或酶减少。主要缺陷的部位和蛋白质功能各不相同。这些疾病根据潜在的蛋白质缺陷(肌营养不良蛋白病、钙蛋白酶病等)来定义。并非所有形式的MD(例如,面肩肱型肌营养不良症)的基因或基因产物都已明确。因此,基于蛋白质缺陷的命名法和术语MD同时使用。本文讨论了较常见的MDs的临床症状、发病机制、诊断、治疗、预后以及可能的预防方法:肌营养不良蛋白病(杜氏、贝克型)、埃默里-德赖富斯综合征(3种形式)、面肩肱型MD、肢带型MD(17种形式)、强直性肌营养不良症(2种形式)和先天性MD(11种形式)。本文强调了分子分析的重要性以及这些肌病中可能出现的多系统症状。