Herouy Yared, Krutmann Jean, Norgauer Johannes, Schöpf Erwin
Universitäts-Hautklinik, Albert-Ludwigs-Universität, Freiburg.
J Dtsch Dermatol Ges. 2003 Mar;1(3):191-8. doi: 10.1046/j.1610-0387.2003.02032.x.
Xeroderma pigmentosum is based on a genetic defect in the DNA repair system, which is diagnosed in early childhood. Xeroderma pigmentosum is a rare disorder, which is transmitted in an autosomal recessive manner. Children with xeroderma pigmentosum display hypersensitivity to ultraviolet (UV) radiation. These patients experience serious sunburns with minimal exposure and then develop poikiloderma in the sun-exposed areas. Squamous cell carcinomas, basal cell carcinomas and malignant melanomas all appear during childhood. The majority of patients do not reach adult, but die from metastatic cutaneous malignancies. Genetically, xeroderma pigmentosum is differentiated into 7 complementation groups (XP-A to XP-G) and the xeroderma pigmentosum variants (XP-V). The assignment to the specific complementation group is made by fusing of xeroderma pigmentosum fibroblasts. Xeroderma pigmentosum must be distinguished from other so-called DNA repair deficiency syndromes, including Cockayne syndrome and trichothiodystrophy. A topical DNA repair enzyme appears to be helpful. A recombinant liposomal encapsulated T4 endonuclease V repairs UV-induced cyclobutane-pyrimidine dimers. Direct curative treatment of xeroderma pigmentosum could be achieved with gene therapy in future. Transfection of an intact repair gene which specifically codes for the missing repair protein could open new possibilities in the therapy of xeroderma pigmentosum.
着色性干皮病基于DNA修复系统的基因缺陷,在儿童早期被诊断出来。着色性干皮病是一种罕见的疾病,以常染色体隐性方式遗传。患有着色性干皮病的儿童对紫外线(UV)辐射表现出超敏反应。这些患者在极少暴露的情况下就会出现严重晒伤,然后在暴露于阳光的部位出现皮肤异色症。鳞状细胞癌、基底细胞癌和恶性黑色素瘤均在儿童期出现。大多数患者活不到成年,而是死于转移性皮肤恶性肿瘤。在基因方面,着色性干皮病分为7个互补组(XP - A至XP - G)和着色性干皮病变异型(XP - V)。通过将着色性干皮病成纤维细胞融合来确定具体的互补组。着色性干皮病必须与其他所谓的DNA修复缺陷综合征区分开来,包括科凯恩综合征和毛发硫营养不良。局部使用DNA修复酶似乎有帮助。重组脂质体包裹的T4内切核酸酶V可修复紫外线诱导的环丁烷 - 嘧啶二聚体。未来基因治疗可能实现对着色性干皮病的直接治愈性治疗。转染一个完整的修复基因,该基因专门编码缺失的修复蛋白,可能为着色性干皮病的治疗开辟新的可能性。