Paylor Richard, Lindsay Elizabeth
Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA.
Biol Psychiatry. 2006 Jun 15;59(12):1172-9. doi: 10.1016/j.biopsych.2006.01.018. Epub 2006 Apr 17.
22q11 deletion syndrome (22q11DS) is caused by an interstitial chromosomal microdeletion that encompasses about 40 genes. It is the most common of the microdeletion syndromes. The clinical phenotype, which is complex and variable, includes specific congenital defects of the cardiovascular system, craniofacies, and immune system. In early childhood, patients manifest cognitive impairment, behavioral disorders, and delays in motor development and language acquisition. Adult patients have a high risk for developing serious psychiatric disorders, especially schizophrenia, schizoaffective disorder, and bipolar disorder. The great majority of patients have an identical or near identical chromosomal deletion, and genotype-phenotype correlations have not been established. Indeed, little progress was made toward resolving the complex clinical phenotype until the deletion was successfully modeled in the mouse. In recent years, through a variety of mouse mutants that carry multigene and single gene mutations, we have learned that mutation in a single gene, Tbx1, is responsible for most of the congenital defects seen in the mouse models and in patients. We now face a greater challenge as we attempt to use the mouse to address the pathogenesis of the behavioral and psychiatric disorders associated with 22q11DS. Significant progress has already been made, and recent studies in the mouse suggest that several genes from the deleted region affect behavior and might contribute to disease burden in patients.
22q11缺失综合征(22q11DS)由一个包含约40个基因的间质性染色体微缺失引起。它是最常见的微缺失综合征。其临床表型复杂且多变,包括心血管系统、颅面和免疫系统的特定先天性缺陷。在幼儿期,患者表现出认知障碍、行为紊乱以及运动发育和语言习得延迟。成年患者患严重精神疾病的风险很高,尤其是精神分裂症、分裂情感性障碍和双相情感障碍。绝大多数患者具有相同或近乎相同的染色体缺失,尚未建立基因型与表型的相关性。事实上,在小鼠中成功建立该缺失模型之前,在解决复杂的临床表型方面进展甚微。近年来,通过多种携带多基因突变和单基因突变的小鼠突变体,我们了解到单个基因Tbx1的突变是小鼠模型和患者中所见大多数先天性缺陷的原因。当我们试图利用小鼠来研究与22q11DS相关的行为和精神疾病的发病机制时,我们现在面临着更大的挑战。已经取得了重大进展,最近在小鼠中的研究表明,缺失区域的几个基因会影响行为,可能会加重患者的疾病负担。