Hara Kenju, Kuwano Ryozo, Miyashita Akinori, Kokubo Yasumasa, Sasaki Ryogen, Nakahara Yasuo, Goto Jun, Nishizawa Masatoyo, Kuzuhara Shigeki, Tsuji Shoji
Department of Neurology, Brain Research Institute, Niigata University.
Rinsho Shinkeigaku. 2007 Nov;47(11):974-6.
Recent clinical research have revealed that more than 70% of the patients with ALS/PDC, which is highly prevalent in Hohara area in the Kii peninsula, have family history. 80% of Guamanian patients, who have identical pathological findings to those of ALS/PDC in Kii, are also known to have family history with non-Mendelian trait. These facts suggest strong genetic predisposition to ALS/PDC in both Kii and Guam. However, no genes associated with ALS/PDC have been identified by molecular genetic studies using candidate gene approach. To identify the causative or susceptibility genes for ALS/PDC, we have conducted a genomewide linkage analysis for five families with ALS/PDC in Hohara. The fact that affected individuals were ascertained in successive generations suggest an autosomal dominant (AD) inheritance, while the presence of consanguinity suggests an autosomal recessive (AR) inheritance. Although we can raise possibilities of AD model with incomplete penetrance or AR model with high gene frequency (pseudo-dominant model), the mode of inheritance of ALS/PDC families is complicated and controversial. Therefore, we are also conducting model-free (non-parametric) linkage analysis to identify the disease locus without setting mode of inheritance. More family members and detailed clinical evaluations are required to obtain the convincing evidence of linkage.
近期临床研究表明,在纪伊半岛小原地区高发的肌萎缩侧索硬化/进行性延髓麻痹(ALS/PDC)患者中,超过70%有家族病史。已知关岛患者中有80%也有家族病史,且具有与纪伊地区ALS/PDC相同的病理表现,其遗传特征不符合孟德尔遗传定律。这些事实表明,纪伊地区和关岛的ALS/PDC都有很强的遗传易感性。然而,采用候选基因法进行的分子遗传学研究尚未鉴定出与ALS/PDC相关的基因。为了确定ALS/PDC的致病基因或易感基因,我们对小原地区的5个ALS/PDC家族进行了全基因组连锁分析。连续几代出现患病个体这一事实提示可能为常染色体显性(AD)遗传,而近亲结婚的情况则提示可能为常染色体隐性(AR)遗传。虽然我们可以提出不完全显性的AD模型或高基因频率的AR模型(假显性模型)的可能性,但ALS/PDC家族的遗传模式复杂且存在争议。因此,我们也在进行无模型(非参数)连锁分析,以在不设定遗传模式情况下确定疾病位点。需要更多家庭成员和更详细的临床评估来获得令人信服的连锁证据。