Lisik Małgorzata Z, Sieroń Aleksander L
Katedry i Zakładu Biologii Ogólnej, Molekularnej i Genetyki Slaskiego Uniwersytetu Medycznego w Katowicach.
Wiad Lek. 2008;61(4-6):146-53.
Mental retardation is a serious medical and social problem. The prevalence of mental retardation is estimated at 2-3%. Establishing the cause of mental retardation is extremely important for prognosis, management, and genetic counseling. It is postulated that 25-35% of mental retardation cases may be of genetic background. Among the genetic causes 25-30% are probably result of mutations located in the X chromosome (X-linked mental retardation--XLMR). X-linked mental retardation is a heterogeneous set of conditions responsible for a large proportion of inherited mental retardation. More than 200 XLMR conditions and 45 cloned genes are listed in catalogue available on the Internet. Traditionally, based on clinical presentation, XLMR conditions were divided into specific and nonspecific forms or syndromic and nonsyndromic. The distinction between specific and non-specific forms of XLMR is gradually becoming less clear and spectrum of phenotypic variability is very large as both syndromic and nonsyndromic forms have been described for several of the XLMR genes. Mutations in patients suffering from X-linked mental retardation genes have been found only in a relatively limited number of cases. Up to 50% of the patients from XLMR families might have mutations in one of the known genes implicated in XLMR so far. However, current methods are generally too expensive or too unreliable to justify mutation screening of all known XLMR genes in diagnostic testing. Thus it is necessary to use empirical data of recurrence risk in genetic counseling of the family with mental retardation.
智力迟钝是一个严重的医学和社会问题。据估计,智力迟钝的患病率为2%-3%。确定智力迟钝的病因对于预后、治疗和遗传咨询极为重要。据推测,25%-35%的智力迟钝病例可能具有遗传背景。在遗传病因中,25%-30%可能是位于X染色体上的突变所致(X连锁智力迟钝——XLMR)。X连锁智力迟钝是一组异质性疾病,导致了很大一部分遗传性智力迟钝。互联网上的目录中列出了200多种XLMR疾病和45个已克隆的基因。传统上,根据临床表现,XLMR疾病分为特异性和非特异性形式或综合征性和非综合征性。XLMR特异性和非特异性形式之间的区别正逐渐变得不那么清晰,表型变异范围非常大,因为几种XLMR基因都有综合征性和非综合征性形式的描述。仅在相对有限的病例中发现了患有X连锁智力迟钝基因的患者的突变。到目前为止,XLMR家族中高达50%的患者可能在已知的与XLMR相关的基因之一中存在突变。然而,目前的方法通常过于昂贵或不可靠,无法在诊断测试中对所有已知的XLMR基因进行突变筛查。因此,在智力迟钝家庭的遗传咨询中,有必要使用复发风险的经验数据。