University of Alaska Anchorage, Anchorage, AK 99508, USA.
Biometals. 2011 Jun;24(3):455-66. doi: 10.1007/s10534-011-9430-9. Epub 2011 Mar 5.
Wilson's disease (WD) is a severe disorder of copper misbalance, which manifests with a wide spectrum of liver pathology and/or neurologic and psychiatric symptoms. WD is caused by mutations in a gene encoding a copper-transporting ATPase ATP7B and is accompanied by accumulation of copper in tissues, especially in the liver. Copper-chelation therapy is available for treatment of WD symptoms and is often successful, however, significant challenges remain with respect to timely diagnostics and treatment of the disease. The lack of genotype-phenotype correlation remains unexplained, the causes of fulminant liver failure are not known, and the treatment of neurologic symptoms is only partially successful, underscoring the need for better understanding of WD mechanisms and factors that influence disease manifestations. Recent gene and protein profiling studies in animal models of WD began to uncover cellular processes that are primarily affected by copper accumulation in the liver. The results of such studies, summarized in this review, revealed new molecular players and pathways (cell cycle and cholesterol metabolism, mRNA splicing and nuclear receptor signaling) linked to copper misbalance. A systems biology approach promises to generate a comprehensive view of WD onset and progression, thus helping with a more fine-tune treatment and monitoring of the disorder.
威尔逊病(WD)是一种严重的铜代谢失衡疾病,表现为广泛的肝脏病理学和/或神经和精神症状。WD 是由编码铜转运 ATP 酶 ATP7B 的基因突变引起的,伴有铜在组织中的积累,特别是在肝脏中。铜螯合疗法可用于治疗 WD 症状,且通常是有效的,然而,在疾病的及时诊断和治疗方面仍存在重大挑战。基因型-表型相关性的缺乏仍未得到解释,暴发性肝功能衰竭的原因尚不清楚,神经症状的治疗也只是部分成功,这突显了需要更好地了解 WD 机制以及影响疾病表现的因素。WD 动物模型中的基因和蛋白质谱研究开始揭示主要受肝脏铜积累影响的细胞过程。本综述总结了这些研究的结果,揭示了与铜失衡相关的新的分子参与者和途径(细胞周期和胆固醇代谢、mRNA 剪接和核受体信号转导)。系统生物学方法有望对 WD 的发病和进展产生全面的认识,从而有助于更精细地治疗和监测该疾病。