Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Paediatr Respir Rev. 2011 Dec;12(4):223-9. doi: 10.1016/j.prrv.2011.01.005. Epub 2011 Mar 5.
Mutations in genes encoding proteins needed for normal surfactant function and metabolism cause acute lung disease in newborns and chronic lung disease in older children and adults. While rare these disorders are associated with considerable pulmonary morbidity and mortality. The identification of genes responsible for surfactant dysfunction provides clues for candidate genes contributing to more common respiratory conditions, including neonatal respiratory distress syndrome and lung diseases associated with aging or environmental insults. While clinical, imaging and histopathology features of these disorders overlap, certain features are distinctive for surfactant dysfunction. Natural histories differ depending upon the genes involved and a specific diagnosis is important to provide accurate information concerning prognosis and mode of inheritance. Diagnosis of surfactant dysfunction can be made by biopsy, but identification of the specific gene involved requires molecular genetic testing, which is non-invasive. Currently there are no effective medical treatments for surfactant dysfunction. Development of therapies is a priority for research, which may benefit patients with other lung diseases.
基因突变会导致编码正常表面活性剂功能和代谢所需蛋白质的基因失活,从而引发新生儿急性肺疾病和年长儿童及成年人慢性肺疾病。尽管这些疾病较为罕见,但它们与相当高的肺部发病率和死亡率相关。对导致表面活性剂功能障碍的基因的鉴定为更常见的呼吸状况的候选基因提供了线索,包括新生儿呼吸窘迫综合征和与衰老或环境损伤相关的肺部疾病。尽管这些疾病的临床表现、影像学和组织病理学特征存在重叠,但某些特征对表面活性剂功能障碍具有特异性。由于涉及的基因不同,其自然病史也有所不同,因此明确诊断对于提供有关预后和遗传方式的准确信息非常重要。表面活性剂功能障碍可以通过活检来诊断,但要确定具体涉及的基因,则需要进行非侵入性的分子遗传学检测。目前,针对表面活性剂功能障碍尚无有效的治疗方法。开发治疗方法是研究的重点,这可能使患有其他肺部疾病的患者受益。