Radlović Nedeljko
School of Medicine, University of Belgrade, Belgrade, Serbia.
Srp Arh Celok Lek. 2012 Mar-Apr;140(3-4):244-9.
Cystic fibrosis (CF) is a multisystemic autosomal recessive disease caused by a defect in the expression of CFTR protein, i.e. chloride channel present in the apical membrane of respiratory, digestive, reproductive and sweat glands epithelium. It primarily occurs in the Caucasians, while being considerably or excep tionally rare in persons of other races. Absence, deficit or structural and functional abnormalities of CFTR protein lead to mucosal hyperconcentration in the respiratory, digestive and reproductive systems and malabsorption of chloride and sodium in the sweat glands. Thus, the clinical features of patients' with CF are predominated by respiratory, digestive and reproductive disorders, as well as the tendency to dehydration in the condition of increased sweating. Beside genotype variations, the degree of disease manifestation is also essentially influenced by various exogenous factors, such as the frequency and severity of respiratory infections, the level of aero-pollution, quality of immunoprophylaxis, patients' nutritional condition and other. Chloride concentration of over 60 mmol/L in sweat, a high level of immunoreactive chymotrypsinogen in blood and the verification of homozygous mutation of CFTR gene are the basic methods in the diagnostics of the disease. CF belongs to the group of severe and complex chronic diseases, and therefore requires multidisciplinary therapeutic approach. Owing to the improvement of healthcare provision, most patients with CF now survive into adulthood. In addition, their quality of life is also considerably improved.
囊性纤维化(CF)是一种多系统常染色体隐性疾病,由CFTR蛋白表达缺陷引起,CFTR蛋白即存在于呼吸道、消化道、生殖系统和汗腺上皮顶端膜的氯离子通道。该病主要发生在白种人中,在其他种族人群中相当罕见或极为罕见。CFTR蛋白的缺失、缺陷或结构与功能异常会导致呼吸、消化和生殖系统黏膜过度浓缩,以及汗腺中氯和钠的吸收不良。因此,CF患者的临床特征主要表现为呼吸、消化和生殖系统紊乱,以及在出汗增加时出现脱水倾向。除了基因变异外,疾病表现程度还受到各种外部因素的显著影响,如呼吸道感染的频率和严重程度、空气污染水平、免疫预防质量、患者营养状况等。汗液中氯化物浓度超过60 mmol/L、血液中免疫反应性糜蛋白酶原水平升高以及CFTR基因纯合突变的验证是该病诊断的基本方法。CF属于严重且复杂的慢性疾病,因此需要多学科治疗方法。由于医疗保健条件的改善,现在大多数CF患者能够存活至成年。此外,他们的生活质量也有了显著提高。