Scavone-Mauro Cristina, Barros Graciela
Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
Rev Neurol. 2013 Sep 6;57 Suppl 1:S47-52.
From the clinical and genetic point of view, congenital muscular dystrophies (CMD) are a heterogenic group of diseases within neuromuscular pathologies. The best known forms are: merosin deficiency CMD, collagen VI deficiency CMD, LMNA-related CMD, selenoprotein-related CMD (SEPN1) and alpha-dystroglycan-related CMD. They present with a broad spectrum of clinical phenotypes. Most of them are transmitted by recessive autosomal inheritance. The initial manifestations very often begin in infancy or in the neonatal period. There are clinical suspicions of the existence of hypotonia and paresis, and they are characterised by a dystrophic pattern in the muscular biopsy (muscle replaced by fibroadipose tissue, with necrosis and cell regeneration). Advances in the understanding of the molecular pathogenesis of CMD have made it possible to make further progress in the classification of the different subtypes. The aim of this review is to comment on the advances made in recent years as regards the classification of CMD in terms of genetics, the proteins involved and their clinical presentation.
从临床和遗传学角度来看,先天性肌营养不良症(CMD)是神经肌肉疾病中的一组异质性疾病。最常见的类型有:缺乏merosin的CMD、缺乏胶原蛋白VI的CMD、与LMNA相关的CMD、与硒蛋白相关的CMD(SEPN1)以及与α- dystroglycan相关的CMD。它们表现出广泛的临床表型。大多数通过常染色体隐性遗传传递。最初的表现常常始于婴儿期或新生儿期。临床上怀疑存在肌张力减退和轻瘫,其特征是肌肉活检呈现营养不良模式(肌肉被纤维脂肪组织替代,伴有坏死和细胞再生)。对CMD分子发病机制认识的进展使得在不同亚型的分类上取得了进一步进展。本综述的目的是评论近年来在CMD的遗传学分类、所涉及的蛋白质及其临床表现方面取得的进展。