Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Suite 68-237, Los Angeles, CA 90064, USA.
University of California Los Angeles, Los Angeles, CA 90095, USA.
Nat Rev Neurol. 2014 Feb;10(2):74-81. doi: 10.1038/nrneurol.2013.278. Epub 2014 Jan 28.
Autism spectrum disorder (ASD) represents a heterogeneous group of disorders, which presents a substantial challenge to diagnosis and treatment. Over the past decade, considerable progress has been made in the identification of genetic risk factors for ASD that define specific mechanisms and pathways underlying the associated behavioural deficits. In this Review, we discuss how some of the latest advances in the genetics of ASD have facilitated parsing of the phenotypic heterogeneity of this disorder. We argue that only through such advances will we begin to define endophenotypes that can benefit from targeted, hypothesis-driven treatments. We review the latest technologies used to identify and characterize the genetics underlying ASD and then consider three themes-single-gene disorders, the gender bias in ASD, and the genetics of neurological comorbidities-that highlight ways in which we can use genetics to define the many phenotypes within the autism spectrum. We also present current clinical guidelines for genetic testing in ASD and their implications for prognosis and treatment.
自闭症谱系障碍(ASD)代表了一组异质性疾病,这对诊断和治疗提出了重大挑战。在过去的十年中,人们在识别 ASD 的遗传风险因素方面取得了相当大的进展,这些因素确定了相关行为缺陷的特定机制和途径。在这篇综述中,我们讨论了 ASD 遗传学的一些最新进展如何促进了对这种疾病表型异质性的分析。我们认为,只有通过这些进展,我们才开始定义可以从有针对性的、基于假设的治疗中受益的内表型。我们回顾了用于识别和描述 ASD 遗传基础的最新技术,然后考虑了三个主题——单基因疾病、ASD 中的性别偏见以及神经共病的遗传学——这些主题突出了我们可以利用遗传学来定义自闭症谱系内许多表型的方式。我们还介绍了 ASD 基因检测的当前临床指南及其对预后和治疗的影响。