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[日本的遗传性红细胞膜疾病:与其他国家的比较]

[Hereditary red cell membrane disorders in Japan: comparison with other countries].

作者信息

Nakanishi Hidekazu, Wada Hideho, Suemori Shinichiro, Sugihara Takashi

机构信息

Department of Hematology, Kawasaki Medical School.

出版信息

Rinsho Ketsueki. 2015 Jul;56(7):760-70. doi: 10.11406/rinketsu.56.760.

Abstract

Red cell membrane disorders are the most common type of inherited hemolytic disorders in the Japanese population. In hereditary spherocytosis (HS), the primary presentation is a loss of membrane surface area, leading to reduced deformability because of defects in the membrane proteins ankyrin, band 3, β-spectrin, α spectrin, or protein 4.2 (P4.2). Complete P4.2 deficiencies, which are inherited in an autosomal recessive manner, comprise a unique HS subgroup and are common in Japanese, but rare in other populations. In contrast, the principle presentation in hereditary elliptocytosis (HE) is mechanical weakness of the erythrocyte membrane skeleton due to defects in α-spectrin, β-spectrin, or protein 4.1. Although α-spectrin mutations are the most frequent cause of HE in Caucasian, African, and Mediterranean populations, these mutations are rare in the Japanese population, in which P4.1 deficiencies are instead most common. Furthermore, hereditary stomatocytoses (HSt) are disorders of monovalent cation permeability in the red cell membrane.

摘要

红细胞膜疾病是日本人群中最常见的遗传性溶血性疾病类型。在遗传性球形红细胞增多症(HS)中,主要表现为膜表面积减少,由于膜蛋白锚蛋白、带3蛋白、β-血影蛋白、α-血影蛋白或蛋白4.2(P4.2)缺陷导致变形性降低。完全性P4.2缺陷以常染色体隐性方式遗传,构成独特的HS亚组,在日本人中常见,但在其他人群中罕见。相比之下,遗传性椭圆形红细胞增多症(HE)的主要表现是由于α-血影蛋白、β-血影蛋白或蛋白4.1缺陷导致红细胞膜骨架机械性脆弱。虽然α-血影蛋白突变是白种人、非洲人和地中海人群中HE最常见的原因,但这些突变在日本人群中罕见,在日本人群中P4.1缺陷反而最常见。此外,遗传性口形红细胞增多症(HSt)是红细胞膜单价阳离子通透性障碍。

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