Dietrich Paula, Dragatsis Ioannis
Department of Physiology, The University of Tennessee, Memphis, TN, USA.
Genet Mol Biol. 2016 Oct-Dec;39(4):497-514. doi: 10.1590/1678-4685-GMB-2015-0335. Epub 2016 Aug 4.
Hereditary Sensory and Autonomic Neuropathies (HSANs) compose a heterogeneous group of genetic disorders characterized by sensory and autonomic dysfunctions. Familial Dysautonomia (FD), also known as HSAN III, is an autosomal recessive disorder that affects 1/3,600 live births in the Ashkenazi Jewish population. The major features of the disease are already present at birth and are attributed to abnormal development and progressive degeneration of the sensory and autonomic nervous systems. Despite clinical interventions, the disease is inevitably fatal. FD is caused by a point mutation in intron 20 of the IKBKAP gene that results in severe reduction in expression of IKAP, its encoded protein. In vitro and in vivo studies have shown that IKAP is involved in multiple intracellular processes, and suggest that failed target innervation and/or impaired neurotrophic retrograde transport are the primary causes of neuronal cell death in FD. However, FD is far more complex, and appears to affect several other organs and systems in addition to the peripheral nervous system. With the recent generation of mouse models that recapitulate the molecular and pathological features of the disease, it is now possible to further investigate the mechanisms underlying different aspects of the disorder, and to test novel therapeutic strategies.
遗传性感觉和自主神经病(HSANs)是一组异质性的遗传疾病,其特征为感觉和自主神经功能障碍。家族性自主神经功能异常(FD),也称为HSAN III,是一种常染色体隐性疾病,在阿什肯纳兹犹太人群中,其发病率为1/3600活产儿。该病的主要特征在出生时就已存在,归因于感觉和自主神经系统的异常发育和进行性退化。尽管有临床干预措施,但该病仍不可避免地会导致死亡。FD由IKBKAP基因第20内含子的一个点突变引起,该突变导致其编码蛋白IKAP的表达严重减少。体外和体内研究表明,IKAP参与多种细胞内过程,并提示靶神经支配失败和/或神经营养逆行运输受损是FD中神经元细胞死亡的主要原因。然而,FD要复杂得多,除了外周神经系统外,似乎还会影响其他几个器官和系统。随着最近能够重现该疾病分子和病理特征的小鼠模型的产生,现在有可能进一步研究该疾病不同方面的潜在机制,并测试新的治疗策略。