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天使综合征——对一种罕见神经遗传疾病的深入了解。

Angelman syndrome - insights into a rare neurogenetic disorder.

机构信息

Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, D-45122 Essen, Germany.

Raymond C. Philips Unit, Division of Genetics and Metabolism, Department of Pediatrics, University of Florida, 1600 SW Archer Road, PO Box 100296, Gainesville, Florida 32610-0296, USA.

出版信息

Nat Rev Neurol. 2016 Oct;12(10):584-93. doi: 10.1038/nrneurol.2016.133. Epub 2016 Sep 12.

DOI:10.1038/nrneurol.2016.133
PMID:27615419
Abstract

Angelman syndrome is a rare neurogenetic disorder that is characterized by microcephaly, severe intellectual deficit, speech impairment, epilepsy, EEG abnormalities, ataxic movements, tongue protrusion, paroxysms of laughter, abnormal sleep patterns, and hyperactivity. Angelman syndrome results from loss of function of the imprinted UBE3A (ubiquitin-protein ligase E3A) gene on chromosome 15q11.2-q13. This loss of function can be caused by a mutation on the maternal allele, a 5-7 Mb deletion of the maternally inherited chromosomal region, paternal uniparental disomy of chromosome 15, or an imprinting defect. The chromosomal deletion tends to cause the most severe symptoms, possibly owing to co-deletion of GABA receptor genes. UBE3A mutations and imprinting defects can be associated with a high risk of recurrence within families. Disruption of UBE3A function in neurons seems to inhibit synapse formation and experience-dependent synapse remodelling. Clinical diagnosis of Angelman syndrome in infants and young children is sometimes difficult, but can be verified by genetic tests. At present, treatment of symptoms such as seizures is the only medical strategy, but genetic therapies aimed at activating the silent copy of UBE3A on the paternal allele are conceivable.

摘要

安琪曼综合征是一种罕见的神经遗传疾病,其特征为小头畸形、严重智力缺陷、言语障碍、癫痫、脑电图异常、共济失调运动、伸舌、阵发性大笑、睡眠模式异常和多动。安琪曼综合征是由于 15 号染色体 q11.2-q13 上印迹的 UBE3A(泛素蛋白连接酶 E3A)基因功能丧失引起的。这种功能丧失可能是由母系等位基因突变、母源性染色体区域 5-7 Mb 缺失、15 号染色体父源单亲二倍体或印迹缺陷引起的。染色体缺失往往会导致最严重的症状,可能是由于 GABA 受体基因的共缺失。UBE3A 突变和印迹缺陷可能与家族内的高复发风险相关。神经元中 UBE3A 功能的破坏似乎抑制了突触的形成和经验依赖性的突触重塑。婴儿和幼儿安琪曼综合征的临床诊断有时较为困难,但可以通过基因检测来验证。目前,治疗癫痫等症状的唯一医疗策略是,但可以设想针对父源等位基因上沉默副本 UBE3A 的基因治疗。

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Angelman syndrome patient-derived neuron screen leads to clinical ASO rugonersen targeting UBE3A-ATS with long-lasting effect in monkeys.源自天使综合征患者的神经元筛选促成了针对UBE3A-ATS的临床反义寡核苷酸药物鲁戈纳森,该药物在猴子身上具有持久疗效。
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UBE3A reinstatement restores behaviorand proteome in an Angelman syndrome mouse model of imprinting defects.

本文引用的文献

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Pharmacological therapies for Angelman syndrome.天使综合征的药物治疗
Wien Med Wochenschr. 2017 Jun;167(9-10):205-218. doi: 10.1007/s10354-015-0408-z. Epub 2016 Jan 12.
2
Epigenetic regulation of UBE3A and roles in human neurodevelopmental disorders.泛素蛋白连接酶E3A的表观遗传调控及其在人类神经发育障碍中的作用。
Epigenomics. 2015 Oct;7(7):1213-28. doi: 10.2217/epi.15.70. Epub 2015 Nov 20.
3
Dissociation of locomotor and cerebellar deficits in a murine Angelman syndrome model.小鼠安吉尔曼综合征模型中运动和小脑缺陷的分离
UBE3A 恢复可在印记缺陷的天使综合征小鼠模型中恢复行为和蛋白质组。
Mol Autism. 2025 Aug 28;16(1):45. doi: 10.1186/s13229-025-00675-z.
4
Increased Extra-Axial Cerebrospinal Fluid Volume in Children with Angelman Syndrome: Links to Sleep Problems and Seizures.天使综合征患儿脑外脑脊液量增加:与睡眠问题和癫痫发作的关联
Ann Child Neurol Soc. 2025 Jul 30. doi: 10.1002/cns3.70024.
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Assessment of Dysphagia in Chinese Cohort of Angelman Syndrome: An Observational Study.中国天使综合征队列中吞咽困难的评估:一项观察性研究。
CNS Neurosci Ther. 2025 Aug;31(8):e70587. doi: 10.1111/cns.70587.
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Therapeutic strategies for fragile X syndrome and implications for other gene-silencing disorders.脆性X综合征的治疗策略及其对其他基因沉默障碍的启示。
Nat Genet. 2025 Jul 17. doi: 10.1038/s41588-025-02255-6.
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The UBE3A-ATS antisense oligonucleotide rugonersen in children with Angelman syndrome: a phase 1 trial.用于天使综合征患儿的UBE3A-ATS反义寡核苷酸鲁戈纳森:一项1期试验。
Nat Med. 2025 Jul 11. doi: 10.1038/s41591-025-03784-7.
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Impaired Proteostasis is Linked to Neurological Pathology in a Zebrafish NGLY1 Deficiency Model.蛋白质稳态受损与斑马鱼NGLY1缺乏模型中的神经病理学有关。
J Inherit Metab Dis. 2025 Jul;48(4):e70050. doi: 10.1002/jimd.70050.
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Chromatin modifiers in neurodevelopment.神经发育中的染色质修饰因子
Front Mol Neurosci. 2025 May 21;18:1551107. doi: 10.3389/fnmol.2025.1551107. eCollection 2025.
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Remote EEG acquisition in Angelman syndrome using PANDABox-EEG.使用PANDABox-EEG对天使综合征进行远程脑电图采集。
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Ube3a reinstatement identifies distinct developmental windows in a murine Angelman syndrome model.泛素蛋白连接酶E3A恢复在小鼠天使综合征模型中确定了不同的发育窗口。
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Science. 2015 Jan 23;347(6220):1260419. doi: 10.1126/science.1260419.
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