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