Cheon Chong Kun
Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Ann Pediatr Endocrinol Metab. 2016 Sep;21(3):126-135. doi: 10.6065/apem.2016.21.3.126. Epub 2016 Sep 30.
The Prader-Willi syndrome (PWS) is a human imprinting disorder resulting from genomic alterations that inactivate imprinted, paternally expressed genes in human chromosome region 15q11-q13. This genetic condition appears to be a contiguous gene syndrome caused by the loss of at least 2 of a number of genes expressed exclusively from the paternal allele, including , , , and several , but it is not yet well known which specific genes in this region are associated with this syndrome. Prader-Will-Like syndrome (PWLS) share features of the PWS phenotype and the gene functions disrupted in PWLS are likely to lie in genetic pathways that are important for the development of PWS phenotype. However, the genetic basis of these rare disorders differs and the absence of a correct diagnosis may worsen the prognosis of these individuals due to the endocrine-metabolic malfunctioning associated with the PWS. Therefore, clinicians face a challenge in determining when to request the specific molecular test used to identify patients with classical PWS because the signs and symptoms of PWS are common to other syndromes such as PWLS. This review aims to provide an overview of current knowledge relating to the genetics of PWS and PWLS, with an emphasis on identification of patients that may benefit from further investigation and genetic screening.
普拉德-威利综合征(PWS)是一种人类印记障碍,由基因组改变引起,这些改变使人类染色体区域15q11-q13中印记的父源表达基因失活。这种遗传状况似乎是一种连续性基因综合征,是由于多个仅从父本等位基因表达的基因中至少2个基因缺失所致,包括 、 、 、 以及几个 ,但该区域中哪些特定基因与该综合征相关尚不清楚。普拉德-威利样综合征(PWLS)具有PWS表型的特征,且PWLS中功能受损的基因可能存在于对PWS表型发育至关重要的遗传途径中。然而,这些罕见疾病的遗传基础不同,由于与PWS相关的内分泌代谢功能障碍,缺乏正确诊断可能会使这些个体的预后恶化。因此,临床医生在确定何时要求进行用于识别经典PWS患者的特定分子检测时面临挑战,因为PWS的体征和症状与其他综合征如PWLS相同。本综述旨在概述与PWS和PWLS遗传学相关的当前知识,重点是识别可能受益于进一步调查和基因筛查的患者。