Raginis-Zborowska Alicja, Pendleton Neil, Hamdy Shaheen
Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK.
Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, UK.
Curr Phys Med Rehabil Rep. 2016;4(4):249-256. doi: 10.1007/s40141-016-0133-6. Epub 2016 Aug 8.
Here we review the latest literature and evidence in the field of genetics and determinants of swallowing and its treatments-specifically, this is a very recent concept in the field of oropharyngeal dysphagia, with only now an emerging research interest in the relationship between our genetic makeup and the effect this has on swallowing function and dysfunction. As such our review will look at preclinical, clinical and hypothesis generating research covering all aspects of the genetics of swallowing, giving new importance to the genotype-phenotype influences pertaining to dysphagia and its recovery.
There appear to be a number of candidate gene systems that interact with swallowing or its neurophysiology, which include brain-derived neurotrophic factor, apolipoprotein E and catechol--methyltransferase, that have been shown to impact on either swallowing function or the brain's ability to respond to neurostimulation and induce plasticity. In addition, a number of genetic disorders, where dysphagia is a clinical phenomenon, have given us clues as to how multiple genes or the polygenetics of dysphagia might interact with our swallowing phenotype.
There is currently limited research in the field of genetic factors that influence (human) swallowing and oropharyngeal dysphagia, but this is an emerging science and one which, in the future, may herald a new era in precision medicine and better targeting of therapies for dysphagia based on an individual's genetic makeup.
在此,我们回顾吞咽遗传学及其治疗领域的最新文献和证据——具体而言,这是口咽吞咽困难领域中一个非常新的概念,目前才刚刚出现对我们的基因构成与这对吞咽功能及功能障碍的影响之间关系的研究兴趣。因此,我们的综述将审视涵盖吞咽遗传学各个方面的临床前、临床及提出假设的研究,赋予与吞咽困难及其恢复相关的基因型 - 表型影响新的重要性。
似乎有许多候选基因系统与吞咽或其神经生理学相互作用,其中包括脑源性神经营养因子、载脂蛋白E和儿茶酚 - 甲基转移酶,这些已被证明会影响吞咽功能或大脑对神经刺激作出反应并诱导可塑性的能力。此外,一些吞咽困难作为临床现象的遗传疾病,为我们提供了关于多个基因或吞咽困难的多基因如何与我们的吞咽表型相互作用的线索。
目前在影响(人类)吞咽和口咽吞咽困难的遗传因素领域的研究有限,但这是一门新兴科学,未来可能预示着精准医学的新时代,并基于个体的基因构成更好地靶向治疗吞咽困难。