Bruikman Caroline S, Hovingh Gerard K, Kastelein John J P
Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Curr Opin Cardiol. 2017 May;32(3):262-266. doi: 10.1097/HCO.0000000000000385.
To provide an overview about the molecular basis of familial hypercholesterolemia.
Familial hypercholesterolemia is a common hereditary cause of premature coronary heart disease. It has been estimated that 1 in every 250 individuals has heterozygous familial hypercholesterolemia and that fewer than 1% of patients with familial hypercholesterolemia have been identified across the globe. If heterozygous familial hypercholesterolemia is left untreated, it is likely that coronary heart disease will manifest clinically prior to the age of 55 years and that half of all patients will prematurely die from the consequences of myocardial infarction. It is crucial to understand the molecular basis of familial hypercholesterolemia to diagnose familial hypercholesterolemia properly.
The phenotype of familial hypercholesterolemia is caused by more than 1700 mutations the LDLR, apoB and PCSK9 genes, which explains approximately 85% of familial hypercholesterolemia cases. By means of next-generation sequencing, an increasing number of mutations in established and putative novel genes associated with this phenotype have been identified.
概述家族性高胆固醇血症的分子基础。
家族性高胆固醇血症是早发性冠心病的常见遗传病因。据估计,每250人中就有1人患有杂合子家族性高胆固醇血症,而全球范围内已确诊的家族性高胆固醇血症患者不到1%。如果杂合子家族性高胆固醇血症不接受治疗,冠心病很可能在55岁之前出现临床症状,并且所有患者中有一半会因心肌梗死的后果而过早死亡。正确诊断家族性高胆固醇血症,了解其分子基础至关重要。
家族性高胆固醇血症的表型由低密度脂蛋白受体(LDLR)、载脂蛋白B(apoB)和前蛋白转化酶枯草溶菌素9(PCSK9)基因的1700多个突变引起,这解释了约85%的家族性高胆固醇血症病例。通过下一代测序,已在与该表型相关的既定和假定新基因中鉴定出越来越多的突变。