Laforêt Pascal, Malfatti Edoardo, Vissing John
aNord-Est-Ile de France Neuromuscular Reference Center, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris bMyology Institute, Neuromuscular Pathology Reference Center, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Sorbonne Universités UPMC Univ Paris 06, Paris, France cCopenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Curr Opin Neurol. 2017 Oct;30(5):449-456. doi: 10.1097/WCO.0000000000000484.
The field of muscle glycogenoses has progressed in recent years by the identification of new disorders, and by reaching a better understanding of pathophysiology of the disorders and the physiology of glycogen metabolism.
In this review, we describe the clinical and pathological features of the three most recently described muscle glycogenoses caused by recessive mutations in GYG1, RBCK1 and PGM1. The three involved enzymes play different roles in glycogen metabolism. Glycogenin-1 (GYG1) is involved in the initial steps of glycogen synthesis, whereas phosphoglucomutase catalyzes two metabolic pathways; the connection between galactose and glycogen on one side, and glucose metabolism on the other side. The metabolic consequences of mutations in the ubiquitin ligase gene RBCK1 are still poorly understood. GYG1 deficiency has been associated with cardiomyopathies with abnormal storage material in the heart, but most cases present with a polyglucosan body myopathy without cardiac involvement.
The recent identification of new glycogenosis not only allows to improve the knowledge of glycogen metabolism, but also builds bridges with protein glycosylation and immune system.
近年来,肌肉糖原贮积症领域取得了进展,发现了新的疾病,并且对这些疾病的病理生理学以及糖原代谢的生理学有了更好的理解。
在本综述中,我们描述了由GYG1、RBCK1和PGM1隐性突变引起的三种最新描述的肌肉糖原贮积症的临床和病理特征。这三种相关酶在糖原代谢中发挥不同作用。糖原合酶-1(GYG1)参与糖原合成的起始步骤,而磷酸葡萄糖变位酶催化两条代谢途径;一方面是半乳糖与糖原之间的联系,另一方面是葡萄糖代谢。泛素连接酶基因RBCK1突变的代谢后果仍知之甚少。GYG1缺乏与心脏中存在异常储存物质的心肌病有关,但大多数病例表现为无心脏受累的多葡聚糖体肌病。
最近新糖原贮积症的发现不仅有助于增进对糖原代谢的了解,还在蛋白质糖基化和免疫系统之间架起了桥梁。