Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
DNA Diagnostic Laboratory, Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, United States.
Mol Genet Metab. 2017 Nov;122(3):130-133. doi: 10.1016/j.ymgme.2017.08.012. Epub 2017 Sep 1.
X-linked adrenoleukodystrophy (X-ALD) is a genetic disorder leading to the accumulation of very long chain fatty acids (VLCFA) due to a mutation in the ABCD1 gene. ABCD1 mutations lead to a variety of phenotypes, including cerebral X-ALD and adrenomyeloneuropathy (AMN) in affected males and 80% of carrier females. There is no definite genotype-phenotype correlation with intrafamilial variability. Cerebral X-ALD typically presents in childhood, but can also present in juveniles and adults. The most affected tissues are the white matter of the brain and adrenal cortex. MRI demonstrates a characteristic imaging appearance in cerebral X-ALD that is used as a diagnostic tool.
We aim to correlate a mutation in the ABCD1 gene in a chimpanzee to the human disease X-ALD based on MRI features, neurologic symptoms, and plasma levels of VLCFA.
Diagnosis of X-ALD made using MRI, blood lipid profiling, and DNA sequencing.
An 11-year-old chimpanzee showed remarkably similar features to juvenile onset cerebral X-ALD in humans including demyelination of frontal lobes and corpus callosum on MRI, elevated plasma levels of C24:0 and C26:0, and identification of the c.1661G>A ABCD1 variant.
This case study presents the first reported case of a leukodystrophy in a great ape, and underscores the fidelity of MRI pattern recognition in this disorder across species.
X 连锁肾上腺脑白质营养不良(X-ALD)是一种遗传性疾病,由于 ABCD1 基因突变导致极长链脂肪酸(VLCFA)积累。ABCD1 突变导致多种表型,包括受影响男性的脑性 X-ALD 和肾上腺脑白质营养不良(AMN),以及 80%的携带者女性。家族内存在明显的基因型-表型变异性,无明确相关性。脑性 X-ALD 通常在儿童期发病,但也可在青少年和成人期发病。受影响最严重的组织是大脑白质和肾上腺皮质。MRI 显示脑性 X-ALD 的特征性影像学表现,可用作诊断工具。
我们旨在根据 MRI 特征、神经症状和 VLCFA 血浆水平,将黑猩猩 ABCD1 基因突变与人类疾病 X-ALD 相关联。
通过 MRI、血脂谱分析和 DNA 测序诊断 X-ALD。
一只 11 岁的黑猩猩表现出与人类青少年起病脑性 X-ALD 非常相似的特征,包括 MRI 上额叶和胼胝体脱髓鞘、血浆 C24:0 和 C26:0 水平升高,以及 c.1661G>A ABCD1 变异的鉴定。
本病例研究首次报道了大型猿类中的白质营养不良病例,并强调了 MRI 模式识别在该疾病中的跨物种准确性。