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[埃勒斯-当洛综合征]

[Ehlers-Danlos syndromes].

作者信息

Germain D-P

机构信息

Service de génétique médicale, UFR des sciences de la santé Simon-Veil, université de Versailles-Saint-Quentin-en-Yvelines, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny, France.

出版信息

Ann Dermatol Venereol. 2017 Dec;144(12):744-758. doi: 10.1016/j.annder.2017.06.017. Epub 2017 Oct 9.

Abstract

Ehlers-Danlos syndromes (EDS) are a heterogeneous group of inheritable connective tissue disorders characterized by skin hyperextensibility, joint hypermobility and cutaneous fragility with delayed wound healing. Over and above these common features, they differ in the presence or absence of various organ and tissue abnormalities, and differences in genetic causal mechanisms and degree of severity. They are complex and multisystem diseases, with the majority being highly disabling because of major joint problems and neurosensory deficiencies, and in some cases, they may be life-threatening due to associated complications, especially vascular disorders. In 1997, the Villefranche classification defined 6 subtypes of EDS. However, many other new variants have been described over the last years. The "historical" EDS were characterized by abnormalities in fibrillar collagen protein synthesis. More recently, disorders of synthesis and organization of the extracellular matrix have been shown to be responsible for other types of EDS. Thus, many EDS are in fact metabolic diseases related to enzymatic defects. While there is no curative treatment for any type of EDS, early diagnosis is of utmost importance in order to optimize the symptomatic management of patients and to prevent avoidable complications. Patients must be treated and monitored by multidisciplinary teams in highly specialized reference centers. In this article, we present the current state of knowledge on these diseases that continue to be elucidated thanks to new molecular genetic techniques.

摘要

埃勒斯-当洛综合征(EDS)是一组遗传性结缔组织疾病的统称,其特征为皮肤过度伸展、关节活动过度以及皮肤脆弱且伤口愈合延迟。除了这些常见特征外,它们在是否存在各种器官和组织异常、遗传致病机制以及严重程度方面存在差异。它们是复杂的多系统疾病,大多数因严重的关节问题和神经感觉缺陷而导致严重残疾,在某些情况下,由于相关并发症,尤其是血管疾病,可能会危及生命。1997年,维勒弗朗什分类法定义了6种EDS亚型。然而,在过去几年中又描述了许多其他新的变体。“传统”的EDS以纤维状胶原蛋白合成异常为特征。最近发现,细胞外基质的合成和组织紊乱是导致其他类型EDS的原因。因此,许多EDS实际上是与酶缺陷相关的代谢性疾病。虽然目前尚无针对任何类型EDS的治愈性治疗方法,但早期诊断对于优化患者的症状管理和预防可避免的并发症至关重要。患者必须在高度专业化的参考中心由多学科团队进行治疗和监测。在本文中,我们介绍了借助新的分子遗传学技术不断得到阐明的这些疾病的当前知识状况。

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