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亨廷顿舞蹈症:走向成熟

Huntington's disease: the coming of age.

作者信息

Pandey Mritunjay, Rajamma Usha

机构信息

Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

J Genet. 2018 Jul;97(3):649-664.

Abstract

Huntington's disease (HD) is caused due to an abnormal expansion of polyglutamine repeats in the first exon of huntingtin gene. The mutation in huntingtin causes abnormalities in the functioning of protein, leading to deleterious effects ultimately to the demise of specific neuronal cells.The disease is inherited in an autosomal dominant manner and leads to a plethora of neuropsychiatric behaviour and neuronal cell death mainly in striatal and cortical regions of the brain, eventually leading to death of the individual. The discovery of the mutant gene led to a surge in molecular diagnostics of the disease and in making different transgenic models in different organisms to understand the function of wild-type and mutant proteins. Despite difficult challenges, there has been a significant increase in understanding the functioning of the protein in normal and other gain-of-function interactions in mutant form. However, there have been no significant improvements in treatments of the patients suffering from this ailment and most of the treatment is still symptomatic. HD warrants more attention towards better understanding and treatment as more advancement in molecular diagnostics and therapeutic interventions are available. Several different transgenic models are available in different organisms, ranging from fruit flies to primate monkeys, for studies on understanding the pathogenicity of the mutant gene. It is the right time to assess the advancement in the field and try new strategies for neuroprotection using key pathways as target. The present review highlights the key ingredients of pathology in the HD and discusses important studies for drug trials and future goals for therapeutic interventions.

摘要

亨廷顿舞蹈症(HD)是由于亨廷顿基因第一外显子中的聚谷氨酰胺重复序列异常扩增所致。亨廷顿蛋白的突变导致蛋白质功能异常,最终对特定神经元细胞产生有害影响并导致其死亡。该疾病以常染色体显性方式遗传,主要导致大脑纹状体和皮质区域出现大量神经精神行为和神经元细胞死亡,最终导致个体死亡。突变基因的发现推动了该疾病分子诊断的发展,并促使人们在不同生物体中制作不同的转基因模型,以了解野生型和突变型蛋白质的功能。尽管面临重重困难,但在理解该蛋白质在正常情况下的功能以及突变形式下其他功能获得性相互作用方面仍取得了显著进展。然而,对于患有这种疾病的患者的治疗并没有显著改善,大多数治疗仍只是对症治疗。随着分子诊断和治疗干预方面取得更多进展,HD需要更多关注以实现更好的理解和治疗。从果蝇到灵长类猴子等不同生物体中都有几种不同的转基因模型,可用于研究突变基因的致病性。现在是评估该领域进展并尝试以关键途径为靶点进行神经保护新策略的时候了。本综述重点介绍了HD病理学的关键要素,并讨论了药物试验的重要研究以及治疗干预的未来目标。

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