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国际工作组确定需要对黏多糖贮积症 I 型进行新生儿筛查,但表示必须克服现有障碍。

International working group identifies need for newborn screening for mucopolysaccharidosis type I but states that existing hurdles must be overcome.

机构信息

Rare Metabolic Diseases Unit, Paediatric Clinic, MBBM Foundation, San Gerardo University Hospital, Monza, Italy.

TIGET Institute, IRCCS San Raffaele Hospital, Milano, Italy.

出版信息

Acta Paediatr. 2018 Dec;107(12):2059-2065. doi: 10.1111/apa.14587. Epub 2018 Oct 23.

Abstract

AIM

Mucopolysaccharidosis type I is a lysosomal storage disorder that can result in significant disease burden, disability and premature death, if left untreated. The aim of this review was to elaborate on the diagnosis of mucopolysaccharidosis type I and the pros and cons of newborn screening.

METHODS

An international working group was established to discuss ways to improve the early diagnosis of mucopolysaccharidosis type I. It consisted of 13 experts in paediatrics, rare diseases and inherited metabolic diseases from Europe and the Middle East.

RESULTS

It is becoming increasingly clearer that the delay between symptom onset and clinical diagnosis is considerable for mucopolysaccharidosis type I and other rare lysosomal storage disorders, despite numerous awareness campaigns since therapies became available. Diagnosis currently depends on recognising the signs and symptoms of the disease. The practice of newborn screening, which is being explored by pilot programmes around the world, enables early diagnosis and consequently early treatment. However, these studies have highlighted numerous new problems and pitfalls that must be faced before newborn screening becomes generally available.

CONCLUSION

Newborn screening for mucopolysaccharidosis type I offers the potential for early diagnosis and early pre-symptomatic treatment, but existing hurdles need to be overcome.

摘要

目的

黏多糖贮积症 I 型是一种溶酶体贮积病,如果不进行治疗,可能会导致严重的疾病负担、残疾和过早死亡。本综述旨在详细阐述黏多糖贮积症 I 型的诊断以及新生儿筛查的优缺点。

方法

成立了一个国际工作组,讨论如何改善黏多糖贮积症 I 型的早期诊断。它由来自欧洲和中东的 13 名儿科、罕见病和遗传性代谢疾病方面的专家组成。

结果

尽管自治疗方法问世以来,已经开展了多次宣传活动,但黏多糖贮积症 I 型和其他罕见溶酶体贮积病从出现症状到临床诊断的时间延迟仍然相当大。目前的诊断依赖于识别疾病的体征和症状。全世界正在通过试点项目探索新生儿筛查,以便能够早期诊断并随后进行早期治疗。然而,这些研究突出了在新生儿筛查广泛应用之前必须面对的许多新问题和陷阱。

结论

黏多糖贮积症 I 型的新生儿筛查具有早期诊断和早期症状前治疗的潜力,但需要克服现有的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c34/6282980/726d3e992dec/APA-107-2059-g001.jpg

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