Wieczorek Dagmar
Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Universitätsstr. 1, 40225 Düsseldorf, Germany.
Med Genet. 2018;30(3):318-322. doi: 10.1007/s11825-018-0206-2. Epub 2018 Oct 11.
Intellectual disability (ID) is a heterogeneous entity defined as a substantial impairment of cognitive and adaptive function with an onset in early childhood and an IQ measure of less than 70. During the last few years, the next generation technologies, namely whole exome (WES) and whole genome sequencing (WGS), have given rise to the identification of many new genes for autosomal dominant (ADID), autosomal recessive (ARID) and X‑linked forms of ID (XLID). The prevalence of ID is 1.5-2% for milder forms (IQ < 70) and 0.3-0.5% for more severe forms of ID (IQ < 50). Up to now, about 650 genes for ADID have been reported and it is expected that there are at least 350 genes still unidentified. Although the ADID genes can easily be classified according to the associated clinical findings, e. g. different kind of seizures, abnormal body measurements, an advanced selection of reasonable genes for analyses is challenging. Many different panels for ID genes have been developed for a first diagnostic step, but more meaningful is the use of trio exome sequencing in individuals with sporadic ID. Using trio WES the mutation detection rate for mutations in ID varies from 20 to 60%. Further research is needed for the identification of the remaining ID genes, a deeply understanding of the pathways and the development of therapies for the mostly rare causes of ID.
智力残疾(ID)是一种异质性疾病,定义为认知和适应功能严重受损,起病于儿童早期,智商测量值低于70。在过去几年中,新一代技术,即全外显子组测序(WES)和全基因组测序(WGS),已促使人们鉴定出许多与常染色体显性遗传(ADID)、常染色体隐性遗传(ARID)和X连锁型智力残疾(XLID)相关的新基因。轻度智力残疾(智商<70)的患病率为1.5%-2%,重度智力残疾(智商<50)的患病率为0.3%-0.5%。到目前为止,已报道了约650个与常染色体显性遗传智力残疾相关的基因,预计至少还有350个基因尚未被鉴定。尽管常染色体显性遗传智力残疾相关基因可根据相关临床发现轻松分类,例如不同类型的癫痫发作、身体测量异常,但要预先筛选出合理的基因进行分析仍具有挑战性。已开发出许多不同的智力残疾相关基因检测板用于初步诊断,但对于散发性智力残疾个体,采用三联体外显子组测序更具意义。使用三联体全外显子组测序,智力残疾相关突变的检测率在20%至60%之间。还需要进一步研究来鉴定其余的智力残疾相关基因,深入了解其发病机制,并开发针对大多数罕见智力残疾病因的治疗方法。