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X 连锁细丝蛋白病:临床与分子分析的协同见解。

The X-linked filaminopathies: Synergistic insights from clinical and molecular analysis.

机构信息

Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

出版信息

Hum Mutat. 2020 May;41(5):865-883. doi: 10.1002/humu.24002. Epub 2020 Mar 11.

Abstract

The X-linked filaminopathies represent a diverse group of clinical conditions, all caused by variants in the gene FLNA. FLNA encodes the widely expressed actin binding protein, filamin A that has multiple roles during embryonic development including cell migration, mechanical sensing, and cell signaling. In this review, we discuss the 10 distinct X-linked filaminopathy conditions that between them affect almost all organ systems, including the brain, skeleton, heart, and skin, highlighting the critical role of this protein in human development. We review each of the phenotypes and discuss their pathogenesis, where known. Assigning pathogenicity to variants in FLNA can prove difficult, especially for missense variants and small indels, in-part because of the X-linked nature of the phenotypes, the overlap of phenotypic features between conditions, and poor understanding of the function of certain protein domains. We outline here approaches to characterize phenotypes, highlight hotspot regions within FLNA commonly mutated in these conditions, and approaches to resolving some variants of uncertain significance.

摘要

X 连锁细丝蛋白病是一组表现多样的临床病症,均由 FLNA 基因变异引起。FLNA 编码广泛表达的肌动蛋白结合蛋白——细丝蛋白 A,在胚胎发育过程中具有多种作用,包括细胞迁移、机械感知和细胞信号转导。在这篇综述中,我们讨论了 10 种不同的 X 连锁细丝蛋白病,它们几乎影响所有器官系统,包括大脑、骨骼、心脏和皮肤,突出了该蛋白在人类发育中的关键作用。我们回顾了每种表型,并讨论了已知的发病机制。将 FLNA 中的变异归类为致病性可能很困难,尤其是错义变异和小的插入缺失,部分原因是表型的 X 连锁性质、病症之间表型特征的重叠以及对某些蛋白结构域功能的理解不足。我们在这里概述了表征表型的方法,强调了这些病症中常见突变的 FLNA 热点区域,以及解决某些意义不明变异的方法。

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