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囊性纤维化的当前及未来诊断:性能与局限性

Current and future diagnosis of cystic fibrosis: Performance and limitations.

作者信息

Bienvenu T, Nguyen-Khoa T

机构信息

Laboratoire de Génétique et Biologie Moléculaires, Hôpital Cochin, APHP. Centre Université de Paris, Paris.

Laboratoires de Biochimie Générale & du Centre Régional du Dépistage Néonatal Ile-de-France, Hôpital Necker-Enfants Malades, APHP. Centre Université de Paris, Paris; Centre de Ressources et de Compétences de la Mucoviscidose, Hôpital Necker-Enfants Malades, AP-HP. Centre Université de Paris, Paris; Institut Necker Enfants Malades/INSERM U1151, Mucoviscidose et autres maladies épithéliales respiratoires par défaut de repliement protéique, Université Paris Descartes, Paris.

出版信息

Arch Pediatr. 2020 Feb;27 Suppl 1:eS19-eS24. doi: 10.1016/S0929-693X(20)30046-4.

Abstract

Cystic fibrosis (CF) is the most frequent genetic disorder in the Caucasian population benefiting from systematic newborn screening tests. It is also the most frequent indication of prenatal and preimplantation genetic diagnosis for a single gene disorder. During the past thirty years, thanks in part to the evolution of diagnostic techniques, our knowledge on CFTR genetics and pathophysiological mechanisms involved in CF have significantly improved. With the implementation of newborn screening in France and in several countries, the diagnosis now often occurs in clinically asymptomatic infants and this has modified the criteria for CF diagnosis. Recently, guidelines for CF diagnosis have been reformulated in Europe and the US, in regard to sweat chloride usual values and disease terminology. This review describes the methods and molecular approaches that are used in routine practice or are being developed to detect CFTR protein dysfunction and to identify disease-causing CFTR variants. Ultimately, an optimal use of all these functional and genetic resources may improve patient care and therapeutic decision-making. © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

摘要

囊性纤维化(CF)是白种人群中最常见的遗传性疾病,得益于系统性新生儿筛查测试。它也是单基因疾病产前和植入前基因诊断最常见的指征。在过去三十年里,部分得益于诊断技术的发展,我们对CFTR遗传学以及CF所涉及的病理生理机制的认识有了显著提高。随着法国和其他几个国家实施新生儿筛查,现在诊断往往发生在临床无症状的婴儿身上,这改变了CF的诊断标准。最近,欧洲和美国针对汗液氯化物正常值和疾病术语重新制定了CF诊断指南。本综述描述了在常规实践中使用或正在开发的用于检测CFTR蛋白功能障碍和识别致病CFTR变异体的方法和分子途径。最终,对所有这些功能和遗传资源的最佳利用可能会改善患者护理和治疗决策。© 2020法国儿科学会。由爱思唯尔马松出版社出版。保留所有权利。

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