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临床中的基因诊断:从囊性纤维化到CFTR相关疾病

Genetic diagnosis in practice: From cystic fibrosis to CFTR-related disorders.

作者信息

Pagin A, Sermet-Gaudelus I, Burgel P-R

机构信息

Service de Toxicologie et Génopathies, Institut de Biochimie et Biologie Moléculaire, Centre Hospitalier Régional Universitaire, Lille, France.

National Reference Center for Cystic Fibrosis, Hôpital Necker, Service de Pneumologie, AP-HP, Paris, France; ERN-Lung CF network; Université de Paris, INSERM U 1016, Institut Cochin, Paris, France.

出版信息

Arch Pediatr. 2020 Feb;27 Suppl 1:eS25-eS29. doi: 10.1016/S0929-693X(20)30047-6.

Abstract

Cystic fibrosis (CF) is a channelopathy caused by mutations in the gene encoding the CF transmembrane conductance regulator (CFTR) protein. Diagnosis of CF has long relied on a combination of clinical (including gastrointestinal and/or respiratory) symptoms and elevated sweat chloride concentration. After cloning of the CFTR gene in 1989, genetic analysis progressively became an important aspect of diagnosis. Although combination of sweat test and genetic analysis have simplified the diagnosis of CF in most cases, difficult situations remain, especially in cases that do not fulfill all diagnostic criteria. Such situations are most frequently encountered in patients presenting with a single-organ disease (e.g., congenital absence of the vas deferens, pancreatitis, bronchiectasis) leading to a diagnosis of CFTR-related disorder, or when the presence/ absence of CF is not resolved after newborn screening. This article reviews the diagnostic criteria of CF, with special emphasis on genetic testing. © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

摘要

囊性纤维化(CF)是一种通道病,由编码CF跨膜电导调节因子(CFTR)蛋白的基因突变引起。CF的诊断长期以来依赖于临床症状(包括胃肠道和/或呼吸道症状)和汗液氯化物浓度升高的综合判断。1989年CFTR基因克隆成功后,基因分析逐渐成为诊断的一个重要方面。虽然汗液检测和基因分析相结合在大多数情况下简化了CF的诊断,但仍存在困难情况,尤其是在不符合所有诊断标准的病例中。这种情况最常出现在表现为单器官疾病(如先天性输精管缺如、胰腺炎、支气管扩张)的患者中,导致CFTR相关疾病的诊断,或者在新生儿筛查后CF的存在与否仍未明确时。本文回顾了CF的诊断标准,特别强调基因检测。©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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