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肌萎缩侧索硬化症诊断中常见的突变:ALS 基因中的常见突变有多常见?

Common mutations of interest in the diagnosis of amyotrophic lateral sclerosis: how common are common mutations in ALS genes?

机构信息

Department of Pharmacy, Health and Nutritional Sciences, University of Calabria , Arcavacata di Rende (Cosenza), Italy.

出版信息

Expert Rev Mol Diagn. 2020 Jul;20(7):703-714. doi: 10.1080/14737159.2020.1779060. Epub 2020 Jun 16.

Abstract

INTRODUCTION

Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease predominantly affecting upper and lower motor neurons. Diagnosis of this devastating pathology is very difficult because the high degree of clinical heterogeneity with which it occurs and until now, no truly effective treatment exists.

AREAS COVERED

Molecular diagnosis may be a valuable tool for dissecting out ALS complex heterogeneity and for identifying new molecular mechanisms underlying the characteristic selective degeneration and death of motor neurons. To date, pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases and can be associated with risks for ALS only or risks for other neurodegenerative diseases. This paper shows the procedure currently used in diagnostic laboratories to investigate most frequent mutations in ALS and evaluating the utility of involved molecular techniques as potential tools to discriminate 'common mutations' in ALS patients.

EXPERT OPINION

Genetic testing may allow for establishing an accurate pathological diagnosis and a more precise stratification of patient groups in future drug trials.

摘要

简介

肌萎缩侧索硬化症(ALS)是一种主要影响上下运动神经元的复杂神经退行性疾病。由于其极高的临床异质性,以及迄今为止尚无真正有效的治疗方法,这种破坏性病理的诊断非常困难。

涵盖领域

分子诊断可能是剖析 ALS 复杂异质性和识别运动神经元特征性选择性退化和死亡背后新的分子机制的有价值工具。迄今为止,已知 ALS 基因中的致病性变异在高达 70%的家族性和 10%的明显散发性 ALS 病例中存在,并且仅与 ALS 风险或其他神经退行性疾病风险相关。本文展示了目前在诊断实验室中用于研究 ALS 中最常见突变的程序,并评估了相关分子技术作为区分 ALS 患者“常见突变”的潜在工具的效用。

专家意见

遗传测试可以在未来的药物试验中为建立准确的病理诊断和更精确的患者分组提供帮助。

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