Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Adv Exp Med Biol. 2020;1276:171-188. doi: 10.1007/978-981-15-6082-8_11.
Rare diseases are gathering increasing attention in last few years, not only for its effects on innovation scientific research, but also for its propounding influence on common diseases. One of the most famous milestones made by Michael Brown and Joseph Goldstein in metabolism field is the discovery of the defective gene in familial hypercholesterolemia, a rare human genetic disease manifested with extreme high level of serum cholesterol (Goldstein JL, Brown MS, Proc Natl Acad Sci USA 70:2804-2808, 1973; Brown MS, Dana SE, Goldstein JL, J Biol Chem 249:789-796, 1974). Follow-up work including decoding the gene function, mapping-related pathways, and screening therapeutic targets are all based on the primary finding (Goldstein JL, Brown MS Arterioscler Thromb Vasc Biol 29:431-438, 2009). A series of succession win the two brilliant scientists the 1985 Nobel Prize, and bring about statins widely used for lipid management and decreasing cardiovascular disease risks. Translating the clinical extreme phenotypes into laboratory bench work has turned out to be the first important step in the paradigm conducting translational and precise medical research. Here we review the main categories of rare disorders related with lipoprotein metabolism, aiming to strengthen the notion that human rare inheritable genetic diseases would be the window to know ourselves better, to treat someone more efficiently, and to lead a healthy life longer. Few rare diseases related with lipoprotein metabolism were clustered into six sections based on changes in lipid profile, namely, hyper- or hypocholesterolemia, hypo- or hyperalphalipoproteinemia, abetalipoproteinemia, hypobetalipoproteinemia, and sphingolipid metabolism diseases. Each section consists of a brief introduction, followed by a summary of well-known disease-causing genes in one table, and supplemented with one or two diseases as example for detailed description. Here we aimed to raise more attention on rare lipoprotein metabolism diseases, calling for more work from basic research and clinical trials.
近年来,罕见病受到了越来越多的关注,不仅因为其对创新科学研究的影响,还因为其对常见疾病的启示作用。迈克尔·布朗和约瑟夫·戈德斯坦在代谢领域最著名的里程碑之一是发现家族性高胆固醇血症的缺陷基因,这是一种罕见的人类遗传性疾病,表现为血清胆固醇水平极高(戈尔茨坦,J.L.,布朗,M.S.,美国国家科学院院刊 70:2804-2808,1973 年;布朗,M.S.,达纳,S.E.,戈尔茨坦,J.L.,生物化学杂志 249:789-796,1974 年)。后续工作包括解码基因功能、相关途径的定位和治疗靶点的筛选都是基于这一初步发现(戈尔茨坦,J.L.,布朗,M.S.,动脉粥样硬化血栓形成与血管生物学 29:431-438,2009 年)。一系列的成功使这两位杰出的科学家获得了 1985 年诺贝尔生理学或医学奖,并使他汀类药物广泛用于血脂管理和降低心血管疾病风险。将临床极端表型转化为实验室工作台工作已成为开展转化和精准医学研究的重要第一步。在这里,我们回顾了与脂蛋白代谢相关的主要罕见疾病类别,旨在加强这样一种观念,即人类罕见的遗传性疾病将是更好地了解自身、更有效地治疗他人和更长寿的健康生活的窗口。根据血脂谱的变化,我们将与脂蛋白代谢相关的少数几种罕见疾病分为六类,即高胆固醇血症或低胆固醇血症、低或高载脂蛋白血症、无载脂蛋白血症、低载脂蛋白血症和鞘脂代谢疾病。每一节都包括一个简介,后面是一个表格,总结了一个已知的致病基因,再加上一两个疾病作为详细描述的例子。我们的目的是引起对罕见脂蛋白代谢疾病的更多关注,并呼吁从基础研究和临床试验中开展更多的工作。