Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
Nat Rev Dis Primers. 2020 Jul 30;6(1):64. doi: 10.1038/s41572-020-0194-9.
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of hereditary disorders of connective tissue, with common features including joint hypermobility, soft and hyperextensible skin, abnormal wound healing and easy bruising. Fourteen different types of EDS are recognized, of which the molecular cause is known for 13 types. These types are caused by variants in 20 different genes, the majority of which encode the fibrillar collagen types I, III and V, modifying or processing enzymes for those proteins, and enzymes that can modify glycosaminoglycan chains of proteoglycans. For the hypermobile type of EDS, the molecular underpinnings remain unknown. As connective tissue is ubiquitously distributed throughout the body, manifestations of the different types of EDS are present, to varying degrees, in virtually every organ system. This can make these disorders particularly challenging to diagnose and manage. Management consists of a care team responsible for surveillance of major and organ-specific complications (for example, arterial aneurysm and dissection), integrated physical medicine and rehabilitation. No specific medical or genetic therapies are available for any type of EDS.
埃勒斯-当洛斯综合征(EDS)是一组异质性遗传性结缔组织疾病,其共同特征包括关节过度活动、皮肤柔软且可过度伸展、伤口愈合异常和容易瘀伤。目前已识别出 14 种不同类型的 EDS,其中 13 种的分子病因已明确。这些类型是由 20 个不同基因的变异引起的,其中大多数编码纤维状胶原蛋白 I、III 和 V、这些蛋白质的修饰或加工酶,以及可以修饰蛋白聚糖聚糖链的酶。对于高活动型 EDS,其分子基础仍不清楚。由于结缔组织在全身广泛分布,不同类型的 EDS 的表现,在不同程度上,存在于几乎每个器官系统。这使得这些疾病的诊断和管理特别具有挑战性。管理包括一个负责监测主要和器官特异性并发症的护理团队(例如,动脉夹层和动脉瘤),综合物理医学和康复。目前还没有针对任何类型 EDS 的特定的医学或遗传治疗方法。