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眼咽型肌营养不良症的最新进展

Recent Progress in Oculopharyngeal Muscular Dystrophy.

作者信息

Yamashita Satoshi

机构信息

Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.

出版信息

J Clin Med. 2021 Mar 29;10(7):1375. doi: 10.3390/jcm10071375.

Abstract

Oculopharyngeal muscular dystrophy (OPMD) is a late-onset intractable myopathy, characterized by slowly progressive ptosis, dysphagia, and proximal limb weakness. It is caused by the abnormal expansion of the alanine-encoding (GCN)n trinucleotide repeat in the exon 1 of the gene (11-18 repeats in OPMD instead of the normal 10 repeats). As the disease progresses, the patients gradually develop a feeling of suffocation, regurgitation of food, and aspiration pneumonia, although the initial symptoms and the progression patterns vary among the patients. Autologous myoblast transplantation may provide therapeutic benefits by reducing swallowing problems in these patients. Therefore, it is important to assemble information on such patients for the introduction of effective treatments in nonendemic areas. Herein, we present a concise review of recent progress in clinical and pathological studies of OPMD and introduce an idea for setting up a nation-wide OPMD disease registry in Japan. Since it is important to understand patients' unmet medical needs, realize therapeutically targetable symptoms, and identify indices of therapeutic efficacy, our attempt to establish a unique patient registry of OPMD will be a helpful tool to address these urgent issues.

摘要

眼咽型肌营养不良症(OPMD)是一种迟发性难治性肌病,其特征为缓慢进展的上睑下垂、吞咽困难和近端肢体无力。它是由基因外显子1中编码丙氨酸的(GCN)n三核苷酸重复序列异常扩增所致(OPMD中有11 - 18个重复序列,而非正常的10个重复序列)。随着疾病进展,患者会逐渐出现窒息感、食物反流和吸入性肺炎,尽管患者的初始症状和进展模式各不相同。自体成肌细胞移植可能通过减轻这些患者的吞咽问题而带来治疗益处。因此,收集此类患者的信息对于在非流行地区引入有效治疗方法至关重要。在此,我们简要回顾了OPMD临床和病理研究的最新进展,并介绍了在日本建立全国性OPMD疾病登记处的想法。由于了解患者未满足的医疗需求、认识可治疗的症状以及确定治疗效果指标非常重要,我们建立独特的OPMD患者登记处的尝试将成为解决这些紧迫问题的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7252/8036457/8e4aa8883a99/jcm-10-01375-g001.jpg

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