Menozzi Elisa, Schapira Anthony H V
Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
Front Neurol. 2021 Jun 24;12:694764. doi: 10.3389/fneur.2021.694764. eCollection 2021.
Variants in the glucocerebrosidase () gene are the most common genetic risk factor for Parkinson disease (PD). These include pathogenic variants causing Gaucher disease (GD) (divided into "severe," "mild," or "complex"-resulting from recombinant alleles-based on the phenotypic effects in GD) and "risk" variants, which are not associated with GD but nevertheless confer increased risk of PD. As a group, -PD patients have more severe motor and nonmotor symptoms, faster disease progression, and reduced survival compared with noncarriers. However, different variants impact variably on clinical phenotype. In the heterozygous state, "complex" and "severe" variants are associated with a more aggressive and rapidly progressive disease. Conversely, "mild" and "risk" variants portend a more benign course. Homozygous or compound heterozygous carriers usually display severe phenotypes, akin to heterozygous "complex" or "severe" variants carriers. This article reviews genotype-phenotype correlations in -PD, focusing on clinical and nonclinical aspects (neuroimaging and biochemical markers), and explores other disease modifiers that deserve consideration in the characterization of these patients.
葡萄糖脑苷脂酶()基因变异是帕金森病(PD)最常见的遗传风险因素。这些变异包括导致戈谢病(GD)的致病变异(根据GD中的表型效应,基于重组等位基因分为“严重型”、“轻型”或“复杂型”)以及“风险”变异,后者与GD无关,但会增加患PD的风险。总体而言,与非携带者相比,携带 -PD的患者有更严重的运动和非运动症状、更快的疾病进展以及更低的生存率。然而,不同的 变异对临床表型的影响各不相同。在杂合状态下,“复杂型”和“严重型”变异与更具侵袭性和快速进展的疾病相关。相反,“轻型”和“风险”变异预示着病程更为良性。纯合或复合杂合携带者通常表现出严重的表型,类似于杂合“复杂型”或“严重型”变异携带者。本文综述了 -PD中的基因型 - 表型相关性,重点关注临床和非临床方面(神经影像学和生化标志物),并探讨了在这些患者特征描述中值得考虑的其他疾病修饰因素。