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青少年起病的成年型糖尿病——疾病建模的新方法。

Maturity Onset Diabetes of the Young-New Approaches for Disease Modelling.

机构信息

Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Krakow, Poland.

Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland.

出版信息

Int J Mol Sci. 2021 Jul 14;22(14):7553. doi: 10.3390/ijms22147553.

Abstract

Maturity-onset diabetes of the young (MODY) is a genetically heterogeneous group of monogenic endocrine disorders that is characterised by autosomal dominant inheritance and pancreatic β-cell dysfunction. These patients are commonly misdiagnosed with type 1 or type 2 diabetes, as the clinical symptoms largely overlap. Even though several biomarkers have been tested none of which could be used as single clinical discriminator. The correct diagnosis for individuals with MODY is of utmost importance, as the applied treatment depends on the gene mutation or is subtype-specific. Moreover, in patients with HNF1A-MODY, additional clinical monitoring can be included due to the high incidence of vascular complications observed in these patients. Finally, stratification of MODY patients will enable better and newer treatment options for MODY patients, once the disease pathology for each patient group is better understood. In the current review the clinical characteristics and the known disease-related abnormalities of the most common MODY subtypes are discussed, together with the up-to-date applied diagnostic criteria and treatment options. Additionally, the usage of pluripotent stem cells together with CRISPR/Cas9 gene editing for disease modelling with the possibility to reveal new pathophysiological mechanisms in MODY is discussed.

摘要

青少年起病的成年型糖尿病(MODY)是一组遗传异质性的单基因内分泌疾病,其特征为常染色体显性遗传和胰岛β细胞功能障碍。这些患者常被误诊为 1 型或 2 型糖尿病,因为临床症状有很大的重叠。尽管已经测试了几种生物标志物,但没有一种可以作为单一的临床鉴别诊断。MODY 患者的正确诊断至关重要,因为应用的治疗方法取决于基因突变或亚型特异性。此外,在 HNF1A-MODY 患者中,由于观察到这些患者血管并发症的高发,因此可以包括额外的临床监测。最后,一旦更好地了解了每个患者群体的疾病病理学,对 MODY 患者进行分层将为 MODY 患者提供更好和更新的治疗选择。在目前的综述中,讨论了最常见的 MODY 亚型的临床特征和已知的与疾病相关的异常,以及最新的应用诊断标准和治疗选择。此外,还讨论了多能干细胞与 CRISPR/Cas9 基因编辑在疾病建模中的应用,这有可能揭示 MODY 中的新病理生理机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87cf/8303136/ca89b5a7b126/ijms-22-07553-g001.jpg

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