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加那利群岛大样本眼咽型肌营养不良症患者的临床和遗传学特征。

Clinical and genetic features of a large homogeneous cohort of oculopharyngeal muscular dystrophy patients from the Canary Islands.

机构信息

Neuromuscular Diseases Unit, Department of Neurology, Department of Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Department of Neurology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.

出版信息

Eur J Neurol. 2022 May;29(5):1488-1495. doi: 10.1111/ene.15252. Epub 2022 Feb 3.

Abstract

BACKGROUND

Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset myopathy characterized by ptosis, dysphagia, and progressive proximal limb muscle weakness. The disease is produced by a short expansion of the (GCN) triplet in the PABPN1 gene. The size of expansion has been correlated to the disease onset and severity. We report the clinical features of a large cohort of OPMD patients harboring the (GCN)15 allele from the Canary Islands.

METHODS

A retrospective observational study was performed analyzing the clinical, demographic, and genetic data of 123 OPMD patients. Clinical data from this cohort were compared with clinical data collected in a large European study including 139 OPMD patients.

RESULTS

A total of 113 patients (94.2%) carried the (GCN)15 expanded PABN1 allele. Age of symptoms' onset was 45.1 years. The most frequent symptom at onset was ptosis (85.2%) followed by dysphagia (12%). The severity of the disease was milder in the Canary cohort compared to European patients as limb weakness (35.1% vs. 50.4%), the proportion of patients that require assistance for walking or use a wheelchair (9.3% vs. 27.4%), and needed of surgery because of severe dysphagia (4.6% vs. 22.8%) was higher in the European cohort.

CONCLUSIONS

Nearly 95% of patients with OPMD from the Canary Islands harbored the (GCN)15 expanded allele supporting a potential founder effect. Disease progression seemed to be milder in the (GCN)15 OPMD Canary cohort than in other cohorts with shorter expansions suggesting that other factors, apart from the expansion size, could be involved in the progression of the disease.

摘要

背景

眼咽型肌营养不良症(OPMD)是一种常染色体显性遗传、迟发性肌病,其特征为上睑下垂、吞咽困难和进行性近端肢体肌无力。该疾病是由 PABPN1 基因中(GCN)三核苷酸短扩展引起的。扩展大小与疾病发病和严重程度相关。我们报告了来自加那利群岛的携带(GCN)15 等位基因的 OPMD 患者的大型队列的临床特征。

方法

进行了一项回顾性观察研究,分析了 123 名 OPMD 患者的临床、人口统计学和遗传数据。将该队列的临床数据与包括 139 名 OPMD 患者的大型欧洲研究中的临床数据进行了比较。

结果

共有 113 名患者(94.2%)携带(GCN)15 扩展的 PABN1 等位基因。症状发作的平均年龄为 45.1 岁。最常见的首发症状是上睑下垂(85.2%),其次是吞咽困难(12%)。与欧洲患者相比,加那利群岛队列的疾病严重程度较轻,上肢无力(35.1%比 50.4%)、需要辅助行走或使用轮椅的患者比例(9.3%比 27.4%)以及因严重吞咽困难而需要手术的患者比例(4.6%比 22.8%)均较低。

结论

来自加那利群岛的 OPMD 患者中,近 95%携带(GCN)15 扩展等位基因,支持潜在的创始人效应。(GCN)15 OPMD 加那利群岛队列的疾病进展似乎比其他扩展较短的队列更温和,这表明除了扩展大小外,其他因素可能参与了疾病的进展。

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