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深入探究单心室先天性心脏病的分子世界。

Delving into the Molecular World of Single Ventricle Congenital Heart Disease.

作者信息

Yu Zhiyun, Pek Nicole Min Qian, Gu Mingxia

机构信息

Division of Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.

Center for Stem Cell and Organoid Medicine (CuSTOM), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

Curr Cardiol Rep. 2022 May;24(5):463-471. doi: 10.1007/s11886-022-01667-8. Epub 2022 Feb 26.

DOI:10.1007/s11886-022-01667-8
PMID:35218503
Abstract

PURPOSE OF REVIEW

Given a general lack of emphasis on the molecular underpinnings of single ventricle (SV) congenital heart diseases (CHD), our review highlights and summarizes recent advances in uncovering the genetic and molecular mechanisms in SV CHD etiology.

RECENT FINDINGS

While common SV-associated genetic mutations were found in key cardiac transcription factors, other mutations were sporadic. With advances in genetic sequencing technologies and animal models, more disease-associated factors have been identified to act in critical cardiac signaling pathways such as NOTCH, Wnt, and TGF signaling. Recent studies have also revealed that different cardiac lineages play different roles in disease pathogenesis. SV defects are attributed to complex combinations of genetic mutations, indicating that sophisticated spatiotemporal regulation of gene transcription networks and functional cellular pathways govern disease progression. Future studies will warrant in-depth investigations into better understanding how different genetic factors converge to influence common downstream cellular pathways, resulting in SV abnormalities.

摘要

综述目的

鉴于目前普遍缺乏对单心室先天性心脏病(CHD)分子基础的重视,我们的综述着重介绍并总结了在揭示单心室先天性心脏病病因中的遗传和分子机制方面的最新进展。

最新发现

虽然在关键心脏转录因子中发现了常见的与单心室相关的基因突变,但其他突变是散发性的。随着基因测序技术和动物模型的发展,已鉴定出更多与疾病相关的因子作用于关键的心脏信号通路,如NOTCH、Wnt和TGF信号通路。最近的研究还表明,不同的心脏谱系在疾病发病机制中发挥不同作用。单心室缺陷归因于基因突变的复杂组合,这表明基因转录网络和功能性细胞通路的复杂时空调节控制着疾病进展。未来的研究需要进行深入调查,以更好地理解不同遗传因素如何汇聚以影响共同的下游细胞通路,从而导致单心室异常。

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本文引用的文献

1
Hypoplastic left heart syndrome (HLHS): molecular pathogenesis and emerging drug targets for cardiac repair and regeneration.左心发育不全综合征 (HLHS):心脏修复和再生的分子发病机制和新兴药物靶点。
Expert Opin Ther Targets. 2021 Aug;25(8):621-632. doi: 10.1080/14728222.2021.1978069. Epub 2021 Sep 15.
2
Fontan circulation has improved life expectancy for infants born with complex heart disease over the last 50 years but has also resulted in significant morbidity.法洛四联症循环在过去 50 年中提高了患有复杂先天性心脏病的婴儿的预期寿命,但也导致了显著的发病率。
Acta Paediatr. 2022 Jan;111(1):11-16. doi: 10.1111/apa.16023. Epub 2021 Jul 23.
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Single Ventricle-A Comprehensive Review.
单心室——全面综述
Children (Basel). 2021 May 24;8(6):441. doi: 10.3390/children8060441.
4
A role of Hey2 transcription factor for right ventricle development through regulation of Tbx2-Mycn pathway during cardiac morphogenesis.Hey2 转录因子在心脏形态发生过程中通过调节 Tbx2-Mycn 通路对右心室发育的作用。
Dev Growth Differ. 2021 Jan;63(1):82-92. doi: 10.1111/dgd.12707. Epub 2021 Jan 27.
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Intrinsic Endocardial Defects Contribute to Hypoplastic Left Heart Syndrome.固有心内膜缺陷导致左心发育不全综合征。
Cell Stem Cell. 2020 Oct 1;27(4):574-589.e8. doi: 10.1016/j.stem.2020.07.015. Epub 2020 Aug 17.
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Molecular Approaches in Single Ventricle Management.单心室管理中的分子方法。
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Contribution of single-gene defects to congenital cardiac left-sided lesions in the prenatal setting.单基因缺陷在产前环境中对先天性心脏左侧病变的影响。
Ultrasound Obstet Gynecol. 2020 Aug;56(2):225-232. doi: 10.1002/uog.21883.
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Hypoplastic left heart syndrome: From bedside to bench and back.左心发育不良综合征:从床边到实验台再回到床边。
J Mol Cell Cardiol. 2019 Oct;135:109-118. doi: 10.1016/j.yjmcc.2019.08.005. Epub 2019 Aug 13.
9
Revisitation of Double-Inlet Left Ventricle or Tricuspid Atresia With Transposed Great Arteries.双入口左心室或大动脉转位三尖瓣闭锁的再探讨。
Ann Thorac Surg. 2019 Apr;107(4):1212-1217. doi: 10.1016/j.athoracsur.2018.11.052. Epub 2018 Dec 23.
10
Novel MEF2C point mutations in Chinese patients with Rett (-like) syndrome or non-syndromic intellectual disability: insights into genotype-phenotype correlation.中国雷特(类雷特)综合征或非综合征性智力障碍患者中的新型MEF2C点突变:对基因型-表型相关性的见解
BMC Med Genet. 2018 Oct 30;19(1):191. doi: 10.1186/s12881-018-0699-1.