先天性甲状腺功能减退症的遗传学:现代概念

Genetics of congenital hypothyroidism: Modern concepts.

作者信息

Stoupa Athanasia, Kariyawasam Dulanjalee, Polak Michel, Carré Aurore

机构信息

Department of Paediatric Endocrinology Gynaecology and Diabetology Ile de France Regional Neonatal Screening Centre (CRDN) Necker Enfants-Malades University Hospital Paris France.

Institut IMAGINE INSERM U1163 Paris France.

出版信息

Pediatr Investig. 2022 May 14;6(2):123-134. doi: 10.1002/ped4.12324. eCollection 2022 Jun.

Abstract

Congenital hypothyroidism (CH) is the most common neonatal endocrine disorder and one of the most common preventable causes of intellectual disability in the world. CH may be due to developmental or functional thyroid defects (primary or peripheral CH) or be hypothalamic-pituitary in origin (central CH). In most cases, primary CH is caused by a developmental malformation of the gland (thyroid dysgenesis, TD) or by a defect in thyroid hormones synthesis (dyshormonogenesis, DH). TD represents about 65% of CH and a genetic cause is currently identified in fewer than 5% of patients. The remaining 35% are cases of DH and are explained with certainty at the molecular level in more than 50% of cases. The etiology of CH is mostly unknown and may include contributions from individual and environmental factors. In recent years, the detailed phenotypic description of patients, high-throughput sequencing technologies, and the use of animal models have made it possible to discover new genes involved in the development or function of the thyroid gland. This paper reviews all the genetic causes of CH. The modes by which CH is transmitted will also be discussed, including a new oligogenic model. CH is no longer simply a dominant disease for cases of CH due to TD and recessive for cases of CH due to DH, but a far more complex disorder.

摘要

先天性甲状腺功能减退症(CH)是最常见的新生儿内分泌疾病,也是世界上最常见的可预防的智力残疾原因之一。CH可能是由于甲状腺发育或功能缺陷(原发性或外周性CH),或源于下丘脑 - 垂体(中枢性CH)。在大多数情况下,原发性CH是由甲状腺发育畸形(甲状腺发育不全,TD)或甲状腺激素合成缺陷(激素合成障碍,DH)引起的。TD约占CH的65%,目前在不到5%的患者中确定了遗传原因。其余35%为DH病例,超过50%的病例在分子水平上得到了确切解释。CH的病因大多未知,可能包括个体和环境因素的影响。近年来,对患者的详细表型描述、高通量测序技术以及动物模型的应用使得发现参与甲状腺发育或功能的新基因成为可能。本文综述了CH的所有遗传原因。还将讨论CH的遗传传递方式,包括一种新的寡基因模型。CH不再简单地是TD导致的CH病例为显性遗传,DH导致的CH病例为隐性遗传,而是一种更为复杂的疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56fe/9218988/148f92c90418/PED4-6-123-g002.jpg

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