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胸主动脉瘤和夹层的遗传学和典型特征。

The Genetics and Typical Traits of Thoracic Aortic Aneurysm and Dissection.

机构信息

Centre of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium; email:

Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Annu Rev Genomics Hum Genet. 2022 Aug 31;23:223-253. doi: 10.1146/annurev-genom-111521-104455.

Abstract

Genetic predisposition and risk factors such as hypertension and smoking can instigate the development of thoracic aortic aneurysm (TAA), which can lead to highly lethal aortic wall dissection and/or rupture. Monogenic defects in multiple genes involved in the elastin-contractile unit and the TGFβ signaling pathway have been associated with TAA in recent years, along with several genetic modifiers and risk-conferring polymorphisms. Advances in omics technology have also provided significant insights into the processes behind aortic wall degeneration: inflammation, epigenetics, vascular smooth muscle phenotype change and depletion, reactive oxygen species generation, mitochondrial dysfunction, and angiotensin signaling dysregulation. These recent advances and findings might pave the way for a therapy that is capable of stopping and perhaps even reversing aneurysm progression.

摘要

遗传易感性和高血压、吸烟等危险因素可引发胸主动脉瘤(TAA),导致高度致命的主动脉壁夹层和/或破裂。近年来,多个参与弹性收缩单位和 TGFβ 信号通路的基因的单基因缺陷与 TAA 相关,以及几个遗传修饰因子和风险赋予多态性。组学技术的进步也为主动脉壁退化背后的过程提供了重要的见解:炎症、表观遗传学、血管平滑肌表型改变和耗竭、活性氧生成、线粒体功能障碍和血管紧张素信号转导失调。这些最新的进展和发现可能为能够阻止甚至可能逆转动脉瘤进展的治疗方法铺平道路。

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