Nathan N
Service de pneumologie pédiatrique, centre de référence des maladies respiratoires rares RespiRare, hôpital Armand Trousseau, Sorbonne université, AP-HP, 75012 Paris, France; Inserm, UMR_S933, laboratoire des maladies génétiques d'expression pédiatriques, hôpital Armand Trousseau, Sorbonne université, 75012 Paris, France.
Rev Mal Respir. 2023 Jan;40(1):38-46. doi: 10.1016/j.rmr.2022.11.003. Epub 2022 Dec 21.
Interstitial lung diseases in children of genetic origin. Interstitial lung disease (ILD) in children (chILD) encompasses a heterogeneous group of rare respiratory disorders, most of which are chronic and severe. In more and more of these cases, a genetic cause has been identified. As of now, the main mutations have been localized in the genes encoding the surfactant proteins (SP)-C (SFTPC), SP-B (SFTPB), their transporter ATP-binding cassette, family 1, member 3 (ABCA3), transcription factor NK2 homeobox 1 (NKX2-1) and, more rarely, SP-A1 (SFTPA1) or SP-A2 (SFTPA2). Pediatric pulmonary alveolar proteinosis (PAP) is associated with mutations in CSF2RA, CSF2RB, and MARS; more recently, mutations in STING1 and COPA have been associated with specific auto-inflammatory disorders including ILD manifestations. The relationships between the molecular abnormalities and the phenotypic expressions generally remain poorly understood. In the coming years, it is expected that newly identified molecular defects will help to more accurately predict disease courses and to produce individualized targeted therapies.
儿童遗传性间质性肺疾病。儿童间质性肺疾病(chILD)涵盖了一组异质性的罕见呼吸系统疾病,其中大多数是慢性且严重的。在越来越多的此类病例中,已确定了遗传原因。截至目前,主要突变已定位在编码表面活性物质蛋白(SP)-C(SFTPC)、SP-B(SFTPB)、它们的转运体ATP结合盒家族1成员3(ABCA3)、转录因子NK2同源盒1(NKX2-1)的基因中,更罕见的是SP-A1(SFTPA1)或SP-A2(SFTPA2)。小儿肺泡蛋白沉积症(PAP)与CSF2RA、CSF2RB和MARS的突变有关;最近,STING1和COPA的突变与包括ILD表现在内的特定自身炎症性疾病有关。分子异常与表型表达之间的关系通常仍了解甚少。在未来几年,预计新发现的分子缺陷将有助于更准确地预测疾病进程并产生个体化的靶向治疗。