Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
Genes (Basel). 2023 Jan 12;14(1):199. doi: 10.3390/genes14010199.
Achondroplasia is an autosomal dominant genetic disease representing the most common form of human skeletal dysplasia: almost all individuals with achondroplasia have identifiable mutations in the fibroblast growth factor receptor type 3 () gene. The cardinal features of this condition and its inheritance have been well-established, but the occurrence of feeding and nutritional complications has received little prominence. In infancy, the presence of floppiness and neurological injury due to foramen magnum stenosis may impair the feeding function of a newborn with achondroplasia. Along with growth, the optimal development of feeding skills may be affected by variable interactions between midface hypoplasia, sleep apnea disturbance, and structural anomalies. Anterior open bite, prognathic mandible, retrognathic maxilla, and relative macroglossia may adversely impact masticatory and respiratory functions. Independence during mealtimes in achondroplasia is usually achieved later than peers. Early supervision of nutritional intake should proceed into adolescence and adulthood because of the increased risk of obesity and respiratory problems and their resulting sequelae. Due to the multisystem involvement, oral motor dysfunction, nutrition, and gastrointestinal issues require special attention and personalized management to facilitate optimal outcomes, especially because of the novel therapeutic options in achondroplasia, which could alter the progression of this rare disease.
软骨发育不全是一种常染色体显性遗传疾病,是最常见的人类骨骼发育不良形式:几乎所有软骨发育不全患者的成纤维细胞生长因子受体 3 (FGFR3)基因都存在可识别的突变。这种疾病及其遗传特征已经得到很好的确立,但喂养和营养并发症的发生却没有得到足够的重视。在婴儿期,由于枕骨大孔狭窄,可能会出现松软和神经损伤,从而损害软骨发育不全新生儿的喂养功能。随着生长,中面部发育不全、睡眠呼吸暂停障碍和结构异常之间的可变相互作用可能会影响喂养技能的最佳发育。前牙开颌、下颌前突、上颌后缩和相对的巨舌可能会对咀嚼和呼吸功能产生不利影响。与同龄人相比,软骨发育不全患者在进餐时通常会较晚实现独立。由于肥胖和呼吸问题及其带来的后果的风险增加,应在青少年和成年期继续对营养摄入进行早期监督。由于多系统受累,口腔运动功能障碍、营养和胃肠道问题需要特别注意和个性化管理,以促进最佳结果,特别是因为软骨发育不全的新型治疗选择可能会改变这种罕见疾病的进展。