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帕金森病——遗传病因。

Parkinson's disease - genetic cause.

机构信息

Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

出版信息

Curr Opin Neurol. 2023 Aug 1;36(4):292-301. doi: 10.1097/WCO.0000000000001167. Epub 2023 May 24.

Abstract

PURPOSE OF REVIEW

Our knowledge of the genetic architecture underlying Parkinson's disease has vastly improved in the past quarter century. About 5-10% of all patients suffer from a monogenic form of Parkinson's disease.

RECENT FINDINGS

Mutations in autosomal dominant genes (e.g. SNCA, LRRK2, VPS35) or autosomal recessive genes (e.g. PRKN, PINK1, DJ-1) can cause genetic Parkinson's disease. Recessive DNAJC6 mutations can present predominantly as atypical parkinsonism, but also rarely as typical Parkinson's disease. Majority of Parkinson's disease is genetically complex. Mutation in RIC3 , a chaperone of neuronal nicotinic acetylcholine receptor subunit α-7 (CHRNA7), provides strong evidence for the role of cholinergic pathway, for the first time, in cause of Parkinson's disease. X-linked parkinsonism manifests at a young age accompanied by many (atypical) features such as intellectual disability, spasticity, seizures, myoclonus, dystonia, and have poor response to levodopa.

SUMMARY

This review article aims to provide a comprehensive overview on Parkinson's disease genetics. MAPT , which encodes the microtubule associated protein tau, TMEM230, LRP10, NUS1 and ARSA are the five new putative disease-causing genes in Parkinson's disease. The validation of novel genes and its association with Parkinson's disease remains extremely challenging, as genetically affected families are sparse and globally widespread. In the near future, genetic discoveries in Parkinson's disease will influence our ability to predict and prognosticate the disease, help in defining etiological subtypes that are critical in implementation of precision medicine.

摘要

目的综述

在过去的四分之一个世纪里,我们对帕金森病遗传结构的认识有了很大的提高。大约 5-10%的患者患有单基因形式的帕金森病。

最新发现

常染色体显性基因突变(如 SNCA、LRRK2、VPS35)或常染色体隐性基因突变(如 PRKN、PINK1、DJ-1)可导致遗传帕金森病。隐性 DNAJC6 突变可表现为非典型帕金森病,但也很少表现为典型帕金森病。大多数帕金森病具有遗传复杂性。神经元烟碱型乙酰胆碱受体亚基 α-7(CHRNA7)伴侣蛋白 RIC3 的突变首次为胆碱能通路在帕金森病发病机制中的作用提供了强有力的证据。X 连锁帕金森病在年轻时发病,伴有许多(非典型)特征,如智力障碍、痉挛、癫痫、肌阵挛、肌张力障碍和对左旋多巴反应不佳。

总结

本文综述了帕金森病遗传学的研究进展。编码微管相关蛋白 tau 的 MAPT、TMEM230、LRP10、NUS1 和 ARSA 是帕金森病的五个新的潜在致病基因。新型基因的验证及其与帕金森病的相关性极具挑战性,因为受遗传影响的家族很少,且分布广泛。在不久的将来,帕金森病的遗传发现将影响我们预测和预后疾病的能力,有助于定义对精准医学至关重要的病因亚型。

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