Hwu Wuh-Liang, Hsu Rai-Hseng, Li Mei-Hsin, Lee Hui-Min, Chen Hui-An, Lee Ni-Chung, Chien Yin-Hsiu
Department of Pediatrics National Taiwan University Hospital Taipei Taiwan.
Department of Medical Genetics National Taiwan University Hospital Taipei Taiwan.
JIMD Rep. 2023 Aug 2;64(5):387-392. doi: 10.1002/jmd2.12387. eCollection 2023 Sep.
Aromatic l-amino acid decarboxylase (AADC) deficiency is a rare inherited disorder that affects neurotransmitter biosynthesis. A founder mutation c.714 + 4A > T (IVS6 + 4A > T) is prevalent in the Chinese population. This study investigated the epidemiology of AADC deficiency in Taiwan by analyzing data from National Taiwan University Hospital (NTUH), a central institution for diagnosing and treating the disease. From January 2000 to March 2023, 77 patients with AADC deficiency visited NTUH. Among them, eight were international patients seeking a second opinion, and another two had one or both non-Chinese parents; all others were ethnically Chinese. The c.714 + 4A > T mutation accounted for 85% of all mutated alleles, and 94% of patients exhibited a severe phenotype. Of the 77 patients, 31 received gene therapy at a mean age of 3.76 years (1.62-8.49) through clinical trials, and their current ages were significantly older than those of the remaining patients. Although the combined incidence of AADC deficiency in this study (1:66491 for 2004 and later) was lower than that reported in newborn screening (1:31997 to 1:42662), case surges coincided with the launch of clinical trials and the implementation of newborn screening. Currently, many young patients are awaiting for treatment.
芳香族L-氨基酸脱羧酶(AADC)缺乏症是一种罕见的遗传性疾病,会影响神经递质的生物合成。一种奠基者突变c.714 + 4A > T(IVS6 + 4A > T)在中国人群中很普遍。本研究通过分析国立台湾大学医院(NTUH)的数据,调查了台湾AADC缺乏症的流行病学情况,NTUH是诊断和治疗该疾病的中心机构。从2000年1月到2023年3月,77例AADC缺乏症患者就诊于NTUH。其中,8例是寻求二次诊断的国际患者,另外2例有一方或双方父母不是中国人;其他所有患者均为华裔。c.714 + 4A > T突变占所有突变等位基因的85%,94%的患者表现出严重的表型。在这77例患者中,31例通过临床试验接受了基因治疗,平均年龄为3.76岁(1.62 - 8.49岁),他们目前的年龄明显大于其余患者。尽管本研究中AADC缺乏症的综合发病率(2004年及以后为1:66491)低于新生儿筛查报告的发病率(1:31997至1:42662),但病例激增与临床试验的启动和新生儿筛查的实施相吻合。目前,许多年轻患者正在等待治疗。