儿童铜代谢紊乱——一个很少被认识到的问题。
Disorders of Copper Metabolism in Children-A Problem too Rarely Recognized.
作者信息
Więcek Sabina, Paprocka Justyna
机构信息
Department of Paediatrics, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Paediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, 40-055 Katowice, Poland.
出版信息
Metabolites. 2024 Jan 7;14(1):38. doi: 10.3390/metabo14010038.
Copper plays an important role in metabolic processes. Both deficiency and excess of this element have a negative effect and lead to pathological conditions. Copper is a cofactor of many enzymatic reactions. Its concentration depends on the delivery in the diet, the absorption in enterocytes, transport with the participation of ATP7A/ATP7B protein, and proper excretion. Copper homeostasis disorders lead to serious medical conditions such as Menkes disease (MD) and Wilson's disease (WD). A mutation in the is the cause of Menkes disease, it prevents the supply of copper ions to enzymes dependent on them, such as dopamine β-hydroxylase and lysyl oxidase. This leads to progressive changes in the central nervous system and disorders of the connective tissue. In turn, Wilson's disease is an inherited autosomal recessive disease. It is caused by a mutation of the encoding the ATP7B protein which means excess copper cannot be removed from the body, leading to the pathological accumulation of this element in the liver and brain. The clinical picture is dominated by the liver, neurological, and/or psychiatric symptoms. Early inclusion of zinc preparations and chelating drugs significantly improves the prognosis in this group of patients. The aim of the study is to analyse, based on the latest literature, the following factors: the etiopathogenesis, clinical picture, diagnostic tests, treatment, prognosis, and complications of disease entities associated with copper disturbances: Menkes disease and Wilson's disease. In addition, it is necessary for general practitioners, neurologists, and gastroenterologists to pay attention to these disease entities because they are recognized too late and too rarely, especially in the paediatric population.
铜在代谢过程中发挥着重要作用。该元素的缺乏和过量都会产生负面影响,并导致病理状况。铜是许多酶促反应的辅助因子。其浓度取决于饮食中的摄入量、肠细胞的吸收、ATP7A/ATP7B蛋白参与的转运以及适当的排泄。铜稳态紊乱会导致严重的医学病症,如门克斯病(MD)和威尔逊病(WD)。 的突变是门克斯病的病因,它阻止铜离子供应给依赖它们的酶,如多巴胺β-羟化酶和赖氨酰氧化酶。这会导致中枢神经系统的渐进性变化和结缔组织紊乱。反过来,威尔逊病是一种常染色体隐性遗传病。它是由编码ATP7B蛋白的 突变引起的,这意味着过量的铜无法从体内排出,导致该元素在肝脏和大脑中病理性蓄积。临床表现以肝脏、神经和/或精神症状为主。早期使用锌制剂和螯合药物可显著改善这类患者的预后。本研究的目的是根据最新文献分析以下因素:与铜紊乱相关的疾病实体(门克斯病和威尔逊病)的病因发病机制、临床表现、诊断测试、治疗、预后和并发症。此外,全科医生、神经科医生和胃肠病学家有必要关注这些疾病实体,因为它们的诊断往往太晚且太少,尤其是在儿科人群中。
相似文献
Metabolites. 2024-1-7
Encephale. 2007-12
Curr Drug Metab. 2012-3
J Investig Med. 1995-8
Cochrane Database Syst Rev. 2019-11-19
Therap Adv Gastroenterol. 2017-11
引用本文的文献
本文引用的文献
N Engl J Med. 2023-9-7
Int J Mol Sci. 2022-8-18
Children (Basel). 2022-7-28
Clin Liver Dis. 2022-8
Lancet Gastroenterol Hepatol. 2022-6
J Clin Lab Anal. 2022-2
J Clin Med. 2021-10-30
J Pediatr Gastroenterol Nutr. 2021-10-1