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神经嵴病的临床与遗传相关性:弥合精准医学差距

Clinical and Genetic Correlation in Neurocristopathies: Bridging a Precision Medicine Gap.

作者信息

Chatzi Despoina, Kyriakoudi Stella Aikaterini, Dermitzakis Iasonas, Manthou Maria Eleni, Meditskou Soultana, Theotokis Paschalis

机构信息

Department of Histology-Embryology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

出版信息

J Clin Med. 2024 Apr 11;13(8):2223. doi: 10.3390/jcm13082223.

Abstract

Neurocristopathies (NCPs) encompass a spectrum of disorders arising from issues during the formation and migration of neural crest cells (NCCs). NCCs undergo epithelial-mesenchymal transition (EMT) and upon key developmental gene deregulation, fetuses and neonates are prone to exhibit diverse manifestations depending on the affected area. These conditions are generally rare and often have a genetic basis, with many following Mendelian inheritance patterns, thus making them perfect candidates for precision medicine. Examples include cranial NCPs, like Goldenhar syndrome and Axenfeld-Rieger syndrome; cardiac-vagal NCPs, such as DiGeorge syndrome; truncal NCPs, like congenital central hypoventilation syndrome and Waardenburg syndrome; and enteric NCPs, such as Hirschsprung disease. Additionally, NCCs' migratory and differentiating nature makes their derivatives prone to tumors, with various cancer types categorized based on their NCC origin. Representative examples include schwannomas and pheochromocytomas. This review summarizes current knowledge of diseases arising from defects in NCCs' specification and highlights the potential of precision medicine to remedy a clinical phenotype by targeting the genotype, particularly important given that those affected are primarily infants and young children.

摘要

神经嵴病(NCPs)包括一系列由神经嵴细胞(NCCs)形成和迁移过程中出现的问题所引发的疾病。NCCs会经历上皮-间质转化(EMT),并且在关键发育基因失调时,胎儿和新生儿根据受影响的区域容易表现出多种症状。这些病症通常较为罕见,且往往具有遗传基础,许多遵循孟德尔遗传模式,因此使其成为精准医学的理想候选对象。例子包括颅面部NCPs,如Goldenhar综合征和Axenfeld-Rieger综合征;心脏-迷走神经NCPs,如DiGeorge综合征;躯干NCPs,如先天性中枢性低通气综合征和Waardenburg综合征;以及肠道NCPs,如先天性巨结肠病。此外,NCCs的迁移和分化特性使其衍生物易于发生肿瘤,根据其NCC起源对各种癌症类型进行了分类。代表性例子包括神经鞘瘤和嗜铬细胞瘤。本综述总结了目前关于NCCs特化缺陷所引发疾病的知识,并强调了精准医学通过针对基因型来纠正临床表型的潜力,鉴于受影响的主要是婴幼儿,这一点尤为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d9/11050951/6fcb2023c7d8/jcm-13-02223-g001.jpg

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