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血色素沉着症的基因诊断:低收入国家与高收入国家的差异

The Genetic Diagnostics of Hemochromatosis: Disparities in Low- Versus High-Income Countries.

作者信息

Villa Nogueyra Sol, Trujillo Rodríguez María F, Garcia Oliva María L, Vidal-Gallardo Andrea, Ramírez Leal Amanda, Beltran Hernandez Jose, Vargas Beltran Andres Manuel, Guillen Sandoval José D, Arriaga Escamilla David, Martinez Ramirez Marily

机构信息

General Practice, Universidad de Buenos Aires, Buenos Aires, ARG.

General Practice, Universidad Nacional Autonoma de Mexico, Mexico City, MEX.

出版信息

Cureus. 2024 Jul 8;16(7):e64074. doi: 10.7759/cureus.64074. eCollection 2024 Jul.

Abstract

This study provides a comprehensive overview of hereditary hemochromatosis (HH), a genetic condition characterized by iron overload due to excessive iron absorption. It elucidates diverse inheritance patterns and clinical manifestations by exploring mutations in critical genes such as HFE (hemochromatosis), HJV (hemojuvelin), HAMP (hepcidin antimicrobial peptide), TfR2 (transferrin receptor 2), and FP (ferroportin). The significance of early screening, diagnosis, and personalized management strategies based on genetic classification is emphasized, particularly in terms of high-income vs. low-income countries. Addressing challenges in diagnosis, genetic testing accessibility, and healthcare disparities, the study highlights the importance of early detection, cost-effective screening strategies, and enhancing healthcare outcomes globally. Advanced genetic testing in high-income countries facilitates early diagnosis and management, reducing complications such as liver disease and cardiomyopathy. In contrast, low-income populations face several barriers, including limited access to genetic testing, high costs, and inadequate healthcare infrastructure. Cost-effective serum ferritin (SF) and transferrin saturation (TS) tests and emerging point-of-care (POC) tests offer affordable diagnostic options for low-resource settings. Additionally, the ongoing development of hepcidin measurement methods holds promise for enhancing diagnostic capabilities. Implementing these strategies can aid healthcare providers in improving global HH management and reducing the burden of iron overload complications. Furthermore, the study underscores the need for public health initiatives to raise awareness about HH, promote routine screenings, and advocate for equitable healthcare policies. Collaborative efforts between governments, healthcare organizations, and research institutions are crucial in addressing the global burden of HH. By fostering international cooperation and resource-sharing, it is possible to bridge the gap between high-income and low-income countries, ensuring all individuals have access to the necessary diagnostic and treatment options. This holistic approach can ultimately lead to better health outcomes and improved quality of life for individuals affected by HH worldwide. This comprehensive examination of HH not only illuminates the genetic and clinical aspects of the condition but also provides a roadmap for addressing the multifaceted challenges associated with its diagnosis and management.

摘要

本研究全面概述了遗传性血色素沉着症(HH),这是一种因铁吸收过多导致铁过载的遗传疾病。通过探索关键基因如HFE(血色素沉着症基因)、HJV(血色素沉着蛋白)、HAMP(铁调素抗菌肽)、TfR2(转铁蛋白受体2)和FP(铁转运蛋白)中的突变,阐明了其多样的遗传模式和临床表现。强调了基于基因分类的早期筛查、诊断和个性化管理策略的重要性,特别是在高收入国家与低收入国家之间。针对诊断、基因检测可及性和医疗保健差距方面的挑战,该研究突出了早期检测、具有成本效益的筛查策略以及改善全球医疗保健结果的重要性。高收入国家的先进基因检测有助于早期诊断和管理,减少诸如肝病和心肌病等并发症。相比之下,低收入人群面临诸多障碍,包括难以获得基因检测、成本高昂以及医疗基础设施不足。具有成本效益的血清铁蛋白(SF)和转铁蛋白饱和度(TS)检测以及新兴的即时检测(POC)为资源匮乏地区提供了经济实惠的诊断选择。此外,铁调素测量方法的不断发展有望提高诊断能力。实施这些策略有助于医疗保健提供者改善全球HH管理并减轻铁过载并发症的负担。此外,该研究强调需要开展公共卫生倡议,以提高对HH的认识、促进常规筛查并倡导公平的医疗政策。政府、医疗保健组织和研究机构之间的合作努力对于应对全球HH负担至关重要。通过促进国际合作和资源共享,有可能弥合高收入国家与低收入国家之间的差距,确保所有人都能获得必要的诊断和治疗选择。这种整体方法最终可为全球受HH影响的个人带来更好的健康结果和更高的生活质量。对HH的这种全面审视不仅阐明了该疾病的遗传和临床方面,还为应对与其诊断和管理相关的多方面挑战提供了路线图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd69/11305073/16cf855d2b19/cureus-0016-00000064074-i01.jpg

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