Barbetti Fabrizio, Deeb Asma, Suzuki Shigeru
Monogenic Diabetes Clinic, Endocrinology and Diabetes Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Pediatric Endocrine Division, Sheikh Shakhbout Medical City and College of Medicine and Health Science, Khalifa University, Abu Dhabi, UAE.
J Diabetes Investig. 2024 Dec;15(12):1711-1724. doi: 10.1111/jdi.14312. Epub 2024 Sep 30.
Neonatal diabetes mellitus (NDM), defined as diabetes with an onset during the first 6 months of life, is a rare form of monogenic diabetes. The initial publications on this condition began appearing in the second half of the 1990s and quite surprisingly, the search for new NDM genes is still ongoing with great vigor. Between 2018 and early 2024, six brand new NDM-genes have been discovered (CNOT1, FICD, ONECUT1, PDIA6, YIPF5, ZNF808) and three genes known to cause different diseases were identified as NDM-genes (EIF2B1, NARS2, KCNMA1). In addition, NDM cases carrying mutations in three other genes known to give rise to diabetes during childhood have been also identified (AGPAT2, BSCL2, PIK3R1). As a consequence, the list of NDM genes now exceeds 40. This genetic heterogeneity translates into many different mechanism(s) of disease that are being investigated with state-of-the-art methodologies, such as induced pluripotent stem cells (iPSC) and human embryonic stem cells (hESC) manipulated with the CRISPR technique of genome editing. This diversity in genetic causes and the pathophysiology of diabetes dictate the need for a variety of therapeutic approaches. The aim of this paper is to provide an overview on recent achievements in all aspects of this area of research.
新生儿糖尿病(NDM)定义为在出生后前6个月内发病的糖尿病,是一种罕见的单基因糖尿病形式。关于这种疾病的最初出版物始于20世纪90年代后半期,令人惊讶的是,对新的NDM基因的寻找仍在大力进行。在2018年至2024年初期间,发现了6个全新的NDM基因(CNOT1、FICD、ONECUT1、PDIA6、YIPF5、ZNF808),并确定了3个已知会导致不同疾病的基因作为NDM基因(EIF2B1、NARS2、KCNMA1)。此外,还发现了另外3个已知在儿童期会引发糖尿病的基因发生突变的NDM病例(AGPAT2、BSCL2、PIK3R1)。因此,NDM基因的列表现在已超过40个。这种遗传异质性转化为许多不同的疾病机制,目前正在使用最先进的方法进行研究,例如用基因组编辑的CRISPR技术操纵的诱导多能干细胞(iPSC)和人类胚胎干细胞(hESC)。糖尿病遗传病因和病理生理学的这种多样性决定了需要多种治疗方法。本文的目的是概述该研究领域各方面的最新成就。