Ganaraja V H, Holla Vikram V, Pal Pramod Kumar
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India-560029.
Tremor Other Hyperkinet Mov (N Y). 2025 May 5;15:17. doi: 10.5334/tohm.938. eCollection 2025.
Wilson's disease (WD) is a disorder of copper metabolism due to variants in the gene. This autosomal recessively inherited disorder is characterized by the accumulation of copper in various body parts, mainly the liver, brain, and kidneys. Initially, WD was described to involve the hepatic and neurological systems. Subsequently, diverse presentations have been reported with skeletal and hematological manifestations and various constellations of symptoms. Neurological manifestations of WD are varied, ranging from asymptomatic neurological state to refractory dystonia. Earlier, the diagnosis was based only on measuring serum ceruloplasmin levels, urinary copper levels, and imaging. Advanced genetic testing has provided an additional mode of diagnosis in the patient, screening of the family members and, a way to better understand the genotype-phenotype associations of the disease if there are any. In the last few decades, the treatment of WD has evolved from symptomatic treatment and chelation therapy to many new advanced measures for both copper chelation and symptomatic relief. With a better understanding of the genetic aspects of WD in recent years, there has been more focus on gene therapy, novel therapies targeting ATP7B genes, and therapies targeting mutant proteins to prevent copper accumulation. This article highlights the advances in diagnostic methods and treatment modalities in WD.
威尔逊病(WD)是一种由于该基因变异导致的铜代谢紊乱疾病。这种常染色体隐性遗传疾病的特征是铜在身体各个部位积聚,主要是肝脏、大脑和肾脏。最初,WD被描述为累及肝脏和神经系统。随后,有报道称其出现了多种表现,包括骨骼和血液系统表现以及各种症状组合。WD的神经学表现多种多样,从无症状神经状态到难治性肌张力障碍不等。早期,诊断仅基于测量血清铜蓝蛋白水平、尿铜水平和影像学检查。先进的基因检测为患者提供了另一种诊断方式,可用于筛查家庭成员,并且如果存在基因型 - 表型关联,还能更好地理解该疾病。在过去几十年中,WD的治疗已从对症治疗和螯合疗法发展为多种新的先进措施,包括铜螯合和症状缓解。近年来,随着对WD遗传方面的深入了解,更多的焦点集中在基因治疗、针对ATP7B基因的新型疗法以及针对突变蛋白以防止铜积聚的疗法上。本文重点介绍了WD诊断方法和治疗方式的进展。
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