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越南和东南亚的囊性纤维化:诊断不足与基因谱

Cystic fibrosis in Vietnam and Southeast Asia: underdiagnosis and genetic spectrum.

作者信息

Cao-Pham Ha-Giang, Tran-Le Quoc-Khanh, Nguyen-Ho Lam

机构信息

University Medical Center Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.

Pediatric Department, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.

出版信息

J Community Genet. 2025 Jun;16(3):221-225. doi: 10.1007/s12687-025-00807-1. Epub 2025 Jun 4.

DOI:10.1007/s12687-025-00807-1
PMID:40465100
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12202266/
Abstract

Recent reports confirm that cystic fibrosis (CF) is a global disease. In Asian populations, both the spectrum of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations and the clinical course differ from those observed in Western populations. Although the recognition of CF is increasing in South Asia, comprehensive data from Southeast Asian countries remain sparse. The underdiagnosis of CF in Southeast Asia is attributed to limited awareness among healthcare professionals and restricted access to sweat chloride testing. Until 2021, CF had not been documented in the indigenous population of Vietnam. This study presents the first three confirmed cases of CF in native Vietnamese individuals. Additionally, a literature review of CF cases reported across Southeast Asia was conducted to provide insights into its prevalence and variations in CFTR mutation profiles within the region. A total of 50 cases were identified, distributed across Malaysia (30 cases), Thailand (8), the Philippines (6), Vietnam (5), and Indonesia (1), revealing a mutation spectrum distinct from that observed in Caucasian populations. The most common mutations included p.Phe508del and p.Ile1295PhefsX32, each found in 11.5% of cases. These findings highlight the need for increased clinical awareness, expanded access to sweat chloride testing, and the establishment of CF centers and regional CF registries to better understand and manage CF in Southeast Asia.

摘要

近期报告证实囊性纤维化(CF)是一种全球性疾病。在亚洲人群中,囊性纤维化跨膜传导调节因子(CFTR)基因突变谱和临床病程与西方人群中观察到的情况有所不同。尽管南亚对CF的认识正在提高,但东南亚国家的全面数据仍然稀少。东南亚CF诊断不足归因于医疗保健专业人员认识有限以及汗液氯化物检测的获取受限。直到2021年,越南本土人口中尚未记录到CF病例。本研究报告了越南本土个体中首批确诊的三例CF病例。此外,对东南亚各地报告的CF病例进行了文献综述,以深入了解该地区CF的患病率以及CFTR突变谱的差异。共确定了50例病例,分布在马来西亚(30例)、泰国(8例)、菲律宾(6例)、越南(5例)和印度尼西亚(1例),显示出与白种人群中观察到的不同突变谱。最常见的突变包括p.Phe508del和p.Ile1295PhefsX32,各在11.5%的病例中发现。这些发现凸显了提高临床认识、扩大汗液氯化物检测可及性以及建立CF中心和区域CF登记处的必要性,以便更好地了解和管理东南亚的CF。

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1
Cystic fibrosis in Vietnam and Southeast Asia: underdiagnosis and genetic spectrum.越南和东南亚的囊性纤维化:诊断不足与基因谱
J Community Genet. 2025 Jun;16(3):221-225. doi: 10.1007/s12687-025-00807-1. Epub 2025 Jun 4.
2
Ataluren and similar compounds (specific therapies for premature termination codon class I mutations) for cystic fibrosis.依伐卡托(Ataluren)及类似化合物(针对 I 类提前终止密码子突变的特异性治疗药物)治疗囊性纤维化。
Cochrane Database Syst Rev. 2023 Mar 3;3(3):CD012040. doi: 10.1002/14651858.CD012040.pub3.
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Airway clearance techniques compared to no airway clearance techniques for cystic fibrosis.气道清除技术与囊性纤维化的非气道清除技术比较。
Cochrane Database Syst Rev. 2023 Apr 12;4(4):CD001401. doi: 10.1002/14651858.CD001401.pub4.
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Topical cystic fibrosis transmembrane conductance regulator gene replacement for cystic fibrosis-related lung disease.用于囊性纤维化相关肺部疾病的局部囊性纤维化跨膜传导调节因子基因替代疗法。
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本文引用的文献

1
A Case Report of the First Filipino Infant Diagnosed with Cystic Fibrosis through the Philippine Newborn Screening Program.首例通过菲律宾新生儿筛查项目确诊为囊性纤维化的菲律宾婴儿病例报告。
Acta Med Philipp. 2024 Apr 15;58(6):69-73. doi: 10.47895/amp.vi0.7570. eCollection 2024.
2
Prevalence of common autosomal recessive mutation carriers in women in the Southern Vietnam following the application of expanded carrier screening.在扩大携带者筛查后,越南南部女性中常见常染色体隐性遗传病携带者的流行率。
Sci Rep. 2024 Mar 29;14(1):7461. doi: 10.1038/s41598-024-57513-0.
3
Carrier frequency estimation of pathogenic variants of autosomal recessive and X-linked recessive mendelian disorders using exome sequencing data in 1,642 Thais.利用外显子组测序数据对 1642 例泰国人常染色体隐性和 X 连锁隐性孟德尔疾病的致病性变异进行载频估计。
BMC Med Genomics. 2024 Jan 2;17(1):9. doi: 10.1186/s12920-023-01771-w.
4
Morbidity and treatment costs of cystic fibrosis in a middle-income country.一个中等收入国家囊性纤维化的发病率和治疗成本。
Singapore Med J. 2023 Sep 19. doi: 10.4103/singaporemedj.SMJ-2022-093.
5
Analysis of clinically relevant variants from ancestrally diverse Asian genomes.分析来自具有亚洲不同祖先背景的基因组中的临床相关变异。
Nat Commun. 2022 Nov 5;13(1):6694. doi: 10.1038/s41467-022-34116-9.
6
Successful Implementation of Expanded Newborn Screening in the Philippines Using Tandem Mass Spectrometry.菲律宾采用串联质谱法成功实施扩大新生儿筛查
Int J Neonatal Screen. 2022 Jan 19;8(1):8. doi: 10.3390/ijns8010008.
7
Elucidating clinical phenotypic variability associated with the polyT tract and TG repeats in CFTR.阐明 CFTR 中多聚 T tract 和 TG 重复序列与临床表型变异性的关系。
Hum Mutat. 2021 Sep;42(9):1165-1172. doi: 10.1002/humu.24250. Epub 2021 Jul 10.
8
The role of biochemical testing in cystic fibrosis.生化检测在囊性纤维化中的作用。
Malays J Pathol. 2020 Aug;42(2):297-300.
9
The future of cystic fibrosis care: a global perspective.囊性纤维化护理的未来:全球视角。
Lancet Respir Med. 2020 Jan;8(1):65-124. doi: 10.1016/S2213-2600(19)30337-6. Epub 2019 Sep 27.
10
A Vietnamese human genetic variation database.越南人类遗传变异数据库。
Hum Mutat. 2019 Oct;40(10):1664-1675. doi: 10.1002/humu.23835. Epub 2019 Jul 3.