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[亨廷顿舞蹈症:临床症状、遗传学及当前诊断方法]

[Huntington's chorea: clinical aspects, genetics and current diagnosis].

作者信息

Spiegel R

机构信息

Institut für Medizinische Genetik, Universität Zürich.

出版信息

Ther Umsch. 1995 Dec;52(12):814-20.

PMID:8539653
Abstract

Huntington's disease is a late manifesting autosomal dominant neurodegenerative disorder. It is characterized by motor disturbance, loss of cognitive functions and psychiatric manifestations. The disease causing mutation, an unstable DNA sequence in the coding region of the Huntington gene on chromosome 2p, has recently been identified. A trinucleotide [CAG] repeat is expanded over the normal range and can be easily detected by standard laboratory methods. Accurate genetic testing can now be offered in clinically questionable cases and to presymptomatic subjects at risk for Huntington's disease. Furthermore, there is a correlation between the size of the expanded CAG repeat and the age of onset in affected individuals. The predictive value of this correlation, however, is limited due to the range of onset ages found at a given repeat length in large series of patients. Expanded triplet repeats exhibit a marked instability especially in male meiosis with a tendency to further increase during transmission over the generations. This is likely to be the molecular mechanism explaining anticipation, as well as the occurrence of juvenile cases and new mutations.

摘要

亨廷顿舞蹈症是一种迟发性常染色体显性神经退行性疾病。其特征为运动障碍、认知功能丧失和精神症状。导致该疾病的突变是位于2号染色体上亨廷顿基因编码区的一段不稳定DNA序列,最近已被确定。一个三核苷酸[CAG]重复序列在正常范围之外扩展,并且可以通过标准实验室方法轻松检测到。现在,在临床可疑病例以及有患亨廷顿舞蹈症风险的症状前个体中,可以进行准确的基因检测。此外,在受影响个体中,扩展的CAG重复序列大小与发病年龄之间存在相关性。然而,由于在大量患者中给定重复长度下发现的发病年龄范围,这种相关性的预测价值有限。扩展的三联体重复序列表现出明显的不稳定性,尤其是在男性减数分裂过程中,并且在代际传递过程中有进一步增加的趋势。这可能是解释遗传早现现象以及青少年病例和新突变发生的分子机制。

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