[Diagnostic and therapeutic perspectives in RASopathies].

Magyar onkologia Pub Date : 2024-12-10 Epub Date: 2024-11-19
Barnabás Péter Botos, Júlia Erhardt, Sámuel Jenei, Kamilla Luca Li, Dávid Sándor Kovács, Bálint Egyed, Jusztina Nikolett Beniczky, Dániel Erdélyi, Judit Müller, Edit Brückner, Monika Csóka, Andrea Szabó, László Környei, Rita Bertalan, Gábor Kovács, Csaba Vilmányi, Miklós Garami, Csaba Bödör, Ferenc Árpád Kovács
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Abstract

RASopathies are congenital diseases that manifest in childhood with symptoms and potential complications, typically associated with an elevated tumour predisposition risk. The heterogeneous symptoms involve mostly central nervous, cardiovascular, musculoskeletal systems and skin, and modified growth pattern. From molecular perspective, the function of a key protein involved in Ras signalling is impaired, leading to disrupted regulation of cell growth and division. It is crucial to uncover genetic history, analyse tumour and cardiac involvement pattern along four generation pedigree and depict minor anomaly pattern. Upon clinical suspicion a stepwise approach to molecular testing is recommended to confirm or rule out the specific RASopathy. Post-test genetic counselling should address potential complications, developmental and follow-up strategies in line with current guidelines. Cascade pedigree segregation analysis according to the inheritance pattern should be offered to family planning parents and potentially affected family members. In case of certain specific organ involvement or complications, targeted therapeutics are available, highlighting the importance of early diagnosis.

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[RAS病的诊断和治疗前景]。
RAS 病是一种先天性疾病,在儿童时期就会出现症状和潜在并发症,通常与肿瘤易感性风险升高有关。其症状多种多样,主要涉及中枢神经、心血管、肌肉骨骼系统和皮肤,以及生长模式的改变。从分子角度看,参与 Ras 信号传导的关键蛋白功能受损,导致细胞生长和分裂的调控紊乱。揭示遗传史、分析四代血统中肿瘤和心脏受累模式以及描述轻微异常模式至关重要。临床怀疑后,建议逐步进行分子检测,以确认或排除特定的 RAS 病。检测后的遗传咨询应针对潜在的并发症、发育和随访策略,并与现行指南保持一致。应根据遗传模式向计划生育父母和可能受影响的家庭成员提供级联血统分离分析。在某些特定器官受累或出现并发症的情况下,可采取有针对性的治疗方法,这突出了早期诊断的重要性。
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