谷氨酸能受体结构遗传缺陷导致的神经发育障碍

A. V. Abramov, E. Makushkin
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摘要

背景:谷氨酸受体功能障碍在精神障碍、神经系统、自身免疫和肿瘤病理学中的作用在过去十年中得到了深入研究。本研究的目的是描述与遗传引起的谷氨酸能受体结构改变有关的神经发育障碍(根据国际疾病分类第 11 版,L1-6A0)的现代概念。材料与方法:在 MEDLINE/Gene 数据库、MEDLINE/PubMed 科学图书馆、Online Mendelian Inheritance in Man (OMIM)、UniProt、ClinGen 和 eLibrary 中搜索了与离子型和代谢型谷氨酸受体亚基遗传缺陷相关的神经精神发育受损病例。大多数已知的离子型谷氨酸受体(GluA、GluN、GluK、GluD)和一些代谢型谷氨酸受体(mGluR1、5、7)的遗传诱导结构异常与神经精神障碍的严重变异有关,这些变异表现在婴儿期和幼儿期。结论:这些病例的临床表现差异很大,需要儿科、儿童精神病学、神经病学、遗传学以及医疗和社会康复等方面的专家合作,采用跨病种的方法对患者进行诊断和管理。
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Neurodevelopmental Disorders Caused by Genetic Defects in Structure of Glutamatergic Receptors
Background: the role of glutamate receptor dysfunction in mental disorders, neurological, autoimmune, and oncological pathology has been intensively investigated in the past decade. The development of drugs that target glutamatergic receptors has also been a focus of research.The aim was to describe modern concepts of neurodevelopmental disorders (according to the International Classification of Diseases 11th revision, L1-6A0) that are associated with genetically induced alterations of the structure of glutamatergic receptors.Material and method: a search for descriptions of cases with impaired neuropsychiatric development associated with genetic defects of ionotropic and metabotropic glutamate receptor subunits was performed in the MEDLINE/Gene database, MEDLINE/PubMed scientific library, Online Mendelian Inheritance in Man (OMIM), UniProt, ClinGen and eLibrary. Genetically induced structural abnormalities of most known ionotropic (GluA, GluN, GluK, GluD) and a number of metabotropic glutamate receptors (mGluR1, 5, 7) are associated with severe variants of neuropsychiatric disorders that manifest in infancy and early childhood.Conclusion: the considerable variation in the clinical presentation of these cases demands a transnosological approach to diagnosis and management of patients, under cooperation of specialists in pediatrics, child psychiatry, neurology, genetics, and medical and social rehabilitation.
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