杜氏肌营养不良症(DMD)的诊断:过去和现在的观点

Nahla O. Mousa, A. Osman, N. Fahmy, Ahmed Abdellatif, S. Zada, H. El-Fawal
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摘要

杜兴肌营养不良(DMD)是一种致命的X连锁疾病,其特征是进行性骨骼肌萎缩。这种疾病是由肌营养不良蛋白基因(DMD)的各种类型的突变引起的。这种疾病的发生频率约为每5000名男性中就有1人,是最常见的严重神经肌肉疾病。除了肌肉力量和功能的临床检查外,DMD的诊断通常还包括使用肌肉活检的免疫测定,通常是免疫组织化学和蛋白质印迹,以及使用血液样本的分子技术,如DMD基因测序或多重连接依赖性探针扩增(MLPA)。事实上,精确的分子诊断是确定合适的个性化治疗方法的先决条件,如外显子跳过、基因治疗或基于干细胞的治疗与CRISPR-Cas9等基因编辑技术相结合。然而,从液体活检中寻找对DMD具有高灵敏度和特异性的可靠生物标志物仍然是研究的热点,因为这种非侵入性生物标志物不仅有助于疾病诊断,而且有助于携带者检测,最终将导致更好的疾病管理。在本章中,我们将详细说明目前和未来的疾病策略。可用于诊断Duchenne肌营养不良的蛋白质生物标志物。
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Duchenne Muscular Dystrophy (DMD) Diagnosis: Past and Present Perspectives
Duchenne muscular dystrophy (DMD) is a fatal X-linked disorder, character-ized by progressive skeletal muscle wasting. The disease is caused by various types of mutations in the dystrophin gene (DMD). The disease occurs at a frequency of about 1 in 5000 male births, making it the most common severe neuro-muscular disease. In addition to clinical examinations of muscle strength and function, diagnosis of DMD usually involves a combination of immunological assays using muscle biopsies, typically immunohistochemistry and western blotting, and molecular techniques such as DMD gene sequencing or Multiplex Ligation Dependent Probe Amplification (MLPA) using blood samples. In fact, precise molecular diagnosis is a prerequisite for determining the appropriate personalized therapeutic approach such as exon-skipping, gene therapy or stem cell-based therapies in conjunction with gene editing techniques like CRISPR-Cas9. However, the quest for reliable biomarkers with high sensitivity and specificity for DMD from liquid biopsy is still a hotspot of research, as such non-invasive biomarker(s) would not only facilitate disease diagnosis but would also help in carrier detection, which will eventually result in better disease management. In this chapter, we will illustrate the detailed current and prospect strategies for disease. protein biomarkers that could be utilized in the diagnosis of Duchenne muscular dystrophy.
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