案例报告:INSR中错误变异的功能性表征与低血糖症相关
Herodes Guzman1,2, Lauren M Mitteer1, Pan Chen1
1Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Frontiers in pediatrics
|November 1, 2024
概括
胰岛素受体 (INSR) 基因中的遗传变异导致儿童患持续性低血糖症. 这一发现强调了INSR基因缺陷是低血糖症的原因,影响了治疗策略.
科学领域:
- 内分泌学 在内分泌学.
- 遗传学 遗传学 是一个
- 分子生物学分子生物学
背景情况:
- 儿童持续性低血糖症通常是由于胰岛素分泌失调 (过胰岛素主义).
- 胰岛素信号通路的缺陷是低血糖症的另一个原因.
- 区分这些原因对于适当的临床管理至关重要.
研究的目的:
- 为了调查儿童患者持续低血糖症的病例.
- 为了确定遗传原因和功能性地描述胰岛素受体 (INSR) 基因中的新型变异.
主要方法:
- 整体外基因组测序以识别遗传变异.
- 在体外使用基于细胞的测定方法对已识别的INSR变异进行功能性表征.
- 对患者和她的母亲的表型评估.
主要成果:
- 在INSR基因中发现了一种异合的误解变异 (c.1151A>G,p.Asn384Ser),该变异是从母亲遗传的,母亲也出现了低血糖症.
- 实验室研究表明,突变的INSR导致了构成性和增强的胰岛素受体信号,增加了Akt和ERK1/2.2的酸化.
- 患者表现出既禁食又食后低血糖症.
结论:
- 一种新型的异构性INSR变体可以由于胰岛素受体激活的增加而导致禁食和食后低血糖症.
- 这一案例强调了在持续性低血糖症中考虑胰岛素信号通路缺陷的重要性.
- 遗传和功能研究是诊断和管理这种罕见疾病的关键.
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