婴儿TK2缺陷导致线粒体脑筋疲劳症与迁移的焦点发作
Luca Bergonzini1, Sara Carli1, Silvia Pelle1
1Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy.
Neurology
|March 3, 2025
概括
脱氧核酸基质增强疗法 (dC/dT) 稳定了肌肉疾病在一个婴儿与胺基酶2缺乏 (TK2d),但显示在大脑参与的有效性有限. 进一步的深度表型化对于在治疗前评估疾病严重程度至关重要.
科学领域:
- 遗传学和神经学 遗传学和神经学
- 线粒体疾病 线粒体疾病
- 罕见的儿科神经系统疾病
背景情况:
- 蒂米丁激酶2 (TK2) 基因的递归变异会导致蒂米丁激酶2 (TK2d) 缺乏,这是一种具有可变发病的肌肉病变.
- 中枢神经系统 (CNS) 的参与在TK2d.的婴儿形式中不常见.
- 脱氧核酸基质增强疗法 (dC/dT) 在TK2d肌病症方面表现有前途,但其对中枢神经系统疾病的影响尚不清楚.
研究的目的:
- 根据早期获取计划,报告第一个婴儿TK2d性脑筋疲劳症的病例,用dC/dT治疗.
- 评估dC/dT对婴儿TK2d的神经症状的疗效.
- 调查婴儿TK2d与中枢神经系统参与的遗传基础和临床过程.
主要方法:
- 一名患有婴儿TK2d性脑膜病变的患者被纳入DC/dT治疗的早期准入计划 (MT1621).
- 记录了临床表现,包括低血压,运动衰退,发育不良,呼吸衰竭和耐药性.
- 外基因序列测序在TK2基因中发现了新的双基异合体变异,其致病性在体外得到证实.
- 大脑MRI被用来评估中枢神经系统的参与,包括缩和皮下病变.
主要成果:
- 患者在3个月后出现了渐进的低血压,运动回归,发育不良和呼吸衰竭.
- 药物耐药性与迁移的焦点发育在8个月.
- 大脑MRI显示渐进性缩和双边皮质下病变与乳酸峰值.
- 基因分析在TK2基因中发现了两种新型异合体变异:c.182G>A (p.Ser61Asn) 和c.704T>C (p.Ile235Thr).
- dC/dT治疗延长了生存时间和稳定了肌肉疾病,但没有改善神经症状或中枢神经系统病变.
结论:
- 这一案例凸显了婴儿TK2d综合表型化的重要性,以便在dC/dT补充之前准确评估疾病严重程度.
- 这些发现表明,dC/dT在治疗婴儿TK2d.脑部表现方面可能具有有限的疗效.
- 需要进一步的研究,以了解线粒体疾病中dC/dT治疗的组织特异性反应.
更多相关视频
09:37Navigating MARRVEL, a Web-Based Tool that Integrates Human Genomics and Model Organism Genetics Information
Published on: August 15, 2019
9.6K
09:57Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
2.5K
相关概念视频
Inborn Errors of Metabolism
122
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
122
Seizures: Classification
297
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
297
ATP Synthase: Mechanism
13.8K
In animals, the mitochondrial F1F0 ATP synthase is the key protein that synthesizes ATP molecules through a complex catalytic mechanism. While the nuclear genome encodes the majority of ATP synthase subunits, the mitochondrial genome encodes some of the enzyme's most critical components. The formation of this multi-subunit enzyme is a complex multi-step process regulated at the level of transcription, translation, and assembly. Defects in one or more of these steps can result in decreased...
13.8K
Electron Transport Chain: Complex I and II
10.1K
The mitochondrial electron transport chain (ETC) is the main energy generation system in the eukaryotic cells. However, mitochondria also produce cytotoxic reactive oxygen species (ROS) due to the large electron flow during oxidative phosphorylation. While Complex I is one of the primary sources of superoxide radicals, ROS production by Complex II is uncommon and may only be observed in cancer cells with mutated complexes.
ROS generation is regulated and maintained at moderate levels necessary...
ROS generation is regulated and maintained at moderate levels necessary...
10.1K
Lysosomal Hydrolases
3.7K
Lysosomes are the site for the degradation of macromolecules and biological polymers released during membrane trafficking events such as secretory, endocytic, autophagic, and phagocytic pathways. The membrane-enclosed area of the lysosome, called the lumen, contains hydrolytic enzymes active in an acidic environment. These acid hydrolases are functional at a pH between 4.5 and 5 and are involved in cellular processes such as cell signaling, energy metabolism, restoration of the plasma membrane,...
3.7K
Arteries of the Lower Limbs
176
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
176
