Kabuki综合征诊治及分子机制研究进展

Diagnosis and treatment of Kabuki syndrome and its recent progress in molecular mechanisms

Kabuki综合征(Kabuki syndrome,KS),又称歌舞伎面谱综合征,主要表现为生长发育迟缓、骨骼发育落后、特殊面容、多器官畸形、皮肤纹理异常以及轻度或中度智力低下等.对于KS的分子遗传学发病机制,目前明确的突变基因有KTM2D基因和KDM6A基因,它们通过组蛋白修饰引起染色质构型重塑,进而调控基因表达.现阶段,KS的病因及发病机制并不十分清楚,也无可用于确诊的生化指标和影像学检查,分子遗传学诊断还有待探索.目前,KS的诊断主要根据特征性的临床表现:特殊面容、骨骼异常、皮纹异常、智力障碍以及发育迟缓.对于这类患者,临床上早期发现、早期干预、尽可能地提高生长发育水平、对其临床表现对症治疗、积极预防和治疗并发症,有利于改善预后.

Kabuki syndrome(KS),also called kabuki make-up syndrome,is characterized by backward growth retardation,skeletal developmental delay,major facial dysmorphic features,multi-organ abnormalities and abnormal dermatoglyphic pattern and mild or moderate mental retardation.For the molecular genetic pathogenesis of KS,KTM2D and KDM6A gene mutations have been identified as pathogenic genes of KS,which regulate the gene expression through chromatin remodelling and histone modification.At present,the etiology and pathogenesis of KS are still unknown.There is no useful biochemical index and standard radiographic findings for the diagnosis of KS.Molecular genetic diagnosis is still to be explored.Currently,the diagnosis of KS is mainly based on five cardinal manifestations:a peculiar face,skeletal anomalies,dermatoglyphic abnormalities,mild to moderate mental retardation and postnatal growth deficiency.For these patients,it can reach a better prognosis the by clinical early detection,early diagnosis,early intervention,as well as improving the growth level,symptomatic treatment,active prevention and treatment of complications as far as possible.