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Tuberous Sclerosis Complex Associated with Autism Spectrum Features and Bumetanide as a Pharmacological Indication: A Case Report
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作者 Maria Cristina Brió Mariana Fazzina Melina Chindi 《Open Journal of Psychiatry》 2021年第3期202-213,共12页
A wide variety of genetic and non-genetic pathologies share serious psychiatric symptoms, which determine a poor quality of life for patients and their families. To evaluate whether bumetanide, a drug initially develo... A wide variety of genetic and non-genetic pathologies share serious psychiatric symptoms, which determine a poor quality of life for patients and their families. To evaluate whether bumetanide, a drug initially developed as a diuretic and currently analyzed for a new indication in patients with severe neuropsychiatric pathologies, could improve the disruptive and self-injurious behaviors secondary to Tuberous Sclerosis Complex (TSC) and characteristic of the autistic spectrum the case of this 6-year-old patient is considered. Following preclinical and clinical evidence of the efficacy of bumetanide in Tuberous Sclerosis and other neurodevelopmental disorders, the drug may alleviate the psychiatric manifestations (TAND) of Tuberous Sclerosis pathology. This would allow avoiding the excessive prescription of antipsychotic drugs indicated to control disruptive behaviors. <strong>Methodology: </strong>The <i>Administración Nacional de Medicamentos, Alimentos y Tecnología Médica </i>(ANMAT) approval was requested for compassionate use since it is not an approved drug in Argentina for this indication. The patient was evaluated with laboratory tests at T0, T1, T2, T3 and T4, corresponding to the basal moments, of 7 days, 30 days, 60 days and 90 days after starting the medication. Likewise, behavior was evaluated with the Aberrant Behavior Checklist (ABC) at the same times described. CARS was used for autistic characteristics and TAND Checklist for psychiatric disorders, both at the beginning. Bumetanide was administered at 1 mg/day and increased to 1.5 mg/day one month after the first dose. <strong>Results:</strong> We observed, in this case, the primary endpoint, irritability, showed moderate improvement. On the contrary, hyperactivity, attention, sociability and better connection through gaze experienced and evident improvement. Regarding isolation scales and stereotyped behaviors, an important improvement was found after 3 months of treatment with bumetanide, an antagonist NKCC1, evaluated through the Aberrant Behavior Checklist (ABC). On the other hand, no remarkable adverse effects were observed. 展开更多
关键词 BUMETANIDE tuberous sclerosis Complex Autism Spectrum Disorder Antagonist NKCC1
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MicroRNA-451 from Human Umbilical Cord-Derived Mesenchymal Stem Cell Exosomes Inhibits Alveolar Macrophage Autophagy via Tuberous Sclerosis Complex 1/Mammalian Target of Rapamycin Pathway to Attenuate Burn-Induced Acute Lung Injury in Rats
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作者 Zhigang Jia Lin Li +5 位作者 Peng Zhao Guo Fei Shuangru Li Qinqin Song Guangpeng Liu Jisong Liu 《Biomedical and Environmental Sciences》 SCIE CAS 2024年第9期1030-1043,共14页
Objective Our previous studies established that microRNA(miR)-451 from human umbilical cord mesenchymal stem cell-derived exosomes(hUC-MSC-Exos)alleviates acute lung injury(ALI).This study aims to elucidate the mechan... Objective Our previous studies established that microRNA(miR)-451 from human umbilical cord mesenchymal stem cell-derived exosomes(hUC-MSC-Exos)alleviates acute lung injury(ALI).This study aims to elucidate the mechanisms by which miR-451 in hUC-MSC-Exos reduces ALI by modulating macrophage autophagy.Methods Exosomes were isolated from hUC-MSCs.Severe burn-induced ALI rat models were treated with hUC-MSC-Exos carrying the miR-451 inhibitor.Hematoxylin-eosin staining evaluated inflammatory injury.Enzyme-linked immunosorbnent assay measured lipopolysaccharide(LPS),tumor necrosis factor-α,and interleukin-1βlevels.qRT-PCR detected miR-451 and tuberous sclerosis complex 1(TSC1)expressions.The regulatory role of miR-451 on TSC1 was determined using a dual-luciferase reporter system.Western blotting determined TSC1 and proteins related to the mammalian target of rapamycin(mTOR)pathway and autophagy.Immunofluorescence analysis was conducted to examine exosomes phagocytosis in alveolar macrophages and autophagy level.Results hUC-MSC-Exos with miR-451 inhibitor reduced burn-induced ALI and promoted macrophage autophagy.MiR-451 could be transferred from hUC-MSCs to alveolar macrophages via exosomes and directly targeted TSC1.Inhibiting miR-451 in hUC-MSC-Exos elevated TSC1 expression and inactivated the mTOR pathway in alveolar macrophages.Silencing TSC1 activated mTOR signaling and inhibited autophagy,while TSC1 knockdown reversed the autophagy from the miR-451 inhibitor-induced.Conclusion miR-451 from hUC-MSC exosomes improves ALI by suppressing alveolar macrophage autophagy through modulation of the TSC1/mTOR pathway,providing a potential therapeutic strategy for ALI. 展开更多
关键词 Acute lung injury Human umbilical cord mesenchymal stem cell-derived exosomes MicroRNA-451 tuberous sclerosis complex 1 Mammalian target of rapamycin pathway Autophagy
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A Tuberous Sclerosis Family with TSC1 (c.1030-1G〉A) Mutation Found through a Female Presenting as Multiple Ground Glass Nodules in Chest Computed Tomography Incidentally
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作者 Ting-Ting Zhao Yong-Sheng Wang +6 位作者 Yan Li Miao Ma Ai-Mei Li Hou-Rong Cai Xiang-Shan Fan Fan-Qing Meng Li-Yun Miao 《Chinese Medical Journal》 SCIE CAS CSCD 2017年第20期2510-2512,共3页
Chest computed tomography (CT) screening is becoming more popular in China. Therefore, more and more rare diseases and early stages of lung diseases were found. Here, we reported a case who presented as multiple gro... Chest computed tomography (CT) screening is becoming more popular in China. Therefore, more and more rare diseases and early stages of lung diseases were found. Here, we reported a case who presented as multiple ground glass nodules incidentally found in chest CT scan who had been suspected as synchronous multiple primary lung cancer (SMPLC) and/or metastatic cancer. She was finally diagnosed as tuberous sclerosis complex (TSC), an autosomal-dominant disorder characterized by the fort-nation of hanaartomatous lesions in the skin, eyes, kidney, and central nervous system. Tuberous sclerosis complex 1 (TSC1) gene mutation (c.1030-1G〉A) was found in her and her family members. This is a very rare report in China. 展开更多
关键词 Computed Tomography FAMILIAL Multiple Nodules tuberous sclerosis: tuberous sclerosis 1 gene mutation
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A Bama miniature pig model of monoallelic TSC1 mutation for human tuberous sclerosis complex 被引量:2
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作者 Xiaoxue Li Tingdong Hu +12 位作者 Jiying Liu Bin Fang Xue Geng Qiang Xiong Lining Zhang Yong Jin Xiaorui Liu Lin Li Ying Wang Rongfeng Li Xiaochun Bai Haiyuan Yang Yifan Dai 《Journal of Genetics and Genomics》 SCIE CAS CSCD 2020年第12期735-742,共8页
Tuberous sclerosis complex(TSC)is a dominant genetic neurocutaneous syndrome characterized by multiple organ hamartomas.Although rodent models bearing a germline mutation in either TSC1 or TSC2 gene have been generate... Tuberous sclerosis complex(TSC)is a dominant genetic neurocutaneous syndrome characterized by multiple organ hamartomas.Although rodent models bearing a germline mutation in either TSC1 or TSC2 gene have been generated,they do not develop pathogenic lesions matching those seen in patients with TSC because of the significant differences between mice and humans,highlighting the need for an improved large animal model of TSC.Here,we successfully generate monoallelic TSC1-modified Bama miniature pigs using the CRISPR/Cas9 system along with somatic cell nuclear transfer(SCNT)technology.The expression of phosphorylated target ribosomal protein S6 is significantly enhanced in the piglets,indicating that disruption of a TSC1 allele activate the mechanistic target of rapamycin(mTOR)signaling pathway.Notably,differing from the mouse TSC models reported previously,the TSC1^(+/−)Bama miniature pig developed cardiac rhabdomyoma and subependymal nodules,resembling the major clinical features that occur in patients with TSC.These TSC1^(+/−)Bama miniature pigs could serve as valuable large animal models for further elucidation of the pathogenesis of TSC and the development of therapeutic strategies for TSC disease. 展开更多
关键词 CRISPR/Cas9 Cardiac rhabdomyosarcoma Subependymal nodules TSC1 tuberous sclerosis complex
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Relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex
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作者 李花 《China Medical Abstracts(Internal Medicine)》 2016年第3期130-,共1页
Objective To study the relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex(TSC).Methods The clinical data of76 patients with TSC diagnosed in Guangdong 999 Brain Hospi... Objective To study the relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex(TSC).Methods The clinical data of76 patients with TSC diagnosed in Guangdong 999 Brain Hospital were collected between May 2007 and 2014 and then TSC gene mutation analysis was performed.Genotype-phenotype analyses for all the patients were also carried out.Results Fifty of the 76(66%)patients 展开更多
关键词 TSC gene Relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex
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A Chinese Tuberous Sclerosis Complex Family and a Novel Tuberous Sclerosis Complex-2 Mutation 被引量:3
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作者 Rong Luo Qianyun Cai Dezhi Mu 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第1期128-130,共3页
Tuberous sclerosis complex (TSC) is a relatively common autosomal dominant genetic disorder affecting l/14,000-1/6000 Western populations.The incidence of TSC in Chinese population is still unknown although case rep... Tuberous sclerosis complex (TSC) is a relatively common autosomal dominant genetic disorder affecting l/14,000-1/6000 Western populations.The incidence of TSC in Chinese population is still unknown although case reports of Chinese TSC patients were documented. The main clinical features of TSC include seizures,mental retardation,and the development ofhamartomas in multiple organs such as the skin,brain,lung,heart,and kidney.Indeed,the disease virtually manifests in every organ. Two causative genes for TSC,TSC 1 gene on chromosome 9q34 and TSC2 gene on chromosome16p13,have been identified in 1997 and 1993 respectively.Approximately,70% of cases of TSC are de novo mutations. Chinese TSC patients are more likely to have TSC2 missense and frame shift mutations.Here,we record one Chinese TSC family and it is novel frame shift mutation of TSC2. 展开更多
关键词 tuberous sclerosis Complex gene mutation TSC2
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Malignancy of renal angiomyolipoma from tuberous sclerosis complex with TSC2 mutation
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作者 Yu-Jing Huang Zong-Pei Jiang +4 位作者 Yu-Ping Chen Jin-Quan Wu Jia-Li Huang Yan-Qiang Chen Meng-Jun Liang 《Chinese Medical Journal》 SCIE CAS CSCD 2019年第1期103-105,共3页
To the Editor:Tuberous sclerosis complex (TSC),with the birth incidence of 1:6000,[1] is an autosomal dominant inherited,multi-system disorder characterized by cellular hyperplasia and tissue dysplasia,among which,ren... To the Editor:Tuberous sclerosis complex (TSC),with the birth incidence of 1:6000,[1] is an autosomal dominant inherited,multi-system disorder characterized by cellular hyperplasia and tissue dysplasia,among which,renal angiomyolipoma (AML) is one common comorbidity.However,malignancy of renal AML is rare.Herein,we shared a case of malignancy of renal AML from TSC in a young man. 展开更多
关键词 MALIGNANCY RENAL ANGIOMYOLIPOMA tuberous sclerosis COMPLEX TSC2 mutation
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携带SOD1-p.A5S突变的1例肌萎缩侧索硬化患者病例报道及相关文献分析
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作者 周青青 贾蕊 +1 位作者 靳娇婷 党静霞 《西安交通大学学报(医学版)》 CSCD 北大核心 2024年第1期139-144,共6页
目的肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)是一种进行性和致命的神经退行性疾病。目前认为Cu/Zn超氧化物歧化酶1基因(Cu/Zn superoxide dismutase gene 1,SOD1)突变是导致家族性ALS的原因之一,对可疑ALS家族史的患者进... 目的肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)是一种进行性和致命的神经退行性疾病。目前认为Cu/Zn超氧化物歧化酶1基因(Cu/Zn superoxide dismutase gene 1,SOD1)突变是导致家族性ALS的原因之一,对可疑ALS家族史的患者进行SOD1基因测序可能有帮助。本文首次报道中国籍汉族SOD1-p.A5S突变的肌萎缩侧索硬化1例,并总结其临床特征。方法与结果首次报道中国籍汉族SOD1-p.A5S突变的1例ALS临床患者并复习相关病例文献,总结其临床特征。研究病例为男性,34岁,以“双下肢无力2年,加重伴双手无力半年”之主诉入住西安交通大学第一附属医院神经内科,主要临床表现为逐渐进展的四肢无力,无吞咽困难,无认知功能障碍。入院后进一步完善常规检查及肌电图等排除其他诊断,并行基因检测。结合患者典型的临床表现和肌电图提示颈髓、胸髓和腰髓三个区域存在下运动神经元受累的证据,合理排除其他诊断及特征性基因检测结果,诊断为ALS。基因检测结果提示患者存在SOD1一号外显子c.13G>T(p.A5S)杂合突变,其母有可疑病史但已死亡未进行基因验证。出院后随访截至2022年8月21日,随访时间共38个月,病程62个月。进一步查阅文献报道的同一位点突变的其他患者的临床特点,总结发现本例突变患者与其他文献报道同一位点突变患者进展较慢。结论基因测序是诊断家族性ALS的有利工具。SOD1一号外显子c.13G>T(p.A5S)突变为罕见的致病性变异,该亚型患者进展较慢,进一步说明基因检测在ALS的诊断和预后判定中具有重要价值。 展开更多
关键词 肌萎缩侧索硬化症(ALS) 铜锌超氧化物歧化酶1基因(SOD1) 基因突变 基因检测
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TSC2/PKD1邻接基因综合征的临床特征及遗传学分析:病例系列研究
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作者 刘欣婷 敦硕 +8 位作者 陈娜 陈健 万林 梁妍 朱刚 张璟 刘国寅 邹丽萍 杨光 《解放军医学院学报》 CAS 2024年第6期584-589,共6页
背景TSC2/PKD1邻接基因综合征(TSC2/PKD1 contiguous deletion syndrome,PKDTS)是TSC2与PKD1基因缺失导致的疾病,国内鲜有报道。目的总结5例TSC2/PKD1邻接基因综合征患儿的临床表型和遗传学特征。方法回顾性分析2015—2023年于解放军总... 背景TSC2/PKD1邻接基因综合征(TSC2/PKD1 contiguous deletion syndrome,PKDTS)是TSC2与PKD1基因缺失导致的疾病,国内鲜有报道。目的总结5例TSC2/PKD1邻接基因综合征患儿的临床表型和遗传学特征。方法回顾性分析2015—2023年于解放军总医院儿科就诊的4例PKDTS患儿以及于山东第一医科大学附属省立医院就诊的1例PKDTS患儿病例资料,采集患儿及其父母的外周血样,分别利用不同的分子生物学方法进行基因检测。结果5例PKDTS患者均以癫痫起病,有相似的临床特征,包括皮肤色素脱失斑、颅内结节、多囊肾、肾功能异常、高血压等,伴有不同程度的发育迟缓,兼具结节性硬化(TSC)和常染色体显性多囊肾疾病(autosomal dominant polycystic kidney disease,ADPKD)的表型。雷帕霉素可以辅助控制TSC相关癫痫发作;严重肾囊肿患者需要穿刺抽液+药物凝固治疗来缓解症状。基因检测结果显示5例患儿分别存在TSC2/PKD1基因不同大小和区域的缺失:病例1,chr16:2131595-2264778区域存在133.18 kb的缺失;病例2,TSC2基因31~42号外显子和PKD1基因30~46号外显子缺失,长度17.64 kb;病例3,chr16:g.2114201-2185990区域存在缺失,长度为71.789 kb;病例4,chr16:2125441-2176668区域缺失拷贝数51.22 kb;病例5,16p13.3(16:2099825-2151077)区域缺失,覆盖51.25 kb。结论本研究发现TSC2/PKD1缺失程度与临床症状的严重程度之间没有明确关联。利用全基因组测序可以早期精准诊断PKDTS并进行干预,雷帕霉素联合抗癫痫发作药物可较好控制TSC相关癫痫。 展开更多
关键词 TSC2/PKD1邻接基因综合征 全基因组测序 癫痫 多囊肾 结节性硬化
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Analysis of genotypes and phenotypes in Chinese children with tuberous sclerosis complex 被引量:6
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作者 Dayong Bai Junyang Zhao +2 位作者 Li Li Jun Gao Xu Wang 《Science China(Life Sciences)》 SCIE CAS CSCD 2017年第7期763-771,共9页
Tuberous sclerosis complex(TSC) is a neurocutaneous syndrome with serious clinical presentations, an autosomal dominant genetic disorder involving multiple organs and systems. We retrospectively investigated the clini... Tuberous sclerosis complex(TSC) is a neurocutaneous syndrome with serious clinical presentations, an autosomal dominant genetic disorder involving multiple organs and systems. We retrospectively investigated the clinical manifestations and genotypes of 20 Chinese children with TSC to enable informed diagnostic and surveillance recommendations in China. A retrospective analysis of clinical manifestations in 20 children(7.00±5.30 years old) with TSC was conducted. A genetic testing of the genes TSC1 and TSC2 was performed in 14 children.The earliest manifestations of TSC were skin lesions(80% of patients) and seizures(75%). Fourteen of the children presented with retinal hamartomas, and 2 of these underwent eye enucleation at other hospitals through misdiagnosis. On magnetic resonance imaging, 18 children exhibited subependymal nodules, and 16 ones showed cortical nodules. 5 cases of non-renal hamartomas, 5 cases of multiple renal cysts, and 5 cases of cardiac rhabdomyomas were observed.The genotyping of TSC1 and TSC2 in 14 children revealed 11 with mutations in TSC2, 2 with mutations in TSC1, and no mutations of either gene in one patient. Eight of these observed mutations are reported here in for the first time. The illness presentations of the TSC2-mutated patients were more severe than that of patients carrying TSC1 mutations.There were differences in the mutations of TSC genes in Chinese children from those reported in other countries. The described clinical characteristics and genotyping will help pediatric neurologists to understand, diagnosis, and treat TSC. 展开更多
关键词 tuberous sclerosis complex TSC1 TSC2 epilepsy hamartoma
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Tuberous Sclerosis Complex Secondary to the Presence of Fetal Cardiac Rhabdomyoma:A Case Report and Literature Review
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作者 Li Hui-Fan Wang Dong +4 位作者 Li Jun-Qi Zhang Li Zhang Xu Qi Hong-Bo Li Jun-Nan 《Maternal-Fetal Medicine》 2020年第4期240-243,共4页
Fetal cardiac rhabdomyoma is associated with tuberous sclerosis complex(TSC)which is an autosomal dominant hereditary neurocutaneous disease with an incidence of approximately 1 in 5000 to 10000 live birth.It is cause... Fetal cardiac rhabdomyoma is associated with tuberous sclerosis complex(TSC)which is an autosomal dominant hereditary neurocutaneous disease with an incidence of approximately 1 in 5000 to 10000 live birth.It is caused by mutations in the TSC1 or TSC2 gene,de novo mutations accounting for approximately 80%of TSC cases,which can involve multiple organs and systems such as the heart,brain,kidney,lung,skin,and so on.Cardiac rhabdomyoma is the most common fetal heart tumor,accounting for about 60%of cases.It is closely related to TSC and may be the only manifestation of TSC which occurs during pregnancy.This study retrospectively analyzed the clinical data of a neonate with TSC diagnosed with fetal cardiac rhabdomyomas and confirmed by amniocentesis prenatal diagnosis as gene testing TSC1 gene positively.The parents had no such mutation.However,due to the influence of the sudden coronavirus disease 2019(COVID-19)epidemic,the TSC genetic test report was not obtained until 38 weeks of pregnancy.Multiple hypo-pigmented spots(diameter>5 mm)were found immediately after birth.The characteristic cardiac feature of TSC is a rhabdomyoma and the diagnosis of TSC is based upon genetic testing and multiple ultrasound examinations or magnetic resonance imaging.Most patients with TSC have epilepsy,and one-half or more have cognitive deficits and learning disabilities.So rigorous follow-up will continue for the case we reported. 展开更多
关键词 tuberous sclerosis Cardiac rhabdomyoma Prenatal diagnosis gene mutation
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Induced pluripotent stem cell-derived motor neurons from amyotrophic lateral sclerosis(ALS)patients carrying different superoxide dismutase 1 mutations recapitulate pathological features of ALS
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作者 Wen-Chao Liu Na Liu +5 位作者 Yan Wang Chen Huang Yan-Fang Li Hao Wang Xiao-Gang Li Min Deng 《Chinese Medical Journal》 SCIE CAS CSCD 2021年第20期2457-2464,共8页
Background:Investigations of the pathogenic mechanisms in motor neurons(MNs)derived from amyotrophic lateral sclerosis(ALS)disease-specific induced pluripotent stem(iPS)cell lines could improve understanding of the is... Background:Investigations of the pathogenic mechanisms in motor neurons(MNs)derived from amyotrophic lateral sclerosis(ALS)disease-specific induced pluripotent stem(iPS)cell lines could improve understanding of the issues affecting MNs.Therefore,in this study we explored mutant superoxide dismutase 1(SOD1)protein expression in MNs derived from the iPS cell lines of ALS patients carrying different SOD1 mutations.Methods:We generated induced pluripotent stem cell(iPSC)lines from two familial ALS(FALS)patients withSOD1-V14M andSOD1-C111Y mutations,and then differentiated them into MNs.We investigated levels of the SOD1 protein in iPSCs and MNs,the intracellular Ca2+levels in MNs,and the lactate dehydrogenase(LDH)activity in the process of differentiation into the MNs derived from the controls and ALS patients’iPSCs.Results:The iPSCs from the two FALS patients were capable of differentiation into MNs carrying different SOD1 mutations and differentially expressed MN markers.We detected high SOD1 protein expression and high intracellular calcium levels in both the MN and iPSCs that were derived from the twoSOD1 mutant patients.However,at no time did we observe stronger LDH activity in the patient lines compared with the control lines.Conclusions:MNs derived from patient-specific iPSC lines can recapitulate key aspects of ALS pathogenesis,providing a cell-based disease model to further elucidate disease pathogenesis and explore gene repair coupled with cell-replacement therapy.Incremental mutant expressions of SOD1 in MNs may have disrupted MN function,either causing or contributing to the intracellular calcium disturbances,which could lead to the occurrence and development of the disease. 展开更多
关键词 Amyotrophic lateral sclerosis Induced pluripotent stem cell SOD1 gene mutation Motor neuron SOD1 aggregation
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新发TSC2基因位点突变致儿童结节性硬化症并色素脱斑相关癫痫
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作者 王雪红 庄生琴 +2 位作者 马溪遥 张博 李锋同 《延安大学学报(医学科学版)》 2024年第1期59-64,共6页
结节性硬化症(tuberous sclerosis complex,TSC)是一种常染色体显性遗传的神经皮肤综合征,以累及多个器官系统为特点。TSC1和TSC2是TSC两个主要的致病基因,二者中任一基因的突变可导致蛋白质结构变化从而导致功能改变,最终表现为TSC的... 结节性硬化症(tuberous sclerosis complex,TSC)是一种常染色体显性遗传的神经皮肤综合征,以累及多个器官系统为特点。TSC1和TSC2是TSC两个主要的致病基因,二者中任一基因的突变可导致蛋白质结构变化从而导致功能改变,最终表现为TSC的各种临床表型。目前,已有多个TSC相关的TSC2和TSC1位点突变被发现。然而,临床接诊过程中,我们收治了1例尚未见报道的TSC2基因c.4569+1G>T杂合突变相关的癫痫发作伴色素脱斑的儿童TSC,在此予以报道,以期为TSC相关疾病的临床诊断及研究提供线索。 展开更多
关键词 结节性硬化症 癫痫 TSC2 TSC1 突变
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结节性硬化105例临床特征和基因型分析 被引量:15
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作者 张林妹 周渊峰 +4 位作者 柴毅明 王佶 吴冰冰 王艺 周水珍 《中国循证儿科杂志》 CSCD 北大核心 2016年第3期219-222,共4页
目的分析结节性硬化(TSC)病例的临床特征和基因型特点,提高TSC诊断水平。方法回顾性纳入2013年8月至2015年9月复旦大学附属儿科医院符合2012年修订的TSC诊断标准并随访的TSC病例。截取脑部、皮肤、心脏、肾脏、眼底等临床特征资料,统... 目的分析结节性硬化(TSC)病例的临床特征和基因型特点,提高TSC诊断水平。方法回顾性纳入2013年8月至2015年9月复旦大学附属儿科医院符合2012年修订的TSC诊断标准并随访的TSC病例。截取脑部、皮肤、心脏、肾脏、眼底等临床特征资料,统计〈1岁、-3岁、-6岁、-13岁和-18岁各临床特征的检出率。分析TSC基因突变与临床特征的相关性。结果 105例TSC病例进入本文分析,男54例,女51例。就诊年龄2月龄至12岁。1就诊原因:83例(79.0%)为癫发作,8例(7.6%)为皮肤异常,5例为心脏肿瘤。239例(37.1%)未行基因检测,以临床特征确诊;66例行TSC基因检测病例中,符合临床特征确诊且TSC基因检测阳性47例(44.8%),符合临床特征确诊但TSC基因检测阴性17例(16.2%);可能符合临床特征诊断,TSC基因检测阳性2例(1.9%)。3临床特征总体检出率:室管膜下结节检出91/99例(91.9%),脑皮质结构异常81/99例(81.8%),在各年龄段检出率相近;皮肤病变中色素脱失斑97/105例(92.4%),面部纤维腺瘤55/105例(52.4%),鲨革斑46/105例(43.8%),面部纤维瘤及鲨革斑随年龄增长检出率增高;心脏横纹肌瘤25/75例(33.3%),检出率随年龄增长降低;肾脏病变14/71例(19.7%),眼部病变5/37例(13.5%)。4TSC1基因突变15/66例(22.7%),TSC2基因突变34/66例(51.5%);TSC2基因突变病例痉挛发作更为常见(29.4%vs13.3%)。结论 TSC可累及多种器官,在不同年龄段脑部病变检出率相近,心脏横纹肌瘤检出率不同。基因检测有助于临床疑似病例的诊断。 展开更多
关键词 结节性硬化 诊断标准 临床特征 TSC基因
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结节性硬化症三例及基因突变分析
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作者 曹晓佳 李楠 韩建文 《中国麻风皮肤病杂志》 2024年第6期387-390,共4页
目的:明确3例结节性硬化症(tuberous sclerosis complex, TSC)患者基因突变位点。方法:对3例患者血液样本进行全外显子基因检测,对患者3进行一代测序验证。结果:患者1存在结节性硬化1型(TSC1)基因杂合插入变异TSC1:NM_000368.5:exon10:c... 目的:明确3例结节性硬化症(tuberous sclerosis complex, TSC)患者基因突变位点。方法:对3例患者血液样本进行全外显子基因检测,对患者3进行一代测序验证。结果:患者1存在结节性硬化1型(TSC1)基因杂合插入变异TSC1:NM_000368.5:exon10:c.989dupT:p.S331Efs^(*)10;患者2和患者3发现存在结节性硬化2型(TSC2)基因的杂合突变,分别是:TSC2:NM_000548.5:exon22:c.2481_2486 del:p.V828_K829 del和TSC2:NM_000548.5:exon5:c.348delG:p.V118Sfs^(*)64;患者3父母未检出该变异。结论:患者2和患者3的2个突变在OMIM中未查询到相应记录,患者3推测为新发变异或父母一方存在生殖细胞嵌合,丰富了该疾病的突变位点谱。 展开更多
关键词 结节性硬化症 基因突变 TSC1 TSC2 基因诊断
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结节性硬化症TSC2基因5238-5255 del 18 bp及2713 C>T基因突变分析 被引量:1
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作者 方玲 吴志英 +4 位作者 王柠 赵桂宪 陈万金 林珉婷 慕容慎行 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2008年第9期550-553,共4页
目的检测并分析2例中国汉族结节性硬化症(tuberous sclerosis complex,TSC)患者TSC2基因突变特点。方法采用直接测序法对31个家系的34例TSC患者及其父母33名进行TSC1基因和TSC2基因全长编码外显子基因检测。测序后发现第25家系先证者为T... 目的检测并分析2例中国汉族结节性硬化症(tuberous sclerosis complex,TSC)患者TSC2基因突变特点。方法采用直接测序法对31个家系的34例TSC患者及其父母33名进行TSC1基因和TSC2基因全长编码外显子基因检测。测序后发现第25家系先证者为TSC2基因外显子40的框内移码突变5238-5255 del 18 bp,第11家系先证者为TSC2基因外显子23错义突变Arg905Trp。进一步采用变性凝胶电泳及内切酶技术在患者与120名正常对照中检测这两种突变。结果第25家系先证者外显子40出现5238-5255d el CATCAAGCGGCTCCGCCA突变,导致6个氨基酸缺失的框内移码突变(1746-1751del His-Ile-Lys-Arg-Leu-Gly),第11家系先证者外显子23出现2713 C>T(Arg905Trp)错义突变,2713位碱基由胞嘧啶(C)改变为胸腺嘧啶(T),导致第905位氨基酸精氨酸被色氨酸替代。120名正常对照未检测到这两种突变。结论TSC2基因5238-5255 del 18 bp及2713 C>T突变为两种致病性突变。 展开更多
关键词 结节性硬化症 TSC2基因 基因突变
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以胎儿心脏占位为首发表现的结节性硬化症1例报告并文献复习 被引量:1
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作者 朱融和 孙媛媛 +3 位作者 梁雅琴 陈斌 殷薇薇 钱燕 《临床儿科杂志》 CSCD 北大核心 2017年第7期481-484,共4页
目的探讨结节性硬化症的临床特点。方法收集1例结节性硬化症患儿的临床资料,分析其临床特征及基因突变结果。结果患儿,女,36日龄,胎儿及生后超声心动图发现异常回声结节,考虑为多发心脏横纹肌瘤;躯干部及双下肢有多处色素脱失斑;头颅磁... 目的探讨结节性硬化症的临床特点。方法收集1例结节性硬化症患儿的临床资料,分析其临床特征及基因突变结果。结果患儿,女,36日龄,胎儿及生后超声心动图发现异常回声结节,考虑为多发心脏横纹肌瘤;躯干部及双下肢有多处色素脱失斑;头颅磁共振成像示皮质结节、室管膜下结节和脑白质辐射状迁移线;高通量二代测序发现TSC2基因突变(c.4541-4544 del CAAA),确诊为结节性硬化症。结论基因检测有助于早期确诊结节性硬化症。 展开更多
关键词 结节性硬化 TSC2基因 心脏肿瘤
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铜/锌超氧化物岐化物1突变致肌萎缩侧索硬化一家系分析并文献复习 被引量:1
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作者 邓娜 周瑾瑕 +2 位作者 廖迪 廖巧 毕方方 《国际神经病学神经外科学杂志》 北大核心 2017年第1期49-53,共5页
目的探索一肌萎缩侧索硬化(ALS)家系基因突变位点并进行文献复习。方法对已知常见的ALS致病基因进行检测,进而对国内铜/锌超氧化物岐化物1(SOD1)基因突变型ALS进行文献复习。结果该家系患者平均起病年龄为(37.8±11.6)岁,均以肢体... 目的探索一肌萎缩侧索硬化(ALS)家系基因突变位点并进行文献复习。方法对已知常见的ALS致病基因进行检测,进而对国内铜/锌超氧化物岐化物1(SOD1)基因突变型ALS进行文献复习。结果该家系患者平均起病年龄为(37.8±11.6)岁,均以肢体症状起病,平均病程约1.3年,死于呼吸衰竭。该家系SOD1基因4号外显子第305位存在A>G突变(D102G)。目前国内报道的SOD1突变基因有26种。起病年龄最早者20岁,最晚者67岁;病程最短者仅1月,最长者达14年。86.4%的患者以肢体症状起病,4.5%以延髓症状起病,7.7%的患者以肢体和延髓症状起病。SOD1基因可表现为完全外显或不完全外显。结论 D102 G为国内首次报道的ALS疾病相关突变。不同SOD1基因突变位点临床症状具有异质性。 展开更多
关键词 肌萎缩侧索硬化 铜/锌超氧化物岐化物1基因 突变
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结节性硬化基因1/2突变与肝细胞癌进展及预后的关系
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作者 张勇 毛正发 《临床肝胆病杂志》 CAS 北大核心 2021年第1期84-88,共5页
目的探讨肝细胞癌(HCC)患者结节性硬化基因1/2(TSC1/2)突变与HCC严重程度及预后的关系,为HCC的诊断及治疗提供可行性依据。方法选取2012年1月—2020年1月江苏大学附属医院收治的HCC患者492例,其中59例患者出现TSC1/2基因突变(TSC1突变20... 目的探讨肝细胞癌(HCC)患者结节性硬化基因1/2(TSC1/2)突变与HCC严重程度及预后的关系,为HCC的诊断及治疗提供可行性依据。方法选取2012年1月—2020年1月江苏大学附属医院收治的HCC患者492例,其中59例患者出现TSC1/2基因突变(TSC1突变20例,TSC2突变41例,共同突变2例),分析TSC1/2突变组患者的临床特征,及TSC1/2突变与HCC临床分期相关性。对35例突变组和35例未突变组患者进行3年随访,观察TSC1/2突变对HCC预后的影响。计数资料两组间比较采用χ^2检验;等级资料两组间比较采用Kruskal-Wallis H秩和检验;采用多元logistic回归分析相关性,随访资料采用Kaplan-Meier生存分析。结果492例HCC患者中,TSC1/2基因总体突变率为11.99%。TSC1、TSC2基因突变组患者性别、年龄、Child-Pugh评分及肿瘤大小与未突变组相较差异均无统计学意义(P值均>0.05),两组肿瘤个数、肝外转移情况及PS评分比较差异均有统计学意义(P值均<0.05)。logistic回归分析结果显示,TSC1/TSC2基因突变与HCC临床分期严重程度呈正相关(OR=1.706,P<0.05)。随访结果显示,TSC1/2突变组患者的生存率明显低于未突变组,前者3年病死率高达60.3%,与未突变组(38.6%)比较差异有统计学意义(χ^2=3.923,P<0.05)。结论TSC1/2基因突变可能早期预测HCC的恶性进展,TSC1/2突变的患者预后更差,应用基因突变靶向药物治疗对于延缓HCC发展可能具有一定疗效。 展开更多
关键词 肝细胞 结节性硬化症 基因 突变
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死亡相关蛋白激酶1及结节性硬化复合物蛋白2基因在胰腺癌组织中的表达及与预后的关系
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作者 孔祥泉 杜开新 +7 位作者 马礼钦 李金銮 廖雪洪 洪俊强 罗水英 林小艺 吴倩 李永恒 《中国医药》 2021年第4期570-574,共5页
目的通过生物信息学方法研究死亡相关蛋白激酶1(DAPK1)和结节性硬化复合物蛋白2(TSC2)基因在胰腺癌中的表达情况,并探讨分析其与预后的关系。方法利用来自癌症和肿瘤基因图谱(TCGA)数据库的胰腺癌患者数据进行Kaplan-Meier分析,进而深... 目的通过生物信息学方法研究死亡相关蛋白激酶1(DAPK1)和结节性硬化复合物蛋白2(TSC2)基因在胰腺癌中的表达情况,并探讨分析其与预后的关系。方法利用来自癌症和肿瘤基因图谱(TCGA)数据库的胰腺癌患者数据进行Kaplan-Meier分析,进而深层次探讨DAPK1和TSC2基因表达水平与患者总生存期或无进展生存期(PFS)的关系,同时,对影响预后的因素进行Cox多因素分析,以及分析胰腺癌中DAPK1和TSC2基因启动子的甲基化水平。此外,通过双荧光素酶报告基因检测系统,验证靶向DAPK1的微小RNA(miR),并应用定量逆转录聚合酶链反应和蛋白质免疫印迹法验证在胰腺癌细胞中miR-324-5p负调控DAPK1的表达。结果多因素分析显示,肿瘤分级(P=0.005)、R0切除(P<0.001)及TSC2表达情况(P=0.005)是影响胰腺癌患者PFS的独立危险因素;肿瘤部位(P=0.006)、病理类型(P=0.002)及分子靶向治疗(P<0.001)是影响胰腺癌患者总生存期的独立危险因素。DAPK1基因低表达且TSC2基因高表达的胰腺癌患者具有更好的总生存期(P=0.024)。DAPK1和TSC2甲基化水平与相应的mRNA表达水平均呈负相关(r=-0.69、-0.37,均P<0.05)。体外实验结果证实,过表达的miR-324-5p显著抑制了胰腺癌Pa Ca-2和PANC-1细胞DAPK1 mRNA和蛋白的表达[mRNA:(0.37±0.02)比(1.00±0.02)、(0.53±0.01)比(1.00±0.06);蛋白:(0.54±0.06)比(1.04±0.12)、(0.63±0.11)比(1.01±0.11)](均P<0.05)。结论DAPK1基因联合TSC2基因的表达情况可以预测胰腺癌患者的预后;在胰腺癌组织中,DAPK1和TSC2启动子的低甲基化水平是DAPK1和TSC2高表达的重要因素;miR-324-5p负调控DAPK1的表达,有望成为胰腺癌靶向治疗的新靶点。 展开更多
关键词 胰腺癌 死亡相关蛋白激酶1 结节性硬化复合物蛋白2 微小RNA-324-5p
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