Exploring the Genotype-Phenotype Correlation in GBA-Parkinson Disease: Clinical Aspects, Biomarkers, and Potential Modifiers.

Exploring the Genotype-Phenotype Correlation in GBA-Parkinson Disease: Clinical Aspects, Biomarkers, and Potential Modifiers.
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探索 GBA-帕金森病的基因型-表型相关性:临床方面、生物标志物和潜在的修饰因素。

DOI:
10.3389/fneur.2021.694764
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发表时间:
2021
影响因子:
3.4
通讯作者:
Schapira AHV
Schapira AHV
中科院分区:
医学3区
文献类型:
--
作者:
Menozzi E;Schapira AHV

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葡萄糖脑苷酶(GBA)基因变异是帕金森病(PD)最常见的遗传风险因素。这些变异包括导致高谢病(GD)的致病变异(根据GD的表型效应,分为“重度”、“轻度”或“复杂”--由重组等位基因引起)和“危险”变异,这些变异与GD无关,但会增加患PD的风险。作为一个群体,与非携带者相比,GBA-PD患者具有更严重的运动和非运动症状,疾病进展更快,生存时间更短。然而,不同的GBA变异对临床表型的影响是不同的。在杂合子状态下,“复杂的”和“严重的”变异与更具侵袭性和快速进展的疾病相关。相反,“温和”和“风险”的变体预示着一个更良性的过程。纯合子或复合杂合子携带者通常表现出严重的表型,类似于杂合子“复杂”或“严重”变异体携带者。本文综述了GBA-PD的基因型-表型相关性,着重于临床和非临床方面(神经影像和生化标记物),并探索在这些患者的特征中值得考虑的其他疾病修饰因素。
Variants in the glucocerebrosidase (GBA) gene are the most common genetic risk factor for Parkinson disease (PD). These include pathogenic variants causing Gaucher disease (GD) (divided into “severe,” “mild,” or “complex”—resulting from recombinant alleles—based on the phenotypic effects in GD) and “risk” variants, which are not associated with GD but nevertheless confer increased risk of PD. As a group, GBA-PD patients have more severe motor and nonmotor symptoms, faster disease progression, and reduced survival compared with noncarriers. However, different GBA variants impact variably on clinical phenotype. In the heterozygous state, “complex” and “severe” variants are associated with a more aggressive and rapidly progressive disease. Conversely, “mild” and “risk” variants portend a more benign course. Homozygous or compound heterozygous carriers usually display severe phenotypes, akin to heterozygous “complex” or “severe” variants carriers. This article reviews genotype–phenotype correlations in GBA-PD, focusing on clinical and nonclinical aspects (neuroimaging and biochemical markers), and explores other disease modifiers that deserve consideration in the characterization of these patients.
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