Telomerase and idiopathic pulmonary fibrosis.

Telomerase and idiopathic pulmonary fibrosis.
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DOI:
10.1016/j.mrfmmm.2011.10.013
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发表时间:
2012-02-01
影响因子:
2.3
通讯作者:
Armanios, Mary
Armanios, Mary
中科院分区:
医学4区
文献类型:
--
作者:
Armanios, Mary

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特发性肺纤维化(IPF)是端粒介导的疾病最常见的表现。在六分之一的肺纤维化家族中,基本端粒酶基因hTERT和hTR的种系突变是致病性遗传缺陷。端粒酶突变在这个子集中的存在对于临床决策是重要的,因为受影响的个体可以发展与端粒缩短相关的肺外并发症,如骨髓衰竭和隐源性肝硬化。还有证据表明,IPF是常染色体显性端粒综合征的祖先表现,在连续几代中,该疾病从肺纤维化演变为骨髓衰竭为主的疾病,定义了一种独特的遗传预测形式。在这里,我回顾端粒缺陷的意义,了解遗传学,疾病模式和病理生理学的IPF。这种诊断的重要性,病人的护理决策也将进行讨论。
Idiopathic pulmonary fibrosis (IPF) is the most common manifestation of telomere-mediated disorders. Germline mutations in the essential telomerase genes, hTERT and hTR, are the causal genetic defect in up to one-sixth of pulmonary fibrosis families. The presence of telomerase mutations in this subset is significant for clinical decisions as affected individuals can develop extra-pulmonary complications related to telomere shortening such as bone marrow failure and cryptogenic liver cirrhosis. There is also evidence that IPF is an ancestral manifestation of autosomal dominant telomere syndromes where, with successive generations, the disease evolves from pulmonary fibrosis into a bone marrow failure-predominant disorder, defining a unique form of genetic anticipation. Here I review the significance of telomere defects for understanding the genetics, disease patterns and pathophysiology of IPF. The importance of this diagnosis for patient care decisions will also be discussed.
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