Primary hyperoxaluria type 1: pathophysiology and genetics.

Primary hyperoxaluria type 1: pathophysiology and genetics.
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DOI:
10.1093/ckj/sfab217
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发表时间:
2022-05
影响因子:
4.6
通讯作者:
--
中科院分区:
医学2区
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--
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原发性高尿酸1型(PH 1)是一种罕见的草酸钙肾结石病的遗传形式。它是由肝脏特异性酶丙氨酸:乙醛酸氨基转移酶(AGT)缺乏引起的,AGT是一种参与乙醛酸代谢的吡哆醛-5 ′-磷酸(PLP)依赖性酶。草酸盐的过量内源性合成导致高尿酸,而草酸盐的难溶性钙盐的结晶是导致严重肾结石病的原因,其可进展为终末期肾病、草酸盐的全身性沉积和死亡。关于乙醛酸和草酸的代谢前体、AGT的分子病理学以及用于诊断和临床评估的分析方法的知识使我们能够更好地理解PH 1的潜在机制,并为新的治疗策略打开了大门。
Primary hyperoxaluria type 1 (PH1) is a rare genetic form of calcium oxalate kidney stone disease. It is caused by a deficiency in the liver-specific enzyme, alanine:glyoxylate aminotransferase (AGT), a pyridoxal-5′-phosphate (PLP)-dependent enzyme involved in the metabolism of glyoxylate. The excessive endogenous synthesis of oxalate that ensues leads to hyperoxaluria, and the crystallization of the poorly soluble calcium salt of oxalate is responsible for a severe kidney stone disease, which can progress to end-stage renal disease, systemic deposition of oxalate and death. Knowledge about metabolic precursors of glyoxylate and oxalate, molecular pathology of AGT and analytical methods for diagnosis and clinical assessment have allowed a better understanding of the mechanisms underlying PH1 and opened the door to new therapeutic strategies.
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