Genetics and Pathogenesis of Parkinson's Syndrome.

Genetics and Pathogenesis of Parkinson's Syndrome.
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DOI:
10.1146/annurev-pathmechdis-031521-034145
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发表时间:
2023-01-24
期刊:
Annual review of pathology
影响因子:
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通讯作者:
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其他
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帕金森氏病(PD)在临床上、病理上和遗传上都是不同的,不能升华为单一的凝聚力障碍。相反,每个受影响的人实际上都会患上一种独特的帕金森综合症。临床表现包括不同的运动和非运动特征,与其他神经退行性疾病有无数的重叠。虽然最常见的特点是中枢和周围神经系统的α-突触核蛋白病理,但其分布各不相同,其他病理通常改变帕金森病或引发类似的表现。几乎所有的帕金森病都受到遗传因素的影响。目前已经确定了100多个基因或遗传位点,大多数病例可能是由于许多常见和罕见的遗传变异之间的相互作用而产生的。尽管它的结构复杂,但来自实验遗传解剖的见解融合在一起,揭示了统一的生物学主题,包括突触、溶酶体、线粒体和免疫介导的发病机制。对帕金森综合征的这种新的理解,加上生物标记物和靶向治疗的进展,预示着精准医学策略的成功。
Parkinson’s disease (PD) is clinically, pathologically, and genetically heterogeneous, resisting distillation to a single, cohesive disorder. Instead, each affected individual develops a virtually unique form of Parkinson’s syndrome. Clinical manifestations consist of variable motor and nonmotor features, and myriad overlaps are recognized with other neurodegenerative conditions. Although most commonly characterized by alpha-synuclein protein pathology throughout the central and peripheral nervous systems, the distribution varies and other pathologies commonly modify PD or trigger similar manifestations. Nearly all PD is genetically influenced. More than 100 genes or genetic loci have been identified, and most cases likely arise from interactions among many common and rare genetic variants. Despite its complex architecture, insights from experimental genetic dissection coalesce to reveal unifying biological themes, including synaptic, lysosomal, mitochondrial, and immune-mediated mechanisms of pathogenesis. This emerging understanding of Parkinson’s syndrome, coupled with advances in biomarkers and targeted therapies, presages successful precision medicine strategies.
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