Marfan syndrome.

Marfan syndrome.
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DOI:
10.1038/s41572-021-00298-7
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发表时间:
2021-09-02
期刊:
Nature reviews. Disease primers
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其他
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马凡综合征 (MFS) 是一种常染色体显性遗传、年龄相关但渗透率很高的疾病,具有显着的家庭内和家庭间变异性。 MFS 是由 FBN1 的致病性变异引起的,FBN1 编码 fibrillin-1,它是细胞外基质的主要结构成分,为结缔组织提供支持,特别是在动脉、软骨膜和眼睛结构中。高达 25% 的 MFS 患者存在新生变异。 MFS 最突出的表现是无症状主动脉根部动脉瘤、主动脉夹层、晶状体脱位(晶状体异位)以及以长骨过度生长为特征的骨骼异常。 MFS 根据根特 II 疾病分类学诊断;诊断并不总是需要基因检测来确认 FBN1 致病性变异的存在,但可以帮助区分 MFS 与其他可表现出与 MFS 相似的骨骼特征的遗传性胸主动脉疾病综合征。未经治疗的主动脉根部动脉瘤可能发展为危及生命的急性主动脉夹层。 MFS 的治疗需要药物治疗来减缓动脉瘤的生长速度并降低夹层风险。需要使用经胸超声心动图、CT 或 MRI 等成像技术进行常规监测,以监测动脉瘤生长并确定何时进行预防性修复手术以预防急性主动脉夹层。马凡综合征 (MFS) 是一种影响结缔组织的遗传性疾病,由 FBN1(编码纤维蛋白-1,细胞外基质的结构成分)突变引起;患有 MFS 的个体通常会出现心血管(主动脉瘤和夹层)、骨骼和眼部表现。
Marfan syndrome (MFS) is an autosomal dominant, age-related but highly penetrant condition with substantial intrafamilial and interfamilial variability. MFS is caused by pathogenic variants in FBN1, which encodes fibrillin-1, a major structural component of the extracellular matrix that provides support to connective tissues, particularly in arteries, pericondrium and structures in the eye. Up to 25% of individuals with MFS have de novo variants. The most prominent manifestations of MFS are asymptomatic aortic root aneurysms, aortic dissections, dislocation of the ocular lens (ectopia lentis), and skeletal abnormalities that are characterized by overgrowth of the long bones. MFS is diagnosed based on the Ghent II nosology; genetic testing confirming the presence of a FBN1 pathogenic variant is not always required for diagnosis but can help to distinguish MFS from other heritable thoracic aortic disease syndromes that can present with skeletal features similar to MFS. Untreated aortic root aneurysms can progress to life-threatening acute aortic dissections. Management of MFS requires medical therapy to slow the rate of growth of aneurysms and decrease the risk for dissection. Routine surveillance with imaging techniques such as transthoracic echocardiography, CT or MRI is necessary to monitor aneurysm growth and determine when to perform prophylactic repair surgery to prevent an acute aortic dissection. Marfan syndrome (MFS) is a genetic disorder affecting the connective tissue, caused by mutations in FBN1 (encoding fibrillin-1, a structural component of the extracellular matrix); individuals with MFS usually present with cardiovascular (aortic aneurysms and dissections), skeletal and ocular manifestations.
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发表时间: 2021-05
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