PROJECT 1: LONGITUDINAL STUDIES

项目概要（OI纵向研究） 脆性骨病罕见病临床研究联盟（BBD RDCRC）纵向 成骨不全（OI）的研究旨在：1）表征发生在不同年龄段的OI表型， 寿命，2）了解各种问题如何影响患有OI的个体，3）评估对常规治疗的反应 临床护理有超过18个基因导致BBD，它们具有多效性效应，导致广泛的 一系列身体和健康挑战以及生活经历。生物化学和分子机制 OI包括单倍不足型I型胶原OI、显性阴性型I型胶原OI、I型胶原紊乱型OI、I型胶原异常型OI、I型胶原异常型OI、I型胶原异常型OI、I型胶原异常型OI和I型胶原异常型OI。 胶原蛋白翻译后修饰、I型胶原蛋白转运障碍以及一些新出现的 由于异常信号而引起的疾病。我们非常需要了解这些生物的自然历史 条件以及将基因型与表型相关联，以定义护理标准并改善 治疗选择根据我们迄今为止在BBDC第1-5年的经验，我们确定了以下内容 需要进行纵向评估的重要问题： 1)评估患有以下疾病的个体在表型、疾病进展和治疗反应方面的差异： 显性和隐性形式的OI，以评估这些疾病的自然史。 2)描述I型胶原单倍不足OI（OI-HI或OI I型）中椎体骨折的发生率 通过前瞻性、多中心观察性研究，评价临床易感因素的影响 脊椎骨折的发展 3)描述脊柱侧凸的自然病史，评估各种形式的OI的特征， 畸形的进展，脊柱侧凸对肺功能、活动性和生活质量的影响， 脊柱侧凸干预（支具、手术等）脊柱侧凸和肺功能。 4)利用患者报告的结局工具评估导致焦虑和疼痛增加的因素 干预成人和儿童OI，以制定干预措施，提高生活质量。 5)通过分析妊娠前和哺乳期骨质疏松妇女的骨健康状况， 妊娠后骨密度和含量及骨折发生率。 6)评估牙齿咬合不正和颅面异常，并确定随时间的动态变化 以及对口腔健康相关生活质量的影响。 BBD RDCRC纵向研究将由联盟的所有11家临床研究中心进行。V·里德萨顿 贝勒医学院和蒙特利尔施里纳儿童医院的弗兰克·劳奇将担任共同首席研究员 在整个纵向研究中。

PROJECT SUMMARY (Longitudinal Study of OI) The Brittle Bone Disorders Rare Disease Clinical Research Consortium (BBD RDCRC) longitudinal study of Osteogenesis Imperfecta (OI) seeks to 1) characterize the phenotypes of OI that occur across the lifespan, 2) understand how various issues effect individuals with OI and 3) assess the response to routine clinical care. There are over 18 genes that cause BBDs and they have pleiotropic effects resulting in a broad spectrum of physical and health challenges and life experiences. Biochemical and molecular mechanisms of OI include haploinsufficient type I collagen OI, dominant negative type I collagen OI, disorders of type I collagen post-translational modification, disorders of type I collagen transport, and an emerging number of disorders due to abnormal signaling. There is great need to understand the natural histories of these conditions as well as correlating genotypes with phenotypes to define a standard of care and improve therapeutic options. Based on our experience to date in the BBDC years 1-5, we have identified the following important issues in need of longitudinal assessment: 1) Evaluate the difference in phenotype, disease progression and response to therapies in individuals with dominant and recessive forms of OI to assess the natural history of these disorders. 2) Describe the incidence of vertebral fractures in type I collagen haploinsufficient OI (OI-HI or OI type I) through a prospective, multi-center observational study, and evaluate the impact of clinical susceptibility factors on the development of incident vertebral fractures 3) Describe the natural history of scoliosis in various forms of OI and assess the characteristics predisposing to progression of the deformity, effects of scoliosis on pulmonary function, mobility & quality of life and impact of scoliosis interventions (bracing, surgery, etc.) on scoliosis and pulmonary function. 4) Utilize patient reported outcomes tools to assess factors that contribute to increased anxiety and pain interference in adults and children with OI, in order to develop interventions to improve quality of life. 5) Characterize the effect of pregnancy and lactation on bone health in women with OI by analyzing pre- and post-pregnancy bone mineral density and content and fracture incidence. 6) Evaluate dental malocclusion & craniofacial abnormalities and determine the dynamic changes over time and impact upon oral-health related quality of life. The BBD RDCRC longitudinal study will be performed by all 11 clinical sites of the consortium. V. Reid Sutton at Baylor College of Medicine and Frank Rauch at the Montreal Shriners Hospital for Children will be the co-PIs of the overall longitudinal study.