Genetic studies provide clues on the pathogenesis of idiopathic pulmonary fibrosis.

Genetic studies provide clues on the pathogenesis of idiopathic pulmonary fibrosis.
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DOI:
10.1242/dmm.010736
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发表时间:
2013-01
影响因子:
4.3
通讯作者:
Blackwell TS
Blackwell TS
中科院分区:
医学2区
文献类型:
--
作者:
Kropski JA;Lawson WE;Young LR;Blackwell TS

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特发性肺纤维化(IPF)是一种进行性且往往致命的肺部疾病,目前尚无已知的治疗方法。尽管传统的IPF发病机制强调慢性炎症是纤维化重塑的主要驱动因素,但最近的研究结果对这一观点提出了挑战。连锁分析和候选基因方法已经确定了导致IPF,家族性间质性肺炎(FIP)遗传形式的四个基因。这四个基因编码两种表面活性剂蛋白,表面活性剂蛋白C(由SFTPC编码)和表面活性剂蛋白A2 (SFTPA2),以及端粒酶复合体的两种组分,端粒酶逆转录酶(TERT)和端粒酶的RNA组分(TERC)。在这篇综述中,我们讨论了如何研究这些突变,以及在其他与肺纤维化相关的遗传性疾病中发现的遗传变异,为了解常见特发性间质性肺疾病,特别是IPF的发病机制提供了新的见解。该领域的研究强调了上皮细胞损伤和功能障碍在肺纤维化发展中的关键作用。此外,遗传学方法已经揭示了几个过程的重要性,包括内质网应激和未折叠蛋白反应,dna损伤和修复途径以及细胞衰老,这些过程可能为纤维化肺部疾病提供新的治疗靶点。
Idiopathic pulmonary fibrosis (IPF) is a progressive and often fatal lung disease for which there is no known treatment. Although the traditional paradigm of IPF pathogenesis emphasized chronic inflammation as the primary driver of fibrotic remodeling, more recent insights have challenged this view. Linkage analysis and candidate gene approaches have identified four genes that cause the inherited form of IPF, familial interstitial pneumonia (FIP). These four genes encode two surfactant proteins, surfactant protein C (encoded by SFTPC) and surfactant protein A2 (SFTPA2), and two components of the telomerase complex, telomerase reverse transcriptase (TERT) and the RNA component of telomerase (TERC). In this review, we discuss how investigating these mutations, as well as genetic variants identified in other inherited disorders associated with pulmonary fibrosis, are providing new insights into the pathogenesis of common idiopathic interstitial lung diseases, particularly IPF. Studies in this area have highlighted key roles for epithelial cell injury and dysfunction in the development of lung fibrosis. In addition, genetic approaches have uncovered the importance of several processes – including endoplasmic reticulum stress and the unfolded protein response, DNA-damage and -repair pathways, and cellular senescence – that might provide new therapeutic targets in fibrotic lung diseases.
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