东京大学和德岛大学的联合研究小组在新一期《美国人类遗传学杂志》上报告说,他们发现了遗传性运动和感觉神经变性病的一个致病基因。这将有助于研发运动神经元疾病的治疗药物。
遗传性运动和感觉神经变性病是一种神经元疾病,在成人期发病后,表现为运动神经出现变化,肩和腰等部位的肌肉力量逐渐下降,与肌萎缩侧索硬化症(俗称渐冻症)的症状类似。
研究小组对于家族中有人患此病的日本西部4个家族共32人的血液进行了分析,结果发现,在13名已经发病的人体内,名为“TFG”基因全部出现变异,从而证实这种基因可能是该病的致病基因之一。
研究小组发现,“TFG”基因如果出现变异,名为“TDP-43”的蛋白质就会在细胞内异常蓄积,导致运动神经细胞死亡。此前,研究人员已知渐冻症患者的脊髓中都有这种蛋白质蓄积。研究小组由此认为,遗传性运动和感觉神经变性病与渐冻症有可能是由于共同的分子机制而导致运动神经细胞死亡的。
扩展阅读:
神经变性病 (Neurodegenerative Diseases) 是指由于神经元变性、凋亡所导致的神经系统退行性疾病,临床表现主要分为两种:运动功能障碍和记忆与认知功能障碍。组织病理学研究均显示神经元缓慢渐进性凋亡,大多在神经细胞内存在蛋白质的异常聚集,形成包涵体,提示它们可能具有相类似的发病机制。
这类疾病临床多隐袭起病,病程缓慢进展,可持续多年甚至十几年或更长,部分病例可有家族遗传史。治疗尚无成熟有效的方法,部分症状(如帕金森病的症状)可因有经验的治疗而缓解,但总体病程不断进展。
运动神经元病一般病因未明,选择性侵犯上、下运动神经元的进行性变性疾病。病变范围包括皮质锥体细胞、脑神经运动核、脊髓前角细胞、皮质延髓束和皮质脊髓束。
突出的病理特点是大脑皮质运动区锥体细胞,脑干下运动神经元及脊髓前角细胞变性和数目减少。皮质脊髓束和皮质脑干束变性。可见不同程度的胶质细胞增生。主要表现为锥体束征、肌无力和肌萎缩、延髓麻痹,但无感觉障碍。
“渐冻症”是一组运动神经元疾病(Motor Neuron Disease,简称M.N.D.)、卢伽雷氏症的俗称,主要类型是肌萎缩性脊髓侧索硬化症(Amyotrophic Lateral Sclerosis,简称A.L.S.)(也就是运动神经细胞萎缩症) , 因为特征性表现是肌肉逐渐萎缩和无力,吞咽和呼吸困难,逐渐丧失生活自理能力。身体如同被逐渐冻住一样,故俗称“渐冻症”。由于目前没有特效药,而与癌症、艾滋病等疾病并列为世界五大顽症。
The TRK-Fused Gene Is Mutated in Hereditary Motor and Sensory Neuropathy with Proximal Dominant Involvement
Hiroyuki Ishiura, Wataru Sako, Mari Yoshida et al.
Hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P) is an autosomal-dominant neurodegenerative disorder characterized by widespread fasciculations, proximal-predominant muscle weakness, and atrophy followed by distal sensory involvement. To date, large families affected by HMSN-P have been reported from two different regions in Japan. Linkage and haplotype analyses of two previously reported families and two new families with the use of high-density SNP arrays further defined the minimum candidate region of 3.3 Mb in chromosomal region 3q12. Exome sequencing showed an identical c.854C>T (p.Pro285Leu) mutation in the TRK-fused gene (TFG) in the four families. Detailed haplotype analysis suggested two independent origins of the mutation. Pathological studies of an autopsied patient revealed TFG- and ubiquitin-immunopositive cytoplasmic inclusions in the spinal and cortical motor neurons. Fragmentation of the Golgi apparatus, a frequent finding in amyotrophic lateral sclerosis, was also observed in the motor neurons with inclusion bodies. Moreover, TAR DNA-binding protein 43 kDa (TDP-43)-positive cytoplasmic inclusions were also demonstrated. In cultured cells expressing mutant TFG, cytoplasmic aggregation of TDP-43 was demonstrated. These findings indicate that formation of TFG-containing cytoplasmic inclusions and concomitant mislocalization of TDP-43 underlie motor neuron degeneration in HMSN-P. Pathological overlap of proteinopathies involving TFG and TDP-43 highlights a new pathway leading to motor neuron degeneration.