综述
ENGLISH ABSTRACT
(CAG)n·(CTG)n三核苷酸重复序列扩增及相关疾病机制研究进展
王希恒
潘学峰
李红权
段斐
作者及单位信息
·
DOI: 10.3760/cma.j.issn.1673-4386.2016.05.008
Advances in the studies of the expansion of (CAG)n·(CTG)n trinucleotide repeats and mechanisms underlying its related diseases
Wang Xiheng
Pan Xuefeng
Li Hongquan
Duan Fei
Authors Info & Affiliations
Wang Xiheng
Laboratory of Pharmacology, School of Medicine, Hebei University, Baoding 071000, China
Pan Xuefeng
Li Hongquan
Duan Fei
·
DOI: 10.3760/cma.j.issn.1673-4386.2016.05.008
3316
61
0
0
0
0
PDF下载
APP内阅读
摘要

出现在基因内三核苷酸重复序列(CAG)n·(CTG)n的"动态"扩增与包括多型脊髓小脑共济失调在内的神经-肌肉系统退行性病变的发生密切有关。正常个体中,相关(CAG)n·(CTG)n三核苷酸重复序列的重复单元数目被限制在一定的阈值之下,而在患者的受累基因内,(CAG)n·(CTG)n的重复数则超出该阈值,并导致患者出现与神经和肌肉系统有关的疾病症候。本文总结归纳了与(CAG)n·(CTG)n重复扩增相关的疾病在国内的发病情况和相关疾病的病理特征,并分析讨论了(CAG)n·(CTG)n序列在患者体内出现扩增的可能分子机制。

三核苷酸重复序列;扩增性不稳定性;神经肌肉系统退行性病变;遗传性共济失调
ABSTRACT

The dynamic expansion of (CAG)n·(CTG)n trinucleotide repeat in certain human genes is tightly associated with the occurrences of neuromuscular degenerative diseases, including multiple types of Spinal-cerebellar Ataxias. The repeating numbers of the relating (CAG)n·(CTG)n trinucleotide repeats in normal individuals are lower than a threshold level, while such repeating numbers of the repeats are beyond the threshold in the affiliated genes in patients, leading to the penetrations of different disease symptoms that mainly involve the neuro-and muscular systems. This review summarizes the disease condition and the pathological characteristics of the (CAG)n·(CTG)n repeat expansion-associated human diseases in China while discussing the possible molecular mechanisms underlying the (CAG)n·(CTG)n repeat expansion in vivo.

Trinucleotide Repeats;Expansion Instability;Nero-Muscular Degeneration diseases;Genetic Ataxia
Pan Xuefeng. E-mail: mocdef.nabuyilamacnapgnefeux Li Hongquan. E-mail: mocdef.6ab21liamenauqgnohil
Natural Science Foundation of Hebei Province (H2015201131); Beijing Natural Science Foundation (5132014); Special Funds of Medical Science of Hebei University (2012A2004)
引用本文

王希恒,潘学峰,李红权,等. (CAG)n·(CTG)n三核苷酸重复序列扩增及相关疾病机制研究进展[J]. 国际遗传学杂志,2016,39(5):274-281.

DOI:10.3760/cma.j.issn.1673-4386.2016.05.008

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价
20世纪90年代以来,陆续发现了40种以上的人类神经-肌肉系统退行性病变与患者基因组内的三核苷酸重复序列(CAG)n·(CTG)n、(CGG)n·(CCG)n和(GAA)n·(TTC)n的"动态扩增"有关 [ 1 ]。其中,脆性X染色体综合征是最早被确证与三核苷酸重复序列(CGG)n·(CCG)n扩增有关的疾病。位于X染色体长臂的(CGG)n·(CCG)n重复序列在正常人体内为5~54次重复,在携带者体内为60~230次重复,而在患者体内则为230到4000次重复,显然高强度的重复数改变与患者病情的严重程度呈正相关。扩增后的CGG重复序列稳定性急剧下降,在临床上表现出CGG重复数越高,包括智力障碍、异常的面部特征(长脸)等临床表现越明显。之后,在X染色体上又进一步明确了CCG重复扩增与脆性X综合征E位点有关 [ 2 ]
鉴于发现越来越多的疾病与三核苷酸重复序列扩增有关,因此现已依据疾病的相似性把与三核苷酸重复扩增有关的人类疾病分为三大类:①包括亨廷顿舞蹈病和脊髓小脑共济失调,它们主要起因于特定基因编码区内的CAG重复序列的扩增;②可以表现出更加复杂的疾病表型,但相关的三核苷酸重复序列只表现出小幅扩增,与这类疾病有关的三核苷酸重复序列主要分布于受累基因的编码区的内含子和外显子区域;③以脆性X染色体综合征、肌营养不良、两种脊髓小脑共济失调、青年型肌阵挛性癫痫、弗里德赖希氏共济失调(Fried reich’s ataxia)为代表,它们的三核苷酸重复序列扩增剧烈,但三核苷酸重复序列位于蛋白编码区外。
现在已确定了至少14种神经类疾病与(CAG)n·(CTG)n的扩增有关,包括脊髓小脑性共济失调综合征(spinocerebellar ataxia,SCA)SCA1、SCA2、SCA3、SCA6、SCA7、SCA8、SCA12和SCA17,亨廷顿舞蹈病(Huntington’s disease,HD)、HD-like 2、肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)、脊髓延髓肌萎缩症(spinal and bulbar muscular atrophy,SBMA)、肌强直性营养不良1型(myotonic dystrophy,MD1),齿状核红核苍白球路易体萎缩症(dentatorubral-pallidoluysian atrophy,DRPLA)等(见 表1 )。与(CGG)n·(CCG)n和(CAA)n·(TTC)n扩增的情况不同,有扩增倾向的(CAG)n·(CTG)n重复主要分布于基因内的蛋白编码区,并因此可以转录到mRNA中,并被进一步翻译成聚谷氨酰胺残基重复(polyglutamine repeat,简称polyQ)。而疾病症候主要通过polyQ对蛋白质折叠能力的影响加以体现 [ 16 , 17 , 18 ]。尽管如此,也有报道表明,扩增之后的(CAG)n·(CTG)n序列还可能影响基因转录,生成病理性RNA分子,并借此影响疾病表征 [ 2 ]
疾病名称 基因 重复序列 正常重复次数 异常重复次数 疾病的临床表现 参考文献
脊髓小脑共济失调1型(SCA1) ATXN1 CAG 6~39 41~83 共济失调、弓形足、视神经萎缩、脊柱侧弯、心肌病等眼肌麻痹,上视不能 [ 3 ]
脊髓小脑共济失调2型(SCA2) ATXN2 CAG 13~30 36~41 上肢腱反射减弱或消失,眼球慢扫视运动 [ 4 ]
脊髓小脑共济失调3型(SCA3) ATXN3 CAG 14~37 61~84 肌张力增高,腱反射亢进,肌萎缩、面肌及舌肌纤颤、眼睑退缩形成凸眼 [ 5 ]
脊髓小脑共济失调6型(SCA6) CACNA1A CAG 4~18 21~30 共济失调,慢眼活动,假性球麻痹,眼颤,意向性震颤,腱反射活跃或减弱 [ 6 ]
脊髓小脑共济失调7型(SCA7) ATXN7 CAG 7~17 36~70 遗传早现,共济失调,视力下降,眼肌麻痹,智力正常,腱反射活跃,多无夜盲,多无眼震 [ 7 ]
脊髓小脑共济失调17型(SCA17) TBP CAG 30~42 >42 共济失调,肌张力障碍,精神症状,痴呆,舞蹈样动作 [ 8 ]
非编码区            
脊髓小脑共济失调8型(SCA8) OSCA SCA8 CTG 15~50 80~250 多发性神经病,可表现为感觉或感觉运动性神经病,常为轴索损害 [ 9 ]
脊髓小脑共济失调12型(SCA12) PPP2R2BSCA12 CAG 7~30 66~78 视力减退或丧失,视网膜色素变性,心脏损害也较突出 [ 10 ]
亨廷顿疾病(HD) HTT(Huntingtin) CAG 11~34 >40 不自主运动、精神异常和进行性痴呆 [ 11 ]
肌萎缩侧索硬化(ALS) ATXN2 CAG <30 ≥31 上、下运动神经元合并受损的混合性瘫痪 [ 12 ]
脊髓延髓肌萎缩症(SBMA) AR CAG 6~35 >38 青春期症状主要是肌肉痉挛和疼痛,全身和咀嚼肌疲劳,男性乳房女性化;中年男性(40~50岁)病程进展缓慢,常在发病前有多年的肌肉痛性痉挛。主要表现为肢体近端(肩胛带和骨盆带)肌肉萎缩和无力,并随病情进展波及到远端,下肢重于上肢。 [ 13 ]
肌强直性营养不良1型(DM1) DMPK CTG 5~37 >50 肌无力、肌萎缩和肌强直 [ 14 ]
齿状核红核苍白球路易体萎缩症(DRPLA) ATN1 DRPLA CAG 6~35 ≥49 痴呆、语言障碍、共济失调、癫痫和不自主运动(包括舞蹈样动作、震颤和肌阵挛等) [ 15 ]
三核苷酸重复相关疾病正常异常重复序列次数及其临床表现汇总
一直以来,与疾病过程中三核苷酸重复序列扩增的原因长期困扰着研究者和临床医务工作者。几十年的研究发现,(CAG)n·(CTG)n既可以在人的生殖细胞内扩增,也可以在体细胞内扩增 [ 3 ]。一般表现为,在生殖细胞中的扩增将传给后代较长的重复序列,可以使得有关症状提前,并且病情相对严重,表现出"早现现象"。而在神经细胞等体细胞内的扩增则一般只影响特定个体的疾病的病情。
鉴于(CAG)n·(CTG)n三核苷酸重复序列扩增与国内临床实践中多种神经退行性疾病的发生发展具有密切相关性,本文将对主要围绕中国人群中SCA、HD和ALS等疾病过程中(CAG)n·(CTG)n的重复序列不稳定性情况加以总结分析。
试读结束,您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
潘学峰. 基因疾病的分子生物学[M]. 北京化学工业出版社 2014.
[2]
Groh M , Silva LM , Gromak N . Mechanisms of transcriptional dysregulation in repeat expansion disorders[J]. Biochem Soc Trans, 201442(4):1123-1128. DOI: 10.1042/BST20140049 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Pearson CE , Edamura KN , Cleary JD . Repeat instability: mechanisms of dynamic mutations[J]. Nat Rev Genet, 20056(10):729-742. DOI: 10.1038/nrg1689 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
张麟伟顾卫红. 脊髓小脑共济失调1型研究进展[J]. 中国现代神经疾病杂志 201414(5):450-454. DOI: 10.3969/j.issn.1672-6731.2014.05.017 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Menon RP , Nethisinghe S , Faggiano S ,et al. The role of interruptions in polyQ in the pathology of SCA1[J]. PLoS Genet, 20139(7):e1003648. DOI: 10.1371/journal.pgen.1003648 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
赵静程楠王训韩咏竹. 安徽地区遗传性脊髓小脑性共济失调1型患者的临床研究[J]. 安徽医学 201233(4):388-390. DOI: 10.3969/j.issn.1000-0399.2012.04.002 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Katagiri S , Hayashi T , Takeuchi T . Somatic instability of expanded CAG repeats of ATXN7 in Japanese patients with spinocerebellar ataxia type 7[J]. Doc Ophthalmol, 2015130189-195. DOI: 10.1007/s10633-015-9488-8 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Huang SS Su Y , Guo J , Yan S ,et al. Large polyglutamine repeats cause muscle degeneration in SCA17 Mice[J]. Cell Reports, 201513(1):196-208. DOI: http://dx.doi.org/10.1016/j.celrep.2015.08.060 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Kim JS , Son TO , Youn J . Non-Ataxic phenotypes of SCA8 mimicking amyotrophic lateral sclerosis and parkinson disease[J]. J Clin Neurol, 20139(4):274-279. DOI: 10.3988/jcn.2013.9.4.274 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
陈朴马明义商慧芳. 常染色体显性小脑性共济失调致病基因动态突变位点三核苷酸重复变异的研究[J]. 中华医学杂志 200926(6):626-633. DOI: 10.3760/cma.j.issn.1003-9406.2009.06.006 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Lee JM , Wheeler VC , Chao MJ ,et al. Identification of genetic factors that modify clinical onset of Huntington's disease[J]. Cell, 2015162(3):516-526. DOI: 10.1016/j.cell.2015.07.003 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Neuenschwander AG , Thai KK , Figueroa KP ,et al. Amyotrophic lateral sclerosis risk for spinocerebellar ataxia type 2 ATXN2 CAG repeat alleles: a meta-analysis[J]. JAMA Neurol, 201471(12):1529-1534. DOI: 10.1001/jamaneurol.2014.2082 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Zelinkova H , Lexova KK , Spalek P ,et al. Molecular diagnosis of spinal and bulbar muscular atrophy in Slovakia[J]. Brtisl Lek Listyl, 2016117(3):137-141.
返回引文位置Google Scholar
百度学术
万方数据
[14]
Bargiela A , Cerro-Herreros E , Fernandez-Costa JM ,et al. Increased autophagy and apoptosis contribute to muscle atrophy in a myotonic dystrophy type 1 Drosophila model[J]. Dis Models Mech, 20158(7):679-690. DOI: 10.1242/dmm.018127 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Maruyama S , Saito Y , Nakagawa E . Importance of CAG repeat length in childhood-onset dentatorubral-pallidoluysian atrophy[J]. J Neurol, 20122592329-2334. DOI: 10.1007/s00415-012-6493-7 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
La Spada AR , Taylor JP . Repeat expansion disease: progress and puzzles in disease pathogenesis[J]. Nat Rev Genet, 201011(4):247-258. DOI: 10.1038/nrg2748 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Orr HT , Zoghbi HY . Trinucleotide repeat disorders[J]. Annu Rev Neurosci, 200730575-621. DOI: 10.1146/annurev.neuro.29.051605.113042 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Gatchel JR , Zoghbi HY . Diseases of unstable repeat expansion: mechanisms and common principles[J]. Nat Rev Genet, 20056(10):743-755. DOI: 10.1038/nrg1691 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Spadarpra P Annesi G Liguori M ,et al. Gene dosage influences the age at onset of SCA2 in a family from southern Italy[J]. Clin Genet, 200772(4):381-383. DOI: 10.1111/j.1399-0004.2007.00868.x .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Almaguer-Mederos LE , Falcon NS , Almira YR ,et al. Estimation of the age at onset in spincerebellar ataxia type 2 Cuban patients by survival analysis[J]. Clin Genet, 201078(2):169-174. DOI: 10.1111/j.1399-0004.2009.01358.x .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Klockgether T , Wullner U , Spauschus A ,et al. The molecular biology of the autosomal-dominant cerebellar ataxias[J]. Mov Disord, 200015(4):604-612. DOI: 10.1002/hed.20144 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Schöls L , Bauer P , Schmidt T ,et al. Autosomal dominant cerebellar ataxias:clinical features, genetics, and pathogenesis[J]. Lancet Neurol, 20043(5):291-304. DOI: 10.1016/S1474-4422(04)00737-9 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Ichikawa Y , Goto J , Hattori M ,et al. The genomic structure and expression of MJD, the Machado Joseph disease gene[J]. J Hum Genet, 200146(7):413-422. 10.1007/s100380170060 . DOI:.
返回引文位置Google Scholar
百度学术
万方数据
[24]
Tang B , Liu C , Shen L ,et al. Frequency of SCA1, SCA2, SCA3/MJD, SCA6, SCA7, and DRPLA CAG trinucleotide repeat expansion in patients with hereditary spinocerebellar ataxia from Chinese kindreds[J]. Arch Neurol, 200057(4):540-544. DOI: 10.1001/archneur.57.4.540 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
顾卫红王国相王康. 脊髓小脑共济失调3型临床变异型特征及突变分析[J]. 中国现代神经疾病杂志 20088(2):134-138. DOI: 10.3969/j.issn.1672-6731.2008.02.012 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
吴超张基伟李洵桦. 脊髓小脑性共济失调3型的非共济失调症状[J]. 中国神经精神疾病杂志 201440(9):569-572. DOI: 10.3936/j.issn.1002-0152.2014.09.015 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Maciel P , Gaspar C , DeStefano AL ,et al. Correlation between CAG repeat length and clinical features in Machado-Joseph disease[J]. Am J Hum Genet, 199557(1):54-61.
返回引文位置Google Scholar
百度学术
万方数据
[28]
Holmes SE , O’Hearn E , Marqolis RL . Why is SCA12 different from other SCAs[J]. Cytogenet Genome Res, 2003100(1-4):189-197. DOI: 10.1159/000072854 .
返回引文位置Google Scholar
百度学术
万方数据
[29]
Marcy E , MacDonald , Christine M ,et al. A novel gene containing a trinucleotide repeat that is expanded and unstable on Huntington's disease chromosomes[J]. Cell, 199372(6):971-983. DOI: 10.1016/0092-8674(93)90585-E .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Trottier Y , Biancalana V , Mandel JL . Instability of CAG repeats in Huntington’s disease: relation to parental transmission and age of onset[J]. Med Genet, 199431(5):377-382. PMID:8064815.
返回引文位置Google Scholar
百度学术
万方数据
[31]
Squitieri F , Gellera C , Cannella M ,et al. Homozygosity for CAG mutation in Huntington disease is associated with a more severe clinical course[J]. Brain, 2003126(Pt4):946-955. DOI: 10.1093/brain/awg077 .
返回引文位置Google Scholar
百度学术
万方数据
[32]
Duyao M , Ambrose C , Myers R ,et al. Trinucleotide repeat length instability and age of onset in Huntington's disease[J]. Nat Genet, 19934(4):387-392. DOI: 10.1038/ng0893-387 .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Telenius H , Kremer B , Goldberg YP ,et al. Somatic and gonadal mosaicism of the Huntington disease gene CAG repeat in brain and sperm[J]. Nat Genet, 19946(4):409-414. DOI: 10.1038/ng0494-409 .
返回引文位置Google Scholar
百度学术
万方数据
[34]
Kennedy L , Evans E , Chen CM ,et al. Dramatic tissue-specific mutation length increases are an early molecular event in Huntington disease pathogenesis[J]. Hum Mol Genet, 200312(24):3359-3367. DOI: 10.1093/hmg/ddg352 .
返回引文位置Google Scholar
百度学术
万方数据
[35]
Epping EA , Paulsen JS . Depression in the early stages of Huntington disease[J]. Neurodegener Dis Manag, 20111(5):407-414. DOI: 10.2217/nmt.11.45 .
返回引文位置Google Scholar
百度学术
万方数据
[36]
潘学峰姜楠陈细芳. R环的形成及对基因组稳定性的影响[J]. 遗传 201436(12):1185-1194. DOI: 10.3724/SP.J.1005.2014.1185 .
返回引文位置Google Scholar
百度学术
万方数据
[37]
Helmrich A , Ballarino M , Nudler E ,et al. Transcription-replication encounters, consequences and genomic instability[J]. Nat Struct Mol Biol, 201320(4):412-418. DOI: 10.1038/nsmb.2543 .
返回引文位置Google Scholar
百度学术
万方数据
[38]
Aguilera A , García-Muse T . R Loops: From transcription byproducts to threats to genome stability[J]. Mol Cell, 201246(2):115-124. DOI: 10.1016/j.molcel.2012.04.009 .
返回引文位置Google Scholar
百度学术
万方数据
[39]
Lin YL , Pasero P . Interference between DNA replication and transcription as a cause of genomic instability[J]. Curr Genomics, 201213(1):65-73. DOI: 10.2174/138920212799034767 .
返回引文位置Google Scholar
百度学术
万方数据
[40]
Cook PR . The organization of replication and transcription[J]. Science 1999284(5421):1790-1795.
返回引文位置Google Scholar
百度学术
万方数据
[41]
Kogoma T . Stable DNA Replication: interplay between DNA replication, homologous recombination, and transcription[J]. Microbiol Mol Biol Rev, 199761(2):212-238. DOI: 10.1016/j.ijpharm.2004.07.027 .
返回引文位置Google Scholar
百度学术
万方数据
[42]
Pan XF . Mechanism of trinucleotide repeats instabilities: The necessities of repeat non-B secondary structure for-mation and the roles of cellular trans-acting factors[J]. Yi Chuan Xue Bao, 200633(1):1-11. DOI: 10.1016/S0379-4172(06)60001-2 .
返回引文位置Google Scholar
百度学术
万方数据
[43]
姜楠潘学峰. 表观遗传学及现代表观遗传生物医药技术的发展[J]. 生物技术通报 201531(4):105-119. DOI: 10.13560/j.cnki.biotech.bull.1985.2015.03.005 .
返回引文位置Google Scholar
百度学术
万方数据
[44]
丁云峰潘学峰. 三核苷酸重复序列(GAA·TTC)n扩增的分子机制研究现状[J]. 国际遗传学杂志 200932(6):412-435. DOI: 10.3760/cma.j.issn.1673-4386.2009.06.005 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
潘学峰(E-mail: mocdef.nabuyilamacnapgnefeux)李红权(E-mail: mocdef.6ab21liamenauqgnohil)
B
河北省自然科学基金 (H2015201131)
北京市自然科学基金 (5132014)
河北大学医学学科专项资金建设项目 (2012A2004)
评论 (0条)
注册
登录
时间排序
暂无评论,发表第一条评论抢沙发
MedAI助手(体验版)
文档即答
智问智答
机器翻译
回答内容由人工智能生成,我社无法保证其准确性和完整性,该生成内容不代表我们的态度或观点,仅供参考。
生成快照
文献快照

你好,我可以帮助您更好的了解本文,请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持:

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号