首页|希特林缺陷病的全周期、多学科和系统化管理

希特林缺陷病的全周期、多学科和系统化管理

Full-cycle,multidisciplinary and systematic management of citrin deficiency

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1999年6月,日本鹿儿岛大学佐伯武赖教授团队在Nature Genetics发表论文,明确了成人发病瓜氨酸血症Ⅱ型的致病基因为SLC25A13,并将该基因编码的蛋白质产物命名为希特林(citrin).25年来,作为一种常染色体隐性遗传病,希特林缺陷病(CD)的病理生理机制、临床表型、分子诊断、治疗和预后等方面研究取得积极进展.目前已经发现3种年龄依赖性的CD临床表型,即希特林缺陷导致的新生儿肝内胆汁淤积症、希特林缺陷导致的生长发育迟缓和血脂异常,以及成人发病瓜氨酸血症Ⅱ型.虽然相关药物正在研发,肝脏移植已用于CD患者救治,但CD管理的基础、核心和关键在于科学的饮食治疗.CD管理涉及患者全生命周期,需要基础和临床医学多学科通力合作,也需要父母、家庭和社会等多层次的系统衔接.通过全周期、多学科和系统化管理,让CD患者健康地学习、工作和生活是有望实现的目标.
Professor Takeyori Saheki's team at Kagoshima University,Japan,published a paper in Nature Genetics in June 1999,pinpointing the pathogenic gene for adult-onset type Ⅱ citrullinemia as SLC25A13 and naming the protein product encoded by this gene as citrin.Over the past 25 years,the researches have made positive progress on the pathophysiological mechanism,clinical phenotype,molecular diagnosis,treatment,and prognosis of citrin deficiency(CD)as an autosomal recessive genetic disease.Currently,three age-dependent clinical phenotypes of CD have been found,namely neonatal intrahepatic cholestasis caused by citrin deficiency,failure to thrive and dyslipidemia caused by citrin deficiency,and adult-onset type Ⅱ citrullinemia.Although relevant internal medicine drugs are being researched and developed while liver transplantation has been used for the treatment of CD patients,scientific dietary therapy remains the foundation,core,and key for the management of this disease.Furthermore,CD management involves the full life cycle of patients,requiring the joint efforts of basic and clinical medicine as well as systematic articulation at multi-levels,such as the parents,family,and society.By full-cycle,multidisciplinary,and systematic management,it is an achievable goal for CD patients to learn,work,and live in a healthy manner.

Citrin deficiencyIntrahepatic cholestasisGrowth and developmentDyslipidemiaTherapeutic

宋元宗、邓梅、郭丽、林伟霞

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暨南大学附属第一医院儿科,广州 510630

希特林缺陷病 肝内胆汁淤积 生长发育 血脂异常 治疗

国家自然科学基金项目国家自然科学基金项目国家自然科学基金项目国家自然科学基金项目国家自然科学基金项目广东省基础和应用基础研究基金广州市科技计划项目广州市科技计划项目广州市科技计划项目暨南大学附属第一医院临床前沿新技术立项项目

81070279812709578157079381741080819740572021A15151110832022010200882023A03J10102024A03J0972JNU1AF-CFTP2022-a01228

2024

中华肝脏病杂志
中华医学会

中华肝脏病杂志

CSTPCD北大核心
影响因子:1.625
ISSN:1007-3418
年,卷(期):2024.32(9)
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