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中华临床实验室管理电子杂志 ›› 2014, Vol. 02 ›› Issue (01) : 21 -25. doi: 10.3877.cma.j.issn.2095-5820.2014.01.005

综述

小儿先天性心脏病的遗传机制及研究进展
耿娟1, 傅启华1,()   
  1. 1.200127 上海交通大学医学院附属上海儿童医学中心检验科
  • 收稿日期:2013-07-24 出版日期:2014-02-28
  • 通信作者: 傅启华
  • 基金资助:
    上海市新一轮卫生系统优秀学科带头人培养计划资助课题(XBR2011046)

The genetic mechanism and research progress of congenital heart diseases

Juan Geng1, Qihua Fu1,()   

  1. 1.Department of Laboratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Received:2013-07-24 Published:2014-02-28
  • Corresponding author: Qihua Fu
引用本文:

耿娟, 傅启华. 小儿先天性心脏病的遗传机制及研究进展[J/OL]. 中华临床实验室管理电子杂志, 2014, 02(01): 21-25.

Juan Geng, Qihua Fu. The genetic mechanism and research progress of congenital heart diseases[J/OL]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2014, 02(01): 21-25.

先天性心脏病(congenital heart disease, CHD)是一种最为常见的出生缺陷,遗传因素对CHD的发生、发展具有重要作用。至今,人类已发现的与CHD发生有关的基因包括心脏形成过程中的转录因子和调节因子基因、发育信号通路分子基因、心脏结构基因、循环中多种配体以及心脏细胞膜表面受体-配体等。涉及这些基因的染色体结构变异及点突变均是CHD的重要发病机制。这些变异通过单倍体剂量不足或降低基因编码蛋白表达量进而干扰心脏正常发育。尽管CHD的遗传基础研究已取得很大进展,但已发现的所有遗传因素仍仅能解释很少一部分CHD病例。进一步鉴定CHD相关基因,确定不同类型遗传变异在疾病发生中的贡献度仍是阐明CHD遗传机制的重要领域。

Congenital heart disease (CHD) is the most common birth defect. Genetic factors play important roles in pathogenesis and development of CHD. So far, causative genes found associated with CHD include those which encode transcription factors and transcription regulators, molecules participating in developmental signaling pathway, cardiac structural proteins, multiple ligands in circulation, and receptor-ligand on myocardial cell membrane. Chromosomal structural variants and point mutations that imperil the function of these genes are significantly relevant to the pathogenesis of CHD. These variants perturb heart development through haploinsufficiency, or reduction in the dosage of the encoded proteins. Great progress has been achieved in elucidating the genetic basis of CHD, but these genetic factors can only account for a small fraction of all CHD cases. Further identification of CHD-associated genes and the contribution of different types of variants to the development of disease are still important for demonstrating the genetic mechanism of CHD.

图1 小儿CHD各种心脏畸形解剖位置示意图及不同CHD发生率 注:图中括号中数据为CONCOR数据库估计的各种CHD发生率(1/100万)[7]
图2 用于CHD发病机制研究的各种高通量技术平台示意图[1]
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