Proximal symphalangism(SYM1B)(OMIM 615298) is an autosomal dominant developmental disorder affecting joint fusion. It is characterized by variable fusions of the proximal interphalangeal joints of the hands,typically ...Proximal symphalangism(SYM1B)(OMIM 615298) is an autosomal dominant developmental disorder affecting joint fusion. It is characterized by variable fusions of the proximal interphalangeal joints of the hands,typically of the ring and little finger,with the thumb typically being spared. SYM1 is frequently associated with coalition of tarsal bones and conductive hearing loss. Molecular studies have identified two possible genetic aetiologies for this syndrome,NOG and GDF5. We herein present a British caucasian family with SYM1 B caused by a mutation of the GDF5 gene. A mother and her three children presented to the orthopaedic outpatient department predominantly for feet related problems. All patients had multiple tarsal coalitions and hand involvement in the form of either brachydactyly or symphalangism of the proximal and middle phalanx of the little fingers. Genetic testing in the eldest child and his mother identified a heterozygous missense mutation in GDF5 c.1313G>T(p.R438L),thereby establishing SYM1 B as the cause of the orthopaedic problems in this family. There were no mutations identified in the NOG gene. This report highlights the importance of thorough history taking,including a three generation family history,and detailed clinical examination of children with fixed planovalgus feet and other family members to detect rare skeletal dysplasia conditions causing pain and deformity,and provides details of the spectrum of problems associated with SYM1 B.展开更多
细胞片技术是应用组织工程方法使培养细胞从培养表面分离而形成含有细胞外基质的一层完整片状结构,弥补了传统组织工程技术的不足,是获取种子细胞以及对种子细胞进行转移的一项新技术。为探讨体外生长分化因子-5(GDF5)基因转染修饰的BM...细胞片技术是应用组织工程方法使培养细胞从培养表面分离而形成含有细胞外基质的一层完整片状结构,弥补了传统组织工程技术的不足,是获取种子细胞以及对种子细胞进行转移的一项新技术。为探讨体外生长分化因子-5(GDF5)基因转染修饰的BMSCs细胞片与GDF5转基因BMSCs负载的PLGA支架形成的共聚物修复兔甲状软骨缺损的效果,实验通过腺病毒转染GDF5基因至四代兔BMSCs,温度敏感性培养皿制备GDF5转基因细胞片并与负载有转染GDF5基因BMSCs的PLGA支架复合,移植至同种兔甲状软骨缺损处,分别于术后4、8周行大体观察和组织学检测其修复效果。实验分3组:(A)转基因细胞片包裹负载有转基因BMSCs的PLGA支架组;(B)负载有转基因BMSCs的PLGA支架组;(C)负载BMSCs的PLGA支架组。结果显示,体外成功收获了完整的GDF5转基因细胞片,Real time PCR检测到GDF5 mRNA的表达,行大体组织的II型胶原免疫组化和阿利新蓝染色显示:A组和B组均表达II型胶原和糖胺聚糖(GAG),但A组表达高于B组,有统计学意义(P<0.05)。由此可得,转基因细胞片包裹负载转基因BMSCs PLGA支架较传统转基因BMSCs负载PLGA支架方法具有更加优越的成软骨能力,能更有效地促进软骨缺损的修复。展开更多
发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是一种主要因髋臼、股骨近端和关节囊等存在结构性畸形而导致的不稳定关节病变,进而发展成为髋关节的脱位。髋关节内软骨发育不良、骨骼及肌腱的异常均可导致髋关节结构...发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是一种主要因髋臼、股骨近端和关节囊等存在结构性畸形而导致的不稳定关节病变,进而发展成为髋关节的脱位。髋关节内软骨发育不良、骨骼及肌腱的异常均可导致髋关节结构的畸形,最终造成DDH。因此,早期预防与诊断是DDH治疗的关键。研究表明,DDH具有遗传基础,其易感基因包括GDF5、HOXD9、COL2AL、PAPPA2等,其中遗传因子转化生长因子5(growth differentiation factor 5,GDF5)对软骨细胞的增殖、分化具有重要作用,是当前研究治疗DDH的热点之一。因而,了解GDF5基因对软骨发育及分化的影响,对于DDH的发病机制和治疗具有重要意义。基于此,综述了国内外近期探讨的GDF5在基因层面上对DDH的影响,以及通过关节内注射重组人GDF5等基于GDF5的DDH治疗方案,以期为DDH的临床治疗提供新的策略。展开更多
文摘Proximal symphalangism(SYM1B)(OMIM 615298) is an autosomal dominant developmental disorder affecting joint fusion. It is characterized by variable fusions of the proximal interphalangeal joints of the hands,typically of the ring and little finger,with the thumb typically being spared. SYM1 is frequently associated with coalition of tarsal bones and conductive hearing loss. Molecular studies have identified two possible genetic aetiologies for this syndrome,NOG and GDF5. We herein present a British caucasian family with SYM1 B caused by a mutation of the GDF5 gene. A mother and her three children presented to the orthopaedic outpatient department predominantly for feet related problems. All patients had multiple tarsal coalitions and hand involvement in the form of either brachydactyly or symphalangism of the proximal and middle phalanx of the little fingers. Genetic testing in the eldest child and his mother identified a heterozygous missense mutation in GDF5 c.1313G>T(p.R438L),thereby establishing SYM1 B as the cause of the orthopaedic problems in this family. There were no mutations identified in the NOG gene. This report highlights the importance of thorough history taking,including a three generation family history,and detailed clinical examination of children with fixed planovalgus feet and other family members to detect rare skeletal dysplasia conditions causing pain and deformity,and provides details of the spectrum of problems associated with SYM1 B.
文摘细胞片技术是应用组织工程方法使培养细胞从培养表面分离而形成含有细胞外基质的一层完整片状结构,弥补了传统组织工程技术的不足,是获取种子细胞以及对种子细胞进行转移的一项新技术。为探讨体外生长分化因子-5(GDF5)基因转染修饰的BMSCs细胞片与GDF5转基因BMSCs负载的PLGA支架形成的共聚物修复兔甲状软骨缺损的效果,实验通过腺病毒转染GDF5基因至四代兔BMSCs,温度敏感性培养皿制备GDF5转基因细胞片并与负载有转染GDF5基因BMSCs的PLGA支架复合,移植至同种兔甲状软骨缺损处,分别于术后4、8周行大体观察和组织学检测其修复效果。实验分3组:(A)转基因细胞片包裹负载有转基因BMSCs的PLGA支架组;(B)负载有转基因BMSCs的PLGA支架组;(C)负载BMSCs的PLGA支架组。结果显示,体外成功收获了完整的GDF5转基因细胞片,Real time PCR检测到GDF5 mRNA的表达,行大体组织的II型胶原免疫组化和阿利新蓝染色显示:A组和B组均表达II型胶原和糖胺聚糖(GAG),但A组表达高于B组,有统计学意义(P<0.05)。由此可得,转基因细胞片包裹负载转基因BMSCs PLGA支架较传统转基因BMSCs负载PLGA支架方法具有更加优越的成软骨能力,能更有效地促进软骨缺损的修复。
文摘发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是一种主要因髋臼、股骨近端和关节囊等存在结构性畸形而导致的不稳定关节病变,进而发展成为髋关节的脱位。髋关节内软骨发育不良、骨骼及肌腱的异常均可导致髋关节结构的畸形,最终造成DDH。因此,早期预防与诊断是DDH治疗的关键。研究表明,DDH具有遗传基础,其易感基因包括GDF5、HOXD9、COL2AL、PAPPA2等,其中遗传因子转化生长因子5(growth differentiation factor 5,GDF5)对软骨细胞的增殖、分化具有重要作用,是当前研究治疗DDH的热点之一。因而,了解GDF5基因对软骨发育及分化的影响,对于DDH的发病机制和治疗具有重要意义。基于此,综述了国内外近期探讨的GDF5在基因层面上对DDH的影响,以及通过关节内注射重组人GDF5等基于GDF5的DDH治疗方案,以期为DDH的临床治疗提供新的策略。