【正文】
l. Nat Ge 2022。12:11823. 2022,10,22,南京,崔麗英 19 FUS基因突變分析 ?10例家族性 ALS中檢測出 1例 R521L突變患者 ?先證者為 43歲女性, 42歲起病,初始癥狀左上肢無力,漸累及其余三肢,球部及上運(yùn)動神經(jīng)元受累均不明顯,家系中其他 6例患者起病年齡及首發(fā)癥狀和先證者相似,病情進(jìn)展快,生存期為 14年,已故 ?家系其他成員檢測發(fā)現(xiàn)其無癥狀 19歲女兒亦攜帶相同的突變基因,目前在追隨 ?210例散發(fā)性 ALS中檢測出 2例 P521H突變患者 2022,10,22,南京,崔麗英 20 FUS基因突變家系圖 圖 . R521L突變家系的家系圖 . 黑色填充的代表患者,斜線代表已死亡成員, +/ 代表攜帶 /未攜帶 R521L突變,患者右下角的數(shù)字代表起病年齡 . 2022,10,22,南京,崔麗英 21 Subject /gender Age at onset,y Disease duration,m Site of onset Disease course II2/M 31 ? 24 Upper limbs Rapid progression to respiratory failure. III2/M 32 22 Left proximal upper limb Rapid progression to respiratory failure. III3/F 59 37 Right lower limb Rapid progression to upper limbs in 6 months. Dysphasia and dyspnea after 1 year, death from respiratory failure. IV1/F 42 25 Right proximal upper limb Rapid progression to lower limbs. Frequent falls and death 1 month after a fall. IV2/F 38 12 Left proximal upper limb Rapid development of respiratory failure in 1 month, death from this after 1 year. No bulbar signs. IV3/F 35 24 Left distal upper limb Rapid progression to right upper limb in 2 months. Rapid progression to respiratory failure in 6 months. No bulbar signs. IV5/F 43 48 Right distal upper limb Rapid progression to left arm and both legs in 6 months. No bulbar signs. Table 1. Clinical features of the family with the R521L FUS mutation 2022,10,22,南京,崔麗英 22 FUS基因 (T) R521L突變的測序圖,箭號所指的第 1562位核苷酸位置上堿基 G顛換為 T,導(dǎo)致 521號密碼子由精氨酸變?yōu)榱涟彼帷? ?FUS在遺傳性 ALS中占 %;在散發(fā)性 ALS中占 % 18 ? Mackenzie IR, Rademakers R, Neumann M. Lancet Neurol, 2022, 9: