摘要
选择性先天缺牙是由遗传或环境因素导致的牙齿数目异常,多累及恒牙列。低密度脂蛋白受体相关蛋白6(low-density lipoprotein receptor-related protein 6,LRP6)是选择性先天缺牙的常见致病基因之一,该基因突变为常染色体显性遗传,可导致非综合征型先天缺牙或综合征型先天缺牙;非综合征型先天缺牙仅表现为牙齿数目、形态异常;综合征型先天缺牙可表现为耳部发育畸形、口面裂、毛发稀少、汗腺异常等。笔者就近年来关于LRP6基因突变导致选择性先天缺牙的表型及基因突变特点的研究现况进行综述,文献收纳24个LRP6基因突变位点和38例相关先天缺牙患者,发现LRP6基因突变导致的选择性先天缺牙好发于上颌侧切牙及上下颌第二前磨牙和第一前磨牙,极少发生于第一磨牙,尤其是下颌第一磨牙,未见上颌中切牙缺失。LRP6基因在牙发育过程中主要通过WNT/β-catenin信号通路发挥重要作用,LRP6基因突变可导致蛋白表达和功能异常、信号通路破坏从而导致选择性先天缺牙。现有文献结果显示,LRP6基因突变好发于胞外段E1、E2亚结构域,影响WNT/β-catenin信号通路的传导而致病。然而目前对于选择性先天缺牙仍缺乏成熟完善的对因治疗。
Selective tooth agenesis(STA) is an abnormal number of teeth due to genetic factors or the environment and is most commonly observed for permanent teeth. LRP6 is one of the common causative genes of STA and is inherited by an autosomal dominant mechanism, leading to non-syndrome tooth agenesis(NSTA) or syndrome tooth agenesis(STA). NSTA is only involved in tooth number and appearance abnormalities, whereas STA caused by LRP6 gene mutation results abnormal ear development, oral-facial clefting, sparse hair and hypohidrosis. In this paper, we review the phenotype and gene mutation traits of selective STA caused by LRP6 gene mutation identified in recent years and describe 38 patients with tooth agenesis from 24 mutation sites of LRP6 gene. We analyzed the percentage of missing teeth and found that the lateral incisor in the maxilla and the second premolar in the maxilla and mandible were most commonly lost, whereas all central incisors in the maxilla remained. LRP6 gene plays a major role in tooth development via the WNT/β-catenin signaling pathway, and LRP6 gene mutation can lead to a series of abnormal manifestations due to the disruption of the signaling pathway. The literature showed that LRP6 gene mutations occurred mostly at the E1 or E2 subdomain, meaning that STA due to the mutants extracellularly disturbed the WNT/β-catenin signaling pathway.However, mature treatments for selective congenital tooth loss are lacking.
作者
蒋彩玲
赵彬
吴轶群
JIANG Cailing;ZHAO Bin;WU Yiqun(School of Stomatology Affiliated to Shanxi Medical University,Taiyuan 030012,China;The Sec-ond Department of Stomatology,the Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medi-cine,Shanghai 200125,China)
出处
《口腔疾病防治》
2023年第3期223-228,共6页
Journal of Prevention and Treatment for Stomatological Diseases
基金
上海市自然科学基金(21ZR1437700)。
