NEJM:遗传性NOS2缺乏症成年人致命性巨细胞病毒感染

2020-01-30 xing.T MedSci原创

这些结果表明,遗传性NOS2缺乏症对该患者在临床上一直保持沉默,直到CMV致命性感染为止。此外,NOS2对于控制该患者的其他病原体感染似乎是多余的。

巨细胞病毒(CMV)可在多种遗传性或获得性T细胞免疫缺陷的儿童和成人中引起严重疾病,这些患者容易受到多种感染。但它很少会引起健康人发生疾病。特发性CMV疾病的发病机制尚不清楚。缺少编码一氧化氮合酶2(NOS2)的基因的近交小鼠容易受到鼠CMV感染

近日,顶级医学期刊NEJM上发表了一篇研究文章,研究人员分析了一名来自伊朗的先前健康的51岁男子,该男子在急性CMV感染后开始进行性CMV疾病发作,并在感染后29个月死亡。研究人员假设患者可能患有新型的先天性免疫缺失。因此,研究人员进行了全外显子测序并实验性地测试了候选突变等位基因。

研究人员发现NOS2中的纯合移码突变编码一种截短的NOS2蛋白,其不能产生一氧化氮,这确诊了该患者患有常染色体隐性NOS2缺乏症。此外,研究人员在纯合子公共数据库中查找了所有编码功能蛋白的NOS2变异体,等位基因频率大于0.001的所有其他变体也是如此。

这些结果表明,遗传性NOS2缺乏症对该患者在临床上一直保持沉默,直到CMV致命性感染为止。此外,NOS2对于控制该患者的其他病原体感染似乎是多余的。

原始出处:

Scott B. Drutman, et al.Fatal Cytomegalovirus Infection in an Adult with Inherited NOS2 Deficiency.NEJM.2020.https://www.nejm.org/doi/full/10.1056/NEJMoa1910640

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    2020-02-01 wwzzly
  4. [GetPortalCommentsPageByObjectIdResponse(id=1860099, encodeId=4d2c18600998a, content=<a href='/topic/show?id=cc73951054b' target=_blank style='color:#2F92EE;'>#遗传性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95105, encryptionId=cc73951054b, topicName=遗传性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Mon Nov 09 17:32:00 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010776, encodeId=84832010e76e8, content=<a href='/topic/show?id=ce989510e11' target=_blank style='color:#2F92EE;'>#遗传性NOS2缺乏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95107, encryptionId=ce989510e11, topicName=遗传性NOS2缺乏症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=267e204, createdName=wangyang7958, createdTime=Mon May 04 04:32:00 CST 2020, time=2020-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502271, encodeId=604a15022e166, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Sat Feb 01 02:32:00 CST 2020, time=2020-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035103, encodeId=7cf3103510338, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 30 14:32:00 CST 2020, time=2020-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378711, encodeId=54c83e87117f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/11/13/297abc49521542fee373596e497d37fc.jpg, createdBy=db695226500, createdName=1478fa69m73暂无昵称, createdTime=Thu Jan 30 14:20:26 CST 2020, time=2020-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378656, encodeId=01583e8656a4, content=一般抵抗力下降,才能感染病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/11/13/297abc49521542fee373596e497d37fc.jpg, createdBy=db695226500, createdName=1478fa69m73暂无昵称, createdTime=Thu Jan 30 14:07:14 CST 2020, time=2020-01-30, status=1, ipAttribution=)]
    2020-01-30 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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    2020-01-30 1478fa69m73暂无昵称

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1860099, encodeId=4d2c18600998a, content=<a href='/topic/show?id=cc73951054b' target=_blank style='color:#2F92EE;'>#遗传性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95105, encryptionId=cc73951054b, topicName=遗传性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Mon Nov 09 17:32:00 CST 2020, time=2020-11-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010776, encodeId=84832010e76e8, content=<a href='/topic/show?id=ce989510e11' target=_blank style='color:#2F92EE;'>#遗传性NOS2缺乏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95107, encryptionId=ce989510e11, topicName=遗传性NOS2缺乏症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=267e204, createdName=wangyang7958, createdTime=Mon May 04 04:32:00 CST 2020, time=2020-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502271, encodeId=604a15022e166, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Sat Feb 01 02:32:00 CST 2020, time=2020-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035103, encodeId=7cf3103510338, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 30 14:32:00 CST 2020, time=2020-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378711, encodeId=54c83e87117f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/11/13/297abc49521542fee373596e497d37fc.jpg, createdBy=db695226500, createdName=1478fa69m73暂无昵称, createdTime=Thu Jan 30 14:20:26 CST 2020, time=2020-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378656, encodeId=01583e8656a4, content=一般抵抗力下降,才能感染病毒, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/11/13/297abc49521542fee373596e497d37fc.jpg, createdBy=db695226500, createdName=1478fa69m73暂无昵称, createdTime=Thu Jan 30 14:07:14 CST 2020, time=2020-01-30, status=1, ipAttribution=)]
    2020-01-30 1478fa69m73暂无昵称

    一般抵抗力下降,才能感染病毒

    0