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Wilson’s disease: an update

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Title Wilson’s disease: an update
 
Creator Das, Shyamal K
Ray, Kunal
 
Subject Molecular & Human Genetics
 
Description Wilson’s disease (WD) is an inborn error of copper metabolism caused by a mutation to the copper-transporting gene ATP7B. The disease has an autosomal recessive mode of inheritance, and is characterized by excessive
copper deposition, predominantly in the liver and brain. Diagnosis of the condition depends primarily on clinical features, biochemical parameters and the presence of the Kayser–Fleischer ring, and a new diagnostic scoring system has recently been proposed. Mutations in ATP7B can occur anywhere along the entire 21 exons, which makes the
identification of gene defects particularly challenging. Identification of carriers and presymptomatic family members of affected individuals is achieved by polymerase-chain-reaction-based marker analysis. The
traditional treatment for WD is based on copper chelation with agents such as d-penicillamine, but use of this drug has been questioned because of reported side effects. The use of agents such as trientine and ammonium
tetrathiomolybdate has been advocated, although results of long-term trials are awaited. In selected cases, orthotropic hepatic transplantation can reverse the basic metabolic abnormality in WD and improve both hepatic
and neurological symptoms. Studies of the underlying defects in ATP7B and its suspected modifiers ATOX1 and COMMD1 are expected to unravel the disease’s genotype–phenotype correlation, and should lead to the
design of improved drugs for ameliorating the suffering of patients. KEYWORDS ATP7B gene, chelating agents, magnetic resonance studies, molecular pathogenesis, Wilson’s disease
 
Date 2006
 
Type Article
PeerReviewed
 
Format application/pdf
 
Identifier http://www.eprints.iicb.res.in/437/1/NATURE_CLINICAL_PRACTICE_NEUROLOGY%2C__2(_9)%2C_482%2D493[44].pdf
Das, Shyamal K and Ray, Kunal (2006) Wilson’s disease: an update. Nature Clinical Practice Neurology, 2 (9). pp. 482-493.
 
Relation http://dx.doi.org/10.1038/ncpneuro0291
http://www.eprints.iicb.res.in/437/