Journal
MUTATION RESEARCH-FUNDAMENTAL AND MOLECULAR MECHANISMS OF MUTAGENESIS
Volume 730, Issue 1-2, Pages 52-58Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.mrfmmm.2011.10.013
Keywords
Dyskeratosis congenita; Interstitial lung disease; Aplastic anemia; Liver cirrhosis; Emphysema; Diabetes
Funding
- United States National Institutes of Health
- Maryland Stem Cell Research Foundation
- Flight Attendants Medical Research Institute
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Idiopathic pulmonary fibrosis (IPF) is the most common manifestation of telomere-mediated disorders. Germline mutations in the essential telomerase genes, hTERT and hTR, are the causal genetic defect in up to one-sixth of pulmonary fibrosis families. The presence of telomerase mutations in this subset is significant for clinical decisions as affected individuals can develop extra-pulmonary complications related to telomere shortening such as bone marrow failure and cryptogenic liver cirrhosis. There is also evidence that IPF is an ancestral manifestation of autosomal dominant telomere syndromes where, with successive generations, the disease evolves from pulmonary fibrosis into a bone marrow failure-predominant disorder, defining a unique form of genetic anticipation. Here I review the significance of telomere defects for understanding the genetics, disease patterns and pathophysiology of IPF. The importance of this diagnosis for patient care decisions will also be discussed. (C) 2011 Elsevier B.V. All rights reserved.
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