Defining the Mechanistic Basis for Neurofibromatosis-1 Nervous System Disease Heterogeneity

定义 Neurophimatosis-1 神经系统疾病异质性的机制基础

• 批准号: 10302300
• 负责人: David H Gutmann
• 金额: $ 68.63万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302300
• 关键词: Affect; Assessment tool; Bioinformatics; Brain Neoplasms; Caring; Cell Line; Child; Clinical; Cognitive; Development; Diagnosis; Disease Outcome; Engineering; Etiology; Future; Gene Mutation; Genetic; Genetically Engineered Mouse; Germ-Line Mutation; Goals; Heterogeneity; Human; Individual; Infant; Institutes; Medical; Methodology; Mission; Modeling; Molecular; Mouse Strains; Mus; NF1 gene; Neurofibromatosis 1; Neurologic; Neurologic Dysfunctions; Neurology; Patients; Problem behavior; Research Personnel; Risk Assessment; Risk Factors; System; Systems Biology; Translating; base; clinical application; clinical subtypes; disease heterogeneity; disorder risk; effective therapy; epidemiology study; induced pluripotent stem cell; nervous system disorder; neurogenetics; novel; precision medicine; prognostic; treatment response

Project Summary As we enter into an era of personalized (precision) medicine, it becomes increasingly important to define the factors that confer disease risk and outcome. Since these determinants cannot be easily controlled in human epidemiological studies, genetically-engineered mouse (GEM) strains and human induced pluripotent stem cell (iPSC) lines provide mechanistically-tractable platforms to define the factors underlying disease heterogeneity and translate them to risk assessment tools and treatments. This challenge is nicely illustrated by Neurofibromatosis type 1 (NF1), a rare neurogenetic condition caused by a germline mutation in the NF1 gene. Individuals with NF1 are prone to the development of a wide variety of neurological problems, including cognitive and behavioral problems (60-70% of children) and low-grade brain tumors (~20% of children). While establishing the diagnosis of NF1 in an infant is straightforward, it is currently not possible to predict which child will develop future medical problems, determine whether there will be clinical progression requiring treatment, or institute effective therapies that specifically target the subtype of clinical manifestation in that individual. The pressing challenge for clinicians and researchers alike is to dissect the genetic, cellular, molecular, and systems-level etiologies for these common neurologic problems with the ultimate goal of developing prognostic and precision neurology approaches for children affected with NF1. In this proposal, we plan to leverage human NF1-patient iPSCs, mice engineered with patient germline NF1 gene mutations, bioinformatics and systems biology approaches, and novel modeling approaches to mechanistically define the factors that underlie the heterogeneity that characterizes NF1. The overall mission of this project is to establish the etiologic bases for NF1 clinical variability and to create a blueprint for future clinical application necessary to transform the care of individuals with NF1 from a reactive to a more proactive approach.

项目概要 随着我们进入个性化（精准）医疗时代，定义“个性化（精准）医疗”变得越来越重要。 影响疾病风险和结果的因素。由于这些决定因素在人类中不容易控制 流行病学研究、基因工程小鼠（GEM）品系和人类诱导多能干细胞 (iPSC) 系提供机械上可处理的平台来定义疾病异质性的潜在因素 并将其转化为风险评估工具和治疗方法。这个挑战很好地说明了 1 型神经纤维瘤病 (NF1) 是一种罕见的神经遗传疾病，由 NF1 基因种系突变引起。 患有 NF1 的个体容易出现多种神经系统问题，包括 认知和行为问题（60-70% 的儿童）和低度脑肿瘤（~20% 的儿童）。尽管 确定婴儿 NF1 的诊断很简单，目前无法预测哪种情况 孩子未来是否会出现医疗问题，确定是否需要临床进展 治疗，或制定专门针对该临床表现亚型的有效疗法 个人。临床医生和研究人员面临的紧迫挑战是剖析遗传、细胞、 这些常见神经系统问题的分子和系统水平病因学，最终目标 为患有 NF1 的儿童开发预后和精确的神经学方法。在这个 根据提案，我们计划利用人类 NF1 患者 iPSC、用患者种系 NF1 基因改造的小鼠 突变、生物信息学和系统生物学方法，以及新的机械建模方法 定义 NF1 异质性特征背后的因素。该项目的总体任务是 建立 NF1 临床变异的病因学基础并为未来的临床应用制定蓝图 有必要将 NF1 患者的护理从被动的方法转变为更主动的方法。