L’acondroplasia è una condizione genetica rara che influisce sulla crescita e sullo sviluppo del corpo umano. È la forma più comune di nanismo a causa di un’anomalia genetica che colpisce il gene FGFR3. Questo gene è responsabile della regolazione della crescita delle ossa nel corpo umano.
Cause di acondroplasia
L’acondroplasia è causata da una mutazione genetica spontanea nel gene FGFR3 situato sul cromosoma 4. , che si verifica durante lo sviluppo embrionale. Questa mutazione genetica è generalmente casuale e non è ereditata dai genitori né influenzata dallo stile di vita o dall’ambiente. La mutazione colpisce il modo in cui il gene FGFR3 regola la crescita delle ossa nel corpo umano. La maggior parte delle persone con acondroplasia ha genitori di statura media, ma sono portatori della mutazione genetica. Essi hanno una copia normale del gene FGFR3 e una copia mutata. Quando entrambi i genitori sono portatori della mutazione, esiste una probabilità del 25% che il bambino erediti due copie del gene mutato e sviluppi l’acondroplasia.
Normalmente, il gene FGFR3 è coinvolto nella regolazione della crescita delle ossa, in particolare delle ossa lunghe degli arti. Controlla il processo di ossificazione endocondrale, che è responsabile della conversione del tessuto cartilagineo in tessuto osseo durante la crescita. Nell’acondroplasia, la mutazione genetica nel gene FGFR3 porta a un’iperattivazione di questo gene.
L’iperattivazione del gene FGFR3 causa un’alterazione nella normale crescita delle ossa. In particolare, il gene rallenta la velocità di conversione del tessuto cartilagineo in tessuto osseo, portando a una crescita ossea più lenta e alla formazione di ossa più corte e più spesse. Ciò spiega i sintomi caratteristici dell’acondroplasia, come la bassa statura, le braccia e le gambe più corte e la testa relativamente più grande.
Segni e sintomi dell’acondroplasia
I segni e sintomi dell’acondroplasia sono generalmente presenti alla nascita o si manifestano nei primi anni di vita. I più comuni sono:
Statura significativamente più bassa della media. L’altezza media di un adulto con acondroplasia è di 131 cm nei maschi e di 124 cm nelle femmine.
Braccia e gambe corte e sproporzionate rispetto alle dimensioni del tronco.La parte superiore delle braccia e delle cosce è più accorciata rispetto agli avambracci e alla parte inferiore delle gambe. Le gambe inoltre, nei soggetti con acondroplasia assumono una forma arcuata.
Testa grande e fronte prominente. La testa è sproporzionatamente grande rispetto al corpo, con fronte prominente e sella nasale infossata.
Dita corte e mani a tridente. Le mani sono larghe e corte, con dita corte e tozze che si assottigliano verso l’estremità.
Altri segni e sintomi che possono essere associati all’acondroplasia includono:
Malformazioni del cranio, come la stenosi del forame occipitale mediano, che può causare problemi respiratori e neurologici.
Problemi dentali, come l’affollamento dei denti.
Problemi alle articolazioni, come la displasia dell’anca e del ginocchio.
Problemi al midollo spinale, come la stenosi lombare, che può causare dolore, intorpidimento e debolezza agli arti inferiori.
Problemi cardiaci, come la stenosi aortica.
Diagnosi acondroplasia
La diagnosi prenatale di acondroplasia si basa su un’ecografia ostetrica che evidenzia alcuni segni sospetti, come l’accorciamento delle ossa lunghe e la testa grande. È inoltre possibile effettuare un test genetico su un campione di liquido amniotico o di villi coriali (i tessuti che si sviluppano in placenta e cordone ombelicale) per verificare la presenza della mutazione genetica che causa l’acondroplasia.
Diagnosi post-natale
La diagnosi post-natale di acondroplasia si basa sull’osservazione delle caratteristiche fisiche del bambino, come la bassa statura, le braccia e le gambe corte e le dita corte e tozze. È inoltre possibile effettuare un esame ai raggi X per valutare le alterazioni scheletriche tipiche dell’acondroplasia.
Se i medici sospettano che un bambino possa avere l’acondroplasia, di solito raccomandano di effettuare un test genetico per confermare la diagnosi. Questo test può essere eseguito su un campione di sangue o di saliva.
La diagnosi precoce di acondroplasia è importante per consentire di iniziare precocemente i trattamenti necessari per gestire i sintomi e migliorare la qualità di vita del bambino.
Trattamento
Non esiste una cura per l’acondroplasia, ma sono disponibili trattamenti per aiutare a gestire i sintomi e migliorare la qualità di vita delle persone affette. Questi trattamenti possono includere:
Terapia fisica per aiutare a migliorare la mobilità e la forza. La terapia fisica può aiutare le persone con acondroplasia a sviluppare la forza e la flessibilità necessarie per svolgere le attività quotidiane. Può anche aiutare a prevenire o ridurre il dolore e l’infiammazione.
Chirurgia per correggere le malformazioni scheletriche. La chirurgia può essere utilizzata per correggere malformazioni scheletriche che causano dolore, limitazione dei movimenti o altri problemi. Ad esempio, la chirurgia può essere utilizzata per allungare le ossa lunghe, correggere la curvatura delle gambe o migliorare l’allineamento delle articolazioni.
Farmaci per alleviare il dolore e l’infiammazione. I farmaci possono essere utilizzati per alleviare il dolore e l’infiammazione associati all’acondroplasia. Ad esempio, i farmaci antinfiammatori non steroidei (FANS) possono essere utilizzati per alleviare il dolore e l’infiammazione a breve termine. I corticosteroidi possono essere utilizzati per alleviare il dolore e l’infiammazione a lungo termine.
Il trattamento specifico per l’acondroplasia viene personalizzato in base alle esigenze individuali della persona affetta. Il medico discuterà delle opzioni di trattamento disponibili con la persona affetta e la sua famiglia per sviluppare un piano di trattamento che soddisfi le loro esigenze.
Oltre ai trattamenti medici, le persone con acondroplasia possono beneficiare di un supporto psicosociale. Questo supporto può aiutarle ad affrontare le sfide associate all’acondroplasia e a vivere una vita piena e soddisfacente.
Ecco alcuni suggerimenti per migliorare la qualità di vita delle persone con acondroplasia:
Fare esercizio regolarmente. L’esercizio fisico può aiutare a migliorare la mobilità, la forza e la flessibilità.
Mangiare una dieta sana. Una dieta sana può aiutare a mantenere un peso sano e a ridurre il rischio di problemi di salute associati all’acondroplasia.
Rimanere attivi. È importante rimanere attivi e partecipare alle attività che si amano.
Cercare supporto. Le persone con acondroplasia possono beneficiare del supporto di amici, familiari e di gruppi di supporto per persone con acondroplasia.
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