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遗传性大疱性表皮松解症:近期的基础和临床进展。

Inherited epidermolysis bullosa: recent basic and clinical advances.

机构信息

Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37204, USA.

出版信息

Curr Opin Pediatr. 2010 Aug;22(4):453-8. doi: 10.1097/MOP.0b013e32833bb74f.

Abstract

PURPOSE OF REVIEW

This review highlights key findings, both clinical and basic, that have been published in the field of inherited epidermolysis bullosa within the past few years.

RECENT FINDINGS

New epidermolysis bullosa phenotypes, genotypes and modes of transmission have been identified, resulting in a revised classification system. Detailed evidence-based data are now available on the risk of extracutaneous complications in each of the major epidermolysis bullosa subtypes. Studies are now underway to try to better explain the biological aggressiveness of squamous cell carcinomas arising in epidermolysis bullosa skin. Cell and animal models have been refined and used to ascertain the feasibility of gene replacement therapy, stem cell transplantation, and treatment with injected allogeneic fibroblasts or recombinant type VII collagen. As a result, clinical trials are now being pursued to test each of these in humans.

SUMMARY

Epidermolysis bullosa is caused by mutations in at least 14 genes, leading to a broad spectrum of entities, each of which has its own relative risk for the development of specific extracutaneous complications and/or premature death. Intensive research, both basic and clinical, is bringing us closer to more effective treatments and possibly even a cure.

摘要

目的综述

本篇综述重点介绍了过去几年中在遗传性大疱性表皮松解症领域发表的临床和基础方面的重要发现。

最近的发现

已确定新的大疱性表皮松解症表型、基因型和传播方式,从而修订了分类系统。目前,每种主要大疱性表皮松解症亚型的皮肤外并发症风险均有详细的循证数据。目前正在进行研究,以试图更好地解释在大疱性表皮松解症皮肤中发生的鳞状细胞癌的生物学侵袭性。细胞和动物模型得到了改进,并用于确定基因替代疗法、干细胞移植以及用注射的同种异体成纤维细胞或重组 VII 型胶原蛋白治疗的可行性。因此,目前正在进行临床试验以测试这些方法在人体中的应用。

总结

大疱性表皮松解症是由至少 14 种基因突变引起的,导致广泛的疾病实体,每种疾病都有其自身发生特定皮肤外并发症和/或过早死亡的相对风险。基础和临床的深入研究使我们更接近更有效的治疗方法,甚至可能实现治愈。

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