Fajac I, Sermet-Gaudelus I
Faculté de médecine, université Paris-Descartes, Sorbonne Paris Cité, 75006 Paris, France.
Rev Mal Respir. 2013 Apr;30(4):255-61. doi: 10.1016/j.rmr.2012.10.631. Epub 2013 Jan 11.
Cystic fibrosis is an autosomal recessive genetic disease due to mutations in the (cystic fibrosis transmembrane conductance regulator) CFTR gene. The CFTR protein is a chloride channel expressed at the surface of several epithelial cells. Defective function of the CFTR protein leads to a severe disease in which lung disease is the leading cause of death. Current treatments are symptomatic. Nevertheless, with specialist and holistic care in dedicated cystic fibrosis centres, the median survival has improved. But the average age of death remains 29 years. Innovative molecules aiming to correct the CFTR protein itself are under development. These will be personalised treatments depending on the genotype or the type of CFTR dysfunction. The first molecule, ivacaftor, has just been approved in Europe and the USA. Adults and children treated with ivacaftor in clinical trials had a 10% improvement in FEV1 that was maintained for more than a year. Although at present ivacaftor is approved for only a small percentage of patients, the therapeutic strategy of correcting CFTR protein has been proved a valid approach. Other molecules targeting other defects in the CFTR protein are under evaluation.
囊性纤维化是一种常染色体隐性遗传病,由(囊性纤维化跨膜传导调节因子)CFTR基因突变所致。CFTR蛋白是一种在多种上皮细胞表面表达的氯离子通道。CFTR蛋白功能缺陷会导致一种严重疾病,其中肺部疾病是主要死因。目前的治疗方法只是对症治疗。然而,在专门的囊性纤维化治疗中心接受专业的整体护理后,患者的中位生存期有所延长。但平均死亡年龄仍为29岁。旨在纠正CFTR蛋白本身的创新分子正在研发中。这些将是根据基因型或CFTR功能障碍类型进行的个性化治疗。首个分子依伐卡托刚刚在欧洲和美国获批。在临床试验中接受依伐卡托治疗的成人和儿童,其第一秒用力呼气量(FEV1)提高了10%,且这一效果持续了一年多。虽然目前依伐卡托仅被批准用于一小部分患者,但纠正CFTR蛋白的治疗策略已被证明是一种有效的方法。针对CFTR蛋白其他缺陷的其他分子正在评估中。