Duat-Rodriguez A, Hernandez-Martin A
Hospital Infantil Universitario Nino Jesus, 28009 Madrid, Espana.
Rev Neurol. 2017 May 17;64(s03):S13-S17.
The term 'RASopathies' covers a series of diseases that present mutations in the genes that code for the proteins of the RAS/MAPK pathway. These diseases include neurofibromatosis type 1, Noonan syndrome, Legius syndrome, LEOPARD syndrome, Costello syndrome and cardiofaciocutaneous syndrome. Involvement of the RAS/MAPK pathway not only increases predisposition to develop tumours, but also determines the presence of phenotypic anomalies and alterations in learning processes.
To review the use of therapeutic strategies with mechanisms that have a selective action on RASopathies.
The fact that the RAS pathway is involved in a third of all neoplasms has led to the development and study of different drugs at this level. Some of these pharmaceutical agents have been tested in RASopathies, mainly in neurofibromatosis type 1. Here we analyse the use of different antitarget treatments: drugs that act on the membrane receptors, such as tyrosine kinase inhibitors, in the mTOR pathway or MEK inhibitors. These latter have shown potential benefits in recent studies conducted on different RASopathies.
Today, thanks to the results from the first studies conducted with MEK inhibitor based mainly on animal models, a number of promising clinical trials are being carried out.
“RAS 病”一词涵盖了一系列疾病,这些疾病在编码 RAS/MAPK 通路蛋白的基因中存在突变。这些疾病包括 1 型神经纤维瘤病、努南综合征、勒吉尤斯综合征、豹皮综合征、科斯特洛综合征和心脏颜面皮肤综合征。RAS/MAPK 通路的参与不仅增加了患肿瘤的易感性,还决定了表型异常的存在以及学习过程中的改变。
综述对 RAS 病具有选择性作用机制的治疗策略的应用。
RAS 通路参与了三分之一的所有肿瘤这一事实促使在此水平上开发和研究不同的药物。其中一些药物已在 RAS 病中进行了测试,主要是在 1 型神经纤维瘤病中。在此我们分析不同抗靶点治疗方法的应用:作用于膜受体的药物,如酪氨酸激酶抑制剂、mTOR 通路中的药物或 MEK 抑制剂。后者在最近针对不同 RAS 病进行的研究中已显示出潜在益处。
如今,得益于主要基于动物模型使用 MEK 抑制剂进行的首批研究结果,正在开展一些有前景的临床试验。