Vionnet Julien, Pascual Manuel, Kuntzer Thierry, Yerly Patrick, Moradpour Darius
Service de gastroentérologie et d'hépatologie, CHUV, Université de Lausanne, 1011 Lausanne.
Centre de transplantation d'organes, CHUV, Université de Lausanne, 1011 Lausanne.
Rev Med Suisse. 2016 Aug 31;12(528):1434-1440.
Transthyretin-related hereditary amyloidosis (ATTR) is a progressive and potentially lethal genetic disorder, transmitted as an autosomal dominant trait. Tissue injury is induced by amyloid fibrils consisting of mutated transthyretin. The symptomatology and clinical course of ATTR is highly variable but typically causes peripheral polyneuropathy and autonomic dysfunction, leading to death within 10 years. As transthyretin is produced mainly in the liver, liver transplantation was the first successful therapeutic approach. Several disease-modifying treatments, including transthyretin stabilizers and gene therapy, are now available or in clinical development, with promising results.
转甲状腺素蛋白相关遗传性淀粉样变性(ATTR)是一种进行性且可能致命的遗传性疾病,以常染色体显性特征遗传。由突变的转甲状腺素蛋白组成的淀粉样原纤维会导致组织损伤。ATTR的症状和临床病程高度可变,但通常会引发周围性多发性神经病和自主神经功能障碍,导致患者在10年内死亡。由于转甲状腺素蛋白主要在肝脏中产生,肝移植是首个成功的治疗方法。目前已有几种疾病修饰疗法,包括转甲状腺素蛋白稳定剂和基因疗法,或者正在临床开发中,且取得了有前景的成果。