Giusy Ranucci, Raffaele Iorio, Department of Translational Medical Science, Section of Pediatric, University Federico II, 80131 Naples, Italy.
World J Gastroenterol. 2017 Aug 14;23(30):5451-5456. doi: 10.3748/wjg.v23.i30.5451.
Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism, caused by mutations in the gene. A clear demand for novel WD treatment strategies has emerged. Although therapies using zinc salts and copper chelators can effectively cure WD, these drugs exhibit limitations in a substantial pool of WD patients who develop intolerance and/or severe side effects. Several lines of research have indicated intriguing potential for novel strategies and targets for development of new therapies. Here, we review these new approaches, which comprise correction of mutants and discovery of new compounds that circumvent -deficiency, as well as cell and gene therapies. We also discuss whether and when these new therapeutic strategies will be translated into clinical use, according to the key requirements for clinical trials that remain to be met. Finally, we discuss the hope for the current rapidly developing research on molecular mechanisms underlying WD pathogenesis and for the related potential therapeutic targets to provide a solid foundation for the next generation of WD therapies that may lead to an effective, tolerable and safe cure.
威尔逊病(WD)是一种常染色体隐性遗传的铜代谢疾病,由 基因的突变引起。对新型 WD 治疗策略的明确需求已经出现。尽管使用锌盐和铜螯合剂的疗法可以有效治疗 WD,但这些药物在大量出现不耐受和/或严重副作用的 WD 患者中存在局限性。多项研究表明,针对新型策略和新疗法开发的新靶点具有诱人的潜力。在这里,我们回顾了这些新方法,包括对 突变体的纠正和发现规避 -缺陷的新化合物,以及细胞和基因疗法。我们还根据临床试验仍需满足的关键要求,讨论了这些新的治疗策略是否以及何时会转化为临床应用。最后,我们讨论了目前 WD 发病机制的分子机制研究和相关潜在治疗靶点的希望,为下一代 WD 治疗方法提供坚实的基础,这些方法可能会带来有效、耐受和安全的治疗。