Pranke Iwona, Golec Anita, Hinzpeter Alexandre, Edelman Aleksander, Sermet-Gaudelus Isabelle
INSERM U 1151, Institut Necker Enfants Malades, Université Paris Descartes, Paris, France.
Centre de Référence Maladie Rare, Mucoviscidose et Maladies de CFTR, Paris, France.
Front Pharmacol. 2019 Feb 27;10:121. doi: 10.3389/fphar.2019.00121. eCollection 2019.
An improved understanding of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) protein structure and the consequences of gene mutations have allowed the development of novel therapies targeting specific defects underlying CF. Some strategies are mutation specific and have already reached clinical development; some strategies include a read-through of the specific premature termination codons (read-through therapies, nonsense mediated decay pathway inhibitors for Class I mutations); correction of CFTR folding and trafficking to the apical plasma membrane (correctors for Class II mutations); and an increase in the function of CFTR channel (potentiators therapy for Class III mutations and any mutant with a residual function located at the membrane). Other therapies that are in preclinical development are not mutation specific and include gene therapy to edit the genome and stem cell therapy to repair the airway tissue. These strategies that are directed at the basic CF defects are now revolutionizing the treatment for patients and should positively impact their survival rates.
对囊性纤维化(CF)跨膜传导调节因子(CFTR)蛋白结构以及基因突变后果的深入了解,推动了针对CF潜在特定缺陷的新型疗法的开发。一些策略是针对特定突变的,并且已经进入临床开发阶段;一些策略包括通读特定的提前终止密码子(通读疗法、I类突变的无义介导衰变途径抑制剂);纠正CFTR折叠并使其转运至顶端质膜(II类突变的校正剂);以及增强CFTR通道功能(III类突变及膜上具有残余功能的任何突变体的增强剂疗法)。其他处于临床前开发阶段的疗法并非针对特定突变,包括编辑基因组的基因疗法和修复气道组织的干细胞疗法。这些针对CF基本缺陷的策略正在彻底改变患者的治疗方式,并有望对其生存率产生积极影响。