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脉络膜血症:未满足需求的视网膜变性。

CHOROIDEREMIA: Retinal Degeneration With an Unmet Need.

机构信息

Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.

Retina Foundation of the Southwest, Dallas, Texas.

出版信息

Retina. 2019 Nov;39(11):2059-2069. doi: 10.1097/IAE.0000000000002553.

Abstract

PURPOSE

Choroideremia is an incurable, X-linked, recessive retinal dystrophy caused by loss of function mutations in the CHM gene. It is estimated to affect approximately 1 in 50,000 male patients. It is characterized by progressive degeneration of the retinal pigment epithelium, choroid, and photoreceptors, resulting in visual impairment and blindness. There is an unmet need in choroideremia, because currently, there are no approved treatments available for patients with the disease.

METHODS

We review the patient journey, societal impact, and emerging treatments for patients with choroideremia.

RESULTS

Its relative rarity and similarities with other retinal diseases in early years mean that diagnosis of choroideremia can often be delayed. Furthermore, its impact on affected individuals, and wider society, is also likely underestimated. AAV2-mediated gene therapy is an investigational treatment that aims to replace the faulty CHM gene. Early-phase studies reported potentially important visual acuity gains and maintenance of vision in some patients, and a large Phase 3 program is now underway.

CONCLUSION

Choroideremia is a disease with a significant unmet need. Interventions that can treat progression of the disease and improve visual and functional outcomes have the potential to reduce health care costs and enhance patient quality of life.

摘要

目的

脉络膜视网膜变性是一种由 CHM 基因突变导致的不可治愈的 X 连锁隐性视网膜退行性疾病。据估计,大约每 50,000 名男性患者中就有 1 名受到影响。其特征是视网膜色素上皮、脉络膜和光感受器的进行性退化,导致视力损害和失明。脉络膜视网膜变性患者存在未满足的治疗需求,因为目前尚无针对该疾病的批准治疗方法。

方法

我们回顾了脉络膜视网膜变性患者的治疗历程、对社会的影响以及新兴治疗方法。

结果

由于其相对罕见性以及与早年其他视网膜疾病的相似性,脉络膜视网膜变性的诊断往往会被延迟。此外,该病对受影响个体以及更广泛的社会的影响也可能被低估了。腺相关病毒 2 介导的基因治疗是一种有前景的治疗方法,旨在替换有缺陷的 CHM 基因。早期研究报告了一些患者潜在的重要视力提高和视力维持,目前正在进行一项大型的 3 期临床试验。

结论

脉络膜视网膜变性是一种有重大未满足治疗需求的疾病。能够治疗疾病进展并改善视力和功能结果的干预措施有潜力降低医疗成本并提高患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89aa/7347087/84a40bc28f96/nihms-1575144-f0001.jpg

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