Paediatric Neurology Unit, V. Buzzi Children's Hospital, Milan, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Expert Rev Clin Immunol. 2020 Feb;16(2):189-198. doi: 10.1080/1744666X.2019.1707663. Epub 2020 Jan 6.
: Aicardi-Goutières syndrome (AGS) is the prototype of the type I interferonopathies, a new heterogeneous group of autoinflammatory disorders in which type I interferon plays a pivotal role. The disease usually manifests itself during infancy, primarily affecting the brain and the skin, and is characterized by cerebrospinal fluid chronic lymphocytosis and raised levels of interferon-alpha and by cardinal neuroradiological features: cerebral calcification, leukoencephalopathy and cerebral atrophy. Recently many aspects of the pathogenesis of AGS have been clarified, making it possible to hypothesize new therapeutic strategies.: We here review recent data concerning pathogenesis and novel therapeutic strategies in AGS, including the use of Janus kinase inhibitors, reverse transcriptase inhibitors, anti-IFN-α antibodies, anti-interleukin antibodies, antimalarial drugs and other cGAS inhibitors.: Thanks to the identification of the molecular basis of AGS, many aspects of its pathogenesis have been clarified, making it possible to propose new therapeutic strategies for AGS and type I interferonopathies. A number of therapeutic options are now becoming possible, even though their efficacy is still to be proven. However, in spite of research advances coming from clinical trials and case series, there are still a number of open questions, which urgently need to be addressed.
Aicardi-Goutières 综合征(AGS)是 I 型干扰素病的原型,I 型干扰素在其中发挥关键作用,这是一组新的异质性自身炎症性疾病。这种疾病通常在婴儿期发病,主要影响大脑和皮肤,其特征是脑脊液慢性淋巴细胞增多和干扰素-α水平升高,并具有主要的神经放射学特征:脑钙化、脑白质病和脑萎缩。最近,AGS 的发病机制的许多方面已经得到阐明,这使得可以假设新的治疗策略。在这里,我们回顾了 AGS 的发病机制和新的治疗策略的最新数据,包括使用 Janus 激酶抑制剂、逆转录酶抑制剂、抗 IFN-α 抗体、抗白细胞介素抗体、抗疟药物和其他 cGAS 抑制剂。由于 AGS 的分子基础得到了鉴定,其发病机制的许多方面已经得到阐明,这使得为 AGS 和 I 型干扰素病提出新的治疗策略成为可能。现在有许多治疗选择成为可能,尽管它们的疗效仍有待证实。然而,尽管临床试验和病例系列研究取得了进展,但仍有许多悬而未决的问题亟待解决。