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常染色体隐性遗传先天性黑矇 290 型突变所致 LEBER-遗传性视神经病变——高度未满足的医疗需求的严重视力损害:综述。

LEBER CONGENITAL AMAUROSIS DUE TO CEP290 MUTATIONS-SEVERE VISION IMPAIRMENT WITH A HIGH UNMET MEDICAL NEED: A Review.

机构信息

Department of Ophthalmology, Ghent University and Ghent University Hospital, Ghent, Belgium.

Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium.

出版信息

Retina. 2021 May 1;41(5):898-907. doi: 10.1097/IAE.0000000000003133.

Abstract

PURPOSE

Leber congenital amaurosis due to CEP290 mutations (LCA10) is an inherited retinal disease that often results in severe visual impairment or blindness in early childhood. Currently, there are no approved treatments, highlighting the considerable unmet medical need associated with LCA10. We aimed to review the clinical characteristics of LCA10, its impact on patients and society, and the investigational treatment strategies currently in development.

METHODS

Review of the current literature.

RESULTS

LCA10 is an autosomal recessive ciliopathy, for which the CEP290 intronic variant c.2991+1655A>G (p.Cys998X) is the most common mutation. Usually diagnosed in early childhood, most patients with LCA10 have severe visual impairment during their first decade of life, which significantly affects the quality of life and development. LCA10 also has a significant societal burden (direct and indirect costs). RNA editing using antisense oligonucleotides or Staphylococcus aureus CRISPR-associated protein-9 nuclease is currently under investigation for treatment of p.Cys998X LCA10. Specifically, the antisense oligonucleotide therapy QR-110 (sepofarsen) has demonstrated encouraging safety and efficacy data in a first-in-human trial; a phase 3 clinical trial is ongoing.

CONCLUSION

Interventions that can preserve or improve vision in patients with LCA10 have considerable potential to improve the patient quality of life and reduce burden of disease.

摘要

目的

CEP290 突变导致的莱伯先天性黑蒙(LCA10)是一种遗传性视网膜疾病,常导致儿童早期严重视力损害或失明。目前尚无批准的治疗方法,突出了与 LCA10 相关的巨大未满足的医疗需求。我们旨在回顾 LCA10 的临床特征、对患者和社会的影响,以及目前正在开发的研究性治疗策略。

方法

对当前文献进行综述。

结果

LCA10 是一种常染色体隐性纤毛病,最常见的突变是 CEP290 内含子变异 c.2991+1655A>G(p.Cys998X)。通常在儿童早期诊断,大多数 LCA10 患者在生命的第一个十年就有严重的视力损害,这严重影响了生活质量和发育。LCA10 也给社会带来了巨大的负担(直接和间接成本)。目前正在研究使用反义寡核苷酸或金黄色葡萄球菌 CRISPR 相关蛋白-9 核酸酶进行 RNA 编辑来治疗 p.Cys998X LCA10。具体来说,反义寡核苷酸疗法 QR-110(sepofarsen)在首次人体试验中显示出令人鼓舞的安全性和疗效数据;一项 3 期临床试验正在进行中。

结论

能够在 LCA10 患者中保留或改善视力的干预措施,具有显著改善患者生活质量和减轻疾病负担的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/164a/8078118/17075947fd35/retina-41-0898-g001.jpg

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