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一名验光师了解基因治疗的最佳候选遗传性视网膜疾病的指南。

An optometrist's guide to the top candidate inherited retinal diseases for gene therapy.

机构信息

Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.

Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia.

出版信息

Clin Exp Optom. 2021 May;104(4):431-443. doi: 10.1080/08164622.2021.1878851. Epub 2021 Feb 25.

Abstract

This review presents the phenotypic and genotypic profiles of a select group of inherited retinal diseases (IRDs) that are currently the focus of retinal gene therapy trials globally. Research progress in IRD treatment trials may soon lead to their availability in Australia and New Zealand, as either approved treatment or a clinical trial. The salient clinical characteristics of retinitis pigmentosa-the largest IRD category-are highlighted, with specific reference to -associated Leber congenital amaurosis, followed by other specific IRDs, namely choroideremia and -associated Stargardt disease. These IRDs are selected based on their candidacy for gene therapy. Guidance on the clinical diagnostic tests that support each of these diagnoses will be presented. More broadly, the most useful structure and function measures to monitor IRD progression is discussed, along with the key assessments that offer differential diagnostic insight. This review is intended to be a clinical guide for optometrists, to assist in assessment and management of individuals who may be eligible for current and future gene therapies. A companion article in this issue will provide an overview of the basic principles of gene therapy and its development as a new treatment for inherited retinal diseases.

摘要

本综述介绍了一组目前全球视网膜基因治疗试验关注的精选遗传性视网膜疾病(IRDs)的表型和基因型特征。IRD 治疗试验的研究进展可能很快会导致它们在澳大利亚和新西兰被批准为治疗方法或临床试验。突出了最大的 IRD 类别——色素性视网膜炎的显著临床特征,并特别提到了相关的莱伯先天性黑矇,其次是其他特定的 IRD,即脉络膜视网膜炎和相关的斯塔加特病。这些 IRD 是基于其基因治疗的候选资格而选择的。将介绍支持这些诊断的每一种诊断的临床诊断测试的指导。更广泛地说,讨论了监测 IRD 进展最有用的结构和功能测量方法,以及提供鉴别诊断见解的关键评估。本综述旨在为验光师提供临床指南,以帮助评估和管理可能有资格接受当前和未来基因治疗的个体。本期的另一篇文章将概述基因治疗的基本原则及其作为遗传性视网膜疾病新治疗方法的发展。

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