Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, United States of America.
Expert Opin Pharmacother. 2021 Aug;22(11):1489-1503. doi: 10.1080/14656566.2021.1902989. Epub 2021 Mar 25.
The past decades have witnessed a remarkable improvement in the health of patients with Gaucher disease, the inherited deficiency of the lysosomal enzyme glucocerebrosidase, resulting from the availability of enzyme replacement and substrate reduction therapies. Especially in pediatric populations, early diagnosis and initiation of treatment is essential to achieving optimal outcomes.
The authors review the literature pertaining to the effectiveness of currently available therapies and describe new pharmacotherapies under development, especially for young patients.
For pediatric patients with non-neuronopathic Gaucher disease, there may be new therapeutic options on the horizon in the form of gene therapy or small molecule glucocerebrosidase chaperones. These have the potential to result in a cure for systemic disease manifestations and/or to reduce the cost and convenience of treatment. For children with neuronopathic Gaucher disease, the challenge of targeting therapy to the central nervous system is being explored through new modalities including brain-targeted gene therapy, therapy, brain-penetrant small molecule chaperones, and other methods that convey enzyme across the blood-brain barrier. Indeed, these are exciting times for both pediatric patients with Gaucher disease and those with other lysosomal storage disorders.
过去几十年,由于酶替代和底物减少疗法的出现,戈谢病(一种溶酶体酶葡萄糖脑苷脂酶遗传性缺乏导致的遗传性疾病)患者的健康状况得到了显著改善。特别是在儿科人群中,早期诊断和开始治疗对于实现最佳治疗效果至关重要。
作者回顾了与现有疗法的有效性相关的文献,并描述了正在开发的新的药物治疗方法,特别是针对年轻患者的治疗方法。
对于非神经病变型戈谢病的儿科患者,可能会出现新的治疗选择,例如基因疗法或小分子葡萄糖脑苷脂酶伴侣。这些治疗方法有可能治愈全身性疾病表现,或降低治疗的成本和便利性。对于神经病变型戈谢病患儿,正在通过新的方式探索靶向治疗中枢神经系统的方法,包括脑靶向基因治疗、 治疗、脑穿透小分子伴侣以及其他可以将酶递送到血脑屏障的方法。实际上,对于戈谢病和其他溶酶体贮积症的儿科患者来说,这是令人兴奋的时刻。