Department of Pediatric Neurology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
Metab Brain Dis. 2021 Jun;36(5):859-863. doi: 10.1007/s11011-021-00716-5. Epub 2021 Mar 15.
Aicardi-Goutières Syndrome (AGS) is a monogenic leukodystrophy with pediatric onset, clinically characterized by a variable degree of neurologic impairment. It belongs to a group of condition called type I interferonopathies that are characterized by abnormal overproduction of interferon alpha, an inflammatory cytokine which action is mediated by the activation of two of the four human Janus Kinases. Thanks to an ever-increasing knowledge of the molecular basis and pathogenetic mechanisms of the disease, Janus Kinase inhibitors (JAKIs) have been proposed as a treatment option for selected interferonopathies. Here we reported the 24 months follow-up of the fifth AGS patient treated with ruxolitinib described so far in literature. The treatment was globally well tolerated; clinical examinations and radiological images demonstrated a progressively improving course. It is however to note that patients presenting with mild and spontaneously improving course have been reported. Large natural history studies on AGS spectrum are strongly required in order to get a better understanding of the results emerging from ongoing therapeutic trials on such rare disease.
Aicardi-Goutières 综合征(AGS)是一种儿科起病的单基因脑白质营养不良,临床上以不同程度的神经功能障碍为特征。它属于一类称为 I 型干扰素病的疾病,其特征是干扰素-α的异常过度产生,干扰素-α是一种炎症细胞因子,其作用通过四个人类 Janus 激酶中的两个的激活来介导。由于对疾病的分子基础和发病机制的认识不断增加,Janus 激酶抑制剂(JAKIs)已被提议作为选定的干扰素病的治疗选择。在这里,我们报告了迄今为止文献中描述的第五例接受鲁索替尼治疗的 AGS 患者的 24 个月随访结果。治疗总体上耐受良好;临床检查和影像学图像显示出逐渐改善的过程。然而,需要注意的是,已经报道了具有轻度和自发改善病程的患者。为了更好地理解正在进行的此类罕见疾病治疗试验中出现的结果,强烈需要对 AGS 谱进行大规模的自然病史研究。