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肌管性肌病的呼吸护理

Respiratory care in myotubular myopathy.

作者信息

Tan Hui-Leng, Chan Elaine

机构信息

Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

出版信息

ERJ Open Res. 2021 Mar 22;7(1). doi: 10.1183/23120541.00641-2020. eCollection 2021 Jan.

Abstract

X-linked myotubular myopathy is a neuromuscular condition caused by pathogenic variants in the gene, which encodes for myotubularin, a phosphatidylinositol 3-phosphate phosphatase. Affected individuals typically require intensive medical intervention to survive, though there are some milder phenotypes. To date, respiratory management has been primarily supportive, optimising clearance of airway secretions, providing ventilatory support and prevention/early intervention of respiratory infections. Encouragingly, there has been significant progress in the development of novel therapeutic strategies such as gene therapy, enzyme replacement therapy and drugs that modulate downstream pathways. In this review, we discuss the common respiratory issues using four illustrative real-life cases, and summarise recent translational research, which offers hope to many patients and their families.

摘要

X连锁肌管性肌病是一种由该基因的致病变异引起的神经肌肉疾病,该基因编码肌管素,一种磷脂酰肌醇3-磷酸磷酸酶。受影响的个体通常需要强化医疗干预才能存活,不过也有一些症状较轻的表型。迄今为止,呼吸管理主要是支持性的,包括优化气道分泌物清除、提供通气支持以及预防/早期干预呼吸道感染。令人鼓舞的是,在基因治疗、酶替代疗法以及调节下游通路的药物等新型治疗策略的开发方面已经取得了重大进展。在本综述中,我们通过四个具有代表性的真实病例讨论常见的呼吸问题,并总结近期的转化研究,这些研究为许多患者及其家庭带来了希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bd8/7983207/ae4ffe21fba6/00641-2020.01.jpg

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