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巴西南部囊性纤维化跨膜传导调节因子(CFTR)变异的频率及对囊性纤维化患者进行调节剂治疗的指征

Frequency of CFTR variants in southern Brazil and indication for modulators therapy in patients with cystic fibrosis.

作者信息

Lima Eliandra da Silveira, Pezzin Luíse Sgarabotto, Fensterseifer Ana Carolina, Pinto Leonardo Araújo

机构信息

Pontifícia Universidade Católica do Rio Grande do Sul, Pós-graduação em Pediatria e Saúde da Criança, Porto Alegre, RS, Brazil.

Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Porto Alegre, RS, Brazil.

出版信息

Genet Mol Biol. 2021 Dec 6;45(1):e20200275. doi: 10.1590/1678-4685-GMB-2020-0275. eCollection 2021.

Abstract

This is a descriptive cross-sectional study that aims to determine the distribution of the CFTR causing variant in a group of patients at a cystic fibrosis (CF) center in southern Brazil, as well as to describe causing variants that are treatable with mutation-specific drugs. Ninety-two patients from a CF reference center were assessed in this research, all of them with a clinical diagnosis of CF and both alleles identified with pathogenic variants. The most prevalent causing variants were F508del, R1162X, G542X, and N1303K. As for patients with a mutation-specific drug indication, 69.6 % were candidates for the use of Elexacaftor/Tezacaftor/Ivacaftor (Trikafta®), 44.6 % for the use of Tezacaftor/Ivacaftor (Symdeko®), and 35.9 % for the use of Lumacaftor/Ivacaftor (Orkambi®). For the use of Ivacaftor (Kalydeco®), only two patients (2.2 %) were candidates following the Brazilian agency approval. According to the FDA, 10 patients would be candidates for Ivacaftor (10.9 %). Causing variants of classes I and II, which are related to a major severity of the illness, were identified in 135 of 184 alleles (73.3 %). In this study, more than 2/3 of the patients were candidates for the use of CFTR modulators therapy.

摘要

这是一项描述性横断面研究,旨在确定巴西南部一家囊性纤维化(CF)中心的一组患者中导致CFTR变异的分布情况,并描述可用针对特定突变的药物治疗的致病变异。本研究评估了来自一家CF参考中心的92名患者,他们均有CF的临床诊断且两个等位基因均鉴定为致病变异。最常见的致病变异是F508del、R1162X、G542X和N1303K。至于有使用针对特定突变药物指征的患者,69.6%有使用依列卡福/替扎卡福/依伐卡福(Trikafta®)的指征,44.6%有使用替扎卡福/依伐卡福(Symdeko®)的指征,35.9%有使用鲁马卡福/依伐卡福(Orkambi®)的指征。对于使用依伐卡福(Kalydeco®),在巴西机构批准后仅有两名患者(2.2%)有使用指征。根据美国食品药品监督管理局(FDA)的数据,有10名患者(10.9%)有使用依伐卡福的指征。在184个等位基因中的135个(73.3%)中鉴定出与疾病严重程度相关的I类和II类致病变异。在本研究中,超过2/3的患者有使用CFTR调节剂治疗的指征。

相似文献

本文引用的文献

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Cystic fibrosis.囊性纤维化。
Nat Rev Dis Primers. 2015 May 14;1:15010. doi: 10.1038/nrdp.2015.10.
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Genetics of Cystic Fibrosis: Clinical Implications.囊性纤维化的遗传学:临床意义
Clin Chest Med. 2016 Mar;37(1):9-16. doi: 10.1016/j.ccm.2015.11.002. Epub 2015 Dec 24.

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