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α-1抗胰蛋白酶缺乏症:当前治疗方法与新出现的靶点

Alpha-1 antitrypsin deficiency: current therapy and emerging targets.

作者信息

McElvaney Oisín F, Fraughen Daniel D, McElvaney Oliver J, Carroll Tomás P, McElvaney Noel G

机构信息

Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.

Department of Medicine, Beaumont Hospital, Dublin, Ireland.

出版信息

Expert Rev Respir Med. 2023 Mar;17(3):191-202. doi: 10.1080/17476348.2023.2174973. Epub 2023 Mar 15.

Abstract

INTRODUCTION

Alpha1 antitrypsin deficiency (AATD), a common hereditary disorder affecting mainly lungs, liver and skin has been the focus of some of the most exciting therapeutic approaches in medicine in the past 5 years. In this review, we discuss the therapies presently available for the different manifestations of AATD and new therapies in the pipeline.

AREAS COVERED

We review therapeutic options for the individual lung, liver and skin manifestations of AATD along with approaches which aim to treat all three. Along with this renewed interest in treating AATD come challenges. How is AAT best delivered to the lung? What is the desired level of AAT in the circulation and lungs which therapeutics should aim to provide? Will treating the liver disease increase the potential for lung disease? Are there treatments to target the underlying genetic defect with the potential to prevent all aspects of AATDrelated disease?

EXPERT OPINION

With a relatively small population able to participate in clinical studies, increased awareness and diagnosis of AATD is urgently needed. Better, more sensitive clinical parameters will assist in the generation of acceptable and robust evidence of therapeutic effect for current and emerging treatments.

摘要

引言

α1抗胰蛋白酶缺乏症(AATD)是一种主要影响肺部、肝脏和皮肤的常见遗传性疾病,在过去5年中一直是医学领域一些最令人兴奋的治疗方法的重点。在本综述中,我们讨论了目前可用于AATD不同表现形式的治疗方法以及正在研发的新疗法。

涵盖领域

我们回顾了针对AATD在肺部、肝脏和皮肤的个体表现的治疗选择,以及旨在治疗所有这三个方面的方法。随着对治疗AATD的兴趣重新燃起,也带来了挑战。如何将AAT最佳地递送至肺部?治疗应旨在提供的循环和肺部中AAT的理想水平是多少?治疗肝脏疾病会增加患肺部疾病的可能性吗?是否有针对潜在基因缺陷的治疗方法,有可能预防AATD相关疾病的各个方面?

专家意见

由于能够参与临床研究的人群相对较少,迫切需要提高对AATD的认识和诊断。更好、更敏感的临床参数将有助于为当前和新兴治疗方法生成可接受且有力的治疗效果证据。

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