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[脊髓性肌萎缩症患者的现代治疗原则]

[Modern principles of therapy for patients with spinal muscular atrophy].

作者信息

Bofanova N S, Eliseeva A R, Onchina V S

机构信息

Penza State University, Penza, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(3):34-40. doi: 10.17116/jnevro202312303134.

Abstract

Spinal muscular atrophy (SMA) is a common cause of childhood mortality among hereditary diseases of the central nervous system, which are caused by the processes of degeneration and death of motor neurons of the anterior horns of the spinal cord. An urgent issue of modern neurology is pathogenetic therapy for this group of patients, the purpose of which is to increase the level of motoneuron survival protein. We performed a search on current methods of treating SMA in Web of Science, Scopus, PubMed, Embase by the keywords: spinal muscular atrophy, neuromuscular diseases, pathogenetic therapy. Significant progress has been made in the treatment of SMA over the past 7 years. A major advance is the introduction of disease-modifying therapies using SMN2 splicing modulation or gene replacement therapy. At the moment, there are 3 FDA-approved drugs for pathogenetic therapy: Nusinersen, Risdiplam, Zolgensma. The article compares the drugs, evaluates their safety and effectiveness according to the available literature. Modern drugs for the pathogenetic therapy of SMA are highly effective and reduce the mortality rate. The results of clinical trials predict the emergence of new modern drugs. This suggests a favorable prognosis for the treatment of patients with SMA.

摘要

脊髓性肌萎缩症(SMA)是中枢神经系统遗传性疾病中儿童死亡的常见原因,其由脊髓前角运动神经元的变性和死亡过程引起。现代神经病学的一个紧迫问题是针对这组患者的发病机制治疗,其目的是提高运动神经元存活蛋白的水平。我们通过关键词“脊髓性肌萎缩症”“神经肌肉疾病”“发病机制治疗”在科学网、Scopus、PubMed、Embase上搜索了当前治疗SMA的方法。在过去7年中,SMA的治疗取得了重大进展。一项重大进展是引入了使用SMN2剪接调节或基因替代疗法的疾病修饰疗法。目前,有3种FDA批准的用于发病机制治疗的药物:诺西那生钠、利司扑兰、佐伦沙。本文对这些药物进行了比较,并根据现有文献评估了它们的安全性和有效性。现代用于SMA发病机制治疗的药物非常有效,并降低了死亡率。临床试验结果预示着新的现代药物将会出现。这表明SMA患者的治疗预后良好。

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