Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Vile Parle (West), Mumbai, 400056, India.
Am J Cardiovasc Drugs. 2023 Nov;23(6):623-640. doi: 10.1007/s40256-023-00609-1. Epub 2023 Sep 5.
Hypertrophic cardiomyopathy (HCM) is a complicated, heterogeneous genetic condition that causes left ventricular hypertrophy, fibrosis, hypercontractility, and decreased compliance. Despite the advances made over the past 3 decades in understanding the molecular and cellular mechanisms aggravating HCM, the relationship between pathophysiological stress stimuli and distinctive myocyte growth profiles is still imprecise. Currently, mavacamten, a selective and reversible inhibitor of cardiac myosin ATPase, is the only drug approved by the US FDA for the treatment of HCM. Thus, there is an unmet need for developing novel disease-specific therapeutic approaches. This article provides an overview of emerging therapeutic targets for the treatment of HCM based on various molecular pathways and novel developments that are hopefully soon to enter the clinical study. These newly discovered targets include the dual specificity tyrosine-phosphorylation-regulated kinase 1B, the absence of the melanoma 1 inflammasome, the leucine-rich repeat kinase 2 enzyme, and the cluster of differentiation 147.
肥厚型心肌病(HCM)是一种复杂的、异质性的遗传疾病,导致左心室肥厚、纤维化、高收缩性和顺应性降低。尽管在过去 30 年中,人们在理解加重 HCM 的分子和细胞机制方面取得了进展,但病理生理应激刺激与独特的心肌细胞生长特征之间的关系仍然不精确。目前,肌球蛋白 ATP 酶的选择性和可逆抑制剂 mavacamten 是唯一被美国食品和药物管理局批准用于治疗 HCM 的药物。因此,需要开发新的针对特定疾病的治疗方法。本文基于各种分子途径和新的发展,概述了治疗 HCM 的新兴治疗靶点,这些靶点有望很快进入临床研究。这些新发现的靶点包括双特异性酪氨酸磷酸化调节激酶 1B、黑色素瘤 1 炎症小体缺失、富含亮氨酸重复激酶 2 酶和分化抗原 147。