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脑白质营养不良的最新进展和临床试验

Update on leukodystrophies and developing trials.

机构信息

Department of Neuromuscular Disorders, Institute of Neurology, University College London (UCL), London, UK.

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

出版信息

J Neurol. 2024 Jan;271(1):593-605. doi: 10.1007/s00415-023-11996-5. Epub 2023 Sep 27.

Abstract

Leukodystrophies are a heterogeneous group of rare genetic disorders primarily affecting the white matter of the central nervous system. These conditions can present a diagnostic challenge, requiring a comprehensive approach that combines clinical evaluation, neuroimaging, metabolic testing, and genetic testing. While MRI is the main tool for diagnosis, advances in molecular diagnostics, particularly whole-exome sequencing, have significantly improved the diagnostic yield. Timely and accurate diagnosis is crucial to guide symptomatic treatment and assess eligibility to participate in clinical trials. Despite no specific cure being available for most leukodystrophies, gene therapy is emerging as a potential treatment avenue, rapidly advancing the therapeutic prospects in leukodystrophies. This review will explore diagnostic and therapeutic strategies for leukodystrophies, with particular emphasis on new trials.

摘要

脑白质营养不良是一组罕见的遗传性疾病,主要影响中枢神经系统的白质。这些疾病的诊断具有挑战性,需要综合临床评估、神经影像学、代谢测试和基因测试。磁共振成像(MRI)是主要的诊断工具,而分子诊断技术的进步,特别是外显子组测序,大大提高了诊断的效率。及时准确的诊断对于指导对症治疗和评估参与临床试验的资格至关重要。尽管大多数脑白质营养不良尚无特效治疗方法,但基因治疗正成为一种潜在的治疗方法,为脑白质营养不良的治疗前景带来了快速的进展。本文将探讨脑白质营养不良的诊断和治疗策略,特别强调新的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b86a/10770198/ae60554938d5/415_2023_11996_Fig1_HTML.jpg

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