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神经罕见病:新兴创新与基因治疗的作用

Neurologic orphan diseases: Emerging innovations and role for genetic treatments.

作者信息

Kioutchoukova Ivelina P, Foster Devon T, Thakkar Rajvi N, Foreman Marco A, Burgess Brandon J, Toms Rebecca M, Molina Valero Eduardo E, Lucke-Wold Brandon

机构信息

College of Medicine, University of Florida, Gainesville, FL 32611, United States.

Florida International University Herbert Wertheim College of Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL 33199, United States.

出版信息

World J Exp Med. 2023 Sep 20;13(4):59-74. doi: 10.5493/wjem.v13.i4.59.

Abstract

Orphan diseases are rare diseases that affect less than 200000 individuals within the United States. Most orphan diseases are of neurologic and genetic origin. With the current advances in technology, more funding has been devoted to developing therapeutic agents for patients with these conditions. In our review, we highlight emerging options for patients with neurologic orphan diseases, specifically including diseases resulting in muscular deterioration, epilepsy, seizures, neurodegenerative movement disorders, inhibited cognitive development, neuron deterioration, and tumors. After extensive literature review, gene therapy offers a promising route for the treatment of neurologic orphan diseases. The use of clustered regularly interspaced palindromic repeats/Cas9 has demonstrated positive results in experiments investigating its role in several diseases. Additionally, the use of adeno-associated viral vectors has shown improvement in survival, motor function, and developmental milestones, while also demonstrating reversal of sensory ataxia and cardiomyopathy in Friedreich ataxia patients. Antisense oligonucleotides have also been used in some neurologic orphan diseases with positive outcomes. Mammalian target of rapamycin inhibitors are currently being investigated and have reduced abnormal cell growth, proliferation, and angiogenesis. Emerging innovations and the role of genetic treatments open a new window of opportunity for the treatment of neurologic orphan diseases.

摘要

罕见病是指在美国影响不到20万人的疾病。大多数罕见病起源于神经和遗传方面。随着当前技术的进步,更多资金已投入到为患有这些疾病的患者开发治疗药物上。在我们的综述中,我们重点介绍了神经罕见病患者的新兴治疗选择,具体包括导致肌肉退化、癫痫、发作、神经退行性运动障碍、认知发育迟缓、神经元退化和肿瘤的疾病。经过广泛的文献综述,基因治疗为神经罕见病的治疗提供了一条有前景的途径。成簇规律间隔短回文重复序列/Cas9(CRISPR/Cas9)在研究其在几种疾病中的作用的实验中已显示出积极结果。此外,腺相关病毒载体的使用已在生存率、运动功能和发育里程碑方面显示出改善,同时也在弗里德赖希共济失调患者中证明了感觉性共济失调和心肌病的逆转。反义寡核苷酸也已用于一些神经罕见病并取得了积极成果。雷帕霉素靶蛋白抑制剂目前正在研究中,已减少了异常细胞生长、增殖和血管生成。新兴的创新和基因治疗的作用为神经罕见病的治疗打开了一扇新的机会之窗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/10520757/f0c82451119c/WJEM-13-59-g001.jpg

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