Aicardi-Goutières 综合征中 JAK 抑制剂治疗的神经病理学影响。
Neuropathologic Impacts of JAK Inhibitor Treatment in Aicardi-Goutières Syndrome.
机构信息
Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop 82, Los Angeles, CA, 90027, USA.
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
出版信息
J Clin Immunol. 2024 Feb 21;44(3):68. doi: 10.1007/s10875-024-01672-2.
Aicardi-Goutières syndrome (AGS) is a genetic interferonopathy characterized by upregulation of type I interferon response. It is associated with increased mortality and severe disabilities. Janus Kinase (JAK) inhibitors have shown effectiveness in treatment of AGS through blocking the downstream effects of interferon activation. We illustrate post-mortem histopathologic findings in a patient with AGS who received baricitinib treatment for a duration of over 4 years, initiating at a remarkably young age of 2 months. We observed global cerebral atrophy, markedly diminished white matter, abundant calcifications involving supratentorial white matter, basal ganglia, dentate nuclei, and brainstem. This study showed profound central nervous system (CNS) sequelae despite early initiation of treatment. Our findings highlight the potential necessity for therapeutic options with enhanced CNS bioavailability.
Aicardi-Goutières 综合征(AGS)是一种以 I 型干扰素反应上调为特征的遗传性干扰素病。它与死亡率增加和严重残疾有关。Janus 激酶(JAK)抑制剂通过阻断干扰素激活的下游效应,在 AGS 的治疗中显示出有效性。我们描述了一名接受巴瑞替尼治疗超过 4 年的 AGS 患者的死后组织病理学发现,该患者在 2 个月大时就开始接受治疗。我们观察到全脑萎缩,明显减少的白质,广泛的钙化,涉及幕上白质、基底节、齿状核和脑干。尽管早期开始治疗,但本研究显示出严重的中枢神经系统(CNS)后遗症。我们的研究结果强调了需要具有增强 CNS 生物利用度的治疗选择的可能性。