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[进行性家族性肝内胆汁淤积症的治疗进展]

[Progress in the treatment of progressive familial intrahepatic cholestasis].

作者信息

Liu T, Wang J S

机构信息

The Department of Infection Diseases, Children's Hospital of Fudan University, Shanghai 201102, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2024 Sep 20;32(9):772-776. doi: 10.3760/cma.j.cn501113-20240731-00354.

Abstract

Progressive familial intrahepatic cholestasis (PFIC) is an important cause of liver-related death or transplantation in children. The PFIC spectrum is expanding, twelve types of PFIC are currently included in the Online Mendelian Inheritance in Man (OMIM) database. With the increase of PFIC types and the inconsistence of certain types in numbering, the current numbering classification of PFIC is confusing, so the experts in the field recommend using the corresponding mutant gene/ protein defect to name different type of PFIC except for PFIC type 1-3. The clarification of the genotype-phenotype relationship and/or the establishment of phenotypic predictors significantly improved the management of patients with PFIC. Odevixibat and maralixibat, inhibitors of the apical sodium ion-dependent bile acid transporter on the intestinal epithelial cells, were approved in European Union and the United States for the treatment of PFIC pruritus in 2021, expanding the treatment options for PFIC. Additionally, personalized treatments for specific mutations and novel gene therapy is promising.

摘要

进行性家族性肝内胆汁淤积症(PFIC)是儿童肝相关死亡或肝移植的重要原因。PFIC的范围正在扩大,目前《人类孟德尔遗传在线》(OMIM)数据库中包含12种PFIC类型。随着PFIC类型的增加以及某些类型编号的不一致,目前PFIC的编号分类令人困惑,因此该领域的专家建议,除PFIC 1-3型外,使用相应的突变基因/蛋白质缺陷来命名不同类型的PFIC。基因型-表型关系的阐明和/或表型预测指标的建立显著改善了PFIC患者的管理。odevixibat和maralixibat是肠道上皮细胞顶端钠离子依赖性胆汁酸转运蛋白的抑制剂,于2021年在欧盟和美国获批用于治疗PFIC瘙痒症,拓宽了PFIC的治疗选择。此外,针对特定突变的个性化治疗和新型基因治疗前景广阔。

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