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泛酸激酶相关神经变性的病理学及治疗方法

Pathology and treatment methods in pantothenate kinase-associated neurodegeneration.

作者信息

Kwinta Robert, Kopcik Katarzyna, Koberling Agnieszka

机构信息

Municipal Hospital in Zabrze, Poland.

Virgin Mary Provincial Specialist Hospital in Częstochowa, Poland.

出版信息

Postep Psychiatr Neurol. 2024 Sep;33(3):163-171. doi: 10.5114/ppn.2024.141713. Epub 2024 Jul 23.

DOI:10.5114/ppn.2024.141713
PMID:39678459
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11635428/
Abstract

PURPOSE

The purpose of this review is to present current scientific reports on the pathophysiology, diagnosis and treatment of pantothenate kinase-associated neurodegeneration (PKAN).

VIEWS

The condition is caused by a mutation in the PANK2 gene, which results in iron accumulation in the brain and changes in the functioning of biochemical pathways dependent on coenzyme A. There are two clinical types of PKAN, which differ in the time of onset of symptoms and speed of disease progression. Imaging studies, specifically magnetic resonance (MR), and genetic testing are commonly used in the diagnosis process. The characteristic radiological image seen in T2-MR images is the "eye of the tiger". Patients with PKAN can only receive treatment for symptoms because there are no effective treatment methods available. Pharmacological methods include symptomatic medications, such as pregabalin, gabapentin, or botulinum toxin, and disease-modifying agents, such as iron chelators. Surgical procedures or deep brain stimulation as alternative methods can also be considered. The review presents data from studies published between 2017 and 2024.

CONCLUSIONS

There are many studies on the pathophysiology and treatment methods for PKAN patients, but the results are still limited. The future of PKAN treatment will be characterized by personalized treatment that is based on the patient's genetic and environmental factors. Further investigation of these is necessary.

摘要

目的

本综述旨在介绍目前关于泛酸激酶相关神经变性(PKAN)的病理生理学、诊断和治疗的科学报告。

观点

该病症由PANK2基因突变引起,导致大脑中铁质蓄积以及依赖辅酶A的生化途径功能改变。PKAN有两种临床类型,在症状出现时间和疾病进展速度方面有所不同。影像学检查,特别是磁共振成像(MR)和基因检测常用于诊断过程。T2加权磁共振图像中典型的放射学图像是“虎眼征”。由于没有有效的治疗方法,PKAN患者只能接受对症治疗。药物治疗方法包括对症药物,如普瑞巴林、加巴喷丁或肉毒杆菌毒素,以及疾病修饰剂,如铁螯合剂。也可考虑手术或深部脑刺激作为替代方法。本综述呈现了2017年至2024年间发表的研究数据。

结论

关于PKAN患者的病理生理学和治疗方法有许多研究,但结果仍然有限。PKAN治疗的未来将以基于患者遗传和环境因素的个性化治疗为特征。对此有必要进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d154/11635428/ce7fcf152297/PPN-33-54507-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d154/11635428/ce7fcf152297/PPN-33-54507-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d154/11635428/ce7fcf152297/PPN-33-54507-g001.jpg

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Diagnosis and Treatment of Pantothenate Kinase-Associated Neurodegeneration (PKAN): A Systematic Review.
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Cureus. 2023 Sep 28;15(9):e46135. doi: 10.7759/cureus.46135. eCollection 2023 Sep.
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Patient-Derived Cellular Models for Polytarget Precision Medicine in Pantothenate Kinase-Associated Neurodegeneration.泛酸激酶相关神经变性中用于多靶点精准医学的患者来源细胞模型
Pharmaceuticals (Basel). 2023 Sep 26;16(10):1359. doi: 10.3390/ph16101359.
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Brain MRI detects early-stage alterations and disease progression in Friedreich ataxia.脑部磁共振成像可检测弗里德赖希共济失调的早期改变和疾病进展。
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