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转甲状腺素蛋白淀粉样变性病的治疗进展

Advances in the treatment of transthyretin amyloidosis.

作者信息

Anan Intissar

机构信息

Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Department of Medicine, Umeå University Hospital, Umeå, Sweden.

出版信息

eGastroenterology. 2025 Jul 18;3(3):e100198. doi: 10.1136/egastro-2025-100198. eCollection 2025.

Abstract

This review aims to provide a comprehensive overview of the existing therapeutic options for managing neuropathic and/or cardiac manifestations associated with transthyretin amyloidosis (ATTR), along with investigational therapeutic candidates under evaluation in ongoing clinical trials. Additionally, emerging approaches for combating this life-threatening disease are discussed. Recent advancements in non-invasive diagnostic techniques for the detection of ATTR have facilitated improved diagnosis and identification at an earlier disease stage, thereby enhancing the potential efficacy of therapeutic interventions. Presently, there exists a range of clinically available treatments targeting ATTR, alongside investigational agents undergoing assessment in clinical trials. Therapeutic modalities encompass tetramer stabilisation, gene silencing, and ATTR fibril disruption and removal strategies. Historically, ATTR has been underdiagnosed. However, with the progression of diagnostic methodologies and the introduction of disease-modifying treatments, early diagnosis and initiation of treatment have significantly transformed the management of this condition, and effective treatment modalities have been introduced and are under development.

摘要

本综述旨在全面概述用于治疗与转甲状腺素蛋白淀粉样变性(ATTR)相关的神经病变和/或心脏表现的现有治疗选择,以及正在进行的临床试验中正在评估的研究性治疗候选药物。此外,还讨论了对抗这种危及生命疾病的新方法。用于检测ATTR的非侵入性诊断技术的最新进展有助于在疾病早期阶段进行更好的诊断和识别,从而提高治疗干预的潜在疗效。目前,有一系列针对ATTR的临床可用治疗方法,以及正在临床试验中进行评估的研究性药物。治疗方式包括四聚体稳定、基因沉默以及ATTR纤维破坏和清除策略。从历史上看,ATTR一直未得到充分诊断。然而,随着诊断方法的进步和疾病修饰治疗的引入,早期诊断和治疗的启动显著改变了这种疾病的管理方式,并且已经引入并正在开发有效的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b081/12278169/2215c791bf19/egastro-3-3-g001.jpg

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