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杜兴氏肌肉营养不良症:历史治疗回顾

Duchenne muscular dystrophy: an historical treatment review.

作者信息

Werneck Lineu Cesar, Lorenzoni Paulo José, Ducci Renata Dal-Prá, Fustes Otto Hernández, Kay Cláudia Suemi Kamoi, Scola Rosana Herminia

机构信息

Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Doenças Neuromusculares, Curitiba PR, Brasil.

出版信息

Arq Neuropsiquiatr. 2019 Sep 5;77(8):579-589. doi: 10.1590/0004-282X20190088.

Abstract

In this review, we discuss the therapies used in the treatment of patients with Duchenne muscular dystrophy since the first description of the disease. A short description is given of the various theories based on disease pathogenesis, which give the substrates for the many therapeutic interventions. A brief review of the methods of evaluation used in therapeutic trials is made. Of all the treatments, the only drugs that are still considered able to modify the course of the disease are the corticosteroids (prednisone/prednisolone/deflazacort). Other drugs (coenzyme Q10 and creatine) have had a little effect in a few functions without adverse reactions. Idebenone seems to improve the respiratory function in the long term. The trials with mRNA transcription, through nonsense mutations or exon 51 skipping, show some beneficial results in a few functional tests, but they are limited to a small set of DMD patients.

摘要

在本综述中,我们讨论了自杜氏肌营养不良症首次被描述以来用于治疗该病患者的疗法。基于疾病发病机制对各种理论进行了简短描述,这些理论为众多治疗干预提供了基础。对治疗试验中使用的评估方法进行了简要综述。在所有治疗方法中,目前仍被认为能够改变疾病进程的唯一药物是皮质类固醇(泼尼松/泼尼松龙/地夫可特)。其他药物(辅酶Q10和肌酸)在一些功能上有轻微作用且无不良反应。艾地苯醌似乎能长期改善呼吸功能。通过无义突变或外显子51跳跃进行mRNA转录的试验在一些功能测试中显示出一些有益结果,但仅限于一小部分杜氏肌营养不良症患者。

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