University of Lisbon, Lisbon, Portugal.
UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Expert Opin Drug Discov. 2021 Aug;16(8):897-913. doi: 10.1080/17460441.2021.1912732. Epub 2021 Apr 13.
Cystic fibrosis (CF) is a life-threatening inherited disease caused by mutations in the gene encoding the CF transmembrane conductance regulator (CFTR) protein, an anion channel expressed at the apical membrane of secretory epithelia. CF leads to multiorgan dysfunction with progressive deterioration of lung function being the major cause of untimely death. Conventional CF therapies target only symptoms and consequences downstream of the primary genetic defect and the current life expectancy and quality of life of these individuals are still very limited.
CFTR modulator drugs are novel-specialized therapies that enhance or even restore functional expression of CFTR mutants and have been approved for clinical use for individuals with specific CF genotypes. This review summarizes classical approaches used for the pre-clinical development of CFTR correctors and potentiators as well as emerging strategies aiming to accelerate modulator development and expand theratyping efforts.
Highly effective CFTR modulator drugs are expected to deeply modify the disease course for the majority of individuals with CF. A multitude of experimental approaches have been established to accelerate the development of novel modulators. CF patient-derived specimens are valuable cell models to predict therapeutic effectiveness of existing (and novel) modulators in a precision medicine approach.
囊性纤维化(CF)是一种危及生命的遗传性疾病,由编码 CF 跨膜电导调节因子(CFTR)蛋白的基因突变引起,CFTR 蛋白是一种在分泌上皮的顶膜表达的阴离子通道。CF 导致多器官功能障碍,肺功能进行性恶化是导致过早死亡的主要原因。传统的 CF 治疗方法仅针对主要遗传缺陷下游的症状和后果,这些个体的预期寿命和生活质量仍然非常有限。
CFTR 调节剂药物是新型专门治疗药物,可增强甚至恢复 CFTR 突变体的功能性表达,并已批准用于特定 CF 基因型个体的临床使用。这篇综述总结了用于 CFTR 校正剂和增强剂的临床前开发的经典方法,以及旨在加速调节剂开发和扩大治疗效果的新兴策略。
高度有效的 CFTR 调节剂药物有望极大地改变大多数 CF 患者的疾病进程。已经建立了多种实验方法来加速新型调节剂的开发。CF 患者来源的标本是有价值的细胞模型,可用于预测现有(和新型)调节剂在精准医疗方法中的治疗效果。