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[分子疗法:神经肌肉疾病的现状与未来]

[Molecular therapies: present and future in neuromuscular diseases].

作者信息

Ziegler Andreas, Walter Maggie C, Schoser Benedikt E

机构信息

Zentrum für Kinder- und Jugendmedizin Heidelberg, Sektion Neuropädiatrie und Stoffwechselmedizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Deutschland.

Friedrich-Baur-Institut an der Neurologischen Klinik und Poliklinik, Universitätsklinikum München, LMU München, Ziemssenstr. 1, 80336, München, Deutschland.

出版信息

Nervenarzt. 2023 Jun;94(6):473-487. doi: 10.1007/s00115-023-01495-3. Epub 2023 May 23.

Abstract

BACKGROUND

The possibilities in the field of molecular therapies of neuromuscular diseases have rapidly developed in recent years. First compounds are already available in clinical practice and numerous other substances are in advanced phases of clinical trials. This article gives an exemplary overview of the current state of clinical research in molecular therapies of neuromuscular diseases. It also gives a view into the near future of the clinical application, including the challenges.

DISCUSSION

Using Duchenne muscular dystrophy (DMD) and myotubular myopathy as examples, the principles of gene addition in monogenetic skeletal muscle diseases, which are already manifested in childhood are described. In addition to initial successes, the challenges and setbacks hindering the approval and regular clinical application of further compounds are demonstrated. Furthermore, the state of current clinical research in Becker-Kiener muscular dystrophy (BMD) and the numerous forms of limb-girdle muscular dystrophy (LGMD) are summarized. Numerous new therapeutic approaches and a corresponding outlook are also shown for facioscapulohumeral muscular dystrophy (FSHD), Pompe disease, and myotonic dystrophy.

CONCLUSION

Clinical research in the field of molecular therapy of neuromuscular diseases is one of the pacesetters of modern precision medicine; however, challenges need to be seen, jointly addressed and overcome in the future.

摘要

背景

近年来,神经肌肉疾病分子治疗领域的可能性迅速发展。首批化合物已应用于临床实践,众多其他物质正处于临床试验的后期阶段。本文对神经肌肉疾病分子治疗的临床研究现状进行了示例性概述。它还展望了临床应用的近期未来,包括所面临的挑战。

讨论

以杜氏肌营养不良症(DMD)和肌管性肌病为例,描述了在儿童期就已显现的单基因骨骼肌疾病中基因添加的原理。除了初步的成功之外,还展示了阻碍进一步化合物获批和常规临床应用的挑战与挫折。此外,总结了贝克 - 基尼埃尔肌营养不良症(BMD)和多种类型的肢带型肌营养不良症(LGMD)的当前临床研究状况。对于面肩肱型肌营养不良症(FSHD)、庞贝病和强直性肌营养不良症,也展示了众多新的治疗方法及相应的前景。

结论

神经肌肉疾病分子治疗领域的临床研究是现代精准医学的领跑者之一;然而,未来需要看到、共同应对并克服这些挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6abf/10204661/3fad09d8aade/115_2023_1495_Fig1_HTML.jpg

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