对心力衰竭的战争:兰塞特医学杂志的讲座
1TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Lancet (London, England)
|December 4, 2014
概括
新的心力衰竭治疗方法显示出希望,包括用于处理的基因疗法,microRNA阻断剂,细胞疗法和心室辅助装置. 这些创新方法为对抗这种广泛的心血管疾病提供了希望.
科学领域:
- 心脏病学 心脏病学
- 分子生物学分子生物学
- 再生医学是一种再生医学.
背景情况:
- 心力衰竭影响全球3800万,随着人口老龄化而增加,并且预后比大多数癌症更差.
- 它是老年人住院的主要原因,特别是在高收入国家.
- 尽管取得了进展,但在心力衰竭管理方面仍然存在重大未满足的需求.
研究的目的:
- 审查和强调心力衰竭的新兴治疗策略.
- 讨论针对处理,基因表达和心脏支持的新方法.
- 提出一个多方面的"对心力衰竭的战争"战略.
主要方法:
- 增强肌纤维对 (Ca2+) 的敏感性.
- 研究针对SERCA2a和其他处理的蛋白质的基因疗法.
- 探索使用抗体的微RNA (miRNA) 向疗法.
- 评估基于细胞的疗法 (骨髓单核细胞,介质细胞).
- 评估长期心室辅助设备作为目的地治疗.
主要成果:
- 在第二阶段试验中,SERCA2a基因转移显示出前景.
- 在心力衰竭的动物模型中,抗体药物改善了心脏功能.
- 细胞疗法在临床前和早期临床试验中显示出潜力.
- 心室辅助器件越来越多地被使用,一些病例显示心肌恢复和器件扩展.
结论:
- 多种新的治疗途径,包括基因疗法,miRNA调制,细胞疗法和机械支持,正在出现心力衰竭.
- 这些方法,单独或组合,代表了对抗心力衰竭的重大进展.
- 进一步的研究和临床试验至关重要,以充分实现这些创新治疗的潜力.
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