与GRIN相关的脑病变患者的L-血清治疗:一个2A期的非随机化研究
Natalia Juliá-Palacios1, Mireia Olivella2,3, Mariya Sigatullina Bondarenko1
1Neurometabolic Unit and Synaptic Metabolism Lab, Department of Neurology, Hospital Sant Joan de Déu-IRSJD, CIBERER and MetabERN, 08950 Barcelona, Spain.
Brain : a journal of neurology
|February 21, 2024
概括
对于患有GRIN相关疾病的儿童来说,L-氨酸是一个安全的治疗方法,有望改善适应性行为和运动功能. 轻度受影响的儿童从这种GRIN障碍治疗中获得了最显著的好处.
科学领域:
- 神经科学是一个神经科学.
- 遗传学 是一个遗传学.
- 儿科神经学 儿科神经学
背景情况:
- 与GRIN相关的疾病是罕见的发育性脑病变,治疗选择有限.
- 这些疾病是由导致GRIN基因功能丧失的遗传变异引起的.
- 目前对GRIN疾病的治疗策略不足以解决广泛的临床表现.
研究的目的:
- 评估L-氨酸在患有GRIN功能丧失变异的儿科患者的安全性和疗效.
- 评估L-氨酸对适应性行为,运动功能和生活质量的影响.
- 探索对受影响儿童的发作频率和EEG模式的潜在益处.
主要方法:
- 进行了一项非随机的,开放的,单臂的2A期试验 (NCT04646447).
- 24名患有GRIN功能丧失变异的儿童 (2-18岁) 接受了52周的L-氨酸治疗.
- 标准化尺度 (Vineland,Bayley,Wechsler等) 已经成为标准. 和EEG监测被用来评估多个时间点的结果.
主要成果:
- 一般来说,L-氨酸耐受性很好,由于易怒和失眠而停止服用一次.
- 在适应性行为 (日常生活技能,表达,个人,社区,人际关系子领域) 和运动功能 (总运动功能-88) 中观察到显著的改善.
- 认知功能 (贝利-III) 在严重组有所改善,生活质量得分在整个队列中增加,在较温和的表型中发现的益处更大.
结论:
- 对于患有GRIN功能丧失变异的儿童来说,L-氨酸是一种安全且潜在的有效治疗方法.
- 该补充剂显示了改善适应性行为,运动技能和生活质量的潜力.
- 较温和的表型似乎对L-氨酸治疗的反应更好,这表明在早期干预中可能发挥作用.
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