患有MCT8缺乏症的男孩的甲酸治疗:改善甲状腺功能测试和可能的肝毒性
Felix Schreiner1, Heike Vollbach1, Niklas Sonntag2
1Pediatric Endocrinology Division, Children's Hospital, University Hospital Bonn, 53127 Bonn, Germany.
The Journal of clinical endocrinology and metabolism
|May 23, 2024
概括
一个患有单碳酸转运体8 (MCT8) 缺乏症的男孩的基酸盐 (PB) 治疗改善了甲状腺激素水平,并显示了轻微的神经发育收益. 然而,PBPB却没有.
科学领域:
- 内分泌学 在内分泌学.
- 遗传学 是一个遗传学.
- 儿科 儿科 儿科
背景情况:
- 单碳酸载体8 (MCT8) 缺乏症是一种罕见的X相关疾病,导致严重的认知和运动障碍.
- 缺少MCT8会导致外围甲状腺毒性和荷尔蒙失衡.
- 像甲酸 (PB) 这样的化学伴侣在体外显示出拯救突变MCT8功能的潜力.
研究的目的:
- 评估酸 (PB) 对患有MCT8缺乏症的患者的生物化学和临床影响.
- 为了评估PB治疗,使用用于尿素循环障碍的批准剂量.
- 在患者身上调查一种新的MCT8误解突变 (c.703G>T,p.V235L).
主要方法:
- 一个患有MCT8缺乏症的男孩接受了13个月的PB治疗.
- 对包括甲状腺激素和肝酶在内的生化标志物进行监测.
- 进行了神经发育评估 (BSID-III) 和体外细胞研究.
主要成果:
- PB治疗显著降低了铁氨酸和三铁氨酸 (T3) 水平,同时增加了自由甲状腺素 (fT4).
- 患者表现出粗运动技能的轻微改善,体重z-score稳定.
- 实验室研究表明,PB增加了突变MCT8蛋白的表达,但没有恢复T3运输,这表明它对甲状腺功能测试有间接影响.
结论:
- 基酸盐 (PB) 治疗显示,甲状腺激素配置和微妙的神经发育进展在MCT8缺乏的改善.
- 观察到肝毒性和酸积累,需要调整剂量并突出潜在的治疗限制.
- 需要进一步的研究,以了解PB在MCT8缺乏症中的机制和长期影响,特别是肝毒性.
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