预防性双重治疗婴儿发病脊柱肌肉缩的风险儿童
Susan E Matesanz1, Karlla W Brigatti2, Millie Young2
1Division of Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Annals of clinical and translational neurology
|May 31, 2024
概括
脊椎肌肉缩1型 (SMA1) 的基因疗法表明,双重疗法耐受性良好,并提供了轻微的益处. 然而,它并没有防止风险婴儿的广泛肌肉退化.
科学领域:
- 神经学 神经学
- 遗传学 是一个遗传学.
- 儿科 儿科 儿科
背景情况:
- 脊椎肌肉缩1型 (SMA1) 是一种严重的遗传神经肌肉疾病.
- 早期干预对于改善患有SMA1风险的婴儿的结果至关重要.
研究的目的:
- 为了比较基因疗法单疗法与双疗法 (基因疗法加SMN2增强剂) 在患有SMA1风险的婴儿中的疗效.
- 为了评估运动里程碑,肌肉完整性通过超声波,和感觉神经功能.
主要方法:
- 18名具有双性SMN1缺失和2个SMN2副本的新生儿接受了预防性单疗法 (n=11) 或双疗法 (n=7).
- 患者的随访时间中位数为3年,主要结局包括独立坐着和走路.
- 肌肉超声波和感官动作潜能被用作有效性和安全性的生物标志物.
主要成果:
- 两个小组中的大多数儿童都实现了坐着 (17/18) 和走路 (15/18) 的里程碑,其中44%的儿童经历了运动延迟.
- 双疗法显示,与单疗法相比,较早坐但不行走的趋势较早.
- 肌肉超声检查显示,在3-61个月后,94%的患者出现了退行性变化,无论治疗类型如何.
- 在双重治疗组中没有报告与治疗相关的不良事件,感官反应保持不变.
结论:
- 对SMA1的预防性双重治疗耐受性良好,并且可能在运动功能方面提供适度的益处.
- 尽管进行了治疗干预,但发生了广泛的退行性肌肉变化,这表明目前治疗方法的局限性.
- 需要进一步的研究来优化治疗策略,以防止SMA1的长期肌肉损伤.
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