在线粒体疾病中烯酸毒性的证据:系统分析
Thiloka E Ratnaike1,2, Nour Elkhateeb3, Angela Lochmüller4,5
1Department of Paediatrics, University of Cambridge, Cambridge, UK.
BMJ neurology open
|June 11, 2024
概括
甲 (VPA) 在患有复发性POLG变异的患者中是禁忌的,因为严重药物不良反应的风险很高. 对于其他线粒体DNA和核基因型,VPA可能是安全的,等待进一步的研究.
科学领域:
- 药物基因组学 药物基因组学
- 线粒体遗传学 线粒体遗传学
- 药品安全 药品安全
背景情况:
- 甲 (VPA) 在某些线粒体疾病中与严重的肝毒性有关.
- 这项研究调查了所有线粒体疾病患者对VPA的禁忌的必要性.
研究的目的:
- 为了评估不同线粒体疾病基因型中甲 (VPA) 的安全性.
- 为了确定在患有线粒体疾病的患者中使用VPA的具体禁忌.
主要方法:
- 对PubMed,Embase,Medline和MitoPhen数据库的系统文献审查,截至2022年7月.
- 包括156个被遗传诊断为线粒体疾病的个体的患者级数据.
- 利用人类现象形体学来编码临床表现.
主要成果:
- 35名患有线粒体DNA (mtDNA) 疾病的患者没有观察到致命的不良药物反应 (ADR).
- 一例急性肝衰竭发生在54名患有非POLG线粒体疾病的患者中.
- 52% (53/102) 患有复发性POLG突变的VPA暴露患者发生了致命的结局.
结论:
- 由于严重副作用的高风险,VPA在患有复发性POLG变异的患者中禁用.
- 有限的证据表明,VPA在其他线粒体疾病基因型中可能是安全的,这需要进一步调查.
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