针对FUS-ALS的反感性寡核酸:由研究人员发起的多中心,开放的病例系列
Neil A Shneider1, Matthew B Harms1, Vlad A Korobeynikov1
1Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Lancet (London, England)
|May 25, 2025
概括
通过降低神经退行症标志物和FUS蛋白水平,Jacifusen在治疗FUS- ALS方面表现有前途. 目前正在对这种潜在的肌缩性侧面硬化治疗进行进一步评估.
科学领域:
- 神经科学
- 遗传学
- 药理学
背景情况:
- 在瘤中融合 (FUS) 基因中的致病变体会导致肌缩侧面硬化症 (ALS),通常涉及功能增强机制.
- 针对FUS前mRNA的抗意义寡核类药物Jacifusen在临床前和早期人类研究中显示出FUS- ALS的潜力.
- 这项研究旨在通过扩大接入计划进一步评估jacifusen在FUS- ALS患者中的安全性和有效性.
研究的目的:
- 评估FUS-ALS患者内服药时的安全性和耐受性.
- 评估jacifusen对神经退行症生物标志物的影响,包括脑脊液 (CSF) 神经纤维光链 (NfL) 水平.
- 研究jacifusen对FUS- ALS功能衰退和FUS蛋白病理的潜在临床影响.
主要方法:
- 一个扩展的访问计划, 涉及12名FUS变体和运动神经元疾病症状的参与者.
- 连续注射jacifusen,每月剂量增加至120毫克.
- 安全性评估包括不良事件监测和脑液分析;通过NfL水平和ALSFRS- R得分测量疗效;进行了死后中枢神经系统组织分析.
主要成果:
- 一般来说,Jacifusen的耐受性很好,可控的副作用包括背部疼痛和头痛.
- 经过6个月的治疗,脑脊髓中NfL水平降低了82. 8%,表明轴突损伤减少.
- 虽然大多数参与者经历了功能衰退,但其中一人出现了显著的恢复,另一个人仍然没有症状,电生理学发现有所改善;死后分析显示FUS蛋白水平降低.
结论:
- 这些研究结果表明jacifusen是一种潜在的安全和有效的FUS-ALS治疗方法.
- 在一些患者中,Jacifusen 显示了神经退行的一个关键生物标志物的减少,并显示出有前途的临床信号.
- 需要进一步评估jacifusen的疗效,目前正在进行临床试验.
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