Emerging therapies in Friedreich's Ataxia.

Emerging therapies in Friedreich's Ataxia.
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弗里德里希共济失调的新兴疗法。

DOI:
10.1080/14737175.2020.1821654
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发表时间:
2020-12
影响因子:
4.3
通讯作者:
Vega J
Vega J
中科院分区:
医学3区
文献类型:
--
作者:
Zesiewicz TA;Hancock J;Ghanekar SD;Kuo SH;Dohse CA;Vega J

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弗里德赖希共济失调(FRDA)是一种进行性神经退行性疾病,可导致步态和肢体共济失调、糖尿病、心脏肥大和脊柱侧凸。在细胞水平上,FRDA导致共济失调蛋白(frataxin)缺乏,共济失调蛋白是一种线粒体蛋白,在铁稳态和改善氧化应激中起着至关重要的作用。目前还没有治愈FRDA的方法,但针对病理级联反应不同部分的令人兴奋的治疗进展即将出现。所涵盖的领域包括FRDA的过去和新兴疗法,包括抗氧化剂和神经系统相关药物、核因子红细胞衍生2-相关因子2(Nrf 2)激活剂、氘代多不饱和脂肪酸、铁螯合剂、组蛋白脱乙酰酶(HDAC)抑制剂、转录反式激活因子(达特)-共济失调蛋白、干扰素γ(IFNγ)、促红细胞生成素、白藜芦醇、基因治疗和反义寡核苷酸(ASO),还有其他的虽然药物发现一直具有挑战性,但FRDA的新的和令人兴奋的前瞻性治疗方法目前正在出现,包括药物制剂和基因治疗。增强线粒体功能的药物,如Nrf 2激活剂,dPUFA和催化抗氧化剂,以及共济失调蛋白增强和遗传调节的新方法,将有望为这种毁灭性疾病提供治疗。
Friedreich’s ataxia (FRDA) is a progressive, neurodegenerative disease that results in gait and limb ataxia, diabetes, cardiac hypertrophy, and scoliosis. At the cellular level, FRDA results in the deficiency of frataxin, a mitochondrial protein that plays a vital role in iron homeostasis and amelioration of oxidative stress. No cure currently exists for FRDA, but exciting therapeutic developments which target different parts of the pathological cascade are on the horizon. Areas covered include past and emerging therapies for FRDA, including antioxidants and mitochondrial-related agents, nuclear factor erythroid-derived 2-related factor 2 (Nrf2) activators, deuterated polyunsaturated fatty acids, iron chelators, histone deacetylase (HDAC) inhibitors, trans-activator of transcription (TAT)-frataxin, interferon gamma (IFNγ), erythropoietin, resveratrol, gene therapy, and anti-sense oligonucleotides (ASOs), among others. While drug discovery has been challenging, new and exciting prospective treatments for FRDA are currently on the horizon, including pharmaceutical agents and gene therapy. Agents that enhance mitochondrial function, such as Nrf2 activators, dPUFAs and catalytic antioxidants, as well as novel methods of frataxin augmentation and genetic modulation will hopefully provide treatment for this devastating disease.
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