Improved clinical and biologic outcome measures in Aicardi Goutieres Syndrome

摘要 古铁雷斯综合征（AGS）是一种罕见的干扰素（IFN）过度产生的遗传性疾病， 严重的全身性炎症损伤和潜在的严重残疾。大多数受AGS影响的人 表现出一定程度的神经功能障碍，从轻度痉挛性轻瘫到严重的全球性瘫痪 发育迟缓此外，干扰素过表达导致全身性表现和复发， 无菌性发热，伴有严重的慢性过敏。AGS治疗试验受到异质性患者的限制 人口和缺乏疾病特异性结果指标。 在具体目标1中，我们将在介绍时描述临床上不同的AGS亚组，并评估 与纵向历史的相关性。我们预计，根据统计学相关性， 最能预测临床轨迹和结果的疾病特征。 在具体目标2中，我们将定义一个新的AGS评级量表来评估纵向变化。我们假设 在确定的时间点应用疾病特异性临床评定量表将与疾病 与每日症状日记和传统临床结局评估工具结果相比， 在项目1中。 在具体目标3中，我们将探讨一个前瞻性生物标志物，干扰素信号基因， (ISG)表达和临床结果。 这些目标的预期成果是开发AGS临床试验准备工具。我们将 确定AGS的临床不同亚组，设计AGS特异性临床评定量表，并探索 ISG与临床疾病的关系。预计这些工具的开发将促进临床 试验设计，在这种情况下立即使用。

ABSTRACT Aicardi Goutières Syndrome (AGS) is a rare genetic disorder of excessive interferon (IFN) production, resulting in severe, systemic inflammatory injury and potentially profound disabilities. Most individuals affected by AGS exhibit some degree of neurologic impairment, ranging from mild spastic paraparesis to severe global developmental delay. Additionally, interferon overexpression results in systemic manifestations and recurrent aseptic fevers with severe, chronic irritability. AGS therapeutic trials are limited by heterogeneous patient populations and the lack of disease-specific outcome measures. In Specific Aim 1, we will characterize clinically distinct AGS subgroups at the time of presentation and assess correlation with longitudinal history. We anticipate the identification of cohorts based on statistically relevant disease features that best predict clinical trajectory and outcome. In Specific Aim 2, we will define a novel AGS rating scale to assess longitudinal change. We hypothesize that application of a disease-specific clinical rating scale at defined time points will more closely correlate with disease progression compared to a daily symptom diary and traditional clinical outcome assessment tool results obtained in Project 1. In Specific Aim 3, we will explore the proportionality between a prospective biomarker, interferon signaling gene (ISG) expression, and clinical outcomes. The expected outcome of these aims is the development of tools for clinical trial readiness in AGS. We will identify clinically distinct subgroups of AGS, design an AGS-specific clinical rating scale, and explore the relationship of ISGs to clinical disease. It is expected that the development of these tools will facilitate clinical trial design, with immediate utilization in this setting.