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遺傳性代謝疾病之治療

Treatment for Inherited Metabolic Disorders

摘要


遺傳性代謝疾病的種類繁多,但病人數相對偏少,以致於藥物開發的速度緩慢。傳統的代謝疾病治療以飲食控制、移除有毒物質堆積、補充缺乏酵素或蛋白質以及小分子治療為主。近年來,基因治療的開發,讓這群疾病的治療跨入新的世紀。目前遺傳性代謝疾病上市的治療主要以慢病毒載體(lentivrius)以及反義寡核苷酸(antisense oligonucleotide)以及RNA干擾治療(RNAi)為主。而腺相關病毒(adeno-associated virus)載體的治療及非病毒載體的mRNA治療,也都在進行臨床試驗。相信在不久的將來,會有越來越多的疾病,可以獲得治療。

並列摘要


Although there are varieties of diseases belonging to inborn error of metabolism (IEM), patient number is relatively small compared to other common disease. Because of the smaller patient number, the development of treatment for IEM is relatively slow. The traditional treatment for IEM patients includes diet control, toxin removal, supplementation, or small molecule therapy. Recently, the management of IEM entered a new era because of the development of gene therapy. Currently, treatment of IEM using lentivirus, antisense oligonucleotide, and RNAi had been approved. Also, products for adeno-associated virus and mRNA therapy using lipid nanoparticle are emerging clinical trials. We believe there will be more and more treatment available soon.

參考文獻


Ferreira CR, Rahman S, Keller M, et al. An international classification of inherited metabolic disorders (ICIMD). J Inherit Metab Dis 2021;44:164-77. doi: 10.1002/jimd.12348
Waters D, Adeloye D, Woolham D, et al. Global birth prevalence and mortality from inborn errors of metabolism: a systematic analysis of the evidence. J Glob Health 2018;8:021102. doi: 10.7189/jogh.08.021102
Scriver CR. Garrod's Croonian Lectures (1908) and the charter 'Inborn Errors of Metabolism': albinism, alkaptonuria, cystinuria, and pentosuria at age 100 in 2008. J Inherit Metab Dis 2008;31:580-98. doi: 10.1007/s10545-008-0984-9
Vernon HJ, Manoli I. Milestones in treatments for inborn errors of metabolism: Reflections on Where chemistry and medicine meet. Am J Med Genet A 2021;185:3350-8. doi: 10.1002/ajmg.a.62385
Forny P, Hörster F, Ballhausen D, et al. Guidelines for the diagnosis and management of methylmalonic acidaemia and propionic acidaemia: First revision. J Inherit Metab Dis 2021;44:566-92. doi: 10.1002/jimd.12370

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