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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (6): 575-579.DOI: 10.3969/j.issn.1006⁃298X.2025.02.014

• 肾脏病临床 • 上一篇    下一篇

转甲状腺素蛋白淀粉样变性的发病机制及治疗进展

  

  • 出版日期:2025-12-28 发布日期:2025-12-29

Pathogenetic mechanism and treatment advance of transthyretin amyloidosis

  • Online:2025-12-28 Published:2025-12-29

摘要: 淀粉样变性是一类由异常蛋白质沉积导致组织和器官功能障碍的疾病,可导致多系统受累,包括周围神经、心脏、肝脏、肾脏、胃肠道、皮肤和眼睛。转甲状腺素蛋白淀粉样变性(ATTR)主要与转甲状腺素蛋白(TTR)异常有关,TTR 是一种运输甲状腺素和视黄醇结合蛋白的同源四聚体蛋白,主要在肝脏和大脑脉络丛中产生。ATTR 可分为突变型(ATTRv)和野生型(ATTRwt),其治疗策略主要包括减少循环中的 TTR 的生成及稳定 TTR 四聚体结构以防止其解离成单体。近年来,针对 ATTR 的创新疗法不断涌现,包括 TTR 沉默剂、TTR 稳定剂以及基因编辑技术。本文将详细探讨 ATTR 的发病机制及治疗的最新研究进展。

关键词: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#FFFFFF, ">转甲状腺素蛋白淀粉样变性、发病机制、沉默剂、稳定剂、基因编辑

Abstract: Amyloidosis represents a category of diseases that stem from the deposition of aberrant proteins, subsequently giving rise to the malfunction of tissues and organs. It has the propensity to trigger multisystemic afflictions, encompassing the peripheral nerves, heart, liver, kidneys, gastrointestinal tract, skin, and eyes. Transthyretin amyloidosis (ATTR) is predominantly associated with anomalies in transthyretin (TTR). TTR is a homotetrameric protein capable of transporting thyroxine and retinol binding protein, and it is principally generated in the liver and the choroid plexus of the brain. ATTR can be subdivided into the variant type (ATTRv) and the wild type (ATTRwt), the principal strategies for treating ATTR involve curtailing the production of TTR in the circulation as well as stabilizing the TTR tetramer structure to preclude its dissociation into monomers. In recent years, a continuous stream of innovative therapies for this ailment has emerged, comprising TTR silencers, TTR stabilizers, and gene editing techniques. This article will meticulously dissect the pathogenesis of ATTR and the latest research advancements of these therapies.

Key words: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#FFFFFF, ">transthyretin amyloidosis、pathogenesis、silencing agents、stabilizing agents、gene editing