Precision medicine advances in cystic fibrosis: Exploring genetic pathways for targeted therapies

IF 5.2 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Life sciences Pub Date : 2024-10-28 DOI:10.1016/j.lfs.2024.123186
Abinesh R.S., Madhav R., K. Trideva Sastri, Meghana G.S., Akhila A.R., Balamuralidhara V.
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Abstract

Personalized medicine has transformed the treatment of cystic fibrosis (CF), providing customized therapeutic approaches based on individual genetic profiles. This review explores the genetic foundations of CF, focusing on mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and their implications for the development of the disease. The advent of genetic testing has enabled the association of specific mutations to disease severity, leading to the development of CFTR modulators like Ivacaftor, Lumacaftor, and Tezacaftor. Beyond CFTR mutations, genetic modifiers, including gene replacement therapy, genetic manipulation, lentivirus, and non-viral gene therapy formulations, along with environmental factors, play critical roles in influencing disease expression and outcomes. The identification of these modifiers is essential for optimizing therapeutic strategies. Emerging biomarkers, including inflammatory markers and pulmonary function indicators, aid in early disease detection and monitoring progression. Omics technologies are uncovering novel biomarkers, enabling more precise disease management.
Pharmacogenomics has become integral to CF care, allowing for personalized approaches that consider genetic variations influencing drug metabolism, especially in antibiotics and anti-inflammatory therapies. The future of CF treatment lies in precision therapies, including CFTR modulators and cutting-edge techniques like gene therapy and CRISPR-Cas9 for mutation correction. As research evolves, these advances can improve patient outcomes while minimizing adverse effects. Ethical considerations and regulatory challenges remain critical as personalized medicine advances, ensuring equitable access and the long-term effectiveness of these innovative therapies.

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囊性纤维化的精准医疗进展:探索靶向疗法的遗传途径。
个性化医疗改变了囊性纤维化(CF)的治疗方法,提供了基于个体遗传特征的定制治疗方法。本综述探讨了囊性纤维化的遗传基础,重点是囊性纤维化跨膜传导调节器(CFTR)基因的突变及其对疾病发展的影响。基因检测的出现使特定基因突变与疾病严重程度的关联得以确定,从而促进了Ivacaftor、Lumacaftor和Tezacaftor等CFTR调节剂的开发。除 CFTR 基因突变外,基因修饰因子(包括基因替代疗法、基因操作、慢病毒和非病毒基因疗法制剂)以及环境因素在影响疾病表达和预后方面也起着至关重要的作用。确定这些修饰因子对于优化治疗策略至关重要。新出现的生物标志物,包括炎症标志物和肺功能指标,有助于疾病的早期检测和进展监测。Omics 技术正在发现新的生物标志物,从而实现更精确的疾病管理。药物基因组学已成为 CF 治疗不可或缺的一部分,它允许采用个性化方法,考虑影响药物代谢的基因变异,尤其是抗生素和抗炎疗法。CF 治疗的未来在于精准疗法,包括 CFTR 调节剂以及基因治疗和 CRISPR-Cas9 基因突变校正等尖端技术。随着研究的不断发展,这些进步可以改善患者的治疗效果,同时最大限度地减少不良反应。随着个性化医疗的发展,伦理方面的考虑和监管方面的挑战仍然至关重要,这将确保这些创新疗法的公平获取和长期有效性。
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来源期刊
Life sciences
Life sciences 医学-药学
CiteScore
12.20
自引率
1.60%
发文量
841
审稿时长
6 months
期刊介绍: Life Sciences is an international journal publishing articles that emphasize the molecular, cellular, and functional basis of therapy. The journal emphasizes the understanding of mechanism that is relevant to all aspects of human disease and translation to patients. All articles are rigorously reviewed. The Journal favors publication of full-length papers where modern scientific technologies are used to explain molecular, cellular and physiological mechanisms. Articles that merely report observations are rarely accepted. Recommendations from the Declaration of Helsinki or NIH guidelines for care and use of laboratory animals must be adhered to. Articles should be written at a level accessible to readers who are non-specialists in the topic of the article themselves, but who are interested in the research. The Journal welcomes reviews on topics of wide interest to investigators in the life sciences. We particularly encourage submission of brief, focused reviews containing high-quality artwork and require the use of mechanistic summary diagrams.
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