Is gene therapy in spinal muscular atrophy safe? A casereport of thrombotic microangiopathy following onasemnogene abeparvovec

Aleksandra Ziółkiewicz, Michał Bielak, Iwona Welian, Magdalena Chrościńska- Krawczyk
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Abstract

Spinal muscular atrophy is a neuromuscular disorder caused by a mutation in the survival of SMN1 gene. Diagnosis of the disease is based mainly on the presence of hypotonia and symmetrical [1]. A five-month-old male with SMA type 1 was admitted to the Children’s Neurology Clinic for gene therapy with onasemnogene abeparvovec. He was diagnosed with spinal muscular atrophy in newborn screening.Neurological examination of the patient revealed abolition of deep tendon reflexes. Administration of the medication proceeded without complications. Two weeks after gene therapy, abnormal test results were observed. The patient experienced several adverse effects of the therapy, which indicated thrombotic microangiopathy (TMA). Gene therapy with onasemnogene abeparvovec provides many hopes for patients with SMA. On the other hand, its safety remains uncertain and patients require comprehensive long-term monitoring for possible side-effects.
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基因治疗脊髓性肌萎缩症安全吗?onasemnogene abparvovec致血栓性微血管病变1例报告
脊髓性肌萎缩是一种由SMN1基因存活突变引起的神经肌肉疾病。该疾病的诊断主要基于肌张力减退和对称性[1]。一名患有SMA 1型的五个月大男性被送入儿童神经病学诊所接受onasemnogene abeparvovec基因治疗。在新生儿筛查中,他被诊断为脊髓性肌萎缩。患者的神经系统检查显示深肌腱反射消失。用药过程中没有出现并发症。基因治疗两周后,观察到异常检测结果。该患者经历了几次治疗的不良反应,显示为血栓性微血管病(TMA)。肌氨酸原abeparvovec基因治疗为SMA患者带来了许多希望。另一方面,其安全性仍不确定,患者需要对可能的副作用进行全面的长期监测。
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