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Current and Future Therapeutical Options in Alport Syndrome

Alport syndrome (AS) is a hereditary kidney disease caused by pathogenic variants in COL4A3 and COL4A4 genes with autosomal recessive or autosomal dominant transmission or in the COL4A5 gene with X-linked inheritance. Digenic inheritance was also described. Clinically it is associated with microscop...

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Autores principales: Reiterová, Jana, Tesař, Vladimír
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056269/
https://www.ncbi.nlm.nih.gov/pubmed/36982595
http://dx.doi.org/10.3390/ijms24065522
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author Reiterová, Jana
Tesař, Vladimír
author_facet Reiterová, Jana
Tesař, Vladimír
author_sort Reiterová, Jana
collection PubMed
description Alport syndrome (AS) is a hereditary kidney disease caused by pathogenic variants in COL4A3 and COL4A4 genes with autosomal recessive or autosomal dominant transmission or in the COL4A5 gene with X-linked inheritance. Digenic inheritance was also described. Clinically it is associated with microscopic hematuria, followed by proteinuria and chronic renal insufficiency with end-stage renal disease in young adults. Nowadays, there is no curative treatment available. The inhibitors of RAS (renin-angiotensin system) since childhood slow the progression of the disease. Sodium-glucose cotransporter-2 inhibitors seem to be promising drugs from DAPA-CKD (dapagliflozin–chronic kidney disease) study, but only a limited number of patients with Alport syndrome was included. Endothelin type A receptor and angiotensin II type 1 receptor combined inhibitors, and lipid-lowering agents are used in ongoing studies in patients with AS and focal segmental glomerulosclerosis (FSGS). Hydroxychloroquine in AS is studied in a clinical trial in China. Molecular genetic diagnosis of AS is crucial not only for prognosis prediction but also for future therapeutic options. Different types of mutations will require various types of gene, RNA, or protein therapy to improve the function, the of final protein product.
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spelling pubmed-100562692023-03-30 Current and Future Therapeutical Options in Alport Syndrome Reiterová, Jana Tesař, Vladimír Int J Mol Sci Review Alport syndrome (AS) is a hereditary kidney disease caused by pathogenic variants in COL4A3 and COL4A4 genes with autosomal recessive or autosomal dominant transmission or in the COL4A5 gene with X-linked inheritance. Digenic inheritance was also described. Clinically it is associated with microscopic hematuria, followed by proteinuria and chronic renal insufficiency with end-stage renal disease in young adults. Nowadays, there is no curative treatment available. The inhibitors of RAS (renin-angiotensin system) since childhood slow the progression of the disease. Sodium-glucose cotransporter-2 inhibitors seem to be promising drugs from DAPA-CKD (dapagliflozin–chronic kidney disease) study, but only a limited number of patients with Alport syndrome was included. Endothelin type A receptor and angiotensin II type 1 receptor combined inhibitors, and lipid-lowering agents are used in ongoing studies in patients with AS and focal segmental glomerulosclerosis (FSGS). Hydroxychloroquine in AS is studied in a clinical trial in China. Molecular genetic diagnosis of AS is crucial not only for prognosis prediction but also for future therapeutic options. Different types of mutations will require various types of gene, RNA, or protein therapy to improve the function, the of final protein product. MDPI 2023-03-14 /pmc/articles/PMC10056269/ /pubmed/36982595 http://dx.doi.org/10.3390/ijms24065522 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Reiterová, Jana
Tesař, Vladimír
Current and Future Therapeutical Options in Alport Syndrome
title Current and Future Therapeutical Options in Alport Syndrome
title_full Current and Future Therapeutical Options in Alport Syndrome
title_fullStr Current and Future Therapeutical Options in Alport Syndrome
title_full_unstemmed Current and Future Therapeutical Options in Alport Syndrome
title_short Current and Future Therapeutical Options in Alport Syndrome
title_sort current and future therapeutical options in alport syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056269/
https://www.ncbi.nlm.nih.gov/pubmed/36982595
http://dx.doi.org/10.3390/ijms24065522
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