更新于：2024-11-01

MFN2

更新于：2024-11-01

基本信息

别名

CMT2A2、CPRP1、KIAA0214

+ [5]

简介

Mitochondrial outer membrane GTPase that mediates mitochondrial clustering and fusion (PubMed:11181170, PubMed:11950885, PubMed:26214738, PubMed:28114303). Mitochondria are highly dynamic organelles, and their morphology is determined by the equilibrium between mitochondrial fusion and fission events (PubMed:28114303). Overexpression induces the formation of mitochondrial networks (PubMed:28114303). Membrane clustering requires GTPase activity and may involve a major rearrangement of the coiled coil domains (Probable). Plays a central role in mitochondrial metabolism and may be associated with obesity and/or apoptosis processes (By similarity). Plays an important role in the regulation of vascular smooth muscle cell proliferation (By similarity). Involved in the clearance of damaged mitochondria via selective autophagy (mitophagy) (PubMed:23620051). Is required for PRKN recruitment to dysfunctional mitochondria (PubMed:23620051). Involved in the control of unfolded protein response (UPR) upon ER stress including activation of apoptosis and autophagy during ER stress (By similarity). Acts as an upstream regulator of EIF2AK3 and suppresses EIF2AK3 activation under basal conditions (By similarity).

关联

靶点

MFN2

作用机制

MFN2 agonists

在研机构

Washington University School of Medicine

原研机构

Washington University School of Medicine

在研适应症

2A型进行性神经性腓骨肌萎缩

非在研适应症-

最高研发阶段临床前

首次获批国家/地区-

首次获批日期1800-01-20

ON05+Lu177-di-HSG

靶点

Histamine succinyl glycine x MFN2

作用机制

Histamine succinyl glycine抑制剂 [+2]

在研机构

OncoOne Research & Development GmbH初创企业

原研机构

OncoOne Research & Development GmbH初创企业

在研适应症

结直肠癌 [+3]

非在研适应症-

最高研发阶段临床前

首次获批国家/地区-

首次获批日期1800-01-20

WO2022015715

专利挖掘

靶点

MFN2

作用机制-

在研机构

Trustees of the University of Pennsylvania

原研机构

Trustees of the University of Pennsylvania

在研适应症

神经系统疾病

非在研适应症-

最高研发阶段药物发现

首次获批国家/地区-

首次获批日期1800-01-20

100 项与 MFN2 相关的临床结果

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100 项与 MFN2 相关的转化医学

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0 项与 MFN2 相关的专利（医药）

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2,477

项与 MFN2 相关的文献（医药）

2025-01-01·Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease

SENP1 prevents high fat diet-induced non-alcoholic fatty liver diseases by regulating mitochondrial dynamics

Article

作者: Wang, Yuan ; Zeng, Wenjing ; Chen, Sheng ; Wang, Chaowen ; Huang, Qianqian ; Liu, Chen ; Xiong, Xiaowei ; Liu, Wentao ; Wang, Li ; Huang, Qiren

Mitochondrial dynamics plays a crucial role in the occurrence and development of non-alcoholic fatty liver diseases (NAFLD). SENP1, a SUMO-specific protease, catalyzes protein de-SUMOylation and involves in various physiological and pathological processes. However, the exact role of SENP1 in NAFLD remains unclear. Therefore, we investigated the regulatory role of SENP1 in mitochondrial dynamics during the progression of NAFLD. In the study, the NAFLD in vivo model induced by high fat diet (HFD) and in vitro model induced by free fatty acids (FFA) were established to investigate the role and underlying mechanism of SENP1 through detecting mitochondrial morphology and dynamics. Our results showed that the down-regulation of SENP1 expression and the mitochondrial dynamics dysregulation occurred in the NAFLD, evidenced as mitochondrial fragmentation, up-regulation of p-Drp1 ser616 and down-regulation of MFN2, OPA1. However, over-expression of SENP1 significantly alleviated the NAFLD, rectified the mitochondrial dynamics disorder, reduced Cyt-c release and ROS levels induced by FFA or HFD; moreover, the over-expression of SENP1 also reduced the SUMOylation levels of Drp1 and prevented the Drp1 translocation to mitochondria. Our findings suggest that the possible mechanisms of SENP1 were through rectifying the mitochondrial dynamics disorder, reducing Cyt-c release and ROS-mediated oxidative stress. The findings would provide a novel target for the prevention and treatment of NALFD.

2025-01-01·Journal of Ethnopharmacology

Study on the role of Dihuang Yinzi in regulating the AMPK/SIRT1/PGC-1α pathway to promote mitochondrial biogenesis and improve Alzheimer's disease

Article

作者: He, Wenbin ; Han, Cheng ; Li, Qinqing ; Zhang, Zheng ; Hou, Jiangqi ; Zhang, Junlong ; Du, Yuzhong ; Zhu, Yousong ; Zhao, Qiong ; Qin, Yali ; Zhu, Chao

ETHNOPHARMACOLOGICAL RELEVANCEDihuang Yinzi (DHYZ) is a classic prescription in traditional Chinese medicine. Its therapeutic effect on Alzheimer's disease (AD) has been widely validated. However, the underlying molecular mechanisms of DHYZ in AD treatment remain unclear and require further research.AIM OF THE STUDYElucidating DHYZ's promotion of mitochondrial biogenesis through the AMPK/SIRT1/PGC-1α pathway improves neuronal loss, mitochondrial damage, and memory deficits in AD.MATERIALS AND METHODSAdministering DHYZ by gavage to SAMP8 mice, after completing behavioral tests, the effects of DHYZ on hippocampal neuron loss and mitochondrial structural damage in AD model mice were assessed using Nissl staining and transmission electron microscopy. Western blot was used to detect the expression of mitochondrial biogenesis-related proteins PGC-1α, CREB, mitochondrial fusion protein MFN2, and mitochondrial fission proteins DRP1 and FIS1. At the same time, immunofluorescence (IF) was employed to measure the relative fluorescence intensity of mitochondrial fusion protein MFN1. After determining the optimal dose of DYHZ for treating AD, we conducted mechanistic studies. By intraperitoneally injecting SAMP8 mice with the AMPK inhibitor (Compound C) to inhibit AMPK protein expression and subsequently treating them with DHYZ, the impact of DHYZ on hippocampal neurons in AD model mice was evaluated using Nissl and hematoxylin-eosin staining. Western blot was used to detect the protein expression of AMPK, p-AMPK, SIRT1, PGC-1α, NRF1, and TFAM. In contrast, IF was used to measure the relative fluorescence intensity of PGC-1α, NRF1, and TFAM proteins in the hippocampal CA1 region.RESULTSDHYZ significantly improved AD model mice's cognitive impairment and memory deficits and mitigated hippocampal neuron loss and degeneration. Additionally, it ameliorated mitochondrial morphological structures. DHYZ upregulated the protein expression of mitochondrial biogenesis-related proteins PGC-1α, CREB, and mitochondrial fusion proteins MFN1 and MFN2 while inhibiting the expression of mitochondrial fission proteins DRP1 and FIS1. Further studies revealed that DHYZ could upregulate the expression of the AMPK/SIRT1/PGC-1α pathway proteins and their downstream proteins NRF1 and TFAM.CONCLUSIONDHYZ promotes mitochondrial biogenesis by activating the AMPK/SIRT1/PGC-1α signaling pathway, thereby improving memory deficits, neuronal loss, and mitochondrial dysfunction in AD.

2025-01-01·Journal of Ethnopharmacology

Mitigation of lipopolysaccharide-induced intestinal injury in rats by Chimonanthus nitens Oliv. essential oil via suppression of mitochondrial fusion protein mitofusin 2 (MFN2)-mediated mitochondrial-associated endoplasmic reticulum membranes (MAMs) formation

Article

作者: Qing, Cheng ; Zhang, Shichao ; Cheng, Wang ; Li, Wenjuan ; Zhou, Chaoqi ; Huang, Shuying ; Yang, Songyu ; Zeng, Zhenguo ; Yang, Yuting ; Zhou, Jia ; Hu, Zhiguo ; Chen, Shengbin ; Chu, Yuelei

ETHNOPHARMACOLOGICAL RELEVANCEChimonanthus nitens Oliv. is a traditional Chinese medicine with anti-inflammatory and antioxidant properties that has commonly been used for colds, fevers, and other diseases. However, its role and specific mechanism in sepsis-associated intestinal injury have not been reported.AIM OF THE STUDYC. nitens Oliv. essential oil (CEO), an organic active compound extracted from the traditional Chinese medicine C. nitens Oliv. exhibits notable anti-inflammatory and antioxidant properties. Nevertheless, the therapeutic potential of CEO for septic intestinal injury remains undocumented. This study thus aims to elucidate the anti-inflammatory and antioxidant effects of CEO in the context of acute intestinal injury and to investigate its mechanisms of action in septic rats.MATERIALS AND METHODSCell and animal models were established using LPS to investigate the impact of CEO on LPS-induced intestinal pathological injury and the secretion of inflammatory factor IL-1β. The effects of CEO on the expression of NLRP3, caspase-1, and MFN2, p-p65 protein were also examined, as well as its influence on oxidative stress injury and mitochondrial-associated endoplasmic reticulum membrane (MAM) formation. Generation of an MFN2 knockout IEC-6 cell line allowed comprehensive investigation of the protective mechanism of CEO.RESULTSIn rat models, CEO reduced IL-1β secretion, inhibited caspase-1, ZO-1 expression and NF-κB p65 phosphorylation, while also decreasing malondialdehyde levels and enhancing superoxide dismutase activity in intestinal tissues. Cellular experiments demonstrated its ability to decrease IL-1β secretion; NLRP3, caspase-1, and MFN2 expression; NF-κB p65 phosphorylation; reactive oxygen species (ROS) production, and mitochondrial dysfunction. MFN2 knockdown enhanced these effects synergistically with CEO, indicating potential therapeutic synergy. Further, MFN2 knockdown significantly mitigated LPS-induced NLRP3 and caspase-1 expression, IL-1β secretion, ROS production, NF-κB p65 phosphorylation and MMP reduction in IEC-6 cells, while inhibiting MAM formation and NLRP3 localization on MAMs. Importantly, MFN2 downregulation and CEO synergistically reduced LPS-induced IL-1β secretion and ROS production while inhibiting MAM formation in IEC-6 cells, thus inhibiting NLRP3 inflammasome activation.CONCLUSIONCEO mitigates inflammation and oxidative stress by inhibiting MAM formation and is thus a promising intervention for septic intestinal injury.

项与 MFN2 相关的新闻（医药）

2024-08-14

·生物探索

JCB丨洪智团队揭示管状内质网塑形蛋白REEP5与MFN1/2互作调节线粒体“搭便车”新机制

引言细胞器之间通过膜接触位点进行信号转导和物质交换，在脂质合成、钙离子传递和细胞自噬等方面发挥重要作用。线粒体作为参与多种重要生物学过程的细胞器，其与内质网的膜接触点（Mitochondria-ER contact sites, MERCs）被广泛报道。早期研究指出，线粒体融合蛋白Mitofusin1/2（MFN1/2）通过和内质网上的MFN2形成二聚体，作为线粒体和内质网膜接触位点的物理连接发挥功能。然而支持MFN2定位于内质网的数据有限，野生型MFN2在过表达状态下，超分辨成像无法检测到其在内质网上的定位，因此，MFN2能够定位至内质网并作为桥接蛋白一直是个高度值得探讨的问题。最近的发现表明MFN2能特异将磷脂酰丝氨酸（PS）从内质网转运至线粒体，合成磷脂酰乙醇胺（PE）和磷脂酰胆碱（PC），进一步提示MFN2在线粒体和内质网膜接触点可能参与多个重要功能。这些功能是否均由MFN2-MFN2二聚体介导，是否存在其他未知的内质网蛋白和MFN2一起参与，领域内尚无定论。因此，找到内质网上和MFN2互作的新蛋白并解析其生物学功能，将帮助我们重新审视MFN2-MFN2同源二聚体介导线粒体-内质网膜接触参与多种生理功能的观点，为我们理解细胞器互作调控生命活动提供更多的视角。 2024年8月12日，浙江大学爱丁堡大学联合学院洪智实验室在JCB期刊上发表文章Dynamic interaction of REEP5-MFN1/2 enables mitochondrial hitchhiking on tubular ER。该研究首次揭示了内质网塑形蛋白REEP5，作为一个全新的MFN1/2互作蛋白，介导线粒体在管状内质网上的“搭便车（hitchhiking）”行为，最终实现线粒体在胞内的均匀分布，进而调控细胞的ROS稳态。前人结果表明，内质网REEPs蛋白家族成员的敲降/敲除导致线粒体功能异常。因此，该研究首先做了REEPs蛋白家族的小规模筛选，发现REEP5能够特异结合MFN1/2。结合光漂白技术的活细胞成像，明确REEP5与MFN1/2富集于MERCs。利用GI-SIM超高分辨系统，观察到线粒体-内质网互作是个接触-解离-接触的动态过程，REEP5-MFN2互作促使线粒体搭载在管状内质网上被共同运输，这一运输方式被命名为“搭便车”。“搭便车”在溶酶体的运输中扮演着重要功能，而线粒体的搭便车行为尚属首次发现。研究发现减弱REEP5-MFNs之间的互作导致细胞内均匀分布的线粒体网络坍塌至细胞核外周。有意思的是，当REEP5-MFNs互作被锁定时，搭载在管状内质网上的线粒体无法随机释放，持续附着于内质网上进而导致线粒体的过度融合（hyperfusion）。操控REEP5-MFNs互作，无论是减弱还是过度增强线粒体和内质网之间的接触，都会导致线粒体分布异常。既往研究表明，线粒体的亚细胞定位和其ROS稳态密切相关。研究团队利用线粒体定位的ROS信号传感器roGFP2和HyPer7，在REEP5-MFN1/2不同的互作强度下特异检测线粒体ROS水平，明确REEP5-MFN2介导的线粒体-内质网互作参与调控线粒体ROS稳态。模式图（Credit: J Cell Biol）综上所述，本研究发现了REEP5-MFN1/2蛋白复合体促进线粒体在管状内质网上“搭便车”迁移的一种新模式，促进线粒体在胞内的均匀分布，进而调控细胞的 ROS 稳态。细胞器互作本质是个彼此接触继而解离的动态过程，本项目为解析这个动态过程提供了坚实的理论基础。参考文献 http://doi.org/10.1083/jcb.202304031 责编|探索君排版|探索君文章来源|“BioArt” End 往期精选围观一文读透细胞死亡(Cell Death) | 24年Cell重磅综述（长文收藏版）热文 Cell | 是什么决定了细胞的大小？热文 Nature | 2024年值得关注的七项技术热文 Nature | 自身免疫性疾病能被治愈吗？科学家们终于看到了希望热文 CRISPR技术进化史 | 24年Cell综述

2024-06-05

·CPHI制药在线

全面解析腓骨肌萎缩症（CMT）：诊治与前沿进展

关注并星标CPHI制药在线一、腓骨肌萎缩症简介腓骨肌萎缩症（Charcot- Marie- Tooth diseases，CMT）是一种常见的遗传性周围神经疾病。在1886年由法国Charcot、Marie和英国Tooth三名医生报道，因此用三位医生名字首字母命名CMT。“CMT”和“渐冻症”不能混为一谈，是有本质区别的，CMT是遗传性运动感觉神经病，主要侵犯周围神经。而“渐冻症”是一个通俗的叫法，这个疾病的专业名字叫运动神经元病，有多个类型，最常见的类型是肌萎缩侧索硬化症（渐冻症），跟老年痴呆、帕金森病一样，属于中枢神经系统退行性疾病。腓骨肌萎缩症临床特点包括对称性远端为主的肌无力伴萎缩、感觉减退以及弓形足、脊柱侧凸等骨骼畸形。临床上根据神经电生理、病理学和遗传学特点可分为多种亚型，基因检测手段有助于明确其致病基因。康复治疗、外科矫形手术治疗和改善症状的药物治疗有助于缓解疾病症状，减轻骨骼畸形。部分针对病因和发病机制的特异性治疗药物已进入临床试验阶段，其疗效和安全性有待进一步明确。 CMT的患病率约为40/100000，是2018 年国家卫生健康委员会发布121种《第一批罕见病目录》中的其中一种疾病，但却是遗传性周围神经病中最常见的一种。临床特点包括：儿童或青少年起病，慢性进行性的对称性肌无力及肌萎缩、远端型感觉障碍、腱反射减弱或消失、弓形足等骨骼畸形。CMT具有显著的遗传异质性和临床异质性，相同的基因突变可导致不同的临床表型，目前已有大约100个不同的CMT致病基因相继被克隆并报道。 CMT的发病过程表现各异，其中多数患者在出生时无明显异常，但随着生长发育，逐渐出现足踝部力量减弱或步态改变等轻微症状。当家长发现并带患儿前往当地医院就诊时，有很大一部分情况下医生难以立即确定病因。随着时间的推移和疾病的逐步进展，患者的足踝畸形会进一步加剧，表现为踮脚、内翻、乏力以及下蹲困难等不同程度的身体在病情严重的情况下，患者可能需要依赖拐杖行走甚至乘坐轮椅。 CMT的发作时间点存在较大的差异，统计显示，约有50%的患者在10岁前即表现出相关症状，而70%的患者则在20岁前发病。其余患者则可能在20至30岁，甚至更晚的年龄段才出现病征。因此，在发病早期的患者群体中，主要为青少年患者。二、遗传方式及临床分型根据神经电生理和神经病理学的特征，临床上将CMT细分为以下三种类型：（1）脱髓鞘型 CMT：其显著特点在于神经传导速度（NCV）明显减缓，通常上肢运动的NCV低于38 m/s。进一步通过神经活组织检查（活检）结果显示出显著的周围神经髓鞘异常，由此特征区分此类型CMT。（2）轴索型 CMT：其特点在于周围神经NCV略有减缓或基本接近正常值，上肢运动的NCV一般超过38 m/s。神经活检的病理结果则提示存在慢性轴索变性及再生现象，这是该类型CMT的主要诊断依据。（3）中间型 CMT：该类型介于前两者之间，上肢运动的NCV介于25~45m/s之间。此外，CMT的遗传方式多样，以常染色体显性遗传为主，但也可能表现为常染色体隐性遗传或X连锁显性或隐性遗传。结合这些遗传方式、临床表现、电生理和病理特点，我们可以进一步将CMT细分为多种亚型，以便更精确地诊断和治疗。三、临床表现该病显著特点是对称性、缓慢进行性的四肢周围神经脱髓鞘和轴索变性 , 造成肢体远端肌肉的萎缩和无力，进而出现肢体变形。典型表现有: （1）高弓足：CMT第一个特征就是足弓很高，逐渐发展为弓形足。（2）跨阈步态：一般早期是无意中发现脚踝力量减退，随着病情的发展，双小腿缓慢进行性萎缩及无力，呈“仙鹤腿”或“倒酒瓶”样改变。同时伴有行走及平衡障碍，为避免摔倒，患者会将膝部异常高抬而表现出“跨阈步态”。部分患者的大腿肌肉也会出现无力。（3）腕部、手部肌肉萎缩：出现手部肌萎缩，难以完成一些精细运动，如书写、从地面拾起细小物品等。后期可以出现抓握困难，部分患者累计上臂。（4）感觉障碍：不是腓骨肌萎缩症的突出表现，患者可以有末梢型感觉减退和麻木，呈现手套袜套样感觉障碍，部分患者可以合并疼痛。（5）其他：有些患者可以出现听力减退，视神经萎缩和脊柱侧弯等骨骼发育异常。四、检查 1、神经电生理检查神经电生理检测，特别是NCV检测，对于明确周围神经脱髓鞘或轴索损害具有显著意义，对于CMT的分型也当检测到NCV的匀一性减慢，即上肢正中神经或尺神经的运动传导速度低于38 m/s时，这提示我们可能面临脱髓鞘型的CMT，例如CMT1和CMT4。然而，当NCV仅出现轻度的减慢或保持正常状态（即上肢正中神经或尺神经的运动传导速度超过38 m/s），同时伴随复合肌肉动作电位或感觉动作电位波幅的降低，这是CMT2的经典表现。在某些中间型情况下，即上肢运动的NCV介于25~45 m/s之间，特别是针对男性患者，我们还应警惕可能存在CMTX的风险。此外，不论患者性别如何，显性遗传的中间型CMT同样是一个可能的诊断方向，尽管这种情况相比CMTX更为少见。在肌电图检查方面，常见的特征是运动单位电位的时程较长、波幅较高，同时募集相减少，而纤颤电位相对罕见，这些表现都提示了慢性失神经支配和神经再生的现象。此外，NCV检查还是区分CMT与其他获得性多发性周围神经病的重要手段。在CMT1中，NCV的减慢通常十分显著且基本对称，运动神经很少出现传导阻滞或动作电位波形离散。相比之下，获得性脱髓鞘性周围神经病如CIDP的NCV减慢并不那么显著，并常呈不对称性，伴有运动神经传导阻滞或动作电位波形离散的特点。然而，值得注意的是，CMTX1型患者可能会有不对称性的NCV减慢，甚至伴有波形离散或传导阻滞的情况。更为罕见的是，由MPZ基因突变导致的CMT1B也可能出现传导阻滞。电生理检测不仅有助于鉴别CMT，还能帮助我们区分其他神经肌肉疾病如远端型肌病/肌营养不良、dHMN等 2、基因检测基因检测在确诊CMT的过程中扮演着至关重要的角色。随着二代测序技术的广泛应用，包括疾病特异性基因检测、全外显子测序、全基因组测序以及高通量转录组测序等，我们已经能够发现越来越多的CMT致病基因及其突变位点。其中，PMP22、MPZ、GJB1、MFN2和GDAP1等基因被认为是CMT的主要致病基因。在针对常染色体显性遗传的CMT1和散发CMT1患者的诊断中，我们通常会首先采用多重连接探针扩增技术（MLPA）来检测PMP22基因的大片段重复突变。如果检测结果为阴性，并且在家系内没有出现男性传男性的情况，那么我们会考虑CMTX的可能性，并进一步对GJB1基因进行突变分析。如果排除了CMTX1的可能性，我们还将对PMP22和MPZ基因进行点突变检测。对于疑似CMT2的患者，我们会首先进行MFN2和MPZ基因的突变检测。对于家系内无男传男现象的病例，尤其是女性CMT2患者，我们同样会考虑CMTX的可能性，并对GJB1基因进行突变分析。对于中间型NCV的患者，我们会优先进行GJB1、MPZ、NFL、GDAP1等基因的突变分析。而对于常染色体隐性遗传的CMT患者，无论是脱髓鞘型（CMT4）还是轴索型CMT2，我们都将首先进行GDAP1基因检测。如果在一个疑似CMT的家系中，基因检测结果为阴性，那么我们可能需要考虑是否可能存在其他类型的遗传性周围神经病，例如dHMN、遗传性感觉自主神经病等。在这种情况下，我们可以进一步进行相关基因检测。同时，也不能排除存在未报道的新CMT致病基因的可能性。为此，我们可以采用全外显子测序或全基因组测序的方法来寻找可能的新的致病基因突变，并进行功能验证。 3、神经活检病理基因检测技术的日益普及，使得神经活检病理检查在多数CMT（遗传性运动感觉神经病）病例的诊断中变得不再必须。不过，对于那些诊断颇具挑战的散发型病例，或者基因检测结果为阴性的家族性病例来说，周围神经活检的病理检查结果仍能给予关键的诊断线索。通过光镜观察，我们可以看到周围神经在经过甲苯胺蓝染色后展现出有髓纤维的多样化大小。而在电镜的放大下，薄鞘纤维和裸轴索纤维的形态清晰可见。当施万细胞增生形成特殊的“洋葱头”状结构时，这往往暗示着CMT1类型的CMT。另一方面，有髓与无髓纤维的减少以及再生簇的形成，则倾向于表明CMT2类型的病情。在CMTX的病理表现上，我们可以看到轴索的丢失以及部分脱髓鞘的改变并存，但“洋葱头”结构相对较少值得注意的是，某些独特的髓鞘病理改变与特定的基因变异相关联。举例来说，MPZ基因变异的患者中，常常可以看到髓鞘的松解与肿胀；而在MTMR2基因或FGD4基因突变所导致的CMT4患者中，可以观察到大量髓鞘向外折叠的病理特征；至于NEFL基因突变的病例，则常呈现巨轴索的现象。这些病理改变不仅有助于我们更准确地诊断病情，也为后续的治疗提供了宝贵的参考依据。五、治疗目前尚无有效逆转CMT病程的治疗方法，支持性治疗包括康复治疗、外科矫形手术治疗和缓解症状为主的药物治疗等，同时需要多学科团队相互协作。已有研究针对不同CMT亚型的发病机制和治疗靶点研发了相应的特异性治疗药物，但绝大多数处于药物临床试验阶段，尚未进入临床治疗。 1、康复治疗多种康复治疗手段已被用于CMT的治疗。有研究结果表明，轻到中等强度的运动训练能有助于CMT患者改善下肢肌力及行走能力。适当的有氧训练能够改善患者的体能，提高有氧运动功能。下肢的被动拉伸训练有助于预防和改善跟腱挛缩。适当穿戴辅助器具如矫形器能够改善患者的姿势和平衡功能。个体化的踝?足矫形器有助于改善足下垂，辅助患者行走并缓解足弓疼痛。 2、外科矫形手术治疗多数患者在儿童和青少年时期足部的内翻畸形是柔软可恢复的，此时应首先选择非手术治疗。随着病情的发展，足内翻逐步进展加重为固定畸形，无法穿戴矫形器具，此时需要采取外科手术治疗。手术治疗的原则是纠正足部畸形，重建和平衡足踝肌力。手术方案包括肌力平衡手术（各种类型的肌腱转移术）、软组织松解与矫形（足底筋膜切开术）、跟骨截骨矫形、腓肠肌复合体处理、踇趾矫形或其他足趾矫形手术。 3、缓解症状的药物治疗 CMT患者饱受疼痛之苦，该症状在23%至85%的病患群体中都有所体现。这种疼痛常与骨骼形变、长时间姿势不当或是肌肉疲劳紧密相连。为了缓解这一症状，除了常规的物理康复、佩戴矫形器械和进行外科矫形手术外，非甾体类抗炎药如对乙酰氨基酚也是有效的治疗手段。对于神经性疼痛尤为明显的患者来说，药物选择需更为细致。首选的是那些针对神经病理性疼痛的特效药，如三环类抗抑郁药、选择性五羟色胺再摄取抑制剂以及抗惊厥药（普瑞巴林、加巴喷丁、卡马西平等）等。同时，应尽量避免使用阿片类药物，以免给患者带来更多负担。此外，CMT患者还普遍感到易疲劳，这可能与肌力减退及心肺功能下降有关，部分患者还可能与阻塞性睡眠呼吸暂停有关。根据研究，莫达非尼在一定程度上能够改善这一情况，但使用该药物时需注意可能产生的不良反应。最后，需特别强调，患者应避免使用可能加重周围神经损伤的药物，包括但不限于长春新碱、铂类、紫杉醇衍生物、硼替佐米、呋喃妥因、氨苯砜、来氟米特、甲硝唑、司他夫定、他克莫司等。这些药物的潜在风险不容忽视，患者应遵循医生的建议，合理选用药物。 4、特异性药物治疗对于CMT发病机制的相关靶点，当前的研究重点主要侧重于PMP22基因突变所引发的CMT1A。CMT1X是一种表现为进行性肌肉萎缩、四肢无力和感觉丧失特征的遗传性神经病变。它主要由连接蛋白32（Cx32）的突变造成，这种蛋白是形成髓鞘间隙连接通道的重要成分，对神经功能和完整性具有关键作用。 1）维生素C 在体外细胞实验中，维生素C被发现有助于促进髓鞘形成。在动物实验层面上，高剂量的维生素C被证实能够改善CMT1A模型鼠的运动表现。然而，在临床实践中，尽管尝试了不同剂量的维生素C（1~4 g/d）治疗，但并未能显著改善CMT1A患者的临床症状。因此，维生素C在CMT1A治疗中的实际效果仍需通过更多的临床实验来进一步探索。 2)黄体酮及其衍生物动物实验结果还显示，黄体酮及其衍生物可能会加剧CMT1A大鼠的神经功能缺损和神经病理损害。但值得注意的是，奥司那酮，一种黄体酮拮抗剂，已被证实在降低CMT1A大鼠的神经周围PMP22蛋白表达及改善疾病表型方面具有积极效果。遗憾的是，由于奥司那酮的毒副作用较大，使其在临床治疗中的应用受到严重限制。不过，ulapristal，作为奥司那酮的生物等效剂，展现出了较好的安全性，这可能为未来的CMT1A治疗提供了一种新的选择。 3)神经营养因子3（neurotrophin-3，NT3）在法国开展的 ulapristal治疗CMT1A 的Ⅱ期临床研究正在进行中。神经营养因子3（neurotrophin-3，NT3）能够促进轴突生长，在一项随机、双盲、安慰剂对照试验中，8例 CMT1A患者接受了6个月的皮内NT3注射治疗， NT3似乎能够改善患者的感觉神经受累程度，增加腓肠神经小直径有髓纤维的数量。 4)PXT3003 PXT3003作为复方药剂，主要包含小剂量巴氯芬、山梨醇及纳曲酮等成分。根据临床前期研究，此药能有效减少PMP22转基因大鼠体内PMP22蛋白表达，并优化髓鞘的生成过程。此前，PXT3003已在法国进行了多中心Ⅱ期临床实验，并完成了欧美多中心Ⅲ期临床研究。这些研究结果显示，相较于安慰剂组，高剂量组的CMT1A患者在若干关键指标上均取得了显著的进步，同时该药物的安全性也得到了验证。不过，在Ⅲ期临床研究中，高剂量组制剂出现了析晶问题，这导致约一半的患者被迫提前退出试验。因此，美国食品药品监督管理局要求在欧洲和美国再次进行一项Ⅲ期临床试验，以进一步验证PXT3003的治疗效果。与此同时，国内也正积极开展关于PXT3003治疗CMT1A的多中心、随机、双盲、安慰剂对照Ⅲ 为了进一步研发出既安全又高效的治疗方案，本研究正致力于设计一种新型适配体偶联纳米颗粒，这种纳米颗粒能够表达Cx32基因，并特异性地作用于CMT1X小鼠模型的雪旺细胞。我们相信，通过这种方法，可以实现更加精准的生物分布，并可能为CMT1X等由雪旺细胞基因缺陷导致的脱髓鞘神经性疾病提供更安全、更具可操作性的基因治疗手段。 5)新型适配体偶联纳米颗粒 2023年9月12日，肌萎缩症协会(MDA)和Charcot- Marie - Tooth协会(CMTA)宣布了一项总额为299,992美元的合作研究资助，用于测试使用纳米颗粒向雪旺细胞传递基因以治疗CMT1X。这项为期三年的研究名为“基于纳米颗粒的施旺细胞基因递送治疗CMT病”，将由塞浦路斯神经病学与遗传学研究所的Alexia Kagiava医学博士领导。这项研究的积极结果将为周围神经系统基因传递提供一种新的策略，预计比腺相关病毒(AAV)基因传递策略更有针对性，更安全，可用于临床转化。新的雪旺细胞靶向纳米颗粒递送也有望应用于其他形式的Charcot- Marie - Tooth(CMT)和其他由雪旺细胞基因缺陷引起的脱髓鞘神经病变。为了开发一种更安全、更有针对性的方法，本研究旨在设计一种携带表达Cx32基因的新型适配体偶联纳米颗粒，使基因能够特异性地进入CMT1X小鼠模型中的雪旺细胞。这种靶向纳米颗粒方法有望实现更有针对性的生物分布，并为CMT1X以及其他由雪旺细胞基因缺陷引起的脱髓鞘神经性疾病提供更安全、更可转化的基因治疗 6)CKD-510 韩国经济日报2023年11月6日消息，韩国制药公司钟根堂（CKD制药集团）的股价在周一飙升逾25%，原因是该公司与诺华医药(Novartis)签署了一项价值13亿美元用于治疗腓骨肌萎缩症(Charcot-Marie-Tooth disease,CMT)的外包许可协议，这是该公司有史以来最大的一笔交易。该公司周一宣布，它与诺华签署了13亿美元的授权协议以授予这一瑞士跨国制药公司开发并商业化其所研发的新药CKD-510的权利，CKD-510是专门为罕见病CMT研究的药物，根据协议，诺华将向钟根堂支付8000万美元的预付款，并根据后期药物的开发、获批情况再支付12亿美元，另外还有单独的销售版税收益。这是这家韩国制药公司成立80多年以来最大的对外授权交易，也是整个韩国制药行业今年最大的交易。 CKD-510是由钟根堂制药开发的一种作用于组蛋白去乙酰化酶6（HDAC6）的小分子抑制剂，可用于调节各类炎症疾病。韩国制药商钟根堂在临床前试验中证明了CKD-510在治疗心血管疾病和其他hdac6相关疾病方面的疗效，并在法国的1期临床试验中证明了其安全性和耐受性. 众所周知，CMT会损害周围神经，由于手脚肌肉萎缩、运动和感觉功能的丧失，病人难以行走并丧失活动能力。虽然目前还没有完全授权的治疗该遗传性疾病的方法，但美国食品和药物管理局（FDA）在2020年3月认定了CKD-510治疗CMT的孤儿药资格。六、小结 CMT 是最常见的周围神经遗传性疾病，具有显著的临床表型和遗传表型异质性。随着二代测序等基因检测技术的发展和普及，越来越多的 CMT致病基因和新发突变位点被发现和克隆，极大地丰富了 CMT的基因谱。康复训练治疗和外科矫形手术治疗仍是 CMT的主要治疗手段，针对发病机制中重要靶点的多种特异性治疗药物的研究处于临床试验阶段或临床前研究阶段，有望将来为CMT的治疗带来新的突破参考文献 1.腓骨肌萎缩症的诊治，姚晓黎, 何若洁. 中华神经科杂志, 2024,57 (03)290-297.DOI:10.3760/cma.j.cn113694-20230915-00165 2.Https://www.kedglobal.com/bio-pharma/newsView/ked202311060009 【企业推荐】【智药研习社直播预告】来源：CPHI制药在线声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。投稿邮箱：Kelly.Xiao@imsinoexpo.com ▼更多制药资讯，请关注CPHI制药在线▼ 点击阅读原文，进入智药研习社~

临床研究基因疗法

2024-04-22

·BioSpace

Sangamo Therapeutics to Present Neurology-Focused Pre-Clinical Data From Its Epigenetic Regulation, Capsid Delivery and Genome Engineering Platforms at the 27th Annual Meeting of the American Society of Gene & Cell Therapy (ASGCT)

RICHMOND, Calif.--(BUSINESS WIRE)-- Sangamo Therapeutics, Inc. (Nasdaq: SGMO), a genomic medicine company, today announced that the American Society of Gene & Cell Therapy (ASGCT) has accepted 20 Sangamo abstracts for presentation at the 27th ASGCT Annual Meeting being held May 7-11, 2024, in-person in Baltimore, MD and in a virtual format. Presentations will focus on the progression of Sangamo’s neurology-focused pre-clinical pipeline, including data supporting innovations in zinc finger epigenetic regulation, advances in AAV capsid engineering, and discovery of next-generation integrase technology. “We are thrilled to be showcasing at ASGCT the strong depth of our neurology pipeline, including various applications for our zinc finger epigenetic regulation platform, exciting advances in our capsid delivery technology, and new, potentially transformative Modular Integrases (MInts), that together reflect our continued commitment to developing potential neurology genomic medicines for patients in need,” said Amy Pooler, Head of Research at Sangamo. “Potent epigenetic regulation in diseases such as prion disease and tauopathies are complemented by our exceptional AAV delivery capabilities, a combination that is essential to the development of effective potential genomic medicine treatments to treat devastating neurological conditions.” “These data showcase the deep expertise of our scientific team in engineering DNA-protein interactions and the broad potential reach of our innovative pre-clinical approaches, including exciting new discoveries for site-directed integration of large DNA sequences via engineered MInts,” said Greg Davis, Head of Technology at Sangamo. “Using compact, protein-guided integrases built from Bxb1 variants as a means of targeted integration expands our genome editing abilities and underscores our drive to develop technologies that enable potentially transformative new medicines.” Data presentations at the ASGCT Annual Meeting include three oral presentations, two of which detail Sangamo’s potent delivery capabilities developed through its AAV capsid engineering platform SIFTER, and one that will discuss a new breakthrough in programming Bxb1, a large serine recombinase, for the development of MInts to potentially enable large-scale genome engineering. These data will showcase a novel AAV capsid, STAC-BBB, that exhibited robust and widespread central nervous system transduction in cynomolgus macaques after intravenous delivery, as well as another novel AAV capsid, STAC-150, engineered to accelerate the discovery of potent and highly specific epigenetic regulators. Sangamo will also showcase data highlighting the use of MInts, derived from compact Bxb1 variants, to integrate large sequences of DNA into the genome with minimal double-stranded DNA breaks and without the need for assistance from ancillary genome editing or DNA-repair modulating cargo. Additional poster presentations at the ASGCT Annual Meeting will showcase the use of zinc finger activators and repressors for the potential treatment of neurological diseases such as prion disease, tauopathies, Charcot-Marie-Tooth disease type 1A (CMT1A), Dravet Syndrome, SOD1-mediated amyotrophic lateral sclerosis (ALS), Phelan-McDermid syndrome, Parkinson’s disease, Angelman syndrome, and other CNS disorders. Sangamo will also present additional data from its AAV capsid engineering platform SIFTER and its efforts for integrase evolution and utilization. ASGCT Annual Meeting Presentations and Invited Sessions Epigenetic Regulation for the Central Nervous System Restoration of Normal Gene and Protein Expression in Mouse and Human Disease Models of SCN2A Haploinsufficiency Using Zinc Finger Activators Abstract No. 636 Poster Presentation – May 8; 5:30-7:00 pm ET A Zinc Finger Activator Platform to Restore Normal Gene & Protein Expression in Cellular Models of Dravet Syndrome Abstract No. 642 Poster Presentation – May 8; 5:30-7:00 pm ET SNCA Gene Repression Mediated by Zinc Finger Repressors (ZFRs) as a Therapeutic Approach for Parkinson's Disease Abstract No. 1120 Poster Presentation – May 9; 5:30-7:00 pm ET UBE3A Gene Activation Mediated by Zinc Finger Activators (ZFAs) as a Therapeutic Approach for Angelman Syndrome Abstract No. 1121 Poster Presentation – May 9; 5:30-7:00 pm ET Whole CNS Human Tau Knockdown for the Potential Treatment of Alzheimer’s Disease and Other Tauopathies Abstract No. 1126 Poster Presentation – May 9; 5:30-7:00 pm ET SOD1 Gene Repression Mediated by Zinc Finger Repressors (ZFRs) as a Therapeutic Approach for SOD1-Mediated ALS Abstract No. 1597 Poster Presentation – May 10; 5:30-7:00 pm ET PMP22 Gene Repression Mediated by Zinc Finger Repressors (ZFRs) as a Therapeutic Approach for CMT1A Abstract No. 1600 Poster Presentation – May 10; 5:30-7:00 pm ET Shank3 Gene Activation Mediated by Zinc Finger Transcriptional Activators (ZFA) as a Therapeutic Approach for Phelan-McDermid Syndrome Abstract No. 1605 Poster Presentation – May 10; 5:30-7:00 pm ET Development of a Robust Zinc Finger Activation Platform for Treatment of Neurological Disorders Abstract No. 1609 Poster Presentation – May 10; 5:30-7:00 pm ET Epigenetic Regulation of Human Prion Expression as a Potential One-Time Treatment for Prion Disease Abstract No. 1616 Poster Presentation – May 10; 5:30-7:00 pm ET Viral Engineering for the Central Nervous System Identification and Characterization of STAC-BBB, an Engineered AAV Capsid That Exhibits Widespread Transduction of the Central Nervous System in Cynomolgus Macaques Abstract No. 117 Oral Presentation – May 8; 4:00-4:15 pm ET A Highly Potent Engineered AAV Capsid, STAC-150, Enables High-Throughput AAV Production and Arrayed Epigenetic Regulator Screening Directly in Cultured Neurons Abstract No. 351 Oral Presentation – May 10; 5:15-5:30 pm ET Optimal Drug Product Presentation and Container Closure Selection for AAV-Based Genomic Medicines Abstract No. 547 Poster Presentation – May 8; 5:30-7:00 pm ET Development of Blood-Brain Barrier Penetrant AAVs through Receptor-Targeted Capsid Engineering Abstract No. 985 Poster Presentation – May 9; 5:30-7:00 pm ET Unraveling Impact of Manufacturing Process-Related Stresses on AAV Stability, Aggregation, and DNA Release Abstract No. 1032 Poster Presentation – May 9; 5:30-7:00 pm ET Process and Formulation Development for a Novel Blood-Brain Barrier Penetrant AAV Capsid Abstract No. 1052 Poster Presentation – May 9; 5:30-7:00 pm ET Next-Generation Genome Engineering Directed Evolution of Bxb1 for the Development of Modular Integrases (MInts) Abstract No. 192 Oral Presentation – May 9; 4:00-4:15 pm ET Zinc Finger Mediated Repression and Replacement of MFN2 Leads to the Rescue of Cellular Disease Phenotype in CMT2A Patient-Derived Cells Abstract No. 637 Poster Presentation – May 8; 5:30-7:00 pm ET Highly Specific Zinc Finger Proteins with Synthetic Target Sites Enable Self-Regulated Expression of Dosage-Sensitive Transgenes Abstract No. 722 Poster Presentation – May 8; 5:30-7:00 pm ET Site-directed integration of large DNA sequences into endogenous sites in the human genome using engineered Modular Integrases (MInts) Abstract No. 1680 Poster Presentation – May 10; 5:30-7:00 pm ET All abstracts for the ASGCT Annual Meeting are available on ASGCT’s website. About Sangamo Therapeutics Sangamo Therapeutics is a genomic medicine company dedicated to translating ground-breaking science into medicines that transform the lives of patients and families afflicted with serious neurological diseases who do not have adequate or any treatment options. Sangamo’s zinc finger epigenetic regulators are ideally suited to potentially address devastating neurological disorders and Sangamo’s capsid discovery platform is expanding delivery beyond currently available intrathecal delivery capsids, including in the central nervous system. Sangamo’s pipeline also includes multiple partnered programs and programs with opportunities for partnership and investment. To learn more, visit and connect with us on LinkedIn and Twitter/X. Sangamo Forward Looking Statements This press release contains forward-looking statements based on Sangamo's current expectations. These forward-looking statements include, without limitation, statements relating to Sangamo’s technologies, the presentation of data from various therapeutic and research programs and the potential of these programs to demonstrate therapeutic benefit and transform the lives of patients. These statements are not guarantees of future performance and are subject to certain risks and uncertainties that are difficult to predict. Factors that could cause actual results to differ include, but are not limited to, the research and development process, including the results of clinical trials; the regulatory approval process for product candidates; and the potential for technological developments that obviate technologies used by Sangamo. Actual results may differ from those projected in forward-looking statements due to risks and uncertainties that exist in Sangamo's operations and business. These risks and uncertainties are described more fully in our Securities and Exchange Commission filings and reports, including in our Annual Report on Form 10-K for the year ended December 31, 2023. Forward-looking statements contained in this announcement are made as of this date, and Sangamo undertakes no duty to update such information except as required under applicable law. View source version on businesswire.com: Contacts Investor Relations & Media Inquiries Louise Wilkie ir@sangamo.com media@sangamo.com Source: Sangamo Therapeutics, Inc. View this news release online at:

临床研究