Leveraging Genetics for Hereditary Angioedema: A Road Map to Precision Medicine.
Acquired angioedema
C1-inhibitor deficiency
Genomics
Hereditary angioedema
Next-generation sequencing
Precision medicine
Journal
Clinical reviews in allergy & immunology
ISSN: 1559-0267
Titre abrégé: Clin Rev Allergy Immunol
Pays: United States
ID NLM: 9504368
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
accepted:
07
01
2021
pubmed:
29
1
2021
medline:
15
12
2021
entrez:
28
1
2021
Statut:
ppublish
Résumé
Biochemical studies performed during the last decades resulted in the development of various innovative medicinal products for hereditary angioedema (HAE). These therapeutic agents target the production or the function of bradykinin-the main mediator of HAE due to C1-inhibitor (C1-INH) deficiency. However, despite these remarkable achievements, current knowledge cannot provide convincing explanations for the clinical variability of the disease. As a consequence, treatment indications apply for drugs available for C1-INH deficiency. The advent of high-throughput next-generation sequencing technologies may assist in covering the missing part of our understanding of HAE pathogenesis. During the last 3 years alone, several new entities were added to the already described genotypes. The recent discovery of four novel target genes expands our understanding of other causes which may explain recurrent angioedema in individuals and families with normal C1-INH activity. Furthermore, new genetic technologies allowed the recognition of deep intronic variants associated with the disease, and elegant functional studies characterized new variants for the C1-INH gene. Thus, evidence has been provided regarding pathogenetic aspects remaining obscure for many years, such as the defective intracellular transport of mutant C1-INH, and environmental effect on the disease expression. Therefore, it seems that the stage for Precision Medicine era in HAE management is ready. Disease endotypes are expected to be uncovered and specified targets for therapeutic intervention will be detected, promising a more effective, individualized management of the disease.
Identifiants
pubmed: 33507496
doi: 10.1007/s12016-021-08836-7
pii: 10.1007/s12016-021-08836-7
doi:
Substances chimiques
Complement C1 Inhibitor Protein
0
Bradykinin
S8TIM42R2W
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
416-428Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
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