嗜睡症的管理的新发展。

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Abad VC, Guilleminault C

嗜睡症的管理的新发展。

Nat Sci睡眠。2017年3月3,9:39-57。doi: 10.2147 / NSS.S103467。eCollection 2017。

PubMed ID

28424564 (在PubMed

]

文摘

猝睡症是一个终身,underrecognized睡眠障碍影响美国和西欧人口-0.18%的0.02%。遗传倾向怀疑因为嗜睡症的强大与HLA DQB1 * 06-02,和全基因组关联研究已经确定了在t细胞受体位点多态性。嗜睡症病理生理学与损失由hypocretin-producing神经元信号;自体免疫性病因可能引发的一些环境代理可能沉淀食欲素神经元的损失。目前的治疗方法缓解白天过度困倦的主要症状(EDS)和猝倒,在较小程度上,减少夜间睡眠中断,催眠的幻觉,睡眠瘫痪症。钠oxybate (SXB)、γ羟丁酸钠盐,是猝倒的一线代理和EDS和有助于睡眠中断,催眠的幻觉,睡眠瘫痪症。各种抗抑郁药物包括去甲肾上腺素5 -羟色胺再摄取抑制剂、选择性5 -羟色胺再摄取抑制剂,三环类抗抑郁药治疗猝倒二线药物。除了SXB,莫达非尼和莫达非尼治疗EDS的一线药物。二线药物对EDS兴奋剂哌醋甲酯和延长释放安非他明等。新兴疗法包括non-hypocretin-based疗法,hypocretin-based治疗,免疫治疗以防止食欲素神经元死亡。 Non-hypocretin-based novel treatments for narcolepsy include pitolisant (BF2.649, tiprolisant); JZP-110 (ADX-N05) for EDS in adults; JZP 13-005 for children; JZP-386, a deuterated sodium oxybate oral suspension; FT 218 an extended-release formulation of SXB; and JNJ-17216498, a new formulation of modafinil. Clinical trials are investigating efficacy and safety of SXB, modafinil, and armodafinil in children. gamma-amino butyric acid (GABA) modulation with GABAA receptor agonists clarithromycin and flumazenil may help daytime somnolence. Other drugs investigated include GABAB agonists (baclofen), melanin-concentrating hormone antagonist, and thyrotropin-releasing hormone agonists. Hypocretin-based therapies include hypocretin peptide replacement administered either through an intracerebroventricular route or intranasal route. Hypocretin neuronal transplant and transforming stem cells into hypothalamic neurons are also discussed in this article. Immunotherapy to prevent hypocretin neuronal death is reviewed.

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药物

johnson & johnson - 17216498

药物靶点

药物	目标	类	生物	药理作用	行动
johnson & johnson - 17216498	组胺H3受体	蛋白质	人类	是的	拮抗剂	细节