)本文版权归《肾脏病与透析肾移植杂志》编辑部所有CD0I:10.3969298X.2023.03.015Vol.32No.3Jun.2023JNephrolDialyTransplant270Alport综合征的药物研发进展伍琳琳刘栋董宁宁综述夏宏光审校摘要Alport综合征(AS)是一种以肾脏、眼部及听力受损为主要表现的遗传性胶原病,可导致患者早期进人终末期肾病(ESKD),已纳人我国《第一批罕见病目录》。目前,AS尚无根治手段,但是治疗AS的药物研发在加速进展。本文综述了近十年来AS的国内外药物研发和临床试验进展,希望为AS的药物研发及治疗提供策略和思路,使AS患者及其家庭获益关键词Alport综合征遗传性肾病肾素-血管紧张素-醛固酮系统抑制剂临床试验新药研发ProgressindrugdevelopmentofAlportsyndromeWULinlin,LIUDong,DONGNingning,XIAHongguangHangzhouPhecdaMedCo.Ltd,Hangzhou311121,ChinaABSTRACTAlportsyndrome(AS)isakindofhereditarycollagendiseasewithkidney,eyeandhearingimpairmentasprimarymanifestations,whichwillleadtoend-stagekidneydisease(ESKD)intheearlystage,andisincludedinthefirstbatchofrarediseaseslistinChina.Atpresent,thereisnocureforAS,buttheresearchanddevelopmentofdrugsforthetreatmentofASisaccelerating.ThisarticlereviewstheprogressofdrugresearchandclinicaltrialsofASathomeandabroadinthepastdecade,hopingtoprovidestrategiesandideasforthefuturedrugdevelopmentandtreatmentofAS,soastobenefitASpatientsandtheirfamilies.KeywordssAlportsyndromehereditarynephropathyrenin-angiotensin-aldosteronesysteminhibitorsclinicaltrialnewdrugdevelopmentAlport综合征(AS)是一种遗传性胶原病,由编码肾小球基膜中的IV型胶原蛋白α3链、α4链和α5链的基因COL4A3,COL4A4和COL4A5突变引起,主要临床特征为肾脏病变、眼部改变及听力受损。根据不同的遗传方式AS分为X连锁AS(XLAS)、常染色体隐性AS(ARAS)和常染色体显性AS(ADAS)。其中XLAS由COLAA5基因突变引起,占AS患者比例为80%;ARAS和ADAS由COL4A3或COL4A4基因突变引起,占AS患者比例分别为15%和5%]。AS在世界各地均有报道,美国有近20万例[2],我国资料显示AS在肾活检患儿中占遗传性肾脏疾病的81.82%[3]。AS会导致患者早期进人终末期肾病(ESKD),约90%的XLAS男性患者,表现为无义突变者,在30岁前发生ESKD的概率为90%[4],暂无根治手段。近十年来,药物治疗AS已【作者单位】杭州天玑济世...