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Abstract: Haemophilia A(HA)is an X-linked and inherited bleeding disorder which is resulted from deficiency of coagulant factorⅧ(FⅧ).The severity of hemophilia is classified based on plasma levels of FⅧ activity:severe if<1%,moderate if between 1 and 5%and mild if>5 and<40% of normal.Inhibitor formation is among the most severe complications of hemophilia treatment,with a cumulative incidence of 30%in HA patients.And it usually occurs on the 9 th-12 th exposure day.Inhibitors patients become unresponsive to standard factor treatment,resulting in 2-fold the hospitalizations,10-fold the cost,and 3.5-fold mortality of noninhibitor patients.Furthermore,inhibitors are a recognized contraindication to gene therapy.
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Key words:
- hemophilia A /
- inhibitors /
- risk factors /
- treatment
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[1] 中华医学会血液学分会血栓与止血学组、中国血友病协作组,血友病诊断与治疗中国专家共识(2017年版)[J].中华血液学杂志,2017,38(5):364-370.
[2] Callan MB,Haskins ME,Wang P,et al.Successful Phenotype Improvement following Gene Therapy for Severe Hemophilia A in Privately Owned Dogs[J].Plos One,2016,11:pe0151800.
[3] Walsh CE,Jiménez-Yuste V,Auerswald G,et al.The burden of inhibitors in haemophilia patients[J].Thromb Haemost,2016,116:S10-17.
[4] Ragni MV.Novel alternate hemostatic agents for patients with inhibitors:beyond bypass therapy[J].Hematology Am Soc Hematol Educ Program,2017,2017:605-609.
[5] Srivastava A,Brewer AK,Mauser-Bunschoten EP,et al.Guidelines for the management of hemophilia[J].Haemophilia,2012,19:e1-e47.
[6] Gouw SC,van den Berg HM,Oldenburg J,et al.F8 gene mutation type and inhibitor development in patients with severe hemophilia A:systematic review and meta-analysis[J].Blood,2012,119:2922-2934.
[7] Chen Y,Luo X,Schroeder JA,et al.Immune tolerance induced by platelet-targeted Factor VIII gene therapy in hemophilia A mice is CD4 T cell-mediated[J].J Thromb Haemost,2017,15:1994-2004.
[8] Pinto P,Ghosh K,Shetty S.F8 gene mutation profile in Indian hemophilia A patients:Identification of 23 novel mutations and factor VIII inhibitor risk association[J].Mutat Res,2016,786:27-33.
[9] Sauna ZE,Lozier JN,Kasper CK,et al.The intron-22-inverted F8 locus permits factor VIII synthesis:explanation for low inhibitor risk and a role for pharmacogenomics[J].Blood,2015,125:223-228.
[10] Wu Y,Hu Z,Li Z,et al.In situ genetic correction of F8 intron 22 inversion in hemophilia A patient-specific iPSCs[J].Scientific Reports,2016,6:18865-18865.
[11] Gouw SC,Jg V DB,Hm VDB,et al.Influence of the type of F8 gene mutation on inhibitor development in a single centre cohort of severe haemophilia A patients[J].Haemophilia,2015,17:275-281.
[12] Iorio A,Barbara AM,Makris M,et al.Natural history and clinical characteristics of inhibitors in previously treated haemophilia A patients:a case series[J].Haemophilia,2017,23:255-263.
[13] Kempton CL,Meeks SL.Toward optimal therapy for inhibitors in hemophilia[J].Hematology Am Soc Hematol Educ Program,2014,2014:364-371.
[14] Iorio A,Skinner MW,Makris M.Factor VIII products and inhibitor development in severe hemophilia A[J].N Engl J Med,2013,68:1456-1456.
[15] Marcucci M,Mancuso ME,Santagostino E,et al.Type and intensity of FVIII exposure on inhibitor development in PUPs with haemophilia A.A patient-level meta-analysis[J].Thromb Haemost,2015,113:958-967.
[16] Konkle BA.Impacting inhibitor development in hemophilia A[J].Blood,2017,130:1689-1690.
[17] Jg VDB.Age at first treatment and immune tolerance to factor VIII in severe hemophilia[J].Thromb Haemostasis,2003,89:475-479.
[18] Gouw SC,van der Bom JG,Marijke van den Berg H.Treatment-related risk factors of inhibitor development in previously untreated patients with hemophilia A:the CANAL cohort study[J].Blood,2007,109:4648-4654.
[19] 张露璐,余自强,张威,等.血友病A患者产生凝血因子Ⅷ抑制物的相关因素分析[J].中华血液学杂志,2010,31(3):168-171.
[20] Kitazawa T,Igawa T,Sampei Z,et al.A bispecific antibody to factors IXa and X restores factor VIII hemostatic activity in a hemophilia A model[J].Nat Med,2012,18:1570-1574.
[21] Muto A,Yoshihashi K,Takeda M,et al.Anti-factor IXa/X bispecific antibody ACE910 prevents joint bleeds in a long-term primate model of acquired hemophilia A[J].Blood,2014,124:3165-3171.
[22] Uchida N,Sambe T,Yoneyama K,et al.A first-in-human phase 1 study of ACE910,a novel factor VIII-mimetic bispecific antibody,in healthy subjects[J].Blood,2016,127:1633-1641.
[23] Shima M,Hanabusa H,Taki M,et al.Factor VIII-Mimetic Function of Humanized Bispecific Antibody in Hemophilia A[J].N Engl J Med,2016,374:2044-2053.
[24] Oldenburg J,Levy GG.Emicizumab Prophylaxis in Hemophilia A with Inhibitors[J].N Engl J Med,2017,377:2194-2195.
[25] von Drygalski A,Cramer TJ,Bhat V,et al.Improved hemostasis in hemophilia mice by means of an engineered factor Va mutant[J].J Thromb Haemost,2014,12:363-372.
[26] Bhat V,von Drygalski A,Gale AJ,et al.Improved coagulation and hemostasis in hemophilia with inhibitors by combinations of superFactor Va and Factor VIIa[J].Thromb Haemost,2016,115:551-561.
[27] Gale AJ,Bhat V,Pellequer JL,et al.Safety,Stability and Pharmacokinetic Properties of (super) Factor Va,a Novel Engineered Coagulation Factor V for Treatment of Severe Bleeding[J].Pharm Res,2016,33:1517-1526.
[28] Ivanciu L,Toso R,Margaritis P,et al.A zymogen-like factor Xa variant corrects the coagulation defect in hemophilia[J].Nat Biotechnol,2011,29:1028-1033.
[29] George LA,Thalji NK,Raffini LJ,et al.Correction of human hemophilia A whole blood abnormalities with a novel bypass agent:zymogen-like FXaI16L[J].J Thromb Haemost,2015,13:1694-1698.
[30] Ivanciu L,Camire RM.Hemostatic agents of broad applicability produced by selective tuning of factor Xa zymogenicity[J].Blood,2015,126:94-102.
[31] Sorensen B.A Subcutaneously Administered RNAi Therapeutic (ALN-AT3) Targeting Antithrombin for Treatment of Hemophilia:Interim Phase 1 Study Results in Healthy Volunteers and Patients with Hemophilia a or B[J].Blood,2014,124:693-693.
[32] Sehgal A,Barros S,Ivanciu L,et al.An RNAi therapeutic targeting antithrombin to rebalance the coagulation system and promote hemostasis in hemophilia[J].Nat Med,2015,21:492-497.
[33] Ragni MV.Fitusiran,an Investigational RNAi Therapeutic Targeting Antithrombin for the Treatment of Hemophilia:Updated Results from a Phase 1 and Phase 1/2 Extension Study in Patients without Inhibitors[J].Blood,2016,128:2572-2572.
[34] Dockal M,Hartmann R,Fries M,et al.Small peptides blocking inhibition of factor Xa and tissue factor-factor VIIa by tissue factor pathway inhibitor (TFPI)[J].J Biol Chem,2014,289:1732-1741.
[35] Hilden I.Hemostatic effect of a monoclonal antibody mAb 2021 blocking the interaction between FXa and TFPI in a rabbit hemophilia model[J].Blood,2012,119:5871-5878.
[36] Chowdary P,Lethagen S,Friedrich U,et al.Safety and pharmacokinetics of anti-TFPI antibody (concizumab) in healthy volunteers and patients with hemophilia:a randomized first human dose trial[J].J Thromb Haemost,2015,13:743-54.
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