Treatment of Genetic Disease Flashcards

(45 cards)

1
Q

Why is it difficult to cure genetic disease

A

Because every single cell in your body is fucked

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2
Q

Trisomy Treatment

A

Supportive care and better cardiac surgery has increased mean survival from 25 to 49

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3
Q

Multiple Endocrine Neoplasia Treatment

A

Genetic testing for autosomal dominant mutations IDs presymptomatic carrier –> take out thyroid (prevent thyroid carcinoma)

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4
Q

Multiple Endocrine Neoplasia - inheritance pattern?

how does genetic relate?

A

Autosomal dominant

Use genetic testing to manage disease (remove thyroid if have mutation)

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5
Q

Metabolic diseases

Usual inheritance pattern

A

autosomal recessive

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6
Q
Metabolic diseases (e.g. PKU)
How do we target?
A

Newborn screening

Diet modification - low phenylalanine diet

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7
Q

How can we target alpha-1 AT?

A

Protein replacement therapy

Recombinant AT1 therapy

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8
Q

How can we target Fabry disease?

A

Alpha galactosidase

Protein replacement therapy

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9
Q

My patient has G6PD deficiency, what would I tell him to avoid?

A

Antimalarial drugs

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10
Q

My patient has Acute intermittent porphyria, what would I tell him to avoid?

A

Barbiturates

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11
Q

My patient has PKU, what would I tell them to avoid?

A

Phenylalanine

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12
Q

My patient has Galactosemia, what would I tell them to avoid?

A

Galactose

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13
Q

My patient has Congenital hypothyroidism, what would I give them

A

Thyroxine

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14
Q

My patient has biotinidase deficiency, what woudl I give them

A

Biotin

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15
Q

My patient has Urea cycle deficieny, what would I give them

A

Sodium benzoate

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16
Q

My patient is heterozygous for hypercholesterolemia
what diversion would I give them
what inhibitor would I give them?

A

oral resin diversion

statin drug inhibition

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17
Q

My patient is homozygous for hypercholesterolemia, what depletor would I give them

A

LDL apheresis

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18
Q

Target at level of mutant protein

What would I give homocystinuria patient?

A

pyridoxine
50% respond
cofactor replacement

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19
Q

What would I give my patient with hemophilia?

A

factor VIII

extracellular replacement

20
Q

What would I give my patient with alpha-1 AD?

A

Alpha-1 Antitrypsin

extracellular replacement

21
Q

What would I given my patient with ADA deficiceny?

A

ADA (adenosine deaminase)

Intracellular

22
Q

Protein targets for Guacher and Fabry are examples of ?

A

Intracellular protein targeting

23
Q

Chaperone therapy?

A

Chemical chaperones assist in proper protein folding

24
Q

Example of chaperone therapy?

A

mutant-alpha-galactosidase A

Fabry disease

25
Protein replacement mainly helps what kind of illnesses?
autosomal recessive
26
challenges of protein based therapy?
``` production delivery targeting immune cost ```
27
Farnesyl Transferase Inhibitors in Progeria is an example of?
Compensation of Functional defects with novel drugs
28
How do Farnesyl Transferase Inhibitors work in Progeria?
Prevent Lamin A/C protein product (Progerin) from sequestration at the nuclear membrane
29
Gene Therapy | Approaches? (3)
Non-viral (liposome, direct DNA) Adenoviral (DNA virus) Retroviral (RNA virus)
30
Retroviral Gene Therapy | Advantage?
Integrate into cell genome | Minimal host immune reactions
31
Retroviral | Disadvantage?
Insert limited to 7-8kb | Infect only dividing cells (cannot reach quiescent tissue)
32
Retroviral | Safety?
Risk of insertional mutageneis / germline integration
33
Retroviral | Efficiency?
Titers of retroviruses relatively low | Efficient at infecting dividing cells
34
Retroviral | Duration?
As these integrate into genomic DNA, the transgene can be passed to daughter cells
35
Adenoviral | Advantage?
Wide variety of cell types can be infected Transgene insert size can be 35-36kb Stable and easy to get high titers
36
Adenoviral | Disadvantage?
Does not integrate into cell genome Expression can be very transient Some risk of malignant transformation
37
Adenoviral | Safety?
Lower risk of insertional mutagenesis | Immune reactions can be severe
38
Adenoviral | Efficiency?
Can infect non-dividing cells | Higher titers are possible
39
Adenoviral | Duration?
Typically short lived effect; not passed to daughter cells
40
Non viral | Advantage?
Insert size can be very large Could deliver mini-chromosomes Minimal host immune response
41
Non viral | Disadvantages?
Low efficiency | Transient expression
42
Non viral | Safety?
Safest? | Does not integrate into host genome
43
Non Viral | Efficiency
Often degraded by cellular mechanism - so non specific uptake is inefficient process
44
Non Viral | Duration?
Typically short lived effect | Not passed to daughter cell lines
45
Gene therapy approaches include what two broad strategies?
In vivo - ex vivo