Advanced drug delivery systems targeting metabolic disorders: erythropoietic protoporphyria

Publisher:
Elsevier
Publication Type:
Chapter
Citation:
Drug Delivery Systems for Metabolic Disorders, 2022, pp. 85-95
Issue Date:
2022-01-01
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Erythropoietic protoporphyria (EPP) is an inherited condition heme biosynthesis disorder characterized by extreme hepatotoxicity and photosensitivity. Too far, no viable therapies are available. Cimetidine has already been proven to suppress heme production and alleviate symptoms in individuals suffering from porphyria cutanea tarda and acute intermittent porphyria. These sicknesses cause the development of erythrocyte protoporphyrin within the plasma, which would then be able to be drawn basically in the liver and vascular endothelium. Sun exposure activates the stored protoporphyrin, causing singlet oxygen radical interactions that cause tissue injury and agonizing agony. Protoporphyrin accumulation in hepatocytes/or bile causes symptomatic severe liver damage in 2%–5% of individuals, which could progress to cholestatic organ failure necessitating transplantation. Following minutes of sunlight exposure, most individuals develop immediate, acute, non-blistering phototoxicity. Anemia affects around 47 percent of cases, and approximately 27 percent have aberrant serum aminotransferases. The presence of considerably increased erythrocyte protoporphyrin concentrations, with a predominance of metal-free protoporphyrin, is used to detect EPPP and XLP. Genetic testing, which includes sequencing the FECH or ALAS2 genes, confirms the diagnosis. There are presently no FDA-approved treatments for such diseases, therefore therapy is confined to protection from the sun. Afamelanotide, a synthesized counterpart of -melanocyte-stimulating hormone, is shown to raise the standard of living and enhance pain-free sunlight exposure in people with EPP. It was authorized for usage in European Union in 2014, however, it is not currently accessible in the United States. The medication delivery system and therapy of erythropoietic uroporphyria have been discussed in this chapter.
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