Spinal muscular atrophy: a timely review.

Spinal muscular atrophy: a timely review.
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DOI:
10.1001/archneurol.2011.74
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发表时间:
2011-08
影响因子:
--
通讯作者:
Kissel, John T.
Kissel, John T.
中科院分区:
其他
文献类型:
--
作者:
Kolb, Stephen J.;Kissel, John T.

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脊髓性肌萎缩症(SMA)是一种神经退行性疾病,其特征是脊髓前角运动神经元的丢失和由此产生的虚弱。SMA最常见的形式(占病例的95%)是与运动神经元存活(SMN1)基因突变相关的常染色体隐性近端SMA。在过去15年中,对SMA分子遗传学和病理生理学的理解不断取得进展,为合理、有效的治疗试验提供了独特的机会。SMA治疗的目标是在正确的时间增加正确细胞中SMN蛋白的表达水平。有了这个目标,研究人员现在可以有效地在体外筛选潜在的治疗方法,在准确可靠的动物模型中进行测试,将有前途的药物推向临床试验,并在疾病的早期或症状前阶段准确诊断患者。SMA社区面临的一个主要挑战是在适当监管机构的指导下,以有效、及时和安全的方式优先考虑和开发最有前途的治疗方法。本综述将从历史的角度强调SMA有效疗法开发道路上的重要里程碑。
Spinal muscular atrophy (SMA) is a neurodegenerative disease characterized by loss of motor neurons in the anterior horn of the spinal cord and resultant weakness. The most common form of SMA, accounting for 95% of cases, is autosomal recessive proximal SMA associated with mutations in the survival of motor neurons (SMN1) gene. Relentless progress during the past 15 years in the understanding of the molecular genetics and pathophysiology of SMA has resulted in a unique opportunity for rational, effective therapeutic trials. The goal of SMA therapy is to increase the expression levels of the SMN protein in the correct cells at the right time. With this target in sight, investigators can now effectively screen potential therapies in vitro, test them in accurate, reliable animal models, move promising agents forward to clinical trials, and accurately diagnose patients at an early or presymptomatic stage of disease. A major challenge for the SMA community will be to prioritize and develop the most promising therapies in an efficient, timely, and safe manner with the guidance of the appropriate regulatory agencies. This review will take a historical perspective to highlight important milestones on the road to developing effective therapies for SMA.
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