Anderson Kirstie, Talbot Kevin
Department of Human Anatomy and Genetics, University of Oxford and Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK.
Curr Opin Neurol. 2003 Oct;16(5):595-9. doi: 10.1097/01.wco.0000093102.34793.13.
Many forms of spinal muscular atrophy, a pure lower motor neuron disease, have been characterized clinically but the molecular basis of most of these is unknown. In this article we review recent developments in our understanding of the spinal muscular atrophies and how this knowledge has revealed important new insights into the causes of motor neuron vulnerability which may ultimately lead to novel therapies for this untreatable group of disorders.
The identification of the genetic basis of two forms of autosomal recessive spinal muscular atrophy has revealed that lower motor neurons appear to have a specific vulnerability to defects in RNA metabolism. Most notably, the survival motor neuron protein, deficient in the most common form of spinal muscular atrophy, plays a multifunctional role in ribonucleoprotein metabolism and pre-messenger RNA splicing. The role of this protein in motor neurons is currently under intense study. The identification of two other spinal muscular atrophy-causing genes has provided support for the central role of components of the RNA metabolic pathway in determining motor neuron survival.
Understanding the molecular basis of lower motor neuron vulnerability in disorders such as spinal muscular atrophy will ultimately allow these disabling disorders to be treated. In addition we can expect to learn much about basic neuronal biology and about the pathways that are relevant to more common neurodegenerative disorders such as amyotrophic lateral sclerosis.
脊髓性肌萎缩症是一种纯下运动神经元疾病,有多种临床类型,但其中大多数的分子基础尚不清楚。在本文中,我们回顾了对脊髓性肌萎缩症认识的最新进展,以及这些知识如何揭示了关于运动神经元易损性原因的重要新见解,这最终可能会为这类无法治疗的疾病带来新的治疗方法。
两种常染色体隐性脊髓性肌萎缩症遗传基础的确定表明,下运动神经元似乎对RNA代谢缺陷具有特定的易损性。最值得注意的是,在最常见的脊髓性肌萎缩症类型中缺乏的存活运动神经元蛋白,在核糖核蛋白代谢和信使前体RNA剪接中发挥着多功能作用。目前正在深入研究这种蛋白在运动神经元中的作用。另外两个导致脊髓性肌萎缩症的基因的确定,为RNA代谢途径成分在决定运动神经元存活中的核心作用提供了支持。
了解脊髓性肌萎缩症等疾病中下运动神经元易损性的分子基础,最终将使这些致残性疾病得到治疗。此外,我们有望深入了解基础神经元生物学以及与诸如肌萎缩侧索硬化症等更常见神经退行性疾病相关的途径。