Department of Physiology, UT Southwestern Medical Center at Dallas, Texas, USA.
Cerebellum. 2012 Sep;11(3):630-9. doi: 10.1007/s12311-010-0182-9.
Spinocerebellar ataxias (SCAs) constitute a heterogeneous group of more than 30 autosomal-dominant genetic and neurodegenerative disorders. SCAs are generally characterized by progressive ataxia and cerebellar atrophy. Although all SCA patients present with the phenotypic overlap of cerebellar atrophy and ataxia, 17 different gene loci have so far been implicated as culprits in these SCAs. It is not currently understood how mutations in these 17 proteins lead to the cerebellar atrophy and ataxia. Several pathogenic mechanisms have been studied in SCAs but there is yet to be a promising target for successful treatment of SCAs. Emerging research suggests that a fundamental cellular signaling pathway is disrupted by a majority of these mutated genes, which could explain the characteristic death of Purkinje cells, cerebellar atrophy, and ataxia that occur in many SCAs. We propose that mutations in SCA genes cause disruptions in multiple cellular pathways but the characteristic SCA pathogenesis does not begin until calcium signaling pathways are disrupted in cerebellar Purkinje cells either as a result of an excitotoxic increase or a compensatory suppression of calcium signaling. We argue that disruptions in Purkinje cell calcium signaling lead to initial cerebellar dysfunction and ataxic sympoms and eventually proceed to Purkinje cell death. Here, we discuss a calcium hypothesis of Purkinje cell neurodegeneration in SCAs by primarily focusing on an example of spinocerebellar ataxia 2 (SCA2). We will also present evidence linking deranged calcium signaling to the pathogenesis of other SCAs (SCA1, 3, 5, 6, 14, 15/16) that lead to significant Purkinje cell dysfunction and loss in patients.
脊髓小脑共济失调(SCAs)是一组由 30 多种常染色体显性遗传和神经退行性疾病组成的异质性疾病。SCAs 的一般特征是进行性共济失调和小脑萎缩。虽然所有 SCA 患者都表现出小脑萎缩和共济失调的表型重叠,但到目前为止,已经有 17 个不同的基因座被认为是这些 SCA 的罪魁祸首。目前还不清楚这些 17 种蛋白质的突变如何导致小脑萎缩和共济失调。已经研究了几种致病机制,但目前还没有一个有希望的靶点可以成功治疗 SCA。新的研究表明,大多数这些突变基因破坏了一个基本的细胞信号通路,这可以解释许多 SCA 中发生的浦肯野细胞死亡、小脑萎缩和共济失调的特征。我们提出,SCA 基因的突变导致多个细胞通路的破坏,但只有当小脑浦肯野细胞的钙信号通路被破坏时,才会出现特征性的 SCA 发病机制,这种破坏可能是由于兴奋性增加或钙信号的代偿性抑制。我们认为,浦肯野细胞钙信号的破坏导致最初的小脑功能障碍和共济失调症状,最终导致浦肯野细胞死亡。在这里,我们主要以脊髓小脑共济失调 2 型(SCA2)为例,讨论了 SCA 中浦肯野细胞神经退行性变的钙假说。我们还将提供证据,将紊乱的钙信号与其他 SCA(SCA1、3、5、6、14、15/16)的发病机制联系起来,这些 SCA 导致患者的浦肯野细胞功能显著障碍和丧失。