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HD 的实验模型与治疗策略的思考。

Experimental models of HD and reflection on therapeutic strategies.

机构信息

Departments of Neurological Surgery, Pittsburgh, PA 15213, USA.

出版信息

Int Rev Neurobiol. 2011;98:419-81. doi: 10.1016/B978-0-12-381328-2.00016-X.

Abstract

Huntington's disease (HD) is an autosomal dominant, progressive, and fatal neurodegenerative disorder caused by an expanded polyglutamine cytosine-adenine-guanine repeat in the gene coding for the protein huntingtin. Despite great progress over the past two decades since the identification of the gene mutation, a direct causative pathway from the HD gene mutation to neuronal dysfunction and death has not yet been established. One important advance in understanding the pathogenic mechanisms of this disease has been the development of experimental mouse models that replicate many of the clinical, neuropathological, and molecular events in HD patients. These murine models have played a critical role in providing accurate and experimentally accessible systems to study multiple features of disease pathogenesis and to test potential therapeutic strategies. A better understanding of the pathophysiological mechanisms of disease and how they interrelate has become important in identifying a treatment for HD and in the design of human clinical trials. In this chapter, we review the current state of HD mouse models and their successes in elucidating disease pathogenesis and in developing pharmacotherapies. There is no clinically proven treatment for HD that can halt or ameliorate the inexorable disease progression. As such, a guide to assessing studies in mouse models and salient issues related to translation from mice to humans are included.

摘要

亨廷顿病(HD)是一种常染色体显性、进行性和致命的神经退行性疾病,由编码 huntingtin 蛋白的基因中的扩展多聚谷氨酰胺胞嘧啶-腺嘌呤-鸟嘌呤重复序列引起。尽管自基因突变被确定以来的过去二十年取得了巨大进展,但尚未确定从 HD 基因突变到神经元功能障碍和死亡的直接因果途径。了解该疾病发病机制的一个重要进展是开发了实验性小鼠模型,这些模型复制了 HD 患者的许多临床、神经病理学和分子事件。这些鼠模型在提供精确且易于实验的系统来研究疾病发病机制的多个特征以及测试潜在的治疗策略方面发挥了关键作用。更好地了解疾病的病理生理机制及其相互关系,对于确定 HD 的治疗方法以及设计人类临床试验变得至关重要。在本章中,我们回顾了 HD 小鼠模型的现状及其在阐明发病机制和开发药物治疗方面的成功。目前尚无可用于阻止或改善 HD 不可逆转疾病进展的临床证实的治疗方法。因此,包括了评估小鼠模型研究的指南以及与从小鼠到人类的转化相关的突出问题。

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