Institute of Human Genetics, University of Cologne, Germany.
Curr Pharm Des. 2013;19(28):5093-104. doi: 10.2174/13816128113199990356.
Among hereditary diseases, the group of motor neuron diseases (MNDs) includes some of the most devastating and rapidly progressive lethal conditions. Although degeneration of motor neurons is common to all of them, the phenotypic spectrum of MNDs is relatively broad and ranges from perinatal conditions like spinal muscular atrophy (SMA) to adult-onset diseases such as amyotrophic lateral sclerosis (ALS). While the understanding of the pathology of the diseases is constantly growing, the development of therapeutic approaches lags behind. In fact, there is no approved therapy for MNDs available at the moment. Recent findings demonstrated the existence of some patterns that are shared by several MNDs such as transcriptional dysregulation. In addition, conditions like SMA or certain types of Charcot-Marie-Tooth disease provide some defined targets which may be amenable to therapeutic approaches. Consequently, counteracting this dysregulation may be a valuable therapeutic option and ameliorate disease progression in MND patients. The feasibility of such an approach has been proven during the past years by the epigenetic treatment of various neoplastic entities with histone deacetylase inhibitors (HDACi). On these grounds, also epigenetic therapy of MNDs has become a promising option. So far, several HDACi have been tested in vitro and in animal models and some proceeded further and were evaluated in clinical trials. This review will summarize the advances of HDACi in MNDs and will give a perspective where the road will lead us.
在遗传性疾病中,运动神经元疾病(MND)包括一些最具破坏性和快速进展性的致命疾病。虽然所有这些疾病都存在运动神经元的退化,但 MND 的表型谱相对较广,范围从脊髓性肌萎缩症(SMA)等围产期疾病到肌萎缩侧索硬化症(ALS)等成年发病疾病。尽管对疾病的病理学认识不断发展,但治疗方法的开发却落后了。事实上,目前尚无针对 MND 的批准疗法。最近的研究结果表明,几种 MND 存在一些共同的模式,如转录失调。此外,SMA 或某些类型的遗传性运动感觉神经病等疾病提供了一些明确的靶点,可能适用于治疗方法。因此,对抗这种失调可能是一种有价值的治疗选择,可以改善 MND 患者的疾病进展。近年来,组蛋白去乙酰化酶抑制剂(HDACi)对各种肿瘤实体的表观遗传治疗已经证明了这种方法的可行性。基于这些原因,MND 的表观遗传治疗也成为一种有前途的选择。到目前为止,已经在体外和动物模型中测试了几种 HDACi,其中一些已经进一步进行了临床试验评估。这篇综述将总结 HDACi 在 MND 中的进展,并展望未来的发展方向。