Pareyson Davide, Marchesi Chiara, Salsano Ettore
Clinics of Central and Peripheral Degenerative Neuropathies Unit, Department of Clinical Neurosciences, IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy.
Handb Clin Neurol. 2013;115:817-45. doi: 10.1016/B978-0-444-52902-2.00047-3.
Charcot-Marie-Tooth neuropathy (CMT) is a group of genetically heterogeneous disorders sharing a similar phenotype, characterized by wasting and weakness mainly involving the distal muscles of lower and upper limbs, variably associated with distal sensory loss and skeletal deformities. This chapter deals with dominantly transmitted CMT and related disorders, namely hereditary neuropathy with liability to pressure palsies (HNPP) and hereditary neuralgic amyotrophy (HNA). During the last 20 years, several genes have been uncovered associated with CMT and our understanding of the underlying molecular mechanisms has greatly improved. Consequently, a precise genetic diagnosis is now possible in the majority of cases, thus allowing proper genetic counseling. Although, unfortunately, treatment is still unavailable for all types of CMT, several cellular and animal models have been developed and some compounds have proved effective in these models. The first trials with ascorbic acid in CMT type 1A have been completed and, although negative, are providing relevant information on disease course and on how to prepare for future trials.
夏科-马里-图斯神经病(CMT)是一组具有相似表型的遗传性异质性疾病,其特征是主要累及下肢和上肢远端肌肉的萎缩和无力,并伴有不同程度的远端感觉丧失和骨骼畸形。本章讨论显性遗传的CMT及相关疾病,即遗传性压力易感性神经病(HNPP)和遗传性神经性肌萎缩(HNA)。在过去20年中,已发现多个与CMT相关的基因,我们对其潜在分子机制的理解有了很大提高。因此,现在大多数病例都可以进行精确的基因诊断,从而能够提供适当的遗传咨询。遗憾的是,虽然目前并非所有类型的CMT都有治疗方法,但已经建立了一些细胞和动物模型,并且一些化合物在这些模型中已证明有效。针对1A型CMT的抗坏血酸首次试验已经完成,尽管结果为阴性,但为疾病进程以及如何为未来试验做准备提供了相关信息。