Phan Han C, Taylor Jennifer L, Hannon Harry, Howell Rodney
Department of Pediatrics, Emory University, Atlanta, GA.
Research Scientist, Atlanta, GA.
Semin Perinatol. 2015 Apr;39(3):217-29. doi: 10.1053/j.semperi.2015.03.006.
Spinal muscular atrophy (SMA) is the most common genetic cause of infant mortality. Children with type I SMA typically die by the age of 2 years. Recent progress in gene modification and other innovative therapies suggest that improved outcomes may soon be forthcoming. In animal models, therapeutic intervention initiated before the loss of motor neurons alters SMA phenotype and increases lifespan. Presently, supportive care including respiratory, nutritional, physiatry, and orthopedic management can ameliorate clinical symptoms and improve survival rates if SMA is diagnosed early in life. Newborn screening could help optimize these potential benefits. A recent report demonstrated that SMA detection can be multiplexed at minimal additional cost with the assay for severe combined immunodeficiency, already implemented by many newborn screening programs. The public health community should remain alert to the rapidly changing developments in early detection and treatment of SMA.
脊髓性肌萎缩症(SMA)是婴儿死亡最常见的遗传原因。I型SMA患儿通常在2岁前死亡。基因修饰和其他创新疗法的最新进展表明,改善的治疗结果可能很快就会出现。在动物模型中,在运动神经元丧失之前开始的治疗干预可改变SMA表型并延长寿命。目前,如果在生命早期诊断出SMA,包括呼吸、营养、物理治疗和骨科管理在内的支持性护理可以改善临床症状并提高存活率。新生儿筛查有助于优化这些潜在益处。最近的一份报告表明,SMA检测可以以最小的额外成本与严重联合免疫缺陷检测同时进行,许多新生儿筛查项目已经实施了该检测。公共卫生界应继续关注SMA早期检测和治疗的快速变化发展。