Faravelli Irene, Frattini Emanuele, Ramirez Agnese, Stuppia Giulia, Nizzardo Monica, Corti Stefania
Dino Ferrari Centre, Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), University of Milan, Neurology Unit, IRCCS Foundation Ca'Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122 Milan, Italy.
J Clin Med. 2014 Oct 17;3(4):1124-45. doi: 10.3390/jcm3041124.
Motor neuron diseases (MNDs) are neuromuscular disorders affecting rather exclusively upper motor neurons (UMNs) and/or lower motor neurons (LMNs). The clinical phenotype is characterized by muscular weakness and atrophy leading to paralysis and almost invariably death due to respiratory failure. Adult MNDs include sporadic and familial amyotrophic lateral sclerosis (sALS-fALS), while the most common infantile MND is represented by spinal muscular atrophy (SMA). No effective treatment is ccurrently available for MNDs, as for the vast majority of neurodegenerative disorders, and cures are limited to supportive care and symptom relief. The lack of a deep understanding of MND pathogenesis accounts for the difficulties in finding a cure, together with the scarcity of reliable in vitro models. Recent progresses in stem cell field, in particular in the generation of induced Pluripotent Stem Cells (iPSCs) has made possible for the first time obtaining substantial amounts of human cells to recapitulate in vitro some of the key pathogenetic processes underlying MNDs. In the present review, recently published studies involving the use of iPSCs to unravel aspects of ALS and SMA pathogenesis are discussed with an overview of their implications in the process of finding a cure for these still orphan disorders.
运动神经元病(MNDs)是一类神经肌肉疾病,主要影响上运动神经元(UMNs)和/或下运动神经元(LMNs)。其临床表型的特征是肌肉无力和萎缩,最终导致瘫痪,几乎无一例外因呼吸衰竭而死亡。成人MNDs包括散发性和家族性肌萎缩侧索硬化症(sALS - fALS),而最常见的婴儿型MND是脊髓性肌萎缩症(SMA)。与绝大多数神经退行性疾病一样,目前尚无针对MNDs的有效治疗方法,治疗手段仅限于支持性护理和症状缓解。由于对MND发病机制缺乏深入了解,加上可靠的体外模型稀缺,导致难以找到治愈方法。干细胞领域的最新进展,特别是诱导多能干细胞(iPSCs)的产生,首次使得获取大量人类细胞以在体外重现MNDs一些关键发病过程成为可能。在本综述中,将讨论最近发表的涉及使用iPSCs来揭示ALS和SMA发病机制的研究,并概述它们在寻找这些尚无有效治疗方法的疾病的治愈方法过程中的意义。