Pareyson Davide, Saveri Paola, Pisciotta Chiara
Unit of Rare Neurological Diseases of Adulthood, Department of Clinical Neurosciences, C. Besta Neurological Institute IRCCS Foundation, Milan, Italy.
Curr Opin Neurol. 2017 Oct;30(5):471-480. doi: 10.1097/WCO.0000000000000474.
Charcot-Marie-Tooth disease (CMT) and related neuropathies represent a heterogeneous group of hereditary disorders. The present review will discuss the most recent advances in the field.
Knowledge of CMT epidemiology and frequency of the main associated genes is increasing, with an overall prevalence estimated at 10-28/100 000. In the last years, the huge number of newly uncovered genes, thanks to next-generation sequencing techniques, is challenging the current classification of CMT. During the last 18 months other genes have been associated with CMT, such as PMP2, MORC2, NEFH, MME, and DGAT2. For the most common forms of CMT, numerous promising compounds are under study in cellular and animal models, mainly targeting either the protein degradation pathway or the protein overexpression. Consequently, efforts are devoted to develop responsive outcome measures and biomarkers for this overall slowly progressive disorder, with quantitative muscle MRI resulting the most sensitive-to-change measure.
This is a rapidly evolving field where better understanding of pathophysiology is paving the way to develop potentially effective treatments, part of which will soon be tested in patients. Intense research is currently devoted to prepare clinical trials and develop responsive outcome measures.
夏科-马里-图思病(CMT)及相关神经病变代表了一组遗传性疾病的异质性群体。本综述将讨论该领域的最新进展。
CMT流行病学及主要相关基因频率的知识不断增加,总体患病率估计为10-28/10万。近年来,由于新一代测序技术,大量新发现的基因正在挑战CMT的当前分类。在过去18个月里,其他基因也与CMT相关,如PMP2、MORC2、NEFH、MME和DGAT2。对于最常见的CMT形式,许多有前景的化合物正在细胞和动物模型中进行研究,主要针对蛋白质降解途径或蛋白质过度表达。因此,人们致力于为这种总体进展缓慢的疾病开发有反应性的结局指标和生物标志物,定量肌肉MRI是最敏感的变化指标。
这是一个快速发展的领域,对病理生理学的更好理解正在为开发潜在有效的治疗方法铺平道路,其中部分治疗方法很快将在患者中进行测试。目前正在进行深入研究以准备临床试验并开发有反应性的结局指标。