Department of Health Sciences, University of Milan, via A. di Rudinì 8, 20142, Milan, Italy.
Stem Cell Rev Rep. 2019 Dec;15(6):795-813. doi: 10.1007/s12015-019-09910-6.
Spinal Muscular Atrophy (SMA) is a neurodegenerative disease characterized by specific and predominantly lower motor neuron (MN) loss. SMA is the main reason for infant death, while about one in 40 children born is a healthy carrier. SMA is caused by decreased levels of production of a ubiquitously expressed gene: the survival motor neuron (SMN). All SMA patients present mutations of the telomeric SMN1 gene, but many copies of a centromeric, partially functional paralog gene, SMN2, can somewhat compensate for the SMN1 deficiency, scaling inversely with phenotypic harshness. Because the study of neural tissue in and from patients presents too many challenges and is very often not feasible; the use of animal models, such as the mouse, had a pivotal impact in our understanding of SMA pathology but could not portray totally satisfactorily the elaborate regulatory mechanisms that are present in higher animals, particularly in humans. And while recent therapeutic achievements have been substantial, especially for very young infants, some issues should be considered for the treatment of older patients. An alternative way to study SMA, and other neurological pathologies, is the use of induced pluripotent stem cells (iPSCs) derived from patients. In this work, we will present a wide analysis of the uses of iPSCs in SMA pathology, starting from basic science to their possible roles as therapeutic tools.
脊髓性肌萎缩症(SMA)是一种神经退行性疾病,其特征是特定的、主要是下运动神经元(MN)丧失。SMA 是婴儿死亡的主要原因,而大约每 40 个出生的儿童中就有一个是健康携带者。SMA 是由于一个广泛表达的基因:运动神经元存活(SMN)的产生水平降低引起的。所有 SMA 患者都存在端粒 SMN1 基因的突变,但着丝粒、部分功能的同源基因 SMN2 的许多拷贝可以在一定程度上弥补 SMN1 的缺乏,与表型的严重程度成反比。由于研究患者体内和体外的神经组织存在太多挑战,而且通常是不可行的;因此,使用动物模型(如小鼠)对我们理解 SMA 病理学产生了至关重要的影响,但不能完全令人满意地描绘出在高等动物中存在的复杂调节机制,尤其是在人类中。虽然最近的治疗成就已经相当可观,尤其是对非常年幼的婴儿,但对于老年患者的治疗,还应该考虑一些问题。另一种研究 SMA 和其他神经病理学的方法是使用源自患者的诱导多能干细胞(iPSC)。在这项工作中,我们将从基础科学到它们作为治疗工具的可能作用,对 iPSC 在 SMA 病理学中的应用进行广泛分析。