Department of Neurology, University of California San Francisco, San Francisco, California.
Department of Neurology, Ohio State University, Columbus, Ohio.
Semin Neurol. 2020 Jun;40(3):335-341. doi: 10.1055/s-0040-1702940. Epub 2020 Apr 15.
In the past decade, the number of genes linked to neuromuscular diseases of childhood has expanded dramatically, and this genetic information is forming the basis for gene-specific and even mutation-specific therapies. At the forefront of these advances are the two recently approved treatments for spinal muscular atrophy: one, an antisense oligonucleotide that modifies splicing of the SMN2 gene, and, the other, a gene therapy vector that delivers the gene to motor neurons, both of which are allowing patients to acquire developmental milestones previously unseen in this fatal disease. This review highlights these advances and emerging targeted therapies for Duchenne muscular dystrophy and centronuclear myopathy, while also covering enzyme replacement therapy and small molecule-based targeted therapies for conditions such as Pompe's disease and congenital myasthenic syndromes. With these and other newer techniques for targeted correction of genetic defects, such as CRISPR/Cas9, there is now hope that treatments for many more genetic diseases of the nervous system will follow in the near future.
在过去的十年中,与儿童神经肌肉疾病相关的基因数量急剧增加,这些遗传信息正在为基因特异性甚至突变特异性治疗奠定基础。在这些进展的前沿是最近批准的两种脊髓性肌萎缩症治疗方法:一种是修饰 SMN2 基因剪接的反义寡核苷酸,另一种是将基因传递到运动神经元的基因治疗载体,这两种方法都使患者能够获得以前在这种致命疾病中从未见过的发育里程碑。这篇综述强调了这些进展和新兴的针对杜氏肌营养不良症和中核肌病的靶向治疗方法,同时还涵盖了针对庞贝病和先天性肌无力综合征等疾病的酶替代疗法和基于小分子的靶向治疗方法。随着这些和其他针对遗传缺陷的新型靶向校正技术,如 CRISPR/Cas9 的出现,现在有希望在不久的将来针对更多的神经系统遗传疾病进行治疗。