Previtali Stefano Carlo, Zambon Alberto Andrea
Neuromuscular Repair Unit, Institute of Experimental Neurology (InSpe), Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Neurology, IRCCS Ospedale San Raffaele, Milan, Italy.
Front Mol Neurosci. 2020 Apr 23;13:60. doi: 10.3389/fnmol.2020.00060. eCollection 2020.
Merosin deficient Congenital Muscular Dystrophy (MDC1A), or LAMA2-related muscular dystrophy (LAMA2-RD), is a recessive disorder resulting from mutations in the gene, encoding for the alpha-2 chain of laminin-211. The disease is predominantly characterized by progressive muscular dystrophy affecting patient motor function and reducing life expectancy. However, LAMA2-RD also comprises a developmentally-associated dysmyelinating neuropathy that contributes to the disease progression, in addition to brain abnormalities; the latter often underappreciated. In this brief review, we present data supporting the impact of peripheral neuropathy in the LAMA2-RD phenotype, including both mouse models and human studies. We discuss the molecular mechanisms underlying nerve abnormalities and involved in the laminin-211 pathway, which affects axon sorting, ensheathing and myelination. We conclude with some final considerations of consequences on nerve regeneration and potential therapeutic strategies.
merosin缺乏型先天性肌营养不良(MDC1A),或层粘连蛋白α2链相关肌营养不良(LAMA2-RD),是一种由编码层粘连蛋白-211α-2链的基因突变引起的隐性疾病。该疾病的主要特征是进行性肌营养不良,影响患者的运动功能并缩短预期寿命。然而,LAMA2-RD还包括一种与发育相关的脱髓鞘性神经病变,除了脑部异常外,这种病变也会促进疾病进展;而脑部异常往往未得到充分认识。在这篇简短的综述中,我们展示了支持周围神经病变对LAMA2-RD表型影响的数据,包括小鼠模型和人体研究。我们讨论了神经异常以及层粘连蛋白-211通路中涉及的分子机制,该通路影响轴突分选、包裹和髓鞘形成。我们最后对神经再生的后果和潜在治疗策略进行了一些思考。