Perrier Stefanie, Michell-Robinson Mackenzie A, Bernard Geneviève
Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.
Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada.
Front Cell Neurosci. 2021 Jan 28;14:631802. doi: 10.3389/fncel.2020.631802. eCollection 2020.
Leukodystrophies are a class of rare inherited central nervous system (CNS) disorders that affect the white matter of the brain, typically leading to progressive neurodegeneration and early death. Hypomyelinating leukodystrophies are characterized by the abnormal formation of the myelin sheath during development. POLR3-related or 4H (hypomyelination, hypodontia, and hypogonadotropic hypogonadism) leukodystrophy is one of the most common types of hypomyelinating leukodystrophy for which no curative treatment or disease-modifying therapy is available. This review aims to describe potential therapies that could be further studied for effectiveness in pre-clinical studies, for an eventual translation to the clinic to treat the neurological manifestations associated with POLR3-related leukodystrophy. Here, we discuss the therapeutic approaches that have shown promise in other leukodystrophies, as well as other genetic diseases, and consider their use in treating POLR3-related leukodystrophy. More specifically, we explore the approaches of using stem cell transplantation, gene replacement therapy, and gene editing as potential treatment options, and discuss their possible benefits and limitations as future therapeutic directions.
脑白质营养不良是一类罕见的遗传性中枢神经系统(CNS)疾病,会影响大脑的白质,通常导致进行性神经退行性变和早亡。低髓鞘形成性脑白质营养不良的特征是在发育过程中髓鞘形成异常。POLR3相关或4H(低髓鞘形成、少牙症和低促性腺激素性性腺功能减退)脑白质营养不良是最常见的低髓鞘形成性脑白质营养不良类型之一,目前尚无治愈性治疗或疾病修饰疗法。本综述旨在描述一些潜在疗法,这些疗法可在临床前研究中进一步研究其有效性,最终转化至临床以治疗与POLR3相关脑白质营养不良相关的神经学表现。在此,我们讨论了在其他脑白质营养不良以及其他遗传疾病中已显示出前景的治疗方法,并考虑将其用于治疗POLR3相关脑白质营养不良。更具体地说,我们探讨了使用干细胞移植、基因替代疗法和基因编辑作为潜在治疗选择的方法,并讨论了它们作为未来治疗方向可能的益处和局限性。