Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Expert Rev Neurother. 2021 Jun;21(6):701-713. doi: 10.1080/14737175.2021.1935242. Epub 2021 Jun 7.
: Charcot-Marie-Tooth disease (CMT) and related neuropathies represent the most prevalent inherited neuromuscular disorders. Nonetheless, there is still no pharmacological treatment available for any CMT type. However, the landscape is rapidly evolving and several novel approaches are providing encouraging results in preclinical studies and leading to clinical trials.: The authors review the most promising therapies under study and the ongoing/planned clinical trials. Several approaches to address PMP22 overexpression underlying CMT1A, the most frequent subtype, are being tested. Gene silencing, targeting PMP22, and gene therapy, to introduce specific genes or to substitute or modulate defective ones, are being experimented in animal models. Compounds acting on ER stress, unfolded protein response, neuregulin pathways, phosphoinositides metabolism, axonal transport and degeneration, inflammation, polyol pathway, deoxysphingolipid metabolism, purine nucleotide pool are potential therapeutic candidates for different forms of CMT and related neuropathies.: We are getting closer to find effective therapies for CMT, but are far behind the exciting examples of other genetic neuromuscular disorders. The authors analyze the possible reasons for this gap and the way to fill it. Preclinical and clinical research is ongoing with coordinated efforts and they are confident that in the next few years we will see the first effective treatments.
: 腓骨肌萎缩症(CMT)和相关神经病是最常见的遗传性神经肌肉疾病。尽管如此,目前仍然没有针对任何 CMT 类型的药物治疗方法。然而,目前的治疗方法正在迅速发展,几种新的方法在临床前研究中取得了令人鼓舞的结果,并正在进行临床试验。: 作者回顾了正在研究的最有前途的治疗方法和正在进行/计划进行的临床试验。正在测试几种针对 CMT1A(最常见的亚型)中 PMP22 过表达的方法。在动物模型中,正在尝试基因沉默、靶向 PMP22 和基因治疗,以引入特定基因或替代或调节有缺陷的基因。作用于内质网应激、未折叠蛋白反应、神经调节素途径、磷酸肌醇代谢、轴突运输和退化、炎症、多元醇途径、脱氧鞘脂代谢、嘌呤核苷酸池的化合物是不同形式的 CMT 和相关神经病的潜在治疗候选物。: 我们正在接近为 CMT 找到有效的治疗方法,但与其他遗传性神经肌肉疾病令人兴奋的例子相比还有很大的差距。作者分析了造成这种差距的可能原因以及填补这种差距的方法。正在进行临床前和临床研究,通过协调努力,他们有信心在未来几年内我们将看到第一个有效的治疗方法。