School of Medicine, Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Research II Building 96, 4625 2nd Avenue, Suite 1001B, Davis, Sacramento, CA, 95817, USA.
Stem Cell Program and Gene Therapy Center, Department of Neurology, MIND Institute, University of California, Davis, Sacramento, CA, USA.
Neurotherapeutics. 2021 Jul;18(3):1535-1547. doi: 10.1007/s13311-021-01082-x. Epub 2021 Sep 15.
Angelman syndrome (AS) is a rare (~1:15,000) neurodevelopmental disorder characterized by severe developmental delay and intellectual disability, impaired communication skills, and a high prevalence of seizures, sleep disturbances, ataxia, motor deficits, and microcephaly. AS is caused by loss-of-function of the maternally inherited UBE3A gene. UBE3A is located on chromosome 15q11-13 and is biallelically expressed throughout the body but only maternally expressed in the brain due to an RNA antisense transcript that silences the paternal copy. There is currently no cure for AS, but advancements in small molecule drugs and gene therapies offer a promising approach for the treatment of the disorder. Here, we review AS and how loss-of-function of the maternal UBE3A contributes to the disorder. We also discuss the strengths and limitations of current animal models of AS. Furthermore, we examine potential small molecule drug and gene therapies for the treatment of AS and associated challenges faced by the therapeutic design. Finally, gene therapy offers the opportunity for precision medicine in AS and advancements in the treatment of this disorder can serve as a foundation for other single-gene neurodevelopmental disorders.
安琪曼综合征(AS)是一种罕见的(约 1:15000)神经发育障碍,其特征是严重的发育迟缓、智力残疾、沟通能力受损、癫痫、睡眠障碍、共济失调、运动缺陷和小头症的发病率较高。AS 是由于母源性 UBE3A 基因功能丧失引起的。UBE3A 位于染色体 15q11-13 上,在全身呈双等位基因表达,但由于 RNA 反义转录本使父本拷贝沉默,仅在大脑中呈母源性表达。目前尚无 AS 的治愈方法,但小分子药物和基因治疗的进展为该疾病的治疗提供了有前途的方法。在这里,我们回顾了 AS 以及母源性 UBE3A 的功能丧失如何导致该疾病。我们还讨论了当前 AS 动物模型的优缺点。此外,我们研究了用于治疗 AS 的潜在小分子药物和基因治疗方法,以及治疗设计所面临的挑战。最后,基因治疗为 AS 提供了精准医学的机会,该疾病治疗的进展可以为其他单基因神经发育障碍奠定基础。