van Gool Raquel, Tucker-Bartley Anthony, Yang Edward, Todd Nicholas, Guenther Frank, Goodlett Benjamin, Al-Hertani Walla, Bodamer Olaf A, Upadhyay Jaymin
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Trends Pharmacol Sci. 2022 Jun;43(6):495-509. doi: 10.1016/j.tips.2021.11.005. Epub 2021 Nov 27.
Central nervous system (CNS) abnormalities and corresponding neurological and psychiatric symptoms are frequently observed in lysosomal storage disorders (LSDs). The genetic background of individual LSDs is indeed unique to each illness. However, resulting defective lysosomal function within the CNS can transition normal cellular processes (i.e., autophagy) into aberrant mechanisms, facilitating overlapping downstream consequences including neurocircuitry dysfunction, neurodegeneration as well as sensory, motor, cognitive, and psychological symptoms. Here, the neurological and biobehavioral phenotypes of major classes of LSDs are discussed alongside therapeutic strategies in development that aim to tackle neuropathology among other disease elements. Finally, focused ultrasound blood-brain barrier opening is proposed to enhance therapeutic delivery thereby overcoming the key hurdle of central distribution of disease modifying therapies in LSDs.
溶酶体贮积症(LSDs)中经常观察到中枢神经系统(CNS)异常以及相应的神经和精神症状。每种LSD的遗传背景确实因疾病而异。然而,CNS内由此产生的溶酶体功能缺陷可使正常细胞过程(即自噬)转变为异常机制,从而导致包括神经回路功能障碍、神经退行性变以及感觉、运动、认知和心理症状在内的重叠下游后果。在此,将讨论主要类型LSD的神经和生物行为表型以及正在开发的旨在解决神经病理学和其他疾病因素的治疗策略。最后,提出聚焦超声打开血脑屏障以增强治疗药物递送,从而克服LSDs中疾病修饰疗法中枢分布的关键障碍。