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自闭症谱系障碍中分子信号转导功能障碍的观点及其临床意义和治疗。

A perspective on molecular signalling dysfunction, its clinical relevance and therapeutics in autism spectrum disorder.

机构信息

Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Bengaluru, 560064, India.

Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560 012, India.

出版信息

Exp Brain Res. 2022 Oct;240(10):2525-2567. doi: 10.1007/s00221-022-06448-x. Epub 2022 Sep 5.

Abstract

Intellectual disability (ID) and autism spectrum disorder (ASD) are neurodevelopmental disorders that have become a primary clinical and social concern, with a prevalence of 2-3% in the population. Neuronal function and behaviour undergo significant malleability during the critical period of development that is found to be impaired in ID/ASD. Human genome sequencing studies have revealed many genetic variations associated with ASD/ID that are further verified by many approaches, including many mouse and other models. These models have facilitated the identification of fundamental mechanisms underlying the pathogenesis of ASD/ID, and several studies have proposed converging molecular pathways in ASD/ID. However, linking the mechanisms of the pathogenic genes and their molecular characteristics that lead to ID/ASD has progressed slowly, hampering the development of potential therapeutic strategies. This review discusses the possibility of recognising the common molecular causes for most ASD/ID based on studies from the available models that may enable a better therapeutic strategy to treat ID/ASD. We also reviewed the potential biomarkers to detect ASD/ID at early stages that may aid in diagnosis and initiating medical treatment, the concerns with drug failure in clinical trials, and developing therapeutic strategies that can be applied beyond a particular mutation associated with ASD/ID.

摘要

智力障碍 (ID) 和自闭症谱系障碍 (ASD) 是神经发育障碍,已成为主要的临床和社会关注点,在人群中的患病率为 2-3%。在发育的关键时期,神经元功能和行为会发生显著的可塑性,而在 ID/ASD 中发现这种可塑性受损。人类基因组测序研究揭示了许多与 ASD/ID 相关的遗传变异,并通过许多方法进一步验证,包括许多小鼠和其他模型。这些模型促进了对 ASD/ID 发病机制基础机制的识别,并且有几项研究提出了 ASD/ID 中趋同的分子途径。然而,将致病基因的机制与其导致 ID/ASD 的分子特征联系起来的进展缓慢,阻碍了潜在治疗策略的发展。这篇综述讨论了基于现有模型的研究是否有可能识别大多数 ASD/ID 的常见分子原因,这可能有助于制定治疗 ID/ASD 的更好治疗策略。我们还回顾了在早期检测 ASD/ID 的潜在生物标志物,这可能有助于诊断和开始治疗,以及临床试验中药物失败的关注,以及开发可应用于与 ASD/ID 相关的特定突变之外的治疗策略。

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