脆性X综合征的神经发育与早期药物干预
Neurodevelopment and early pharmacological interventions in Fragile X Syndrome.
作者信息
Milla Luis A, Corral Lucia, Rivera Jhanpool, Zuñiga Nolberto, Pino Gabriela, Nunez-Parra Alexia, Cea-Del Rio Christian A
机构信息
Centro de Investigacion Biomedica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Medicas, Universidad de Santiago de Chile, Santiago, Chile.
Laboratorio de Neurofisiopatologia, Centro de Investigacion Biomedica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Medicas, Universidad de Santiago de Chile, Santiago, Chile.
出版信息
Front Neurosci. 2023 Aug 2;17:1213410. doi: 10.3389/fnins.2023.1213410. eCollection 2023.
Fragile X Syndrome (FXS) is a neurodevelopmental disorder and the leading monogenic cause of autism and intellectual disability. For years, several efforts have been made to develop an effective therapeutic approach to phenotypically rescue patients from the disorder, with some even advancing to late phases of clinical trials. Unfortunately, none of these attempts have completely succeeded, bringing urgency to further expand and refocus research on FXS therapeutics. FXS arises at early stages of postnatal development due to the mutation and transcriptional silencing of the Fragile X Messenger Ribonucleoprotein 1 gene () and consequent loss of the Fragile X Messenger Ribonucleoprotein (FMRP) expression. Importantly, FMRP expression is critical for the normal adult nervous system function, particularly during specific windows of embryogenic and early postnatal development. Cellular proliferation, migration, morphology, axonal guidance, synapse formation, and in general, neuronal network establishment and maturation are abnormally regulated in FXS, underlying the cognitive and behavioral phenotypes of the disorder. In this review, we highlight the relevance of therapeutically intervening during critical time points of development, such as early postnatal periods in infants and young children and discuss past and current clinical trials in FXS and their potential to specifically target those periods. We also discuss potential benefits, limitations, and disadvantages of these pharmacological tools based on preclinical and clinical research.
脆性X综合征(FXS)是一种神经发育障碍,是自闭症和智力残疾的主要单基因病因。多年来,人们为开发一种有效的治疗方法以从表型上拯救患者摆脱该疾病做出了多项努力,其中一些甚至进入了临床试验后期。不幸的是,这些尝试均未完全成功,这使得进一步扩大和重新聚焦脆性X综合征治疗研究变得紧迫。脆性X综合征在出生后发育的早期阶段出现,原因是脆性X信使核糖核蛋白1基因()发生突变和转录沉默,随后脆性X信使核糖核蛋白(FMRP)表达丧失。重要的是,FMRP表达对于正常成人神经系统功能至关重要,尤其是在胚胎发生和出生后早期发育的特定窗口期。在脆性X综合征中,细胞增殖、迁移、形态、轴突导向、突触形成,以及一般而言的神经网络建立和成熟均受到异常调节,这是该疾病认知和行为表型的基础。在这篇综述中,我们强调了在发育的关键时间点(如婴幼儿出生后早期)进行治疗干预的相关性,并讨论了过去和当前针对脆性X综合征的临床试验及其针对这些时期的特异性靶向潜力。我们还根据临床前和临床研究讨论了这些药理学工具的潜在益处、局限性和缺点。