Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Institute for Experimental Neurology, Inspe, Milan, Italy.
Neurology Department, San Raffaele Scientific Institute, Milan, Italy.
Cell Mol Life Sci. 2024 Apr 28;81(1):198. doi: 10.1007/s00018-024-05229-9.
Neuromuscular diseases encompass a heterogeneous array of disorders characterized by varying onset ages, clinical presentations, severity, and progression. While these conditions can stem from acquired or inherited causes, this review specifically focuses on disorders arising from genetic abnormalities, excluding metabolic conditions. The pathogenic defect may primarily affect the anterior horn cells, the axonal or myelin component of peripheral nerves, the neuromuscular junction, or skeletal and/or cardiac muscles. While inherited neuromuscular disorders have been historically deemed not treatable, the advent of gene-based and molecular therapies is reshaping the treatment landscape for this group of condition. With the caveat that many products still fail to translate the positive results obtained in pre-clinical models to humans, both the technological development (e.g., implementation of tissue-specific vectors) as well as advances on the knowledge of pathogenetic mechanisms form a collective foundation for potentially curative approaches to these debilitating conditions. This review delineates the current panorama of therapies targeting the most prevalent forms of inherited neuromuscular diseases, emphasizing approved treatments and those already undergoing human testing, offering insights into the state-of-the-art interventions.
神经肌肉疾病包括一系列异质性疾病,其特征为不同的发病年龄、临床表现、严重程度和进展速度。尽管这些疾病可能源于获得性或遗传性原因,但本篇综述特别关注源于遗传异常的疾病,不包括代谢疾病。致病缺陷可能主要影响前角细胞、周围神经的轴突或髓鞘成分、神经肌肉接头或骨骼和/或心肌。虽然神经肌肉遗传性疾病在历史上被认为无法治疗,但基于基因和分子的治疗方法的出现正在改变这一组疾病的治疗前景。需要注意的是,许多产品仍然未能将临床前模型中获得的积极结果转化为人类,技术的发展(例如,组织特异性载体的应用)以及对致病机制的认识的进步为这些使人衰弱的疾病提供了潜在的治愈方法的集体基础。本篇综述阐述了针对最常见的遗传性神经肌肉疾病的治疗方法的现状,强调了已批准的治疗方法和正在进行人体测试的方法,为最新干预措施提供了深入了解。
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