Barbeau A
Can J Neurol Sci. 1984 Nov;11(4 Suppl):646-60. doi: 10.1017/s0317167100035228.
In this paper the author reviews the progress accomplished in the understanding of Friedreich's disease since the start of the "Quebec Cooperative Study of Friedreich's Ataxia" in 1974. The last ten years have indeed seen important strides taken in the definition and nosography of the hereditary ataxias and the characterization of a number of new entities. Biochemically, the principal leads uncovered during the initial prospective survey, have been pursued to great detail. Unfortunately no clear-cut constant and severe enzyme block in the principal metabolic pathways has yet been identified, despite intensive studies. It is postulated that the defect may instead be a regulatory one and involve a decreased availability or utilization of one of the vitamin cofactors that are known experimentally, or clinically, to produce central nervous system damage with ataxia: Vitamin E, Biotin or Pantothenic Acid. Studies in that direction and in molecular genetics to localize the Friedreich's disease gene are being undertaken for the next phase of the Cooperative Study.
在本文中,作者回顾了自1974年“魁北克弗里德赖希共济失调合作研究”启动以来,在对弗里德赖希共济失调的认识方面所取得的进展。在过去十年里,遗传性共济失调的定义、疾病分类学以及一些新病种的特征描述确实取得了重大进展。从生化角度来看,在最初的前瞻性调查中发现的主要线索已经得到了深入研究。遗憾的是,尽管进行了深入研究,但在主要代谢途径中尚未明确鉴定出明确、持续且严重的酶阻断现象。据推测,缺陷可能反而在于调节方面,涉及已知在实验或临床上会导致中枢神经系统损伤并伴有共济失调的一种维生素辅助因子的可用性或利用率降低:维生素E、生物素或泛酸。在下一阶段的合作研究中,正在朝着这个方向以及在分子遗传学方面开展研究,以定位弗里德赖希共济失调基因。