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Spinal Muscular Atrophy: From Approved Therapies to Future Therapeutic Targets for Personalized Medicine

Overview
Journal Cell Rep Med
Publisher Cell Press
Date 2021 Aug 2
PMID 34337562
Citations 56
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Abstract

Spinal muscular atrophy (SMA) is a devastating childhood motor neuron disease that, in the most severe cases and when left untreated, leads to death within the first two years of life. Recent therapeutic advances have given hope to families and patients by compensating for the deficiency in survival motor neuron (SMN) protein via gene therapy or other genetic manipulation. However, it is now apparent that none of these therapies will cure SMA alone. In this review, we discuss the three currently licensed therapies for SMA, briefly highlighting their respective advantages and disadvantages, before considering alternative approaches to increasing SMN protein levels. We then explore recent preclinical research that is identifying and targeting dysregulated pathways secondary to, or independent of, SMN deficiency that may provide adjunctive opportunities for SMA. These additional therapies are likely to be key for the development of treatments that are effective across the lifespan of SMA patients.

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References
1.
Chand D, Mohr F, McMillan H, Tukov F, Montgomery K, Kleyn A . Hepatotoxicity following administration of onasemnogene abeparvovec (AVXS-101) for the treatment of spinal muscular atrophy. J Hepatol. 2020; 74(3):560-566. DOI: 10.1016/j.jhep.2020.11.001. View

2.
Boyd P, Tu W, Shorrock H, Groen E, Carter R, Powis R . Bioenergetic status modulates motor neuron vulnerability and pathogenesis in a zebrafish model of spinal muscular atrophy. PLoS Genet. 2017; 13(4):e1006744. PMC: 5417717. DOI: 10.1371/journal.pgen.1006744. View

3.
Brichta L, Hofmann Y, Hahnen E, Siebzehnrubl F, Raschke H, Blumcke I . Valproic acid increases the SMN2 protein level: a well-known drug as a potential therapy for spinal muscular atrophy. Hum Mol Genet. 2003; 12(19):2481-9. DOI: 10.1093/hmg/ddg256. View

4.
Maggi L, Bello L, Bonanno S, Govoni A, Caponnetto C, Passamano L . Nusinersen safety and effects on motor function in adult spinal muscular atrophy type 2 and 3. J Neurol Neurosurg Psychiatry. 2020; 91(11):1166-1174. DOI: 10.1136/jnnp-2020-323822. View

5.
Foust K, Nurre E, Montgomery C, Hernandez A, Chan C, Kaspar B . Intravascular AAV9 preferentially targets neonatal neurons and adult astrocytes. Nat Biotechnol. 2008; 27(1):59-65. PMC: 2895694. DOI: 10.1038/nbt.1515. View