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2014 ; 11
(4
): 786-95
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Spinal muscular atrophy: journeying from bench to bedside
#MMPMID24990202
Awano T
; Kim JK
; Monani UR
Neurotherapeutics
2014[Oct]; 11
(4
): 786-95
PMID24990202
show ga
Spinal muscular atrophy (SMA) is a frequently fatal neuromuscular disorder and
the most common inherited cause of infant mortality. SMA results from reduced
levels of the survival of motor neuron (SMN) protein. Although the disease was
first described more than a century ago, a precise understanding of its genetics
was not obtained until the SMA genes were cloned in 1995. This was followed in
rapid succession by experiments that assigned a role to the SMN protein in the
proper splicing of genes, novel animal models of the disease, and the eventual
use of the models in the pre clinical development of rational therapies for SMA.
These successes have led the scientific and clinical communities to the cusp of
what are expected to be the first truly promising treatments for the human
disorder. Yet, important questions remain, not the least of which is how SMN
paucity triggers a predominantly neuromuscular phenotype. Here we review how our
understanding of the disease has evolved since the SMA genes were identified. We
begin with a brief description of the genetics of SMA and the proposed roles of
the SMN protein. We follow with an examination of how the genetics of the disease
was exploited to develop genetically faithful animal models, and highlight the
insights gained from their analysis. We end with a discussion of ongoing debates,
future challenges, and the most promising treatments to have emerged from our
current knowledge of the disease.