An update on multiple system atrophy

被引:2
作者
Stankovic, Iva [1 ]
Kuijpers, Mechteld [2 ]
Kaufmann, Horacio [2 ]
机构
[1] Univ Belgrade, Sch Med, Clin Ctr Serbia, Neurol Clin, Belgrade, Serbia
[2] NYU Langone Hlth, Dysauton Ctr, NYU Grossman Sch Med, New York, NY 10016 USA
关键词
biomarkers; disease modifying treatment; early diagnosis; multiple system atrophy; FAS-ASSOCIATED FACTOR-1; ALPHA-SYNUCLEIN; PARKINSONS-DISEASE; C-ABL; SAFETY; TOLERABILITY; ANLE138B; THERAPY; DRUG;
D O I
10.1097/WCO.0000000000001285
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of reviewMultiple system atrophy (MSA) is a rapidly progressive synucleinopathy characterized by autonomic failure, parkinsonism, and cerebellar ataxia. Here, we provide an update on alpha-synuclein's role in MSA pathophysiology and review the new Movement Disorders Society (MDS) diagnostic criteria and the utility of alpha-synuclein-based biomarkers. We also highlight ongoing efforts toward clinical trial readiness and review potential disease-modifying therapies undergoing clinical trials.Recent findingsA role of urinary tract infections in triggering alpha-synuclein aggregation and contribution of genes implicated in oligodendroglial development have been suggested in the MSA pathophysiology. The clinically probable MSA category of the new diagnostic criteria shows improved accuracy in early disease stages. Predictors of phenoconversion from pure autonomic failure to MSA are now better defined. Alpha-synuclein strains in CSF and serum, phosphorylated alpha-synuclein deposits in the skin, and brain alpha-synuclein pathology visualized using PET ligand [18F]ACI-12589 are emerging as valuable diagnostic tools. Clinical trials in MSA investigate drugs targeting alpha-synuclein aggregation or preventing alpha-synuclein expression, along with stem cell and gene therapies to halt disease progression.SummaryNew MSA diagnostic criteria and alpha-synuclein-based biomarkers may enhance diagnostic accuracy while promising therapies are in development to address disease progression.
引用
收藏
页码:400 / 408
页数:9
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