The cause(s) of amyotrophic lateral sclerosis (ALS) is not fully understood in the vast majority of cases and the mechanisms involved in motor neuron degeneration are multi-factorial and complex. There is substantial evidence to support the hypothesis that oxidative stress is one mechanism by which motor neuron death occurs. This theory becomes more persuasive with the discovery that mutation of the anti-oxidant enzyme, superoxide dismutase 1 (SOD1), causes disease in a significant minority of cases. However, the precise mechanism(s) by which mutant SOD1 leads to motor neuron degeneration have not been defined with certainty, and trials of anti-oxidant therapies have been disappointing. Here, we review the evidence implicating oxidative stress in ALS pathogenesis, discuss how oxidative stress may affect and be affected by other proposed mechanisms of neurodegeneration, and review the trials of various anti-oxidants as potential therapies for ALS.
The development of therapeutics for ALS/MND is largely based on work in experimental animals carrying human SOD mutations. However, translation of apparent therapeutic successes from in vivo to the human disease has proven difficult and a considerable amount of financial resources has been apparently wasted. Standard operating procedures (SOPs) for preclinical animal research in ALS/MND are urgently required. Such SOPs will help to establish SOPs for translational research for other neurological diseases within the next few years. To identify the challenges and to improve the research methodology, the European ALS/MND group held a meeting in 2006 and published guidelines in 2007 (1). A second international conference to improve the guidelines was held in 2009. These second and improved guidelines are dedicated to the memory of Sean F. Scott.
Amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD)
constitutes a devastating disease spectrum characterised by TDP-43 pathology.
Understanding how TDP-43 contributes to neurodegeneration will help direct
therapeutic efforts. Here, we have created a novel TDP-43 knock-in mouse with a
human-equivalent mutation in the endogenous mouse Tardbp gene.
TDP-43Q331K mice demonstrate cognitive dysfunction and a paucity
of parvalbumin interneurons. Critically, TDP-43 autoregulation is perturbed
leading to a gain of TDP-43 function, and altered splicing of
Mapt, another pivotal dementia gene. Furthermore, a novel
approach to stratify transcriptomic data by phenotype in differentially affected
mutant mice reveals 471 changes linked with improved behaviour. These changes
include downregulation of two known modifiers of neurodegeneration,
Atxn2 and Arid4a, and upregulation of
myelination and translation genes. With one base change in murine
Tardbp, this study identifies TDP-43 misregulation as a
pathogenic mechanism that may underpin ALS-FTD, and exploits phenotypic
heterogeneity to yield candidate suppressors of neurodegenerative disease.
Spinal muscular atrophy is one of the most common genetic causes of death in childhood, and there is currently no effective treatment. The disease is caused by mutations in the survival motor neuron gene. Gene therapy aimed at restoring the protein encoded by this gene is a rational therapeutic approach to ameliorate the disease phenotype. We previously reported that intramuscular delivery of a lentiviral vector expressing survival motor neuron increased the life expectancy of transgenic mice with spinal muscular atrophy. The marginal efficacy of this therapeutic approach, however, prompted us to explore different strategies for gene therapy delivery to motor neurons to achieve a more clinically relevant effect. Here, we report that a single injection of self-complementary adeno-associated virus serotype 9 expressing green fluorescent protein or of a codon-optimized version of the survival motor neuron protein into the facial vein 1 day after birth in mice carrying a defective survival motor neuron gene led to widespread gene transfer. Furthermore, this gene therapy resulted in a substantial extension of life span in these animals. These data demonstrate a significant increase in survival in a mouse model of spinal muscular atrophy and provide evidence for effective therapy.
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