Spinal muscular atrophy is an autosomal recessive neuromuscular disease with incidence of 1 in 5000 to 10000 live births and is produced by homozygous deletion of exons 7 and 8 in the SMN1 gene.The SMN1 and SMN2 genes...Spinal muscular atrophy is an autosomal recessive neuromuscular disease with incidence of 1 in 5000 to 10000 live births and is produced by homozygous deletion of exons 7 and 8 in the SMN1 gene.The SMN1 and SMN2 genes encode the survival motor neuron protein,a crucial protein for the preservation of motor neurons.Use of the newer drug,Nusinersen,from early infancy has shown improvement in clinical outcomes of spinal muscular atrophy patients.展开更多
Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typical...Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typically classified into types 1-3,with types 2 and 3 referred to as later-onset SMA[2].Nusinersen,the first drug approved as a disease-modifying therapy(DMT)for SMA[3],is an antisense oligonucleotide that promotes increased production of the full-length SMN protein by modifying pre-messenger RNA splicing of the SMN2 gene to improve the function of motor neurons and alleviate disease symptoms[4].展开更多
Background This study investigated the efficacy and safety of nusinersen,an antisense oligonucleotide,in patients with spinal muscular atrophy(SMA)types II(OMIM:253,550)or III(OMIM:253,400),including those with severe...Background This study investigated the efficacy and safety of nusinersen,an antisense oligonucleotide,in patients with spinal muscular atrophy(SMA)types II(OMIM:253,550)or III(OMIM:253,400),including those with severe scoliosis or requiring respiratory support via mechanical ventilation.Methods Data from 40 patients with genetically confirmed SMA who were treated with nusinersen at our institute from March 2019 to April 2022 were retrospectively analyzed.Of these,30 patients with an age of onset<3 years and not on permanent ventilation were selected.Clinical and genetic characteristics were investigated,and motor function was evaluated based on the Hammersmith Functional Motor Scale-Expanded(HFMSE)score.Results The mean age of symptom onset was 1.2 years.Most patients were diagnosed with SMA type II(27/30,90%).Nusinersen was administered via computed tomography-guided or direct intrathecal injection in 87%(26/30)and 13%(4/30)of the patients,respectively.At the 6-,14-,22-,and 26-month follow-ups,72%,71%,88%,and 86%of patients showed motor improvement,respectively,with mean changes in HFMSE scores of 2.10,2.88,4.21,and 5.29,respectively.Multivariable analysis showed that the use of noninvasive ventilation was associated with poorer outcomes of motor function.Conclusions Patients with SMA type II or III who received nusinersen treatment showed significant improvement in motor function.A longer treatment duration led to a higher number of patients with improved motor function.No significant side effects of nusinersen were observed.Patients with SMA,even those with severe scoliosis or on respiratory support,can be safely treated using nusinersen.展开更多
Spinal muscular atrophy is a devastating motor neuron disease characterized by severe cases of fatal muscle weakness.It is one of the most common genetic causes of mortality among infants aged less than 2 years.Biomar...Spinal muscular atrophy is a devastating motor neuron disease characterized by severe cases of fatal muscle weakness.It is one of the most common genetic causes of mortality among infants aged less than 2 years.Biomarker research is currently receiving more attention,and new candidate biomarkers are constantly being discovered.This review initially discusses the evaluation methods commonly used in clinical practice while briefly outlining their respective pros and cons.We also describe recent advancements in research and the clinical significance of molecular biomarkers for spinal muscular atrophy,which are classified as either specific or non-specific biomarkers.This review provides new insights into the pathogenesis of spinal muscular atrophy,the mechanism of biomarkers in response to drug-modified therapies,the selection of biomarker candidates,and would promote the development of future research.Furthermore,the successful utilization of biomarkers may facilitate the implementation of gene-targeting treatments for patients with spinal muscular atrophy.展开更多
文摘Spinal muscular atrophy is an autosomal recessive neuromuscular disease with incidence of 1 in 5000 to 10000 live births and is produced by homozygous deletion of exons 7 and 8 in the SMN1 gene.The SMN1 and SMN2 genes encode the survival motor neuron protein,a crucial protein for the preservation of motor neurons.Use of the newer drug,Nusinersen,from early infancy has shown improvement in clinical outcomes of spinal muscular atrophy patients.
基金supported by the National Natural Science Foundation of China(grant number:82271735).
文摘Spinal muscular atrophy(SMA)is a fatal and disabling hereditary disease characterized by progressive motor dysfunction caused by survival motor neuron 1(SMN1)gene deletion or mutation[1].Childhood-onset SMA is typically classified into types 1-3,with types 2 and 3 referred to as later-onset SMA[2].Nusinersen,the first drug approved as a disease-modifying therapy(DMT)for SMA[3],is an antisense oligonucleotide that promotes increased production of the full-length SMN protein by modifying pre-messenger RNA splicing of the SMN2 gene to improve the function of motor neurons and alleviate disease symptoms[4].
文摘Background This study investigated the efficacy and safety of nusinersen,an antisense oligonucleotide,in patients with spinal muscular atrophy(SMA)types II(OMIM:253,550)or III(OMIM:253,400),including those with severe scoliosis or requiring respiratory support via mechanical ventilation.Methods Data from 40 patients with genetically confirmed SMA who were treated with nusinersen at our institute from March 2019 to April 2022 were retrospectively analyzed.Of these,30 patients with an age of onset<3 years and not on permanent ventilation were selected.Clinical and genetic characteristics were investigated,and motor function was evaluated based on the Hammersmith Functional Motor Scale-Expanded(HFMSE)score.Results The mean age of symptom onset was 1.2 years.Most patients were diagnosed with SMA type II(27/30,90%).Nusinersen was administered via computed tomography-guided or direct intrathecal injection in 87%(26/30)and 13%(4/30)of the patients,respectively.At the 6-,14-,22-,and 26-month follow-ups,72%,71%,88%,and 86%of patients showed motor improvement,respectively,with mean changes in HFMSE scores of 2.10,2.88,4.21,and 5.29,respectively.Multivariable analysis showed that the use of noninvasive ventilation was associated with poorer outcomes of motor function.Conclusions Patients with SMA type II or III who received nusinersen treatment showed significant improvement in motor function.A longer treatment duration led to a higher number of patients with improved motor function.No significant side effects of nusinersen were observed.Patients with SMA,even those with severe scoliosis or on respiratory support,can be safely treated using nusinersen.
基金supported by the Collaborative Innovation Center for Clinical and Translational Science by Chinese Ministry of Education&Shanghai,No.CCTS-2022205the“Double World-Class Project”of Shanghai Jiaotong University School of Medicine(both to JZ)。
文摘Spinal muscular atrophy is a devastating motor neuron disease characterized by severe cases of fatal muscle weakness.It is one of the most common genetic causes of mortality among infants aged less than 2 years.Biomarker research is currently receiving more attention,and new candidate biomarkers are constantly being discovered.This review initially discusses the evaluation methods commonly used in clinical practice while briefly outlining their respective pros and cons.We also describe recent advancements in research and the clinical significance of molecular biomarkers for spinal muscular atrophy,which are classified as either specific or non-specific biomarkers.This review provides new insights into the pathogenesis of spinal muscular atrophy,the mechanism of biomarkers in response to drug-modified therapies,the selection of biomarker candidates,and would promote the development of future research.Furthermore,the successful utilization of biomarkers may facilitate the implementation of gene-targeting treatments for patients with spinal muscular atrophy.
