Discovery of therapeutic approaches for polyglutamine diseases: a summary of recent efforts

S Esteves, S Duarte‐Silva… - Medicinal Research …, 2017 - Wiley Online Library
Medicinal Research Reviews, 2017Wiley Online Library
Polyglutamine (PolyQ) diseases are a group of neurodegenerative disorders caused by the
expansion of cytosine–adenine–guanine (CAG) trinucleotide repeats in the coding region of
specific genes. This leads to the production of pathogenic proteins containing critically
expanded tracts of glutamines. Although polyQ diseases are individually rare, the fact that
these nine diseases are irreversibly progressive over 10 to 30 years, severely impairing and
ultimately fatal, usually implicating the full‐time patient support by a caregiver for long time …
Abstract
Polyglutamine (PolyQ) diseases are a group of neurodegenerative disorders caused by the expansion of cytosine–adenine–guanine (CAG) trinucleotide repeats in the coding region of specific genes. This leads to the production of pathogenic proteins containing critically expanded tracts of glutamines. Although polyQ diseases are individually rare, the fact that these nine diseases are irreversibly progressive over 10 to 30 years, severely impairing and ultimately fatal, usually implicating the full‐time patient support by a caregiver for long time periods, makes their economic and social impact quite significant. This has led several researchers worldwide to investigate the pathogenic mechanism(s) and therapeutic strategies for polyQ diseases. Although research in the field has grown notably in the last decades, we are still far from having an effective treatment to offer patients, and the decision of which compounds should be translated to the clinics may be very challenging. In this review, we provide a comprehensive and critical overview of the most recent drug discovery efforts in the field of polyQ diseases, including the most relevant findings emerging from two different types of approaches—hypothesis‐based candidate molecule testing and hypothesis‐free unbiased drug screenings. We hereby summarize and reflect on the preclinical studies as well as all the clinical trials performed to date, aiming to provide a useful framework for increasingly successful future drug discovery and development efforts.
Wiley Online Library