Managing amyotrophic lateral sclerosis: slowing disease progression and improving patient quality of life.
It is now possible to slow the disease progression of amyotrophic lateral sclerosis (ALS), but documented improvement in the quality of life of ALS patients has been difficult to quantitate. Putative mechanisms involved in motor neuron degeneration in ALS include oxidative damage, mitochondrial dysfunction, neuroinflammation, growth factor deficiency, and glutamate excitotoxicity. Several pharmacological agents that target these potential targets have demonstrated therapeutic potential in animal models with mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1). Many treatments that have been moderately effective in this animal model have not been successfully translated into effective treatments for humans with ALS. Only the glutamate modulator riluzole has demonstrated efficacy in clinical trials and is approved for treating ALS. Combination treatments may represent a potential therapeutic strategy to more robustly prolong life and preserve function, but only vitamin E with riluzole has been formally studied in clinical trials, and to date, no combination treatments have been found to be more effective than currently available single agents.
Brooks
Benjamin Rix
BR
University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. benjamin.brooks@carolinashealthcare.org
D000690:Amyotrophic Lateral Sclerosis / Q000235:genetics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D004195:Disease Models, Animal; D018450:Disease Progression; D015316:Genetic Therapy; D006801:Humans; D007114:Immunization / Q000379:methods; D009046:Motor Neurons / Q000473:pathology; D009154:Mutation; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D011788:Quality of Life; D034741:RNA, Small Interfering / Q000235:genetics; D033581:Stem Cell Transplantation; D013482:Superoxide Dismutase / Q000235:genetics; D000072105:Superoxide Dismutase-1
D000893:Anti-Inflammatory Agents; D016376:Oligonucleotides, Antisense; D034741:RNA, Small Interfering; C000606290:SOD1 protein, human; D013482:Superoxide Dismutase; D000072105:Superoxide Dismutase-1