title: Childhood spinal muscular atrophy: controversies and challenges.
abstract: Spinal muscular atrophy is an autosomal recessive disorder characterised by degeneration of motor neurons in the spinal cord and is caused by mutations of the survival of motor neuron 1 gene SMN1. The severity of spinal muscular atrophy is highly variable and no cure is available at present. Consensus has been reached on several aspects of care, the availability of which can have a substantial effect on prognosis, but controversies remain. The development of standards of care for children with the disorder and the identification of promising treatment strategies have changed the natural history of spinal muscular atrophy, and the prospects are good for further improvements in function, quality of life, and survival. A long-term benefit for patients will be the development of effective interventions (such as antisense oligonucleotides), some of which are in clinical trials. The need to be prepared for clinical trials has been the impetus for a remarkable and unprecedented cooperation between clinicians, scientists, industry, government, and volunteer organisations on an international scale.
authors.affiliation: Pediatric Neurology Unit, Catholic University, Rome, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
authors.forename: Enrico
authors.initials: E
authors.lastname: Bertini
authors.forename: Susan T
authors.initials: ST
authors.lastname: Iannaccone
mesh_terms: D002648:Child; D002872:Chromosome Deletion; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D004252:DNA Mutational Analysis; D005091:Exons / Q000235:genetics; D006801:Humans; D033183:Interdisciplinary Communication; D009460:Neurologic Examination; D010348:Patient Care Team; D014897:Spinal Muscular Atrophies of Childhood / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D059039:Standard of Care; D055533:Survival of Motor Neuron 1 Protein / Q000235:genetics
chemical_list: C526471:SMN1 protein, human; D055533:Survival of Motor Neuron 1 Protein