Vissing John
Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Curr Opin Neurol. 2016 Oct;29(5):635-41. doi: 10.1097/WCO.0000000000000375.
The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions.
Close to half of all LGMD subtypes have been discovered within the last 6 years of the 21-year-period in which the current classification system for LGMD has existed. The number of letters for annotation of new recessive LGMD conditions is exhausted, and multiple already classified LGMDs do not strictly fulfill diagnostic criteria for LGMD or are registered in other classification systems for muscle disease. On the contrary, diseases that fulfill classical criteria for LGMD have found no place in the LGMD classification system. These shortcomings call for revision/creation of a new classification system for LGMD. The rapidly expanding gene sequencing capabilities have helped to speed up new LGMD discoveries, and unveiled pheno-/genotype relations. Parallel to this progress in identifying new LGMD subtypes, emerging therapies for LGMDs are under way, but no disease-specific treatment is yet available for nonexperimental use.
The field of LGMD is rapidly developing from a diagnostic and therapeutic viewpoint, but a uniform and universally agreed classification system for LGMDs is needed.
本研究旨在描述肢带型肌营养不良症(LGMDs)的临床谱、当前LGMD分类系统存在的缺陷以及针对这些病症的新兴疗法。
在LGMD现行分类系统存在的21年期间,近一半的LGMD亚型是在过去6年中发现的。用于标注新的隐性LGMD病症的字母已用尽,而且多个已分类的LGMD并不严格符合LGMD的诊断标准,或被登记在其他肌肉疾病分类系统中。相反,符合LGMD经典标准的疾病在LGMD分类系统中却没有位置。这些缺陷要求对LGMD的分类系统进行修订/创建新的分类系统。快速扩展的基因测序能力有助于加快新LGMD的发现,并揭示表型/基因型关系。在确定新的LGMD亚型取得这一进展的同时,针对LGMD的新兴疗法正在进行中,但尚无针对非实验用途的疾病特异性治疗方法。
从诊断和治疗角度来看,LGMD领域正在迅速发展,但需要一个统一且得到普遍认可的LGMD分类系统。