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Spinal Muscular Atrophy: Journeying From Bench to Bedside

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  • Published:
Neurotherapeutics

Abstract

Spinal muscular atrophy (SMA) is a frequently fatal neuromuscular disorder and the most common inherited cause of infant mortality. SMA results from reduced levels of the survival of motor neuron (SMN) protein. Although the disease was first described more than a century ago, a precise understanding of its genetics was not obtained until the SMA genes were cloned in 1995. This was followed in rapid succession by experiments that assigned a role to the SMN protein in the proper splicing of genes, novel animal models of the disease, and the eventual use of the models in the pre clinical development of rational therapies for SMA. These successes have led the scientific and clinical communities to the cusp of what are expected to be the first truly promising treatments for the human disorder. Yet, important questions remain, not the least of which is how SMN paucity triggers a predominantly neuromuscular phenotype. Here we review how our understanding of the disease has evolved since the SMA genes were identified. We begin with a brief description of the genetics of SMA and the proposed roles of the SMN protein. We follow with an examination of how the genetics of the disease was exploited to develop genetically faithful animal models, and highlight the insights gained from their analysis. We end with a discussion of ongoing debates, future challenges, and the most promising treatments to have emerged from our current knowledge of the disease.

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Acknowledgments

We are grateful to Drs. S. Kariya and R. Finkel for the data presented in Fig. 1. We apologize to those of our colleagues whose original work could not be directly cited in the review. Research on SMA in the Monani laboratory is supported by MDA-USA, SMA-Europe, the Motor Neuron Center, Columbia University, Department of Defense (W81XWH-11-1-0753), and National Institutes of Health R01NS057482.

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  1. Department of Pathology and Cell Biology, Columbia University Medical Center, 630 W. 168th St., New York, NY, 10032, USA

    Tomoyuki Awano, Jeong-Ki Kim & Umrao R. Monani

  2. Center for Motor Neuron Biology and Disease, Columbia University Medical Center, 630 W. 168th St., New York, NY, 10032, USA

    Tomoyuki Awano, Jeong-Ki Kim & Umrao R. Monani

  3. Department of Neurology, Columbia University Medical Center, 630 W. 168th St., New York, NY, 10032, USA

    Umrao R. Monani

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  1. Tomoyuki Awano
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Awano, T., Kim, JK. & Monani, U.R. Spinal Muscular Atrophy: Journeying From Bench to Bedside. Neurotherapeutics 11, 786–795 (2014). https://doi.org/10.1007/s13311-014-0293-y

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  • DOI: https://doi.org/10.1007/s13311-014-0293-y

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