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Why is ALS so Difficult to Treat?

机译:为什么ALS很难治疗?

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摘要

Amyotrophic lateral sclerosis (ALS) is proving intractable. Difficulties in pre-clinical studies contribute in small measure to this futility, but the chief reason for failure is an inadequate understanding of disease pathogenesis. Many acquired and inherited processes have been advanced as potential causes of ALS but, while they may predispose to disease, it seems increasingly likely that none leads directly to ALS. Rather, two recent overlapping considerations, both involving aberrant protein homeostasis, may provide a better explanation for a common disease phenotype and a common terminal pathogenesis. If so, therapeutic approaches will need to be altered and carefully nuanced, since protein homeostasis is essential and highly conserved. Nonetheless, these considerations provide new optimism in a difficult disease which has hitherto defied treatment.
机译:肌萎缩性侧索硬化症(ALS)证明是难治的。临床前研究的困难在某种程度上造成了这种徒劳,但失败的主要原因是对疾病发病机理的了解不足。许多获得性和遗传性过程已被认为是导致ALS的潜在原因,但是尽管它们可能易患疾病,但似乎越来越有可能没有一种直接导致ALS。相反,最近两个相互重叠的考虑都涉及异常的蛋白质稳态,这可能为常见的疾病表型和常见的终末发病机制提供更好的解释。如果是这样,由于蛋白质稳态是必不可少且高度保守的,因此治疗方法将需要改变并仔细细化。尽管如此,这些考虑为迄今已无视治疗的困难疾病提供了新的乐观态度。

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