4.6 Review

Fragile X Syndrome: Lessons Learned and What New Treatment Avenues Are on the Horizon

Journal

ANNUAL REVIEW OF PHARMACOLOGY AND TOXICOLOGY
Volume 62, Issue -, Pages 365-381

Publisher

ANNUAL REVIEWS
DOI: 10.1146/annurev-pharmtox-052120-090147

Keywords

FMR1; autism; FXAND; FMRP; CGG repeat

Funding

  1. Azrieli Foundation
  2. MIND Institute IDDRC - National Institute of Child Health and Human Development [P50 HD103526]

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Fragile X syndrome is a common form of inherited intellectual disability and autism spectrum disorder, caused by large expansions of noncoding CGG repeats in the FMR1 gene. While there is currently no direct way to reverse the loss of FMRP, there is potential for effective treatments targeting dysregulated pathways in the near future.
Fragile X syndrome (FXS) is the most common form of inherited intellectual disability and the leading single-gene form of autism spectrum disorder, encompassing cognitive, behavioral, and physical forms of clinical involvement. FXS is caused by large expansions of a noncoding CGG repeat (>200 repeats) in the FMR1 gene, at which point the gene is generally silenced. Absence of FMR1 protein (FMRP), important for synaptic development and maintenance, gives rise to the neurodevelopmental disorder. There is, at present, no therapeutic approach that directly reverses the loss of FMRP; however, there is an increasing number of potential treatments that target the pathways dysregulated in FXS, including those that address the enhanced activity of the mGluR5 pathway and deficits in GABA pathways. Based on studies of targeted therapeutics to date, the prospects are good for one or more effective therapies for FXS in the near future.

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