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Molecular approaches for the treatment and prevention of Friedreich's ataxia

Journal

DRUG DISCOVERY TODAY
Volume 27, Issue 3, Pages 866-880

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.drudis.2021.11.003

Keywords

Anti-inflammatory; Antioxidant; Epigenetics; Friedreich's ataxia; Frataxin; Gene therapy

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Friedreich's ataxia is caused by an intronic GAA trinucleotide expansion in the gene, leading to frataxin protein deficiency. Current management focuses on symptomatic relief as there are no treatments to prevent disease progression, highlighting the importance of targeting molecular pathways to alter the course of the condition.
Friedreich's ataxia (FRDA) is caused by an intronic guanine-adenine-adenine (GAA) trinucleotide expansion in the gene encoding the frataxin protein (FXN). This triggers the transcriptional silencing of the fratxin gene (FXN) and subsequent FXN deficiency in affected cells, which accounts for the multisystemic symptoms of this condition. Current management strategies aim for symptomatic relief and no treatments can prevent disease onset or progression. Thus, research efforts have focused on targeting the molecular pathways that silence FXN and downstream pathological processes. However, progression of potential therapies into clinical use has been hindered by inconclusive clinical trials because of the small patient sample size associated with the low prevalence of this condition. Here, we discuss various molecular approaches and explore their therapeutic potential to alter the course of this progressive condition.

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