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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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Facioscapulohumeral Muscular Dystrophy.

Jeffrey M Statland, Rabi Tawil

    Continuum (Minneapolis, Minn.)
    |December 7, 2016
    PubMed
    Summary
    This summary is machine-generated.

    Facioscapulohumeral muscular dystrophy (FSHD) has two types, FSHD1 and FSHD2, both causing toxic DUX4 protein expression. Research now focuses on drug development and clinical trials for this epigenetic disease.

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    Area of Science:

    • Neurology
    • Genetics
    • Epigenetics

    Background:

    • Facioscapulohumeral muscular dystrophy (FSHD) is a genetically heterogeneous neuromuscular disorder.
    • Understanding its molecular pathogenesis is crucial for developing effective treatments.

    Observation:

    • FSHD involves two distinct genetic types (FSHD1 and FSHD2) that converge on the expression of the toxic DUX4 protein.
    • FSHD1 results from D4Z4 repeat loss on chromosome 4q, leading to DUX4 derepression.
    • FSHD2 arises from a deletion-independent mechanism, also causing DUX4 derepression, often involving SMCHD1 mutations.

    Findings:

    • Both FSHD types require permissive 4q polymorphisms for DUX4 expression due to its lack of a polyadenylation signal.
    • FSHD is an epigenetic disease where severity correlates with D4Z4 units and methylation.
    • FSHD1 exhibits dominant inheritance, while FSHD2 shows digenic inheritance.

    Implications:

    • Recent guidelines provide standards of care for FSHD patients.
    • Identification of therapeutic targets is driving research towards drug development and clinical trial planning for FSHD.