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CDKL5 Deficiency Disorder: Some Lessons Learned 20 Years After the First Description
Elia M Pestana Knight1, Heather E Olson2
1Elia M. Pestana Knight, Cleveland Clinic Epilepsy Center.
Abstract:
Loss of function variants in the Cyclin-dependent kinase-like 5 gene (CDKL5) causes CDKL5 deficiency disorder (CDD). Most cases of CDD are due to a de novo missense or truncating variants. The CDKL5 gene was discovered in 1998 as part of the genomic mapping of the chromosome Xp22 region that led to the discovery of the serine-threonine kinases STK9. Since then, there have been significant advancements in the description of the disease in humans, the understanding of the pathophysiology, and the management of the disease. There have been many lessons learned since the initial description of the condition in humans in 2003. In this article, we will focus on pathophysiology, clinical manifestations, with particular focus on seizures because of its relevance to the medical practitioners and researchers and guidelines for management. We finalize the manuscript with the voice of the parents and caregivers, as discussed with the 2019 meeting with the Food and Drug Administration.
Insights
Cyclin-dependent kinase-like 5 gene (CDKL5) variants cause CDKL5 deficiency disorder (CDD), a condition with significant advancements in understanding its pathophysiology and management since its 2003 description.
Area of Science:
- Genetics and Molecular Biology
- Neuroscience
- Developmental Biology
Background:
- CDKL5 deficiency disorder (CDD) is caused by loss-of-function variants in the CDKL5 gene.
- Most CDD cases result from de novo missense or truncating variants.
- The CDKL5 gene was identified in 1998 during genomic mapping of the Xp22 region.
Purpose of the Study:
- To provide a comprehensive overview of CDKL5 deficiency disorder.
- To focus on the pathophysiology and clinical manifestations, particularly seizures.
- To outline current management guidelines and incorporate caregiver perspectives.
Main Methods:
- Review of existing literature on CDKL5 deficiency disorder.
- Analysis of clinical data and reported disease progression.
- Synthesis of information from scientific meetings and regulatory discussions.
Main Results:
- Significant progress has been made in understanding CDD pathophysiology since its initial human description in 2003.
- Seizures are a key clinical manifestation requiring focused attention.
- Established guidelines exist for disease management.
Conclusions:
- CDKL5 deficiency disorder requires a multidisciplinary approach to management.
- Continued research is vital for improving patient outcomes.
- Incorporating patient and caregiver experiences is crucial for comprehensive care.
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