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Pioglitazone halts axonal degeneration in a mouse model of X-linked adrenoleukodystrophy.
[adrenomyeloneuropathy]
X-
linked
adrenoleukodystrophy
is
a
neurometabolic
disorder
caused
by
inactivation
of
the
peroxisomal
ABCD
1
transporter
of
very
long
-chain
fatty
acids
.
In
mice
,
ABCD
1
loss
causes
late
onset
axonal
degeneration
in
the
spinal
cord
in
association
with
locomotor
disability
resembling
the
most
common
phenotype
in
patients
,
adrenomyeloneuropathy
.
Increasing
evidence
indicates
that
oxidative
stress
and
bioenergetic
failure
play
major
roles
in
the
pathogenesis
of
X-
linked
adrenoleukodystrophy
.
In
this
study
,
we
aimed
to
evaluate
whether
mitochondrial
biogenesis
is
affected
in
X-
linked
adrenoleukodystrophy
.
We
demonstrated
that
Abcd
1
null
mice
show
reduced
mitochondrial
DNA
concomitant
with
downregulation
of
mitochondrial
biogenesis
pathway
driven
by
PGC
-
1
α
/
PPAR
γ
and
reduced
expression
of
mitochondrial
proteins
cytochrome
c
,
NDUFB
8
and
VDAC
.
Moreover
,
we
show
that
the
oral
administration
of
pioglitazone
,
an
agonist
of
PPAR
γ
,
restored
mitochondrial
content
and
expression
of
master
regulators
of
biogenesis
,
neutralized
oxidative
damage
to
proteins
and
DNA
,
and
reversed
bioenergetic
failure
in
terms
of
ATP
levels
,
NAD
+
/
NADH
ratios
,
pyruvate
kinase
and
glutathione
reductase
activities
.
Most
importantly
,
the
treatment
halted
locomotor
disability
and
axonal
damage
in
X-
linked
adrenoleukodystrophy
mice
.
These
results
lend
support
to
the
use
of
pioglitazone
in
clinical
trials
with
patients
with
adrenomyeloneuropathy
and
reveal
novel
molecular
mechanisms
of
action
of
pioglitazone
in
neurodegeneration
.
Future
studies
should
address
the
effects
of
this
anti-diabetic
drug
on
other
axonopathies
in
which
oxidative
stress
and
mitochondrial
dysfunction
are
contributing
factors
.
Diseases
Validation
Diseases presenting
"adrenomyeloneuropathy"
symptom
adrenomyeloneuropathy
x-linked adrenoleukodystrophy
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