Assuntos
Doenças Autoimunes do Sistema Nervoso/tratamento farmacológico , Azetidinas/uso terapêutico , Inibidores de Janus Quinases/uso terapêutico , Malformações do Sistema Nervoso/tratamento farmacológico , Sulfonamidas/uso terapêutico , Adolescente , Idade de Início , Azetidinas/efeitos adversos , Biomarcadores , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Pré-Escolar , Relação Dose-Resposta a Droga , Feminino , Expressão Gênica/efeitos dos fármacos , Humanos , Lactente , Interferons/genética , Interferons/metabolismo , Inibidores de Janus Quinases/efeitos adversos , Análise dos Mínimos Quadrados , Masculino , Purinas , Pirazóis , Sulfonamidas/efeitos adversos , Adulto JovemRESUMO
Aicardi-Goutières syndrome (AGS) is an early-onset, autoimmune and genetically heterogeneous disorder with severe neurologic injury. Molecular studies have established that autosomal recessive mutations in one of the following genes are causative: TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR1 and IFIH1/MDA5. The phenotypic presentation and pathophysiology of AGS is associated with over-production of the cytokine Interferon-alpha (IFN-α) and its downstream signaling, characterized as type I interferonopathy. Astrocytes are one of the major source of IFN in the central nervous system (CNS) and it is proposed that they could be key players in AGS pathology. Astrocytes are the most ubiquitous glial cell in the CNS and perform a number of crucial and complex functions ranging from formation of blood-brain barrier, maintaining ionic homeostasis, metabolic support to synapse formation and elimination in healthy CNS. Involvement of astrocytic dysfunction in neurological diseases-Alexander's disease, Epilepsy, Alzheimer's and amyotrophic lateral sclerosis (ALS)-has been well-established. It is now known that compromised astrocytic function can contribute to CNS abnormalities and severe neurodegeneration, nevertheless, its contribution in AGS is unclear. The current review discusses known molecular and cellular pathways for AGS mutations and how it stimulates IFN-α signaling. We shed light on how astrocytes might be key players in the phenotypic presentations of AGS and emphasize the cell-autonomous and non-cell-autonomous role of astrocytes. Understanding the contribution of astrocytes will help reveal mechanisms underlying interferonopathy and develop targeted astrocyte specific therapeutic treatments in AGS.