New Targeted Treatments for Fragile X Syndrome

Curr Pediatr Rev. 2019;15(4):251-258. doi: 10.2174/1573396315666190625110748.

Abstract

Fragile X Syndrome (FXS) is the most common cause of inherited intellectual disability with prevalence rates estimated to be 1:5,000 in males and 1:8,000 in females. The increase of >200 Cytosine Guanine Guanine (CGG) repeats in the 5' untranslated region of the Fragile X Mental Retardation 1 (FMR1) gene results in transcriptional silencing on the FMR1 gene with a subsequent reduction or absence of fragile X mental retardation protein (FMRP), an RNA binding protein involved in the maturation and elimination of synapses. In addition to intellectual disability, common features of FXS are behavioral problems, autism, language deficits and atypical physical features. There are still no currently approved curative therapies for FXS, and clinical management continues to focus on symptomatic treatment of comorbid behaviors and psychiatric problems. Here we discuss several treatments that target the neurobiological pathway abnormal in FXS. These medications are clinically available at present and the data suggest that these medications can be helpful for those with FXS.

Keywords: Fragile X syndrome; acamprosate; cannabidiol; lovastatin; metformin; minocycline; sertraline; targeted treatment..

Publication types

  • Review

MeSH terms

  • Animals
  • Cellular Reprogramming / genetics
  • Child
  • DNA Methylation
  • Disease Models, Animal
  • Epigenesis, Genetic
  • Fragile X Mental Retardation Protein
  • Fragile X Syndrome / drug therapy*
  • Fragile X Syndrome / genetics
  • Fragile X Syndrome / physiopathology
  • GABA Agonists / pharmacology*
  • Gene Expression Regulation / drug effects*
  • Gene Silencing / drug effects*
  • Humans
  • Molecular Targeted Therapy* / trends
  • Serotonin Uptake Inhibitors / pharmacology*
  • Signal Transduction
  • Treatment Outcome

Substances

  • FMR1 protein, human
  • GABA Agonists
  • Serotonin Uptake Inhibitors
  • Fragile X Mental Retardation Protein