Since advancing age gradually increases stressor load as long as underlying causes are present, strategies targeting cellular stressor pathways should aim at processes that are critical to drive vicious circles of increasing cellular stress and misfolding protein acumulation. Such critically important stressors may be identified through modifier screens in genetic model organisms and patient-derived this website stem cells, as well as through sequencing strategies in selected groups of patients. Potential
targets may include specific regulators of neuronal excitability, and reagents to reduce the accumulation of specific misfolding species, such as chaperon-like molecules or specific antibodies. Key disease-relevant processes
may differ among NDDs, and possibly also among NDD subtypes, suggesting that it may be important to establish and apply sensitive biomarkers of disease subtypes. Should conversion processes indeed be critical to progress from prodromic dysfunction to advancing degeneration, then these would be potentially valuable targets for treatments, as they may prevent, and possibly even reverse conversion to disease. Candidate targets may involve local interactions within the neuronal environment in the CNS, e.g., inflammatory processes and/or vascular lesions. Finally, at least in sporadic forms of the diseases, effective treatments may target disease spreading, Ribociclib in vitro thereby restricting degeneration to CNS regions initially affected by disease. Again, potential targets include vascular integrity, inflammation, and the immune Rebamipide system, and interventions aimed at reducing extracellular misfolding protein levels, e.g., through specific antibodies. An evaluation of the potential value of such treatment strategies in well characterized animal models of NDDs should at the same time represent a valuable strategy to test and revise postulated causality relations in
these diseases, which, in turn, should lead to further improvement of candidate treatment strategies. It seems reasonable to hope that such an iterative testing process in improved disease models will provide a rational path to develop treatments that will at last show efficacy in the clinics. We thank Mathias Jucker (Hertie-Institut für klinische Hirnforschung, Tübingen, Germany), Patrick Brundin (Wallenberg Institute, Lund Univ., Sweden), and Chris Henderson (Motor Neuron Center, Columbia University, New York, USA) for valuable comments on the manuscript. The Friedrich Miescher Institut is part of the Novartis Research Foundation. “
“Converging evidence from neuroimaging studies indicates that the ventral visual pathway is important for object recognition (Grill-Spector et al., 1999 and Malach et al., 1995).
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