Progress in gene therapy for neurological disorders

Diseases of the nervous system have devastating effects and are widely distributed among the population, being especially prevalent in the elderly. These diseases are often caused by inherited genetic mutations that result in abnormal nervous system development, neurodegeneration, or impaired neuronal function. Other causes of neurological diseases include genetic and epigenetic changes induced by environmental insults, injury, disease-related events or inflammatory processes. Standard medical and surgical practice has not proved effective in curing or treating these diseases, and appropriate pharmaceuticals do not exist or are insufficient to slow disease progression. Gene therapy is emerging as a powerful approach with potential to treat and even cure some of the most common diseases of the nervous system. Gene therapy for neurological diseases has been made possible through progress in understanding the underlying disease mechanisms, particularly those involving sensory neurons, and also by improvement of gene vector design, therapeutic gene selection, and methods of delivery. Progress in the field has renewed our optimism for gene therapy as a treatment modality that can be used by neurologists, ophthalmologists and neurosurgeons. In this Review, we describe the promising gene therapy strategies that have the potential to treat patients with neurological diseases and discuss prospects for future development of gene therapy

The S cell: an interneuron essential for sensitization and full dishabituation of leech shortening

Sensory neurons in the leech excite the S interneuron, which in turn excites motoneurons that shorten the leech, although activity in the S cell reportedly cannot by itself shorten the animal. Experiments were performed in semi-intact leeches using established dishabituation and sensitization protocols. S-cell activity increased during reflexive shortening once the animal was sensitized or dishabituated with a strong shock. S-cell activity otherwise was not associated with shortening. To test the role of the S-cell in dishabituation and sensitization of the shortening reflex, single S cells were ablated in vivo by intracellular injections of pronase. S-cell lesions reduced but did not eliminate dishabituation; however, sensitization was completely disrupted. This was consistent with recent evidence that separate processes contribute to dishabituation and sensitization. Since the S cell in each ganglion is a link in a rapidly conducting chain along the length of the animal, it may be sufficient to break the chain at a single point to eliminate sensitization