Hutchinson-Gilford progeria syndrome: unraveling the genetic basis, symptoms, and advancements in therapeutic approaches

Ther Adv Rare Dis. 2024 Dec 16:5:26330040241305144. doi: 10.1177/26330040241305144. eCollection 2024 Jan-Dec.

Abstract

Hutchinson-Gilford Progeria syndrome (HGPS) serves as a prominent model for Progeroid syndromes, a group of rare genetic disorders characterized by accelerated aging. This review explores the genetic basis, clinical presentation, and complications of HGPS. HGPS is caused by mutations in the LMNA gene, resulting in the production of a defective structural protein, prelamin A. This protein contains a "CAAX" motif, where C represents cysteine, and its abnormal processing is central to the disease's pathology. HGPS leads to multiple organ systems being affected, including cardiovascular, skeletal, neurological, and dermatological systems, causing severe disability and increased mortality. Cardiovascular issues are particularly significant in HGPS and are crucial for developing therapeutic strategies. Recent advances in treatment modalities offer promise for managing HGPS. Farnesyltransferase inhibitors and genetic interventions, such as CRISPR-Cas9, have shown potential in mitigating progerin-associated symptoms, with encouraging results observed in preclinical and clinical studies. Additionally, emerging therapies such as rapamycin, sulforaphane, and MG132 hold promise in targeting underlying disease mechanisms. Comprehensive management approaches, including growth hormone therapy, retinoids, and dental care, are emphasized to enhance overall patient well-being. Despite progress, further research is essential to unravel the complex pathophysiology of Progeroid syndromes and develop effective treatments. Continued focus on therapies that address progerin accumulation and its downstream effects is vital for improving patient care and outcomes for individuals affected by HGPS and related disorders. This review highlights ongoing efforts to understand and combat Progeroid syndromes, aiming to alleviate the burdens imposed by these debilitating conditions.

Keywords: Hutchinson–Gilford progeria syndrome; accelerated aging; farnesyltransferase; lamin A; progerin therapy; rare diseases.

Plain language summary

Progeroid syndromes: unraveling the genetic basis, multifaceted symptoms, and advancements in therapeutic approaches This comprehensive review delves into the intricate landscape of Progeroid Syndromes, focusing on the Hutchinson-Gilford Progeria Syndrome (HGPS) and its atypical forms. From the genetic underpinnings involving the LMNA gene to the myriad of symptoms affecting various organ systems, the article illuminates the pathophysiology and disease progression of HGPS. It outlines the spectrum of complications spanning cardiovascular, skeletal, neurological, skin, oral health, and growth abnormalities seen in patients. Furthermore, it highlights the emerging therapeutic approaches, from farnesyltransferase inhibitors to genetic therapies like CRISPR, providing hope for managing this rare and challenging condition.

Publication types

  • Review