Abstract
Background: Friedreich's Ataxia (FRDA) is a rare hereditary neurodegenerative disorder characterized by progressive ataxia, cardiomyopathy, and diabetes. The disease is caused by a deficiency of frataxin, a mitochondrial protein involved in iron-sulfur cluster synthesis and iron metabolism.
Objective: This review aims to summarize recent advances in the development of treatment strategies for FRDA, with a focus on potential drug candidates and their mechanisms of action.
Methods: A comprehensive literature search was conducted using various authentic scientific databases to identify studies published in the last decade that investigated potential treatment strategies for FRDA. The search terms used included “Friedreich's ataxia”, “treatment”, “drug candidates”, and “mechanisms of action”.
Results: To date, only one drug got approval from US-FDA in the year 2023; however, significant developments were achieved in FRDA-related research focusing on diverse therapeutic interventions that could potentially alleviate the symptoms of this disease. Several promising drug candidates have been identified for the treatment of FRDA, which target various aspects of frataxin deficiency and aim to restore frataxin levels, reduce oxidative stress, and improve mitochondrial function. Clinical trials have shown varying degrees of success, with some drugs demonstrating significant improvements in neurological function and quality of life in FRDA patients.
Conclusion: While there has been significant progress in the development of treatment strategies for FRDA, further research is needed to optimize these approaches and identify the most effective and safe treatment options for patients. The integration of multiple therapeutic strategies may be necessary to achieve the best outcomes in FRDA management.
[http://dx.doi.org/10.1042/ETLS20230017] [PMID: 37698160]
[http://dx.doi.org/10.1016/j.eclinm.2019.11.006] [PMID: 31938785]
[http://dx.doi.org/10.1016/j.brainresrev.2011.04.001] [PMID: 21550666]
[http://dx.doi.org/10.1080/14656566.2019.1639671] [PMID: 31311349]
[http://dx.doi.org/10.2217/nmt-2022-0011] [PMID: 35766110]
[http://dx.doi.org/10.1016/j.tips.2019.02.001] [PMID: 30905359]
[PMID: 36919030]
[http://dx.doi.org/10.1385/1-59745-088-X:197] [PMID: 16930014]
[http://dx.doi.org/10.1016/j.jns.2011.01.010] [PMID: 21315377]
[http://dx.doi.org/10.2217/nmt.15.73] [PMID: 26782317]
[http://dx.doi.org/10.1089/ars.2009.3015] [PMID: 20156111]
[http://dx.doi.org/10.1093/hmg/ddq165] [PMID: 20413654]
[http://dx.doi.org/10.1038/ng0897-345] [PMID: 9241270]
[http://dx.doi.org/10.1038/84818] [PMID: 11175786]
[http://dx.doi.org/10.1038/nrneurol.2009.26] [PMID: 19347027]
[http://dx.doi.org/10.1002/1531-8257(200011)15:6<1255::AID-MDS1031>3.0.CO;2-C] [PMID: 11104216]
[http://dx.doi.org/10.3390/ijms22041815] [PMID: 33670433]
[PMID: 23935342]
[http://dx.doi.org/10.1136/practneurol-2018-002096] [PMID: 31048364]
[http://dx.doi.org/10.1186/s13023-022-02568-3] [PMID: 36371255]
[http://dx.doi.org/10.1016/j.pjnns.2018.02.003] [PMID: 29499876]
[http://dx.doi.org/10.1136/jmg.37.1.1] [PMID: 10633128]
[http://dx.doi.org/10.1080/14737175.2017.1356721] [PMID: 28724340]
[http://dx.doi.org/10.1001/archneur.62.4.621] [PMID: 15824263]
[PMID: 27572719]
[http://dx.doi.org/10.3390/antiox9080664] [PMID: 32722309]
[http://dx.doi.org/10.1080/14737175.2020.1821654] [PMID: 32909841]
[http://dx.doi.org/10.1007/s10863-014-9571-y] [PMID: 25262284]
[http://dx.doi.org/10.3390/antiox12071464] [PMID: 37508002]
[http://dx.doi.org/10.1007/s00210-021-02161-8] [PMID: 34596729]
[http://dx.doi.org/10.1007/s12603-023-1943-8] [PMID: 37498106]
[http://dx.doi.org/10.1016/j.trsl.2020.08.009] [PMID: 32841735]
[http://dx.doi.org/10.3390/ijms23010128] [PMID: 35008564]
[http://dx.doi.org/10.1002/mds.25058] [PMID: 22744651]
[http://dx.doi.org/10.1080/13543784.2023.2173063] [PMID: 36708320]
[http://dx.doi.org/10.2217/nmt-2020-0057] [PMID: 33430645]
[http://dx.doi.org/10.1007/s40265-023-01874-9] [PMID: 37155124]
[http://dx.doi.org/10.1093/hmg/ddu408] [PMID: 25113747]
[http://dx.doi.org/10.1007/s00415-016-8244-7] [PMID: 27488863]
[http://dx.doi.org/10.1136/bcr-2013-009424] [PMID: 23704441]
[http://dx.doi.org/10.1002/ptr.7176] [PMID: 34184327]
[http://dx.doi.org/10.1177/1759091419899782] [PMID: 31964153]
[http://dx.doi.org/10.3389/fncel.2019.00356] [PMID: 31417369]
[http://dx.doi.org/10.1186/s12951-022-01333-9] [PMID: 35264205]
[http://dx.doi.org/10.3390/biomedicines11051293] [PMID: 37238963]
[http://dx.doi.org/10.1517/13543784.12.2.235] [PMID: 12556217]
[http://dx.doi.org/10.1002/yea.3845] [PMID: 36755518]
[http://dx.doi.org/10.1111/jnc.12300] [PMID: 23859349]
[http://dx.doi.org/10.1002/ana.24248] [PMID: 25112865]
[http://dx.doi.org/10.1016/j.jtemb.2016.03.010] [PMID: 27033472]
[http://dx.doi.org/10.3390/ph11040109] [PMID: 30347635]
[http://dx.doi.org/10.1093/hmg/8.3.425] [PMID: 9949201]
[http://dx.doi.org/10.1158/1541-7786.MCR-07-0324] [PMID: 17951399]
[http://dx.doi.org/10.1371/journal.pone.0008825] [PMID: 20098685]
[http://dx.doi.org/10.1016/S0140-6736(14)60573-0] [PMID: 24794818]
[http://dx.doi.org/10.1016/S0140-6736(14)60382-2] [PMID: 24794816]
[http://dx.doi.org/10.3389/fmolb.2022.830650] [PMID: 35664670]
[http://dx.doi.org/10.1002/ana.21177] [PMID: 17702040]
[http://dx.doi.org/10.1002/mds.22294] [PMID: 18759345]
[http://dx.doi.org/10.1177/26330040221139872] [PMID: 37180421]
[http://dx.doi.org/10.3389/fnins.2019.00386] [PMID: 31105516]
[http://dx.doi.org/10.1186/s41120-022-00058-1] [PMID: 35789594]
[http://dx.doi.org/10.1093/hmg/ddx167] [PMID: 28460056]
[http://dx.doi.org/10.1007/s00415-015-7719-2] [PMID: 25845763]
[http://dx.doi.org/10.1038/s41598-019-49870-y] [PMID: 31601825]
[http://dx.doi.org/10.3390/ijms241612687] [PMID: 37628866]
[http://dx.doi.org/10.1002/mds.27979] [PMID: 31930551]
[http://dx.doi.org/10.2217/nmt.15.52] [PMID: 26634868]
[http://dx.doi.org/10.1002/acn3.731] [PMID: 30911578]
[http://dx.doi.org/10.1111/ane.12337] [PMID: 25335475]
[http://dx.doi.org/10.29271/jcpsp.2022.05.671] [PMID: 35546709]
[http://dx.doi.org/10.3390/ijms24043201] [PMID: 36834611]
[http://dx.doi.org/10.1371/journal.pone.0010025] [PMID: 20383327]
[http://dx.doi.org/10.3389/fphar.2023.1220620] [PMID: 37576821]
[http://dx.doi.org/10.1016/S1474-4422(15)00144-1] [PMID: 26116315]
[http://dx.doi.org/10.1016/j.freeradbiomed.2016.06.023] [PMID: 27352979]
[http://dx.doi.org/10.2174/092986711796957257] [PMID: 21824087]
[http://dx.doi.org/10.1089/ars.2014.5952] [PMID: 25546574]
[http://dx.doi.org/10.1007/s40263-013-0124-4] [PMID: 24242074]
[http://dx.doi.org/10.1093/hmg/ddaa282] [PMID: 33432356]
[http://dx.doi.org/10.1371/journal.pone.0217776] [PMID: 31158268]
[http://dx.doi.org/10.3389/fnins.2023.1260977] [PMID: 37746147]
[http://dx.doi.org/10.3390/ijms21030916] [PMID: 32019240]
[http://dx.doi.org/10.3390/biomedicines10030616] [PMID: 35327418]
[http://dx.doi.org/10.1016/j.bbadis.2017.05.019] [PMID: 28529047]
[http://dx.doi.org/10.1002/mds.27353] [PMID: 29624723]
[http://dx.doi.org/10.1007/s00415-022-11501-4] [PMID: 36462055]
[http://dx.doi.org/10.1007/s13311-020-00941-3] [PMID: 33021724]
[http://dx.doi.org/10.3390/biom10111551] [PMID: 33202971]
[http://dx.doi.org/10.1002/14651858.CD008953.pub2] [PMID: 25348587]
[http://dx.doi.org/10.1212/WNL.0000000000005055] [PMID: 29440566]
[http://dx.doi.org/10.3389/fphar.2022.1057083] [PMID: 36506513]
[http://dx.doi.org/10.1007/s13311-015-0409-z] [PMID: 26729332]
[http://dx.doi.org/10.1186/s12974-019-1627-9] [PMID: 31747905]
[http://dx.doi.org/10.1038/s41598-017-10320-2] [PMID: 28852135]
[http://dx.doi.org/10.1002/prp2.755] [PMID: 33951329]
[http://dx.doi.org/10.1016/j.ebiom.2021.103244] [PMID: 33647769]
[http://dx.doi.org/10.1042/NS20200093] [PMID: 34046211]
[http://dx.doi.org/10.1002/jimd.12285] [PMID: 32677106]
[http://dx.doi.org/10.3390/pharmaceutics15061626] [PMID: 37376074]
[http://dx.doi.org/10.2217/nmt-2018-0013] [PMID: 30051753]
[PMID: 36890218]
[http://dx.doi.org/10.1371/journal.pone.0122942] [PMID: 25897966]
[http://dx.doi.org/10.1002/ana.25934] [PMID: 33068037]
[http://dx.doi.org/10.1002/mds.29286] [PMID: 36444905]
[http://dx.doi.org/10.1111/j.1468-1331.2008.02318.x] [PMID: 19049556]