Insulin Signaling as a Key Moderator in Myotonic Dystrophy Type 1.

Abstract:

:Myotonic dystrophy type 1 (DM1) is an autosomal dominant genetic disease characterized by multi-system involvement. Affected organ system includes skeletal muscle, heart, gastro-intestinal system and the brain. In this review, we evaluate the evidence for alterations in insulin signaling and their relation to clinical DM1 features. We start by summarizing the molecular pathophysiology of DM1. Next, an overview of normal insulin signaling physiology is given, and evidence for alterations herein in DM1 is presented. Clinically, evidence for involvement of insulin signaling pathways in DM1 is based on the increased incidence of insulin resistance seen in clinical practice and recent trial evidence of beneficial effects of metformin on muscle function. Indirectly, further support may be derived from certain CNS derived symptoms characteristic of DM1, such as obsessive-compulsive behavior features, for which links with altered insulin signaling has been demonstrated in other diseases. At the basic scientific level, several pathophysiological mechanisms that operate in DM1 may compromise normal insulin signaling physiology. The evidence presented here reflects the importance of insulin signaling in relation to clinical features of DM1 and justifies further basic scientific and clinical, therapeutically oriented research.

journal_name

Front Neurol

journal_title

Frontiers in neurology

authors

Nieuwenhuis S,Okkersen K,Widomska J,Blom P,'t Hoen PAC,van Engelen B,Glennon JC

doi

10.3389/fneur.2019.01229

subject

Has Abstract

pub_date

2019-11-26 00:00:00

pages

1229

issn

1664-2295

journal_volume

10

pub_type

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