mTOR Inhibitors in Children: Current Indications and Future Directions in Neurology

Curr Neurol Neurosci Rep. 2016 Dec;16(12):102. doi: 10.1007/s11910-016-0708-8.

Abstract

The mammalian/mechanistic target of rapamycin (mTOR) pathway is a key signaling pathway that has been implicated in genetic epilepsy syndromes, neurodegenerative diseases, and conditions associated with autism spectrum disorder and cognitive impairment. The mTOR pathway has become an exciting treatment target for these various disorders, with mTOR inhibitors such as rapamycin being studied for their potential therapeutic applications. In particular, tuberous sclerosis complex (TSC) is a genetic disorder resulting from overactivation of the mTOR pathway, and pharmacologic therapy with mTOR inhibitors has emerged as a viable treatment option for the systemic manifestations of the disease. In this review, we discuss the approved indications for mTOR inhibitors in TSC, the potential future applications of mTOR inhibitors in TSC and other neurological conditions, and the safety considerations applicable to mTOR therapy in the pediatric population.

Keywords: Everolimus; Rapamycin; Sirolimus; Tuberous sclerosis; mTOR.

Publication types

  • Review

MeSH terms

  • Autism Spectrum Disorder / drug therapy
  • Autism Spectrum Disorder / metabolism
  • Child
  • Enzyme Inhibitors / pharmacology
  • Enzyme Inhibitors / therapeutic use*
  • Epilepsy / drug therapy*
  • Humans
  • Signal Transduction / drug effects
  • Sirolimus / pharmacology
  • Sirolimus / therapeutic use*
  • TOR Serine-Threonine Kinases / antagonists & inhibitors*
  • TOR Serine-Threonine Kinases / metabolism
  • Tuberous Sclerosis / drug therapy*
  • Tuberous Sclerosis / metabolism

Substances

  • Enzyme Inhibitors
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Sirolimus