Wolfram Syndrome: Diagnosis, Management, and Treatment

Abstract

Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing loss, and neurodegeneration. Although there are currently no effective treatments that can delay or reverse the progression of Wolfram syndrome, the use of careful clinical monitoring and supportive care can help relieve the suffering of patients and improve their quality of life. The prognosis of this syndrome is currently poor, and many patients die prematurely with severe neurological disabilities, raising the urgency for developing novel treatments for Wolfram syndrome. In this article, we describe natural history and etiology, provide recommendations for diagnosis and clinical management, and introduce new treatments for Wolfram syndrome.

Keywords: Blindness; Deafness; Endoplasmic reticulum stress; Genetic disorder; Neurodegeneration; Type 1 diabetes; Type 2 diabetes; Wolfram syndrome; β cells.

Fig. 1

Common clinical manifestations in Wolfram syndrome

Fig. 2

Development of diagnostics and therapeutics for Wolfram syndrome

Fig. 3

Power of Wolfram syndrome. It has been established that endoplasmic reticulum (ER) dysfunction and ER stress are critical pathogenic components of Wolfram syndrome. It would be possible to identify biomarkers and treatments targeting ER in mechanistically homogenous Wolfram syndrome patients, which may lead to a breakthrough for treatments of common diseases, such as type 1 diabetes, type 2 diabetes, and neurodegeneration, in which ER dysfunction is involved