Histone deacetylase 4—accelerator of progression in ALS?

During early stages of amyotrophic lateral sclerosis (ALS), motor neuron loss is compensated for by collateral innervation, which delays onset of muscle wasting. In a recent study of 11 patients with ALS, researchers identified increased muscle expression of histone deacetylase 4 (HDAC4) in patients with rapidly progressing disease compared with long-term ALS survivors. Moreover, HDAC4 expression levels were inversely correlated with extent of muscle reinnervation. Inhibitors of HDAC4 could, therefore, be a therapeutic option to slow disease progression in ALS.