Introduction to the review series Autophagy in Higher Eukaryotes--a matter of survival or death.

Single celled eukaryotes utilize autophagy (or self-consumption) to adapt to fluctuating energy sources in the environment. The identification in multicellular organisms of orthologs of autophagy-related yeast genes has led to some of the major advances in the molecular dissection of the pathway in the last decade. In higher eukaryotes, autophagy is much more than a 'stress response' pathway. The complexity of multicellular systems calls for greater sophistication and coordination not only in regulating the stress response but also in sustaining normal physiological functions and a homeostatic environment in the whole organism. The review series on 'Autophagy in Higher Eukaryotes--a matter of survival or death' in the current issue comprises a variety of perspectives on the role of autophagy in cell growth, survival and death, in neurodegeneration, tumor suppression and tumor progression. For example, Høyer-Hansen and Jäättellä cogitate on the emergence of autophagy as a target in cancer therapy. In addition, Sanjuan and Green examine its role in the defense against microbial pathogens and Sachdeva and Thompson offer an intriguing look at autophagy in the context of circadian clocks and diurnal rhythms. Presented below are some of the salient points from these perspectives.

Facial onset sensory and motor neuronopathy (FOSMN syndrome): a novel syndrome in neurology.

A 'syringomyelia-like' syndrome has been infrequently reported in neurological disorders such as Tangiers disease and lepromatous leprosy. This study reports a novel 'syringomyelia-like' syndrome in four adult male patients, which we have termed facial onset sensory and motor neuronopathy, or FOSMN syndrome, that appears to have a neurodegenerative aetiology. Clinical, neurophysiological and pathological data of four patients were reviewed, including the autopsy in one patient. Four male patients (mean age at onset 43), initially developed paraesthesiae and numbness in a trigeminal nerve distribution, which slowly progressed to involve the scalp, neck, upper trunk and upper limbs in sequential order. Motor manifestations, including cramps, fasciculations, dysphagia, dysarthria, muscle weakness and atrophy developed later in the course of the illness. Neurophysiological findings revealed a generalized sensory motor neuronopathy of caudally decreasing severity in all four patients. Autopsy in one patient disclosed loss of motoneurons in the hypoglossal nucleus and cervical anterior horns, along with loss of sensory neurons in the main trigeminal sensory nucleus and dorsal root ganglia. FOSMN syndrome appears to be a slowly progressive neurodegenerative disorder, whose pathogenesis remains to be determined.