关键词: Duchenne muscular dystrophy Fukuyama congenital muscular dystrophy Miyoshi myopathy antisense therapy dysferlinopathy exon skipping limb-girdle muscular dystrophy 2B spinal muscular atrophy splice modulation

Mesh : Animals Exons Gene Expression Regulation Genetic Therapy / methods Humans Muscular Atrophy, Spinal / genetics physiopathology therapy Muscular Dystrophies, Limb-Girdle / genetics physiopathology therapy Muscular Dystrophy, Duchenne / genetics physiopathology therapy Oligonucleotides, Antisense / therapeutic use RNA Splicing Treatment Outcome Walker-Warburg Syndrome / genetics physiopathology therapy

来  源:   DOI:10.1517/14712598.2014.896335   PDF(Sci-hub)

Abstract:
BACKGROUND: Antisense oligonucleotide (AON) therapy is a form of treatment for genetic or infectious diseases using small, synthetic DNA-like molecules called AONs. Recent advances in the development of AONs that show improved stability and increased sequence specificity have led to clinical trials for several neuromuscular diseases. Impressive preclinical and clinical data are published regarding the usage of AONs in exon-skipping and splice modulation strategies to increase dystrophin production in Duchenne muscular dystrophy (DMD) and survival of motor neuron (SMN) production in spinal muscular atrophy (SMA).
METHODS: In this review, we focus on the current progress and challenges of exon-skipping and splice modulation therapies. In addition, we discuss the recent failure of the Phase III clinical trials of exon 51 skipping (drisapersen) for DMD.
CONCLUSIONS: The main approach of AON therapy in DMD and SMA is to rescue (\'knock up\' or increase) target proteins through exon skipping or exon inclusion; conversely, most conventional antisense drugs are designed to knock down (inhibit) the target. Encouraging preclinical data using this \'knock up\' approach are also reported to rescue dysferlinopathies, including limb-girdle muscular dystrophy type 2B, Miyoshi myopathy, distal myopathy with anterior tibial onset and Fukuyama congenital muscular dystrophy.
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