Antisense oligonucleotides

反义寡核苷酸
  • 文章类型: Journal Article
    创伤后应激障碍(PTSD)是一种使人衰弱的精神疾病,在暴露于创伤事件后会产生重大的公共卫生影响。最近的研究强调了免疫失调参与创伤后应激障碍,以炎症标志物升高为特征。然而,这种免疫失衡的确切机制尚不清楚.先前的研究涉及朋友白血病病毒整合1(FLI1),一种成红细胞转化特异性(ETS)转录因子,在脓毒症和阿尔茨海默病的炎症反应中。外周血单核细胞(PBMC)中FLI1水平升高与狼疮严重程度有关。然而,FLI1在PTSD相关炎症中的作用仍未被探索。在我们的研究中,从有和没有PTSD的退伍军人收集PBMC。我们发现PTSD患者的PBMC中FLI1表达显着增加,特别是在CD4+T细胞中,CD8+T细胞无显著变化。与对照相比,用LPS刺激导致PTSDPBMC中FLI1表达增强和炎性细胞因子IL-6和IFNγ水平升高。在PTSDPBMC中使用Gapmers敲除FLI1导致炎性细胞因子水平显著降低,恢复到控制组水平。此外,来自对照和PTSD退伍军人的PBMC与人脑小胶质细胞HMC3共培养显示HMC3中的炎症介质水平增加。值得注意的是,与对照Gapmer处理的PTSDPBMC相比,与用FLI1Gapmer处理的PTSDPBMC共培养的HMC3细胞表现出显著更低的炎症介质水平。这些发现表明,抑制FLI1可能会重新平衡PBMC中的免疫活性并减轻大脑中的小胶质细胞激活。这些见解可以为PTSD提供新的治疗策略。
    Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition with significant public health implications that arise following exposure to traumatic events. Recent studies highlight the involvement of immune dysregulation in PTSD, characterized by elevated inflammatory markers. However, the precise mechanisms underlying this immune imbalance remain unclear. Previous research has implicated friend leukemia virus integration 1 (FLI1), an erythroblast transformation-specific (ETS) transcription factor, in inflammatory responses in sepsis and Alzheimer\'s disease. Elevated FLI1 levels in peripheral blood mononuclear cells (PBMCs) have been linked to lupus severity. Yet, FLI1\'s role in PTSD-related inflammation remains unexplored. In our study, PBMCs were collected from Veterans with and without PTSD. We found significantly increased FLI1 expression in PBMCs from PTSD-afflicted Veterans, particularly in CD4+ T cells, with no notable changes in CD8+ T cells. Stimulation with LPS led to heightened FLI1 expression and elevated levels of inflammatory cytokines IL-6 and IFNγ in PTSD PBMCs compared to controls. Knockdown of FLI1 using Gapmers in PTSD PBMCs resulted in a marked reduction in inflammatory cytokine levels, restoring them to control group levels. Additionally, co-culturing PBMCs from both control and PTSD Veterans with the human brain microglia cell line HMC3 revealed increased inflammatory mediator levels in HMC3. Remarkably, HMC3 cells co-cultured with PTSD PBMCs treated with FLI1 Gapmers exhibited significantly lower inflammatory mediator levels compared to control Gapmer-treated PTSD PBMCs. These findings suggest that suppressing FLI1 may rebalance immune activity in PBMCs and mitigate microglial activation in the brain. Such insights could provide novel therapeutic strategies for PTSD.
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  • 文章类型: Journal Article
    融合肉瘤(FUS)基因的致病变异与肌萎缩侧索硬化症(ALS)的罕见和侵袭性形式有关。由于FUS-ALS是一种优势疾病,有针对性的,等位基因选择性方法对FUS敲低是最合适的。反义寡核苷酸(AO)是用于治疗此类疾病的有希望的治疗平台。在这项研究中,我们已经探索了FUS等位基因选择性敲低的可能性。设计了靶向FUS中两种常见中性多态性的Gapmer型AOs,并在人成纤维细胞中进行了评估。AOs具有甲氧基乙基(MOE)或硫代吗啉(TMO)修饰。我们发现,当与MOE对应物相比时,TMO修饰改善了前导序列的等位基因选择性和功效。在TMO修饰的gapmer敲除目标等位基因后,检测到的多达93%的FUS转录本来自非目标等位基因。与MOE修改的AOs相比,TMO修饰的AOs还显示出可由含硫代磷酸酯的AOs触发的结构化核包裹体和SFPQ聚集的形成减少。TMO修饰的AOs的总长度和间隙长度如何影响等位基因选择性,还评估了效率和脱靶基因敲低。我们已经表明,FUS的等位基因选择性敲除可能是治疗FUS-ALS的可行治疗策略,并证明了TMO修饰对等位基因选择性应用的益处。
    Pathogenic variations in the fused in sarcoma (FUS) gene are associated with rare and aggressive forms of amyotrophic lateral sclerosis (ALS). As FUS-ALS is a dominant disease, a targeted, allele-selective approach to FUS knockdown is most suitable. Antisense oligonucleotides (AOs) are a promising therapeutic platform for treating such diseases. In this study, we have explored the potential for allele-selective knockdown of FUS. Gapmer-type AOs targeted to two common neutral polymorphisms in FUS were designed and evaluated in human fibroblasts. AOs had either methoxyethyl (MOE) or thiomorpholino (TMO) modifications. We found that the TMO modification improved allele selectivity and efficacy for the lead sequences when compared to the MOE counterparts. After TMO-modified gapmer knockdown of the target allele, up to 93% of FUS transcripts detected were from the non-target allele. Compared to MOE-modified AOs, the TMO-modified AOs also demonstrated reduced formation of structured nuclear inclusions and SFPQ aggregation that can be triggered by phosphorothioate-containing AOs. How overall length and gap length of the TMO-modified AOs affected allele selectivity, efficiency and off-target gene knockdown was also evaluated. We have shown that allele-selective knockdown of FUS may be a viable therapeutic strategy for treating FUS-ALS and demonstrated the benefits of the TMO modification for allele-selective applications.
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  • 文章类型: Journal Article
    钾通道四聚化结构域含有17(KCTD17)蛋白,cullin3(Cul3)泛素连接酶复合物的衔接子,已经牵涉到各种人类疾病;然而,其在肝细胞癌(HCC)中的作用仍然难以捉摸。这里,我们旨在阐明KCTD17的临床特征,并探讨KCTD17影响HCC进展的机制.
    我们分析了HCC患者的转录组数据。用二乙基亚硝胺(DEN)治疗肝细胞特异性KCTD17缺陷小鼠,以评估其对HCC进展的影响。此外,我们测试了KCTD17定向反义寡核苷酸在体内的治疗潜力.
    我们的调查显示,在肝癌患者和肝癌小鼠模型的肿瘤中,KCTD17表达上调,与非肿瘤对照相比。我们鉴定了亮氨酸拉链样转录调节因子1(Lztr1)蛋白,先前确定的Ras不稳定剂,作为KCTD17-Cul3复合物的底物。KCTD17介导的Lztr1降解导致Ras稳定,导致增殖增加,迁移,和肝癌细胞的伤口愈合。肝细胞特异性KCTD17缺陷小鼠或肝癌异种移植模型对致癌作用或肿瘤生长较不敏感。同样,用KCTD17指导的反义寡核苷酸(ASO)在HCC小鼠模型中治疗显着降低了肿瘤体积以及Ras蛋白水平,与对照ASO治疗的小鼠相比。
    KCTD17诱导Ras和下游信号通路的稳定和HCC进展,可能是HCC的新治疗靶点。
    UNASSIGNED: Potassium channel tetramerization domain containing 17 (KCTD17) protein, an adaptor for the cullin3 (Cul3) ubiquitin ligase complex, has been implicated in various human diseases; however, its role in hepatocellular carcinoma (HCC) remains elusive. Here, we aimed to elucidate the clinical features of KCTD17, and investigate the mechanisms by which KCTD17 affects HCC progression.
    UNASSIGNED: We analyzed transcriptomic data from patients with HCC. Hepatocyte-specific KCTD17 deficient mice were treated with diethylnitrosamine (DEN) to assess its effect on HCC progression. Additionally, we tested KCTD17-directed antisense oligonucleotides for their therapeutic potential in vivo.
    UNASSIGNED: Our investigation revealed the upregulation of KCTD17 expression in both tumors from patients with HCC and mouse models of HCC, in comparison to non-tumor controls. We identified the leucine zipper-like transcriptional regulator 1 (Lztr1) protein, a previously identified Ras destabilizer, as a substrate for KCTD17-Cul3 complex. KCTD17-mediated Lztr1 degradation led to Ras stabilization, resulting in increased proliferation, migration, and wound healing in liver cancer cells. Hepatocyte-specific KCTD17 deficient mice or liver cancer xenograft models were less susceptible to carcinogenesis or tumor growth. Similarly, treatment with KCTD17-directed antisense oligonucleotides (ASO) in a mouse model of HCC markedly lowered tumor volume as well as Ras protein levels, compared to those in control ASO-treated mice.
    UNASSIGNED: KCTD17 induces the stabilization of Ras and downstream signaling pathways and HCC progression and may represent a novel therapeutic target for HCC.
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  • 文章类型: Journal Article
    TGFβ1是纤维化的强大调节因子;以潜伏形式分泌,它从潜在的复合物中释放后变得活跃。在组织纤维化期间,细胞纤连蛋白的EDA+同种型过表达。在肺纤维化中,已经提出包括EDA结构域(FNEDA+)的纤连蛋白剪接变体激活潜伏的TGFβ。我们的工作研究了用反义寡核苷酸阻断EDA的“剪接”以抑制TGFβ1诱导的EDA纤连蛋白并防止TGFβ1在人肾近曲小管细胞(PTEC)中引发的事件级联的潜力。人原发性PTEC用TGFβ1治疗48小时,去除培养基,并用设计用于阻断EDA外显子包含(ASO5)的非RNaseH依赖性反义寡核苷酸(ASO)转染细胞。通过EDA+纤连蛋白RNA和蛋白表达评估ASO阻断EDA外显子包合的功效;TGFβ的表达,αSMA(α平滑肌肌动蛋白),MMP2(基质金属蛋白酶-2),MMP9(基质金属蛋白-9),胶原蛋白I,分析了K钙粘蛋白和连接蛋白43。设计用于阻断纤连蛋白前mRNA中的EDA外显子包合的靶向反义寡核苷酸在体外细胞培养模型中有效减少人近端小管细胞中TGFβ1诱导的细胞EDA+纤连蛋白RNA和分泌的EDA+纤连蛋白蛋白的量(通过蛋白质免疫印迹和免疫细胞化学评估)。该效应对EDA+外显子是选择性的,而对EDB+纤连蛋白RNA和总纤连蛋白mRNA没有影响。外源性TGFβ1诱导内源性TGFβ,αSMA,MMP2、MMP9和ColImRNA。TGFβ1处理48h降低了K-Cadherin的表达,增加了连接蛋白-43的表达。这些TGFβ1诱导的促纤维化变化通过ASO5处理减弱。去除外源性TGFβ后48小时,αSMA进一步增加,观察到MMP2、MMP9;ASO5显著抑制这种随后的增加。ASO5处理还显著抑制在实验结束时(96h)收获的细胞培养基刺激SMAD3报告细胞的能力。通过使用TGFβ受体抑制剂证实了内源性TGFβ1的作用。我们的结果表明,FNEDA在人PTEC中TGFβ驱动的促纤维化反应循环中发挥关键作用,并用ASO技术阻断其产生提供了一种潜在的疗法来中断这种恶性循环,从而限制肾纤维化的进展。
    TGFβ1 is a powerful regulator of fibrosis; secreted in a latent form, it becomes active after release from the latent complex. During tissue fibrosis, the EDA + isoform of cellular fibronectin is overexpressed. In pulmonary fibrosis it has been proposed that the fibronectin splice variant including an EDA domain (FN EDA+) activates latent TGFβ. Our work investigates the potential of blocking the \'splicing in\' of EDA with antisense oligonucleotides to inhibit TGFβ1-induced EDA + fibronectin and to prevent the cascade of events initiated by TGFβ1 in human renal proximal tubule cells (PTEC). Human primary PTEC were treated with TGFβ1 for 48 h, medium removed and the cells transfected with RNase H-independent antisense oligonucleotides (ASO) designed to block EDA exon inclusion (ASO5). The efficacy of ASO to block EDA exon inclusion was assessed by EDA + fibronectin RNA and protein expression; the expression of TGFβ, αSMA (α smooth muscle actin), MMP2 (matrix metalloproteinse-2), MMP9 (matrix metalloproteinse-9), Collagen I, K Cadherin and connexin 43 was analysed. Targeting antisense oligonucleotides designed to block EDA exon inclusion in fibronectin pre mRNA were effective in reducing the amount of TGFβ1 -induced cellular EDA + fibronectin RNA and secreted EDA + fibronectin protein (assessed by western immunoblotting and immunocytochemistry) in human proximal tubule cells in an in vitro cell culture model. The effect was selective for EDA + exon with no effect on EDB + fibronectin RNA and total fibronectin mRNA. Exogenous TGFβ1 induced endogenous TGFβ, αSMA, MMP2, MMP9 and Col I mRNA. TGFβ1 treatment for 48h reduced the expression of K-Cadherin and increased the expression of connexin-43. These TGFβ1-induced pro-fibrotic changes were attenuated by ASO5 treatment. 48 h after the removal of exogenous TGFβ, further increases in αSMA, MMP2, MMP9 was observed; ASO5 significantly inhibited this subsequent increase. ASO5 treatment also significantly inhibited ability of the cell culture medium harvested at the end of the experiment (96h) to stimulate SMAD3 reporter cells. The role of endogenous TGFβ1 was confirmed by the use of a TGFβ receptor inhibitor. Our results demonstrate a critical role of FN EDA+ in a cycle of TGFβ driven pro-fibrotic responses in human PTEC and blocking its production with ASO technology offers a potential therapy to interrupt this vicious circle and hence limit the progression of renal fibrosis.
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  • 文章类型: Journal Article
    直接作用抗病毒(DAA)药物已被证明可以有效降低病毒载量并治愈高比例的丙型肝炎病毒(HCV)感染。然而,还应考虑与治疗过程相关的费用和任何可能的不良反应。重要的是要承认,此外,某些群体可能没有资格接受治疗。鉴于目前尚无批准的HCV感染疫苗,需要一个有效的,安全,可获得的治疗仍然是至关重要的优先事项。这项研究的目的是开发一种可以抑制HCV衣壳的基于反义寡核苷酸(ASO)的治疗药物。在使用NCBI病毒数据门户分析817个HCV衣壳蛋白mRNA序列后,在所有基因型(1-7)中鉴定出7个核苷酸(nt)的保守区。然而,由于其GC含量高,该区域不是ASO的合适目标。相反,另一个高度保守的区域,只有8nt长,在删除缺失和不同的序列数据后,保留在801个数据集中。然后使用计算机模拟研究候选ASO以评估其潜力。因此,由8nt组成的ASO序列可能是抑制HCV衣壳的可行治疗靶标。此外,7nt序列,在所有数据集中都是保守的,可以使用替代策略代替基于ASO的靶向。
    Direct-acting antiviral (DAA) drugs have been shown to effectively reduce viral load and cure a high proportion of hepatitis C virus (HCV) infections. However, costs associated with the course of therapy and any possible adverse effects should also be considered. It is important to acknowledge, moreover, that certain groups may not be eligible for treatment. Given that there is currently no approved vaccine for HCV infection, the need for an effective, safe, and accessible treatment remains a crucial priority. The aim of this study is to develop an antisense oligonucleotide (ASO)-based therapeutic drug that can inhibit HCV capsid. After analyzing 817 HCV capsid protein mRNA sequences using the NCBI Virus Data Portal, a conserved region of 7 nucleotides (nt) was identified in all genotypes (1-7). However, because of its high GC% content, this region is not a suitable target for ASO. Conversely, the other highly conserved region, which is only 8 nt long, was preserved in 801 datasets after removing missing and differing sequence data. The candidate ASO was then investigated using computer simulations to assess its potential. Thus, it is possible that the ASO sequence consisting of 8 nt could be a viable therapeutic target for the inhibition of HCV capsid. Furthermore, the 7 nt sequence, which is conserved in all datasets, may be targeted using alternative strategies in lieu of ASO-based targeting.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    反义寡核苷酸(ASO)是用于许多疾病的非常有前途的药物,所述疾病包括诸如杜氏肌营养不良症(DMD)的神经肌肉病症。几种ASO药物已经被美国食品和药物管理局批准用于DMD,全球仍在努力进一步提高其效力。特别是通过开发新的输送系统或替代化学品。在这种情况下,最近的一项研究调查了不同化学修饰的ASO在DMD小鼠模型中诱导外显子跳跃的潜力。重要的是,作者报告了外显子跳跃和蛋白质恢复水平之间的强烈差异,这主要是由于锁定核酸(LNA)修饰对靶RNA的高亲和力,从而干扰未跳过的产物的扩增并导致外显子跳过的产物的人工过度扩增。这些发现促使我们验证三环DNA(tcDNA)-ASO是否会发生类似的现象,该现象也对靶RNA具有高亲和力。因此,我们进行了一系列对照实验,并在此证明,与含LNA的ASO所观察到的相比,由于tcDNA-ASO干扰了未跳过的产物,因此外显子跳过水平并未被高估。
    Antisense oligonucleotides (ASO) are very promising drugs for numerous diseases including neuromuscular disorders such as Duchenne muscular dystrophy (DMD). Several ASO drugs have already been approved by the US Food and Drug Administration for DMD and global efforts are still ongoing to improve further their potency, notably by developing new delivery systems or alternative chemistries. In this context, a recent study investigated the potential of different chemically modified ASO to induce exon-skipping in mouse models of DMD. Importantly, the authors reported a strong discrepancy between exon-skipping and protein restoration levels, which was mainly owing to the high affinity of locked nucleic acid (LNA) modifications to the target RNA, thereby interfering with the amplification of the unskipped product and resulting in artificial overamplification of the exon-skipped product. These findings urged us to verify whether a similar phenomenon could occur with tricyclo-DNA (tcDNA)-ASO that also display high-affinity properties to the target RNA. We thus ran a series of control experiments and demonstrate here that exon-skipping levels are not overestimated owing to an interference of tcDNA-ASO with the unskipped product in contrast to what was observed with LNA-containing ASO.
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  • 文章类型: Journal Article
    杜氏肌营养不良症(DMD)是一种由肌营养不良蛋白缺乏引起的进行性肌肉疾病。目前的一种DMD治疗策略,外显子跳跃,使用二氨基磷酸吗啉代低聚物(PMO)产生截短的肌营养不良蛋白同工型。然而,外显子跳跃疗法的潜力尚未完全意识到,因为在临床试验中,肌养蛋白的增加很少。这里,我们研究了miR-146a-5p,在营养不良的肌肉中高度升高,影响肌营养不良蛋白水平。我们发现炎症在营养不良中强烈诱导miR-146a,但不是野生型肌管.生物信息学分析显示,肌营养不良蛋白3UTR具有miR-146a结合位点,和随后的荧光素酶测定证明miR-146a结合抑制肌养蛋白翻译。在肌营养不良蛋白缺失的mdx52小鼠中,miR-146a的共注射通过外显子51跳跃PMO减少了肌营养不良蛋白的恢复。为了直接研究miR-146a如何影响治疗性肌营养不良蛋白救援,我们产生了具有全体miR-146a缺失(146aX)的mdx52.通过肌内或静脉注射施用外显子跳过PMO显着增加146aX中的肌营养不良蛋白水平。mdx52肌肉,而跳过的肌营养不良蛋白转录水平不变,支持转录后的作用机制。一起,这些数据显示miR-146a表达对抗治疗性肌营养不良蛋白恢复,提示miR-146a抑制作为一种潜在的DMD外显子跳跃联合治疗值得进一步研究.
    Duchenne muscular dystrophy (DMD) is a progressive muscle disease caused by the absence of dystrophin protein. One current DMD therapeutic strategy, exon skipping, produces a truncated dystrophin isoform using phosphorodiamidate morpholino oligomers (PMOs). However, the potential of exon skipping therapeutics has not been fully realized as increases in dystrophin protein have been minimal in clinical trials. Here, we investigate how miR-146a-5p, which is highly elevated in dystrophic muscle, impacts dystrophin protein levels. We find inflammation strongly induces miR-146a in dystrophic, but not wild-type myotubes. Bioinformatics analysis reveals that the dystrophin 3\' UTR harbors a miR-146a binding site, and subsequent luciferase assays demonstrate miR-146a binding inhibits dystrophin translation. In dystrophin-null mdx52 mice, co-injection of miR-146a reduces dystrophin restoration by an exon 51 skipping PMO. To directly investigate how miR-146a impacts therapeutic dystrophin rescue, we generated mdx52 with body-wide miR-146a deletion (146aX). Administration of an exon skipping PMO via intramuscular or intravenous injection markedly increases dystrophin protein levels in 146aX vs. mdx52 muscles while skipped dystrophin transcript levels are unchanged supporting a post-transcriptional mechanism of action. Together, these data show that miR-146a expression opposes therapeutic dystrophin restoration, suggesting miR-146a inhibition warrants further research as a potential DMD exon skipping co-therapy.
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  • 文章类型: Journal Article
    联合疗法在对抗复杂病理中起着关键作用,如癌症和相关的耐药性问题。这在靶向治疗中是特别相关的,其中药物靶标的抑制可以通过交叉激活互补途径来克服。不幸的是,迄今为止批准的药物组合-主要基于小分子-面临几个问题,如毒性作用,这限制了它们的临床应用。为了解决这些问题,我们设计了一类新的RNA酶H敏感构建体(3ASO),可以在细胞进入后在细胞内分解,导致同时释放三种不同的治疗性寡核苷酸(ON),处理不同蛋白质的mRNA。这里,我们使用大肠杆菌RNaseH1作为模型来研究一种前所未有的识别和裂解模式,这主要是由我们的基于RNA·DNA的杂交构建体的拓扑结构决定的。作为我们技术的模型系统,我们已经创建了3ASO构建体,旨在特异性抑制HER2,Akt和Hsp27在HER2乳腺癌细胞中的表达。这些三功能ON工具在HER2+乳腺癌细胞中显示非常低的毒性和良好水平的抗增殖活性。本研究将在对抗涉及多个mRNA靶标的复杂病理方面具有巨大潜力,因为提出的可裂解设计将允许同时有效单剂量施用不同的ON药物。
    Combined therapies play a key role in the fight against complex pathologies, such as cancer and related drug-resistance issues. This is particularly relevant in targeted therapies where inhibition of the drug target can be overcome by cross-activating complementary pathways. Unfortunately, the drug combinations approved to date -mostly based on small molecules- face several problems such as toxicity effects, which limit their clinical use. To address these issues, we have designed a new class of RNase H-sensitive construct (3ASO) that can be disassembled intracellularly upon cell entry, leading to the simultaneous release of three different therapeutic oligonucleotides (ONs), tackling each of them the mRNA of a different protein. Here, we used Escherichia coli RNase H1 as a model to study an unprecedented mode of recognition and cleavage, that is mainly dictated by the topology of our RNA·DNA-based hybrid construct. As a model system for our technology we have created 3ASO constructs designed to specifically inhibit the expression of HER2, Akt and Hsp27 in HER2+ breast cancer cells. These trifunctional ON tools displayed very low toxicity and good levels of antiproliferative activity in HER2+ breast cancer cells. The present study will be of great potential in the fight against complex pathologies involving multiple mRNA targets, as the proposed cleavable designs will allow the efficient single-dose administration of different ON drugs simultaneously.
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  • 文章类型: Journal Article
    对于以扩展的胞嘧啶-腺嘌呤-鸟嘌呤(CAG)重复为特征的各种遗传性疾病,如脊髓小脑共济失调(SCA)亚型和亨廷顿病(HD),遗传干预目前正在不同的临床试验阶段进行测试.患者对此类干预措施的看法应包括在这些新治疗方法的进一步开发和实施中。
    深入了解SCA和HD患者对遗传干预的想法和观点。
    在这项定性研究中,参与者采用半结构化访谈技术进行访谈.讨论的主题是可能的风险和收益,和逻辑因素,如时机,位置和专业知识。使用通用主题分析对数据进行了分析。回应被编码为上级主题。
    采访了10名参与者(5名SCA和5名HD)。总的来说,参与者似乎愿意接受基因干预.重要的动机是缺乏替代的疾病修饰治疗方案,减缓疾病进展的希望,和保持当前的生活质量。在接受遗传干预之前,与会者希望进一步了解情况。Logistic因素,如给药方式和频率,医疗保健提供者的专业知识,治疗的时机对决策过程有影响。
    这项研究确定了假设,动机,以及在这些新疗法之前需要进一步关注的话题,如果证明有效,可以在临床实践中实施。结果可能有助于设计针对这些和其他罕见的遗传性运动障碍的遗传干预措施的护理途径。
    UNASSIGNED: For various genetic disorders characterized by expanded cytosine-adenine-guanine (CAG) repeats, such as spinocerebellar ataxia (SCA) subtypes and Huntington\'s disease (HD), genetic interventions are currently being tested in different clinical trial phases. The patient\'s perspective on such interventions should be included in the further development and implementation of these new treatments.
    UNASSIGNED: To obtain insight into the thoughts and perspectives of individuals with SCA and HD on genetic interventions.
    UNASSIGNED: In this qualitative study, participants were interviewed using semi-structured interview techniques. Topics discussed were possible risks and benefits, and logistic factors such as timing, location and expertise. Data were analyzed using a generic thematic analysis. Responses were coded into superordinate themes.
    UNASSIGNED: Ten participants (five with SCA and five with HD) were interviewed. In general, participants seemed to be willing to undergo genetic interventions. Important motives were the lack of alternative disease-modifying treatment options, the hope for slowing down disease progression, and preservation of current quality of life. Before undergoing genetic interventions, participants wished to be further informed. Logistic factors such as mode and frequency of administration, expertise of the healthcare provider, and timing of treatment are of influence in the decision-making process.
    UNASSIGNED: This study identified assumptions, motives, and topics that require further attention before these new therapies, if proven effective, can be implemented in clinical practice. The results may help in the design of care pathways for genetic interventions for these and other rare genetic movement disorders.
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