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杜氏肌营养不良症:常见可用疗法的最新综述

Duchenne muscular dystrophy: an updated review of common available therapies.

作者信息

Salmaninejad Arash, Valilou Saeed Farajzadeh, Bayat Hadi, Ebadi Nader, Daraei Abdolreza, Yousefi Meysam, Nesaei Abolfazl, Mojarrad Majid

机构信息

a Drug Applied Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.

b Student Research Committee, Department of Medical Genetics, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran.

出版信息

Int J Neurosci. 2018 Sep;128(9):854-864. doi: 10.1080/00207454.2018.1430694. Epub 2018 Feb 5.

Abstract

BACKGROUND AND PURPOSE

Duchenne muscular dystrophy (DMD) is a lethal progressive pediatric muscle disorder and genetically inherited as an X-linked disease that caused by mutations in the dystrophin gene. DMD leads to progressive muscle weakness, degeneration, and wasting; finally, follows with the premature demise in affected individuals due to respiratory and/or cardiac failure typically by age of 30. For decades, scientists tried massively to find an effective therapy method, but there is no absolute cure currently for patients with DMD, nevertheless, recent advanced progressions on the treatment of DMD will be hopeful in the future. Several promising gene therapies are currently under investigation. These include gene replacement, exon skipping, suppression of stop codons. More recently, a promising gene editing tool referred to as CRISPR/Cas9 offers exciting perspectives for restoring dystrophin expression in patients with DMD. This review intents to briefly describe these methods and comment on their advances. Since DMD is a genetic disorder, it should be treated by replacing the deficient DMD copy with a functional one. However, there are different types of mutations in this gene, so such therapeutic approaches are highly mutation specific and thus are personalized. Therefore, DMD has arisen as a model of genetic disorder for understanding and overcoming of the challenges of developing personalized genetic medicines, consequently, the lessons learned from these approaches will be applicable to many other disorders.

CONCLUSIONS

This review provides an update on the recent gene therapies for DMD that aim to compensate for dystrophin deficiency and the related clinical trials.

摘要

背景与目的

杜氏肌营养不良症(DMD)是一种致命的进行性儿科肌肉疾病,为X连锁遗传病,由肌营养不良蛋白基因突变引起。DMD会导致进行性肌肉无力、退化和萎缩;最终,受影响个体通常在30岁时因呼吸和/或心力衰竭而过早死亡。几十年来,科学家们大量尝试寻找有效的治疗方法,但目前DMD患者尚无绝对的治愈方法,不过,DMD治疗方面最近的进展在未来有望取得成果。目前有几种有前景的基因疗法正在研究中。这些包括基因替代、外显子跳跃、终止密码子抑制。最近,一种被称为CRISPR/Cas9的有前景的基因编辑工具为恢复DMD患者的肌营养不良蛋白表达提供了令人兴奋的前景。本综述旨在简要描述这些方法并对其进展进行评论。由于DMD是一种遗传性疾病,应通过用功能性拷贝替代缺陷的DMD拷贝来进行治疗。然而,该基因存在不同类型的突变,因此此类治疗方法具有高度的突变特异性,因而具有个性化特点。因此,DMD已成为一种遗传性疾病的模型,用于理解和克服开发个性化基因药物所面临的挑战,因此,从这些方法中学到的经验教训将适用于许多其他疾病。

结论

本综述提供了有关旨在弥补肌营养不良蛋白缺陷的DMD最新基因疗法及相关临床试验的最新信息。

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