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基于肽偶联反义寡核苷酸的剪接校正治疗杜氏肌营养不良症和其他神经肌肉疾病。

Peptide-conjugate antisense based splice-correction for Duchenne muscular dystrophy and other neuromuscular diseases.

机构信息

Department of Molecular Therapy, National Institute of Neuroscience, National Centre of Neurology and Psychiatry, Kodaira-shi, Tokyo, Japan.

Fujii Memorial Institute of Medical Sciences, University of Tokushima, Tokushima, Japan.

出版信息

EBioMedicine. 2019 Jul;45:630-645. doi: 10.1016/j.ebiom.2019.06.036. Epub 2019 Jun 27.

Abstract

Duchenne muscular dystrophy (DMD) is an X-linked disorder characterized by progressive muscle degeneration, caused by the absence of dystrophin. Exon skipping by antisense oligonucleotides (ASOs) has recently gained recognition as therapeutic approach in DMD. Conjugation of a peptide to the phosphorodiamidate morpholino backbone (PMO) of ASOs generated the peptide-conjugated PMOs (PPMOs) that exhibit a dramatically improved pharmacokinetic profile. When tested in animal models, PPMOs demonstrate effective exon skipping in target muscles and prolonged duration of dystrophin restoration after a treatment regime. Herein we summarize the main pathophysiological features of DMD and the emergence of PPMOs as promising exon skipping agents aiming to rescue defective gene expression in DMD and other neuromuscular diseases. The listed PPMO laboratory findings correspond to latest trends in the field and highlight the obstacles that must be overcome prior to translating the animal-based research into clinical trials tailored to the needs of patients suffering from neuromuscular diseases.

摘要

杜氏肌营养不良症(DMD)是一种 X 连锁疾病,其特征是肌肉进行性退化,由肌营养不良蛋白缺失引起。反义寡核苷酸(ASO)的外显子跳跃最近被认为是 DMD 的一种治疗方法。将肽与 ASO 的磷酰胺二酯吗啉代骨架(PMO)缀合,生成了肽缀合的 PMO(PPMO),其表现出显著改善的药代动力学特征。在动物模型中进行测试时,PPMO 在靶肌肉中表现出有效的外显子跳跃,并在治疗方案后延长了肌营养不良蛋白恢复的持续时间。本文总结了 DMD 的主要病理生理特征,以及 PPMO 作为有前途的外显子跳跃剂的出现,旨在挽救 DMD 和其他神经肌肉疾病中缺陷基因的表达。列出的 PPMO 实验室发现反映了该领域的最新趋势,并强调了在将基于动物的研究转化为针对神经肌肉疾病患者需求的临床试验之前,必须克服的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0923/6642283/754ef80dd884/gr1.jpg

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