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胎儿反义寡核苷酸治疗先天性耳聋和前庭功能障碍。

Fetal antisense oligonucleotide therapy for congenital deafness and vestibular dysfunction.

机构信息

Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, OR 97239, USA.

Center for Genetic Diseases, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.

出版信息

Nucleic Acids Res. 2020 May 21;48(9):5065-5080. doi: 10.1093/nar/gkaa194.

Abstract

Disabling hearing loss impacts ∼466 million individuals worldwide with 34 million children affected. Gene and pharmacotherapeutic strategies to rescue auditory function in mouse models of human deafness are most effective when administered before hearing onset, after which therapeutic efficacy is significantly diminished or lost. We hypothesize that preemptive correction of a mutation in the fetal inner ear prior to maturation of the sensory epithelium will optimally restore sensory function. We previously demonstrated that transuterine microinjection of a splice-switching antisense oligonucleotide (ASO) into the amniotic cavity immediately surrounding the embryo on embryonic day 13-13.5 (E13-13.5) corrected pre-mRNA splicing in the juvenile Usher syndrome type 1c (Ush1c) mouse mutant. Here, we show that this strategy only marginally rescues hearing and partially rescues vestibular function. To improve therapeutic outcomes, we microinjected ASO directly into the E12.5 inner ear. A single intra-otic dose of ASO corrects harmonin RNA splicing, restores harmonin protein expression in sensory hair cell bundles, prevents hair cell loss, improves hearing sensitivity, and ameliorates vestibular dysfunction. Improvements in auditory and vestibular function were sustained well into adulthood. Our results demonstrate that an ASO pharmacotherapeutic administered to a developing organ system in utero preemptively corrects pre-mRNA splicing to abrogate the disease phenotype.

摘要

失聪会影响全球约 4.66 亿人,其中 3400 万是儿童。在人类耳聋的小鼠模型中,基因和药物治疗策略在听力出现之前进行干预,效果最佳,而在此之后,治疗效果会显著降低或消失。我们假设,在感觉上皮成熟之前,对胎儿内耳中的突变进行预先纠正,将最佳地恢复感觉功能。我们之前曾证明,在 E13-13.5 时,通过向胚胎周围的羊膜腔中直接注射剪接转换反义寡核苷酸(ASO),可以纠正幼年型 Usher 综合征 1c 型(Ush1c)小鼠突变体中的前 mRNA 剪接。在这里,我们发现这种策略只能略微挽救听力,部分挽救前庭功能。为了改善治疗效果,我们直接将 ASO 注射到 E12.5 内耳中。单次内耳内剂量的 ASO 可纠正 harmonin RNA 剪接,恢复感觉毛细胞束中的 harmonin 蛋白表达,防止毛细胞丢失,提高听力敏感性,并改善前庭功能障碍。听觉和前庭功能的改善可持续到成年期。我们的结果表明,在子宫内对发育中的器官系统进行 ASO 药物治疗可以预先纠正前 mRNA 剪接,从而消除疾病表型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/883b/7229850/714ca3410ec1/gkaa194fig1.jpg

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