Dzierlega Kasia, Yokota Toshifumi
Department of Medical Genetics, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
Gene Ther. 2020 Sep;27(9):407-416. doi: 10.1038/s41434-020-0156-6. Epub 2020 Jun 1.
Duchenne muscular dystrophy (DMD) is one of the most common lethal muscle-wasting disorders affecting young boys caused by mutations in the DMD gene. Exon skipping has emerged as a promising therapy for DMD. Antisense oligonucleotides (AONs) are designed to induce the skipping of exon(s), in order to restore the reading frame, and therefore, allow for dystrophin expression. Eteplirsen and golodirsen, AONs for DMD exons 51 and 53 skipping, have been recently approved by the FDA. Viltolarsen, an AON for DMD exon 53 skipping, was approved in Japan earlier this year. Although promising, the efficacy of eteplirsen and AON sequence employed remain controversial. In addition, exon skipping faces challenges including the applicability and delivery. This article reviews and discusses exon skipping and the current advances being made in the field, on drugs, multi-exon skipping, sequence design, and applicability. We also discuss challenges and future directions that will facilitate the development of exon skipping therapy.
杜氏肌营养不良症(DMD)是影响年轻男孩的最常见的致死性肌肉萎缩疾病之一,由DMD基因突变引起。外显子跳跃已成为一种有前景的DMD治疗方法。反义寡核苷酸(AONs)旨在诱导外显子跳跃,以恢复阅读框,从而实现抗肌萎缩蛋白的表达。用于DMD外显子51和53跳跃的AONs药物依特普瑞森和戈洛迪森最近已获美国食品药品监督管理局(FDA)批准。用于DMD外显子53跳跃的AONs药物维托拉森今年早些时候在日本获批。尽管前景广阔,但依特普瑞森的疗效以及所采用的AON序列仍存在争议。此外,外显子跳跃面临包括适用性和递送等方面的挑战。本文回顾并讨论了外显子跳跃以及该领域在药物、多外显子跳跃、序列设计和适用性方面的当前进展。我们还讨论了有助于外显子跳跃疗法发展的挑战和未来方向。