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针对哈钦森-吉尔福德早衰综合征的靶向反义治疗方法。

A targeted antisense therapeutic approach for Hutchinson-Gilford progeria syndrome.

机构信息

Molecular Genetics Section, Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.

Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, MD, USA.

出版信息

Nat Med. 2021 Mar;27(3):536-545. doi: 10.1038/s41591-021-01274-0. Epub 2021 Mar 11.

Abstract

Hutchinson-Gilford progeria syndrome (HGPS) is a rare accelerated aging disorder characterized by premature death from myocardial infarction or stroke. It is caused by de novo single-nucleotide mutations in the LMNA gene that activate a cryptic splice donor site, resulting in the production of a toxic form of lamin A, which is termed progerin. Here we present a potential genetic therapeutic strategy that utilizes antisense peptide-conjugated phosphorodiamidate morpholino oligomers (PPMOs) to block pathogenic splicing of mutant transcripts. Of several candidates, PPMO SRP-2001 provided the most significant decrease in progerin transcripts in patient fibroblasts. Intravenous delivery of SRP-2001 to a transgenic mouse model of HGPS produced significant reduction of progerin transcripts in the aorta, a particularly critical target tissue in HGPS. Long-term continuous treatment with SRP-2001 yielded a 61.6% increase in lifespan and rescue of vascular smooth muscle cell loss in large arteries. These results provide a rationale for proceeding to human trials.

摘要

亨廷顿氏舞蹈症-吉福德早衰综合征(HGPS)是一种罕见的加速衰老疾病,其特征是心肌梗死或中风导致的过早死亡。它是由 LMNA 基因中的从头单核苷酸突变引起的,这些突变激活了一个隐秘的剪接受体位点,导致产生一种毒性形式的核纤层蛋白 A,即称为 progerin。在这里,我们提出了一种潜在的基因治疗策略,该策略利用反义肽缀合的磷酰胺二酯吗啉寡聚物(PPMOs)来阻断突变转录本的致病剪接。在几个候选物中,PPMO SRP-2001 在患者成纤维细胞中提供了 progerin 转录本的最大程度降低。将 SRP-2001 静脉内递送至 HGPS 的转基因小鼠模型中,导致主动脉中 progerin 转录本的显著减少,而主动脉是 HGPS 中特别关键的靶组织。用 SRP-2001 进行长期连续治疗可使寿命延长 61.6%,并挽救大动脉中血管平滑肌细胞的丢失。这些结果为进行人体试验提供了依据。

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