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通读方法治疗杜氏肌营养不良症中的终止突变。更新。

Read-through approach for stop mutations in Duchenne muscular dystrophy. An update.

机构信息

Cardiomiology and Medical Genetics, "Luigi Vanvitelli" University, Naples, Italy.

出版信息

Acta Myol. 2021 Mar 31;40(1):43-50. doi: 10.36185/2532-1900-041. eCollection 2021 Mar.

DOI:10.36185/2532-1900-041
PMID:33870095
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8033424/
Abstract

Dystrophinopathies are allelic conditions caused by deletions, duplications and point-mutations in the gene, located on the X chromosome (Xp21.2). Mutations that prematurely interrupt the dystrophin protein synthesis lead to the most severe clinical form, Duchenne muscular Dystrophy, characterized by early involvement of muscle strength. There is no known cure for dystrophinopathies. In DMD, treatment with corticosteroids have changed the natural history and the progression of the disease, prolonging ambulation, and slowing the onset of respiratory and cardiac involvement and scoliosis by several years. In the last few years, new perspectives and options are deriving from the discovery of pharmacological approaches able to restore normal, full-length dystrophin and potentially reverse the course of the disease. Read-through (RT) of nonsense mutations, thanks to its ability to bypass the premature stop codon and to act on virtually any region of the dystrophin gene, independently of the location in which the mutation resides, is one of these promising approaches. This non-systematic review shows the different steps that, passing from yeast to humans, have made it possible to use this innovative successful approach to treat serious diseases such as Duchenne muscular dystrophy.

摘要

肌营养不良症是由位于 X 染色体(Xp21.2)上的基因缺失、重复和点突变引起的等位基因疾病。导致肌营养不良蛋白合成过早中断的突变导致最严重的临床形式,即杜氏肌营养不良症,其特征是肌肉力量早期受累。目前尚无肌营养不良症的治愈方法。在 DMD 中,皮质类固醇治疗改变了疾病的自然史和进展,延长了步行能力,并通过数年时间延缓了呼吸和心脏受累以及脊柱侧凸的发生。在过去的几年中,由于发现了能够恢复正常全长肌营养不良蛋白并可能逆转疾病进程的药理学方法,新的观点和选择正在出现。无义突变的通读(RT),由于其能够绕过过早的终止密码子并在肌营养不良基因的几乎任何区域发挥作用,而与突变所在的位置无关,是这些有前途的方法之一。本非系统性综述展示了从酵母到人类的不同步骤,这些步骤使得利用这种创新的成功方法来治疗严重疾病(如杜氏肌营养不良症)成为可能。

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本文引用的文献

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Causes of clinical variability in Duchenne and Becker muscular dystrophies and implications for exon skipping therapies.杜氏肌营养不良症和贝克肌营养不良症临床变异性的原因及其对外显子跳跃疗法的影响。
Acta Myol. 2020 Dec 1;39(4):179-186. doi: 10.36185/2532-1900-020. eCollection 2020 Dec.
2
Developing DMD therapeutics: a review of the effectiveness of small molecules, stop-codon readthrough, dystrophin gene replacement, and exon-skipping therapies.开发 DMD 疗法:小分子、终止密码子通读、肌营养不良蛋白基因替换和外显子跳跃疗法的疗效评价。
Expert Opin Investig Drugs. 2021 Feb;30(2):167-176. doi: 10.1080/13543784.2021.1868434. Epub 2021 Jan 6.
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Pediatr Nephrol. 2025 May;40(5):1523-1538. doi: 10.1007/s00467-024-06551-x. Epub 2024 Nov 1.
4
Transition and management of patients with Duchenne Muscular Dystrophy: a narrative review based on Italian experts' opinion and real-world experience.杜氏肌营养不良症患者的转归和管理:基于意大利专家意见和真实世界经验的叙述性综述。
Acta Myol. 2024 Sep;43(3):102-107. doi: 10.36185/2532-1900-447.
5
Molecular and Biochemical Therapeutic Strategies for Duchenne Muscular Dystrophy.杜氏肌营养不良症的分子与生化治疗策略
Neurol Int. 2024 Jul 5;16(4):731-760. doi: 10.3390/neurolint16040055.
6
Treatment with ataluren in four symptomatic Duchenne carriers. A pilot study.用ataluren 治疗 4 名有症状的杜氏肌营养不良症携带者:一项初步研究。
Acta Myol. 2024 Feb 21;43(1):8-15. doi: 10.36185/2532-1900-398. eCollection 2024.
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CPT Pharmacometrics Syst Pharmacol. 2024 May;13(5):891-903. doi: 10.1002/psp4.13126. Epub 2024 Mar 27.
8
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J Comp Eff Res. 2020 Apr;9(5):341-360. doi: 10.2217/cer-2019-0171. Epub 2020 Jan 30.
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J Comp Eff Res. 2019 Oct;8(14):1187-1200. doi: 10.2217/cer-2019-0086. Epub 2019 Aug 15.
10
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