Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK.
Department of Paediatrics, University of Oxford, Oxford, UK.
Nat Rev Drug Discov. 2023 Nov;22(11):917-934. doi: 10.1038/s41573-023-00775-6. Epub 2023 Aug 31.
Duchenne muscular dystrophy (DMD) is a monogenic muscle-wasting disorder and a priority candidate for molecular and cellular therapeutics. Although rare, it is the most common inherited myopathy affecting children and so has been the focus of intense research activity. It is caused by mutations that disrupt production of the dystrophin protein, and a plethora of drug development approaches are under way that aim to restore dystrophin function, including exon skipping, stop codon readthrough, gene replacement, cell therapy and gene editing. These efforts have led to the clinical approval of four exon skipping antisense oligonucleotides, one stop codon readthrough drug and one gene therapy product, with other approvals likely soon. Here, we discuss the latest therapeutic strategies that are under development and being deployed to treat DMD. Lessons from these drug development programmes are likely to have a major impact on the DMD field, but also on molecular and cellular medicine more generally. Thus, DMD is a pioneer disease at the forefront of future drug discovery efforts, with these experimental treatments paving the way for therapies using similar mechanisms of action being developed for other genetic diseases.
杜氏肌营养不良症(DMD)是一种单基因肌肉消耗性疾病,是分子和细胞治疗的优先候选者。尽管它很少见,但它是最常见的影响儿童的遗传性肌肉疾病,因此一直是密集研究活动的重点。它是由破坏肌营养不良蛋白产生的突变引起的,目前有大量的药物开发方法正在进行,旨在恢复肌营养不良蛋白的功能,包括外显子跳跃、终止密码子通读、基因替换、细胞治疗和基因编辑。这些努力导致了四种外显子跳跃反义寡核苷酸、一种终止密码子通读药物和一种基因治疗产品的临床批准,其他批准可能很快就会到来。在这里,我们讨论了正在开发和部署用于治疗 DMD 的最新治疗策略。这些药物开发项目的经验教训很可能对 DMD 领域产生重大影响,但也对分子和细胞医学产生更广泛的影响。因此,DMD 是一种处于未来药物发现前沿的先驱疾病,这些实验性治疗为针对其他遗传疾病开发的类似作用机制的治疗方法铺平了道路。
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