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杜氏肌营养不良症的治疗方法。

Therapeutic approaches for Duchenne muscular dystrophy.

机构信息

Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK.

Department of Paediatrics, University of Oxford, Oxford, UK.

出版信息

Nat Rev Drug Discov. 2023 Nov;22(11):917-934. doi: 10.1038/s41573-023-00775-6. Epub 2023 Aug 31.


DOI:10.1038/s41573-023-00775-6
PMID:37652974
Abstract

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.

摘要

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。

相似文献

[1]
Therapeutic approaches for Duchenne muscular dystrophy.

Nat Rev Drug Discov. 2023-11

[2]
Developing DMD therapeutics: a review of the effectiveness of small molecules, stop-codon readthrough, dystrophin gene replacement, and exon-skipping therapies.

Expert Opin Investig Drugs. 2021-2

[3]
Molecular correction of Duchenne muscular dystrophy by splice modulation and gene editing.

RNA Biol. 2021-7

[4]
Quantitative Antisense Screening and Optimization for Exon 51 Skipping in Duchenne Muscular Dystrophy.

Mol Ther. 2017-7-28

[5]
[Genetic Diagnosis and Molecular Therapies for Duchenne Muscular Dystrophy].

Rinsho Byori. 2015-10

[6]
Skipping multiple exons of dystrophin transcripts using cocktail antisense oligonucleotides.

Nucleic Acid Ther. 2013-12-31

[7]
Contributions of Japanese patients to development of antisense therapy for DMD.

Brain Dev. 2016-1

[8]
Use of Small Animal Models for Duchenne and Parameters to Assess Efficiency upon Antisense Treatment.

Methods Mol Biol. 2022

[9]
New developments in the use of gene therapy to treat Duchenne muscular dystrophy.

Expert Opin Biol Ther. 2013-12-6

[10]
Clinical trials using antisense oligonucleotides in duchenne muscular dystrophy.

Hum Gene Ther. 2013-5-2

引用本文的文献

[1]
Continuous adipose-derived stem cell therapy from the neonatal stage effectively reduces Duchenne muscular dystrophy symptoms in rats.

Stem Cell Res Ther. 2025-8-26

[2]
Current perspectives on gene therapy and its involvement in curing genetic disorders.

Hum Genet. 2025-6-18

[3]
Pharmacologic Inhibition of Glutamate Dehydrogenase 1 Improves Functional Recovery of Neuromuscular Junctions and Muscle Function in Duchenne Muscular Dystrophy.

Am J Pathol. 2025-8

[4]
Serum protein biomarker signature of Duchenne muscular dystrophy.

Eur J Transl Myol. 2025-6-27

[5]
Current clinical applications of AAV-mediated gene therapy.

Mol Ther. 2025-6-4

[6]
Is dystrophin immunogenicity a barrier to advancing gene therapy for Duchenne muscular dystrophy?

Gene Ther. 2025-4-3

[7]
Valproic Acid Improves Antisense-Mediated Exon-Skipping Efficacy in Mice.

Int J Mol Sci. 2025-3-13

[8]
Expansion of Splice-Switching Therapy with Antisense Oligonucleotides.

Int J Mol Sci. 2025-3-4

[9]
Activation of endogenous full-length utrophin by MyoAAV-UA as a therapeutic approach for Duchenne muscular dystrophy.

Nat Commun. 2025-3-10

[10]
G-Quadruplex-Based Splice Switching as a Therapeutic Approach in Duchenne Muscular Dystrophy.

ACS Chem Biol. 2025-3-21

本文引用的文献

[1]
Histone deacetylase inhibitors improve antisense-mediated exon-skipping efficacy in mice.

Mol Ther Nucleic Acids. 2022-11-21

[2]
Non-uniform dystrophin re-expression after CRISPR-mediated exon excision in the dystrophin/utrophin double-knockout mouse model of DMD.

Mol Ther Nucleic Acids. 2022-10-23

[3]
Exon skipping induces uniform dystrophin rescue with dose-dependent restoration of serum miRNA biomarkers and muscle biophysical properties.

Mol Ther Nucleic Acids. 2022-8-25

[4]
Enhanced exon skipping and prolonged dystrophin restoration achieved by TfR1-targeted delivery of antisense oligonucleotide using FORCE conjugation in mdx mice.

Nucleic Acids Res. 2022-11-11

[5]
Emerging therapies for Duchenne muscular dystrophy.

Lancet Neurol. 2022-9

[6]
Muscle regeneration affects Adeno Associated Virus 1 mediated transgene transcription.

Sci Rep. 2022-6-11

[7]
Partial Restoration of Brain Dystrophin and Behavioral Deficits by Exon Skipping in the Muscular Dystrophy X-Linked (mdx) Mouse.

Ann Neurol. 2022-8

[8]
Dilated cardiomyopathy as the initial presentation of Becker muscular dystrophy: a systematic review of published cases.

Orphanet J Rare Dis. 2022-5-12

[9]
Time to diagnosis of Duchenne muscular dystrophy remains unchanged: Findings from the Muscular Dystrophy Surveillance, Tracking, and Research Network, 2000-2015.

Muscle Nerve. 2022-8

[10]
Repeated intravenous cardiosphere-derived cell therapy in late-stage Duchenne muscular dystrophy (HOPE-2): a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial.

Lancet. 2022-3-12

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