Yameogo Pouiré, Aguilar Selina, Prakash Thazha P, Rigo Frank, Lynch David R, Napierala Jill S, Napierala Marek
Department of Neurology, O'Donnell Brain Institute, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA.
Ionis Pharmaceuticals Inc., 2855 Gazelle Court, Carlsbad, CA 92010, USA.
Mol Ther Nucleic Acids. 2025 Jul 1;36(3):102617. doi: 10.1016/j.omtn.2025.102617. eCollection 2025 Sep 9.
Friedreich's ataxia (FRDA) is a multisystem, progressive disease. 96% of patients carry biallelic GAA triplet expansion mutations in intron 1 of the frataxin gene (). The remaining 4% have a pathogenic GAA expansion on one allele and another mutation on the second allele. A point mutation, c.165+5G>C, was identified in intron 1 of a patient with FRDA resulting in a significant decrease of FXN levels. Using patient fibroblasts, we demonstrated that the c.165+5G>C mutation affects canonical splicing of , leading to the generation of an aberrant transcript. A library of antisense oligonucleotides (ASOs) was designed to target potential intronic splicing regulator motifs and tested in patient cells. Selected O-methoxyethyl (MOE)-ASOs increased FXN levels in c.165+5G>C patient cells without affecting splicing in control cells. The leading MOE-ASO increased expression of a mini gene carrying the c.165+5G>C point mutation by splicing repair. To increase efficacy, we simultaneously targeted the GAA-expanded allele in patient cells using a synthetic transcription factor (synthetic transcription elongation factor 1 [Syn-TEF1]). This ASO strategy may be therapeutically feasible for patients with FRDA with other point mutations that cause splicing defects. Success in developing treatments for disorders with only a few known cases will give hope to patients with FRDA carrying these rare point mutations.
弗里德赖希共济失调(FRDA)是一种多系统进行性疾病。96%的患者在铁调素基因第1内含子中携带双等位基因GAA三联体扩增突变()。其余4%的患者在一个等位基因上有致病性GAA扩增,在第二个等位基因上有另一种突变。在一名FRDA患者的第1内含子中鉴定出一个点突变c.165 + 5G>C,导致FXN水平显著降低。利用患者成纤维细胞,我们证明c.165 + 5G>C突变影响的经典剪接,导致异常转录本的产生。设计了一个反义寡核苷酸(ASO)文库,以靶向潜在的内含子剪接调节基序,并在患者细胞中进行测试。选定的O - 甲氧基乙基(MOE)-ASO在c.165 + 5G>C患者细胞中增加了FXN水平,而不影响对照细胞中的剪接。领先的MOE-ASO通过剪接修复增加了携带c.165 + 5G>C点突变的微型基因的表达。为了提高疗效,我们使用合成转录因子(合成转录延伸因子1 [Syn-TEF1])在患者细胞中同时靶向GAA扩增的等位基因。这种ASO策略对于患有其他导致剪接缺陷的点突变的FRDA患者可能在治疗上是可行的。在仅少数已知病例的疾病治疗开发方面取得成功将给携带这些罕见点突变的FRDA患者带来希望。