Therapeutic exon skipping for dysferlinopathies?
Antisense-mediated exon skipping is a promising therapeutic approach for Duchenne muscular dystrophy (DMD) currently tested in clinical trials. The aim is to reframe dystrophin transcripts using antisense oligonucleotides (AONs). These hide an exon from the splicing machinery to induce exon skipping, restoration of the reading frame and generation of internally deleted, but partially functional proteins. It thus relies on the characteristic of the dystrophin protein, which has essential N- and C-terminal domains, whereas the central rod domain is largely redundant. This approach may also be applicable to limb-girdle muscular dystrophy type 2B (LGMD2B), Myoshi myopathy (MM) and distal myopathy with anterior tibial onset (DMAT), which are caused by mutations in the dysferlin-encoding DYSF gene. Dysferlin has a function in repairing muscle membrane damage. Dysferlin contains calcium-dependent C2 lipid binding (C2) domains and an essential transmembrane domain. However, mildly affected patients in whom one or a large number of DYSF exons were missing have been described, suggesting that internally deleted dysferlin proteins can be functional. Thus, exon skipping might also be applicable as a LGMD2B, MM and DMAT therapy. In this study we have analyzed the dysferlin protein domains and DYSF mutations and have described what exons are promising targets with regard to applicability and feasibility. We also show that DYSF exon skipping seems to be as straightforward as DMD exon skipping, as AONs to induce efficient skipping of four DYSF exons were readily identified.
Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands. a.m.rus@lumc.nl
Annemieke
A
Aartsma-Rus
Kavita H K
KH
Singh
Ivo F A C
IF
Fokkema
Ieke B
IB
Ginjaar
Gert-Jan
GJ
van Ommen
Johan T
JT
den Dunnen
Silvère M
SM
van der Maarel
D016373:DNA, Antisense / Q000627:therapeutic use; D000073939:Dysferlin; D016189:Dystrophin / Q000235:genetics; D005091:Exons; D005260:Female; D016368:Frameshift Mutation; D015316:Genetic Therapy; D006801:Humans; D008565:Membrane Proteins / Q000737:chemistry / Q000235:genetics*; D009124:Muscle Proteins / Q000737:chemistry / Q000235:genetics*; D009136:Muscular Dystrophies / Q000235:genetics* / Q000628:therapy; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use*; D017434:Protein Structure, Tertiary; D016364:Reading Frames / Q000235:genetics*; D017384:Sequence Deletion
D016373:DNA, Antisense; C114839:DYSF protein, human; D000073939:Dysferlin; D016189:Dystrophin; D008565:Membrane Proteins; D009124:Muscle Proteins; D016376:Oligonucleotides, Antisense