Restoring Protein Expression in Neuromuscular Conditions: A Review Assessing the Current State of Exon Skipping/Inclusion and Gene Therapies for Duchenne Muscular Dystrophy and Spinal Muscular Atrophy.

BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Omar Sheikh, Toshifumi Yokota

Abstract

The debilitating neuromuscular disorders Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA), which harm 1 in 5000 newborn males and 1 in 11,000 newborns, respectively, are marked by progressive muscle wasting among other complications. While DMD causes generalized muscle weakness due to the absence of the dystrophin protein, SMA patients generally face motor neuron degeneration because of the lack of the survival motor neuron (SMN) protein. Many of the most promising therapies for both conditions restore the absent proteins dystrophin and SMN. Antisense oligonucleotide-mediated exon skipping and inclusion therapies are advancing clinically with the approved DMD therapies casimersen, eteplirsen, golodirsen, and viltolarsen, and the SMA therapy nusinersen. Existing antisense therapies focus on skeletal muscle for DMD and motor neurons for SMA, respectively. Through innovative techniques, such as peptide conjugation and multi-exon skipping, these therapies could be optimized for efficacy and applicability. By contrast, gene replacement therapy is administered only once to patients during treatment. Currently, only onasemnogene abeparvovec for SMA has been approved. Safety shortcomings remain a major challenge for ...Continue Reading

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Citations

Jul 3, 2021·International Journal of Molecular Sciences·Sharon MordechayOrna Halevy

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Methods Mentioned

BETA
SMA
antisense
gene replacement therapy
antisense oligonucleotides

Clinical Trials Mentioned

NCT01736553
NCT02193074
NCT02122952
NCT03505099
NCT03837184
NCT03461289
NCT03306277
NCT02052791
NCT01780246
NCT02292537

Software Mentioned

Sarepta
ENDEAR
NURTURE

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