Long-Term Morpholino Oligomers in Hexose Elicits Long-Lasting Therapeutic Improvements in mdx Mice.

Long-Term Morpholino Oligomers in Hexose Elicits Long-Lasting Therapeutic Improvements in mdx Mice.
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己糖中的长期形态寡聚物引发了MDX小鼠的长期治疗改善。

DOI:
10.1016/j.omtn.2018.06.005
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发表时间:
2018-09-07
期刊:
Molecular therapy. Nucleic acids
影响因子:
--
通讯作者:
Yin H
Yin H
中科院分区:
其他
文献类型:
--
作者:
Han G;Lin C;Ning H;Gao X;Yin H

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反义寡核苷酸 eteplirsen 的批准凸显了外显子跳跃疗法治疗杜氏肌营养不良症患者的前景。然而,eteplirsen 的有限疗效凸显了改善全身给药和疗效的重要性。最近,我们证明葡萄糖和果糖 (GF) 递送制剂可有效增强磷二酰胺吗啉低聚物 (PMO)。考虑到 GF 的临床潜力,在临床转化之前确定与 PMO 在 mdx 小鼠中的长期相容性和功效非常重要。在这里,我们报告了临床适用的 PMO 剂量(50 mg/kg/周,持续 3 周,随后 50 mg/kg/月,持续 11 个月)与 GF 的全年给药,在 mdx 小鼠中引发了持续高水平的肌营养不良蛋白表达,在大多数外周肌肉中恢复了高达 45% 的肌营养不良蛋白正常水平,而没有任何可检测到的毒性。重要的是,PMO-GF 导致表型拯救和线粒体生物发生以及功能改善。碳水化合物代谢物测量显示,在没有代谢异常的 mdx 小鼠中,经 PMO-GF 治疗后,代谢和能量状况得到改善。总的来说,我们的研究表明 PMO-GF 能够产生持久的治疗效果和可耐受的毒性,代表了杜氏肌营养不良症的一种新治疗方式,并为 GF 反义寡核苷酸的临床使用提供了指南。
Approval of antisense oligonucleotide eteplirsen highlights the promise of exon-skipping therapeutics for Duchenne muscular dystrophy patients. However, the limited efficacy of eteplirsen underscores the importance to improve systemic delivery and efficacy. Recently, we demonstrated that a glucose and fructose (GF) delivery formulation effectively potentiates phosphorodiamidate morpholino oligomer (PMO). Considering the clinical potential of GF, it is important to determine the long-term compatibility and efficacy with PMO in mdx mice prior to clinical translation. Here, we report that yearlong administration of a clinically applicable PMO dose (50 mg/kg/week for 3 weeks followed by 50 mg/kg/month for 11 months) with GF elicited sustainably high levels of dystrophin expression in mdx mice, with up to 45% of the normal level of dystrophin restored in most peripheral muscles without any detectable toxicity. Importantly, PMO-GF resulted in phenotypical rescue and mitochondrial biogenesis with functional improvement. Carbohydrate metabolites measurements revealed improved metabolic and energetic conditions after PMO-GF treatment in mdx mice without metabolic anomaly. Collectively, our study shows PMO-GF’s ability to elicit long-lasting therapeutic effects with tolerable toxicity and represents a new treatment modality for Duchenne muscular dystrophy, and provides guidelines for antisense oligonucleotides with GF in clinical use.
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