FSHD Therapeutic Strategies: What Will It Take to Get to Clinic?

FSHD Therapeutic Strategies: What Will It Take to Get to Clinic?
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FSHD治疗策略:需要什么才能进入诊所?

DOI:
10.3390/jpm12060865
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发表时间:
2022-05-25
影响因子:
--
通讯作者:
Jones, Peter L.
Jones, Peter L.
中科院分区:
医学4区
文献类型:
--
作者:
Himeda, Charis L.;Jones, Peter L.

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面肩肱型肌营养不良症(FSHD)可以说是最难理解和治疗的遗传性疾病之一。该疾病是由大卫星重复序列的表观遗传失调引起的,要么是重复序列的收缩,要么是沉默蛋白的突变。这两种情况都会导致染色质松弛,并且在允许等位基因的情况下,导致骨骼肌中 DUX4 的致病性错误表达。该位点的复杂性以及 FSHD 是一种有毒的功能获得性疾病这一事实给治疗策略的设计带来了独特的挑战。 FSHD 的 DUX4 靶向治疗主要有三种途径:小分子、寡核苷酸疗法和基于 CRISPR 的方法。在这里,我们评估每个途径的临床前进展,并讨论为克服翻译的主要障碍而做出的努力。
Facioscapulohumeral muscular dystrophy (FSHD) is arguably one of the most challenging genetic diseases to understand and treat. The disease is caused by epigenetic dysregulation of a macrosatellite repeat, either by contraction of the repeat or by mutations in silencing proteins. Both cases lead to chromatin relaxation and, in the context of a permissive allele, pathogenic misexpression of DUX4 in skeletal muscle. The complex nature of the locus and the fact that FSHD is a toxic, gain-of-function disease present unique challenges for the design of therapeutic strategies. There are three major DUX4-targeting avenues of therapy for FSHD: small molecules, oligonucleotide therapeutics, and CRISPR-based approaches. Here, we evaluate the preclinical progress of each avenue, and discuss efforts being made to overcome major hurdles to translation.
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