Center for Research Translation of Systemic Exon-skipping in Muscular Dystrophy

肌营养不良症系统性外显子跳跃研究转化中心

• 批准号: 8544772
• 负责人: ERIC P. HOFFMAN
• 金额: $ 146.96万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-09 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8544772
• 关键词: Becker Muscular Dystrophy; Biological Assay; Canis familiaris; Cells; Clinical Trials; Complex; Consensus; Diagnostic; Drug Approval; Duchenne muscular dystrophy; Dystrophin; Exons; Gene Delivery; Gene Proteins; Genes; Goals; Human; In Vitro; Methods; Modeling; Molecular; Muscle; Muscular Dystrophies; Mutation; Natural History; Patients; Pharmaceutical Preparations; Procedures; Production; Proteins; RNA Splicing; Reading; Reporting; Research; Safety; System; Terminator Codon; Testing; Therapeutic; Transcript; Translational Research; Translations; Viral Vector; cell bank; clinical efficacy; cost; drug development; exon skipping; functional outcomes; gene therapy; in vivo; innovation; mouse model; mutant; pre-clinical; programs; protein function; repaired; small molecule; stem cell therapy

DESCRIPTION (provided by applicant): The identification of the Duchenne muscular dystrophy gene and protein in the late 1980's led to high hopes of rapid translation to rational therapeutics. Early reports of delivering new functional genes to mouse model muscle via gene therapy and stem cell therapy fueled this hope. However, these same studies illuminated the very high hurdles facing human applications. Insufficient therapeutic material (cells, viral vectors), challenges in systemic delivery, and immunological hurdles all remain barriers to demonstration of efficacy of exogenous gene delivery. An alternative approach Is to repair the patient's own gene, and two innovative small molecule approaches have emerged as front-line experimental therapeutics: stop codon read through, and exon skipping. Both approaches are In human clinical trials, and aim to coax dystrophin protein production from mutant genes. In the clinically severe dog model of DMD, the exon-skipping approach is the first therapeutic method that showed improvement of multiple functional outcomes. The proposed CORT is focusing on exon-skipping, the approach that holds promise for the majority of DMD patients. Exon skipping as a drug development program Is highly complex. Patients have different mutations, and drugs must be customized to groups of patients sharing overlapping deletions. Given the high cost of drug development, there is an emerging consensus that exon skipping should achieve drug approval 'as a class'. Three exon-specific drugs should be systematically studied, showing safety and efficacy. The procedures and rules optimized for these three drugs can then be generalized to other, less commonly applicable exon- specific drugs, with reduced regulatory hurdles. The goal of this CORT is to systematically study the three most commonly applicable exon-specific drugs (exons 45,51.53). Project 1 will determine the splicing fidelity and protein function corresponding to the In-frame transcripts generated by the drugs. Project 2 will optimize sequence selection for each exon using multiple experimental systems, and test optimized drugs in a 1 yr pre-clinical efficacy study. Project 3 will carry out the first natural history study of the targeted in-frame deletions (Becker muscular dystrophy); this will permit some prediction of clinical efficacy from production of the relevant semi-functional dystrophin proteins. These three Projects draw upon two research cores: Core B (In vitro and In vivo functional assays), and Core C (Molecular diagnostics and cell banking).

描述（由申请人提供）：20世纪80年代末，杜氏肌营养不良症基因和蛋白的鉴定导致了对快速转化为合理治疗的高度希望。通过基因治疗和干细胞治疗将新的功能基因输送到小鼠模型肌肉的早期报道助长了这一希望。然而，这些研究也揭示了人类应用所面临的非常高的障碍。治疗材料（细胞、病毒载体）不足、全身递送的挑战和免疫学障碍都仍然是证明外源基因递送功效的障碍。另一种方法是修复患者自身的基因，两种创新的小分子方法已经成为一线实验疗法：终止密码子通读和外显子跳跃。这两种方法都在人体临床试验中，目的是诱导突变基因产生肌营养不良蛋白。在临床上严重的DMD犬模型中，外显子跳跃方法是第一种显示多功能结局改善的治疗方法。拟议的CORT专注于外显子跳跃，这种方法对大多数DMD患者有希望。外显子跳跃作为一种药物开发程序是非常复杂的。患者有不同的突变，药物必须根据共享重叠缺失的患者群体进行定制。鉴于药物开发的高成本，人们逐渐达成共识，即外显子跳读应该“作为一类”获得药物批准。三种外显子特异性药物应进行系统研究，显示安全性和有效性。针对这三种药物优化的程序和规则可以推广到其他不太常用的外显子特异性药物，减少监管障碍。本CORT的目的是系统地研究三种最常用的外显子特异性药物（外显子45、51、53）。项目1将确定药物产生的框内转录物对应的剪接保真度和蛋白质功能。项目2将使用多个实验系统优化每个外显子的序列选择，并在1年临床前疗效研究中测试优化的药物。项目3将进行第一个针对框内缺失（贝克尔肌营养不良症）的自然史研究;这将允许从相关半功能性肌营养不良蛋白的生产中预测临床疗效。这三个项目借鉴了两个研究核心：核心B（体外和体内功能测定）和核心C（分子诊断和细胞库）。