Increase in Full-Length Dystrophin by Exon Skipping in Duchenne Muscular Dystrophy Patients with Single Exon Duplications: An Open-label Study

杜氏肌营养不良症患者中存在单个外显子重复,外显子跳跃导致全长肌营养不良蛋白增加:一项开放标签研究

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作者:Stefan Nicolau, Jyoti Malhotra, Maryann Kaler, Pamela Magistrado-Coxen, Megan A Iammarino, Natalie F Reash, Emma C Frair, Saranga Wijeratne, Benjamin J Kelly, Peter White, Linda P Lowes, Megan A Waldrop, Kevin M Flanigan

Abstract

Single exon duplications account for disease in a minority of Duchenne muscular dystrophy patients. Exon skipping in these patients has the potential to be highly therapeutic through restoration of full-length dystrophin expression. We conducted a 48-week open label study of casimersen and golodirsen in 3 subjects with an exon 45 or 53 duplication. Two subjects (aged 18 and 23 years) were non-ambulatory at baseline. Upper limb, pulmonary, and cardiac function appeared stable in the 2 subjects in whom they could be evaluated. Dystrophin expression increased from 0.94 % ±0.59% (mean±SD) of normal to 5.1% ±2.9% by western blot. Percent dystrophin positive fibers also rose from 14% ±17% at baseline to 50% ±42% . Our results provide initial evidence that the use of exon-skipping drugs may increase dystrophin levels in patients with single-exon duplications.

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