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Characterizing Exon Skipping Efficiency in DMD Patient Samples in Clinical Trials of Antisense Oligonucleotides
Published on: May 7, 2020
RETRACTED: Proteasome inhibitors increase missense mutated dysferlin in patients with muscular dystrophy
Bilal A Azakir1, Beat Erne1, Sabrina Di Fulvio1
1Neuromuscular Research Group, Departments of Neurology and Biomedicine, University Hospital Basel, 4031 Basel, Switzerland.
Abstract:
No treatment is available for patients affected by the recessively inherited, progressive muscular dystrophies caused by a deficiency in the muscle membrane repair protein dysferlin. A marked reduction in dysferlin in patients harboring missense mutations in at least one of the two pathogenic DYSF alleles encoding dysferlin implies that dysferlin is degraded by the cell's quality control machinery. In vitro evidence suggests that missense mutated dysferlin might be functional if salvaged from degradation by the proteasome. We treated three patients with muscular dystrophy due to a homozygous Arg555Trp mutation in dysferlin with the proteasome inhibitor bortezomib and monitored dysferlin expression in monocytes and in skeletal muscle by repeated percutaneous muscle biopsy. Expression of missense mutated dysferlin in the skeletal muscle and monocytes of the three patients increased markedly, and dysferlin was correctly localized to the sarcolemma of muscle fibers on histological sections. Salvaged missense mutated dysferlin was functional in a membrane resealing assay in patient-derived muscle cells treated with three different proteasome inhibitors. We conclude that interference with the proteasomal system increases expression of missense mutated dysferlin, suggesting that this therapeutic strategy may benefit patients with dysferlinopathies and possibly other genetic diseases.
Insights
Researchers explored a new treatment for dysferlinopathies, a muscular dystrophy. By inhibiting the proteasome, they increased functional dysferlin protein expression in patients, offering hope for this genetic muscle disease.
Area of Science:
- Biochemistry
- Genetics
- Neurology
Background:
- Dysferlinopathies are progressive muscular dystrophies caused by dysferlin deficiency.
- Missense mutations in the DYSF gene lead to reduced functional dysferlin, implying degradation by cellular quality control.
Purpose of the Study:
- To investigate the therapeutic potential of proteasome inhibition for dysferlinopathies.
- To determine if salvaging missense-mutated dysferlin can restore protein function.
Main Methods:
- Treatment of three patients with a homozygous Arg555Trp DYSF mutation using the proteasome inhibitor bortezomib.
- Monitoring dysferlin expression in monocytes and skeletal muscle via muscle biopsies.
- Assessing membrane resealing function in patient-derived muscle cells.
Main Results:
- Marked increase in dysferlin expression in skeletal muscle and monocytes.
- Corrected localization of dysferlin to the sarcolemma in muscle fibers.
- Demonstrated functional membrane repair capabilities of salvaged dysferlin.
Conclusions:
- Proteasome inhibition effectively increases the expression of missense-mutated dysferlin.
- This therapeutic strategy shows promise for treating dysferlinopathies.
- The approach may also be applicable to other genetic diseases involving protein degradation.
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