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Peptide-phosphorodiamidate morpholino oligomer therapy for dysferlinopathy induces pseudoexon skipping and restoration of functional protein
James E. Gooding, Gyeongsu Park, Atish Wagh, Jonathan K. Watts, Janice A. Dominov, Robert H. Brown Jr
James E. Gooding, Gyeongsu Park, Atish Wagh, Jonathan K. Watts, Janice A. Dominov, Robert H. Brown Jr
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Research Article Genetics Muscle biology

Peptide-phosphorodiamidate morpholino oligomer therapy for dysferlinopathy induces pseudoexon skipping and restoration of functional protein

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Abstract

The dysferlinopathies are a spectrum of autosomal recessive muscle diseases caused by mutations in the dysferlin gene (DYSF). Clinical manifestations vary from asymptomatic hyperCKemia to severe muscle pathology and loss of muscle function. These are designated as limb-girdle muscular dystrophy type 2R (LGMDR2; formerly LGMD2B or Miyoshi myopathy). Among other functions, dysferlin is crucial for plasma membrane repair and maintenance of intracellular calcium homeostasis. In previous studies, we identified 2 independent point mutations deep within introns that cause aberrant DYSF mRNA splicing and the inclusion of pseudoexons within transcripts that diminish protein expression. In this study, we generated and characterized a mouse model for 1 of these mutations (within DYSF intron 44). In these mice, a segment of human DYSF DNA containing the mutant intronic sequence flanked by surrounding human exon sequences replaced the normal homologous mouse DNA. These mice exhibited aberrant Dysf pre-mRNA splicing, pseudoexon inclusion, loss of DYSF protein expression, and muscle pathology similar to that observed in patients. Using this model, we identified antisense oligonucleotides and a peptide-phosphorodiamidate morpholino oligomer that blocks the mouse Dysf pre-mRNA splicing complexes from binding the mutant pre-mRNA, thereby restoring nearly normal muscle pathology and function.

Authors

James E. Gooding, Gyeongsu Park, Atish Wagh, Jonathan K. Watts, Janice A. Dominov, Robert H. Brown Jr

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Figure 4

Dysferlin pseudoexon 44.1 removal via PMOs in patient-derived myotubes.

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Dysferlin pseudoexon 44.1 removal via PMOs in patient-derived myotubes.
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(A–C) Patient-derived myotubes heterozygous for the pseudoexon 44.1 disease-causing mutation treated for 72 hours with therapeutic PMO at 10, 5, 3, 0.75, 0.25, 0.01 μM, and 1 μM of nontargeting control (NTC) PMO compared with untreated controls (UT) and untreated WT myotubes analyzed by RT-qPCR. (A) RT-qPCR utilizing primers amplifying pseudoexon containing dysferlin transcripts. (B) RT-qPCR utilizing primers amplifying WT dysferlin transcripts. (C) Western blot detecting dysferlin and β-actin, 2 samples per condition shown. (D) Quantification of dysferlin expression levels determined using the ratio to β-actin protein for normalization. Statistical differences were determined using 1-way ANOVA and Tukey’s post hoc test: **P < 0.005, ***P < 0.0002, and ****P < 0.0001.

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