2
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Watanabe N, Tone Y, Nagata T, Masuda S, Saito T, Motohashi N, Takagaki K, Aoki Y, Takeda S. Exon 44 skipping in Duchenne muscular dystrophy: NS-089/NCNP-02, a dual-targeting antisense oligonucleotide. MOLECULAR THERAPY. NUCLEIC ACIDS 2023; 34:102034. [PMID: 37854955 PMCID: PMC10579524 DOI: 10.1016/j.omtn.2023.102034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 09/15/2023] [Indexed: 10/20/2023]
Abstract
Exon-skipping therapy mediated by antisense oligonucleotides is expected to provide a therapeutic option for Duchenne muscular dystrophy. Antisense oligonucleotides for exon skipping reported so far target a single continuous sequence in or around the target exon. In the present study, we investigated antisense oligonucleotides for exon 44 skipping (applicable to approximately 6% of all Duchenne muscular dystrophy patients) to improve activity by using a novel antisense oligonucleotide design incorporating two connected sequences. Phosphorodiamidate morpholino oligomers targeting two separate sequences in exon 44 were created to target two splicing regulators in exon 44 simultaneously, and their exon 44 skipping was measured. NS-089/NCNP-02 showed the highest skipping activity among the oligomers. NS-089/NCNP-02 also induced exon 44 skipping and dystrophin protein expression in cells from a Duchenne muscular dystrophy patient to whom exon 44 skipping is applicable. We also assessed the in vivo activity of NS-089/NCNP-02 by intravenous administration to cynomolgus monkeys. NS-089/NCNP-02 induced exon 44 skipping in skeletal and cardiac muscle of cynomolgus monkeys. In conclusion, NS-089/NCNP-02, an antisense oligonucleotide with a novel connected-sequence design, showed highly efficient exon skipping both in vitro and in vivo.
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Affiliation(s)
- Naoki Watanabe
- Discovery Research Laboratories in Tsukuba, Nippon Shinyaku Co., Ltd, Tsukuba, Ibaraki, Japan
| | - Yuichiro Tone
- Discovery Research Laboratories in Tsukuba, Nippon Shinyaku Co., Ltd, Tsukuba, Ibaraki, Japan
| | - Tetsuya Nagata
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
- Department of Neurology and Neurological Science, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoru Masuda
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Takashi Saito
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Norio Motohashi
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Kazuchika Takagaki
- Discovery Research Laboratories in Tsukuba, Nippon Shinyaku Co., Ltd, Tsukuba, Ibaraki, Japan
| | - Yoshitsugu Aoki
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Shin’ichi Takeda
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
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3
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Félix TM, Fischinger Moura de Souza C, Oliveira JB, Rico-Restrepo M, Zanoteli E, Zatz M, Giugliani R. Challenges and recommendations to increasing the use of exome sequencing and whole genome sequencing for diagnosing rare diseases in Brazil: an expert perspective. Int J Equity Health 2023; 22:11. [PMID: 36639662 PMCID: PMC9837951 DOI: 10.1186/s12939-022-01809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023] Open
Abstract
Early diagnosis of genetic rare diseases is an unmet need in Brazil, where an estimated 10-13 million people live with these conditions. Increased use of chromosome microarray assays, exome sequencing, and whole genome sequencing as first-tier testing techniques in suitable indications can shorten the diagnostic odyssey, eliminate unnecessary tests, procedures, and treatments, and lower healthcare expenditures. A selected panel of Brazilian experts in fields related to rare diseases was provided with a series of relevant questions to address before a multi-day conference. Within this conference, each narrative was discussed and edited through numerous rounds of discussion until agreement was achieved. The widespread adoption of exome sequencing and whole genome sequencing in Brazil is limited by various factors: cost and lack of funding, reimbursement, awareness and education, specialist shortages, and policy issues. To reduce the burden of rare diseases and increase early diagnosis, the Brazilian healthcare authorities/government must address the barriers to equitable access to early diagnostic methods for these conditions. Recommendations are provided, including broadening approved testing indications, increasing awareness and education efforts, increasing specialist training opportunities, and ensuring sufficient funding for genetic testing.
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Affiliation(s)
- Têmis Maria Félix
- grid.414449.80000 0001 0125 3761Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, 90,035–903 Brazil
| | - Carolina Fischinger Moura de Souza
- grid.414449.80000 0001 0125 3761Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, 90,035–903 Brazil
| | - João Bosco Oliveira
- grid.413562.70000 0001 0385 1941Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Edmar Zanoteli
- grid.11899.380000 0004 1937 0722Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Mayana Zatz
- grid.11899.380000 0004 1937 0722Human Genome and Stem-cell Research Center, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Roberto Giugliani
- grid.414449.80000 0001 0125 3761Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, 90,035–903 Brazil ,House of Rares, Porto Alegre, Rio Grande do Sul Brazil
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6
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Lefebvre M, Sanlaville D, Marle N, Thauvin-Robinet C, Gautier E, Chehadeh SE, Mosca-Boidron AL, Thevenon J, Edery P, Alex-Cordier MP, Till M, Lyonnet S, Cormier-Daire V, Amiel J, Philippe A, Romana S, Malan V, Afenjar A, Marlin S, Chantot-Bastaraud S, Bitoun P, Heron B, Piparas E, Morice-Picard F, Moutton S, Chassaing N, Vigouroux-Castera A, Lespinasse J, Manouvrier-Hanu S, Boute-Benejean O, Vincent-Delorme C, Petit F, Meur NL, Marti-Dramard M, Guerrot AM, Goldenberg A, Redon S, Ferrec C, Odent S, Caignec CL, Mercier S, Gilbert-Dussardier B, Toutain A, Arpin S, Blesson S, Mortemousque I, Schaefer E, Martin D, Philip N, Sigaudy S, Busa T, Missirian C, Giuliano F, Benailly HK, Kien PKV, Leheup B, Benneteau C, Lambert L, Caumes R, Kuentz P, François I, Heron D, Keren B, Cretin E, Callier P, Julia S, Faivre L. Genetic counselling difficulties and ethical implications of incidental findings from array-CGH: a 7-year national survey. Clin Genet 2016; 89:630-5. [PMID: 26582393 DOI: 10.1111/cge.12696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Abstract
Microarray-based comparative genomic hybridization (aCGH) is commonly used in diagnosing patients with intellectual disability (ID) with or without congenital malformation. Because aCGH interrogates with the whole genome, there is a risk of being confronted with incidental findings (IF). In order to anticipate the ethical issues of IF with the generalization of new genome-wide analysis technologies, we questioned French clinicians and cytogeneticists about the situations they have faced regarding IF from aCGH. Sixty-five IF were reported. Forty corresponded to autosomal dominant diseases with incomplete penetrance, 7 to autosomal dominant diseases with complete penetrance, 14 to X-linked diseases, and 4 were heterozygotes for autosomal recessive diseases with a high prevalence of heterozygotes in the population. Therapeutic/preventive measures or genetic counselling could be argued for all cases except four. These four IF were intentionally not returned to the patients. Clinicians reported difficulties in returning the results in 29% of the cases, mainly when the question of IF had not been anticipated. Indeed, at the time of the investigation, only 48% of the clinicians used consents mentioning the risk of IF. With the emergence of new technologies, there is a need to report such national experiences; they show the importance of pre-test information on IF.
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Affiliation(s)
- M Lefebvre
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - D Sanlaville
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - N Marle
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - C Thauvin-Robinet
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - E Gautier
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - S E Chehadeh
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - A-L Mosca-Boidron
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - J Thevenon
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - P Edery
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - M-P Alex-Cordier
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - M Till
- Genetics Service, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, and Eastern Biology and Pathology Centre, Lyon, France
| | - S Lyonnet
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - V Cormier-Daire
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - J Amiel
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - A Philippe
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - S Romana
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - V Malan
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - A Afenjar
- Service de Génétique, Hôpital Pitié Salpêtrière, Paris, France
| | - S Marlin
- Département de Génétique, Hôpital Necker-Enfants Malades, Paris, France
| | - S Chantot-Bastaraud
- APHP, Hôpital Armand Trousseau, Service de Génétique et d'Embryologie Médicales, Paris, France
| | - P Bitoun
- Service de Pédiatrie, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - B Heron
- Department of Neuropediatrics, Armand Trousseau Hospital, APHP, Paris, France
| | - E Piparas
- Cytogenetics Laboratory, Jean Verdier Hospital, Bondy, France
| | - F Morice-Picard
- Department of Clinical Genetics, Bordeaux Children's Hospital, CHU de Bordeaux, Bordeaux, France
| | - S Moutton
- Department of Clinical Genetics, Bordeaux Children's Hospital, CHU de Bordeaux, Bordeaux, France
| | - N Chassaing
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - A Vigouroux-Castera
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - J Lespinasse
- Cytogenetics Laboratory, Chambery Hospital, Chambery, France
| | - S Manouvrier-Hanu
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - O Boute-Benejean
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - C Vincent-Delorme
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - F Petit
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHRU, Lille, France
| | - N L Meur
- Cytogenetics Laboratory, Etablissement Français du Sang de Normandie, Rouen, France
| | - M Marti-Dramard
- Unité de Génétique Clinique, Hôpital Nord, CHU, Amiens, France
| | - A-M Guerrot
- Service de Pédiatrie Néonatale et Réanimation, Centre D'éducation Fonctionnelle de l'enfant, CHU de Rouen, Rouen, France
| | - A Goldenberg
- Unité de Génétique Médicale, CHU Rouen, Rouen, France
| | - S Redon
- Laboratoire de Génétique Moléculaire, CHU, Brest, France
| | - C Ferrec
- Laboratoire de Génétique Moléculaire, CHU, Brest, France
| | - S Odent
- Service de Génétique Clinique, CLAD-Ouest, Hôpital Sud, Rennes, France
| | - C L Caignec
- Service de Génétique Médicale, Unité de Génétique Clinique, CLAD-Ouest, CHU de Nantes, Nantes, France
| | - S Mercier
- Service de Génétique Médicale, Unité de Génétique Clinique, CLAD-Ouest, CHU de Nantes, Nantes, France
| | | | - A Toutain
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - S Arpin
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - S Blesson
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - I Mortemousque
- Service de Génétique, Centre Hospitalo-Universitaire, Tours, France
| | - E Schaefer
- Service de Génétique Médicale, Hôpital de Hautepierre, Strasbourg, France
| | - D Martin
- Service de Génétique Médicale, Hôpital du Mans, Le Mans, France
| | - N Philip
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - S Sigaudy
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - T Busa
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - C Missirian
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - F Giuliano
- Service de Génétique Médicale, Hôpital de l'Archet II, CHU de Nice, Nice, France
| | - H K Benailly
- Service de Génétique Médicale, Hôpital de l'Archet II, CHU de Nice, Nice, France
| | - P K V Kien
- Service de Génétique Médicale, Hôpital Caremeau, CHU de Nimes, Nimes, France
| | - B Leheup
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - C Benneteau
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - L Lambert
- CHU de Nancy Pole Enfant, Centre de Référence Maladies Rares CLAD Est, Service de Médecine Infantile III et Génétique Clinique, Nancy, France
| | - R Caumes
- APHP, Hôpital Robert Debré, Service de Neurologie Pédiatrique, Paris, France
| | - P Kuentz
- Service de génétique, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | | | - D Heron
- Service de Génétique, APHP, Groupe Hospitalier de la Pitié-Salpétrière, Paris, France
| | - B Keren
- Service de Génétique, APHP, Groupe Hospitalier de la Pitié-Salpétrière, Paris, France
| | - E Cretin
- FHU-TRANSLAD, Université de Bourgogne, Dijon, France.,Espace Régional Éthique Bourgogne-Franche Comté, CHU, Besançon, France
| | - P Callier
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
| | - S Julia
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - L Faivre
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Est, FHU-TRANSLAD, Dijon, France.,Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France.,FHU-TRANSLAD, Université de Bourgogne, Dijon, France
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