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Human Gene Therapy
Comparative Analysis of Antisense Oligonucleotide Sequences for Targeted Skipping of Exon 51 During Dystrophin Pre-mRNA Splicing in Human Muscle

To cite this article:
V. Arechavala-Gomeza, I.R. Graham, L.J. Popplewell, A.M. Adams, A. Aartsma-Rus, M. Kinali, J.E. Morgan, J.C. van Deutekom, S.D. Wilton, G. Dickson, F. Muntoni. Human Gene Therapy. September 2007, 18(9): 798-810. doi:10.1089/hum.2006.061.

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V. Arechavala-Gomeza 
Department of Paediatrics, Imperial College, London W12ONN, United Kingdom.
I.R. Graham 
School of Biological Sciences, Royal Holloway-University of London, Egham TW20 0EX, United Kingdom.
L.J. Popplewell 
School of Biological Sciences, Royal Holloway-University of London, Egham TW20 0EX, United Kingdom.
A.M. Adams 
Centre for Neurological and Neuromuscular Disorders, Australian Neuromuscular Research Institute, University of Western Australia, Perth WA6009, Australia.
A. Aartsma-Rus 
Center for Human and Clinical Genetics, Leiden University Medical Center, 2300RC Leiden, The Netherlands.
M. Kinali 
Department of Paediatrics, Imperial College, London W12ONN, United Kingdom.
J.E. Morgan 
Department of Paediatrics, Imperial College, London W12ONN, United Kingdom.
J.C. van Deutekom 
Center for Human and Clinical Genetics, Leiden University Medical Center, 2300RC Leiden, The Netherlands.
Prosensa, 2333AL Leiden, The Netherlands.
S.D. Wilton 
Centre for Neurological and Neuromuscular Disorders, Australian Neuromuscular Research Institute, University of Western Australia, Perth WA6009, Australia.
G. Dickson 
School of Biological Sciences, Royal Holloway-University of London, Egham TW20 0EX, United Kingdom.
F. Muntoni 
Department of Paediatrics, Imperial College, London W12ONN, United Kingdom.

Duchenne muscular dystrophy (DMD) is caused by mutations in the dystrophin gene that result in the absence of functional protein. In the majority of cases these are out-of-frame deletions that disrupt the reading frame. Several attempts have been made to restore the dystrophin mRNA reading frame by modulation of pre-mRNA splicing with antisense oligonucleotides (AOs), demonstrating success in cultured cells, muscle explants, and animal models. We are preparing for a phase I/IIa clinical trial aimed at assessing the safety and effect of locally administered AOs designed to inhibit inclusion of exon 51 into the mature mRNA by the splicing machinery, a process known as exon skipping. Here, we describe a series of systematic experiments to validate the sequence and chemistry of the exon 51 AO reagent selected to go forward into the clinical trial planned in the United Kingdom. Eight specific AO sequences targeting exon 51 were tested in two different chemical forms and in three different preclinical models: cultured human muscle cells and explants (wild type and DMD), and local in vivo administration in transgenic mice harboring the entire human DMD locus. Data have been validated independently in the different model systems used, and the studies describe a rational collaborative path for the preclinical selection of AOs for evaluation in future clinical trials.

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