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      Comparison of Mutation Profiles in the Duchenne Muscular Dystrophy Gene among Populations: Implications for Potential Molecular Therapies

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          Abstract

          Novel therapeutic approaches are emerging to restore dystrophin function in Duchenne Muscular Dystrophy (DMD), a severe neuromuscular disease characterized by progressive muscle wasting and weakness. Some of the molecular therapies, such as exon skipping, stop codon read-through and internal ribosome entry site-mediated translation rely on the type and location of mutations. Hence, their potential applicability worldwide depends on mutation frequencies within populations. In view of this, we compared the mutation profiles of the populations represented in the DMD Leiden Open-source Variation Database with original data from Mexican patients ( n = 162) with clinical diagnosis of the disease. Our data confirm that applicability of exon 51 is high in most populations, but also show that differences in theoretical applicability of exon skipping may exist among populations; Mexico has the highest frequency of potential candidates for the skipping of exons 44 and 46, which is different from other populations ( p < 0.001). To our knowledge, this is the first comprehensive comparison of theoretical applicability of exon skipping targets among specific populations.

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          Gentamicin-induced readthrough of stop codons in Duchenne muscular dystrophy.

          The objective of this study was to establish the feasibility of long-term gentamicin dosing to achieve stop codon readthrough and produce full-length dystrophin. Mutation suppression of stop codons, successfully achieved in the mdx mouse using gentamicin, represents an important evolving treatment strategy in Duchenne muscular dystrophy (DMD). Two DMD cohorts received 14-day gentamicin (7.5mg/kg/day): Cohort 1 (n = 10) stop codon patients and Cohort 2 (n = 8) frameshift controls. Two additional stop codon DMD cohorts were gentamicin treated (7.5mg/kg) for 6 months: Cohort 3 (n = 12) dosed weekly and Cohort 4 (n = 4) dosed twice weekly. Pre- and post-treatment biopsies were assessed for dystrophin levels, as were clinical outcomes. In the 14-day study, serum creatine kinase (CK) dropped by 50%, which was not seen in frameshift DMD controls. After 6 months of gentamicin, dystrophin levels significantly increased (p = 0.027); the highest levels reached 13 to 15% of normal (1 in Cohort 3, and 2 in Cohort 4), accompanied by reduced serum CK favoring drug-induced readthrough of stop codons. This was supported by stabilization of strength and a slight increase in forced vital capacity. Pretreatment stable transcripts predicted an increase of dystrophin after gentamicin. Readthrough efficiency was not affected by the stop codon or its surrounding fourth nucleotide. In 1 subject, antigen-specific interferon-gamma enzyme-linked immunospot assay detected an immunogenic dystrophin epitope. The results support efforts to achieve drug-induced mutation suppression of stop codons. The immunogenic epitope resulting from readthrough emphasizes the importance of monitoring T-cell immunity during clinical studies that suppress stop codons. Similar principles apply to other molecular strategies, including exon skipping and gene therapy.
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            Change in natural history of Duchenne muscular dystrophy with long-term corticosteroid treatment: implications for management.

            In 2005, the American Academy of Neurology and the Child Neurology Society published a practice parameter, based primarily on studies that involved 6 to 18 months of treatment, indicating that prednisone has a beneficial effect on muscle strength and function in patients with Duchenne muscular dystrophy and recommended that corticosteroids be offered (prednisone 0.75 mg/kg/d and deflazacort 0.9 mg/kg/d) as treatment. Recent reports emphasize that longer term treatment with corticosteroids (greater than 3 years) produces important sustained benefits in neuromuscular function without causing major side effects. This review highlights these reports and indicates that long-term corticosteroid therapy (1) prolongs ambulation by 2 to 5 years, (2) reduces the need for spinal stabilization surgery, (3) improves cardiopulmonary function, (4) delays the need for noninvasive nasal ventilation, and (5) increases survival and the quality of life of patients with Duchenne muscular dystrophy. Educational, vocational, and other social counseling is now a vital part of management for Duchenne muscular dystrophy.
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              A fast method for high-quality genomic DNA extraction from whole human blood.

              A simple and fast protocol is described for the purification of genomic DNA from 0.3 ml of whole human blood. The recovery of DNA is quantitative and reproducible; the quality is such that it can be used for all relevant molecular biology techniques.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                09 March 2015
                March 2015
                : 16
                : 3
                : 5334-5346
                Affiliations
                [1 ]National Medical Centre “20 de Noviembre”, Institute for Social Security of State Workers, Mexico City 03100, Mexico; E-Mails: bladimir_roque@ 123456hotmail.com (B.R.-R.); rolasil@ 123456yahoo.com.mx (S.G.)
                [2 ]Asociación de Distrofia Muscular de Occidente A.C., Guadalajara 44380, Mexico; E-Mails: monica207383614@ 123456gmail.com (M.A.-S.); anilorac_zg911@ 123456hotmail.com (C.Z.-G.)
                [3 ]National Institute of Rehabilitation, Mexico City 14389, Mexico; E-Mails: bgodiaz@ 123456gmail.com (B.G.-D.); rescobarmex@ 123456gmail.com (R.E.E.-C.)
                [4 ]Department of Molecular Biology, Panamerican University, Mexico City 03920, Mexico; E-Mails: lunangulo@ 123456gmail.com (A.B.L.-A.); festrada@ 123456up.edu.mx (F.J.E.-M.)
                [5 ]University Center of Exact Sciences and Engineering, University of Guadalajara, Guadalajara 44430, Mexico
                [6 ]Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury SP2 8BJ, UK; E-Mail: Dave.Bunyan@ 123456salisbury.nhs.uk
                [7 ]General Hospital of Durango, Durango, 34000, Mexico; E-Mail: laruanoc@ 123456hotmail.com
                [8 ]Instituto de Investigación en Genética Molecular, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán, 47810, México; E-Mail: hrangel13@ 123456hotmail.com
                [9 ]Department of Human Genetics, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands; E-Mail: julyberries@ 123456hotmail.com
                [10 ]Studies Section of Postgraduate and Research, School of Medicine, National Polytechnic Institute, Mexico City 11340, Mexico; E-Mail: rmcoralv@ 123456gmail.com
                Author notes
                [†]

                These authors contributed equally to this work.

                [* ]Author to whom correspondence should be addressed; E-Mail: lblhmedgen@ 123456gmail.com ; Tel.: +52-55-5200-5003; Fax: +52-33-3632-6200.
                Article
                ijms-16-05334
                10.3390/ijms16035334
                4394478
                25761239
                92d3225e-52ca-4b2e-87dd-afc54cc2bc52
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 17 December 2014
                : 27 February 2015
                Categories
                Article

                Molecular biology
                ataluren,dmd gene,mlpa,exon skipping,duchenne,therapies
                Molecular biology
                ataluren, dmd gene, mlpa, exon skipping, duchenne, therapies

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