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Theragnosis for Duchenne Muscular Dystrophy

تشخيص ضمور العضلات الدوشيني
Authors: Leonela Luce; Leonela Luce; Micaela Carcione; Micaela Carcione; Chiara Mazzanti; Chiara Mazzanti; Paula I. Buonfiglio; +6 Authors

Theragnosis for Duchenne Muscular Dystrophy

Abstract

Dystrophinopathies cover a spectrum of rare progressive X-linked muscle diseases, arising from DMD mutations. They are among the most common pediatric muscular dystrophies, being Duchenne muscular dystrophy (DMD) the most severe form. Despite the fact that there is still no cure for these serious diseases, unprecedented advances are being made for the development of therapies for DMD. Some of which are already conditionally approved: exon skipping and premature stop codon read-through. The present work aimed to characterize the mutational spectrum of DMD in an Argentinian cohort, to identify candidates for available pharmacogenetic treatments and finally, to conduct a comparative analysis of the Latin American (LA) frequencies of mutations amenable for available DMD therapies. We studied 400 patients with clinical diagnosis of dystrophinopathy, implementing a diagnostic molecular algorithm including: MLPA/PCR/Sanger/Exome and bioinformatics. We also performed a meta-analysis of LA’s metrics for DMD available therapies. The employed algorithm resulted effective for the achievement of differential diagnosis, reaching a detection rate of 97%. Because of this, corticosteroid treatment was correctly indicated and validated in 371 patients with genetic confirmation of dystrophinopathy. Also, 20 were eligible for exon skipping of exon 51, 21 for exon 53, 12 for exon 45 and another 70 for premature stop codon read-through therapy. We determined that 87.5% of DMD patients will restore the reading frame with the skipping of only one exon. Regarding nonsense variants, UGA turned out to be the most frequent premature stop codon observed (47%). According to the meta-analysis, only four LA countries (Argentina, Brazil, Colombia and Mexico) provide the complete molecular algorithm for dystrophinopathies. We observed different relations among the available targets for exon skipping in the analyzed populations, but a more even proportion of nonsense variants (∼40%). In conclusion, this manuscript describes the theragnosis carried out in Argentinian dystrophinopathy patients. The implemented molecular algorithm proved to be efficient for the achievement of differential diagnosis, which plays a crucial role in patient management, determination of the standard of care and genetic counseling. Finally, this work contributes with the international efforts to characterize the frequencies and variants in LA, pillars of drug development and theragnosis.

Keywords

FOS: Computer and information sciences, THERAGNOSIS, Molecular Mechanisms of Muscle Regeneration and Atrophy, Pediatrics, Gene, duchenne muscular dystrophy (DMD), Dystrophin, https://purl.org/becyt/ford/3.2, theragnosis, Missense mutation, Internal medicine, Multiplex ligation-dependent probe amplification, Nonsense mutation, Life Sciences, Diagnosis and Management of Hypertrophic Cardiomyopathy, META-ANALYSIS, NONSENSE, RNA Methylation and Modification in Gene Expression, Medicine, dystrophinopathies, Cardiology and Cardiovascular Medicine, Exon skipping, Duchenne muscular dystrophy, Bioinformatics, Exon, RM1-950, LATIN AMERICA, DYSTROPHINOPATHIES, MUTAGENIC SPECTRUM, Biochemistry, Genetics and Molecular Biology, Health Sciences, Genetics, DUCHENNE MUSCULAR DYSTROPHY (DMD), https://purl.org/becyt/ford/3, Molecular Biology, Biology, Pharmacology, EXON SKIPPING, Muscular dystrophy, meta-analysis, nonsense, FOS: Biological sciences, Mutation, mutagenic spectrum, Therapeutics. Pharmacology, Alternative splicing

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
Green
gold