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Antisense‐mediated exon skipping: a therapeutic strategy for titin‐based dilated cardiomyopathy

Authors: Meinrad Gawaz; Alexander Goedel; Brenda Gerull; Katja Metzger; Elvira Immacolata Parrotta; Elvira Immacolata Parrotta; Alessandra Moretti; +18 Authors

Antisense‐mediated exon skipping: a therapeutic strategy for titin‐based dilated cardiomyopathy

Abstract

AbstractFrameshift mutations in the TTN gene encoding titin are a major cause for inherited forms of dilated cardiomyopathy (DCM), a heart disease characterized by ventricular dilatation, systolic dysfunction, and progressive heart failure. To date, there are no specific treatment options for DCM patients but heart transplantation. Here, we show the beneficial potential of reframing titin transcripts by antisense oligonucleotide (AON)‐mediated exon skipping in human and murine models of DCM carrying a previously identified autosomal‐dominant frameshift mutation in titin exon 326. Correction of TTN reading frame in patient‐specific cardiomyocytes derived from induced pluripotent stem cells rescued defective myofibril assembly and stability and normalized the sarcomeric protein expression. AON treatment in Ttn knock‐in mice improved sarcomere formation and contractile performance in homozygous embryos and prevented the development of the DCM phenotype in heterozygous animals. These results demonstrate that disruption of the titin reading frame due to a truncating DCM mutation can be restored by exon skipping in both patient cardiomyocytes in vitro and mouse heart in vivo, indicating RNA‐based strategies as a potential treatment option for DCM.

Keywords

Medicine (General), Titin, Dilated cardiomyopathy, Oligonucleotides, QH426-470, Cardiovascular, 630, Transgenic, Mice, Myofibrils, Dilated, 2.1 Biological and endogenous factors, Connectin, Myocytes, Cardiac, anzsrc-for: 31 Biological Sciences, Frameshift Mutation, Research Articles, Cells, Cultured, Cultured, anzsrc-for: 3101 Biochemistry and Cell Biology, Exons, Induced pluripotent stem cells, Heart Disease, Cardiac, Exon skipping, Biotechnology, exon skipping, Cardiomyopathy, Dilated, Cardiomyopathy, induced pluripotent stem cells, Cells, Cytological Techniques, 610, Mice, Transgenic, 3101 Biochemistry and Cell Biology, Rare Diseases, R5-920, Genetics, Animals, Humans, titin, Antisense, Myocytes, 5.2 Cellular and gene therapies, Animal, Genetic Therapy, Oligonucleotides, Antisense, Stem Cell Research, dilated cardiomyopathy, Disease Models, Animal, Orphan Drug, anzsrc-for: 11 Medical and Health Sciences, Gene Expression Regulation, Cardiovascular and Metabolic Diseases, 1313 Molecular Medicine, Disease Models, anzsrc-for: 06 Biological Sciences, 31 Biological Sciences, ddc: ddc:

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    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).
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    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.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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citations
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!
106
Top 1%
Top 10%
Top 1%
Green
gold