G.O.17 - The physiological consequences of different levels of dystrophin following antisense based exon-skipping in the mdx mouse

Abstract

We examined the effects on muscle physiology of restoring different levels of dystrophin in mdx mice with established dystrophic pathophysiology (12 weeks and older). Dystrophin expression was induced very efficiently using cell penetrating peptides linked to an antisense sequencing targeting exon 23 which contains a premature stop mutation. We assessed muscle physiology in the tibialis anterior (TA) muscle of the mouse using a terminally anaesthetised in situ protocol. To assess muscle physiology in the diaphragm we used strips of diaphragm in an in-vitro system. In both cases we examined the force–frequency relationship and established maximum specific tetanic force. We then subjected the muscles to a 10% stretch while stimulating them to contract. This eccentric exercise was highly damaging to dystrophic muscle. We present data showing that 15% of normal levels of dystrophin were sufficient to prevent eccentric exercise induced damage following a single dose of Pip6a-PMO. Chronic intravenous (IV) administration had a cumulative effect and we show that restoration of 50% of normal levels of dystrophin produced a 40% improvement in maximum specific force. Intraperitoneal administration of a single dose of B-PMO produced an 88% increase in maximum specific force as well as protecting against eccentric exercise induced damage in the diaphragm. Similar results were obtained in the diaphragm with chronic IV delivery of Pip6a-PMO at the same dose as the studies in the TA, even when treating older mice with extensive fibrosis in the diaphragm. While caution must be applied when extrapolating these results to DMD patients, the results suggest that moderate levels of dystrophin may be sufficient to slow-down or possibly prevent disease progression whereas higher levels of dystrophin will also improve muscle force production.