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2018 ; 11
(ä): 1756286418776932
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Antisense oligonucleotides in neurological disorders
#MMPMID29854003
Wurster CD
; Ludolph AC
Ther Adv Neurol Disord
2018[]; 11
(ä): 1756286418776932
PMID29854003
show ga
The introduction of genetics revolutionized the field of neurodegenerative and
neuromuscular diseases and has provided considerable insight into the underlying
pathomechanisms. Nevertheless, effective treatment options have been limited.
This changed recently when antisense oligonucleotides (ASOs) could be translated
from in vitro and experimental animal studies into clinical practice. In 2016,
two ASOs were approved by the United States US Food and Drug Administration (FDA)
and demonstrated remarkable efficacy in Duchenne muscular dystrophy (DMD) and
spinal muscular atrophy (SMA). ASOs are synthetic single-stranded strings of
nucleic acids. They selectively bind to specific premessenger ribonucleic acid
(pre-mRNA)/mRNA sequences and alter protein synthesis by several mechanisms of
action. Thus, apart from gene replacement, ASOs may therefore provide the most
direct therapeutic strategy for influencing gene expression. In this review, we
shall discuss basic mechanisms of ASO action, the role of chemical modifications
needed to improve the pharmacodynamic and pharmacokinetic properties of ASOs, and
we shall then focus on several ASOs developed for the treatment of
neurodegenerative and neuromuscular disorders, including SMA, DMD, myotonic
dystrophies, Huntington's disease, amyotrophic lateral sclerosis and Alzheimer's
disease.