4.1 Review

Gene therapy review: Duchenne muscular dystrophy case study

Journal

REVUE NEUROLOGIQUE
Volume 179, Issue 1-2, Pages 90-105

Publisher

MASSON EDITEUR
DOI: 10.1016/j.neurol.2022.11.005

Keywords

Duchenne muscular dystrophy; DMD; Dystrophin; Gene therapy

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Gene therapy, a therapeutic approach involving genetic material as a drug, is used to treat diseases, including neurological disorders. Different gene therapy approaches have varying mechanisms of action and levels of maturity. This review focuses on gene therapy techniques applied to Duchenne muscular dystrophy (DMD) and discusses gene transfer techniques, DNA editing, and RNA-level approaches. Clinical data and the advantages, limitations, and risks associated with gene therapy are presented.
Gene therapy, i.e., any therapeutic approach involving the use of genetic material as a drug and more largely altering the transcription or translation of one or more genes, covers a wide range of innovative methods for treating diseases, including neurological disorders. Although they share common principles, the numerous gene therapy approaches differ greatly in their mechanisms of action. They also differ in their maturity for some are already used in clinical practice while others have never been used in humans. The aim of this review is to present the whole range of gene therapy techniques through the example of Duchenne muscular dystrophy (DMD). DMD is a severe myopathy caused by mutations in the dystrophin gene leading to the lack of functional dystrophin protein. It is a disease known to all neurologists and in which almost all gene therapy methods were applied. Here we discuss the mechanisms of gene transfer techniques with or without viral vectors, DNA editing with or without matrix repair and those acting at the RNA level (RNA editing, exon skipping and STOP-codon readthrough). For each method, we present the results obtained in DMD with a particular focus on clinical data. This review aims also to outline the advantages, limitations and risks of gene therapy related to the approach used. # 2022 Elsevier Masson SAS. All rights reserved.

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