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Translational read-through as an alternative approach for ocular gene therapy of retinal dystrophies caused by in-frame nonsense mutations

Published online by Cambridge University Press:  10 June 2014

KERSTIN NAGEL-WOLFRUM ,
FABIAN MÖLLER ,
INESSA PENNER  and
UWE WOLFRUM
KERSTIN NAGEL-WOLFRUM*
Affiliation:
Department of Cell and Matrix Biology, Institute of Zoology, Johannes Gutenberg-University of Mainz, Mainz, Germany
FABIAN MÖLLER
Affiliation:
Department of Cell and Matrix Biology, Institute of Zoology, Johannes Gutenberg-University of Mainz, Mainz, Germany
INESSA PENNER
Affiliation:
Department of Cell and Matrix Biology, Institute of Zoology, Johannes Gutenberg-University of Mainz, Mainz, Germany
UWE WOLFRUM
Affiliation:
Department of Cell and Matrix Biology, Institute of Zoology, Johannes Gutenberg-University of Mainz, Mainz, Germany
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Abstract

The eye has become an excellent target for gene therapy, and gene augmentation therapy of inherited retinal disorders has made major progress in recent years. Nevertheless, a recent study indicated that gene augmentation intervention might not stop the progression of retinal degeneration in patients. In addition, for many genes, viral-mediated gene augmentation is currently not feasible due to gene size and limited packaging capacity of viral vectors as well as expression of various heterogeneous isoforms of the target gene. Thus, alternative gene-based strategies to stop or delay the retinal degeneration are necessary. This review focuses on an alternative pharmacologic treatment strategy based on the usage of translational read-through inducing drugs (TRIDs) such as PTC124, aminoglycoside antibiotics, and designer aminoglycosides for overreading in-frame nonsense mutations. This strategy has emerged as an option for up to 30–50% of all cases of recessive hereditary retinal dystrophies. In-frame nonsense mutations are single-nucleotide alterations within the gene coding sequence resulting in a premature stop codon. Consequently, translation of such mutated genes leads to the synthesis of truncated proteins, which are unable to fulfill their physiologic functions. In this context, application of TRIDs facilitates the recoding of the premature termination codon into a sense codon, thus restoring syntheses of full-length proteins. So far, clinical trials for non-ocular diseases have been initiated for diverse TRIDs. Although the clinical outcome is not analyzed in detail, an excellent safety profile, namely for PTC124, was clearly demonstrated. Moreover, recent data demonstrated sustained read-through efficacies of nonsense mutations causing retinal degeneration, as manifested in the human Usher syndrome. In addition, a strong retinal biocompatibility for PTC124 and designer aminoglycosides has been demonstrated. In conclusion, recent progress emphasizes the potential of TRIDs as an alternative pharmacologic treatment strategy for treating nonsense mutation-based retinal disorders.

Keywords

Hereditary retinal dystrophiesUsher syndromeGene-based therapyPharmaceutical treatmentSuppression of nonsense mutations
Type
Review Articles
Information
Visual Neuroscience , Volume 31 , Issue 4-5: Strategies for Restoring Sight in Retinal Dystrophies , September 2014 , pp. 309 - 316
Copyright
Copyright © Cambridge University Press 2014 

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