AON-Mediated Exon Skipping to Bypass Protein Truncation in Retinal Dystrophies Due to the Recurrent CEP290 c.4723A > T Mutation. Fact or Fiction?

I Barny, I Perrault, C Michel, N Goudin… - Genes, 2019 - mdpi.com
I Barny, I Perrault, C Michel, N Goudin, S Defoort-Dhellemmes, I Ghazi, J Kaplan, JM Rozet…
Genes, 2019mdpi.com
Mutations in CEP290 encoding a centrosomal protein important to cilia formation cause a
spectrum of diseases, from isolated retinal dystrophies to multivisceral and sometimes
embryo–lethal ciliopathies. In recent years, endogenous and/or selective non-canonical
exon skipping of mutant exons have been documented in attenuated retinal disease cases.
This observation led us to consider targeted exon skipping to bypass protein truncation
resulting from a recurrent mutation in exon 36 (c. 4723A> T, p. Lys1575*) causing isolated …
Mutations in CEP290 encoding a centrosomal protein important to cilia formation cause a spectrum of diseases, from isolated retinal dystrophies to multivisceral and sometimes embryo–lethal ciliopathies. In recent years, endogenous and/or selective non-canonical exon skipping of mutant exons have been documented in attenuated retinal disease cases. This observation led us to consider targeted exon skipping to bypass protein truncation resulting from a recurrent mutation in exon 36 (c.4723A > T, p.Lys1575*) causing isolated retinal ciliopathy. Here, we report two unrelated individuals (P1 and P2), carrying the mutation in homozygosity but affected with early-onset severe retinal dystrophy and congenital blindness, respectively. Studying skin-derived fibroblasts, we observed basal skipping and nonsense associated–altered splicing of exon 36, producing low (P1) and very low (P2) levels of CEP290 products. Consistent with a more severe disease, fibroblasts from P2 exhibited reduced ciliation compared to P1 cells displaying normally abundant cilia; both lines presented however significantly elongated cilia, suggesting altered axonemal trafficking. Antisense oligonucleotides (AONs)-mediated skipping of exon 36 increased the abundance of the premature termination codon (PTC)-free mRNA and protein, reduced axonemal length and improved cilia formation in P2 but not in P1 expressing higher levels of skipped mRNA, questioning AON-mediated exon skipping to treat patients carrying the recurrent c.4723A > T mutation.
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