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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Neuromuscular Diseases</journal-id><journal-title-group><journal-title xml:lang="en">Neuromuscular Diseases</journal-title><trans-title-group xml:lang="ru"><trans-title>Нервно-мышечные болезни</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2222-8721</issn><issn publication-format="electronic">2413-0443</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">602</article-id><article-id pub-id-type="doi">10.17650/2222-8721-2024-14-2-44-52</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>LECTURES AND REVIEWS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ЛЕКЦИИ И ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Stages of research and development of therapeutic approaches for Duchenne myodystrophy. Part II: etiotropic approaches</article-title><trans-title-group xml:lang="ru"><trans-title>Исторические этапы поиска и разработки терапевтических подходов при миодистрофии Дюшенна. Часть II: этиотропные подходы</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0096-4542</contrib-id><name-alternatives><name xml:lang="en"><surname>Kochergin-Nikitskiy</surname><given-names>K. S.</given-names></name><name xml:lang="ru"><surname>Кочергин-Никитский</surname><given-names>К. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Konstantin Sergeevich Kochergin‑Nikitskiy </p><p>1 Moskvorechye St., Moscow 115522</p></bio><bio xml:lang="ru"><p>Константин Сергеевич Кочергин‑Никитский </p><p>115522 Москва, ул. Москворечье, 1</p></bio><email>KochNik.KS@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1558-3048</contrib-id><name-alternatives><name xml:lang="en"><surname>Smirnikhina</surname><given-names>S. A.</given-names></name><name xml:lang="ru"><surname>Смирнихина</surname><given-names>С. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Moskvorechye St., Moscow 115522</p></bio><bio xml:lang="ru"><p>115522 Москва, ул. Москворечье, 1</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4962-6947</contrib-id><name-alternatives><name xml:lang="en"><surname>Lavrov</surname><given-names>A. V.</given-names></name><name xml:lang="ru"><surname>Лавров</surname><given-names>А. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Moskvorechye St., Moscow 115522</p></bio><bio xml:lang="ru"><p>115522 Москва, ул. Москворечье, 1</p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Research Centre for Medical Genetics</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Медико-генетический научный центр им. акад. Н.П. Бочкова»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2024-05-24" publication-format="electronic"><day>24</day><month>05</month><year>2024</year></pub-date><volume>14</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>44</fpage><lpage>52</lpage><history><date date-type="received" iso-8601-date="2024-05-24"><day>24</day><month>05</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Kochergin-Nikitskiy K.S., Smirnikhina S.A., Lavrov A.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Кочергин-Никитский К.С., Смирнихина С.А., Лавров А.В.</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Kochergin-Nikitskiy K.S., Smirnikhina S.A., Lavrov A.V.</copyright-holder><copyright-holder xml:lang="ru">Кочергин-Никитский К.С., Смирнихина С.А., Лавров А.В.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://nmb.abvpress.ru/jour/article/view/602">https://nmb.abvpress.ru/jour/article/view/602</self-uri><abstract xml:lang="en"><p>Duchenne muscular dystrophy is one of the most common inherited muscular dystrophies. The cause of this disease with an X‑linked recessive type of inheritance is mutations in the <italic>DMD</italic> gene, leading to the absence of the dystrophin protein this gene encodes or its impaired function. Loss of dystrophin leads to severe degenerative processes in patients, especially in muscle tissue, with impaired muscle function, loss of ability to move independently, respiratory failure, cardiomyopathies, etc.</p><p>The collective efforts of many researchers over the years since the 19<sup>th</sup> century, when the diseases was described, not allowed to achieve a cure or significantly influencing the trajectory of the illness. The only notable impact on the disease course has come with the integration of corticosteroid medications into Duchenne muscular dystrophy therapy. While their application can decelerate disease progression and extend the average life expectancy up to 30–40 years, it comes with substantial adversely affects influencing patients’ quality of life.</p><p>Certain hopes were associated in recent decades with the development of etiotropic therapy for Duchenne muscular dystrophy, aimed at restoration of the dystrophin’s function. Some of such approaches were based on the overcoming of the effect of premature stop codons in the <italic>DMD</italic> gene using aminoglycoside antibiotics, ataluren, etc. Several subsequent studies were conducted to explore the applicability of exon‑skipping approaches in the dystrophin gene, aimed at excluding exons carrying pathogenic genetic variants. The rationale for these studies was the available information about a milder course of the disease associated with a truncated but functional dystrophin. The possibility of the pathology correction by means of introduction of the exogenous functional <italic>DMD</italic> gene copy from the outside (gene replacement therapy) has been under study since the beginning of the 20<sup>th</sup> century. One of the most promising directions in recent years was the development of approaches related to genome editing, which, unlike the methods mentioned above, allows for the permanent correction of the underlying cause of genetic diseases. Some of corresponding drugs have already received approval, while others, related to gene therapy, are at the stage of clinical trials.</p></abstract><trans-abstract xml:lang="ru"><p>Мышечная дистрофия Дюшенна – одна из самых распространенных наследственных миодистрофий с X‑сцепленным рецессивным типом наследования. Развитие болезни обусловлено мутациями гена DMD, приводящими к отсутствию или нарушению функции кодируемого им белка дистрофина. Потеря дистрофина приводит к тяжелым дегенеративным процессам у пациентов, особенно в мышечных тканях, вызывающим нарушение функционирования мышц, утрату способности к самостоятельному перемещению, дыхательную недостаточность, кардиомиопатии и др.</p><p>Усилия множества исследователей, разрабатывавших различные терапевтические подходы с момента описания заболевания в XIX веке до настоящего времени, не привели к возможности излечивать миодистрофию Дюшенна или хотя бы значительно повлиять на заболевание. Последнее стало возможно только с внедрением в терапию глюкокортикостероидных препаратов. Их применение позволяет замедлить развитие болезни, продлить средний ожидаемый срок жизни до 30–40 лет, однако связано с серьезными осложнениями, негативно влияющими на качество жизни пациентов.</p><p>В последние десятилетия определенные надежды связаны с развитием этиотропной терапии миодистрофии Дюшенна, направленной на восстановление функции гена <italic>DMD</italic><bold>.</bold> Некоторые из таких подходов связаны с попытками преодолевать эффекты, создаваемые преждевременными стоп‑кодонами в гене <italic>DMD</italic>, при использовании антибиотиков группы аминогликозидов, аталурена и пр. Ряд более поздних исследований провели с целью изучения применимости подходов, основанных на пропуске экзонов в гене дистрофина, для исключения экзонов, содержащих патогенные генетические варианты. Основанием стала имеющаяся информация о более мягком течении заболевания, связанного с укороченным, но сохраняющим функциональность дистрофином. Еще с начала XX века изучалась возможность коррекции патологии посредством введения функционального гена <italic>DMD </italic>извне (генозаместительная терапия). Одним из наиболее перспективных направлений в последние годы представляется развитие подходов, связанных с геномным редактированием, позволяющих, в отличие от вышеперечисленных методик, на постоянной основе исправлять этиологическую основу генетических заболеваний. Некоторые из таких препаратов уже получили одобрение, другие же, относящиеся к генной терапии, находятся на стадии клинических исследований.</p></trans-abstract><kwd-group xml:lang="en"><kwd>Duchenne muscular dystrophy</kwd><kwd>Becker muscular dystrophy</kwd><kwd>DMD gene</kwd><kwd>dystrophin</kwd><kwd>neuromuscular disorders</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>мышечная дистрофия Дюшенна</kwd><kwd>мышечная дистрофия Беккера</kwd><kwd>ген DMD</kwd><kwd>дистрофин</kwd><kwd>нервномышечные заболевания</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The work was supported by the Russian Science Foundation grant No. 23-15-00482, https://rscf.ru/project/23-15-00482/.</funding-statement><funding-statement xml:lang="ru">Работа выполнена за счет гранта Российского научного фонда № 23-15-00482, https://rscf.ru/project/23-15-00482/.</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Bladen C.L., Salgado D., Mongeset S. et al. 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