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Carbohydrate-based infusion solutions are widely used in the clinic. Here we show that co-administration of phosphorodiamidate morpholino oligomers (PMOs) with glucose enhances exon-skipping activity in Duchenne muscular dystrophy (DMD) mdx mice. We identify a glucose-fructose (GF) formulation that potentiates PMO activity, completely corrects aberrant Dmd transcripts, restores dystrophin levels in skeletal muscles and achieves functional rescue without detectable toxicity. This activity is attributed to enhancement of GF-mediated PMO uptake in the muscle. We demonstrate that PMO cellular uptake is energy dependent, and that ATP from GF metabolism contributes to enhanced cellular uptake of PMO in the muscle. Collectively, we show that GF potentiates PMO activity by replenishing cellular energy stores under energy-deficient conditions in mdx mice. Our findings provide mechanistic insight into hexose-mediated oligonucleotide delivery and have important implications for the development of DMD exon-skipping therapy.

Original publication

DOI

10.1038/ncomms10981

Type

Journal article

Journal

Nat Commun

Publication Date

11/03/2016

Volume

7

Keywords

Animals, Dystrophin, Exons, Fructose, Genetic Therapy, Glucose, Hexoses, Injections, Intramuscular, Mice, Mice, Inbred mdx, Morpholinos, Muscle, Skeletal, Muscular Dystrophy, Duchenne, Oligonucleotides, Antisense, RNA Splicing, RNA, Messenger