Expert Reviews in Molecular Medicine

Review Article

Emerging strategies for cell and gene therapy of the muscular dystrophies

Lindsey A. Muira1 and Jeffrey S. Chamberlaina2 c1

a1 Program in Molecular and Cellular Biology, University of Washington, Seattle, Washington 98195, USA.

a2 Department of Neurology, Senator Paul D. Wellstone Muscular Dystrophy Cooperative Research Center, Department of Biochemistry, and Department of Medicine, University of Washington, Seattle, Washington 98195, USA.

Abstract

The muscular dystrophies are a heterogeneous group of over 40 disorders that are characterised by muscle weakness and wasting. The most common are Duchenne muscular dystrophy and Becker muscular dystrophy, which result from mutations within the gene encoding dystrophin; myotonic dystrophy type 1, which results from an expanded trinucleotide repeat in the myotonic dystrophy protein kinase gene; and facioscapulohumeral dystrophy, which is associated with contractions in the subtelomeric region of human chromosome 1. Currently the only treatments involve clinical management of symptoms, although several promising experimental strategies are emerging. These include gene therapy using adeno-associated viral, lentiviral and adenoviral vectors and nonviral vectors, such as plasmid DNA. Exon-skipping and cell-based therapies have also shown promise in the effective treatment and regeneration of dystrophic muscle. The availability of numerous animal models for Duchenne muscular dystrophy has enabled extensive testing of a wide range of therapeutic approaches for this type of disorder. Consequently, we focus here on the therapeutic developments for Duchenne muscular dystrophy as a model of the types of approaches being considered for various types of dystrophy. We discuss the advantages and limitations of each therapeutic strategy, as well as prospects and recent successes in the context of future clinical applications.

Correspondence

c1 Corresponding author: Jeffrey S. Chamberlain, Department of Neurology, University of Washington School of Medicine, HSB Room K233, Box 357720, Seattle, Washington 98195, USA. Tel: +1 206 616 6645; Fax: +1 206 616 8272; E-mail: jsc5@u.washington.edu