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Biomarkers for Muscle Disease Gene Therapy

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Abstract

Molecular biomarkers are becoming increasingly attractive in drug development programs for muscle diseases especially for Duchenne muscular dystrophy (DMD). Robust and validated blood and muscle biomarkers that are sensitive to drug treatment (e.g., pharmacodynamic biomarkers) and that can predict later clinical outcomes (e.g., surrogate biomarkers) will likely aid in developing effective therapies for DMD at several levels. Peripheral blood biomarkers can serve as more objective and acute readouts of drug effects relative to clinical outcome measures. Furthermore, they may minimize the burden on patients and families regarding participating in trials and can help with go-no-go decisionmaking at early stages of drug development possibly reducing the length and cost of the clinical development program. Lastly, they may provide insights into pathobiochemical pathways and help define novel therapeutic targets. In this chapter, we will focus mainly on molecular biomarker advances in DMD with the emphasis on their utility to assess efficacy of gene therapy in this disease.

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References

  1. Parent A (2005) Duchenne De Boulogne: a pioneer in neurology and medical photography. Can J Neurol Sci 32(3):369–377

    Article  Google Scholar 

  2. Chamberlain JS, Chamberlain JR, Fenwick RG, Ward PA, Caskey CT, Dimnik LS, Bech-Hansen NT, Hoar DI, Richards S, Covone AE, Govanni R, Abbs S, Bentley DR, Bobrow M, Rysiecki G, Ray PN, Boileau C, Junien C, Boehm C, Venne VL, Fujmura FK, Spiga I, Ferrari M, Tedeschi S, Bakker E, Kneppers AL, van Ommen GJ, Jain K, Spector E, Crandall B, Kiuru A, Savontaus ML, Caskey CT, Chamberlain JS, Chamberlain JR, Rysiecki G (1992) Diagnosis of Duchenne and Becker muscular dystrophies by polymerase chain reaction. A multicenter study. JAMA 267(19):2609–2615

    Article  CAS  Google Scholar 

  3. Hoffman EP, Fischbeck KH, Brown RH, Johnson M, Medori R, Loike JD, Harris JB, Waterston R, Brooke M, Specht L et al (1988) Characterization of dystrophin in muscle-biopsy specimens from patients with Duchenne’s or Becker’s muscular dystrophy. N Engl J Med 318(21):1363–1368. https://doi.org/10.1056/NEJM198805263182104

    Article  CAS  PubMed  Google Scholar 

  4. Finanger EL, Russman B, Forbes SC, Rooney WD, Walter GA, Vandenborne K (2012) Use of skeletal muscle MRI in diagnosis and monitoring disease progression in Duchenne muscular dystrophy. Phys Med Rehabil Clin N Am 23(1):1–10, ix. https://doi.org/10.1016/j.pmr.2011.11.004

    Article  PubMed  Google Scholar 

  5. McDonald CM, Henricson EK, Han JJ, Abresch RT, Nicorici A, Elfring GL, Atkinson L, Reha A, Hirawat S, Miller LL (2010) The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nerve 41(4):500–510. https://doi.org/10.1002/mus.21544

    Article  PubMed  Google Scholar 

  6. Ayoglu B, Chaouch A, Lochmuller H, Politano L, Bertini E, Spitali P, Hiller M, Niks EH, Gualandi F, Ponten F, Bushby K, Aartsma-Rus A, Schwartz E, Le Priol Y, Straub V, Uhlen M, Cirak S, t’Hoen PA, Muntoni F, Ferlini A, Schwenk JM, Nilsson P, Al-Khalili Szigyarto C (2014) Affinity proteomics within rare diseases: a BIO-NMD study for blood biomarkers of muscular dystrophies. EMBO Mol Med 6(7):918–936. https://doi.org/10.15252/emmm.201303724

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Boca SM, Nishida M, Harris M, Rao S, Cheema AK, Gill K, Wang D, An L, Gauba R, Seol H, Morgenroth LP, Henricson E, McDonald C, Mah JK, Clemens PR, Hoffman EP, Hathout Y, Madhavan S (2016) Correction: discovery of metabolic biomarkers for Duchenne muscular dystrophy within a natural history study. PLoS One 11(7):e0159895. https://doi.org/10.1371/journal.pone.0159895

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Giordani L, Sandona M, Rotini A, Puri PL, Consalvi S, Saccone V (2014) Muscle-specific microRNAs as biomarkers of Duchenne muscular dystrophy progression and response to therapies. Rare Dis 2(1):e974969. https://doi.org/10.4161/21675511.2014.974969

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hathout Y, Brody E, Clemens PR, Cripe L, DeLisle RK, Furlong P, Gordish-Dressman H, Hache L, Henricson E, Hoffman EP, Kobayashi YM, Lorts A, Mah JK, McDonald C, Mehler B, Nelson S, Nikrad M, Singer B, Steele F, Sterling D, Sweeney HL, Williams S, Gold L (2015) Large-scale serum protein biomarker discovery in Duchenne muscular dystrophy. Proc Natl Acad Sci U S A 112(23):7153–7158. https://doi.org/10.1073/pnas.1507719112

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hathout Y, Marathi RL, Rayavarapu S, Zhang A, Brown KJ, Seol H, Gordish-Dressman H, Cirak S, Bello L, Nagaraju K, Partridge T, Hoffman EP, Takeda S, Mah JK, Henricson E, McDonald C (2014) Discovery of serum protein biomarkers in the mdx mouse model and cross-species comparison to Duchenne muscular dystrophy patients. Hum Mol Genet 23(24):6458–6469. https://doi.org/10.1093/hmg/ddu366

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Finkel RS, Flanigan KM, Wong B, Bonnemann C, Sampson J, Sweeney HL, Reha A, Northcutt VJ, Elfring G, Barth J, Peltz SW (2013) Phase 2a study of ataluren-mediated dystrophin production in patients with nonsense mutation Duchenne muscular dystrophy. PLoS One 8(12):e81302. https://doi.org/10.1371/journal.pone.0081302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Mendell JR, Goemans N, Lowes LP, Alfano LN, Berry K, Shao J, Kaye EM, Mercuri E, Eteplirsen Study G, Telethon Foundation DMDIN (2016) Longitudinal effect of eteplirsen versus historical control on ambulation in Duchenne muscular dystrophy. Ann Neurol 79(2):257–271. https://doi.org/10.1002/ana.24555

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Aartsma-Rus A, Krieg AM (2017) FDA approves eteplirsen for Duchenne muscular dystrophy: the next chapter in the eteplirsen saga. Nucleic Acid Ther 27(1):1–3. https://doi.org/10.1089/nat.2016.0657

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Haas M, Vlcek V, Balabanov P, Salmonson T, Bakchine S, Markey G, Weise M, Schlosser-Weber G, Brohmann H, Yerro CP, Mendizabal MR, Stoyanova-Beninska V, Hillege HL (2015) European Medicines Agency review of ataluren for the treatment of ambulant patients aged 5 years and older with Duchenne muscular dystrophy resulting from a nonsense mutation in the dystrophin gene. Neuromuscul Disord 25(1):5–13. https://doi.org/10.1016/j.nmd.2014.11.011

    Article  PubMed  Google Scholar 

  15. Anthony K, Arechavala-Gomeza V, Taylor LE, Vulin A, Kaminoh Y, Torelli S, Feng L, Janghra N, Bonne G, Beuvin M, Barresi R, Henderson M, Laval S, Lourbakos A, Campion G, Straub V, Voit T, Sewry CA, Morgan JE, Flanigan KM, Muntoni F (2014) Dystrophin quantification: biological and translational research implications. Neurology 83(22):2062–2069. https://doi.org/10.1212/WNL.0000000000001025

    Article  PubMed  PubMed Central  Google Scholar 

  16. Arnold ME, Booth B, King L, Ray C (2016) Workshop report: crystal city VI-bioanalytical method validation for biomarkers. AAPS J 18(6):1366–1372. https://doi.org/10.1208/s12248-016-9946-6

    Article  CAS  PubMed  Google Scholar 

  17. Hulsker M, Verhaart I, van Vliet L, Aartsma-Rus A, van Putten M (2016) Accurate dystrophin quantification in mouse tissue; identification of new and evaluation of existing methods. J Neuromuscul Dis 3(1):77–90. https://doi.org/10.3233/JND-150126

    Article  PubMed  Google Scholar 

  18. Taylor LE, Kaminoh YJ, Rodesch CK, Flanigan KM (2012) Quantification of dystrophin immunofluorescence in dystrophinopathy muscle specimens. Neuropathol Appl Neurobiol 38(6):591–601. https://doi.org/10.1111/j.1365-2990.2012.01250.x

    Article  CAS  PubMed  Google Scholar 

  19. Brown KJ, Marathi R, Fiorillo AA, Ciccimaro EF, Sharma S, Rowlands DS, Rayavarapu S, Nagaraju K, Hoffman EP, Hathout Y (2012) Accurate quantitation of dystrophin protein in human skeletal muscle using mass spectrometry. J Bioanal Biomed Suppl 7. https://doi.org/10.4172/1948-593X.S7-001

  20. Anthony K, Feng L, Arechavala-Gomeza V, Guglieri M, Straub V, Bushby K, Cirak S, Morgan J, Muntoni F (2012) Exon skipping quantification by quantitative reverse-transcription polymerase chain reaction in Duchenne muscular dystrophy patients treated with the antisense oligomer eteplirsen. Hum Gene Ther Methods 23(5):336–345. https://doi.org/10.1089/hgtb.2012.117

    Article  CAS  PubMed  Google Scholar 

  21. Spitali P, Heemskerk H, Vossen RH, Ferlini A, den Dunnen JT, t’Hoen PA, Aartsma-Rus A (2010) Accurate quantification of dystrophin mRNA and exon skipping levels in duchenne muscular dystrophy. Lab Investig 90(9):1396–1402. https://doi.org/10.1038/labinvest.labinvest201098

    Article  CAS  PubMed  Google Scholar 

  22. Verheul RC, van Deutekom JC, Datson NA (2016) Digital droplet PCR for the absolute quantification of exon skipping induced by antisense oligonucleotides in (pre-)clinical development for Duchenne muscular dystrophy. PLoS One 11(9):e0162467. https://doi.org/10.1371/journal.pone.0162467

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Okinaka S, Kumagai H, Ebashi S, Sugita H, Momoi H, Toyokura Y, Fujie Y (1961) Serum creatine phosphokinase. Activity in progressive muscular dystrophy and neuromuscular diseases. Arch Neurol 4:520–525

    Article  CAS  Google Scholar 

  24. Adornato BT, Kagen LJ, Engel WK (1978) Myoglobinaemia in Duchenne muscular dystrophy patients and carriers: a new adjunct to carrier detection. Lancet 2(8088):499–501

    Article  CAS  Google Scholar 

  25. Carter ND, Heath R, Jeffery S (1980) Serum-carbonic-anhydrase-III in Duchenne dystrophy. Lancet 2(8193):542

    Article  CAS  Google Scholar 

  26. Chung J, Smith AL, Hughes SC, Niizawa G, Abdel-Hamid HZ, Naylor EW, Hughes T, Clemens PR (2016) Twenty-year follow-up of newborn screening for patients with muscular dystrophy. Muscle Nerve 53(4):570–578. https://doi.org/10.1002/mus.24880

    Article  PubMed  Google Scholar 

  27. Mendell JR, Lloyd-Puryear M (2013) Report of MDA muscle disease symposium on newborn screening for Duchenne muscular dystrophy. Muscle Nerve 48(1):21–26. https://doi.org/10.1002/mus.23810

    Article  PubMed  Google Scholar 

  28. Denti MA, Rosa A, D’Antona G, Sthandier O, de Angelis FG, Nicoletti C, Allocca M, Pansarasa O, Parente V, Musaro A, Auricchio A, Bottinelli R, Bozzoni I (2006) Body-wide gene therapy of Duchenne muscular dystrophy in the mdx mouse model. Proc Natl Acad Sci U S A 103(10):3758–3763. https://doi.org/10.1073/pnas.0508917103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Wu B, Lu P, Benrashid E, Malik S, Ashar J, Doran TJ, Lu QL (2010) Dose-dependent restoration of dystrophin expression in cardiac muscle of dystrophic mice by systemically delivered morpholino. Gene Ther 17(1):132–140. https://doi.org/10.1038/gt.2009.120

    Article  CAS  PubMed  Google Scholar 

  30. Gregorevic P, Blankinship MJ, Allen JM, Chamberlain JS (2008) Systemic microdystrophin gene delivery improves skeletal muscle structure and function in old dystrophic mdx mice. Mol Ther 16(4):657–664. https://doi.org/10.1038/mt.2008.28

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Shin JH, Pan X, Hakim CH, Yang HT, Yue Y, Zhang K, Terjung RL, Duan D (2013) Microdystrophin ameliorates muscular dystrophy in the canine model of duchenne muscular dystrophy. Mol Ther 21(4):750–757. https://doi.org/10.1038/mt.2012.283

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Hathout Y, Conklin LS, Seol H, Gordish-Dressman H, Brown KJ, Morgenroth LP, Nagaraju K, Heier CR, Damsker JM, van den Anker JN, Henricson E, Clemens PR, Mah JK, McDonald C, Hoffman EP (2016) Serum pharmacodynamic biomarkers for chronic corticosteroid treatment of children. Sci Rep 6:31727. https://doi.org/10.1038/srep31727

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Fiorillo AA, Heier CR, Novak JS, Tully CB, Brown KJ, Uaesoontrachoon K, Vila MC, Ngheim PP, Bello L, Kornegay JN, Angelini C, Partridge TA, Nagaraju K, Hoffman EP (2015) TNF-alpha-induced microRNAs control dystrophin expression in Becker muscular dystrophy. Cell Rep 12(10):1678–1690. https://doi.org/10.1016/j.celrep.2015.07.066

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Cacchiarelli D, Legnini I, Martone J, Cazzella V, D’Amico A, Bertini E, Bozzoni I (2011) miRNAs as serum biomarkers for Duchenne muscular dystrophy. EMBO Mol Med 3(5):258–265. https://doi.org/10.1002/emmm.201100133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Mizuno H, Nakamura A, Aoki Y, Ito N, Kishi S, Yamamoto K, Sekiguchi M, Takeda S, Hashido K (2011) Identification of muscle-specific microRNAs in serum of muscular dystrophy animal models: promising novel blood-based markers for muscular dystrophy. PLoS One 6(3):e18388. https://doi.org/10.1371/journal.pone.0018388

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Perry MM, Muntoni F (2016) Noncoding RNAs and Duchenne muscular dystrophy. Epigenomics 8(11):1527–1537. https://doi.org/10.2217/epi-2016-0088

    Article  CAS  PubMed  Google Scholar 

  37. Li X, Li Y, Zhao L, Zhang D, Yao X, Zhang H, Wang YC, Wang XY, Xia H, Yan J, Ying H (2014) Circulating muscle-specific miRNAs in Duchenne muscular dystrophy patients. Mol Ther Nucleic Acids 3:e177. https://doi.org/10.1038/mtna.2014.29

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Zaharieva IT, Calissano M, Scoto M, Preston M, Cirak S, Feng L, Collins J, Kole R, Guglieri M, Straub V, Bushby K, Ferlini A, Morgan JE, Muntoni F (2013) Dystromirs as serum biomarkers for monitoring the disease severity in Duchenne muscular dystrophy. PLoS One 8(11):e80263. https://doi.org/10.1371/journal.pone.0080263

    Article  PubMed  PubMed Central  Google Scholar 

  39. Coenen-Stass AM, McClorey G, Manzano R, Betts CA, Blain A, Saleh AF, Gait MJ, Lochmuller H, Wood MJ, Roberts TC (2015) Identification of novel, therapy-responsive protein biomarkers in a mouse model of Duchenne muscular dystrophy by aptamer-based serum proteomics. Sci Rep 5:17014. https://doi.org/10.1038/srep17014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Rouillon J, Poupiot J, Zocevic A, Amor F, Leger T, Garcia C, Camadro JM, Wong B, Pinilla R, Cosette J, Coenen-Stass AM, McClorey G, Roberts TC, Wood MJ, Servais L, Udd B, Voit T, Richard I, Svinartchouk F (2015) Serum proteomic profiling reveals fragments of MYOM3 as potential biomarkers for monitoring the outcome of therapeutic interventions in muscular dystrophies. Hum Mol Genet 24(17):4916–4932. https://doi.org/10.1093/hmg/ddv214

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Hunter DJ, Nevitt M, Losina E, Kraus V (2014) Biomarkers for osteoarthritis: current position and steps towards further validation. Best Pract Res Clin Rheumatol 28(1):61–71. https://doi.org/10.1016/j.berh.2014.01.007

    Article  PubMed  PubMed Central  Google Scholar 

  42. Amur SG, Sanyal S, Chakravarty AG, Noone MH, Kaiser J, McCune S, Buckman-Garner SY (2015) Building a roadmap to biomarker qualification: challenges and opportunities. Biomark Med 9(11):1095–1105. https://doi.org/10.2217/bmm.15.90

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Yetrib Hathout .

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Hathout, Y., Brown, K.J., Nagaraju, K., Hoffman, E.P. (2019). Biomarkers for Muscle Disease Gene Therapy. In: Duan, D., Mendell, J. (eds) Muscle Gene Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-03095-7_14

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