Designing Effective Antisense Oligonucleotides for Exon Skipping

  • Takenori Shimo
  • Rika Maruyama
  • Toshifumi Yokota
Part of the Methods in Molecular Biology book series (MIMB, volume 1687)


During the past 10 years, antisense oligonucleotide-mediated exon skipping and splice modulation have proven to be powerful tools for correction of mRNA splicing in genetic diseases. In 2016, the US Food and Drug Administration (FDA)-approved Exondys 51 (eteplirsen) and Spinraza (nusinersen), the first exon skipping and exon inclusion drugs, to treat patients with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA), respectively. The exon skipping of DMD mRNA aims to restore the disrupted reading frame using antisense oligonucleotides (AONs), allowing the production of truncated but partly functional dystrophin proteins, and slow down the progression of the disease. This approach has also been explored in several other genetic disorders, including laminin α2 chain-deficient congenital muscular dystrophy, dysferlin-deficient muscular dystrophy (e.g., Miyoshi myopathy and limb-girdle muscular dystrophy type 2B), sarcoglycanopathy (limb-girdle muscular dystrophy type 2C), and Fukuyama congenital muscular dystrophy. Antisense-mediated exon skipping is also a powerful tool to examine the function of genes and exons. A significant challenge in exon skipping is how to design effective AONs. The mechanism of mRNA splicing is highly complex with many factors involved. The selection of target sites, the length of AONs, the AON chemistry, and the melting temperature versus the RNA strand play important roles. A cocktail of AONs can be employed to skip multiples exons. In this chapter, we discuss the design of effective AONs for exon skipping.

Key words

Exon skipping Antisense oligonucleotides Splice switching Duchenne muscular dystrophy Becker muscular dystrophy Dystrophin Eteplirsen Phosphorodiamidate morpholino oligomers (PMOs) Locked nucleic acid (LNA) 2′-O-methyl RNA 



This work is supported by the Muscular Dystrophy Canada, the Friends of Garrett Cumming Research Fund, the HM Toupin Neurological Science Research Fund, the Canadian Institutes of Health Research (CIHR), the Alberta Innovates: Health Solutions (AIHS), the Canada Foundation for Innovation (CFI), the Alberta Advanced Education and Technology, and the Women and Children’s Health Research Institute (WCHRI).


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Copyright information

© Springer Science+Business Media LLC 2018

Authors and Affiliations

  • Takenori Shimo
    • 1
    • 2
  • Rika Maruyama
    • 1
  • Toshifumi Yokota
    • 1
    • 3
  1. 1.Department of Medical Genetics, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
  2. 2.Graduate School of Pharmaceutical SciencesOsaka UniversityOsakaJapan
  3. 3.The Friends of Garrett Cumming Research & Muscular Dystrophy Canada, HM Toupin Neurological Science Research ChairEdmontonCanada

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