"Switch-off the trouble: DMPK promoter targeting by CRISPRi as an original specific therapy in DM1"
Résumé
"Introduction: Myotonic dystrophy type 1 (DM1) originates from an amplification of CTG
microsatellites in the DMPK gene. The pathology is primarily explained by a toxic gain of
function where the expanded-CUG DMPK transcripts induce mainly the loss of function of
the MBNL proteins, triggering a wide spliceopathy. Several therapies have been tested to
neutralize the toxic DMPK transcripts or their consequences. Here, we investigated a new
therapeutic strategy consisting of the silencing of the DMPK promoter by a CRISPRi system
in patient-derived myotubes.
Methods: Our DMPK repressing strategy by CRISPRi was tested in immortalized myoblasts
from a DM1 patient or a healthy donor. Stable cell lines expressing a deactivated Cas9
conjugated to an inhibitory KRAB domain in addition to their own sgRNAs were produced
by lentiviral transduction. The efficacy and specificity of our therapeutic strategy were then
assessed in differentiated myotubes.
Results: Our DMPK promoter inhibition strategy is highly efficient to reduce toxic DMPK
transcript quantities up to 80%.
This level of inhibition allows to correct the DM1 hallmark
defects by reducing the presence of foci, improving the spliceopathy and normalizing an
electrophysiological parameter in DM1 myotubes. Furthermore, this approach displays
unprecedented high specificity as evidenced by a complete lack of off-target effects on the
transcriptome from unaffected myotubes.
Conclusions: We conclude that DMPK promoter inhibition is a promising strategy to be
developed for DM1 treatment."