Exon skipping drugs will be used to transform Duchenne muscular dystrophy into a much milder disease as seen in Becker muscular dystrophy patients. eDystrophin is an online database that provides information about inframe mutations typically seen in patients with milder forms of the disease. The database has been constructed using patient records and is easy to use and searchable by mutation type or clinical phenotype.
Correlating dystrophin structure and function with clinical outcomes in Duchenne and Becker Muscular Dystrophy (BMD) patients.
BMD patients display marked differences in their symptoms ranging from asymptomatic to severe disease without a direct link between the size or position of the deletion and the clinical outcome.
Few studies have been published about the specific mutation and severity of the disease in BMD and the introduction of the eDystrophin database attempts to address this. It compliments and extends existing databases of Duchenne human mutations (the Leiden Muscular Dystrophy database and the UMD-DMD French database). eDystrophin is specifically dedicated to providing information about in-frame BMD mutations (deletions, duplications and substitutions) of the DMD gene and the consequences of these alterations from both a clinical perspective and a protein structural perspective.
The eDystrophin database contains 209 different non frame-shifting BMD mutations found in 945 patients. Bioinformatics tools provide models of the three-dimensional protein structure at deletion sites, making it possible to determine whether the mutated protein retains the typical structure of native dystrophin and comparing this with clinical data.
The introduction of the eDystrophin database is timely because of the near-term potential of antisense based exon-skipping drugs to become the new standard of treatment of Duchenne. These therapies aim to transform a Duchenne patient [who expresses no (or very little) dystrophin] into a BMD patient who expresses a mutated but partially functional protein. It will also be useful for other therapeutic opportunities involving gene therapy and micro-dystrophin.
The database is user friendly and informative. It is a source of much needed information for researchers, parents and patients alike. The information it contains will be useful to inform and design therapeutic strategies that lead to treatment and will be updated and expanded with further information from patients as they becomes available.
CureDuchenne is also funding a project to expand the Duchenne database to make it even more relevant and useful for designing treatments and identifying potential outcomes.
eDystrophin Getting Started
The eDystrophin database includes a lot of valuable information. The database is complex and certain sections are geared more toward researchers. Here is a good place to start for Duchenne patients, parents and family members.
Once on the page, click the following on the left navigation bar:
- Here you will find a visual representation of the DMD gene
Pathologies and Therapies
- This section describes the difference between Duchenne and Becker muscular dystrophy
- It also explains the following therapies: injection of the DMD gene, exon skipping therapy and cell therapy with visual examples (i.e., exon skipping by skipping exon 51 on a deletion from exons from 45 to 50)
Mutated dystrophin, search by mutation type
- Deletions – here you can select one exon involved in deletion or select a deletion from list
- Duplications – here you can select one exon involved in duplication or select a duplication from list
- Substitutions – here you can select a missense mutation from the list Once you selected a mutation you can dig deeper by clicking “see protein.” This gives you more detail on clinical data, protein structural domains and protein binding domains. It also provides a link to abstracts of related published papers.