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Genotype characterization and delayed loss of ambulation by glucocorticoids in a large cohort of patients with Duchenne muscular dystrophy

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机构: [1]Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China [2]Department of Neurology, Third MedicalCenter of Chinese PLA General Hospital, Beijing 100039, China [3]Department of Physiology, Yunnan University of Chinese Medicine, Kunming 650500, Yunnan Province, China [4]Department of Neurology, Hunan Children’s Hospital, Changsha 410008, Hunan Province, China [5]Department of Neurology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China. [6]Department of Pediatric Neurology, Henan Children’s Hospital, Zhengzhou 450018, Henan Province, China. [7]Department of Pediatrics, Peking University First Hospital, Beijing 100034, China. [8]Department of Muscle Atrophy, Affiliated Yiling Hospital of Hebei Medical University, Shijiazhuang 050091, Hebei Province, China. [9]Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. [10]Department of Pediatrics, Chongqing Medical University Affiliated Children’s Hospital, Chongqing 400042, China. [11]Department of Neurology, Affiliated People’s Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China. [12]Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China.
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Duchenne muscular dystrophy (DMD) is the most common genetic muscle disease in human. We aimed to describe the genotype distribution in a large cohort of Chinese DMD patients and their delayed loss of ambulation by glucocorticoid (GC) treatments. This is to facilitate protocol designs and outcome measures for the emerging DMD clinical trials.A total of 1163 patients with DMD were recruited and genotyped. Genotype variations were categorized as large deletions, large duplications, and small mutations. Large deletions were further analyzed for those amenable to exon-skipping therapies. Participants aged 5 years or older were grouped into GC-treated and GC-naïve groups. Clinical progression among different genotypes and their responses to GC treatments were measured by age at loss of ambulation (LOA). Among the mutation genotypes, large deletions, large duplications, and small mutations accounted for 68.79%, 7.14%, and 24.07%, respectively. The mean age at diagnosis was 4.59 years; the median ages at LOA for the GC-naïve, prednisone/prednisolone-treated, and deflazacort-treated groups were 10.23, 12.02, and 13.95 years, respectively. The "deletion amenable to skipping exon 44" subgroup and the nonsense-mutation subgroup had older ages at LOA than the "other deletions" subgroup. Subgroups were further analyzed by both genotypes and GC status. All genotypes showed significant beneficial responses to GC treatment. Deletions amenable to skipping exon 44 showed a lower hazard ratio (0.155). The mean age at death was 18.57 years in this DMD group.Genotype variation influences clinical progression in certain DMD groups. Beneficial responses to GC treatment were observed among all DMD genotypes. Compared with other genotypes, deletions amenable to skipping exon 44 had a lower hazard ratio, which may indicate a stronger protective effect of GC treatments on this subgroup. These data are valuable for designing future clinical trials, as clinical outcomes may be influenced by the genotypes.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 遗传学 3 区 医学:研究与实验
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 遗传学 2 区 医学:研究与实验
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出版当年[2020]版:
Q2 GENETICS & HEREDITY Q2 MEDICINE, RESEARCH & EXPERIMENTAL
最新[2023]版:
Q2 GENETICS & HEREDITY Q2 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China [2]Department of Neurology, Third MedicalCenter of Chinese PLA General Hospital, Beijing 100039, China
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通讯机构: [1]Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China [2]Department of Neurology, Third MedicalCenter of Chinese PLA General Hospital, Beijing 100039, China [12]Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China.
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