Teaching an Old Molecule New Tricks: Drug Repositioning for Duchenne Muscular Dystrophy

Int J Mol Sci. 2019 Nov 30;20(23):6053. doi: 10.3390/ijms20236053.

Abstract

: Duchenne muscular dystrophy (DMD) is one of the most severe forms of inherited muscular dystrophies. The disease is caused by the lack of dystrophin, a structurally essential protein; hence, a definitive cure would necessarily have to pass through some form of gene and/or cell therapy. Cell- and genetic-based therapeutics for DMD have been explored since the 1990s and recently, two of the latter have been approved for clinical use, but their efficacy is still very low. In parallel, there have been great ongoing efforts aimed at targeting the downstream pathogenic effects of dystrophin deficiency using classical pharmacological approaches, with synthetic or biological molecules. However, as it is always the case with rare diseases, R&D costs for new drugs can represent a major hurdle for researchers and patients alike. This problem can be greatly alleviated by experimenting the use of molecules that had originally been developed for different conditions, a process known as drug repurposing or drug repositioning. In this review, we will describe the state of the art of such an approach for DMD, both in the context of clinical trials and pre-clinical studies.

Keywords: Duchenne muscular dystrophy; clinical use; drug repurposing; druggable targets.

Publication types

  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Drug Repositioning / methods*
  • Dystrophin / deficiency
  • Dystrophin / genetics
  • Gentamicins / therapeutic use
  • Humans
  • Metformin / therapeutic use
  • Mice, Transgenic
  • Muscular Dystrophy, Duchenne / drug therapy*
  • Muscular Dystrophy, Duchenne / genetics
  • Muscular Dystrophy, Duchenne / metabolism
  • Muscular Dystrophy, Duchenne / pathology
  • Neuromuscular Agents / therapeutic use*
  • Prednisone / therapeutic use*
  • Pregnenediones / therapeutic use
  • Simvastatin / therapeutic use
  • Tadalafil / therapeutic use
  • Tamoxifen / therapeutic use

Substances

  • Dystrophin
  • Gentamicins
  • Neuromuscular Agents
  • Pregnenediones
  • Tamoxifen
  • Tadalafil
  • Metformin
  • Simvastatin
  • deflazacort
  • Prednisone