Is Exon Skipping a Viable Therapeutic Approach for Vascular Ehlers–Danlos Syndrome with Mutations in COL3A1 Exon 10 or 15?

Sasiwimon Utama; Jessica M. Cale; Chalermchai Mitrpant; Sue Fletcher; Steve D. Wilton; May T. Aung-Htut

doi:10.3390/ijms25168816

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Is Exon Skipping a Viable Therapeutic Approach for Vascular Ehlers–Danlos Syndrome with Mutations in COL3A1 Exon 10 or 15?

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Is Exon Skipping a Viable Therapeutic Approach for Vascular Ehlers–Danlos Syndrome with Mutations in COL3A1 Exon 10 or 15?

Sasiwimon Utama, Jessica M. Cale, Chalermchai Mitrpant, Sue Fletcher, Steve D. Wilton and May T. Aung-Htut

International journal of molecular sciences, Vol.25(16), 8816

2024

DOI: https://doi.org/10.3390/ijms25168816

PMCID: PMC11354334

PMID: 39201504

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Abstract

Vascular Ehlers–Danlos syndrome or Ehlers–Danlos syndrome type IV (vEDS) is a connective tissue disorder characterised by skin hyperextensibility, joint hypermobility and fatal vascular rupture caused by COL3A1 mutations that affect collagen III expression, homo-trimer assembly and secretion. Along with collagens I, II, V and XI, collagen III plays an important role in the extracellular matrix, particularly in the inner organs. To date, only symptomatic treatment for vEDS patients is available. Fibroblasts derived from vEDS patients carrying dominant negative and/or haploinsufficiency mutations in COL3A1 deposit reduced collagen III in the extracellular matrix. This study explored the potential of an antisense oligonucleotide (ASO)-mediated splice modulating strategy to bypass disease-causing COL3A1 mutations reported in the in-frame exons 10 and 15. Antisense oligonucleotides designed to redirect COL3A1 pre-mRNA processing and excise exons 10 or 15 were transfected into dermal fibroblasts derived from vEDS patients and a healthy control subject. Efficient exon 10 or 15 excision from the mature COL3A1 mRNA was achieved and intracellular collagen III expression was increased after treatment with ASOs; however, collagen III deposition into the extracellular matrix was reduced in patient cells. The region encoded by exon 10 includes a glycosylation site, and exon 15 encodes hydroxyproline and hydroxylysine-containing triplet repeats, predicted to be crucial for collagen III assembly. These results emphasize the importance of post-translational modification for collagen III homo-trimer assembly. In conclusion, while efficient skipping of target COL3A1 exons was achieved, the induced collagen III isoforms generated showed defects in extracellular matrix formation. While therapeutic ASO-mediated exon skipping is not indicated for the patients in this study, the observations are restricted to exons 10 and 15 and may not be applicable to other collagen III in-frame exons.

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Title: Is Exon Skipping a Viable Therapeutic Approach for Vascular Ehlers–Danlos Syndrome with Mutations in COL3A1 Exon 10 or 15?
Authors/Creators: Sasiwimon Utama - Siriraj Hospital
Jessica M. Cale - Murdoch University
Chalermchai Mitrpant - Siriraj Hospital
Sue Fletcher - Murdoch University
Steve D. Wilton - Murdoch University
May T. Aung-Htut - Murdoch University
Publication Details: International journal of molecular sciences, Vol.25(16), 8816
Publisher: MDPI
Grant note: APP1144791 / NHMRC
Identifiers: 991005697269707891
Murdoch Affiliation: Health Futures Institute; Centre for Molecular Medicine and Innovative Therapeutics
Language: English
Resource Type: Journal article

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