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Correction of ClC-1 splicing eliminates chloride channelopathy and myotonia in mouse models of myotonic dystrophy
Thurman M. Wheeler, John D. Lueck, Maurice S. Swanson, Robert T. Dirksen, Charles A. Thornton
Thurman M. Wheeler, John D. Lueck, Maurice S. Swanson, Robert T. Dirksen, Charles A. Thornton
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Research Article Genetics

Correction of ClC-1 splicing eliminates chloride channelopathy and myotonia in mouse models of myotonic dystrophy

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Abstract

In myotonic dystrophy (dystrophia myotonica [DM]), an increase in the excitability of skeletal muscle leads to repetitive action potentials, stiffness, and delayed relaxation. This constellation of features, collectively known as myotonia, is associated with abnormal alternative splicing of the muscle-specific chloride channel (ClC-1) and reduced conductance of chloride ions in the sarcolemma. However, the mechanistic basis of the chloride channelopathy and its relationship to the development of myotonia are uncertain. Here we show that a morpholino antisense oligonucleotide (AON) targeting the 3′ splice site of ClC-1 exon 7a reversed the defect of ClC-1 alternative splicing in 2 mouse models of DM. By repressing the inclusion of this exon, the AON restored the full-length reading frame in ClC-1 mRNA, upregulated the level of ClC-1 mRNA, increased the expression of ClC-1 protein in the surface membrane, normalized muscle ClC-1 current density and deactivation kinetics, and eliminated myotonic discharges. These observations indicate that the myotonia and chloride channelopathy observed in DM both result from abnormal alternative splicing of ClC-1 and that antisense-induced exon skipping offers a powerful method for correcting alternative splicing defects in DM.

Authors

Thurman M. Wheeler, John D. Lueck, Maurice S. Swanson, Robert T. Dirksen, Charles A. Thornton

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Figure 2

Antisense morpholino localizes preferentially to muscle nuclei and restores ClC-1 expression at the sarcolemma.

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Antisense morpholino localizes preferentially to muscle nuclei and resto...
(A–C) Cross section of HSALR TA muscle showing distribution of 3′-carboxyfluorescein–labeled antisense morpholino (green) 3 weeks after injection. The morpholino was complementary to the 3′ splice site of ClC-1 pre-mRNA. Muscle fibers are outlined by wheat germ agglutinin (WGA; red), and nuclei are highlighted by DAPI (blue). Bright field (D) and fluorescence (E) images of a single FDB fiber showing preferential nuclear localization of the antisense morpholino (day 5 after injection). As compared with invert-treated control (F), immunofluorescence shows an increase of sarcolemmal ClC-1 protein (red) in HSALR TA muscle 3 weeks after treatment with antisense morpholino (G). Scale bars: 20 μm.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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