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Structural engineering of dual-targeting antisense oligonucleotides enhances exon 44 skipping for treating Duchenne muscular dystrophy

Created on 10 Oct 2026

Authors

Shoffner, G., Barthelemy, F., Pi, J., Manoian, S., Nguyen, B. T., Little, I., Nelson, S. F., Miceli, M. C., Guo, F.

Abstract

Antisense oligonucleotides (ASOs) inducing exon-skipping during pre-mRNA splicing offer promising treatment for diseases such as Duchenne muscular dystrophy. Recently, dual-targeting ASOs that simultaneously bind two splicing regulatory sequences have been shown to improve exon-skipping efficiency. Current ASOs are designed to interact with target RNAs solely based on Watson-Crick base pairing. Here we report the development of dual-targeting three-dimensional bridge (3D-bridge) ASOs in which tertiary interactions are engineered to increase target-binding affinity and the number of target residues occupied. We designed a 3D-bridge ASO for skipping exon 44 of dystrophin mRNA and biochemically validated its enhanced binding affinity for the target RNA over a similar ASO with the tertiary interactions disrupted. We subsequently optimized the 3D-bridge ASO by varying its ends and ribose chemical modifications using patient-derived induced directly reprogrammed myotubes and identified an LNA/DNA mixmer as the most potent. We further demonstrate enhanced exon-skipping efficacy and potency of the 3D-bridge ASO compared to previously reported ASOs in myotubes differentiated from patient-derived primary myoblasts and MyoD-reprogrammed fibroblasts harboring mutations amenable to reframing through exon 44 skipping. In conclusion, the 3D-bridge ASO technology improves the current dual-targeting design, demonstrating the utility and power of structure-based ASO design methods.

Preprint server: bioRxiv
The authors list and abstract were imported from bioRxiv on 10 Oct 2026.

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